Lecture 9 - Leg Flashcards

1
Q

Bones of the leg

A

Tibia

Fibula

(Femur)

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2
Q

Tibia

A

Most common long bone to be broken

Relatively poor blood supply

Anteromedial surface is bare

Soleal line on posterior surface

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3
Q

Fibula

A

Lateral malleolus important in ankle stability

Site for muscle attachment

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4
Q

Tibia Structures- Proximal

A

Anterior:

  • medial and lateral condyles
  • tuberosity
  • tubercles of intercondylar eminence

Posterior:

  • medial and lateral condyles
  • tubercles of intercondylar eminence
  • articulate facet for fibula
  • soleal line
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5
Q

Tibia Structures- Distal

A

Anterior:
-medial malleolus

Posterior:

  • fibular notch
  • soleal line
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6
Q

Fibular Structures- Proximal

A

Head

Apex

Articulate Surface for lateral condyle of tibia

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7
Q

Fibular Structures- Distal

A

Lateral malleolus (with articulate facet for talus)

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8
Q

Does the tibia or the fibula contain an interosseous border?

A

BOTH

  • face each other when two bones articulate
  • site of attachment of interosseous membrane
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9
Q

Crucial Fascia

A

Continues with fascia latae

Fascia forms retinacula in foot

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10
Q

Fascia Latae

A

Attachment to anterior and medial borders of tibia

Continuous with periosteum

Leaves bare area

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11
Q

Superior (extensor) retinaculum

A
  • proximal to malleoli

- binds tendons in anterior crural compartment

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12
Q

Inferior (extensor) retinaculum

A

Y shaped

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13
Q

Flexor retinaculum

A

Binds tendons of the deep posterior compartment

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14
Q

Superior/Inferior perineal retinacula

A

Bind tendons of lateral crural compartment

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15
Q

Cutaneous Nerves of Sup. Post. Compartment

A

Lateral sural cutaneous nerve

Medial sural cutaneous

Sural nerve runs with lesser saphenous vein

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16
Q

Muscles of Sup. Post. Compartment

A

Gastrocnemius, plantaris, soleous, triceps surae, common insertion

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17
Q

Gastrocnemius

A
  • Crosses both knee and ankle joint
  • Two heads form inferior boundaries of the popliteal fossa
  • Lateral head may have a sesamoid bone: •Fabella
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18
Q

Plantaris

A

•May be absent •Tendon may be used for hand surgery

19
Q

Soleus

A

•Broad multipennate muscle •Unijoint muscle

20
Q

Triceps surae

A

Soleus + two heads of gastrocnemius

21
Q

common insertion

A

Calcaneus via tendocalcaneus (Achilles tendon)

22
Q

Tibial Nerve

A
  • Supplies all muscles in posterior compartment
  • Divides into medial and lateral plantar nerves inferior and posterior to medial malleolus
  • Gives off medial sural cutaneous nerve
  • Joins with communicating branch of common peroneal (fibular) nerve to form:
  • Sural nerve: •Cutaneous
23
Q

Posterior tibial artery

A

•Largest branch of popliteal artery
Provides both Superficial and Deep Comp
•Divides into medial and lateral plantar arteries deep to origin of abductor hallucis muscle

24
Q

Peroneal (fibular) artery

A
  • Most important branch of posterior tibial artery
  • Supplies lateral compartment and popliteus muscles
  • Supplies other muscles in posterior compartment
25
Q

Muscles of the Deep Posterior Compartment

A

Popliteus, flexor digitorum longus, flexor hallicus longus, tibialis posterior

26
Q

Popliteus

A

•Lies in floor of popliteal fossa •Flexes and rotates knee

27
Q

Flexor digitorum longus

A
  • Tendon passes posterior to medial malleolus and to tendon of tibialis posterior
  • Plantarflexes foot at ankle joint
28
Q

Flexor hallucis longus

A
  • Tendon occupies groove on posterior surface of talus:
  • Continuous with groove on plantar surface of sustentaculum tali.
  • Tendon passes posterior to medial malleolus.
  • Tendon passes between two sesamoid bones.
  • Push-off muscle for walking, jumping, running
29
Q

Tibialis posterior

A
  • Functions in plantar flexion and foot inversion

* Helps to maintain medal longitudinal arch

30
Q

Tibialis nerve

A

supplies deep post. compartment

31
Q

Muscles of the anterior compartment

A

Tibialis anterior, extensor digitorum longus, peroneus (filbularis) terius, extensor hallicus longus

32
Q

Tibialis Anterior

A
  • Lateral to crest of tibia
  • Foot dorsiflexion and inversion
  • L4-L5
  • Paralysis results in foot drop
33
Q

Extensor digitorum longus

A
  • Four tendons of insertion:
  • Each tendon inserts on an extensor expansion similar to arrangement in hand.
  • Toe extension at MTP and also dorsiflexion
34
Q

Peroneus (fibularis) tertius

A
  • Part of extensor digitorum longus
  • Sometimes missing
  • Foot dorsiflexion an eversion
35
Q

Anterior compartment functions

A

toe extension

ankle dorsiflexion

36
Q

deep peroneal (fibular) nerve

A

Innervation of anterior compartment
•L4-5 to tibialis anterior.
•L5-S1 for remaining muscles.
•Runs deep to extensor digitorum longus.
•Accompanies anterior tibial artery between extensor hallucis longus and tibialis anterior muscles.

37
Q

Anterior tibial artery

A

Blood Supply to anterior compartment
•Smaller terminal branch of popliteal artery
•Begins at inferior border of popliteus muscle
•Becomes dorsalis pedis artery at ankle joint

38
Q

Muscles of the Lateral Compartment

A

Peroneus (fibularis) longus, Peroneus (fibularis) brevis

39
Q

Peroneus (fibularis) longus:

A
  • More superficial of the two
  • Easily palpated
  • Its tendon uses lateral malleolus as a pulley
  • Tendon crosses sole of foot and inserts on first metatarsus and cuneiform
  • Helps to maintain transverse and longitudinal arches of the foot
40
Q

Peroneus (fibularis) brevis

A
  • Deep to peroneus longus
  • Inserts on lateral tuberosity
  • Functions in plantar flexion and foot eversion
41
Q

Superficial peroneal (fibular) nerve:

A

•Deep to peroneus longus •Inserts on lateral tuberosit

42
Q

Blood supply of Lateral Compartment:

A
  • No major arteries in lateral compartment

* Muscular branches arise from the peroneal artery: •Branch of posterior tibial

43
Q

Spinal cord levels of lat compartment

A

L5, S1-S2