Leg Stuff

Question 1

Crural Fascia Where, what parts, attachments

Answer 1

Deep fascia of the leg

Continuous with the fascia lata

1. Crural fascia
2. Extensor retinaculum

Question 2

Crural Fascia: parts and compartments

Answer 2

Thick septa anterior, lateral, posterior

Anterior septum
Posterior septum
transverse sptum
interosseous

Question 3

Crural fascia problems

Answer 3

compartmental syndromes: hemorage, edema, inflammation

Intracompartmental pressure: ischemia, permanent injury

Incising fascia fasciotomy

Question 4

CECS/ACS

Answer 4

CECS: over use, expansion of blood flow against fascia

ACE: surgical emergency following trauma

Question 5

Thigh Muscles

Answer 5

1. Anterior compartment: Femoral nerve, Extensors
2. Medial compartments: adduction, obturator nerve
3. Posterior compartment: Flexors, sciatic nerve

Question 6

Anterior Compartment Muscles

Tibialis Anterior

Answer 6

1. Long thick
2. Proximal: tibial condyle
3. Distal: medial 1st cuneiform
4. Function: dorsiflexion/inversion

Strongest dorsiflexor

Question 7

ACM Extensor Digitorum Longus

Answer 7

1. Prox: lateral tibial condyle/Anterior fibular surface/Interosseous membrane
2. Distal: it’s four tendons form an “extensor expansion” over dorsum of later four phalanges

Functions: extension of digits/dorsiflexion

Question 8

ACM Muscle: Fibularis Tertius

Answer 8

1. Fuses with digitorum longus proximally
2. Tendon does NOT attach to a digit

Proximal: fibular surface
Distal: 5th metatarsal

Function: dorsiflexion, eversion

Question 9

ACM Muscle: Extensor Hallucis Longus

Answer 9

1. tibialis anterior

Proximal: fibular surface/interosseous membrane
Distal: Distal phalanx of hallux

Functions: extends hallux

Question 10

Anterior Compartment: Deep fibular Nerve

Anterior Compartment: Anterior Tibial Artery

Answer 10

One of the two main branches of the fibular nerve
-innervates anterior compartment muscles, ankle joint, metacarpal phalangeal joins, dorsal intrinsic foot muscles

Anterior tibial artery:
Arises from popliteal
tibial tuberosity demarcates approx. pt of division between anterior and posterior tibial arteries

becomes dorsalis pedis artery

Question 11

What does the tibial tuberosity demarcate?

Answer 11

The division between the anterior/posterior tibial artery

Question 12

Lateral Compartment contains

Answer 12

1. Fibularis brevis
2. superficial fibular nerve
3. fibularis longus

Question 13

Where is the lateral compartment of the leg?

Answer 13

The lateral surface of the fibula

Question 14

Muscles of the lateral compartment:

Answer 14

Fibularis longus: prox = fibula, distal = 1st metatarsal + medial cuneiform

Functions: eversion and plantar flexion

Fibularis Brevis Muscle: prox = tibia, distal = 5th metatarsal tuberosity

Question 15

5th Metatarsal Fracture

Answer 15

3 fracture zones

1. Avulsion fracture, effects inversion
2. Jones fracture, non-inversion
3. Stress fracture

Question 16

5th Metatarsal Fracture: Avulsion fracture

Answer 16

Effects inversion

occurs at tuberosity of 5th metatarsal

Question 17

5th Metatarsal Fracture: Jones fracture

Answer 17

Non-inversion

acute diaphsyeal fracture

Question 18

5th Metatarsal Fracture: Stress Fracture

Answer 18

Diaphyseal stress fracture

Question 19

Superficial Fibular Nerve

Answer 19

1. One of the two terminal branches of the common fibular nerve
2. begins between finularis longus and fibula

3, nearly entire dorsal surface of foot

4. most of the dorsal aspect of digits

Question 20

Common Fibular Nerve

Answer 20

Winds around fibular head

Question 21

Damage to common fibular nerve

Answer 21

most commonly injured

paralysis of anterior/lateral crural muscles

Loss of dorsiflexion and eversion.

