Legs Flashcards
what bones form the acetabulum?
If we look at the acetabulum, we see that it is formed by each of the three bones of the coccyx, the ilium, ischium, and pubis.
inversion
big to in air
“unhappy triad” injury
damage to medial collateral, medial meniscus, and ACL
The force is being applied to the leg from the lateral side. This leg is firmly planted
(player’s right leg) while the other leg is in the air so all the weight is on this leg
(player’s right leg).
•Somebody or something crashes into the lateral side of the joint and the damage
happens on the medial side.
•So the medial collateral ligament is going to be yanked out of place and tears. It will
pull the medial meniscus with it which is also going to be damaged, and the ACL will
tear as well.
•This is one of the nastiest sports injury, creating a lot of damage. The thing to know is
that even though the damage is on the medial side, the force is coming at you from the
lateral side.
pes anserinus
semitendinosis
gracilis tendon
sartorius tendon
*tendon from eac compartment attaches
ligaments of the hip joint
. Each of the coccyl bones gives rise to one of these ligaments: pubofemoral, illiofemoral, ischiofemoral ligaments. Of those three, the iliofemoral ligament is the strongest ligament we have in the body: it’s Y-shaped and it prevents hip hyperextension. If I stand and bend posteriorly [i.e. lean backwards] you hyperextnd the hip, so if you push into the inguinal crease, you can feel the iliofemoral ligament as it resists the head of the femur which is pushing out. All 3 ligaments form a synovial joint and they’re twisted: there’s tension in order to push the head deep into the acetabulum. If you cut the 3 ligaments and try to pull the head out, it would snap back into place because of fhe 4th ligament, the ligament of the head: it goes from the fovea into the posterior wall of the acetabulum. This one also stabilizes the joint. Over time, the labrum wears away and it doesn’t get replaced, you get bone on bone, osteoarthritis.
what nerve can be damaged if the neck of the fibula fractures?
•Going back up north again, the proximal part of the fibula is the head of the fibula and
below that is a narrow neck. The neck of the fibula is important because it fractures.
And, if it fractures there’s a major nerve that passes right around it and that’s the
common fibular nerve and it’s often damaged in a fracture at the fibular neck.
ischial tuberosity
in posterior compartment Where all the muscles except the short head have their origin.
lumbar plexus
The lumbar plexus comes from ventral rami of L2-L4, and these somatic nerves come together to form this plexus. We’ll focus on two branches to understand the innervations of the thigh: the femoral nerve and the obdurator nerve. The million dollar question: is the femoral nerve medial or lateral to the psoas muscle? And the obdurator? The obdurator is medial, and if Vicky were to ask you “What functional fibers do you find in the obdurator nerve?” you’d say, “GSE for motor, GSAs because all skeletal muscle has proprioreceptors that are GSAs, and post-ganglionic sympathetic because every branch of nerve has it.”
labrum
The head of the femur fits into the acetabulum, but it doesn’t go in all the way because surrounding the acetabulum is a fibrocartilaginous labrum. The function of the labrum is to increase the depth of the acetabular socket so that the head goes in more than half the hemisphere – if you try to disarticulate the head from the acetabulum, you would have to break the labrum. It’s a stable joint given the labrum but there are more ligaments
what is the strongest ligament of the hip?
ileofemoral
On the left, the large iliofemoral ligament: the inverted Y that prevents hyperextension. The other ligaments, the ischiofemoral and pubofemoral ligaments.
medial compartment of thigh innervation
obturator nerve
eversion
small toe in air
soleal line
The only feature on the posterior surface that we care about is this line. called the
soleal line. A muscle called soleus attaches there.
sesamoid bones of the foot
These are sesamoid
bones. You’ve already seen one sesamoid bone and that was the…. Patella. And as
you know (I think), a sesamoid bone is a bone that’s entirely within a tendon. And the
purpose of these two sesamoid bones on the bottom of your foot, is that there is a
tendon that runs right between them to the big toe: the flexor hallucis longus. If you
remember the thumb was pollicus, the big toe is hallucis.
