The Leg Flashcards
Deep fascia of lower limb
-Crural facia-leg
-Extensor retinacula
Veins of lower limb
1) Great saphenous v.
-Ascends anterior to medial malleolus
-Posterior to medial epicondyle of femur
-Empties into femoral v. at saphenous opening in fascia lata
2) Small saphenous v.
-Ascends posterior to lateral malleolus
-Empties into popliteal v. in popliteal fossa
Anterior compartment of the leg
-Dorsiflexion (toes up to shin)
-Deep fibular n (L4-S2
-Anterior tibial a.
Lateral compartment of the leg
-Plantarflexion (point toes out), eversion (lateral side up)
-Superficial fibular n. (L5-S2)
-Fibular artery & anterior tibial artery
Posterior compartment of the leg
-Superficial group: plantarflexion (pointing toes)
-Deep group: plantarflexion, inversion (taking sole of foot and turning it medially)
-Tibial n. (L4-S3)
-Posterior tibial a. & fibular a.
Superficial group of posterior compartment of the leg
-Gastrocnemius m.
-Soleus m.
-Plantaris m.
Collective motion= plantar flexion
Inn= tibial n (L4-S3
Blood supply= posterior tibial & fibular aa.
Gastrocnemius
O: Medial Head: posterior surface, superior to the medial condyle of the femur
Lateral Head: posterior surface, lateral aspect of lateral condyle of the femur
I: Attaches via calcaneal tendon (Achilles tendon) on posterior calcaneus
INN: Tibial n.
Action:
-Plantarflexes ankle
-Flexes knee
Soleus
O: Soleal line (posterior tibia)
I: Attaches via calcaneal tendon on posterior calcaneus
INN: Tibial n.
Action: Plantarflexes ankle
Plantaris
O: Supracondylar ridge of femur
I: Attaches via calcaneal tendon on posterior calcaneus
INN: Tibial n.
Action:
-Plantarflexes ankle
-Weakly flexes knee
Achilles Tendinitis
Definition: Inflammation and degeneration of the tendon and its attachment to calcaneus
-Overuse injury, resulting of improper stretching and training (common in runners and sudden increase in activity)
Clinical Features:
-Gradual onset of pain during or after activity
-Pain in calf, above Achilles tendon
-Tenderness over calf, pain in passive dorsiflexion and resisted plantar flexion
-ROM and strength normal
Deep group of posterior compartment of the leg
Popliteus, tibialis posterior m., flexor hallucis longus m., flexor digitorum longus m.
Collective motion= plantar flexion, inversion
Inn: tibial n. (L4-S3)
Blood Supply: posterior tibial & fibular aa.
Popliteus
O: Lateral femoral condyle
I: Posterior surface of tibia and superior to soleal line
INN: Tibial n.
Action: Medially rotates the tibia
Tibialis Posterior
O: Postertior tibia, fibula, & interosseous membrane
I: Navicular tuberosity & medial cuneiform
INN: Tibial n.
Action
-Plantarflexes foot
-Inverts foot
-Support medial longitudinal arch
Flexor Digitorum Longus
O: Posterior surface of tibia
I: Distal phalanges of digits 2-5 (plantar surface)
INN: Tibial n.
Action
-Flexes digit 2-5
-Assists in plantarflexion
-Supports longitudinal arches
Flexor Hallucis Longus
O: Posterior fibula & interosseous membrane
I: Distal phalanx of hallux (digit 1)
INN: Tibial n.
Action
-Flexes hallux
-Assists in plantarflexion & inversion
-Supports medial longitudinal arch
Tibial n.
L4-S3
-Major branch of sciatic n.
-Runs centrally between deep & superficial posterior compartments
-Courses around the medial ankle to enter the foot
Tarsal Tunnel Contents
“Tom, Dick, And Nervous Harry”
From anterior to posterior:
T: Tibialis posterior m. tendon
D: flexor digitorum longus m. tendon
A: posterior tibial artery
N: tibial Nerve
H: flexor Hallucis longus
Anterior compartment of the leg muscles
Tibialis anterior m., extensor digitorum longus m., extensor hallucis longus m., fibularis tertius m.
Inn: deep fibular n. (L4-S2)
Blood: anterior tibial a. & v.
Tibialis anterior
O: Proximal, lateral tibia & interosseous membrane
I: Medial cuneiform, base of 1st metatarsal
INN: Deep fibular n.
Action:
-Dorsiflexion of ankle
-Inverts foot
-Helps to support the medial longitudinal arch of the foot*
Extensor Hallucis Longus
O: Anterior fibula & interosseous membrane
I: Base of distal phalanx of hallux (digit 1) (dorsal surface)
INN: Deep fibular n.
Action
-Extends hallux (digit 1)
-Dorsiflexes ankle
Extensor Digitorum Longus
O: Fibula, tibia, & interosseous membrane
I: Distal & middle phalanges of digits 2-5
INN: Deep fibular n.
Action:
-Extends digits 2-5
-Dorsiflexes ankle
Fibularis Tertius
**NOT ON EVERYONE
O: Distal anterior fibula & interosseus membrane
I: Base of 5th metatarsal
INN: Deep fibular n.
Action:
-Dorsiflexes ankle
-Everts foot
Shin Splints
Commonly used to describe leg pain. Due to microtears in periosteum of tibia
Causes:
-Typically, an overuse injury
-Strain of tibialis anterior muscle AND/OR tibialis posterior muscle (anterior most common)
-Tears/inflammation of tibial periosteum (may lead to stress fracture if not treated properly)
Lateral Compartment of Leg muscles
-Fibularis longus m., fibularis brevis m.
Inn: superficial fibular n. (L5-S2)
Blood supply: perforating branches from anterior tibial & fibular aa. (does not have its own artery)
Fibularis longus
O: Proximal, lateral fibula
I: Base of 1st metatarsal & medial cuneiform
INN: Superficial fibular n. (L5-S2)
Action
-Everts foot
-Weak plantarflexion of ankle
-Helps support the medial arch
Fibularis brevis
O: Distal 2/3 of lateral fibula
I: Base of 5th metatarsal
INN: Superficial fibular n. (L5-S2)
Action
-Everts foot
-Weak plantar flexion of ankle
Retinacula of ankle
1) Superior fibular retinaculum
2) inferior fibular retinaculum
3) Superior extensor retinaculum
4) Inferior extensor retinaculum
Compartment Syndrome
Increased pressure in the compartment- can lead to muscle & nerve damage and restrict blood flow
-Acute and chronic forms
-May see decreased sensation over the dorsal web space between the 1st and 2nd digit (flipflop region)
Foot drop
Lost plantar flexion ability due to damage to the common fibular n.
L4, L5, S1
L4- ankle dorsiflexion
L5- big toe extension
S1- ankle plantar flexion
