posterior compartment of the leg Flashcards

1
Q

What seperates the deep and superifical posterior compartment?

A

The deep transverse intermuscular septum

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2
Q

What are the contents of the posterior compartment? what actions predominate?

A

knee flexion, ALL ankle plantarflexors, foot invertors, digit plantarflexors

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3
Q

The posterior compartment is innervated by what nerve?

A

tibial nerve

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4
Q

What are the superficial muscles of the posterior compartment?

A

GPS Gastrocnemious , soleus, plantaris

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5
Q

What are highlights of the gastrocnemius?

A

medial head tends to be larger than the lateral head, either head may contain a fabella/ sesamoid head- more common in LATERAL head. ALSO A KNEE FLEXOR, it is not an efficient ankle plantarflexor when knee is flexed.

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6
Q

What are some highlights of the soleus?

A

can plantarflex the ankle regardless of knee posture.

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7
Q

What are some highlights of plantaris?

A

Plantaris plays a minor role and can be removed for grafting

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8
Q

What are the deep muscles of the posterior compartment?

A

popliteus, FHL , FDL, and TP

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9
Q

What are some highlights of the popliteus muscle?

A

Only muscle of the posterior compt that does not cross the ankle, during knee flexion may pull lateral meniscus posteriorly. When knee is partially flexed, may assist PCL in checking ant displacement.

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10
Q

What three muscles are inferior to popliteus and deep to soleus?

A

FHL (lateral) FDL (M) TP

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11
Q

At foot flat, how do post compa muscles act?

A

eccentric contraction of triceps surae moderates ankle dorsiflexion. Tp, FHL and FDL support medial longitudinal arch as foot pronates.

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12
Q

At midstance, how do post comp muscles act?

A

triceps surae controls ankle dorsiflexon

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13
Q

At terminal stance, how do post. comp muscles act?

A

concentric contrations of triceps surae producing heel-up. TP, FHL, and FDL support medial longitudinal arch and stabilize forefoot for propulsion during toe-off

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14
Q

GRF line at toe off- What muscle groups will be recruited at each joint to offset the effect of ground reaction force and to keep the body moving forward?

A

at hip- hip flexors, at knee- knee extensors, at ankle- ankle plantarflexors

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15
Q

What is apropulsive or calcaneal gait?

A

Weakness of the ankle plantarflexors can result in insufficient propulsion. There will be no toe-off, but the entire foot will leave the ground at once. Patient will often rotate the foot as far externally as possible to allow for push-off to occur at midfoot.

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16
Q

At the lateral edge of the achilles tendon, what two structures run within the superficial fascia

A

smalls saphenous vein and sural nerve

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17
Q

S2 dermatome

A

posterior femoral cutaneous

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18
Q

L5 dermatome

A

Lateral sural cutaneous nerve and medial sural cutaneous nerve, superficial fibular , sural

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19
Q

S1 dermatome

A

Sural nerve, some medial sural cutaneous

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20
Q

How is the posterior compartment seperated from the anterior and lateral comaprtment?

A

tibia, interosseus mem, fibula, post intermuscular septum

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21
Q

The superficial posterior compartment is seperated from the deep posterior compartment via

A

deep transverse intermuscular septum

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22
Q

posterior muscles of the posterior compartment : inn, blood, fxn

A

tibial nerve, branches off popliteal artery, post tib, fibular artery, All except popliteus plantarflex the ankle and most contribute to inversion of the foot.

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23
Q

what muscles make up the superficial post compartment or triceps surae?

A

plantaris, gastrocnemius, soleus

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24
Q

What is the origin, insertion, and action of gastrocnemius?

A

O: medial head- pop surface of femur, super to med fem condyle. Lat head: lat aspect of lat femoral condyle fibers for both heads also arise from knee joint capsule

I: posterior surface of calcaneus via calcaneal tendon (achilles tendon) A: flexes leg at knee joint, plantarflexes ankle when knee is extended, contributes to inversion of foot

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25
Q

What is the sesamoid of the most often the lateral head of the gastrocnemious head called?

A

fabella

26
Q

A fabella on the lateral head of the gastroc is in close proximity to what nerve?

A

common fibular nerve

27
Q

What are the origins, insertion and actions of soleus?

A

post fib head, sup 1/4 of post surface of fibula, soleal/popliteal line, tendinous arch btw bony attach, middle 1/3 of medial border of fibula,

I: posterior surface of calcaneus via calacaneal tendon, achilles tendon, A: plantarflexes ankle independent of knee position, contributes to inversion

28
Q

What neurovasculature can become entrapped by the tendinous arch?

A

tibial nerve and popliteal artery/vein

29
Q

What are the two bursa located at the insertion of the achilles tendon?

A

retrocalcaneal and subcutaneous calcaneal bursa

30
Q

What is haglund’s deformity

A

bone “pump bump” on the superior aspect of posterior calcaneus, potential cause of bursitis and achilles tendinopathy

31
Q

what is kager’s triangle? what muscle is deep to the deep transverse intermuscular septum?

