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1
Q

borders of tibia (shaft)

A

3= ant, lateral, medial

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2
Q

surfaces of tibia (shaft)

A

medial, lateral, post

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3
Q

distal tibia surfaces

A

anterior, lateral, medial, posterior, inferior (plafond)

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4
Q

insertion of the soleus

A

soleal line

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5
Q

forms the mallelolar sulcus

A

tendons of tibialis post and FDL

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6
Q

btwn the condyles of the tibia

A

ant and post intercondylar fossa (depressions) and intercondylar eminence (raised area btwn condyles)

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7
Q

ant intercondylar fossa contents

A

medial meniscus, ant cruciate ligament, and lateral meniscus (ant to post)

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8
Q

post intercondylar fossa contents

A

post cruciate ligament, medial meniscus, lateral meniscus (from post to ant)

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9
Q

groove at inferior end of the tibia

A

for attachement of joint capsule

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10
Q

where deltoid ligament attaches to medial malleolus

A

ant + post colliculus + intercollicular sulcus

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11
Q

main func of fibula

A

primary function of fibula is for muscle attachments it is largely non-weight bearing

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12
Q

location/ attachement of lateral malleloar fossa

A

posterior= lateral malleolar fossa for posterior tibiofibular and posterior talofibular ligaments
*this is a great landmark for orienting the fibula!

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13
Q

4 borders shaft of fibula

A

borders= anterolateral, anteromedial (Interosseus crest, most constant), posterolateral, posteromedial

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14
Q

4 surfaces of fibula

A

Surfaces lie in btwn borders= btwn anterolateral/medial= anterior surface
In btwn posterolateral/medial= post
In btwn medials (posteromedial and anteromedial)= medial surface
In btwn laterals (anterolateral and posterolateral)= lateral surface

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15
Q

lateral surface of fibula origin

A

peroneus longus and brevis

-fibular head= biceps femoris and fibular collateral ligament

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16
Q

medial surface of tibia

A

shaft is subcutaneous = proximal portion attachment for IT band, semimeb, gracillis, Sartorius, semitend, quads, tibial collateral ligament

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17
Q

ant fibula surface

A

origin of extensor digitorum longus, extensor hallucis longus, peroneus tertius

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18
Q

lateral surface tibia

A

origin TA and EDL

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19
Q

post surface tibia

A

origin of soleus, flexor digitorum longus, tibialis posterior
insertion of popliteus

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20
Q

medial surface fibula

A

tib post

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21
Q

post surface fibula

A

soleus, FHL origins

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22
Q

soleal line + vertical line notes

A

Note: soleus originates from soleal line

origin of flexor digitorum longus & tibialis posterior are separated by the vertical line

