Posteior Leg and thigh Flashcards
Popiteal fossa
-describe shape
-location (margins superiorly,inferiorly, medially and laterally)
Diamond shape behind knee
The superior margins are the Biceps Femoris (laterally) and Semimembranosus and Semitendinosus (medially). The inferior borders are the medial and lateral heads of Gastrocnemius
What is contained within the popliteal fossa?
The contents of the fossa include the Popliteal artery and vein and the Tibial and Common Peroneal nerves.
The Popliteal artery is the deepest structure in the fossa (closest to the knee joint/ tibia and femur).
Label the posterior thigh from deepest to more superficial (ABC diagram)
Lecture Slide
What/Where are the vessels and nerves in the posterior leg and thigh
Lecture Slide (2 diagrams)
- Sciatic Nerve
-Adductor hiatus - Sural nerve (penetrates deep fascia)
- common fibular nerve
- Tibial Nerve
-Medial calcaneal nerve - Lateral sural nerve
-Sural commnicating nerve - Deep fibular nerve
-Superifical fibualr nerve
Posterior compartment muscles (Superifical)
-Origin
-Insertion
- Action
- Nerve Supply
Gastrocnemious
-Origin
Medial Head: medial
condyle femur
Lateral Head: lateral condyle femur
-Insertion
Post calcaneus (via Tendo Achilles)
- Action
Plantarflexes ankle, flexes knee
-essential for jumping and walking - Nerve Supply
Tibial S1 S2
Soleus
-Origin
Superior 1/3 fibula and soleal line of tibia
-Insertion
Post calcaneus (via Tendo
Achilles)
- Action
Plantarflexes ankle
Walking - Nerve Supply
Tibial L5-S2
Plantaris
-Origin
Superior to lateral head of
Gastrocnemius on femur
-Insertion
Medial side of TA
- Action
Plantarflexes Ankle (and knee) - Nerve Supply
Tibial S1 S2
Posterior Compartment Muscles- Deep
-Origin
-Insertion
- Action
- Nerve Supply
Tibialis Posterior
-Origin
Posterior tibia, fibula and interosseus membrane
-Insertion
Navicular with slips to all mid and hind foot bones
Tendon passes around medial malleolus
- Action
Plantarflexes ankle, inverts foot
Reinforces arches of foot - Nerve Supply
Tibial
Flexor Digitorium Longus
-Origin
Middle half of tibia
-Insertion
Distal phalanges of lateral 4 toes
Tendon passes around medial maleolus
- Action
Flexes toes, plantarflexes ankle
Reinforces the arches of the foot. - Nerve Supply
Tibial
Flexor Hallucis Longus
-Origin
Inferior 2/3 fibula and interosseus membrane
-Insertion
Distal phalanx great toe
Tendon passes around medial malleolus
- Action
Flexes great toe, plantarflexes ankle
Reinforces the arches of the foot. - Nerve Supply
Tibial
Popliteus
-Origin
Lateral condyle femur and lateral meniscus
-Insertion
Posterior tibia sup to soleal line
- Action
Medially rotates tibia - Nerve Supply
Tibial
Arteries of the Posterior Compartment:
Describe the flow of Posterior Tibial artery
The Posterior Tibial artery travels through the deep posterior compartment, accompanied by the Tibial nerve and veins, eventually running posterior to the medial malleolus. After this point the artery divides into its two terminal branches, the Medial and Lateral Plantar arteries, the arteries to the sole of the foot.
Nerves of the Posterior Compartment:
Tibial Nerve flow
The Tibial nerve is the larger of the two terminal branches of the Sciatic nerve. It runs through the Popliteal Fossa with the Popliteal artery, passing between the two heads of Gastrocnemius to enter the posterior compartment of the leg. The Tibial nerve supplies all the muscles of the posterior compartments before passing posterior to the medial malleolus.
What does the Tibial Nerve divide into in the sole of the foot
-Tibial nerve joins with what to create what nerve and purpose of this?
In the sole of the foot it divides into the Medial and Lateral Plantar nerves.
A branch of the Tibial nerve joins with a branch of the Common Peroneal nerve to form the Sural nerve. The Sural nerve supplies the skin to the lateral and posterior sides of the inferior leg and heel.
