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Regional Gross Anatomy > Region 9 - Leg and Foot > Flashcards

Region 9 - Leg and Foot Flashcards

1
Q

Where do the fibres of the interosseous membrane pass?

A

Inferolaterally from tibia to fibula

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2
Q

What is the function of the interosseous membrane?

A

Help resist downward pull of muscles attached to fibula

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3
Q

What type of joint is the superior tibiofibular joint?

A

Plane synovial

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4
Q

What is the superior tibiofibular joint between?

A

Flat articular surface on head of fibula

Articular facet on posterolateral aspect of lateral tibial condyle

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5
Q

What supports the joint capsule of the superior tibiofibular joint?

A

Anterior and posterior ligaments of head of fibula:

- Pass superomedially from head of fibula to lateral tibial condyle

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6
Q

When does the superior tibiofibular joint move and why?

A

During ankle dorsiflexion

Talus pushes up between malleoli of tibia and fibula

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7
Q

Where do the tendons of the anterior leg compartment pass?

A

Anterior to ankle

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8
Q

What is the general function of the anterior leg compartment?

A

Extensors of ankle and digits

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9
Q

What is the general function of the lateral leg compartment?

A

Evertors of foot

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10
Q

What are the origins of fibularis longus?

A

Head of fibula

Upper 2/3 of lateral fibula

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11
Q

What are the insertions of fibularis longus?

A

Base of 1st metatarsal

Medial cuneiform

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12
Q

What is fibularis longus innervated by?

A

Superficial fibular nerve (L5-S2)

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13
Q

What is the course of fibularis longus tendon?

A

Lies posterior to:

  • Fibularis brevis tendon
  • Fibular trochlea of calcaneus
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14
Q

What does fibularis longus tendon create a groove in?

A

Inferior surface of cuboid

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15
Q

What is the origin of fibularis brevis?

A

Inferior 2/3 of lateral fibula

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16
Q

What is the insertion of fibularis brevis?

A

Tuberosity on lateral side of base of 5th metatarsal

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17
Q

What is the innervation to fibularis brevis?

A

Superficial fibular nerve (L5-S2)

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18
Q

What are the relations of the fibularis brevis tendon?

A

Lies anterior to:

  • Fibularis longus tendon
  • Fibular trochlea of calcaneus
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19
Q

What are the muscles of the anterior compartment of the leg?

A

Tibialis anterior
Extensor digitorum longus
Fibularis tertius
Extensor hallucis longus

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20
Q

What is the innervation to the anterior compartment of the leg?

A

Deep fibular nerve (L4-L5)

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21
Q

What are the origins of tibialis anterior?

A

Lateral condyle of tibia
Superior 1/2 of lateral tibial surface
Interosseous membrane

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22
Q

What are the insertions of tibialis anterior?

A

Medial and inferior surfaces of medial cuneiform

Base of 1st metatarsal

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23
Q

What are the functions of tibialis anterior?

A

Dorsiflexes ankle

Inverts foot

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24
Q

What are the origins of extensor digitorum longus?

A

Lateral condyle of tibia
Superior 3/4 of medial surface of fibula
Interosseous membrane

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25
Q

What are the insertions of extensor digitorum longus?

A

Middle and distal phalanges of lateral 4 digits

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26
Q

What are the functions of EDL?

A

Extends lateral 4 digits

Dorsiflexes ankle

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27
Q

What are the origins of fibularis tertius?

A

Inferior 1/3 of anterior fibula

Interosseous membrane

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28
Q

What is the insertion of fibularis tertius?

A

Dorsal surface of the base of 5th metatarsal

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29
Q

What are the functions of fibularis tertius?

A

Dorsiflexes ankle

Assists in eversion of foot

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30
Q

What are the origins of extensor hallucis longus?

A

Middle anterior surface of fibula

Interosseous membrane

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31
Q

What is the insertion of EHL?

A

Dorsal aspect of distal phalanx of the hallux

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32
Q

What are the functions of EHL?

A

Extends hallux

Dorsiflexes ankle

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33
Q

What is the function of the extensor retinacula?

A

Prevent bowstringing of tendons

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34
Q

What are the origins and insertions of the superior extensor retinaculum?

A

Origin:
- Anterior border tibia
Insertion:
- Lower end of fibula

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35
Q

What are the origins and insertions of the inferior extensor retinaculum?

