Mod 3: Lecture 4 - Leg, Ankle, and Foot

Question 1

Foot Osteology

Answer 1

• Talus
• Calcaneus
• Cuboid - tarsal in front of the calcaneus
• Navicular - tarsal in front of the talus, above the cuboid

Question 2

Talocural Joint

Answer 2

• stability and mobility
• between fibula/tibia and the talus
• — inferior surface of tibia and the medial and lateral malleolus
• — superior, lateral, and medial sides of the trochlea (scroll-like) on the top of the talus
• synovial hinge type
• — dorsiflexion/plantar flexion of the foot
• Proximal Portion
• — concave distal tibia
• — concave distal fibula
• Distal Component
• — convex dome of talus

Question 3

Subtalar Joint

Answer 3

• stability and mobility
• between the talus and calcaneus
• — the talus sits on the calcaneus
• Proximal Portion
• — inferior aspect of talus
• Distal Component
• — superior aspect of calcaneus
• Synovial plane type
• — eversion/inversion of the foot
• — foot rotates as calcaneus glides against talus

Question 4

Ligaments of the ankle

Answer 4

• many ligaments stabilize and support this joint

Question 5

Plantar Aponeurosis

Answer 5

• protects structures on the sole of the foot
• makes foot rigid
• supports longitudinal arches
• tendon sheet that goes from the ball of the foot to the heel
• — vertical fibers

Question 6

Ligaments Supporting Foot Arches

Answer 6

• Calcaneoavicular: calcaneus to navicular bone
• Long Plantar: calcaneus to 2,3,4th metatarsals
• — runs across the foot longitudinally

Question 7

Anterior and Lateral Leg Compartment

Answer 7

• Tibius Anterior
• Extensor Digitorum Longus
• Peroneus Longus
• Peroneus Brevis
• Extensor Hallicus Longus
• Peroneus Tertius
• all are innervated by the Peroneal Nerve

Question 8

Posterior Compartment

Answer 8

• Gastrocnemius
• Soleus
• Popliteus
• Tibialis Posterior
• Flexor Digitorum Longus
• Flexor Hallicus Longus
• all are innervated by the Tibial Nerve

Question 9

Intrinsic Foot Muscles

Answer 9

• analogous in structure and function to the intrinsic muscles of the hand

Question 10

Lower Extremity Blood Supply

Answer 10

• abdominal aorta is the continuation of the thoracic aorta after it transverses the diaphragm
• abdominal aorta bifurcates at the level of the iliac crests to form the bilateral common iliac arteries

Question 11

Clinical Correlation: femoral artery

Answer 11

• bc the femoral artery is relatively superficial at the femoral triangle, it is important for clinical procedures
• — it may be cannulated just inferior to the midpoint of the inguinal ligament
• left cardial angiography
• angiogram

Question 12

Clinical Correlation: Left Cardial Angiograph

Answer 12

• a long slender catheter is inserted into the femoral artery
• and passed up the external iliac to the common iliac, the aorta, and then the left ventricle of the heart

Question 13

Origin of the Femoral Artery

Answer 13

• at the level of the L5/S1 intervertebral disc
• each common iliac artery —> internal and external iliac
• internal —> superior gluteal, inferior gluteal, and obturator arteries
• as the external iliac passed below the inguinal ligament, its name changes to the femoral artery

Question 13

Clinical Correlation: femoral artery

Answer 13

• bc the femoral artery is relatively superficial at the femoral triangle, it is important for clinical procedures
• — it may be cannulated just inferior to the midpoint of the inguinal ligament
• left cardial angiography
• angiogram

Question 15

Clinical Correlation: Left Cardial Angiography

Answer 15

• a long slender catheter is inserted into the femoral artery
• and passed up the external iliac to the common iliac, the aorta to the left ventricle of the heart

Question 16

Clinical Correlation: Angiogram

Answer 16

• a contrast medium or dye is injected which is visible by X-ray
• the resulting image is referred to as an angiogram

Question 17

Deep Artery of the Thigh

Answer 17

• also called the profunda femoris artery
• arises from the posterolateral aspect of the femoral artery within the femoral triangle
• largest branch of the femoral artery and chief artery of the thigh
• gives off perforating arteries that wrap around the posterior aspect of the femur

Question 18

Popliteal Artery

Answer 18

• after passing through the adductor hiatus, the femoral artery courses into the popliteal fossa on the posterior aspect of the knee as the popliteal artery
• deepest structure in the fossa
• — runs in close proximity to the joint capsule of the knee
• ends in the knee region by dividing into the posterior and anterior tibial arteries

Question 19

Leg Blood Supply

Answer 19

• Posterior
• — popliteal artery –branches-> posterior tibial —> medial plantar and lateral plantar arteries
• — posterior tibial –branches-> fibular (peroneal) artery of the lateral compartment
• Anterior
• — anterior tibial (from the popliteal) —-> dorsalis pedis

Question 20

Foot Blood Supply

Answer 20

• Dorsum (Back) of Foot
• — dorsalis pedis artery
• — terminal branch of the anterior tibial artery
• Plantar (Sole) Surface of Foot
• — medial and lateral plantar arteries
• — terminal branches of the posterior tibial artery

Question 21

Leg Surface Anatomy: anterior view

Answer 21

• Vastus Lateralis: bump to lateral side right above the knee
• Vastus Medialis: bump to the medial side right above the knee
• Tendon of the Quadriceps Femoris: hard, centered directly above the knee
• Patella: knee cap
• Patellar Ligament: hard, directly below the knee cap

Question 22

Leg Surface Anatomy: posterior view

Answer 22

• Popliteal Fossa: back of the knee
• Tendon of Biceps Femoris Muscle: tendon you can feel on the lateral side of the fossa
• Tendon of the Semi-Membranosus Muscle: tendon you can feel on the medial side of the fossa