Module 9 - Leg Flashcards
What is the organization of the crural fascia?
- synonymous with ante brachial fascia of forearm
- has 3 crural intermuscular septa
anterior: separtates anterior and lateral compartments
posterior: separates lateral and posterior compartments
transverse: separates supererficial and deep posterior compartments
What are the attachments and functions of the superior extensor retinaculum?
- extends from distal tibia to distal fibula
- holds anterior compartment tendons in place (EDL, EHL, TA)
What are the functions and attachments of the inferior extensor retinaculum?
- holds anterior compartment tendons in place (EDL, EHL, TA)
- extends from calcaneus to navicular bone and medial malleolus
What are the functions and attachments of the superior fibular retinaculum?
- prevents movement of lateral compartment tendons (FL, FB)
- extends from lateral malleolus to calcaneus
What are the functions and attachments of the inferior fibular retinaculum?
- prevents movement of lateral compartment tendons (FL, FB)
- extends from inferior extensor retinaculum to calcaneus
What are the functions and attachments of the flexor retinaculum?
- extends from medial malleolus to calcaneus, forming tarsal tunnel
- hold and maintain posterior compartment tendons
Where does the popliteal artery bifurcate?
- at the popliteus muscle into anterior tibial and posterior tibial arteries
What are the compartments of the leg?
- anterior
- lateral
- posterior superficial
-posterior deep
What are the contents, actions, blood supply, and innervation of the anterior compartment of the leg?
content
- tibialis anterior
- extensor hallucis longus
- extensor digitorum longus
- fibularis tertius
action
- dorsiflexion, inversion, toe extension
- ankle eversion if fibularis tertius is isolated
innervation
- deep fibular nerve
blood supply
- anterior tibial artery
What are the contents, actions, innervation, and blood supply of the lateral compartment of the leg?
content
- fibularis longus
- fibularis brevis
action
- eversion
- plantarflexion
(tendons posterior to fibula)
innervation
- superficial fibular nerve
blood supply
- fibular artery
What are the contents, actions, innervation, and blood supply of the posterior-superficial compartment of the leg?
content
- gastrocnemius
- soleus
- plantaris
actions
- plantar flexion
- knee flexion (weak)
innervation
- tibial nerve
blood supply
- posterior tibial artery
What are the contents, actions, innervation, and blood supply of the posterior-deep compartment of the leg?
content
- popliteus
- flexor digitorum longus
- flexor hallucis longus
- tibialis posterior
actions
- plantar flexion
- inversion
- toe flexion
- knee flexion
innervation
- tibial nerve
blood supply
- posterior tibial artery
What are the anterior crural muscles?
- extensor digitorum longus
- extensor hallucis longus
- fibularis tertius
- tibialis anterior
What are the OIANs of extensor digitorum longus?
origin: lateral tibial condyle, proximal 3/4th of the fibula and crural interosseous membrane
insert: dorsal digital expansions of toes 2-5
action: dorsiflexion, extend digits 2-5 (IP & MP)
innervation: deep fibular nerve (L4-5, S1)
What are the OIANs of extensor hallucis longus?
origin: middle 1/2 of the fibular surface and crural interosseous membrane
insert: distal phalangeal base of the 1st toe
action: dorsiflexion, extend great toe (MP & IP)
innervation: deep fibular nerve (L4-5, S1)
What are the OIANs of fibularis tertius?
origin: distal fibula and crural interosseous membrane
insert: base of the 5th metarsal
action: dorsiflexion, evert foot
innervation: deep fibular nerve (L4-5, S1)
What are the OIANs of the tibialis anterior?
origin: lateral condyle and proximal 2/3 of the tibia’s lateral surface and crural interosseous membrane
insert: medial cuneiform and adjacent 1st metatarsal
action: dorsiflex ankle, invert foot
innervation: deep fibular nerve (L4-5, S1)
What are the spinal level innervations of the anterior crural muscles?
deep fibular n: L4-5, S1
What are the lateral crural muscles?
