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Anatomy > Popliteal Fossa and Leg > Flashcards

Popliteal Fossa and Leg Flashcards

1
Q

Fractures of Leg Bones

A
  • Fracture= break in normal continuity of bone tissue
  • most frequent site of tibia fracture is the shaft
  • Fibular fractures commonly occur proximal to lateral malleolus
  • Neurovasculature near fracture at risk of damage
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2
Q

3 Compartments of Leg

A
  • Anterior
  • Lateral
  • Posterior
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3
Q

Compartment Syndrome of Leg

A
  • Increased pressure in fascial compartment that restricts blood flow and compresses nerves
  • Deep fascia covering compartment is unable to expand as pressure builds up
  • Treatment= fasciotomy
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4
Q

Anterior Leg Compartment

A
  • Muscles
    • Tibialis anterior
    • Extensor digitorum longus
    • Extensor halluscis longus
    • Fibularis tertius
  • Muscle action: dorsiflex ankle, extend toes
  • Nerve: Deep fibular nerve
  • Blood: anterior tibial artery/vein
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5
Q

Tibialis Anterior

A
  • Innervation: Deep Fibular nerve
  • Action:
    • dorsiflex ankle joint
    • invert foot
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6
Q

Extensor Digitorum Longus

A
  • Distal attachment: 2nd-5th digits (toes)
  • innervation: deep fibular nerve
  • Action:
    • dorsiflex ankle joint
    • extend 2nd-5th toes
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7
Q

Extensor Hallicus Longus

A
  • Distal attachment: distal phalanx of hallux
  • Motor innervation: Deep fibular nerve
  • Action:
    • dorsiflex ankle
    • extend hallux (big toe)
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8
Q

Fibularis Tertius

A
  • Innervation: deep fibular nerve
  • Action:
    • dorsiflex ankle joint
    • everts foot (weakly)
  • Not present in all people
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9
Q

Shin Splints

A
  • Small tears in periosteum and anterior leg muscles along their attachment onto tibial shaft
    • tibialis anterior muscle commonly involved
  • Cause: traumatic injury or athletic overextension of leg muscles
  • Signs/symptoms: pain and inflammation in anterior compartment of leg
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10
Q

Lateral Leg Compartment

A
  • Muscles:
    • Fibularis (peroneus) longus
    • Fibularis (peroneus) brevis
  • Action:
    • eversion of foot
    • plantarflexion of ankle joint
  • Nerve: superficial fibular nerve
  • Blood:
    • perforating branches of fibular artery/vein
    • posterior tibial artery/vein
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11
Q

Fibularis Longus

A
  • Motor superficial fibular nerve
  • Action
    • evert foot
    • plantarflex ankle joint
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12
Q

Fibularis Brevis

A
  • Nerve: superficial fibular nerve
  • Action:
    • evert foot
    • plantarflex ankle joint
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13
Q

Posterior Leg Compartment

A
  • Muscles:
    • Superficial Group
      • Gastrocnemius
      • Soleus
      • Plantaris
    • Deep Group
      • Flexor digitorum longus
      • Flexor hallicus longus
      • Tibialis Posterior
  • Actions:
    • plantarflexion of ankle joint
    • Flexion of toes
  • Nerve: Tibial nerve (L4-S3)
  • Blood:
    • posterior tibial
    • fibular
    • popliteal
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14
Q

Gastrocnemius

A
  • Distal attachment: calcaneous via calcaneal tendon
  • Nerve: tibial nerve
  • Action:
    • plantarflex ankle joint when knee extended
    • flex leg at knee joint
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15
Q

Soleus

A
  • Distal attachment: Calcaneus via calcaneal tendon
  • Nerve: Tibial nerve
  • Action:
    • plantarflex ankle joint
    • Steadies leg on foot
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16
Q

Plantaris

A
  • Distal attachment: Calcaneus via calcaneal tendon
  • Innervation: Tibial nerve
  • Action: plantarflex ankle joint
17
Q

Calcaneal Tendon

A
  • Achilles’ tendon or tendocalcaneus
  • strongest tendon in body
  • Connects gastrocnemius, soleus and plantaris muscles to calcaneus
    • calf muscle contraction causes calcaneal tendon to pull heel upward. i.e. plantarflexion of ankle
  • Important for walking and jumping
18
Q

Calcaneal Tendon Reflex

A
  • Test function of S1-S2 nerve root components only of tibial nerve
  • Procedure: place foot in slight dorsiflexion and tap calcaneal tendon with reflex hammer
  • Normal response is ankle plantarflexion
19
Q

