MSK 23 - Posterior compartment of leg and popliteal fossa

Question 1

what is the popliteal fossa

Answer 1

diamond shaped space behind the knee where structures pass through on their way from the thigh to the leg and foot

Question 2

what are the margins of the popliteal fossa

lateral, medial and inferior

Answer 2

biceps femoris (lateral)
semimembranosus and semitendinosus (medial)
medial and lateral heads of gastrocnemius (inferior)

Question 3

what 4 structures run in the popliteal fossa

Answer 3

popliteal artery and vein

tibial nerve

common peroneal nerves

Question 4

name the contents of the popliteal fossa from deep to superficial - 4 structures

Answer 4

knee joint capsule
popliteal artery
popliteal vein
tibial nerve

Question 5

of the vessels and nerves which is the deepest structure in the popliteal fossa

Answer 5

the popliteal artery

Question 6

which is the most medial structure in the popliteal fossa

Answer 6

popliteal artery

Question 7

what is the path of the femoral artery down the leg

Answer 7

goes down the anterior part of the leg

passes through adductor hiatus

becomes popliteal artery in posterior of leg

Question 8

the common peroneal/fibula nerve follows which tendon into which compartment

Answer 8

follows biceps tendon

into lateral compartment

Question 9

what structure does the common peroneal/fibula nerve loop around as it passes into the lateral compartment

Answer 9

fibula head

Question 10

the superficial branch of the tibial nerve exits the popliteal fossa and travels down which part of the leg associated with which muscle to become the sural nerve

Answer 10

travels down posterior aspect of leg on gastrocnemius

Question 11

the superficial branch of the tibial nerve is which nerve

Answer 11

sural nerve

Question 12

apart from the tibial nerve which nerve also gives a branch to the sural nerve

Answer 12

common peroneal nerve

Question 13

what does the sural nerve innervate

Answer 13

cutaneous

provides sensation over the skin of back of the calf

Question 14

the sural nerve runs with which vessel

Answer 14

small saphenous vein

Question 15

what nerves form the sural nerve

Answer 15

tibial and some common peroneal

Question 16

the saphenous nerve runs with which vessel

Answer 16

the great saphenous vein

Question 17

the saphenous nerve branches off which nerve

Answer 17

femoral nerve

Question 18

what does the saphenous nerve innervate

Answer 18

cutaneous

part of the skin of the medial calf

Question 19

what is the path of the great saphenous vein down the leg

Answer 19

runs down medial side of leg and joints femoral vein through gap in the fascia lata

Question 20

what structures are at risk in a posterior knee dislocations

Answer 20

neurovascular structures

popliteal artery, vein and the tibial and common fibular nerves

Question 21

what could happen when the posterior knee dislocation damages the neurovascular structures on the posterior knee

Answer 21

leg could become ischaemic and lose your leg

Question 22

what are the 3 compartments of the leg

Answer 22

anterior
lateral
posterior (superficial and deep)

Question 23

what are the 2 sub compartments in the posterior compartment of the leg

Answer 23

superficial and deep

Question 24

all the muscles in the posterior compartment are innervated by which nerve

Answer 24

tibial nerve

Question 25

what are the 3 superficial muscles of the leg's posterior compartment

Answer 25

gastrocnemius soleus plantaris

Question 26

what is the origin and insertion of gastrocnemius

Answer 26

origin = medial condyle of femur (medial head) and lateral condyle of femur (lateral head) insertion = calcaneus via Achillies tendon

Question 27

what is the action of gastrocnemius

Answer 27

plantarflex ankle flex knee

Question 28

what is the innervation of gastrocnemius

Answer 28

tibial nerve

Question 29

which is the most superficial muscle in the legs posterior compartment

Answer 29

gastrocnemius

Question 30

what is the origin and insertion of soleus

Answer 30

origin = superior 1/3 posterior fibula and posterior tibia insertion = calcaneus via achilles tendon

Question 31

what is the action of soleus

Answer 31

plantarflex ankle

Question 32

what is the innervation of soleus

Answer 32

tibial nerve

Question 33

what is the origin and insertion of plantaris

Answer 33

origin = superior to lateral head of gastrocnemius insertion = calcaneus via achilles tendon

Question 34

what is the action of planataris

Answer 34

plantarflex ankle

Question 35

what is the innervation of plantaris

Answer 35

tibial nerve

Question 36

why is plantaris good for tendon grafts

Answer 36

because the muscle is very small with a very long tendon

Question 37

what are the 4 deep muscles of the leg's posterior compartment

Answer 37

tibialis posterior flexor digitorum longus flexor hallucis longus popliteus

Question 38

what nerve innervates the 4 deep muscles of the leg's posterior compartment

Answer 38

tibial nerve

Question 39

what is the origin and insertion of the tibialis posterior

Answer 39

origin = posterior proximal tibia and fibula and interosseous membrane insertion = navicular tuberosity, medial cuneiform and all bones of mid and hind foot

