Lower Limb Flashcards

1
Q

Flexors of the hip

A

Psoas major

Iliacus

=ileopsoas

(rectus femoris)
(Sartorius)

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2
Q

Rotators of the hip

A

Piriformis

Obturator internus

Gemelli

Quadratus femoris

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3
Q

Hip abductors

A

Gluteus medius

Gluteus minimus

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4
Q

Extensor of the hip

A

Gluteal maximus

semimembranosus
(semitendinosus)
(biceps femoris)

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5
Q

Compartments of the thigh

A

Three compartments

Medial (Adductor)

Anterior (Extensor)

Posterior (Flexor)

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6
Q

Muscles inserting on the lesser trochanter

A

Psoas major

Iliacus

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7
Q

Muscle inserting on the quadrate tubercle

A

Quadratus femoris

part of the intertrochanteric crest

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8
Q

Pectineal line ends…

A

Lesser trochanter

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9
Q

Gluteal tuberosity ends…

A

Greater trochanter

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10
Q

Artery of the ligamentum teres branches from

A

Obturator artery

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11
Q

Blood supply to femoral head

A

Mainly medial and lateral circumflex femoral arteries

Branch of profounda femoris artery

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12
Q

Ligaments of the hip joint

A

Ileofemoral ligament

  • Anterior to hip joint (triangular shaped)
  • Arising from ileum between AIIS and acetabulum
  • Attached to intertochanteric line

Pubofemoral ligament

  • Anteroinferior to the hip joint (triangular shaped)
  • Arisies ileopubic eminence and obturator membrane
  • Blends with ileofemoral ligament and fibrous membrane

Ischiofemoral ligament

  • Posterior to hip joint
  • Arises medial ischium
  • Inserts greater trochanter
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13
Q

Ileofemoral ligament

A
  • Anterior to hip joint (triangular shaped)
  • Arising from ileum between AIIS and acetabulum
  • Attached to intertochanteric line
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14
Q

Pubofemoral ligament

A
  • Anteroinferior to the hip joint (triangular shaped)
  • Arisies ileopubic eminence and obturator membrane
  • Blends with ileofemoral ligament and fibrous membrane
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15
Q

Isciofemoral ligament

A
  • Posterior to hip joint
  • Arises medial ischium
  • Inserts greater trochanter
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16
Q

Obturator canal

A

Vertically orientated passageway from pelvis to medial compartment of thigh

Borders of canal:
Superiorly obturator groove on inferior surface of superior ramus

Inferiorly by upper margin of obturator membrane (and by obturator externes and internus

Obturator nerve and vessels pass through it into medial thigh

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17
Q

Greater sciatic foramen

A

Passage between pelvis and gluteal region of lower limb

Borders:

  • Greater sciatic notch
  • Upper borders of sacrospinous and sacrotuberous ligaments
  • Lateral border of the sacrum

Piriformis passes through and separates it into superior and inferior parts
-Superior gluteal nerve passes above piriformis

Passing below:

  • Sciatic nerve
  • Inferior gluteal nerve
  • Inferior gluteal vessels
  • Pudendal nerve
  • Interregnal pudendal vessels
  • Posterior cutaneous nerve of the thigh
  • Nerve to obturator interns and gemellus superior
  • Nerve to quadrates femoris and Gemellus inferior
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18
Q

Structures passing above piriformis in greater sciatic foramen

A

Superior gluteal nerve

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19
Q

Structures passing inferiorly to piriformis out of greater sciatic foramen

A
  • Sciatic nerve
  • Inferior gluteal nerve
  • Inferior gluteal vessels
  • Pudendal nerve
  • Interregnal pudendal vessels
  • Posterior cutaneous nerve of the thigh
  • Nerve to obturator interns and gemellus superior
  • Nerve to quadrates femoris and Gemellus inferior
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20
Q

Lesser sciatic foramen

A

Connects gluteal region to perineum
-Foramen is inferior to lateral attachments of levator ani and coccygeus

