Leg and foot Flashcards
Gastrocnemius
Proximal: Above the medial and lateral femoral condyles
Distal: Posterior surface of calcaneus
Innervation: Branches of tibial portion of sciatic nerve (S1-S2)
actions:
knee: flexes
Ankle: plantarflexes
Palpation: prone
Knee flexion
Soleus
Proximal: Soleal line, medial border of tibia, head of fibula, posterior border of fibula
Distal: Posterior surface of calcaneus
Innervation: Tibial portion of sciatic nerve (S1-S2)
actions: plantarflexes ankle
Palpation: Prone
Flex the knee to 90 degree. Resist plantarflexion palpate the soleus
Tibialis posterior
Proximal: Interosseous membrane, tibia and fibula
Distal: Navicular tuberosity, adjacent tarsal bones and the bases of the metatarsals
Innervation: Tibial nerve (L5-S1)
actions: Inverts ankle.
Assists in plantarflexion of ankle
Palpation: Palpate around medial malleolus, instruct patient to turn the foot in.
Flexor digitorum longus
Proximal: Tibia, below the distal attachment of the popliteus
Distal: Near sustentaculum tali, crosses flexor hallucis longus tendon, and divides into 4 parts attaching into the bases of the distal phalanges of 2nd to 5th toes
Innervation: Tibial nerve (L5-S1)
actions: flexes MTP and IP joints.
Plantarflexes ankle
Palpation: Slightly below TP. Instruct patient to curl their toes
Flexor hallucis longus
Proximal: Posterior fibula, its tendon passes behind the medial malleolus, through a groove in the talus, and then under the sustentaculum tal
Distal: Base of the distal phalanx of the great toe
Innervation: Tibial nerve (L5-S1)
actions: flexes MTP and IP joints.
Plantarflexes ankle
Palpation: below FDL. Curl the big toe
Peroneus longus (Fibularis)
Proximal: Head of the fibula near the distal attachment of the biceps femoris
Distal:plantar surface of 1st cuneiform bone and base of 1st metatarsal
Innervation: Superficial branch (L5, S1-S2) of common peroneal (fibular) nerve
actions: everts and plantarflexes ankle.
Depresses head of 1st metatarsal
Palpation: Palpate over muscle belly just below head of fibula, foot eversion with plantarflexion
Peroneus brevis (Fibularis)
Proximal: Head of the fibula near the distal attachment of the biceps femoris
Distal: Base of 5th metatarsal
Innervation: Superficial branch (L5, S1-S2) of common peroneal (fibular) nerve
actions: everts and plantarflexes ankle
Palpation: PB passes behind lateral malleolus, then across the calcaneus and cuboid.
PB is covered by PL
Tibialis anterior
Proximal: Lateral condyle and proximal half of tibial shaft, interosseous membrane and fascia of the leg
Distal: Medial cuneiform and base of the 1st metatarsal
Innervation: Branch from common peroneal nerve and branch from deep peroneal nerve (L4-S1)
actions: dorsiflexes ankle
Palpation: Instruct patient to dorsiflex the foot and curl the toes
. Palpate the muscle belly over lateral side of the anterior margin of the tibia and the tendon over the ankle
Extensor hallucis longus
Proximal: Middle shaft of the fibula and interosseous membrane
Distal: Base of distal phalanx of great toe
Innervation: Branch from deep peroneal nerve (L4-S1)
actions: Extends 1st MTP and IP joints
Palpation: Palpate with resisted dorsiflexion of the great toe
Extensor digitorum longus
Proximal: EDL: upper tibia and fibula, interosseous membrane, and intermuscular septa and fascia
Distal: All 4 EDL tendons attach to the bases of the middle and distal phalanges of the four toes
Innervation: Branch from deep peroneal nerve (L4-S1)
actions: extends MTP and IP joints of 2nd and 5th toes
Dorsiflexes and everts ankle
Palpation: instruct patient to sit with foot flat on the floor, dorsiflex the lateral 4 toes
Peroneus tertius:
Proximal: distal fibula and interosseous membrane
Distal: Peroneus tertius tendon attach to the dorsum of the 5th metatarsal
Innervation: Branch from deep peroneal nerve (L4-S1)
actions:
Palpation:
Abductor hallucis
Proximal: Medial tubercle of plantar calcaneus, flexor retinaculum, and plantar aponeurosis
Distal: Medial aspect of base of 1st proximal phalange
Innervation: Medial plantar nerve (S2-S3)
actions: abducts and flexes great toe
Palpation: place palpating hand below navicular tubercle.
Place the great toe in hallux valgus and instruct patient to actively move the toe into abduction.
Flexor digitorum brevis
Proximal: Medial tubercle of plantar calcaneus and plantar aponeurosis
Distal: Medial and lateral sides of middle phalanges 2nd to 5th toes
Innervation: Medial plantar nerve (S2-S3)
actions: flexes 2nd to 5th toes
Palpation: palpate the muscle belly in the middle of the longitudinal arch as patient flexes the toe (curl)
