MSK - Lower Limb 2 Flashcards
what bones compose the leg?
tibia - bigger one
and
fibula - skinny one, lateral
label what u can of the anterior leg
label posterior part of leg bones
How is the tibia and fibula held together?
through interosseous membrane
- joins the interosseous border of the tibia with the interosseous borderof the fibula
- also splits the leg into an anterior and posterior compartment
label this pic first
the interosseous membarne isnt exactly complete, it has some openings, these are..?
opening for anterior tibial vessels
opening for perforating branch of fibular artery
What type of joint at the superior end of the fibula and tibia? (knee) -
plane synovial joint which allows for some sliding in dorsiflexion
what are the 4 ligaments that hold the tibia and fibula together (superiorly and inferiorly)
i swear its easy
superior - ant and post ligament of head of fibula
inferior - ant and post tibiofibular ligament
label a cross section of the leg - muscular compartments
anterior, posterior and lateral (small and is formed by intermuscular septum)
What are the 3 parts that the foot? - what are each part made of !!!
label
What are the divisions of the phalanges?
proximal, middle and distal (hallux only has proximal and distal)
What is the body of the ankle contained by?
medial and lateral malleolus
How many tarsal bones are there?
and what are they?
7
calcaneus, talus, navicular, cuboid, medial cuneiform, middle cuneiform, lateral cuneiform
What is the sustentaculum tali?
groove which runs on the anteromedial portion of the calcaneus
- attaches to tuberosity on 5th toe
What is the Achilles tendon?
calf muscle attachment which will pull up when on tippy toes
What are the 5 ankle and foot joints?
- tibiotalar
- subtalar
- transverse tarsal
- metatarsophalangeal
- interphalangeal
What is the tibiotalar joint and what does it do?
actual ankle joint which does hinge dorsiflexion
What is the subtalar joint and what does it do?
reinforced by talocalcaneal ligaments which do eversion and inversion
What are the 2 types of transverse tarsal joint?
- calcaneocuboid
- talocalcaneonavicular
What is the role of the metatarsophalangeal joint?
flexion, extension, abduction and adduction (then happen together to do circumflexion)
Where does abduction and adduction happen from?
the midline is considered to be the 2nd toe
What is the level of movement in the tallus joint?
- hinge joint => main movement is plantarflexion and dorsiflexion
- the articular surface is narrower posteriorly = joint more unstable when plantar flexed
- plantarflexed position allows for ‘wiggle room’ which allows for eversion/inversion or abduction/adduction
What are the 4 parts of the medial ligament of the ankle joint?
- tibiocalcaneal part
- tibionavicular part
- anterior tibiotalar part
- posterior tibiotalar part
What are the lateral ligaments in the ankle?
- anterior talofibular ligament - clinically important because mostly involved in ankle sprains
- calcaneofibular ligament
- posterior talofibular ligament
An ankle sprain refers to partial or complete tears in the ligaments of the ankle joint. It usually occurs via excessive inversion to a plantarflexed and weight-bearing foot.
label the ligaments on the plantar side of the foot
long plantar ligament, short plantar ligament, plantar calcanonavicular ligament, deltoid ligament
What does the natural arch of the foot allow for?
weight distribution acting as a lever
What are the divisions of the arch of the foot?
medial longitudinal arch, lateral longitudinal, transverse arch
How are some people flat-footed? clin rel
calcaneaonavicular joint disruption = collapse of medial arch = flat footed
What are the ligaments across the toes?
collateral ligaments, plantar ligaments
label these
What are the compartments of the leg?
anterior, posterior, and lateral
- anterior and posterior separated by the interosseous membrane
- lateral formed by the anterior and posterior intermuscular septa
What are the components of the superficial compartment of the leg?
- gastrocnemius (lateral and medial head) - become archilles (calcaneous) tendon
- soleus
- plantaris
- popliteal
- popliteus
Where does the gastrocnemius and soleus join?
at the calcaneal tendon / archilles
What does the plantaris do?
not much - but does have a long tendon which can be harvested for repair elsewhere
What does the popliteus allow for?
knee flexion and locks the knee joint for lateral rotation
What are the borders of the popliteal fossa?
- Superomedial border = semimembranous
- Superolateral border = biceps femoris
- Inferomedial border = medial head of gastrocnemius
- Inferolateral border = lateral head of gastrocnemius and plantaris
What are the components of the deep compartment of leg?
- tibialis posterior (forms medial arch of foot as it inserts into medial side of foot)
- flexor digitorum longus
- flexor halllucis longus
What is the tarsal tunnel? clin rel
narrow space in medial ankle where tibialis posterior, flexor digitorum longus, flexor hallucis longus and its nerves and lymphatic run
What is the calcaneal bursa?
reduces friction when the calcaneal tendon moves up and down
What are the components of the lateral leg?
- fibularis longus
- fibularis brevis (attaches to tuberosity on 5th metatarsal)
- fibular retinaculum (helps with plantarflexion)
What is the main job of the lateral compartment of the foot?
evertion of foot
label the tendon and ligaments holding it in place
What is in the anterior compartment of the leg?
- tibialis anterior
- extensor hallucis longus
- extensor digitorum longus
- fibularis tertius (help with eversion and insert into 5th metatarsal)
How does the fibularis longus tendon travel?
underneath the foot to the 1st metatarsal
What is the plantar aponeurosis for?
allow the ligament to come and join before spreading
How does the femoral artery go through the popliteal fossa?
femoral artery => through adductor hiatus => turns into popliteal artery
What are the contents of the popliteal fossa?
- popliteal artery
- popliteal vein - gives small saphenous vein branch
- sciatic nerve starts at the top and splits into common fibular nerve and tibial nerve
What do the genicular arteries do?
pass around the knee
What is the artery travel in posterior leg?
popliteal => anterior tibial (piercing through interosseous membrane) = through the anterior compartment => supply the muscle => becomes dorsalis pedis
Nerve innervation to anterior compartment of leg
Nerve innervation to lateral compartment of leg
common fibular nerve => superifical and deep fibular (L5-S2)
superficial fibular nerve
Nerve innervation to posterior compartment of leg
tibial nerve, medial plantar nerve (further down) and lateral plantar nerve
what does the sural nerve do in the posterior leg?
penetrate deep fascia
How does the saphenous vein travel?
up the dorsal side of the foot and then wraop around the medial part of thigh and peirce the deep fascia
What is the order of the contents through the tarsal tunnel?
Tom, dick, and very nervous harry
1.tibialis posterior
2.Digitiorium liongus
3.Artery, vein, nerve
4.Harry
How does pain in the tarsal tunnel ascend?
through the calf
What are the 5 compartments of the foot?
- Medial compartment of sole
- Central compartment of sole
- Lateral compartment of sole
- Interosseous compartment of foot
- Dorsal compartment of foot
What is in layer 1 of foot?
flexor digitorium brvis, abductor hallucis, abductor digiti minimi
What is in layer 2 of foot?
lumbrical 1-4, flexor hallucis, flexor digitorum longus tendon, flexor hallucis tendon, quadratus plantae
What is in layer 3 of foot?
adductor hallucis, flexor digiti minimi, flexor hallucis brevis
What is in layer 4 of foot?
- plantar interossei (1, 2,3 )
- dorsal interossi (1, 2, )
- fibularis longus tendon
Where do all muscles on the dorsal side of the foot come from?
calcaneus
What bones is the hindfoot made of?
tarsal and calcaneus