Calcaneal Tendon Rupture

A
  • Partial or complete tear of calcaneal tendon
  • Patient with complete tendon rupture exhibits:
    • significant weakness is plantar flexion
    • inability to stand on tiptoes
    • bulge in posterior leg due to muscle shortening
    • palpable gap where tendon has ruptured
20
Q

Tibialis Posterior

A
  • Nerve: Tibial nerve
  • Action:
    • plantarflex ankle
    • invert foot
21
Q

Flexor Hallucis Longus

A
  • Distal Attachment: base of distal phalanx of 1st digit
  • Innervation: tibial nerve
  • Action:
    • flex the hallux
    • weakly plantarflex ankle
22
Q

Flexor Digitorum Longus

A
  • Distal attachment: bases of distal phalanges of 2nd and 5th digits
  • Innervation: Tibial nerve
  • Action:
    • plantarflex ankle
    • Flex 2nd-5th digits
23
Q

Tarsal Tunnel

A
  • Passageway for tendons and neurovasculature to travel from leg to foot
    • formed by medial malleolus, calcaneus and flexor retinaculum
  • Contents (posterior to medial malleolus)
    • TOM (Tibialis posterior tendon)
    • DICK (Flexor digitorum longus tendon)
    • AND (Posterior Tibial Artery)
    • VERY (Posterior Tibial Vein)
    • NERVOUS (Tibial Nerve)
    • HARRY (Flexor Hallicus longus tendon)
24
Q

Popliteal Fossa

A
  • Diamond-shaped, fat-filled area at posterior aspect of knee
  • Contents (superficial to deep)
    • Tibial nerve
    • Popliteal vein
    • Popliteal artery
25
Q

Popliteus

A
  • Proximal attachment: Lateral condyle of femur
  • Distal attachment: Proximal posterior tibia
  • Innervation: Tibial Nerve
  • Action:
    • flex knee
    • unlock knee joint by rotating femur 5 degrees laterally on fixed tibia (or medially rotates tibia on fixed femur)
26
Q

Arterial Supply to Leg Compartments

A
  • Anterior Tibial Artery: supplies anterior compartment of leg
  • Fibular Artery: supplies lateral and posterior compartments of leg
  • Posterior Tibial Artery: supplies posterior and lateral leg
27
Q

Popliteal Artery

A
  • Branches:
    • Anterior tibial artery
    • posterior tibial artery
    • fibular artery
28
Q

Genicular Anastomosis

A
  • Genicular branches of popliteal artery form anastomosis around knee joint
  • other arteries contribute
  • provides collateral circulation to maintain blood flow
29
Q

Motor Innervation of Leg

A
  • Sciatic Nerve (L4-S3)
    • Common fibular nerve (L4-S2)
      • Superficial fibular nerve (lateral compartment)
      • Deep fibular nerve (anterior compartment)
    • Tibial Nerve (L4-S3) (posterior compartment)
30
Q

Tibial Nerve

A
  • Motor function:
    • Normal muscle strength and action of ankle plantarflexors and toe flexors
      • if injured, weakness or inability to plantarflex ankle or flex toes
  • Sensory Function:
    • Normal skin sensation along sole of foot
      • if injured loss of skin sensation on sole of foot
31
Q

Deep Fibular Nerve

A
  • Motor function:
    • Normal strength and actions of ankle dorsiflexors and toe extensors
      • if injured, weakness or inability to dorsiflex ankle (foot drop) or extend toes
  • Sensory:
    • Normal skin sensation between 1st and 2nd toe
      • if injured, loss of skin sensation between 1st and 2nd toe
32
Q

Superficial Fibular Nerve

A
  • Motor function:
    • Normal muscle strength and action of foot elertors (fibularis longus and brevis muscles in lateral leg)
      • if injured, weakness or inability to evert foot
  • Sensory function:
    • Normal skin sensation along dorsum of foot (except skin between digits 1 and 2)
      • if injured, loss of skin sensation over dorsum of foot
33
Q

Common Fibular Nerve

A
  • Common fibular nerve branches into deep fibular and superficial fibular nerves just distal to head of fibula
  • Common fibular nerve has superficial relationship to head and neck of fibula
  • winds laterally around head/neck of fibula
  • This nerve is vulnerable to injury by fracture of fibular head/neck or excessive impact
    • injury results in impairment of foot eversion, ankle dorsiflexion, and extension of toes. Sensory loss on dorsum of foot.

Anatomy (2 decks)

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