Leg

Question 1

muscles that compose dynamic support of longitudinal arch

Answer 1

Tibialis posterior 
Tibialis anterior 
Flexor hallucis longus 
Fibula's longus
Intrinsic plantar muscles

Question 2

muscles that compose passive support of longitudinal arch

Answer 2

plantar aponeurosis
long plantar ligament
short plantar ligament
plantar calcaneonavicular/spring ligament

Question 3

posterior compartment of the leg (general)

Answer 3

flexors, calf
transverse septa divides it into two groups:
1. superficial posterior
2. deep posterior

tibial nerve and tibial vessels are deep to transverse crural intermuscular septum

Question 4

muscles of the superficial posterior group (3)

Answer 4

gastrocnemius
soleus (triceps surae)
plantaris

Question 5

muscles of the deep posterior group (4)

Answer 5

popliteus
flexor hallucis longus
flexor digitorum longus
tibialis posterior

Question 6

Gastrocnemius heads

Answer 6

most superficial of the superficial posteriors

crosses knee and ankle joints

Medial and Lateral head

medial is larger, starts above medial femoral condyle (lateral is above lateral condyle)

both insert and compose achilles tendon

Question 7

actions of gastrocnemius

Answer 7

plantar flexion and flexes leg at knee joint

flexes the knee below the knee

Question 8

fabella

Answer 8

some patients have it, seismoid bone found close to proximal attachment

potentially provides leverage for lateral head of gastrocnemius

if fractured, it may accompany total knee replacement

a rare cause of posterolateral knee pain

Question 9

soleus (general)

Answer 9

posterior, superficial group

broad, flat, mutlipennate muscle

horseshoe shaped origin (soleal line of tibia, head of fibula)

inserts into achilles tendon

Question 10

where is the achilles tendon? what muscle tendons compose it?

Answer 10

it is located on the posterior surface of calcaneus

composed of muscles that attach to the tendon calcaneus

soleus, gastrocnemius (lateral and medial heads), plantaris (if present)

Question 11

triceps surae

Answer 11

tripartite muscle that is formed between the two heads of the gastrocnemius and the soleus

forms the calf prominence

Question 12

action of the soleus

Answer 12

plantar flexion

Question 13

plantaris (general)

Answer 13

superficial posterior

small muscle, often absent (short belly and long tendon)

attaches to the lateral supracondylar line, runs between gastrocnemius and souls, attaches to the achilles tendon

Question 14

function of plantaris

Answer 14

weak plantarflexion and leg flexion

possibly proprioceptive organ for foot position due to high density of proprioceptive receptors

Question 15

clinical application of plantaris

Answer 15

used commonly in reconstructive hand tendon surgery due to little affect on knee/ankle movements

often ruptures during violent ankle movements (sudden dorsiflexion of ankle) common in basketball players, sprinters, and ballet dancers

Question 16

popliteus (general)

Answer 16

deep posterior group

thin flat triangular muscle, deep to plantaris

forms inferior floor of popliteal fossa

inserts on lateral side of leg, origins on tibia

Question 17

functions of popliteus

Answer 17

unlocks extended leg by laterally rotating femur on stationary tibia

flexes leg weakly

Question 18

arteries of the popliteal fossa

Answer 18

superior medial and superior lateral genicular arteries (superior to medial and lateral heads of gastrocnemius)

inferior medial genicular artery (deep to medial gastrocnemius)

inferior lateral genicular artery (deep to plantaris, superficial to popliteus)

Question 19

flexor hallucis longus (general)

Answer 19

largest deep posterior

lies deep to soleus
attaches to inferior fibula and passes inferiorly to deep flexor retinaculum

occupies shallow groove on posterior surface of sustentaculum tali of calcaneus

crosses deep to FDL tendon in sole of foot, approaches great toes between sesamoid bones in FHB tendons

inserts at base of distal phalanx of great toe

Question 20

actions of flexor hallucis longus

Answer 20

flexes great toe

plantar flex foot at ankle joint

Question 21

flexor digitorum longus (general)

Answer 21

deep to soleus and posterior to tibia

attaches to tibia and passes posterior to tibias posterior
diagonally in sole of food, superficial to f.h.l.

attaches at base of lateral four digits

Question 22

functions of flexor digitorum longus

Answer 22

flexes lateral four digits

plantar flexes foot at ankle joint

Question 23

tibialis posterior (general)

Answer 23

deepest posterior crural muscle

lies between F.D.L. and F.H.L.

attaches at the interosseous membrane, and both tibia and fibula

passes anterior to FDL

distally attaches to various tarsal and metatarsal bones

Question 24

functions of tibialis posterior

Answer 24

inversion

plantar flexion

Question 25

tibial nerve supplies which muscles of posterior compartment?