Tendon of obturator internus

Pudendal nerve and internal pudendal vessels enter perineum through lesser foramen after leaving pelvis through greater sciatic foramen

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21
Q

Structures passing under inguinal ligament

A

Psoas major

Ilacus

Pectineus

Femoral artery

Femoral vein

Femoral nerve

Lymphatics of lower limb

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22
Q

Adductors of the Hip

A

Three named ADductors

  • Adductor magnus
  • Adductor brevis
  • Adductor longus

Pectineus

Gracillis

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23
Q

Hamstring muscles

A

Three
All arise from ischial tuberosity

Two attach medially:
Semi-membranosus
Semi-tendinosus (lies behind membranosus)

One attaches laterally:
Biceps femoris: long head arises from ischial tuberosity, short head arises from linea aspera and suprachondylar line

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24
Q

Muscles within fascia late

A

Tensor fascia lata

Gluteus maximus

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25
Saphenous opening
Only opening in fascia lata Allows great saphenous vein to pass deep to join with femoral vein
26
Borders of the femoral triangle
Base: inguinal ligament Medial border: medial margin of adductor longus Lateral margin: Medial margin of sartorius Floor: Medial floor: Pectinous and adductor longus Lateral floor: Iliopsoas major Apex points inferiorly as is continuous with adductor canal
27
Inferior gluteal artery
Arises from anterior trunk of internal iliac artery Leaves pelvis through greater sciatic foramen inferior to piriformis Descends through gluteal region into posterior thigh - Anastomosis with branch of femoral artery - Branch to sciatic nerve - Supplies surrounding muscles
28
Superior gluteal nerve
Arises from posterior trunk of internal iliac artery Leaves pelvis with superior gluteal nerve through greater sciatic foramen superior to piriformis Divides into superficial and deep branch in gluteal region - Superficial branch passes onto deep surface of gluteus maximus - Deep branch passes between gluteus medius and minimus Branches anastomose with medial and lateral femoral circumflex --> supply hip joint
29
Anterior compartment of the thigh
Sartorius Quadriceps: rectus femoris, vastus intermedius, medlialis and lateralis (Iliacus) All innervated be femoral nerve
30
Medial compartment of the thigh
Names Adductors: Adductor magnus Adductor brevis Adductor longus Obturator externus Pectineus Gracilis All innervated by obtruator nerve apart from pectineus which is innervated by the femoral nerve
31
Posterior compartment of the thigh
Hamstrings Biceps femoris Semimembranosus Semitendinosus All innervated by the sciatic nerve
32
Articularis genus
Pulls bursa away from knee joint during extension Arises just inferior to vastus intermedius
33
Attachment of pes anserinus
In order from superior --> inferior Sartorius Gracilis Semitendinosus Pes anserinus bursitis can develop
34
Which muscle is connected to the popliteal muscle?
Lateral meniscus Tendon inserts within the joint capsule
35
Which meniscus is connected the to joint capsule?
Medial meniscus Attached to joint capsule and tibial collateral ligament
36
Insertion of anterior cruciate
Lateral wall of intercondylar fossa
37
Insertion of posterior cruciate
Medial wall of intercindylar fossa
38
Triad of knee soft tissue injury
Anterior cruciate Tibial (medial) collateral Medial meniscus
39
Borders of the popliteal fossa
Lateral upper: biceps femoris Medial upper: semimembranosus and semitendinosus Lateral lower: gastrocnemius and plantaris Medial lower: gastrocnemius
40
Deepest structure in the popliteal fossa
Popliteal artery --> popliteal vein --> Tibial nerve most superficial
41
Contents of the popliteal fossa
Popliteal artery Popliteal vein Tibial nerve Common fibular nerve
42