“foot drop”

Question 22

“foot drop”

Answer 22

damage to common fibular nerve

prevents dorsiflexion and eversion

Question 23

a high stepping gait a wadding fair or a swing gait

Answer 23

common fibular nerve damage

Question 24

Lateral compartment arterial supply

Answer 24

the one compartment without a distinct arterial branch accommodating the compartment nerve

Fibular artery

Question 25

fibular artery

Answer 25

largest branch of posterior tibial artery

Question 26

Anterior compartment "compacted" Muscles, prox attach/ distal attach Innervation Vascularization Function

Answer 26

Muscles : Tibialis Anterior, Extensor Digitorim Longus, Extensor Hallucis Longus, Fibularis Tertius Innervation: Deep fibular never Vascularization: Anterior Tibial artery Prox attach: Tibialis/Digitorum condyle, Hallucis/Tertius Fibula Distal attach: all different Functions: dorsiflexion and eversion

Question 27

Superficial Fibular Nerve vs Deep Fibular Nerve

Answer 27

the two branches of the common fibular nerve Superficial: supplies anterfoinferior leg,nearly entire dorsal surface of foot, most dosal aspect of digits, between fibularis longus/fibula, Deep fibular ner: supplies anterior compartment muscles, between fibularis longus/fibula, runs inferomedially between tibialist anterior/extensor hallucis longus ends medial/lateral terminal branches of foot

Question 28

Shin Splints

Answer 28

Medial tibial stress syndrome indues small tears to periosteum over tibia due to repetitive microtrauma to tibialis anterior

Question 29

Calcaneus: articulates with what? special parts?

Answer 29

``` Cuboid and the talus sustentaculum tali (support of talus and groove for flexor hallucis longus) ``` Fibular trochlea: ridge on lateral surface (lateral pulley)

Question 30

Navicular: articulates with what? specail parts?

Answer 30

Talus head, 3 cunieforms, cuboid navicular tuberosity tibialist posterior attachment

Question 31

Cuboid: articulates with what? special parts?

Answer 31

most lateral bone in distal row of tarsus calcaneus, 4th/5th metatarsals, navicular and lateral cuneiform groove fibularis longus

Question 32

Posterior compartment: superficial and deep

Answer 32

flexors/calf compartment Superficial: gastrocnemius, soleus, plantaris Deep: popliteus, flexor hallucis longus, flexor digitorum longus, tibialis posterior TIBIAL NERVE AND POSTERIOR TIBIAL VESSELS ARE DEEP TO TRANSVERSE CRURAL CRURAL SEPTUM

Question 33

Gastrocnemius

Answer 33

MOST SUPERFICIAL POSTERIOR COMPARTMENT MUSCLE two-headed 1) medial head inserts on medial condyle of tibia and distally via achilles tendon 2) lateral head inserts on lateral condyle of tibia and distally via achilles tendon PLANTAR FLEXION and knee join flexion

Question 34

Sesamoid bone of gastrocnemius

Answer 34

"fabella" lateral head may have sesamoid bone close to proximal attachment fracture can result in total knee replacement

Question 35

Soleus

Answer 35

Broad, flat multipennate muscle, deep to gastrocnemius soleal line of tibia inserts via tendo calcaneus (achilles tendon)

Question 36

"Triceps Surae"

Answer 36

tripartite muscle consisting of gastrocnemius and soleus muscle plantarflexion

Question 37

Plantaris

Answer 37

Can be absent short belly, long tendon attachments: lateral supracondylar line and calcaneal tendon weak plantarflexion and lef flexion

Question 38

Plantaris damage

Answer 38

Long tendon used in reconstructive surgery of hand tendons possibility of rupture during violent ankle movements commonly injured in ballet dancers, basketball players, sprinters

Question 39

Deep Posterior Crural Compartment (4)

Answer 39

1. Popliteus 2. Flexor hallucis longus (FHL) 3. flexor digitorum longus (FDL) 4. tibialis posterior (TP)

Question 40

Popliteus

Answer 40

Thin, flat triangular muscle attachments, lateral femoral condyle & meniscus unlocks extended leg by rotating femur on tibia

Question 41

Popliteal fossa

Answer 41

Superior medial and superior lateral genicular arteries - above gastrocnemiuses Inferior medial genicular artery -deep to medial head of gastrocnemius Inferior lateral genicular artery -deep to plantaris and superficial to popliteus

Question 42

anterior compartment of leg

Answer 42

1) dorsiflexion | 2) extension