Lower Limb ORG

Question 1

-Lower limb-Identify major bony landmarks and the muscles that attach

Answer 1

Tibial Tuberosity- Quadriceps femoris
Head of fibula- bicep femoris
Soleal line- popliteus and soleus
Sustentanaculum tali- medial shelf of calcaneus, protects- FHL sits
5th tuberosity of MT- base of 5th fibularis brevis
Sesamoid bones- FH brevis

Question 2

-Where is the common fibular nerve susceptible to damage due to it’s contact with superficial bone?

Answer 2

Neck of fibula. Fx may lacerate. Foot drop- dec dorsiflexion (deep fib branch), loss of innervation top and lateral (eversion superficial branch)

Question 3

Compartments lower limb

Answer 3

Ant. Compartment- A- Ant. Tibial a.
N- Deep Fibular
M- toe Ext, ankle dorsiflexon, foot inversion, weak eversion

Lat. Compartment- A- Branches of fibular a
N- Superficial fibular from (common fibular n)
M- Eversion

Post. Compartment- A- Post. Tibial a
N- Tibia n
M- PF, toe flex, inversion

Question 4

-Where would you feel for the pulse of the dorsalis pedis artery? Where does this artery come from?

Answer 4

Dorsum of foot btwn 1st and 2nd MT, btwn EHL and 1st Tendon of EDL. Branch from Ant. Tibial artery after it passes th malleoli.

Question 5

-Between which layers of the foot are the medial and lateral plantar arteries found? Where do these arteries branch from?

Answer 5

Post tibial artery branches to medial and later plantar arteries (after passing tarsal tunnel)
Med and Lat plantar – live btwn 1 and 2 muscle layers

Question 6

Between which layers of the foot is the plantar arterial arch found? Which arteries contribute to the formation of this arch?

Answer 6

Plantar Arterial arch- btwn 3rd (FDL) and 4th layers (FHB)

Lateral plantar artery (Posterio tibial a) and Deep plantar a. (Dorsalis pedis)

Question 7

-What is a retinaculum (anatomy & function)?

Answer 7

Fibrous crural fascia thickenings tissue to holds tendon in place. Sounds popping

Question 8

-Which retinacula are responsible for holding down the tendons of the anterior compartment? Lateral compartment? Posterior compartment?

Answer 8

Superior and Inferior extensor retinaculum- Ant
Superior and inferior fibular retinaculum- Lat
Flexor Retinaculum- postermedial

Question 9

-What is the plantar aponeurosis? Where is it located? From what does it come from?

Answer 9

Longitudinally arranged bands of dense Ct that extend from calcaneal tub to fibrous digits sheath and prx planx of toes. Creates a closed pack foot to turn foot to one lever, for stability in toe off cycle of gait.
Central thickening of the plantar fascia
Sole of foot
Two intermuscular septa branches to form Med, Lat, and central compartments. Interossous btwn MTs

Question 10

-How many compartments are found in the foot?

Know the innervation and blood supply associated with each compartment

Answer 10

5 compartments; 
Lat- N: A:
Med N: A:
central N: A:
Dorsal N: A:
 Interosseous: N: lateral plantar n. A:

Question 11

-On which toes do the muscles of each compartment act?

Answer 11

Lateral -5th digit
Med- Hallux
Central-2-4- flexors
Dorsal 2-4 extensors, 
Interosseous 2-4 ABD, ADD

Question 12

• How many layers are there in the sole of the foot?

- Between which layers do the neurovascular structures travel?

Answer 12

4 muscle layers

Lateral plantar VAN – Btwn 1-2 joins with deep plantar to form plantar arteria arch
Medial plantar VAN- Btwn 1-2 layers
Plantar arch- Btwn 3-4th layer

Question 13

-What are the actions of the muscles in the interosseous compartment? What is the axis of the foot?

Answer 13

Splay (ADD, ABD)digits 2-4

Mid 2 toe- Movement based off this location

Question 14

-What are the functions of the intrinsic muscles of the foot?

Answer 14

1. Resist GRF the tend to flatten the longitudinal arch as wt is transferred from heel to MT during locomotion
   2.Stabilize foot during push off by maintain the transverse arch
   3Fine motor movements during inversion and eversion during unstable surface stances
   4Proprioception by fixing the foot, or by inc. pressures applied against the ground by parts of sole or toes

Question 15

Describe the extensor expansion, what are it’s three parts? What structures contribute to its formation?

Answer 15

1Extensor tendon attaches to dorsum of foot and expand attahcement to phalanges.
2Extensor hood wraps around MPs. Creates a triangle hood apex creates
(3) splits: 1 Central band attaches to middle px, 2 lateral band on distal px
Intrinsic m. of sole of foot insert into the lateral bands allowing force distribution over dorsum and entire digit.