Structures in the roof of the popliteal fossa
Short saphenous vein Posterior cutaneous nerve of the thigh
43
Superficial group of posterior leg
Gastrocnemius Plantaris Soleus All insert on calcaneal tendon All innervated by tibial nerve
44
Blood supply to soleus, gastrocnemius and plantaris
Sural arteries Branches of popliteal artery
45
Path of popliteal artery
Passes into posterior compartment between gastrocnemius and popliteus Passes under tendinous arch of soleus Immediately divides into anterior tibial and posterior tibial
46
Branches of the posterior tibial artery
Circumflex fibular artery -Passes laterally through soleus muscle and around neck of fibula to connect with anastomotic network for knee Fibular artery -Parallels the course of the tibial artery but descends on lateral side of posterior compartment
47
Muscles of the lateral compartment of the leg
Fibularis (peroneus) longus Fibularis (peronesu) brevis Both evert foot Both are innervated by the suprtifical fibular nerve which is a branch of the common fibular nerve
48
Stucture running through gap in proximal peroneus | (fibularis) longus muscle
Common fibular nerve
49
Path of fibularis longus muscle
Passes posterior to lateral malleolus in shallow bony groove Swings froward to enter lateral side of foot Descends obliquely down the lateral side of the foot where it curves forward under a bony tubercle (fibular trochlea) Enters deep groove in cuboid Attaches to inferior surface of metatarsal I and medial cuneiform
50
Muscles of the anterior compartment of the leg
Tibialis anterior Extensor hallucis longus Extensor digitroum longus Peroneus tertius All innervated by the deep fibular nerve Dorsiflex foot, invert foot, extend toes
51
Deep fibular nerve
Branch of common fibular nerve Supplies anterior compartment of leg before passing into foot ``` Innervates: Anterior compartment Anterior tibialis Extensor digitorum longus Extensor hallucis longus Peroneus tertius ``` Foot Extensor digitorum brevis First two dorsal interossei Skin web between first and second toes
52
Fracture of the neck of the talus
Lead to osteonecrosis of body and posterior talus Branch of posterior tibial artery through tarsal canal
53
Four parts of the deltoid ligament
= MEDIAL Ligament Tibionavicular ligament -Tibia --> tuberosity of the navicular bone and associated calcaneonavicular ligament (spring) Tibiocalcaneal ligament -Tibia --> substentaculum tali of calcaneus Anterior tibiotalar ligament - Deep to tibionavicular and tibiocalcaneal - Tibia --> medial surface of talus Posterior tibiotalar ligament - Tibia --> medial tuberosity and medial side of talus
54
Lateral ligaments of the ankle
Three separate ligaments Anterior talofibular ligament -Anterior margin of fibular --> adjacent talus Posterior talofibular ligament - Runs horizontally backward and medially from the mallolar fossa on medial side of lateral malleous - -> posterior process of talus Calcaneoifibular ligament -Malleolar fossa --> inferiorly to tubercle on lateral calcaneus
55
Transverse tarsal joint
Composed of Talocalcaneonavicular joint AND Calcaneocuboid joint
56
Components of acetabulum
1/5th pubis 2/5th ischium 2/5th ilium
57
Sacral hiatus
Terminal point of vertebral canal Transmits 5th sacral nerve (only 4 sacral foramina)
58
Termination of dural sheath
Distally at second piece of sacrum Beyond this, the sacral canal continues as the extradural space, caudal equina and filum terminale
59
Gluteus maximumus muscle
O: Ilium above and behind posterior gluteal line] Sacrum and coccyx Sacrotuberous ligaments I: Iliotibial tract =3/4 Gluteal tuberosity of the femur =1/4 Innervated by inferior gluteal nerve L5, S1, S2 Actions: Extends hip Lateral rotator of thigh Tenses fascia lata around knee joint
60
Anatomical points of gluteus maximumus
