Posterior Leg Flashcards

1
Q

Describe the route of the small saphenous vein

A

Starts just posterior to the lateral ankle (malleolus)
Runs up the centre of the posterior leg
Enters popliteal region to drain into popliteal vein

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2
Q

How many muscles reside in the posterior leg?

A

7

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3
Q

Which nerve roots does the calcaneal reflex test?

A

S1-S2

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4
Q

Name the 2 bursae associated with the calcaneal tendon

A

Subcutaneous calcaneal bursa

Deep bursa of calcaneal tendon

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5
Q

What is the origin of gastrocnemius?

A

Medial head = medial femoral condyle

Lateral head = lateral femoral condyle

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6
Q

What is the insertion of the gastrocnemius?

A

Calcaneus

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7
Q

What are the actions of the gastrocnemius?

A

Plantarflexion of foot

Flexor of knee

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8
Q

What is the nerve supply to gastrocnemius?

A

Tibial nerve

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9
Q

What is the nerve supply to all superficial posterior leg muscles?

A

Tibial nerve

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10
Q

What are the superficial posterior leg muscles?

A

Gastrocnemius
Plantaris
Soleus

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11
Q

What is the origin of plantaris?

A

Lateral supracondylar line of femur

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12
Q

What is the insertion of plantaris?

A

Calcaneus

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13
Q

What are the actions of plantaris?

A

Plantarflexion of foot

Flexion of knee

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14
Q

What is the nerve supply to plantaris?

A

Tibial nerve

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15
Q

What is the origin of soleus?

A

Soleal line of tibia

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16
Q

What is the insertion of soleus?

A

Calcaneus

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17
Q

What is the action of soleus?

A

Plantarflexion

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18
Q

What is the nerve supply to soleus?

A

Tibial nerve

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19
Q

Describe a ruptured calcaneal tendon

A

Usually occurs through forceful plantarflexion
Foot will be permanently dorsiflexed
Soleus and gastrocnemius contract to form a lump in the calf

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20
Q

How many deep muscles of the posterior leg are there?

A

4

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21
Q

What is the origin of popliteus?

A

Posterior, proximal tibia

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22
Q

What is the insertion of popliteus?

A

Lateral condyle of femur

23
Q

What is the action of the popliteus?

A

‘Unlocking’ the knee - laterally rotate femur on tibia

24
Q

What is the nerve supply to popliteus?

A

Tibial nerve

25
Q

What is the origin of tibialis posterior?

A

Interosseous membrane of tibia and fibula and the posterior surfaces of these 2 bones

26
Q

What is the insertion of tibialis posterior?

A

Plantar surface of medial tarsal bones

27
Q

What are the actions of TP?

A

Inverts and plantarflexes the foot

Maintains medial arch of foot

28
Q

What is the nerve supply to TP?

A

Tibial nerve

29
Q

What is the origin of FDL?

A

Medial surface of tibia

30
Q

What is the insertion of FDL?

A

Plantar surfaces of lateral 4 toes

31
Q

What is the action of FDL?

A

Flexes the lateral 4 toes

32
Q

What is the nerve supply to FDL?

A

Tibial nerve

33
Q

What is the origin of FHL?

A

Posterior fibula

34
Q

What is the insertion of FHL?

A

Plantar surface of phalanx of great toe

35
Q

What is the action of FHL?

A

Flexes great toe

36
Q

What is the nerve supply to FHL?

A

Tibial nerve

37
Q

Describe the posterior tibial pulse

A

From posterior tibial artery, posterior to medial malleolus
Enters foot via tarsal tunnel
Posterior tibial artery splits into the lateral and medial plantar arteries and supplies the plantar foot (and contributes to toes)

38
Q

Describe the peripheral nerve territory of the sural nerve

A

Posterior, lateral leg

And dorsum of foot over metatarsal V

39
Q

Describe the peripheral nerve territory of medial calcaneal nerve

A

Heel (posterior, inferior leg)

40
Q

What is the common insertion for superficial posterior leg muscles?

A

Calcaneal tendon

41
Q

What is the common insertion for deep posterior leg muscles?

A

Inferior to medial malleolus (passes)

42
Q

What is the main movement of the superficial posterior leg muscles?

A

Plantarflexion

43
Q

What is the main movement of the deep posterior leg muscles?

A

Inversion

44
Q

How many joints does gastrocnemius cross and therefore what are its movements?

A

2
Plantar flexion when knee is extended
Knee flexion

45
Q

Which posterior leg muscle is missing in 10-15% of people?

A

Plantaris

46
Q

What is the mnemonic to remember the contents of the tarsal tunnel?

A

Tom, Dick and very nervous Harry

47
Q

What are the contents of the tarsal tunnel?

A
Tibialis posterior tendon 
Flexor digitorum longus tendon 
Posterior tibial artery 
Posterior tibial vein 
Tibial nerve 
Flexor hallucis longus tendon
48
Q

What is the origin of the tibial nerve?

A

Apex of popliteal fossa

49
Q

Where does the posterior tibial artery come from?

A

Continuation of the popliteal artery

50
Q

Which areas does the posterior tibial artery supply?

A

Posterior compartment of leg and plantar part of foot

51
Q

Where is the posterior tibial artery palpable?

A

Inferior, posterior to medial malleolus

52
Q

How might Achilles rupture occur?

A

Rapid plantarflexion or forced dorsiflexion

53
Q

What do we often see after a Achilles rupture?

A

Contracted gastrocnemius and/or soleus in calf

54
Q

Describe the Simmond’s/Thompson’s test

A

Patient kneels with relaxed calf
Squeeze their calf to imitate contraction of superficial muscles
Should cause plantarflexion
If it doesn’t then something is wrong with the calcaneal tendon