Leg and Foot Flashcards
what is the role of the interosseous membrane and what direction do its fibres pass?
provides a surface for muscle attachment
helps resist the downward pull of the muscles attached to the fibula
from tibia –> fibula
what muscles are found in the lateral compartment?
peroneus longus and brevis
what is the movement of the peroneus longus and brevis and what innervates them?
evertors of the foot
superficial peroneal nerve (L5-S2)
where is peroneus longus?
head and upper 2/3rd lateral fibula –> base of 1st metatarsal and medial cuneiform
where is peroneus brevis?
inferior 2/3rd of lateral fibula –> tuberoisty on lateral side of the base of the 5th metatarsal
what muscles are found in the anterior compartment of the leg?
tibialis anterior
extensor digitorum longus
peroneus tertius
extensor hallucis longus
what side of the ankle joint do the tendons of the anterior compartment cross the ankle joint?
anterior to ankle joint
what side of the ankle joint do the tendons of the lateral compartment pass?
lateral side
where is tibialis anterior?
lateral condyle of tibia, superior 1/3rd lateral tibial surface and interosseous membrane –> medial and inferior surfaces of medial cuniform and base of 1st metatarsal
what innervates tibialis anterior?
deep peroneal nerve (L4+5)
what is the function of tibialis anterior?
dorsiflexes ankle
inverts foot
where is extensor digitorum longus?
lateral condyle of tibia, superior 3/4 of medial surface of fibula and interosseous membrane –> middle and distal phalanges of lateral 4 digits
what is the function of extensor digitorum longus?
extends lateral 4 digits
dorsiflexes ankle
what innervates extensor digitorum longus?
deep peroneal nerve (L4+5)
where is peroneus tertius?
inferior 1/3rd anterior fibula and interosseous membrane –> dorsum of base of 5th metatarsal
what is the function of peroneus tertius?
dorsiflexes ankle
assists in eversion of the foot
what innervates peroneus tertius?
deep peroneal nerve (L4+5)
where is extensor hallucis longus?
middle anterior surface of fibula and interosseous membrane –> dorsal aspect of distal phalanx of hallux
what is the function of extensor hallucis longus?
extends hallux
dorsiflexes ankle
what innervates extensor hallucis longus?
deep peroneal nerve (L4+5)
what are the two extensor retinacula in the foot called?
superior and inferior extensor retinaculum
where is the superior extensor retinaculum found?
anterior border of tibia to lower end of fibula
what shape is the inferior extensor retinaculum?
Y shaped
where does the inferior retinaculum run?
laterally to calcaneus (stem) –> medial malleolus (upper limb) and round border of foot to blend with dense fascia over abductor hallucis (lower limb)
what are the three superficial muscles of the posterior compartment of the leg?
gastrocnemius
plantaris
soleus
what are the four deep muscles of the posterior compartment of the leg?
popliteus
flexor digitorum longus
flexor hallucis longus
tibialis posterior
where is the common insertion of the superficial muscles of the posterior leg?
posterior surface of calcaneous via tendocalcaneous
where do the tendons of the deep muscles (except popliteus) pass behind to insert on the plantar surface of the foot?
medial malleolus
where is gastrocnemius?
popliteal surface of the femur superior to medial condyle (medial head); lateral condyle of femur (lateral head) –> tendinocalcaneous
what innervates both heads of gastrocnemius?
tibial nerve (S1+2)
what is the function of both heads of gastrocnemius?
plantar flexes ankle
flexes knee
where is plantaris?
lateral supracondylar line of femur (proximal to lateral head of gastrocnemius) –> tendocalcaneous
what is the function of plantaris?
assists plantar flexion of ankle
what innervates plantaris?
tibial nerve (S1+2)
where is soleus?
soleal line of tibia and upper 1/3rd posterior fibula –> tendocalcaneous
what innervates soleus?
tibial nerve (S1+2)
where is popliteus?
lateral condyle of femur and lateral minisucs –> popliteal area of tibia (above soleal line)
what is the function of popliteus?
unlocks knee joint by laterally rotating femur on fixed tibia
what innervates popliteus?
tibial nerve (L4-S1)
where is flexor digitorum longus?
posterior surface of tibia –> base of distal phalanx of digits 2-5
what is the function of flexor digitorum longus?
flexes lateral 4 digits
weak plantarflexion of ankle
what innervates flexor digitorum longus?
tibial nerve (L5-S2)
where is flexor hallucis longus?
posterior surface of fibula –> base of distal phalanx of hallux
what is the function of flexor hallucis longus?
flexes hallux
weak plantarflexor of ankle
what innervates flexor hallucis longus?
tibial nerve (L5-S2)
where is tibialis posterior?
posterior surface of tibia and fibula and interosseous membrane –> tuberosity of navicular, cuneiforms, cuboid, sustentaculum tali of calcaneus and base of 2nd-4th metatarsals
what is the function of tibialis posteiror?
platarflexes ankle
inverts foot
what innervates tibialis posterior?
tibial nerve (L4+5)
what tendon does tibialis posterior pass deep to?
tendon of flexor digitorum longus
what is the medial to lateral arrangement of the tendons of the ankle joint?