So the flexor hallucis longus muscle is located in the leg, we’ll see it, and its tendon
runs down under the foot to get to the big toe and these two bones (the little sesamoid
bones) elevate the sole of the foot enough so that you’re not stepping on that tendon
every time you take a step so the tendon passes through here (in between the
sesamoid bones) and these two bones kind of protect that tendon from being trampled.
•And all of the blue stuff indicates an articular surface, that’s where all the bones are
moving. And you can see that there’s articulation even here (pointing in between the
ligament of the head
Frontal section showing the ligament of the head, the 4th ligament going from the fovea to the posterior surface of the acetabular fossa.
where do the quadracep muscles attach?
•And on the anterior surface you will feel a bump on the bone and when you see the
bare bone it’s obvious to see this bump that is the tibial tuberosity and that’s where the
quadriceps muscle (inserts) attaches.
•This is an example for the many, many questions about what do we have to know
about origins and insertions. This would be something that you have to know because a
group of muscles attach here. What group? The quadriceps from the thigh: that’s the
three vastus muscles and the rectus femorus.
•And, because of their attachment here they they are able to straighten the knee joint or
extend the leg
what bone has weight when stadning on toes?
heads of the metatarsals
neurovasculature of the lateral compartment of the leg
Innervation
Brevis and longus are innervated by superficial branch of common fibular nerve
•The nerve is cutaneous to the lateral side of the leg and dorsal of the foot EXCEPT for the
web between the big toe and the second toe
o That web is innervated by the DEEP fibular nerve
Blood supply
•Fibular artery supplies blood
dorsalis pedis
•Pic also shows anterior tibial artery coming down, which lies against bones → it changes
name to dorsalis pedis (on the anterior aspect of ankle joing)
o Dorsalis pedis is good place to take a pulse
o Not everyone has dorsalis pedis artery (or have it only on one side) – if you can’t
find the pulse, don’t assume they’re dead
function of meniscus
•The other structure inside the knee joint, it’s not a ligament, these are pads of cartilage
called a meniscus. There’s a lateral meniscus and a medial meniscus. They are literally
cushions, they’re shaped sort of like a letter C, and they are there to act as shock
absorbers in the knee. The tibia is, every time you take a step, it’s getting the full weight
of your body all the way from your head down to your knee. So It’s very useful to have
these things to cushion the impact.
•Notice that on the medial side, the medial meniscus is attached to the medial collateral
ligament. On the lateral side that’s not the case. Traveling in that space is a tendon of
the muscle from the back of the knee that we will see shortly, it’s called the popliteus
muscle. And that tendon separates the lateral meniscus from the lateral collateral
ligament. This has functional consequences, if you have damage to the medial collateral
ligament it’s usually going to effect the medial meniscus as well so you’re going to get
two injuries for the price of one.
intrinsic muscles in the dorsal foot
- Extensor hallucis brevis
- Extensor digitorum brevis
- They’re innervated by deep fibular nerve
muscles in the anterior compartment of the leg
All 3 muscles in anterior compartment functions to dorsiflex the ankle
•In front, most anteriorly placed muscle, next to tibia, is tibialis anterior
o Tibialis posterior is the deepest muscle in the back
o Tibialis anterior is an inverter (like tibialis posterior)
• We have 2 inverters, one in front and one in back
•Extensor digitorum longus – sits next to tibialis anterior at the same plane
o Has tendon to each of the toes except for the big toe
•Deeply placed in front and anterior compartment is extensor hallucis longus muscle
o Note: flexor hallucis flexes big toe but CROSSES flexordigitorum tendons to get to
big toe
o Extensor digitorum does lie on SAME SIDE as big toe (e.g. lies medially)
deep compartment of posterior compartment of the leg - muscles
•Deep compartment has 3 muscles and will also plantar flex ankle and toes
o Flexor digitorum longus (just like hand ‘s FDL, will have tendon to everything but
the big toe)
o Flexor halucis longus – goes to the big toe
o Tibialis posterior – pressed up against the back of tibia
• In addition to plantar flex, tibialis posterior also inverts foot
medial compartment of the thigh muscles
Adductor longus, and if there is a longus, there is also a Brevis, so adductor Brevis, The third one is so big that some of it cant fit into the medial compartment and is in the posterior compartment. Its called the Adductor Magnus. One muscle that will really save your butt on the practical, The Gracilis muscle. Why is it important… IN practical you cannot differentiate between the medial and the lateral muscles as all are very similar, and if the other part of the foot/toes are covered. You identify medial and lateral by the sartorius muscle (I think he meant Gracilis muscle??). The gracilis is a really powerful adductor of the thigh. Also called the “chastity muscle”.