Question 40

what bone does the tibialis posterior tendon pass around in the foot

Answer 40

medial malleolus

Question 41

what is the action of tibialis posterior - 2 movements and one other thing

Answer 41

plantarflexes foot inverts foot reinforces arch of foot

Question 42

what is the origin and insertion of the flexor digitorum longus

Answer 42

origin = mid half of tibia insertion = distal 4 lateral phalanges (4 toes NOT the big toe)

Question 43

what bone does the flexor digitorum longus tendon pass around in the foot

Answer 43

medial malleolus

Question 44

what is the action of the flexor digitorum longus - 2 movements and one other thing

Answer 44

flexes toes plantarflexes ankle reinforces arches of the foot

Question 45

what is the innervation of tibialis posterior

Answer 45

tibial nerve

Question 46

what is the innervation of flexor digitorum longus

Answer 46

tibial nerve

Question 47

what is the innervation of flexor hallucis longus

Answer 47

tibial nerve

Question 48

what is the innervation of popliteus

Answer 48

tibial nerve

Question 49

what is the origin and insertion of flexor hallucis longus

Answer 49

origin = inferior 2/3 of fibula and interosseous membrane insertion = distal phalanx great toe

Question 50

what is the action of flexor hallucis longus - 2 movements and one other thing

Answer 50

flexes great toe plantarflexes ankle reinforces arch of foot

Question 51

what is the innervation of popliteus

Answer 51

tibial nerve

Question 52

what is the origin and insertion of popliteus

Answer 52

origin = medial proximal tibia insertion = lateral femoral condyle

Question 53

what is the action of popliteus - one movement and one other thing

Answer 53

medially rotates tibia reinforces knee joint laterally

Question 54

where does the femoral artery enter the popliteal fossa

Answer 54

behind the knee

Question 55

what does the femoral artery become when it passes behind the knee

Answer 55

popliteal artery

Question 56

after the popliteal artery exists the fossa inferiorly it trifurcates into what 3 vessels

Answer 56

anterior tibial artery posterior tibial artery peroneal/fibular artery

Question 57

what does the anterior tibial artery go on to become

Answer 57

the dorsalis pedis artery

Question 58

what is the spatial orientation and path of the anterior tibial artery that makes it easier to identify

Answer 58

most lateral artery has 90 degree bend

Question 59

the posterior tibial artery travels around what bone

Answer 59

goes around the medial malleolus

Question 60

the posterior tibial artery travels between what compartments

Answer 60

superficial and deep compartments

Question 61

what nerve and vein accompanies the posterior tibial artery

Answer 61

the tibial nerve and tibial vein NOT the post tibial vein!!

Question 62

the posterior tibial artery divides into which 2 terminal branches

Answer 62

medial and lateral plantar arteries

Question 63

where are the medial and lateral plantar arteries located

Answer 63

in the sole of the foot

Question 64

where does the posterior tibial artery divides into its 2 terminal branches

Answer 64

at the foot

Question 65

the tibial nerve travels with which vessels

Answer 65

posterior tibial artery and vein

Question 66

where do the posterior tibial artery and nerve go

Answer 66

into the foot

Question 67

what is the path of the common peroneal nerve - what muscle does it travel along with and where does it end up

Answer 67

goes lateral along with bicep femoris around head of fibula to the anterior and lateral leg compartments

Question 68

where is the tarsal tunnel

Answer 68

between medial malleolus and calcaneus

Question 69

what structures run in the tarsal tunnel - 6 structures

Answer 69

tibialis posterior flexor digitorum longus posterior tibial artery posterior tibial vein tibial nerve flexor hallucis longus

Question 70

what is significant about the way flexor hallucis longus travels

Answer 70

it crosses other tendons in the tarsal tunnel

Question 71

where can the Achilles tendon commonly snap - 3 places

Answer 71

at the musculotendinous junction within tendon itself where tendon attaches to calcaneus

Question 72

what are the 3 key points in the clinical presentation of achilles tendon injuries

Answer 72

like kicked in back of leg audible snap inability to push off - due to loss of plantarflexion

Question 73

if achilles tendon rupture occurs what position are they casted in when managed conservatively and why is this

Answer 73

casted in equinous position - plantaflexion tendon isnt being stretched so closer together to heal faster

Question 74

what is the fabella and where is it located

Answer 74

sesamoid bone in tendon of lateral head of gastrocnemius

Question 75

what is venous thrombosis

Answer 75

formation of blood clots in deep leg veins

Question 76

when does venous thrombosis occur

Answer 76

slow blood flow increased coagulability damage to epithelium

Question 77

what veins have valves in the legs and how do they work

Answer 77

deep veins have valves muscle contracts and squashes vein pressure increase causes veins to open and blood flow only goes one way if competent valves