A 
Origin:
- Calcaneus laterally
Insertions:
- Medial malleolus (upper limb)
- Blends with fascia over abductor hallucis (lower limb)
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36
Q

What is the shape of the inferior extensor retinaculum?

A

Y-shaped

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37
Q

What are the origins of the muscles on the dorsum of the foot?

A

Superior surface of calcaneus

Inferior extensor retinaculum

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38
Q

What are the insertions of the muscles on the dorsum of the foot?

A

Extensor hallucis brevis:
- Base of proximal phalanx of hallux
Extensor digitorum brevis:
- Long extensor tendons of digits 2-4

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39
Q

What is the innervation to EHB and EDB?

A

Deep fibular nerve (L5-S1)

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40
Q

Where does the superficial fibular nerve originate?

A

Between fibularis longus and neck of fibula

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41
Q

What are the functions of the superficial fibular nerve?

A

Motor to lateral leg compartment
Cutaneous:
- Distal anterior leg
- Most of dorsum of foot

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42
Q

What is the course of the deep fibular nerve?

A

Passes through EDL
Travels with anterior tibial artery on interosseous membrane
Supplies anterior leg compartment
Crosses ankle joint

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43
Q

What is the cutaneous distribution of the deep fibular nerve?

A

Skin between digits 1 and 2

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44
Q

What artery does the fibular artery arise from?

A

Posterior tibial artery

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45
Q

What is the origin of dorsalis pedis?

A

Continuation of anterior tibial artery

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46
Q

What are the branches of the dorsalis pedis artery?

A

Lateral tarsal artery
Deep plantar artery
Arcuate artery:
- Metatarsal arteries -> Digital arteries

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47
Q

What is the common insertion of the 3 superficial muscles in the posterior compartment of the leg?

A

Posterior calcaneus via tendocalcaneus

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48
Q

What structure do the tendons of the 4 deep muscles of the posterior leg compartment pass behind?

A

Medial malleolus

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49
Q

What are the origins of gastrocnemius?

A

Medial head:
- Popliteal (posterior) surface of femur (superior to medial condyle
Lateral head:
- Lateral aspect of lateral condyle of emur

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50
Q

What is the innervation to gastrocnemius?

A

Tibial nerve (S1-S2)

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51
Q

What are the functions of gastrocnemius?

A

Plantarflexes ankle

Flexes knee

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52
Q

What are the origins of plantaris?

A

Inferior end of lateral supracondylar line of femur

Oblique popliteal ligament

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53
Q

What is the innervation to plantaris?

A

Tibial nerve (S1-S2)

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54
Q

What is the function of plantaris?

A

Assists in plantarflexing the ankle

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55
Q

What are the origins of soleus?

A

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

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56
Q

What is the innervation to soleus?

A

Tibial nerve (S1-S2)

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57
Q

What is the function of soleus?

A

Plantarflexes ankle

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58
Q

What are the origins of popliteus?

A

Lateral surface of lateral femoral condyle (pit for popliteus)
Lateral meniscus

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59
Q

What is the insertion of popliteus?

A

Posterior surface of tibia:

- Superior to soleal line -> Popliteal area

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60
Q

What is the innervation to popliteus?

A

Deep fibular nerve (L4-S1)

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61
Q

What are the functions of popliteus?

A

Unlocks knee:
- Laterally rotates femur (5 degrees) on fixed tibia
Can medially rotate tibia if limb unplanted

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62
Q

What is the origin of FDL?

A

Posterior surface of tibia (inferior to soleal line)

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63
Q

What is the insertion of FDL?

A

Bases of distal phalanges of lateral 4 digits

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64
Q

What is the innervation to FDL?

A

Tibial nerve (L5-S2)

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65
Q

What are the functions of FDL?

A

Flexes lateral 4 digits
Weak plantarflexion ankle
Supports longitudinal arches of foot

66
Q

What are the origins of FHL?

A

Inferior 2/3 of posterior fibula

Inferior interosseous membrane

67
Q

What is the insertion of FHL?

A

Base of distal phalanx of hallux

68
Q

What is the innervation to FHL?

A

Tibial nerve (L5-S2)

69
Q

What are the functions of FHL?

A

Flexes hallux

Weak plantarflexion of ankle

70
Q

Why is the muscle belly of FHL relatively large?

A

Flexion of hallux important for toe-off when walking

71
Q

What are the origins of tibialis posterior?