All muscles in this compartment are innervated by the obturator nerve.
divisions of popliteal artery
Popliteal artery pass below the knee and split into anterior and posterior tibial artery
- Anterior tibial artery disappears to go to front of leg (will only see a little bit in lab today)
- Posterior tibial artery will go down to foot and travels with tibial nerve → artery
superficial and deep posterior compartment of leg
•A branch off posterior tibial artery is fibular artery
o Fibular artery is more lateral and will supply lateral compartment through
perforating branch of fibular artery
what is the greatest sesamoid bone in the body?
patella
body. It’s sesamoid because it develops from a tendon, in this case the quadriceps tendon.
soleus function
inserts into achilles
• Standing upright – The muscle is always in state of tension and uses small
contractions to help you stand upright for long period of time
§ If soleus is damaged, you tilt forward
§ This muscle helps you stand up straight
split of the sciatic nerve
•There’s monster giant nerve, the sciatic nerve → splits into tibial nerve and common
fibular nerve
o “Fibular” and “peroneal” (older term) are interchangeable (e.g. common fibular
nerve = common peroneal nerve)
o Sciatic often divide at the back of the knee, the popliteal fossa, but can be seen
splitting up in gluteal region due to anatomical variation
fascia lata
there’ll be a lot of fat in the superficial fascia. Immediately below it, you’ll find the deep fascia (found everywhere in the body). This fascia that wraps around the thigh is the fascia lata: if you look on the medial side of the thigh there’s a big gap and it’s for the drainage of a large superficial vein, the saphenous vein. It goes from the medial side of the foot all the way medially up the leg till it drains in the femoral vein. That hiatus is the called the saphenous hiatus.
On the lateral side of the fascia lata, this material is reinforced by the tendon of the gluteus maximus plus the tendon of the tensor fascia latae. It creates a material so strong, it’s called the iliotibial tract.
plantar flexion
function of collageral ligaments
keep femur and tibia/fibula close togheter
prevent rotation
angle of inclination
formed between the head, the neck, and the shaft
So the longest and strongest bone is the femur. We can see the head, the neck, the shaft of the body. The head and the neck form an angle with the shaft of about 125-126 degrees = angle of inclination. It is really important because if you snap the neck, which is the most likely place for a break, the surgeon has to restore this angle in order for the joint to properly transmit the weight down to the knee joint.
what bone articulates at the ankle joint?
the talus, that articulates at the ankle joint.
• The blue surface is the articular surface that contacts that inferior part of the tibia and
fibula and this is how it rocks back and forth.
crural fascia
fascia of the leg
•However the crural fascia has an important positive function which is, it helps venous
blood travel back up towards the heart. How does it do that? Well, as you can imagine
by the time you get down to the leg and the foot, you’re pretty far away from the
pumping of the heart and you are also fighting gravity to send the blood back up through
your leg towards the heart. The contraction of the leg muscles, assists in pumping the
blood back up and the fact that the crural fascia holds these muscles so tightly against
the bones also helps propel the blood upwards back towards the heart. So the crural
fascia assists in venous return.