Only capable of gross movements Covers posterior gluteus medius Covers all short muscles of the hip, sciatic nerve, proximal hamstrings, both sciatic foramen, Lower border overlaps ischial tuberosity on standing but not on sitting Overlaps sacrotuberous ligament Lower border does not make up gluteal fold, formed by the posterior horizontal skin crease of the hip joint
61
Origin and insertion gluteus medius
O: Outer surface of ilium between anterior and posterior gluteal lines I: Lateral side of greater trochanter
62
Origin and insertion gluteus minimus
O: Outer aspect of ilium between anterior and inferior gluteal lines I: Anterior aspect of greater trochanter
63
Boundaries of greater sciatic foramen
Superior and anterior: greater sciatic notch Posterior: sacrotuberous ligament Inferior: sacrospinous ligament and ischial spine
64
Structures passing through greater sciatic foramen
ABOVE piriformis - Superior gluteal vessels - Superior gluteal nerves PIRIFORMIS BELOW piriformis - Inferior gluteal vessels - Inferior gluteal nerves - Internal pudendal vessels - Internal pudendal nerve - Sciatic nerve - Posterior cutaneous nerve of the thigh - Nerve to quadratus femoris - Nerve to obturator internus
65
Boundaries of the lesser sciatic foramen
Above: sacrospinous ligament Anterior: body of ischium Posterior: sacrotuberous ligament
66
Structures passing through lesser sciatic foramen
Tendon of obturator internus Nerve to obturator internus Internal pudendal vessels Pudendal nerve
67
Surface markings of sciatic nerve
Curved line joining: -midpoint between posterior superior iliac spine and ischial tuberosity AND -midpoint between ischial tuberosity and greater trochanter
68
Lateral patella dislocation
Larger lateral condyle normally prevents this If underdeveloped lateral condyle --> recurrent patella dislocations
69
Shaft of tibia
Subcutaneous anteriorly - most common fractured long bone
70
Fibres of lower limb interosseous membrane
Run down and medially towards tibia from fibular
71
Damage to common peroneal nerve
= foot drop
72
Proximal row tarsal bones
Talus Calcaneum Navicular bone
73
Distal row of tarsal bones
Cuboid bone Three cuneiform bones
74
Boundaries of femoral ring
Anterior: inguinal ligament Medial: lacunar ligament Posterior: pectineal ligament Laterally: femoral vein
75
Boundaires of femoral triangle
Superior: inguinal ligament Medial: medial part of adductor magnus Lateral: sartorius Roof: skin, superficial fascia, great saphenous vein, deep fascia (fascia lata), cribriform fascia Floor: iliacus, psoas major tendon, pectineus, adductor longus
76
Contents femoral TRIANGLE
``` Femoral canal Femroal vein Femoral artery Femoral nerve Deep inguinal lymph nodes ```
77
Boundaries of femoral sheath
Anteriorly: continuation of transversalis fascia Posterior: fascia of ilaicus Contains: medial: femoral canal middle: femoral vein lateral: femoral artery DOES NOT CONTAIN NERVE
78
Contents of femoral canal
Medial compartment of the femoral sheath Entered via the femoral ring Contains fat and lymph nodes (Cloquet’s node).
79
Adductor canal boundaries
Passes from apex of femoral triangle --> popliteal fossa Posterior: adductor longus and magnus Anteromedially: sartorius Anterolaterally: vastus medialis
80
Contents of adductor canal
Superfical femoral artery Superficial femoral vein (behind artery) Saphenous nerve
81
Branches of femoral artery
Superficial epigastric artery Superficial circumflex iliac artery Superficial external pudendal artery Deep external pudendal artery Profunda femoris artery
82
Profunda femoris artery
Branches from femroal artery 5cm inferior to inguinal ligament --> posterolaterally Passes on iliacus, psoas, pectineus, adductor brevis and magnus --> adductor longus passes over it Separated from femoral artery by femoral vein and profunda veins and adductor longus. Terminates in the lower third of the thigh by perforating adductor magnus. Branches include: - lateral circumflex artery - medial circumflex artery - four perforating branches
