Lower leg ankle and foot Flashcards by Lucy Bulpitt

What are the compartments of the lower leg

Superficial posterior compartment

Deep Posterior Compartment

Anterior Crural compartment

Lateral Crural compartment

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Which muscles are in the superficial posterior compartment

Gastrocnemius

Soleus

Plantaris

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Which muscles are in the deep posterior compartment

Popliteus

Tibialis posterior

Flexor Hallucis Longus

Flexor digitorum Longus

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What muscles are in the anterior crural compartment

Tibialis anterior

Extensor Hallucis Longus

Extensor Digitorum Longus

Peroneus Tertius

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What muscles are in the Lateral Crural Compartment

Peroneus Longus

Peroneus Brevis

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Gastronemius

Most superficial in the calf

2 heads Medial and Lateral

Origin: Medial- Medial supercondylar ridge of femur and lateral- lateral condyle of femur

Insertion - Via tendocalaneus to posterior surface of calcaneus

Nerve Supply - Tibial nerve S1,2

Planterflexes ankle and flexes knee

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Soleus

Origin - Soleal line (posterior surface of tibia)

Insertion - Via tendocalcaneus to calcaneus

Nerve - Tibial Nerve S1,2

Plantarflexes ankle

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Tibialis Posterior

Origin - Upper part posterior surface of tibia

Insertion - Tubercle of navicular and medial cuneiform with expansions to all tarsal bones except talus

Nerve - Tibial Nerve L4,5

Inverts and plantarflexes foot

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Flexor Hallucis Longus

Origin - lower 2 thirds posterior surface of fibular

Insertion - Plantar surface base of distal Phalanx

Nerve - Tibial Nerve S1,2

Plantarflexion of big toe

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Flexor Digitorum longus

Origin - medial part posterior surface of tibia

Insertion - Tendon passes behind medial malleolus and divides into 4 to attach to plantar surface base of 4 lateral toes

Nerve - Tibial Nerve L5,S1,2

Plantarflexion

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Tibialis anterior

Origin - Lateral surface of tibia

Insertion - Medial side of medial cuneiform and base 1st metatarsal

Nerve - Deep Peroneal nerve L4,5

Dorsiflexes and inverts foot
Maintains longitudinal arch of foot

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Extensor Hallucis Longus

Origin - middle half anterior surface of fibula

Insertion - Base dorsal surface distal phalanx of hallux

Nerve - Deep Peroneal nerve L5,S1

Dorsiflexes joints of hallux
Assists tibialis anterior on swing phase of gait

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Extensor Digitorum Longus

Origin - Upper 2 thirds anterior surface of fibula

Insertion - distal and middle phalanx of the 4 lateral toes on dorsal surface

Nerve - Deep Peroneal Nerve L5,S1

dorsiflexes ankle

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Peroneus Longus

Origin - lateral surface of head of fibula

Insertion - Plater surface of medial cuneiform and adjacent 1st metatarsal

Nerve - Superficial Peroneal nerve L5,S1

Everts and plantarflexes foot

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Peroneus Brevis

Origin - Lower 2 thirds lateral surface fibular

Insertion - Tubercle on lateral base 5th metatarsal

Nerve - Superficial peroneal nerve L5,S1

Everts and plantarflexes foot

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What are the muscles covered by

Fascia

Deep fascia demonstrates thickening around the ankle on the plantar aspect of the foot

The deep fascia ensheaths the muscles

Deep fascia has intermuscular septa that divides the thigh into compartments

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Dorsal aspect of the foot

Extensor Digitorum Brevis

Origin - calcaneus

Insertion - Lateral side 2-4 toes into hallux

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first layer of the foot

Adductor Hallucis

Flexor digitorum brevis

Abductor digiti minimi

Second layer of the foot

Lumbricals

Quadratus Plantae

Third layer of the foot

Flexor hallucis brevis

Flexor digiti minimi brevis

Adductor Hallucis

Forth layer of the foot

Dorsal Interossei

Plantar Interossei

Abductor Hallucis

Origin - Medial tubercle of calcaneus and planter fascia

Insertion - Medial side of great toe

Nerve - medial plantar nerve S1,2

Flexor digitorum Brevis

Origin - Medial tubercle of calcaneus and plantar fascia

Insertion - lateral 4 toes

Nerve - Medial plantar nerve S1,2

Abductor digiti minimi

Origin - medial and lateral tubercle of calcaneus

Insertion - lateral side 5 toe

nerve - Lateral Plantar nerve S1,2

Quadratus Plantae

Origin - medial and lateral tubercles of the calcaneus Insertion - Tendon of Flexor Digitorum longus Nerve - Lateral Plantar nerve S2,3 Ture synergist: assists FDL Prevents drift of toes during flexion

Flexor Hallucis Brevis

Origin - Plantar surfaces of cuboid and and lateral cuneiform Insertion - Proximal Phalanx of Hallux Nerve - Medial plantar nerve S1,2

Flexor Digiti minimi Brevis

Origin - Base of 5th metatarsal Insertion - lateral side proximal phalanx of 5th toe Nerve - Lateral Plantar nerve S2,3

Adductor Hallicus

Origin - base of metatarsals 2-4 Insertion - Lateral side of big toe Nerve - Lateral plantar nerve S2,3

Dorsi Interossei

Origin - Metatarsals 1-5 Insertion - lateral and medial side of 2nd toe and lateral side 3-4 Nerve - Lateral plantar Nerve S2,3 DAB

Plantar Interossei

Origin - Bases of the medial sides of metatarsals 3-5 Insertion - medial sides of phalanges 3-5 Nerve - Lateral plantar nerve S2,3 PAD

Arch Maintenance

Medial longitudinal arch: Flexor Hallucis Longus, tibialis anterior, Tibialis Posterior Lateral Longitudinal Arch: Peroneus Longus, Peroneus Brevis Transverse Arch: Tibialis Posterior, Peroneus Longus

Functions of the arches of the foot

Shock Absorb Absorb force for locomotion Weightbearing Safe passage for nerves and vessels

What is the role of the retinacula

Hold tendons in position Prevent bowstringing

What is the plantar fascia

Supports arches of the foot Allows increased SA for muscle attachment Provides protection to structures in sole of the foot

Functions of interosseous membrane

Stability Division Attachment Transmission of blood vessels from anterior to posterior

Movement at the ankle joint

As ankle is a true hinge Plantarflexion and dorsiflexion Dorsiflexion: Talus rolls forwards and slides back Limiting - anterior Talus is broader moving into narrower tibiofibular mortise. Inferior tibiofibular ligaments are taut Most stable Plantarflexion: Talus rolls back and slides forward Limiting: Narrower posterior talus moves into broader tibiofibular mortise Least stable position of the joint as less grip on malleoli

Ligaments of Subtalar joint

Interosseus ligament Medial posterior lateral Talocalcanean ligament Talotubercle to surface of calcaneus

Ligaments of calcaneocuboid joint

Plantar and dorsal calcaneocuboid ligaments Reinforces the joint capsule

Ligaments of talonavicular joint

Spring ligament Dorsal talonavicular ligament

Ligaments of midtarsal joint

Bifurcate Long plantar ligament

Ligaments of metatarsophalangeal joint

Collateral ligaments Plantar ligament Deep transverse metatarsal ligament

Movements of the foot

Subtalar and midtarsal joint produce inversion and eversion inversion at subtalar joint is joined by suprination at midtarsal Eversion is accompanied by pronation

AROM

Dorsiflexion 0-25 Apex of lateral malleolous Plantarflexion 0-55 Apex of lateral malleolous Inversion and eversion can not be done with goniometry