Tibialis posterior flexor Digitorum longus posterior tibial Artery posteiror tibial Vein tibial Nerve flexor Hallucis longus Tom, Dick And Very Naught Harry
what are the medial and lateral malleolus?
the bony prominence on each side of the ankle (medial = tibial; lateral = fibular)
what muscles are on the dorsal surface of the foot?
extensor hallucis brevis
extensor digitorum brevis
where is extensor hallucis brevis?
superior surface of calcaneous and inferior extensor retinaculum –> base of proximal phalanx of hallux
what innervates extensor hallucis brevis?
deep peroneal nerve (L5/S1)
what is the function of extensor hallucis brevis?
extend the big toe
what is the function of extensor digitorum brevis?
extends digits 2-4
where is extensor digitorum brevis?
superior surface of calcaneous and inferior extensor retinaculum –> extensor tendons of toes 2-4
what innervates extensor digitorum brevis?
deep peroneal nerve (L5/S1)
what articulates at the superior tibiofibular joint?
head of the fibula with the facet on the lateral condyle of tibia
does the superior tibiofibular joint move during dorsiflexion of the ankle?
yes, slightly
what type of joint is the superior tibiofibular joint?
synovial plane
what type of joint is the inferior tibiofibular joint and what ligaments hold it together?
syndesmosis
anterior and posterior tibiofibular and interosseous tibiofibular ligaments
what is the interosseous tibiofibular ligament continuous with?
interosseous membrane
why does the inferior tibiofibular joint allow slight movement?
to accommodate wedging of the trochlea of the talus during dorsiflexion
how many degrees can the ankle dorsiflex?
20-30o
how many degrees can the ankle plantarflex?
30-50o
what articulates at the ankle joint?
distal ends of tibia and fibula with the trochlea of the talus
what forms the malleolar mortise?
the distal ends of the tibia and fibula
where is the capsule of ankle joint strongest and why?
laterally and medially, becuase it is supported by strong collateral ligaments
what are the three lateral collateral ligaments and where do they run?
anterior talofibular: lateral malleolus (fibula) –> neck of talus
posterior talofibular: lateral malleolus –> lateral tubercle of talus
calcaneofibular: lateral malleolus –> lateral surface of calcaneous
what are the four parts of the medial collateral ligament and where do they run?
anterior tibiotalar: medial malleolus (tibia) –> talus
tibionavicular: medial malleolus –> navicular
tibiocalcaneal: medial malleolus –> calcaneus
posterior tibiotalar: medial malleolus –> talus
on which sides is the deep fascia weakest?
medially and laterally
what forms the superficial ligament of the plantar aponeurosis?
central portion of the deep fascia
what provides proximal attachment of the plantar aponeurosis?
calcaneous
how many bands does the plantar aponeurosis divide into digitally?
5
what is the plantar aponeurosis continuous with?
fibrous digital sheaths
what bones are found in the foot?
calacaneous talus navicular cuboid medial, intermediate and lateral cuneiforms
what is the most posterior bone of the foot?
calcaneus
what bone of the foot articulates with the malleolar mortise?
talus
which of the navicular or cuboid is on the medial side of the foot?
navicular
what does the navicular articulate with?
posteriorly: talus
anteriorly: cuneifroms
laterally: cuboid
what does the cuboid articulate with?
posteriorly: calcaneus
anteriorly: 4th and 5th metatarsals
laterally: navicular, lateral cuneiform
what metatarsal does the medial cuneiform articulate with?
1st
what metatarsal does the intermediate cuneiform articulate with?
2nd
what metatarsal does the lateral cuneiform articutae with?
3rd
what are the muscles found on the dorsum of the foot?
extensor digitorum brevis
extensor hallucis brevis
what does the lateral compartment of the foot contain?
abductor digiti minimi
flexor digiti minimi brevis
–> muscles of the little toe
what does the central compartment of the foot contain?
flexor ditiroum brevis
muscles associated with the tendon of FDL - lumbricals and quadratus plantae
adductor hallucis
what muscles are found in the medial compartment of the foot?
abductor hallucis
flexor hallucis brevis
–> muscles of the great toe
what muscles are found in layer 1 of the foot (medial to lateral)?
abductor hallucis
flexor digitorum brevis
abductor digiti minimi
what is found in layer 2 of the foot?
flexor digitorum longus (FDL) tendon
flexor hallucis longus (FHL) tendon
lumbricals
quadratus plantae
what is found in layer 3 of the foot (medial to lateral)?
flexor hallucis brevis
adductor hallucis
flexor digiti minimi brevis
what is found in layer 4 of the foot?
plantar interossei (x3) dorsal interossei (x4) tendons of peroneus longus and tibialis posterior
where is abductor hallucis?
medial tubercle of calcaneous –> medial side of base of proximal phalanx
what is the function of abductor hallucis and what innervates it?
flex retinaculum
medial plantar nerve (S2+3)
where is flexor digitorum brevis and what innervates it?
medial tubercle of calcaneous –> middle phalanges of lateral 4 toes
medial plantar nerve (S2+3)
where is abductor digiti minimi and what innervates it?
medial and lateral tubercle of calcaneus –> lateral base of proximal phalanx
lateral plantar nerves (S2+3)
where are the lumbricals?
tendons of flexor digitorum longus (FDL) –> medial side of dorsal tendon expansion
what innervates the lumbricals?