•This gets back to what we said earlier about the potential danger of a bleed into any of
the leg compartments. If you knick that artery and it’s bleeding slowly, you don’t know
that you’ve really been injured. The blood will eventually squeeze the other things that
are in that particular compartment. It will compress the nerve, the other vessels,
eventually the muscles and this is called compartment syndrome. This can cause a
great deal of damage and if it’s not recognized and caught soon enough it can cause
permanent muscle and nerve damage and you can lose the function, in fact lose the
leg. I’ll show you a little more about how that can happen momentarily.
contents of the femoral triangle
Content is the vein, artery and nerve.
innervation of anterior compartment of the thigh
All of these muscles are supplied by the femoral nerve, ie nerve that innervates the anterior compartment.
In addition to the 4 quads, there is 1 another muscle, it’s the sartorius muscle, origin from hip-anteriorsup illian spine
Function: Quads: are the Extensors.
sacral plexus
The sacral plexus: the formation of the sacral plexus comes from when the ventral rami of L4-L5 come together to form the lumbosacral trunk. The lumbosacral trunk is NOT the lumbosacral trunk, it’s only the ventral rami of L4-L5. To this trunk, we’ll add S1-S3, and that will form the sacral plexus. The one branch we’ll focus on is the sciatic nerve, which is the largest nerve of the body. It enters beneath the piriformis and is responsible for the muscles on the posterior region below the knee.
gracilis muscle
u cant tell the medial from the lateral. Long head of biceps vs semitendinosis, you have to see the gracilis muscle. Points to Left of diagram..this is the gracilis so this is the medial side and the muscle is the semitendinosis,
where does the ankle joint fit?
Down below, notice the space here is shaped sort of like an upside down U. That’s
where the ankle joint fits. On both, the tibia and the fibula at the very distal end, there’s
a bump or a ridge called the malleolus. The tibia being the medial bone has the medial
malleolus and on the fibula there’s a lateral malleolus and you can feel these two pieces
of bone at your ankle.
innervation of the dorsal foot
intrinsic muscles (extensor digitorum prevus, extensor hallucis brevus) –> deep fibular nerves
cutaneous: superficial and deep fibular nerves
posterior compartment of the thigh muscles
Posteriorly, 5 muscles are there. Biggest chunk: Hamstring, : Laterally: Long and short head of the biceps. Medially: Semitendinosis and semimembrinosis. And the 5th muscle is the rest of the adductor magnus that couldn’t fit in the medial comp, i.e the post part of Adductor magnus.
Last pointer before delving into the muscles: All the muscles of the post compartment except the Adductor Magnus, cross the knee joint.
adducter canal
Key here is that the femoral vessels are the only ones here to supply blood to the lower limb. So these need to get to the leg and the foot and the posterior compartment of the thigh. To reach the leg and foot, the vein and artery run this adductor canal, till they reach the medial side where there is an opening in the adductor magnus, allowing to get them to the back of your knee. Once the femoral vessels get to the back of the knee they are then called the popletial vessels. The femoral nerve does not traverse the canal, it leaves the canal before you reach the back of the knee. Its only function is to innervate the anterior compartment and the cutaneous part of the ant thigh.
lateral ligaments of the ankle
prevent over inversion of the ankle
aversion fracture - break tendon and pull of a piece of the bone
dorsiflexion
•The movement at the ankle joint, we talked about dorsi flexion and plantar flexion, up
and down. The talus rocks up and down underneath the tibia and the fibula.
compartment syndrome
•Because the crural fascia is so tight, it won’t allow expansion as blood fills the
compartment and cause compression of surrounding structures
o This can happen when someone is given a leg cast, if there’s too much compression
or if there’s a leaky vessel (in which case the cast makes things worse)
•If someone in a cast has severe pain, don’t assume it’s due to the fracture – you always
have to check for compartment syndrome!!
o Toe is typically left out b/c
- Ankle is immobilized but flexing toes up and down helps with venous return
- Toes can be used to test for compartment syndrome by plantarflexing them
(bending toes downward)
§ By pulling toes down, you stretch anterior compartment → patient
will be in even more pain → now can be very suspicious that there
may have compartment syndrom
•Treatment is deciding which compartment is affected → then make incision in crural
fascia
o Once crural fascia is cut, will allow blood to flow out
o If this is early enough, will save person from damage
o Good thing about compartment syndrome is that pain is very severe and will cause
person to come back to ER room so it’s early enough to save the person
• You get into trouble when people decide they can be heroes and live with the
pain and come back the next day
what muscles are in the lateral compartment of the leg?