Answer 25

``` soleus gastrocnemius plantaris F.H.L. F. D.L. popliteus tibialis posterior ``` ALL OF THEM

Question 26

tibial nerve pathway through the leg

Answer 26

passes with posterior tibial vessels deep to soleus posterior to tibialis posterior leaves posterior by passing deep to flexor retinaculum between medial malleolus and calcaneous divides into medial and lateral plantar nerves

Question 27

blood supply of posterior compartment

Answer 27

posterior tibial artery

Question 28

pathway of posterior tibial artery

Answer 28

begins near inferior popliteus (deep to soleus) gives rise to fibular artery passes inferomedially on posterior surface of tibias posterior with tibial nerve runs deep to flexor retinaculum ends by dividing into medial and lateral plantar arteries

Question 29

fibular artery

Answer 29

descends from distal popliteus obliquely toward fibula vascularizes posterior and lateral compartments

Question 30

largest branch of posterior tibial artery

Answer 30

fibular artery

Question 31

posterior tibial pulse

Answer 31

palpated between posterior surface of medial malleolus and medial calcanea tendon pt. must relax foot via inversion because it is deep to flexor retinaculum used to examine patients with occlusive peripheral arterial disease (intermittent claudication) caused by ischemia of leg muscles due to narrowing/occulsion of leg arteries characterized by leg cramps and pain during wlaking

Question 32

dural fascia

Answer 32

deep fascia of leg (continuous with fascia late) covers leg muscles part of proximal attachment of underlying muscles thickens distally to form extensor retinaculum prevents bowstringing during dorsifelxion

Question 33

what divides the leg into its compartments

Answer 33

thick septa (anterior, lateral, and posterior) and the interosseous membrane

Question 34

what do all the muscles within a compartment share?

Answer 34

same general function nerve artery and vein

Question 35

anterior thigh muscle compartment general function and innervation

Answer 35

extension femoral nerve

Question 36

medial thigh muscle compartment general function and innervation

Answer 36

adduction obturator nerve

Question 37

posterior thigh muscle compartment general function and innervation

Answer 37

flexion sciatic nerve

Question 38

anterior compartment muscles

Answer 38

``` function in dorsiflexion and extension located anterior to the interosseous membrane ``` tibialis anterior extensor hallucis longus extensor digitorium longus fibularis tertius primary function: dorsiflexion, toe extension

Question 39

tibialis anterior

Answer 39

long thick muscle on anterolateral surface of tibia attaches to lateral condyle and distally on medial surface of cuneiform

Question 40

function of tibialis anterior

Answer 40

dorsiflexion and inversion of foot

Question 41

extensor digitorium function

Answer 41

extends lateral four digits dorsiflexion

Question 42

extensor expansion

Answer 42

distal attachment of the four tendons of the extensor digitorium tendons insert over the lateral four proximal phalanges that divide into two lateral slips and one central slip (middle phalanx)

Question 43

fibularis tertius

Answer 43

fuses with digitorium longus proximally but tendon doesn't attach with digit attachments: anteroinferior surface and dorsal of fifth metatarsal base functions in dorsi flexion and eversion

Question 44

extensor hallucis longus

Answer 44

lateral to tibialis anterior attaches proximally to anteromedial fibular surface and distally at phalanx of hallux (big toe) functions to extend hallux, dorsiflexion

Question 45

deep fibular nerve

Answer 45

innervates anterior compartment begins between fibula and fibulas longus muscles runs inferomedially with anterior tibial vessels and ends in medial and lateral terminal branches on dorsal of foot

Question 46

what does the deep fibular nerve supply

Answer 46

anterior compartment muscles ankle joint and metacarpal phalangeal joints dorsal intrinsic foot muscles skin between first and second digits

Question 47

anterior tibial artery

Answer 47

arises from popliteal artery begins near inferior border of popliteus muscle passes anteriorly over the interosseous membrane descends between EHL and TA muscles with deep fibular nerve ends at malleoli to become pedis artery

Question 48

lateral compartment of leg

Answer 48

found between anterior and posterior crural septa contains: fibularis brevis superficial fibular nerve fibularis longus

Question 49

fibularis longus

Answer 49

lateral compartment extends from fibular head to sole of foot superficial to fibularis brevis attaches to fibula, passes inferior and runs across sole of foot to attach at first metatarsal functions: eversion and plantar flexion

Question 50

fibularis brevis

Answer 50

deep to fibularis longus attaches to lateral tibia, moves laterally to fifth metatarsal functions in eversion and plantar flexion

Question 51

superficial fibular nerve

Answer 51

one of terminal branches of common fibular begins b/t fibularis longus and fibula descends between fibular muscle and lateral to e.d.l.

Question 52

what does the superficial fibular nerve supply

Answer 52

anterior inferior leg entire dorsal surface of foot most dorsal aspect of digits

Question 53

superficial fibular nerve injury

Answer 53

most common injury of lower extremity nerves results in paralysis of all anterior and lateral crural muscles loss of dorsiflexion and eversion-- foot drop (high stepping gait, waddling, or swing out -- can cause clop)

Question 54

arterial supply of lateral compartment

Answer 54

fibular artery largest branch of posterior tibial artery

Question 55

compartment syndrome

Answer 55

injury to crural fascia septa trauma that leads to hemorrhage, edema, and inflammation intracompartmental pressure may lead to ischemia and permanent injury perform fasciotomy to relive this pressure

Question 56

shin splints

Answer 56

caused by repetitive micro trauma to tibialis anterior causes small tears to periosteum of tibia mild form of compartment syndrome