- fibularis longus and brevis
What are the OIANs of fibularis longus?
origin: head of the proximal 2/3 of the fibula
insert: lateral aspects of the 1st metatarsal and adjacent medial cuneiform
action: evert foot, plantar flexion, and depresses 1st metatarsal head
innervation: superficial fibular nerve (L4-5, S1)
What are the OIANs of the fibularis brevis muscle?
origin: distal 2/3 of the fibula
insert: lateral base of 5th metatarsal
action: evert foot, plantar flexion
innervation: superficial fibular nerve (L4-5, S1)
What are the posterior crural muscles?
- flexor digitorum longus
- flexor hallucis longus
- gastrocnemius
- planteris
- popliteus
- soleus
- tibialis posterior
What are the OIANs of flexor digitorum longus?
origin: posterior tibia distal to the soleal line
insert: plantar surface of the distal phalangeal bases
action: plantar flexion, flex digits 2-5 (MP & IP)
innervation: tibial nerve (L5-S1-2)
What are the OIANs of flexor hallucis longus?
origin: distal 2/3 of the posterior fibular surface and crural interosseous membrane
insert: plantar aspect of the distal phalangeal base of 1st toe
action: plantarflexion, flex great toe (MP & IP)
innervation: tibial nerve (L5, S1-2)
What are the OIANs of gastrocnemius?
origin: posterior aspect of the femoral condyles and joint capsules
insert: posterior calcanea surface
action: flexes knee, plantar flexion
nerve: tibial (S1-2)
What are the OIANs of plantaris?
origin: lateral supracondylar line
insert: posterior calcanea surface
action: flexes knee and plantar flexion
nerve: tibial nerve (L4-5, S1)
What are the OIANs of popliteus?
origin: lateral femoral condyle and oblique popliteal ligament
insert: soleal line of tibia
action: in NWB, medial rotation of tibia and knee flexion; in WB insertion is fixed: lateral rotation of femur and knee flexion; unlocks knee from extension into early flexion
nerve: tibial nerve (L4-5-S1)
What are the OIANs of the soleus?
origin: posterior aspect of the head and proximal 1/4 of the fibula and tibial soleal line
insert: posterior calcaneal surface
action: plantar flexion
nerve: tibial nerve (L5-S1-2)
What are the OIANs of the tibialis posterior muscle?
origin: crural interosseous membrane, lateral surface and medial fibular surface
insert: navicular, medial, intermediate cuneiforms and bases of metatarsals 2-4
actions: invert fot and plantarflex
nerve: tibial nerve (L4-5-S1)
What is the path taken by the commonfibular nerve?
- deep to proximal fibularis longus, curves lateral to neck of fibula, splits deep to fibularis longus
What is the path taken by the superficial fibular nerve?
- begins bifurcation of common fib n
- supplies fibularis longus and brevis
- emerges as cutaneous branch
What is the path taken by the deep fibular nerve?
- approaches interosseous membrane
- between tibialis anterior and extensor hallucis longus
- descends with anterior tivital artery
What is the path taken by the tibial nerve?
- joins popliteal v. and a.
- continues with posterior tibial artery
- gives off sural nerve
- splits into lateral and medial plantar n in foot
What are the ligaments of the crural region?
- interosseous membrane
- talocrural fibrous capsule
- medial collateral (deltoid)
- lateral ligaments
What are the attachments of the crural interosseous membrane?
- from interosseous border of the tibia to the interosseous border of the fibula
What are the attachments of the talocrural fibrous capsule?
- from the borders of the articular surfaces of tibia and malleoli to the margins of the trochlear surface of the talus
What are the attachments and functions of the medial collateral (deltoid) ligament of the ankle?
- from the medial malleolus to the talus, navicular and sustentaculum tali of the calcaneous
- stablize joint and resists forced eversion
What is the function of the lateral ligaments of the ankle?
stablize joint and resist inversion
What are the lateral ligaments of the ankle?
- posterior talofibular
- calcaneofibular
- lateral talocalcaneal
- anterior talofibular