•Fibularis longus – more superficial than brevis
o Its tendon is on fibula and runs from lateral side of leg to go under the foot
o Tendon starts laterally and goes medially to big toe
o When fibers contract, will pull foot outward (evert)
•Fibularis brevis –
o Does not go under the foot but attaches to base of fifth metatarsal (lateral side)
o When it contracts, it will pull lateral side outward
o Both brevis and longus acting together (pulling from lateral and medial side,
respectively) → foot everts
boundaries of femoral triangle
The boundaries that make the femoral triangle are the sartorius muscle laterally, inguinal ligament on the top and the Adductor longus medially
blood supply to the sole of the foot
posterior tibial artery passes medially under the foot and divides into medial and lateral plantar arteries
osteoarthritis
- Arthritis caused just by wear is called osteoarthritis
- If you live long enough, probably not accurate to say almost everyone but probably
85% of the population has osteoarthritis in some joint or another. And of course the
knees, the hips are the most common because they get the most weight-bearing.
• When a little bit of cartilage wears away you may remember from histo or you may
not, cartilage has no blood supplies and no nerves. Cartilage is not innervated. So
when you have a bone above with cartilage on it, resting on bone below with cartilage
on it, there’s no pain, no pressure: you don’t feel it. As cartilage wears away, bone is
innervated and that’s when it starts to hurt
• If we look up here (referring to where arrow is pointing to small focal lesion), there’s a
little bit of, the cartilage is normally white and shiny like this. This is a small area
where the cartilage has eroded, this is the beginning of arthritis. That pinkish thing or
beige, that’s bone. So when this piece of bone rests on the piece of cartilage below,
that hurts. What hurts more is when it gets down to what they call bone on bone.
That’s really painful.
• These are actually pictures of sheep (pointing at bottom picture). This sheep is in a
desperate situation. You can’t really see it at this magnification, but around the edges
here, it’s very raggedy looking, it’s not a smooth, even circle or oval. Those little
jagged edges are going to crack and eventually they’ll form visible cracks, you can
see lines in the cartilage here. And here (hole on the left of the bottom picture) the
entire cartilage has worn away and here (hole on the right of the bottom picture) what
we’re looking at is bone and here is even worse you can see the blood vessels in the
bone. This sheep is in desperate need of a joint replacement.
boundaries of the popliteal fossa
Boundaries of popliteal fossa
- Lateral: bicep femoris
- Medially: semitendinosus and semimembranosis (Sally she’s she would
include both these muscles even though only 1 is labeled)
• Inferior boundary: lateral and medial head of gastrocemius muscles
posterior compartment of thigh innervation
. All muscles in the post comp except the short head of biceps originate from Ischial tuberosity. All the muscle which originate from the ischial tuberosity, are innervated by the tibial nerve. That leaves The short head of the biceps to be supplied by the other nerve, called the common peroneal nerve. The Tibial nerve and the common peroneal nerve together lie in a sheath, forming the Sciatic Nerve. So, sciatic N is not one big N, but 2 really big nerves wrapped up in a sheath, forming the sciatic nerve
foot drop
o If you cut off common fibular nerve, will cause numbness, then pain and won’t be
able to elevate the toes (dorsiflex)
o When you can’t pick up foot at ankle or elevate your toes, you have foot drop
• Foot drop – person has to raise leg at the knee to raise the foot because can’t
pick up foot otherwise
§ Foot drop is caused by compression of deep fibular nerve
what bone makes up the heel?