A

Interosseous membrane
Posterior tibia (inferior to soleal line)
Posterior fibula

72
Q

What are the insertions of tibialis posterior?

A 
Every tarsal except talus:
- Tuberosity of navicular
- Cuneiforms
- Cuboid
- Sustentaculum tali of calcaneus
Base of 2nd-4th metatarsals
73
Q

What is the innervation to tibialis posterior?

A

Tibial nerve (L4-L5)

74
Q

What are the functions of tibialis posterior?

A

Plantarflexes ankle

Inverts foot

75
Q

What is the relation of the FDL and tibialis posterior tendons?

A

TP tendon deep to FDL in posterior compartment in groove posterior to medial malleolus

76
Q

What does the FHL form grooves in>

A

Posterior surface of:

  • Lower end of tibia
  • Talus
77
Q

What is the arrangement of the tendons of muscles in the posterior compartment of the leg at the medial malleolus from medial to lateral?

A 
Tibialis posterior
FDL
(Posterior tibial artery)
(Posterior tibial vein)
(Tibial nerve)
FHL
78
Q

What is the course of the flexor retinaculum?

A

Medial malleolus -> Calcaneus

79
Q

Where does the posterior tibial artery arise?

A

Between heads of gastrocnemius

Deep to soleus

80
Q

What does the posterior tibial artery run on the surface of?

A

Tibialis posterior

FDL

81
Q

What are the branches of the posterior tibial artery?

A

Fibular artery:
- Runs medial to fibula (within FHL)
Medial and lateral plantar arteries in foot

82
Q

Where does the tibial nerve enter the leg?

A

Between heads of gastrocnemius

Deep to tendinous arch of soleus

83
Q

Where does the tibial nerve run at the ankle?

A

Between FHL and FDL

84
Q

What are the terminal branches of the tibial nerve?

A

Medial and lateral plantar nerves

85
Q

What type of joint if the inferior tibiofibular joint?

A

Syndesmosis:

  • Slightly movable fibrous joint
  • Accommodates wedging of talar trochlea during ankle dorsiflexion
86
Q

What ligament of the inferior tibiofibular joint is continuous with the interosseous membrane?

A

Interosseous tibiofibular ligament

87
Q

What supports the inferior tibiofibular joint?

A

Anterior and posterior tibiofibular ligaments

88
Q

What do the distal ends of the tibia and fibula form and what does this articulate with?

A

Malleolar mortise

Trochlea of talus

89
Q

What is the range of motion at the ankle?

A

Dorsiflexion -> 20-30 degrees

Plantarflexion -> 30-50 degrees

90
Q

What does the capsule of the ankle joint extend onto anteriorly?

A

Neck of talus

91
Q

Where is the capsule of the ankle joint weak?

A

Anteriorly and posteriorly

92
Q

What is the capsule of the ankle joint supported by and at what aspects?

A

Strong collateral ligaments:

  • Laterally
  • Medially
93
Q

What are the 3 bands of the lateral collateral ligament of the ankle and where do they insert?

A 
Anterior talofibular:
- Neck of talus
Posterior talofibular:
- Lateral tubercle of talus
Calcaneofibular:
- Lateral surface of calcaneus
94
Q

What is the alternate name for the medial collateral ligament of the ankle?

A

Deltoid ligament

95
Q

What are the 4 parts of the medial collateral ligament?

A

Anterior tibiotalar
Tibionavicular
Tibiocalcaneal
Posterior tibiotalar

96
Q

What forms the plantar aponeurosis?

A

Central portion of deep fascia in foot

97
Q

What is the proximal attachment of the plantar aponeurosis?

98
Q

What are the distal attachments of the plantar aponeurosis?

A

Divides into 5 bands distally:

- Continuous with fibrous digital sheaths

99
Q

What structures extend from the plantar aponeurosis in the midfoot and hindfoot? What do they form?

A

Vertical intermuscular septae forming compartments of the foot:

  • Medial
  • Central
  • Lateral
100
Q

What muscles are in the dorsal foot compartment?

101
Q

What muscles are in the lateral foot compartment?

A

Muscles of little toe:

  • Abductor digiti minimi
  • Flexor digiti minimi brevis
102
Q

What muscles are in the central foot compartment?