Label the muscles of the posterior thigh and posterior leg
Lecture Slide
Label where the medial plantar, lateral plantar, medial calcaneal, medial sural cutaneous and sural are on the foot/leg
Lecture SLide
Label the muscles on the sole of the foot
Lecture Slide
Label ONLY the Superifical muscles/tendon/bone on the posterior leg
Lecture Slide
- Gastrocnemius
- soleus
- Plantaris
Lateral head of gastrocemius
Medial head of Gasttrocnemius
Popliteal vessels and tibial nerve
Tendon of plantaris
Calcaneous
Calcaneal tendon
Label Deep muscle layer posterior leg
Lecture Slide
- Popliteus
Tibialis posterior
Flexor digitorium longus
-Flexor hallucis longus
Label the Popliteal fossa from DEEP to Superfifical
Knee joint capsule
Popliteus (not examinable)
Popliteal artery (most medial)
Popliteal vein
Tibial nerve (from sciatic N)
The artery is the deepest structure in the fossa (closest to the knee joint/ tibia and femur).
Common fibula /peroneal nerve follows…
Common fibula /peroneal nerve follows biceps tendon to lateral compartment
Where does the Sural Nerve come from
-purpose
Tibial nerve has superficial branch that exits the popliteal fossa and travels down posterior aspect of leg on gastrocnemeus and becomes = sural nerve (also gets a branch from common peroneal nerve)
Provides sensation over the skin of the calf
Sural Nerve runs with
Saphenous nerve runs with
- Sural nerve runs withSmall saphenous vein
Saphenous nerve runs with the Great saphenous vein
Compartment of leg and subcompartments
Three compartments Anterior, lateral and posterior
Two sub-compartments in posterior leg: Superficial
Deep
What are the Arteries of the Posterior Compartments
-label on diagram
femoral artery
Popliteal artery
Anterior Tibial artery
dorsalis pedis artery
Posterior Tibial artery Peroneal/fibular artery.
Lecture Slide (2 diagrams)
Describe flow of arteries
The femoral artery enters the popliteal fossa behind the knee to become the Popliteal artery.
After the Popliteal artery exits the fossa inferiorly, it trifurcates into 3:
-the Anterior Tibial artery Which becomes the dorsalis pedis artery
-the Posterior Tibial artery
-the Peroneal/fibular artery.
The Posterior Tibial artery
travels between
superficial and deep compartments and is Accompanied by the tibial nerve and veins and Runs posterior to the medial malleolus
Posterior Tibial artery divides into
Artery divides into its two terminal branches, the Medial and Lateral Plantar arteries to the sole of the foot.
Nerves of the Posterior Compartments
-where do they go to?
The Tibial nerve travels with post tibial artery and vein (Post tibial artery and nerve go into foot)
Common peroneal nerve goes lateral around head of fibula to supply the anterior and lateral compartments of leg.
Tarsal Tunnels allows what structures into Foot
ACRONYM:
Tom Dick And Very Naughty Harry
Harry is naughty as tendon crossed everyone in foot
T. Tibialis posterior
D Flexor digitorum longus
A Posterior tibial artery
V Vein (post. Tibial)
N. Tibial nerve
H. Flexor Hallucis longus
Clinical importance: (Achilles Tendon Injuries)
-Where does the injury occur
-CLINICAL presentation
The Achilles tendon is the most commonly injured tendon in the
body
- Injuries can occur at the musculotendinous junction, within the tendon itself, or where it attaches to the calcaneus
The clinical presentation:
* “Like kicked in back if leg”
* Audible snap
* inability to push off (due to loss of plantarflexion)
Fabella (Injury)
- where is it
The fabella (little bean) is a sesamoid bone located in the tendon of the lateral head of gastrocnemius
Venous thrombosis
- What is it
-occurs where
-occurs when
Formation of blood clot in leg veins. Usually deep veins
Occurs when:
Slow blood flow
Increased coagulability
Damage to epithelium
why is anterior compartment more vunerbale to compartment syndrome
anterior compartment is most common for compartment because of such little space (not stretchable fascia)