The bone that actually forms your heel is the calcaneus and you can feel this bone
right through the back of your foot. On the bottom of the calcaneus there’s a fat pad.
and as you get older and spend more and more time on your feet as you likely will in
this profession, that fat pad wears away and your feet start to hurt.
iliotibial tract
On the lateral side of the fascia lata, this material is reinforced by the tendon of the gluteus maximus plus the tendon of the tensor fascia latae. It creates a material so strong, it’s called the iliotibial tract. This reinforcement on the lateral side of the thigh is called the illeo-tibial tract. Its importance is to hold the muscle on the lateral side of the thigh tightly, but it also goes down to form this connective tissue band around the knee to protect it. As discussed earlier, the knee cannot resist displacement forces very well in either of the directions, ant, post, medial, lateral, and this retinaculum is tough Connective tissue ,comes down and helps reinforce the tissue by forming the capsule.
innervation to the sole of the foot
• Tibial nerve goes to bottom of foot and divides into medial and lateral plantar nerve
planatarus muscle function
•Plantarius has long tendon that also fuses with calcaneal tendon
o Functions: similar to soleus and gastrocnemius – plantar flex
• If you lose platarius muscle, won’t have any deficit in function
o Like palmaris longus that has a long tendon in the forearm, b/c plantarius is not
important for function – you can harvest the plantarius tendon (it’s not too deep
down)–to repair tendons/ligaments torn elsewhere in body
transverse acetabular ligament
Here, the acetabular notch has the transverse acetabular ligament and through the acetabular foramen runs the blood supply to the hip, which is very important – if you injure this blood supply, one will get necrosis of the hip.
linea aspera
), you’ll also note a roughened area that extends the length of the shaft called the linea aspera. It’s important because not a single muscle but an entire group of muscles insert here, the adductors of the thigh. The adductors bring the leg back to the midline. […his microphone fell off here: Inferiorly, the femur / condyles / the knee isn’t an incredibly stable joint…)].
obturator nerve
innervates medial compartment
The dissection of this compartment is really nice because the obturator nerve is really your friend here. It divides into and ant and post division. In the anterior compartment uo always find the anterior division between longus and brevis. And the posterior division between brevis and magnus. So u can easily find the plane of dissection because of the divisions of the obturator nerve.
what maintains the shape of the arch of the foot?
- There are curves built into the bones
- Action of muscles around the arch
- Ligaments and plantar fascia
trimalleolar fracture
•This is a weird one. There are two malleoli, there’s a lateral malleolus on the fibula and
a medial malleolus on the tibia. What is a trimalleolar fracture if there’s only two of
them.
•A trimalleolar fracture refers to you also, you break both the lateral and medial malleoli
and you also break off a little piece of the posterior tibia. This is a complicated one to fix
because you have to come at it from three different directions, this is how it’s done
what nerve innervates posterior compartment of the leg
•Both superficial and deep muscles of posterior compartment are innervated by tibial
nerve (branch of sciatic)
o Tibial nerve runs down posterior of leg and to bottom of foot
function of ACL and PCL
•These two ligaments like the others also hold the bones together, close to each other.
But, their additional function is they prevent the tibia from sliding forward or backward.
The ACL prevents the tibia from sliding forward under the femur and the PCL prevents it
from sliding backwards.
what travels behind medial malleous to bottom of foot
•Arteries, nerve, vein, and tendons will travel behind medial malleolus to the bottom of
the foot
o “Tom, Dick, and a very nervous Harry” mnemonic may be useful
- “Tom” is tibialis posterior tendon – most medial
- “Dick” is flexor digitorum longus tendon
- “And” is artery
- “Very” is vein
- “Nervous” is tibial nerve
- “Harry” is hallucis longus longus tendon
deltoid ligament
only ligament in the ankle we care about
- Deltoid is actually a bunch of ligaments hanging together.
- The deltoid ligament protects you against over-eversion. It won’t let your ankle slide all
the way out theoretically, unless of course it tears.