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23
Q

shared compartments of tibia/fibula

A

ant fibula, lateral tibia

post tibia, medial + post fibula

lateral fibula, medial tibia

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24
Q

crural fascia

A 
Crural fascia (=deep fascia of the leg) forms intermuscular septa that divide the leg into compartments that share action, innervation, and blood supply
Very thick= helps w/ venous return 
Ant, post= intermuscular septum located laterally
Interosseus mb and transverse on the medial side
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25
ant compartment
Action: dorsiflexion Innervation: deep peroneal nerve Blood supply: anterior tibial artery tibialis ant, EDL, Peroneus Tertius, EHL, EHC
26
lateral compartment
``` Action: eversion Innervation: superficial peroneal nerve Blood supply: perforating branches from anterior tibial and peroneal arteries No neurovascular bundle (no artery) PL, PB ```
27
deep post compartment
Action: plantarflexion of digits Innervation: tibial nerve Blood supply: posterior tibial and peroneal arteries FDL, FHL, tibialis post,popliteus,
28
sup post compartment
Action: plantarflexion of ankle Innervation: tibial nerve Blood supply: posterior tibial artery gastroc, soleus, plantaris
29
compartment syndrome
trauma to structures within compartments may result in hemorrhage, edema, or inflammation strength of crural fascia precludes outward swelling of tissues leading to compression of neurovasculature treatment includes fasciotomy of affected compartment if untreated, may to ischemia, necrosis, or atrophy of affected tissues
30
tibialis ant
Tibialis anterior Origin: lateral surface of tibia, interosseous mb Insertion: Medial plantar border of medial cuneiform and 1st metatarsal Action: Dorsiflexion (shared w/ other ant compartment muscles) & inversion of ankle, supination of intertarsal joints (anything that inserts medially)
31
EDL
Extensor digitorum longus Origin: Anterior surface of fibula, proximal tibia, interosseous mb Insertion: Extensor expansion of digits 2–5 Action: Extension of MP joints of digits 2–5, dorsiflexion and eversion (going to lateral side) of ankle, pronation of intertarsal joints
32
peroneus tertius
Peroneus tertius Origin: Inferior 1/3 of anterior surface of fibula Insertion: Base of 5th metatarsal (NOT TUBEROSITY) Action: Dorsiflexion and eversion of ankle, pronation of intertarsal joints
33
EHL
Extensor hallucis longus Origin: Anterior surface of fibula, interosseous mb Insertion: Dorsal base of distal phalanx of hallux= don’t blend w/ extensor expansion Action: Extension of 1st MP and ankle joints, supination of intertarsal joints
34
extensor hallucis capsularis (EHC)
Extensor hallucis capsularis= accessory tendon in midshaft of 1st met= goes to joint capsule Origin: Extension of extensor hallucis longus tendon Insertion: Medial surface of 1st MP joint capsule Action: Pull capsule out of MP joint to prevent entrapment
35
PL
Peroneus longus= superficial to PB Origin: Superior 2/3 of lateral surace of fibula Insertion: Lateral base of medial cuneiform and 1st metatarsal Action: Plantar flexion and eversion of ankle, pronation of intertarsal joints (go post to lateral malleoli= plantarflex)
36
PB
Origin: Inferior 2/3 of Lateral surface of fibula Insertion: Tuberosity of 5th metatarsal Action: Plantar flexion and eversion of ankle, pronation of intertarsal joints
37
gastroc
Origin: Medial head: medial condyle of femurLateral head: lateral condyle of femur Insertion: Middle 1/3 of posterior calcaneus via tendo calcaneus Action: Plantar flexion of ankle, supination of intertarsal joints, flexion of knee Doesn’t attach to tibia at all
38
sesamoid in lateral head of gastroc
fabella
39
soleus
Origin: Posterior surface of head and shaft of fibula, soleal line of tibia Insertion: Middle 1/3 of posterior calcaneus via tendo calcaneus Action: Plantar flexion of ankle
40
plantaris
Origin: Lateral supracondylar line of femur Insertion: Middle 1/3 of posterior calcaneus Action: Plantarflexion of ankle, flexion of knee
41
FDL
Flexor digitorum longus= most medial Origin: Posterior tibial shaft medial to vertical line, distal to soleal line Insertion: Plantar base of distal phalanges of digits 2–5 Action: Flexion of DIP joints, plantar flexion of ankle, supination of intertarsal joints
42
FHL
Flexor hallucis longus= most lateral Origin: Post surface of fibula, interosseous mb Insertion: Plantar base of distal phalanx of hallux Action: Plantarflexion of ankle
43
tibialis posterior