1st: medial plantar nerve (S2+3)
2nd: lateral plantar nerve (S2+3)
where is quadratus plantae?
medial and lateral surfaces of calcaneus –> lateral side of FDL tendon
what innervates quadratus plantae?
lateral plantar nerve (S2+3)
where is flexor hallucis brevis?
cuboid and lateral cuneiform –> both sides of the base of the proximal phalanx of hallux
what innervates flexor hallucis brevis?
medial plantar nerve (S2+3)
where is adductor hallucis?
plantar ligament of MTP joints (transverse head) and base of metatarsals 2-4 (oblique head) –> lateral side at the base of proximal phalanx of hallux
what innervates both heads of the adductor hallucis?
lateral plantar nerve (S2+3)
where is flexor digiti minimi brevis?
base of 5th metatarsal –> base of proximal phalanx of digits 3-5
what innervates flexor digit minimi brevis?
lateral plantar nerve (S2+3)
where are the plantar interossei, how many are there and what type of muscle are they?
three muscles, unipennate
bases and medial side of metatarsals 2-5–> medial side of the proximal phalanx of digits 3-5
what is the function and what innervates the plantar interossei?
adduct (–> PAD = plantar adduct)
lateral plantar nerve (S2+3)
where are the dorsal interossei, how many are there and what types of muscle are they?
four muscles, bipennate
adjacent sides of metatarsals 1+2 (1st) and adjacent sides of metatarsals 2-5 (2-4) –> medial side of proximal phalanx of 2nd digit (1st) and lateral side of proximal phalanx of 2nd-4th digits (2-4)
what is the function and what innervates the dorsal interossei?
abduct (–> DAB = dorsal abduct)
lateral plantar nerve (S2+3)
what are the functions of the arches of the foot?
distribute weight
act as shock absorbers and springboards
what bones form the lateral arch and does it rest on the ground when standing?
yes
calcaneous, cuboid and metatarsals 4+5
what bones form the medial arch?
calcaneous talus navicular medial, intermediate and lateral cuneiforms metatarsals 1-3
what provides dynamic support to the arches of the foot?
intrinsic muscles of the foot
flexor hallucis longus
flexor digitorum longus
what provides passive support to the arches of the foot?
plantar calcaneonavicular (spring) ligament short plantar ligament (calcaneocuboid) long plantar ligament plantar aponeurosis
how is weight distributed across the foot?
almost equally between the calcaneous and metatarsal heads
–> across the sesamoid bones of the 1st metatarsal and head of 2nd metatarsal and the heads of metarsals 3-5 and the tuberosity of the calacaneus
what articulates at the subtalar joint?
the talus and calcaneus
–> talus is slightly concave posteriorly and the calcaneous has a convex articular facet
what ligaments support the weak capsule of the subtalar joint?
medial talocalcaneal
lateral talocalcaneal
interosseous talcocalcaneal (v. strong!)
posterior talocalcaneal
what joints form the transverse (mid)tarsal joint and what ligaments support it?
talocalcaneonavicular and calcaneocuboid joint
bifurcate, dorsal calcaneocuboid, long and short plantar and spring ligaments
what type of joint is the talocalcaneal part of the talocalcaneonavicular joint?
plane synovial
what type of joint is the talonavicular part of the talocalcaneonavicular joint?
ball and socket
what type of joint is the clacneocuboid joint?
plane synovial
where does the bifurcate ligament run?
from calcaneous to navicular and cuboid
where does the dorsal calcaneocuboid ligament run?
from calcaneous to cuboid
where does the long plantar ligament run?
calcaneus to cuboid
where does the spring ligament run?
from calcaneus to navicular
what articulates at the tarsometatarsal joints?
between anterior tarsal bones (cuboid and cuneiforms) and the bases of metatarsals
what ligaments hold the tarsometarsal joint together and what is it also known as?
dorsal, plantar and interosseous ligaments
lisfranc’s joint
what type of joint is the metatarsophalangeal (MTP) joint and what is its function?
synovial condyloid joint
flexion, extension, abduction and adduction
what type of joint is the interphalangeal (IP) joint and what is its function?
synovial hinge joint
flexion and extension
what is the function of the subtalar and talocalcaneal parts of the talocalcaneonavicular joints?
inversion/eversion
what is the function of the midtarsal joint?
augments inversion/eversion
