Posterior Leg and Ankle Joint

Question 1

From which nerve does the cutaneous innervation of the posterior leg mostly come from?

Answer 1

Sural nerve

Question 2

What are the attachments of popliteus?

Answer 2

Lateral condyle of the femur (pit for popliteus) and the lateral meniscus

Inserts into the popliteal area of the tibia (above the soleal line)

Question 3

What is highlighted in red?

Answer 3

The malleolar mortise which articulates with the trochlea of the talus

Question 4

What are the parts of the medial collateral ligament?

Answer 4

Fans out from medial malleolus - 4 parts

• Anterior tibiotalar
• Tibionavicular
• Tibiocalcaneal
• Posterior tibiotalar

Question 5

Where does the flexor retinaculum run?

Answer 5

Between the medial malleolus and the calcaeneous

Question 6

What is this muscle and its innervation?

Answer 6

Tibialis posterior
Tibial nerve (L4,5)

Question 7

What muscle is being shown and what is its innervation?

Answer 7

Plantaris
Tibial nerve (S1,2)

Question 8

What are the muscles of the deep aspect of the posterior compartment?

Answer 8

4 muscles

• Popliteus
• Flexor Digitorum Longus
• Flexor Hallucis Longus
• Tibialis Posterior

Question 9

What is the range of motion for dorsiflexion?

Answer 9

20-30 degrees

Question 10

What are the attachments of the 2 heads of the gastrocneumius muscle?

Answer 10

Medial head - popliteal surface of the femur, superior to the medial condyle

Lateral head - lateral aspect of the lateral condyle of the femur

Question 11

What nerve gives cutaneous innervation to the green section?

Answer 11

Medial sural cutaneous nerve (sural nerve)

Question 12

What movement would you see at the inferior tibiofibular joint?

Answer 12

Slight movement to accommodate the wedging of the trochlea of talus during dorsiflexion

Question 13

What are the actions of the gastrocneumius muscle?

Answer 13

Plantarflexion of ankle

Flexion of knee

Question 14

Describe the route of the tendons of the deep muscles

Answer 14

Pass behind the medial malleolus to the plantar surface of the foot (except from popliteus)

Question 15

Between which tendons are the posterior tibial vessels and the tibial nerve found?

Answer 15

Flexor digitorum longus
Flexor hallucis longus

(Tom, Dick and Very Naughty Harry)

Question 16

What is the range of movement for plantarflexion?

Answer 16

30-50 degrees

Question 17

What are the actions of flexor hallucis longus?

Answer 17

Flexes the hallux

Weak plantarflexion of the ankle

Question 18

What are the attachments of flexor hallucis longus?

Answer 18

Posterior surface of the fibula

Inserts into the base of the distal phalanx of the hallux

Question 19

What supports the ankle joint?

Answer 19

Medial and lateral collateral ligaments

Question 20

What muscles belong to the superficial part of the posterior leg?

Answer 20

Gastrocnemius
Plantaris
Soleus

Question 21

Describe the route of the fibular artery

Answer 21

Runs medial to the fibula, usually within the flexor hallucis longus

Question 22

What is this muscle and its innervation?

Answer 22

Popliteus 
Tibial nerve (L4,L5,S1)

Question 23

What surfaces are involved in the ankle joint?

Answer 23

Distal end of tibia and fibula

Trochlea of Talus

Question 24

How many muscles are in the posterior compartment of the leg?

Answer 24

7 muscles

• 3 superficial
• 4 deep

Question 25

What are the attachments of the tibialis posterior muscle?

Answer 25

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

Question 26

What nerve gives cutaneous innervation to the pink patch?

Answer 26

Posterior cutaneous nerve of the thigh

Question 27

What is the action of the popliteus?

Answer 27

Unlocks the knee joint by laterally rotating the femur on fixed tibia

Question 28

What is the action of flexor digitorum longus?

Answer 28

Flexes the lateral 4 digits | Weak plantarflexion of the ankle

Question 29

What are the 3 parts of the lateral collateral ligaments and where they insert?

Answer 29

Anterior talofibular - inserts into neck of talus Posterior talofibular - inserts into lateral tubercle of talus Calcaneofibular - inserts lateral surface of the calcaneous

Question 30

What nerve gives cutaneous innervation to the light blue section?

Answer 30

Lateral sural cutaneous nerve

Question 31

Describe the route of the posterior tibial artery and its branches?

Answer 31

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

Question 32

What is the origin of plantaris?

Answer 32

Lateral supracondylar line of the femur | proximal to the lateral head of gastrocneumius

Question 33

What tarsal bone does the tibialis posterior NOT attach to?

Answer 33

Talus

Question 34

What is the medial to lateral arrangement of the tendons of the deep posterior compartment at the ankle joint?

Answer 34

Tibialis posterior, flexor Digitorum longus, and flexor Hallucis longus (Tom, Dick and Harry)

Question 35

What is the function of plantaris?

Answer 35

Assists with plantarflexion of the ankle

Question 36

What is this muscle and its innervation?

Answer 36

``` Flexor hallucis longus Tibial nerve (L5, S1, S2) ```

Question 37

What does this image show?

Answer 37

The lateral collateral ligaments of the ankle

Question 38

What muscle is being highlighted and what is its innervation?

Answer 38

``` Soleus Tibial nerve (S1,S2) ```

Question 39

Describe the Tibial nerves route

Answer 39

- 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

Question 40

What type of joint is the inferior tibiofibular joint?

Answer 40

Syndesmosis - fibrous joint

Question 41

What is this muscle and its innervation?

Answer 41

``` Flexor Digitorum Longus Tibial neve (L5, S1, S2) ```

Question 42

What is the artery to the posterior aspect of the leg?

Answer 42

Posterior tibial artery

Question 43

What are the attachments of Soleus?

Answer 43

Soleal line of tibia Upper 1/3 of the posterior fibula Tendinous arch between bony attachments

Question 44

What is the function of Soleus?

Answer 44

Plantarflexion of the ankle joint

Question 45

Where does the capsule of the ankle attach?

Answer 45

Attaches around the margins | Anteriorly extends onto the neck of the talus

Question 46

What is the other name for the Tendocalcaneous tendon?

Answer 46

Achilies tendon

Question 47

What is this image showing?

Answer 47

The medial collateral ligament (deltoid)

Question 48

What are the actions of tibialis posterior?

Answer 48

Plantarflexion of the ankle | Inverts foot

Question 49

What is the attachments of the Flexor digitorum longus?

Answer 49

Posterior surface of tibia | Inserts into the base of the distal phalanx of digits 2-5

Question 50

Via which tendon do the superficial muscles insert onto the posterior surface of the calcaneous?

Answer 50

Tendocalcaneous

Question 51

What is being highlighted?

Answer 51

Soleal line

Question 52

What nerve gives cutaneous innervation to the purple section?

Answer 52

Saphenous nerve (from the femoral)

Question 53

What is this muscle and its innervation?

Answer 53

``` Gastrocneumius Tibial nerve (S1,2) ```