Posterior Leg and Ankle Joint Flashcards
What are the 3 important features on the tibia?
Popliteal area, solar line and Medial Malleolus
What are the 4 parts of the Fibula?
Apex, Head, neck and Lateral Malleolus
How many muscles are in the posterior compartment?
7 - 3 superficial and 4 deep
Where do all the superficial muscles insert on?
Posterior surface of calcareous via tendocalcaneous
Where do the tendons of the deep muscles pass?
Pass behind medial malleolus to plantar surface of foot (except popliteus)
What are the 3 superficial muscles?
Gastrocnemius, Plantaris and Soleus
What is the proximal attachment of the medial head of Gastrocnemius?
Popliteal surface of femur superior to medial condyle
What is the proximal attachment of the lateral head of Gastrocnemius?
Lateral aspect of lateral condyle of femur
What innervates Gastrocnemius?
Tibial nerve (S1 and S2)
What is the action of Gastrocnemius?
Plantarflexes ankle and flexes the knee
What is the proximal attachment of Plantaris?
Lateral supracondylar line of femur (proximal to lateral head of Gastrocnemius)
What innervates the Plantaris?
Tibial nerve (S1 and S2)
What is the action of Plantaris?
Assists plantarflexion of ankle
What is the proximal attachment of the Soleus?
Soleal line of Tibia, Upper 1/3rd posterior fibula and Tendinous arch between bony attachments
What innervates the Soleus?
Tibial nerve (S1 and S2)
What is the action of the Soleus?
Plantarflexes ankle joint
What are the 4 deep muscles?
Popliteus, Flexor Digitorum Longus, Flexor Hallucis Longus and Tibialis Posterior
What is the proximal attachment of Popliteus?
Lateral condyle of femur and lateral meniscus
What is the distal attachment of the Popliteus?
Popliteal area of tibia above solar line
What innervates Popliteus?
Tibial nerve (L4, L5 and S1)
What is the action of Popliteus?
Unlocks the knee joint by laterally rotating femur on fixed tibia
What is the proximal attachment of the Flexor Digitorum Longus?
Posterior surface of tibia
What is the distal attachment of the Flexor Digitorum Longus?
Base of distal phalanx of digits 2-5
What innervates the Flexor Digitorum Longus?
Tibial nerve (L5, S1 and S2)
What is the action of the Flexor Digitorum Longus?
Flexes lateral 4 digits and weak plazntarflexor of ankle
What is the proximal attachment of the tibialis posterior?
Posterior surface of tibia and fibula and interosseous membrane
What is the distal attachment of the Tibialis Posterior?
Tuberosity of Navicular, Cuneiforms, Cuboid, Sustentaculum tale of Calcaneus, base of 2nd, 3rd and 4th metatarsals
What innervates the Tibialis posterior?
Tibial nerve (L4 and L5)
What is the action of the Tibialis posterior?
Plantarflexed ankle and inverts foot
What is the proximal attachment of the Flexor Hallucis Longus?
Posterior Surface of Fibula
What is the distal attachment of the Flexor Hallucis Longus?
Base of distal phalanx of hallux
What innervates the Flexor Hallucis Longus?
Tibial nerve (L5, S1 and S2)
What is the action of the Flexor Hallucis Longus?
Flexes Hallux and weak plazntarflexor of ankle
Where does the Tibialis posterior tendon pass?
Passes deep to Flexor Digitorum Longus
Where is the groove of the tibiali posterior tendon?
Posterior to the medial malleolus
Where is the groove for the Flexor Hallucis Longus?
Posterior surface of the lower end of the tibia, the posterior surface of the talus
What is the medial to lateral arrangement of tendons at the ankle joint?
Tibialis Posterior, Flexor Digitorum Longus and Flexor Hallucis Longus
What forms the tendon retinaculum?
Medial malleolus and calcaneous
Where are the posterior tibial vessels and tibial nerve found?
Between FDL and FHL tendons
What is the terminal branch of the posterior tibial artery?
Popliteal artery
Where does the posterior tibial artery run?
Between heads of gastrocnemius and deep t solos to run on surface of tibialis posterior and flexor digitorum longus
What is a branch of the posterior tibial artery?
Fibular artery
Where does the posterior tibial artery terminate?
Medial and Lateral plantar arteries in foot
Where does the fibular artery run?
Medial to fibula usually within FHL
What are the nerves of the leg?
Tibial nerve, Common fibular nerve, Lateral and medial plantar nerve
Where does the tibial nerve pass?
Between the heads of gastrocnemius and deep to tendinous arch of soles, with posterior tibial artery
What muscles are on either side of the Tibial nerve?
FHL and FDL at the ankle joint
What are the terminal branches of the tibial nerve?
Medial and Lateral plantar nerves
What are the cutaneous innervation?
Posterior cutaneous nerve, Saphenous nerve, Lateral and medial cutaneous rural nerve
What movement does the inferior tibiofibular joint give?
Slight movement to accommodate wedging of trochlea of talus during dorsiflexion
What forms the Malleolar mortise?
Distal ends of tibia and fibula
What does Malleolar mortise articulate with?
Trochlea of the talus
What angle is dorsiflexion?
20-30 degrees
What angle is plantarflexion?
30-50 degrees
What does the capsule of the ankle joint attach to?
Attaches around articular margins and anteriorly extends onto neck of talus
Where is the capsule weak?
Anteriorly and posteriorly
What supports the capsule?
Lateral and medial collateral ligaments
What are the three collateral ligaments?
Anterior Talofibular, Posterior Talofibular and Calcaneofibular
Where does the Anterior Talofibular attach to?
Neck of talus
Where does the posterior Talofibular attach to?
Lateral tubercle of talus
Where does Calcaneofibular attach to?
Lateral surface of Calcaneous
What are the 4 parts of the medial collateral ligament?
Anterior Tibiotalar, Tibionavicular, Tibiocalcaneal and Posterior Tibiotalar
Where does the medial collateral ligament fan out from?
Medial Malleolus