A

seperates the achilles tendon from the deep transverse intermuscular septom. Flexor Hallucis Longus

32
Q

How is Flexor hallucis longus tendon related to the kager’s triangle?

A

it is located anterior to the location of the deformity

33
Q

What are the origins, insertions , and actions of Plantaris?

A

O: inf end of lateral supracondylar line of femur, knee jnt capsule(obliq pop lig) I: post surface of calcaneous adjacent to the calcaneal (achilles tendon) actions: weakly flexes the knee, weakly plantarflexes the ankle

“the freshman nerve”

34
Q

what muscles for the deep posterior compartment?

A

popliteus, flexor digitorum longus, flexor hallucis longus, tibialis posterior with fib vessels and post tib vess and tib nerve

35
Q

what are the o, i, act, and inn of popliteus?

A

O: lat surface of lateral condyle of femur, lateral meniscus, knee joint capsule I: posterior surface of tibia proximal to soleal line A: weakly flexes knee, unlocks extended knee, open chain: aids in medially rotating tibia on fixed femur, tibial nerve

only has action at knee

36
Q

What are the origins, insertions, and actions of Flexor digitorum longus?

A

O: posterior surface of tibia inferior to soleal line, medial to vertical line, broad tendon to the fibula, deep transverse intermuscular septum

Ins: each tendinous slip inserts on the center of the base of its respective distal phalanx, Actions: plantarflexes ankle, plantarflexes lateral MTPJ and IPJs, aids in foot inversion

37
Q

before dividing into 4 digital tendons in the plantar foot, it receives the insertion from what muscle?

A

Quadratus plantae ( from 2nd muscular layer)

38
Q

As it divides into 4 digital tendons, FDL provides origins for what muscles?

A

four lumbricals (2nd plantar layer)

39
Q

What are the origins of Flexor Hallucis Longus?

A

inf 2/3 of posterior lateral surface of fibula, interosseus membrane, deep transverse intermuscular septum, posterior crural intermuscular septum

40
Q

The FHLT often shares tendinous slips with what other muscle tendon?

A

FDL distal to the navicular

41
Q

What is the band of tissue (thickening of medial intermuscular septum of foot) that binds the FHL to the FDL against the navicular?

A

The master knot of henry BINDS LONGUS TENDONS TO NAVICULAR

42
Q

What is the insertion and major actions of Flexor hallucis longus?

A

I: base of distal hallucal phalanx, A: plantarflexes ankle, plantarflexes the MTPJ and IPJ of hallux , assists in foot inversion

43
Q

What are the origins insertions and actions of Tibialis posterior?

A

O: post surface of tibia, inf to soleal line, posteromed surface of fib, inter meme, deep transve intermusc septum

I: can insert on all tarsals except TALUS MT 2-4 bases

A: plantarflexes ankle, inverts foot (most POWERFUL)

44
Q

Distally in the leg, the TP veers medially and crosses deep to what muscle?

A

Flexor digitorum longus

45
Q

crossing inferior to the plantar calcaneonavicular spring ligament, the TPT contains a …

A

sesamoid

46
Q

THe post compartment is active during what parts of the gait cycle?

A

flatfoot- moderates ankle dorsiflexion and supports MLA

midstance- preserves momentum by controlling ankle dorsiflexion and helps restore MLA

terminal stance- burst in activity plantarflexes anke and causes heel lift

47
Q

medial calcaneal nerves branch from..

A

tibial nerve

48
Q

medial and lateral plantar nerves branch from

A

tibial nerve

49
Q

What two nerves can cause heel pain?

A

tibial nerve- tarsal tunnel syndrome, medial calcaneal nerve- tibial

50
Q
A

G - soleus L - FHL M- posterior tibial vessels, N- fibular vessels, H- tibialis posterior K- flexor digitorum longus

51
Q
A

Q- achilles tendon, L- flexor hallucis longus, K- flexor digitorum longus H- tibialis posterior

52
Q

What muscle starts off tendinous and ends fleshy?

A

popliteus

53
Q

What muscle is the most powerful inverter?

A

TIbialis posterior

54
Q

What tarsal bone has no muscular attachments?

A

TALUS

55
Q

triceps surae

A

2 gastruc heads and soleus

56
Q

Plantarflexion against resistance is a good test for what dermatome?

A

S1

57
Q

what septum is deep to soleus?

A

deep transverse intermuscular septum

58
Q

Do you need planarflexors or dorsiflexors at heel strike?

A

dorsiflexors at heel strike because the GRF line is behind the ankle

59
Q

contents of the medial malleolar anastamosis

A

posterior medial malleolar artery, medial plantar artery, medial tarsal artery, anterior medial malleolar artery

60
Q

contents of the lateral malleolar anastamosis

A

posterior lateral malleolar artery, perforating of the fibular artery, lateral tarsal artery, lateral plantar artery

61
Q
A