A 
Flexor digitorum brevis
Muscles associated with FDL tendon:
- Lumbricals
- Quadratus plantae
Adductor hallucis
103
Q

What muscles are in the medial foot compartment?

A

Muscles of great toe:

  • Abductor hallucis
  • FHB
104
Q

What muscles form layer 1 of the foot muscles?

A

Abductor hallucis
FDB
Abductor digiti minimi

105
Q

What are the origins of abductor hallucis?

A

Medial tubercle of calcaneus

Flexor retinaculum

106
Q

What is the insertion of abductor hallucis?

A

Medial aspect of base of proximal phalanx of hallux

107
Q

What is the origin and insertion of FDB?

A

Origin:
- Medial tubercle of calcaneus
Insertion:
- Middle phalanges of lateral 4 toes (medial and lateral aspects)

108
Q

What is the origin and insertion of abductor digiti minimi?

A

Origin:
- Medial and lateral tubercles of calcaneus
Insertion:
- Lateral aspect of base of proximal phalanx of little toe

109
Q

What muscles form layer 2 of the foot?

A

Long flexor tendons (FDL and FHL)
Lumbricals
Quadratus plantae

110
Q

What are the origins and insertions of the lumbricals?

A

Origin:
- Tendons of FDL
Insertion:
- Medial aspect of dorsal tendon expansion of lateral 4 digits

111
Q

What are the origins and insertions of the quadratus plantae?

A

Origins:
- Medial and lateral calcaneus
Insertion:
- Lateral side of FDL

112
Q

What are the functions of quadratus plantae?

A

Assists FDL in flexion of digits 2-5

Straightens axis of FDL by pulling it laterally

113
Q

What are the functions of the lumbricals?

A

Flex metatarsophalangeal joints of lateral 4 digits

Extends both interphalangeal joints of lateral 4 digits

114
Q

What are the muscles in layer 3 of the foot?

A

Flexor hallucis brevis
Adductor hallucis
Flexor digiti minimi brevis

115
Q

What are the origins of FHB?

A

Cuboid

Lateral cuneiform

116
Q

What are the insertions of FHB?

A

Both sides of proximal phalanx of hallux

117
Q

What is the function of the sesamoid bones in each tendon of FHB?

A

Create a tunnel to transfer weight to instead of onto FHL

118
Q

What are the origins of adductor hallucis?

A

Transverse head:
- Plantar ligament of MTP joints
Oblique head:
- Base of metatarsals 2-4

119
Q

What is the insertion of adductor hallucis?

A

Lateral side of base of proximal phalanx of hallux

120
Q

What is the origin and insertion of flexor digiti minimi brevis?

A

Origin:
- Base of 5th metatarsal
Insertion:
- Base of proximal phalanx of 5th digit

121
Q

What forms layer 4 of the foot?

A 
3 plantar interossei
4 dorsal interossei
Tendons of:
- Fibularis longus
- Tibialis posterior
122
Q

What are the origins and insertions of the 3 plantar interossei?

A

Origins:
- Bases and medial sides of metatarsals 3-5
Insertions:
- Medial sides of proximal phalanx of 3rd-5th digits

123
Q

What is the function of the plantar interossei?

A

Adduct digits 3-5 towards digit 2 (PAD)

124
Q

What are the origins of the 4 dorsal interossei?

A

Adjacent sides of metatarsals 1-5

125
Q

What are the insertions of the 4 dorsal interossei?

A

1st:
- Medial proximal phalanx of 2nd digit
2nd-4th:
- Lateral proximal phalanges of 2nd-4th digits

126
Q

What are the functions of the 4 dorsal interossei?

A

Abduct digits 2-4

Digit 2 can abduct laterally or medially since it is the axial digit in the foot

127
Q

What is the course of the plantar nerves in the foot?

A

Terminal branches of tibial nerve deep to flexor retinaculum

Enter foot deep to abductor hallucis

128
Q

Where does the medial plantar nerve run?

A

Between abductor hallucis and FDB

129
Q

Where does the lateral plantar nerve run?

A

Between layers 1 and 2
Deep and superficial branches:
- Deep branch between layers 3 and 4

130
Q

What muscles are supplied by the medial plantar nerve?

A

Abductor hallucis
FDB
1st lumbrical
FHB

131
Q

What are the root values of the medial and lateral plantar nerves?

132
Q

What does the medial plantar artery supply

A

Muscles of hallux and overlying skin

133
Q

What is the course of the lateral plantar artery?