Tibialis posterior= deepest and in the middle (leg) Origin: Posterior surface of tibia lateral to vertical line, interosseous membrane, medial surface of fibula Insertion: Navicular tuberosity, sustentaculum tali, all three cuneiforms, bases of metatarsals 2–4 Action: Plantarflexion of ankle, supination of intertarsal joints
44
popliteus
Popliteus Origin: Lateral condyle of femur Insertion: Posterior surface of tibia proximal to soleal line Action: Flexion & rotation (“unlocking”) of the knee laterally rotates femur when leg is fixed medially rotates tibia when leg is free
45
sciatic nerve
tibia and common peroneal= do most of the leg
46
blood supply to leg
branches of the popliteal artery
47
tibial nerve compartment
Tibial nerve does post compartment | Medial and lateral plantar nerves come from here
48
common peroneal compartment
goes lateral
49
sural nerve
sural nerve = medial sural cutaneous (from tibial) + communicating branch of lateral sural cutaneous (from common peroneal) medial sural cutaneous continues on as sural lateral sural cutaneous continues on w/ same name follows small saphenous vein into foot, becoming the lateral dorsal cutaneous
50
saphenous nerve
saphenous nerve is a branch of the femoral follows the great sapheonous vein into the foot Main job is to supply ant and post medial leg Travels w/ femoral artery and femoral vein= then pierces thru fascia in femoral canal to follow great saphenous= wont go thru the adductor hiatus w/ the femoral artery and vein
51
common peroneal nerve branches
Splits into superficial and deep peroneal nerves + lateral sural cutaneous Recurrent articular branch= branch of deep peroneal= travels up to innervate the knee= proprio and sensory to knee Follows ant tibial recurrent artery eventually splits into intermediate/medial dorsal cutaneous nerves from perforating peroneal and lateral/medial terminal branches from deep peroneal
52
motor innervation deep peroneal
tibialis anterior extensor digitorum longus extensor hallucis longus peroneus tertius
53
motor innervation superficial peroneal
PL and PB
54
motor innervation tibial nerve
``` popliteus gastrocnemius soleus plantaris flexor digitorum longus flexor hallucis longus tibialis posterior ```
55
common peroneal nerve injury
Common Peroneal Nerve is most commonly injured nerve in the lower limb vulnerable in fracture of fibular neck and knee dislocation results in unopposed plantarflexion and inversion = foot drop
56
superficial/deep peroneal nerve injury
Injury to only the superficial or deep peroneal nerve is rare but compartment syndromes may cause entrapment of either nerve= cant dorsiflex b/c whole ant compartment is gone
57
tibial nerve injury
injury to tibial nerve is rare but will most frequently happen in the popliteal fossa or as a result of compartment syndromes (lacerations too)
58
form an anastomosis around the knee
genicular a
59
sural arteries
muscular branches from the popliteal to the popliteus, soleus, and gastrocnemius
60
anterior tibial artery branches/ location
``` main blood supply to anterior compartment of the leg Branches: Posterior tibial recurrent Anterior tibial recurrent Circumflex fibular Anterior medial malleolar Anterior lateral malleolar ```
61
post tibial recurrent artery variation
1st branch off ant tibial before it pieres interossues mb 40%= off tibial 32%= from post tibial artery
62
circumflex fibular variation
can come off ant tib (nl) or peroneal
63
ant medial/lateal malleloar arteries anastamose w?
lateral and medial tarsals and perofrating peronel | come off ant tibial
64
post tibial artery branches/location
``` main blood supply to posterior compartment Branches: Peroneal nutrient posterior lateral malleolar lateral calcaneal Nutrient artery to tibia Posterior medial malleolar Posterior lateral malleolar Communicating= btwn peroneal and post tib Medial calcaneal Medial plantar Lateral plantar ```
65
largest branch post tibi artery
Main largest branch= peroneal artery (on lateral aspect of leg near fibula) Main branches= nutrient artery to the fibula= pierces fibula thru nutrient foramen to supply interior of the bone Lateral calcaneal and post lateral malleolar
66
superficial veins
great saphenous (medial) and small saphenous (lateral)
67
deep veins
popliteal vein follows popliteal artery distal to popliteal fossa deep veins form venae comitantes that follow arteries and take the same names From deep veins of the leg
68
popliteal artery
post to knee= continuation of femoral artery in the thigh | Terminal branches in the leg= ant and post tibial arteries
69
ant surface of distal tibia is continuous w/ what surface of the tibial shaft?
the lateral surface

lower limb leg (1 decks)

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