83
Branches of popliteal artery
- Geniculate to the knee joint - Tibioperoneal trunk: posterior tibial artery + peroneal artery - Anterior tibial artery
84
Branches of posterior tibial artery
Terminal branch of popliteal artery --> branch of tibioperoneal trunk Major branch: peroneal atery = lateral compartment -2.5cm below popliteus Lower third lies superficial between medial border of tendo calcaneus and medial border of tibia Extends to lower margin of flexor retinaculum Divides: - -> medial plantar artery - -> lateral plantar artery
85
Orientation of tibial nerve and and posterior tibial artery
Tibial nerve is at first medial to posterior tibial artery at distal fibula But crosses posteriorly to reach lateral side
86
Anterior tibial artery
Terminal branch of popliteal artery Lies deep on interosseuous membrane Emerges superifically between tendons of extensor hallucis longus and tibialis anterior --> crossed superficially by tendon of extensor hallucis longus just proximal to ankle joint Branches - -> small collaterals to knee - -> dorsalis pedis (then anastomose with lateral plantar artery to form plantar arch)
87
Palpation of femoral artery
Mindinguinal point
88
Saphenous opening
4 cm inferolateral to the pubic tubercle
89
Tributaries to great saphenous vein
Superficial epigastric vein Superficial circumflex iliac vein Superficial external pudendal vein Lateral accessory vein - midthigh
90
Nerurovascular supply to anterior compartment of leg
All muscles supplied by deep peroneal nerve Anterior tibial artery
91
Neurovascular supply to posterior compartment of leg
All muscles supplied by tibial nerve Posterior tibial artery
92
Neurovascular supply to peroneal/lateral compartment of leg
All muscles suplied by superficial peroneal nerve Peroneal artery
93
Lumbar plexus
L1 - L4 (with contribution form T12) Formed in substance of psoas major Trunkes emerge from lateral border of psoas major -exception of obtruator nerve medially and genitofemoral nerve anteriorly
94
Principle branches of lumbar plexus
Femoral nerve Obturator nerve Ilioinguinal nerve Lateral cutaneous nerve of thigh Genitofemoral nerve
95
Femoral nerve
L2 - L4 Emerges from lateral aspect of psoas major Passes under inguinal ligament an dlies lateral to femoral artery in femoral triangle -5cm below inguinal ligament --> termianl branches Muscular: - quadriceps - satrorius - pectineus Cutaneous: - medial cutaneous nerve of thigh - intermediate cutaneous nerve of thigh - saphenous nerve Articular branches to hip and knee
96
Obturator nerve
L2 - L4 Emerges medial aspect of psoas major, only lumbar plexus nerve to do so Runs deep to internal iliac vessels --> upper part of obturator foramen Enters the thigh through the obturator foramen with obturator vessels Anterior branch: - gracillis - adductor longus - addductor brevis - skin over medial aspect of thigh and hip joint Posterior branch: passes through obturator externus - adductor magnus - obtruator externus - knee joint - +/- adductor brevis
97
Meralgia paraesthetica
Pressure of inguinal ligament on laternal cutaneous nerve of the thigh Branch from lumbar plexus, descends deep to inguinal ligament
98
Genitofemoral nerve
L1 and L2 Formed in psoas major, emerges anteriorly - only nerve to do so Runs inferiorly passing posteriorly to the ureter Divides into genital and femoral branches Male : the genital branch enters the deep inguinal ring in company with the vas deferens and supplies the cremaster muscle --> emerging from the superficial inguinal ring, it supplies the skin of the scrotum Female: ends in supplying the skin of the labium majus --> femoral branch passes deep to the inguinal ligament within the femoral sheath to supply the skin just inferior to the ligament
99
Sacral plexus