A

Initially runs between layers 1 and 2

Deep arch between layers 3 and 4

134
Q

What does the deep plantar arch join with and branch off to form?

A

Joins deep plantar artery from dorsalis pedis
Gives off:
- Metatarsal arteries -> Digital arteries

135
Q

What are the functions of the foot arches?

A

Distribute weight
Act as shock absorbers
Act as spring boards

136
Q

What supports the transverse arch?

A 
Tarsal arch:
- Tendon of tibialis posterior
- Tendon of fibularis longus
Metatarsal arch:
- Adductor hallucis
Anterior arch:
- Deep transverse metatarsal ligament
137
Q

What bones form the lateral longitudinal arch?

A

Calcaneus
Cuboid
4th and 5th metatarsals

138
Q

What bones form the medial longitudinal arch?

A 
Calcaneus
Talus
Navicular
Cuneiforms
1st-3rd metatarsals
139
Q

What structures provide DYNAMIC support to the longitudinal foot arches?

A

Intrinsic foot muscles
FHL
FDL

140
Q

What structures provide PASSIVE support to the longitudinal foot arches?

A

Plantar calcaneonavicular (spring) ligament
Short plantar ligament (calcaneocuboid)
Long plantar ligament
Plantar aponeurosis

141
Q

What is the anatomical subtalar joint between?

A

Slightly concave posterior calcaneal articular surface of talus
AND
Convex posterior articular facet of calcaneus

142
Q

What type of joint is the anatomical subtalar joint?

A

Plane synovial

143
Q

What joint, lying more anteriorly, is included in the surgical subtalar joint?

A

Talocalcaneal part of talocalcaneonavicular joint

144
Q

What ligaments support the weak capsule of the subtalar joint?

A

Medial talocalcaneal
Lateral talocalcaneal
Posterior talocalcaneal
Interosseous talocalcaneal

145
Q

Where does the interosseous talocalcaneal ligament lie and what does it do?

A

In tarsal sinus:

- Separates the two parts of the surgical subtalar joint

146
Q

What forms the transverse tarsal joint?

A

Talocalcaneonavicular joint

Calcaneoucuboid joint

147
Q

What types of joint are present in the talocalcaneonavicular joint?

A

Talocalcaneal joint -> Plane synovial

Talonavicular joint -> Ball and socket

148
Q

What type of joint is the calcaneocuboid joint?

A

Plane synovial

149
Q

What are the ligaments of the transverse tarsal joint?

A 
Bifurcate ligament
Dorsal calcaneocuboid ligament
Long plantar ligament
Short plantar ligament
Spring ligament
150
Q

What is the course of the bifurcate ligament?

A

Calcaneus -> Navicular and Cuboid

151
Q

What is the course of the long plantar ligament?

A

Calcaneus -> Cuboid and Metatarsals

152
Q

What is the course of the short plantar ligament?

A

Calcaneus -> Cuboid

153
Q

What movements are possible at the subtarsal and talocalcaneal part of the talocalcaneonavicular joints?

A

Inversion/Eversion

154
Q

What is the function of the midtarsal joint?

A

Augments inversion/eversion

155
Q

How does the midtarsal joint carry out its function?

A
  1. Muscles attach on midfoot/forefoot:
    - Start of inversion/eversion is midfoot/forefoot rotating on hindfoot at midtarsal joint
  2. Ligaments tighten
  3. Force transferred to calcaneus
  4. Forefoot, midfoot and calcaneus rotate under talus (subtalar joint)
156
Q

What is Lisfranc’s joint?

A

The collective tarsometatarsal joints:

  • Medial cuneiform -> 1st metatarsal
  • Intermediate cuneiform -> 2nd metatarsal
  • Lateral cuneiform -> 3rd metatarsal
  • Cuboid -> 4th and 5th metatarsals
157
Q

What are the ligaments of the tarsometatarsal joints?

A

Dorsal
Plantar
Interosseous

158
Q

What types of joints are the metatarsophalangeal joints?

A

Synovial condyloid

159
Q

What movements do the metatarsophalangeal joints allow?

A

Flexion/Extension

Abduction/Adduction

160
Q

What types of joints are the interphalangeal joints?

A

Synovial hinge

161
Q

What movements do the interphalangeal joints allow?

A

Flexion/Extension

Regional Gross Anatomy (14 decks)

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