Posterior Leg and Ankle Joint Flashcards
From which nerve does the cutaneous innervation of the posterior leg mostly come from?
Sural nerve
What are the attachments of popliteus?
Lateral condyle of the femur (pit for popliteus) and the lateral meniscus
Inserts into the popliteal area of the tibia (above the soleal line)
What is highlighted in red?
The malleolar mortise which articulates with the trochlea of the talus
What are the parts of the medial collateral ligament?
Fans out from medial malleolus - 4 parts
- Anterior tibiotalar
- Tibionavicular
- Tibiocalcaneal
- Posterior tibiotalar
Where does the flexor retinaculum run?
Between the medial malleolus and the calcaeneous
What is this muscle and its innervation?
Tibialis posterior Tibial nerve (L4,5)
What muscle is being shown and what is its innervation?
Plantaris Tibial nerve (S1,2)
What are the muscles of the deep aspect of the posterior compartment?
4 muscles
- Popliteus
- Flexor Digitorum Longus
- Flexor Hallucis Longus
- Tibialis Posterior
What is the range of motion for dorsiflexion?
20-30 degrees
What are the attachments of the 2 heads of the gastrocneumius muscle?
Medial head - popliteal surface of the femur, superior to the medial condyle
Lateral head - lateral aspect of the lateral condyle of the femur
What nerve gives cutaneous innervation to the green section?
Medial sural cutaneous nerve (sural nerve)
What movement would you see at the inferior tibiofibular joint?
Slight movement to accommodate the wedging of the trochlea of talus during dorsiflexion
What are the actions of the gastrocneumius muscle?
Plantarflexion of ankle
Flexion of knee
Describe the route of the tendons of the deep muscles
Pass behind the medial malleolus to the plantar surface of the foot (except from popliteus)
Between which tendons are the posterior tibial vessels and the tibial nerve found?
Flexor digitorum longus
Flexor hallucis longus
(Tom, Dick and Very Naughty Harry)
What is the range of movement for plantarflexion?
30-50 degrees
What are the actions of flexor hallucis longus?
Flexes the hallux
Weak plantarflexion of the ankle
What are the attachments of flexor hallucis longus?
Posterior surface of the fibula
Inserts into the base of the distal phalanx of the hallux
What supports the ankle joint?
Medial and lateral collateral ligaments
What muscles belong to the superficial part of the posterior leg?
Gastrocnemius
Plantaris
Soleus
Describe the route of the fibular artery
Runs medial to the fibula, usually within the flexor hallucis longus
What is this muscle and its innervation?
Popliteus Tibial nerve (L4,L5,S1)
What surfaces are involved in the ankle joint?
Distal end of tibia and fibula
Trochlea of Talus
How many muscles are in the posterior compartment of the leg?
7 muscles
- 3 superficial
- 4 deep
What are the attachments of the tibialis posterior muscle?
Posterior surface of the tibia and fibula, interosseous membrane
Inserts into the tuberosity of navicular, cuneiforms, cuboid, sustentaculum tail of the calcaeneus, and the base of the 2nd, 3rd and 4th metatarsals
What nerve gives cutaneous innervation to the pink patch?
Posterior cutaneous nerve of the thigh
What is the action of the popliteus?
Unlocks the knee joint by laterally rotating the femur on fixed tibia
What is the action of flexor digitorum longus?
Flexes the lateral 4 digits
Weak plantarflexion of the ankle
What are the 3 parts of the lateral collateral ligaments and where they insert?
Anterior talofibular - inserts into neck of talus
Posterior talofibular - inserts into lateral tubercle of talus
Calcaneofibular - inserts lateral surface of the calcaneous
What nerve gives cutaneous innervation to the light blue section?
Lateral sural cutaneous nerve
Describe the route of the posterior tibial artery and its branches?
Posterior tibial artery is a terminal branch of the popliteal artery. Runs between the heads of gastrocneumius and deep to the soleous on the surfaces of TP and FDL
- Gives the fibular artery as a branch
- Terminates as the medial and lateral plantar arteries in the foot
What is the origin of plantaris?
Lateral supracondylar line of the femur
proximal to the lateral head of gastrocneumius
What tarsal bone does the tibialis posterior NOT attach to?
Talus
What is the medial to lateral arrangement of the tendons of the deep posterior compartment at the ankle joint?
Tibialis posterior, flexor Digitorum longus, and flexor Hallucis longus
(Tom, Dick and Harry)
What is the function of plantaris?
Assists with plantarflexion of the ankle
What is this muscle and its innervation?
Flexor hallucis longus Tibial nerve (L5, S1, S2)
What does this image show?
The lateral collateral ligaments of the ankle
What muscle is being highlighted and what is its innervation?
Soleus Tibial nerve (S1,S2)
Describe the Tibial nerves route
- Passes between the heads of gastrocneumius and deep to tendinous arch of soleus, with the posterior tibial artery
- Passes between the FHL and FDL at the ankle joint
- Gives terminal branches to supply the sole of the foot - the medial and lateral plantar nerves
What type of joint is the inferior tibiofibular joint?
Syndesmosis - fibrous joint
What is this muscle and its innervation?
Flexor Digitorum Longus Tibial neve (L5, S1, S2)
What is the artery to the posterior aspect of the leg?
Posterior tibial artery
What are the attachments of Soleus?
Soleal line of tibia
Upper 1/3 of the posterior fibula
Tendinous arch between bony attachments
What is the function of Soleus?
Plantarflexion of the ankle joint
Where does the capsule of the ankle attach?
Attaches around the margins
Anteriorly extends onto the neck of the talus
What is the other name for the Tendocalcaneous tendon?
Achilies tendon
What is this image showing?
The medial collateral ligament (deltoid)
What are the actions of tibialis posterior?
Plantarflexion of the ankle
Inverts foot
What is the attachments of the Flexor digitorum longus?
Posterior surface of tibia
Inserts into the base of the distal phalanx of digits 2-5
Via which tendon do the superficial muscles insert onto the posterior surface of the calcaneous?
Tendocalcaneous
What is being highlighted?
Soleal line
What nerve gives cutaneous innervation to the purple section?
Saphenous nerve (from the femoral)
What is this muscle and its innervation?
Gastrocneumius Tibial nerve (S1,2)
