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MSK Exam I > Posterior Leg > Flashcards

Posterior Leg Flashcards

1
Q

The talus contains a structure known as the posterior process which has a medial and lateral tubercle. What is the significance of these two tubercles?

A

Creates a groove for the FHL tendon

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2
Q

What does the calcaneus articulate with?

A

Talus superiorly

Cuboid anteriorly

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3
Q

What is the sustentaculum tali?

A

A ligament or shelf like projection that supports the talus and provides a groove for the FHL

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4
Q

What does the navicular bone articulate with?

A

Head of talus posteriorly
Cuneiforms anteriorly
Cuboid laterally

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5
Q

What is the significance of the navicular tuberosity?

A

Site of tibialis posterior attachment

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6
Q

What divides the posterior compartment of the leg into deep and superficial groups?

A

Transverse septa

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7
Q

Which muscles are in the superficial posterior compartment of the leg?

A

Gastrocnemius, soleus and plantaris

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8
Q

Which muscles are in the deep posterior compartment of the leg?

A

Popliteus, FHL, FDL, and tibialis posterior

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9
Q

Where are the tibial nerve and posterior tibial vessels located within the posterior compartment?

A

Deep to transverse crural intermuscular septum

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10
Q

Which nerve innervates all the muscles within the posterior compartment of the leg?

A

Tibial nerve

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11
Q

Structures in each compartment of the leg share what components?

A

Same general function, nerve, artery and vein

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12
Q

What is the most superficial muscle in the posterior compartment and that also crosses both the knee and ankle joints?

A

Gastrocnemius

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13
Q

What are the sites of origin for the medial and lateral heads of the gastrocnemius?

A

Medial head: medial femoral condyle

Lateral head: lateral femoral condyle

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14
Q

What is the insertion site for the gastrocnemius muscle?

A

Posterior surface of calcaneus via tendon calcaneus (Achilles tendon)

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15
Q

What is the overall action of the posterior compartment muscles?

A

Plantarflexion

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16
Q

What is the unique action of the gastrocnemius?

A

Flexes leg at the knee joint

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17
Q

The lateral head of the gastrocnemius may have a sesamoid bone close to its proximal attachment known as a fabella. What is its function and clinical significance?

A

Possibly provide leverage for lateral head of gastrocnemius

Painful fabellar stress fracture may accompany total knee replacement

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18
Q

What are the proximal attachments for the soleus muscle?

A

Soleal line of tibia, posterior head of fibula and superior 1/4 of posterior fibula

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19
Q

What does the soleus insert on?

A

Into posterior surface of calcaneus via tendo calcaneus (Achilles tendon)

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20
Q

What do the gastrocnemius and soleus form?

A

A tripartite muscle known as the triceps surae which forms the calf prominence

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21
Q

What are the attachment sites for the plantaris muscle?

A

O: lateral supracondylar line
I: posterior surface of calcaneus via calcaneal tendon

22
Q

What is the course of the plantaris tendon?

A

Runs between gastrocnemius and soleus

23
Q

Which muscle of the superficial posterior compartment is proposed to be a proprioceptive organ for foot position?

A

Plantaris muscle (has a high density of proprioceptive receptors)

24
Q

What are the unique actions of the plantaris muscle?

A

Only weak plantarflexion

Leg flexion

25
Q

Which posterior compartment muscle forms the floor of the popliteal fossa?

A

Popliteus

26
Q

What are the attachments for the popliteus muscle?

A

O: posterior tibia superior to soleal line
I: lateral femoral condyle and lateral meniscus

27
Q

What are the unique functions of the popliteus muscle?

A

Unlocks extended leg by laterally rotating femur on a stationary tibia
Weakly flexes leg

28
Q

Which structures does the popliteus separate?

A

The laterall collateral L from the lateral meniscus

29
Q

What are the attachment sites for FHL?

A

O: inferior 2/3 of posterior fibula
I: base of distal phalanx of great toe

30
Q

What are the unique actions for the FHL muscle?

A

Flexes great toe

31
Q

What are the attachment sites for FDL?

A

O: posterior tibia inferior to soleal line
I: distal phalanx base of lateral 4 digits

32
Q

Describe the course of FDL’s tendon

A

Passes posterior to tibialis posterior -> passes diagonally in sole of the foot superficial to FHL tendon -> divides into four tendons in the middle of the sole of the foot that pass to lateral 4 digits

33
Q

What is the unique action of FDL?

A

Flexes lateral 4 digits

34
Q

What is the proximal attachment for the tibialis posterior muscle?

A

Interosseous membrane, posterior tibia to soleal line, posteromedial surface of fibula

35
Q

What is the distal attachment for tibialis posterior?

A

Navicular tuberosity, cuneiforms and 2-4 metatarsal bones

36
Q

What is the deepest posterior compartment muscle?

A

Tibialis posterior

37
Q

What is the unique action for the tibialis posterior muscle?

A

Inversion

38
Q

Where are the superior medial and lateral genicular arteries located?

A

Just superior to medial and lateral head of the gastrocnemius

39
Q

Where is the inferior medial genicular A located?

A

Deep to medial head of gastrocnemius

40
Q

Where is the inferior lateral genicular artery located?

A

Deep to plantaris and superficial to popliteus

41
Q

Do genicular arteries branch into muscles?

A

NO

42
Q

Describe the course of the tibial nerve

A

Passes with posterior tibial vessels deep to soleus and posterior to tibialis posterior
Leaves posterior compartment by passing deep to flexor retinaculum b/w medial malleolus and calcaneus

43
Q

How does the tibial nerve end?

A

By dividing into medial and lateral plantar nerves (posteroinferior to medial malleolus)

44
Q

Describe the course of the posterior tibial A

A

Begins near inferior border of popliteus
Passes inferomedially on posterior surface of tibialis posterior w/ tibial nerve
Runs deep to flexor retinaculum
Ends by dividing into medial and lateral plantar arteries

45
Q

What is the largest branch of the posterior tibial A?

A

Fibular A

46
Q

Describe the course of the fibular A

A

Begins inferior to distal border of popliteus
Descends towards fibula under the FHL
Ends by piercing interosseous membrane and anastomosing with anterior lateral malleolar A

47
Q

Which artery vascularizes the posterior compartment?

A

Posterior tibial A and fibular A

48
Q

What is the tendon of the plantaris muscle commonly used for?

A

In reconstructive surgery of hand tendons

It’s removal doesnt affect knee or ankle movements

49
Q

What can rupture during violent ankle movements?

A

Plantaris tendon
Common injury in basketball players, sprinters and ballet dancers
Pain may be so severe that person in unable to bear weight

50
Q

Where can the posterior tibial pulse be palpated?

A

Between posterior surface of medial malleolus, medial border of calcaneal tendon and deep to flexor retinaculum (important to have pt relax this by inverting foot)

51
Q

What is the posterior tibial pulse used for?

A

Examining patients with occlusive peripheral artery disease (intermittent claudication)

52
Q

What causes peripheral occlusive artery disease?

A

Condition caused by ischemia of leg muscles due to narrowing or occlusion of leg arteries
Characterized by leg crams and pain during walking (disappears after rest)

MSK Exam I (34 decks)

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