L4 -L5 S1 - S4 Sacral nerves emerge anterior sacral foramina and unite in front of piriformis --> joined by lumbosacral trunk (L4, 5) Branches - Piriformis - Obturator internus - Quadrate femoris - Gemelli Superior gluteal nerve Inferior gluteal nerve Pudendal nerve Sciatic nerve
100
Superior gluteal nerve
L4, L5 and S1 Passes out of the greater sciatic foramen above piriformis. Accompanies superior gluteal vessels. Supplies: - gluteus medius - gluteus minimus - tensor fascia lata
101
Inferior gluteal nerve
L5 S1 and S2 Passes out of the pelvis below piriformis Supplies gluteus maximus
102
Branches of pudendal nerve
Inferior rectal Perineal Dorsal nerve of penis
103
Pudendal nerve
S2 - S4 Passes out of greater sciatic foramen between priformis and coccygeus --> medial to sciatic nerve Winds over sacrospinous ligament medial to internal pudendal artery Re-enters pelvis through lesser sciatic foramen Enters pudendal canal in obturator fascia
104
Sciatic nerve
L4 - S3 Nerve emerges from the greater sciatic foramen below piriformis Covered by gluteus maximus Crosses posterior surface of ischium Descends on adductor magnus lying deep to the hamstrings Crossed by the long head of biceps femoris Divides into tibial nerve and common peroneal nerve The level of division is variable and the nerves may be separate entities even at their origin from the sacral plexus.
105
Branches of sciatic nerve
Muscular - semitendinosus - semimebranosus - biceps femoris - part of adductor magnus Tibial nerve Common peroneal nerve
106
Branches of tibial nerve
L4 - S3 Popliteal fossa - gastrocnemius - popliteus - soleus - sural nerve Leg - flexor hallucis longus - flexor digitorum longus - tibialis posterior - intrinsic muscles of the foot Cutaneous - skin of the sole of the foot - lateral plantar nerve supplies lateral part and lateral one and a half toes - medial plantar nerve supplies medial half and medial three and a half toes
107
Common peroneal nerve
Root value L4 - S2 Smaller terminal branch of sciatic nerve Enters popliteal fossa lateral to tibial nerve Passes along medial border of biceps tendon. Winds round neck of fibula deep to peroneus longus, where it divides into superficial and deep peroneal nerves
108
Deep peroneal nerve
Branch of common peroneal nerve Pierces extensor digitorum longus Descends with anterior tibial arteyr over anterior interosseous membrane Branches - tibilias anterior - extensor hallucis longus - extensor digitorum longus - extensor digitorum brevis - peroneus tertius Cutaneous:to the skin of the web space between first and second toes.
109
Superficial peroneal nerve
Muscular: - peroneus longus - peroneus brevis Cutaneous: - distal two-thirds of the lateral aspect of the leg, - dorsum of the foot (except the first web space)
110
Ankle reflex
S1 Gastrocnemius Sciatic nerve, tibial nerve branch
111
Knee reflex
L3 / L4 Quadriceps via femoral nerve
112
Strangulated obturator hernia
Pressure effect on obturator nerve --> pain on proximal medial thigh Obstructed symptoms
113
Arteria comitans nervi ischiadici
Nerve running in sciatic nerve itself Must be isolated and ligated separately in Above knee amputation
114
Proximal sciatic nerve injury
Hamstring function lost All muscles to lower leg lost Sensation to lower leg lost with exception of saphenous nerve (branch of femoral) - i.e. over medial malleolus and medial border of foot to great toe
115
Loss of active plantarflexion. | Loss of sensation over the sole of the foot.
Tibial nerve injury
116
Common peroneal nerve
Failure of dorsiflexion owing to paralysis of anterior compartment muscles -deep peroneal nerve Failure of eversion owing to paralysis of lateral compartment muscles -superficial peroneal nerve
117
Iliofemoral ligament
Strongest of the acetabular ligaments Inverted Y O: Anterior inferior iliac spine Bifurcates and inserts on each end of trochanteric line
118
Ischiofemoral ligament
Posterior ligament of acetabulum Base of ischium --> base of greater trochanter