•So the deltoid ligament on the medial side of the ankle prevents over-eversion, you
don’t have to know nay of the labels on the slide here
tibia vs fibula
•The big, heavy weight-bearing bone is the tibia and that is medially placed, it’s on the
medial side and you can all feel the tibia right under your skin. It’s subcutaneous, easy
to get to. And I’m sure at some point, all of you have bumped into a table leg or the
edge of your bed or what and you can easily feel the sensation in the tibia. It’s not just
the skin that has sensory innervation, the bone is innervated also.
•Next to it on the lateral side of your leg is the fibula and if you compare the two of them
you can see that this is a very thin, not particularly sturdy looking bone. And in fact the
fibula is not weight-bearing at all. It does not participate in the knee joint only the tibia
and femur are part of the knee. The fibula is there mostly to provide muscle attachment
space
nail bed of foot - innervation
Nailbeds are similar to hands where neve wraps around from below to innervate
- Medial 3.5 toes are innervated by medial plantar nerve
- Lateral 1.4 are innervated by lateral plantar nerve
why is it important to do imaging if dislocated knee, even if it popped back?
1) always take anterior and lateral imagery
2)
•So, this is the politeal artery and you may recall that once upon a time in the front of the
thigh there was the femoral artery. The femoral artery and vein disappear into the
adductor hiatus and come around to the back of the leg. and of course, they change
their names to popliteal artery and vein
•So once we see them back here, this is already the popliteal artery. And what this X-ray
and the arrow are showing you is that when the joint dislocated, the artery is the closest
structure to the bone and it has a little tiny nick here
•There’s something weird about dislocated knees, they very often resolve by
themselves. At least, approximately half the time this joint will reposition itself.
•So you’re on your way to the emergency room, by the time you get to the ER, you’re
feeling much better, but it’s very important for you to tell the ER doc that your knee was
dislocated because it’s possible that some damage happened to the blood vessel. Here
you can see that little nick in the artery better. This is going to cause a slow leak, maybe
not so slow and we’ll see soon that leaking blood vessels in the leg can cause extreme
damage and in fact may even result in the loss of the limb below the knee.
anterior compartment of the thigh
Anterior compartment, for people who did track/running, this muscle is pulled quite often, its called the quadriceps. It is Made of Rectus femoris muscle and the three Vastus muscles, Vastus lateralis-Lateral, Medialis-Medial and intermedius-Neither lateral/Medial and sartorius muscleThese 4 form the quadriceps, and all together form the quadriceps tendon. The quadriceps tendon continues over the knee and encompasses the patella (making it a sesamoid bone), in theory its given another name-then it is called the patellar tendon, that is where you take your rubber hammer and test the knee jerk reflex.
patella function
Patella is a Sesamoid bone –Not critical for our existance if we are not too active, but maybe in an athlete. Its Importance: If no patella, the quadriceps tendon would insert into the tibial tuberosity at a very shallow angle, and because of that the extension is not that powerful. Due to the patella, the angle of insertion is more sharp and the result is that the last 10-15 degrees of the extension is very powerful. Especially important in kickers, basketball, football players etc. If the patella is badly fractured, it is surgically removed. If it is not that badly fractured, it is left in place to heal. It takes a long time to heal though when left to heal.
what muscles insert into achilles tendon?
Muscles that insert into Achilles tendon–gastrocnemius, soleus, plantarius
•Gastrocnemius is the most posterior muscle on calf and ends in enormous tendon called
calcaneal tendon or more commonly the Achilles tendon
o In the lab, you should appreciate the thickness and strength of the tendon
o Functions:
- Plantar flex ankle
- Assists in flexing the knee a little – gastrocnemius crosses the knees a little
§ Note that the main flexors of knee are in hamstrings
§ Soleus does NOT cross the knee and has no function in flexing the
knee
neurovascular of anterior compartment of the leg
- All 3 muscles innervated by deep fibular nerve
- Blood supply is from anterior tibular artery