119
Pubofemoral ligament
Medial aspect of acetabulum Ilio pubic junction --> medial aspect of capsule
120
Muscles causing flexion of hip
iliacus, psoas major, rectus femoris, sartorius, | pectineus
121
Muscles causing extension of hip
gluteus maximus, biceps, semimembranosus, | semitendinosus
122
Muscles causing ADduction of hip
adductor longus, adductor brevis, adductor | magnus, gracilis, pectineus
123
Muscles causing ABduction of hip
gluteus medius, gluteus minimus, tensor | fasciae latae
124
Muscles causing lateral rotation of hip
``` gluteus maximus (chiefly), obturator internus, obturator externus, gemelli, quadratus femoris ```
125
Muscles causing medial rotation of hip
tensor fasciae latae, anterior fibres | of gluteus medius and gluteus minimus
126
Lateral approach to the hip
Split fibres of: - tensor fascia latae - gluteus medius - gluteus minimus
127
Anterior approach to hip
Between gluteus medius and minimus laterally and sartorius medially Reflected head of rectus femoris is then divided to expose the anterior aspect of the hip joint
128
Posterior approach to hip
Through an angled incision commencing at the posterior superior iliac spine passing to the greater trochanter descending downwards Gluteus maximus is split in the line of its fibres and incised along its tendinous insertion. Gluteus medius and gluteus minimus are detached from their insertions into the greater trochanter
129
Insertion of poplietus
Popliteus inserts on posterior aspect of LATERAL cartilage menisci
130
Lateral ligaments of ankle joint
Anterior talofibular Calcaneofibular Posterior talofibular
131
Medial ligament of the ankle joint
Medial triangular
132
Subtalar joint
Inversion: tibialis anterior and posterior -aided by extensor hallucis longus and flexor hallucis longus Eversion: perneus longus and brevis
133
Arches of the foot
Two longituidnal: medial and lateral One transverse Medial longitudinal arch -calcaneum, talus, navicular, three cuneiform, medial three metatarsals Lateral longitudinal arch -calcaneum, cuboid, lateral two metatarsals Transverse -bases of metatarsals
134
Medial longituindal arch
Calcaneum, talus, navicular, three cuneiforms, medial trhee metatarsals Muscular: - flexor hallucis longus - flexor digitorum longus - tibialis anterior - tibialis posterior - flexor digitorum brevis Ligaments - spring ligament - interosseous ligaments
135
Medial longituindal arch support
Calcaneum, talus, navicular, three cuneiforms, medial trhee metatarsals Muscular: - flexor hallucis longus - flexor digitorum longus - tibialis anterior - tibialis posterior - flexor digitorum brevis Ligaments - spring ligament - interosseous ligaments
136
Lateral longitudinal arch support
Calcaneum, cuboid, lateral two metatarsals Muscular - peroneus longus - flexor digitorum longus ot 4th and 5th toes - flexor digitorum brevis Ligaments: - long plantar ligament - short plantar ligament
137
Transverse arch support
Muscular: peroneus longus Ligaments: interosseous
138
Short planater ligament
Plantar surface of calcaneum --> Cuboid
139
Long plantar ligament
Calcaneum --> base of 2nd, 3rd, and 4th metatarsals Covers short plantar ligament Forms a tunnel for peroneus longus with the cuboid bone
140
Spring ligament
Sustentaculum tali of calcaneum ---> tuberosity of navicualr
141
Components of extensor retinaculum
Superior extensor retinaculum - thickening of deep fascia in distal leg - attached to anterior borders of tibia and fibula Inferior extensor retinaculum - y-shaped - calcaneus --> medial plantar aponeurosis + medial malleolus
142
Structures passing under extensor retinaculum
Extensor digitorum longus Extensor hallucis longus Dorsalis pedis Tibialis anterior Peroneus Tertius
143
Peroneal retinaculum
/fibular retinacula Superior fibular retinaculum -lateral malleolus --> calcaneum Inferior retinaculum -lateral calcaneum --> fibular notch