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Limbs > The Leg > Flashcards

The Leg Flashcards

1
Q

What are the 4 main leg compartments
What are they innervated by
What is their blood supply
What is their main movement

A

Anterior

  • Dorsiflexion, inversion
  • Deep fibular nerve
  • Anterior tibial artery

Lateral

  • Eversion
  • Superficial fibular nerve

Deep and superficial posterior

  • Plantarflex, inversion
  • Tibial nerve
  • Posterior tibial artery
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2
Q

What are the 4 muscles in the anterior leg compartment (dorsiflexion, inversion)

A

Tibialis anterior
Extensor digitorum longus
Extensor hallucis longus
Fibularis tertius

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3
Q

What are the 4 anterior compartment muscles innervated by?

Where does their blood supply comes from

A

Innervated by deep fibular (L4-S1)

Anterior tibial artery

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4
Q

What are the attachments and actions associated with the ant leg compartment muscles

  • Tibialis anterior
  • Extensor digitorum longus
  • Extensor hallucis longus
  • Fibularis tertius
A

Tibialis anterior

  • Lateral tibia => medial cuneiform and MB1
  • Dorsiflexion and inversion

Extensor digitorum longus

  • Lateral tibial condyle and medial fibular surface => 4 toes
  • Extension of lateral 4 toes, dorsiflexion

Extensor hallucis longus

  • Medial fibular shaft => distal phalanx of big toe
  • Extend big toe, dorsiflexion

Fibularis tertius

  • Medial fibular shady => M5
  • Eversion, dorsiflexion
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5
Q

Describe what causes anterior compartment syndrome
What are the consequences of anterior compartment syndrome
How can you relieve pain caused

A

Ant comp bound by tough crucial fascia and ant IMS
Bleeding/muscle swelling compresses vessels and nerves => venous congestion

Muscles starved of O2 => necrosis

Slit crucial fascia to release pressure

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6
Q

What are the 2 muscles found in the lateral leg compartment (Eversion)

A

Fibularis longus

Fibularis brevis

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7
Q

What nerves innervate the 2 lateral compartment muscles

What arteries supply these muscles

A 
Superficial fibular (L4-S2)
No specific supply but receives branches of fibular artery through IMS
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8
Q

Where are the attachments and actions of the 2 lateral compartment muscles

  • Fibularis longus
  • Fibularis brevis
A

Fibularis longus

  • Lateral fibula and tibial condyle => medial cuneiform and MB1
  • Eversion and plantarflexion
  • Supports lateral and transverse arches

Fibularis brevis

  • Fibula => MB5
  • Eversion
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9
Q

What are the 3 muscles found in the superficial posterior leg compartment

A

Gastrocnemius
Plantaris
Soleus

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10
Q

What is the innervation of the posterior leg compartment

What arteries supply this compartment

A 
Tibial nerve (L4-S3)
Post tibial and fibular artery
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11
Q

What is the attachment and actions associated with the superficial deep leg muscles

  • Gastrocnemius (lateral head)
  • Gastrocnemius (medial head)
  • Plantaris
  • Soleus
A

Gastrocnemius (lateral head)

  • Lateral femoral condyle => calcaneal tendon
  • Plantarflexion, knee flexor

Gastrocnemius (medial head)

  • Medial femoral condyle => calcaneal tendon
  • Plantarflexion, knee flexor

Plantaris

  • Lateral femoral condyle => calcaneal tendon
  • Plantarflexion, knee flexor

Soleus

  • Soleal tibial line and fibula => calcaneal tendon
  • Plantarflexion
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12
Q

Describe what happens in an Achilles’ tendon rupture

How can you test if someone has an Achilles’ tendon rupture

A

Calcineal tendon ruptures

Squeeze calf => plantarflexion of foot if calcaneal not injured

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13
Q

Name the 4 muscles in the deep posterior leg compartment

A

Popliteus
Tibialis posterior
Flexor digitorum longus
Flexor hallucis longus

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14
Q

What are the attachments and associated movements of the muscles in the deep posterior leg compartment

  • Popliteus
  • Tibialis posterior
  • Flexor digitorum longus
  • Flexor hallucis longus
A

Popliteus

  • Lateral femur condyle and post horn => soleus tibial line
  • Lateral femur rotation

Tibialis posterior

  • Interosseus membrane => plantar medial tarsal
  • Inversion, plantarflexion
  • Maintains medial arch

Flexor digitorum longus

  • Medial tibia => plantar of lateral 4 toes
  • Lateral 4 toe flexion

Flexor hallucis longus

  • Post fibular => plantar phalanx of big toe
  • Great toe flexion
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15
Q

Describe how the tendons of the 3 main muscles of the deep posterior leg compartment (tibialis posterior, flexor digitorum longus, flexor hallucis longus) cross over each other in the plantar surface

A

Tibialis posterior tendon, between both => most medial at cuneiform

Flexor hallucis longus, most lateral => passes under FDL => between both

Flexor digitorum longus, most medial => passes over FHL => most lateral

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16
Q

Describe the tarsal tunnel and the order of arteries, veins, nerves and tendons that pass underneath

A

Pass under flexor retinaculum

Tibialis posterior (Tom)
Flexor digitorum longus (Dick)
Post tibial artery (A)
Tibial nerve (N)
Tibial veins (D)
Flexor hallucis longus (Harry)
17
Q

Describe the route of the popliteal artery from the knee to the leg

A

Posterior popliteal
Ant and post tibial

Ant tibial passes through intraosseous membrane => anterior of leg

Post tibial => fibular artery => branches into lateral comp

18
Q

Describe the route of the anterior tibial artery

A

Ant tibial => dorsalis pedis => anastomoses w lateral plantar => deep plantar arch

Dorsalis pedis supplies dorsal of metatarsals

19
Q

Describe the route of the posterior tibial artery

A

Post tibial => plantar side via tarsal tunnel

Splits => lateral and medial plantar => both form deep plantar arch => toes

20
Q

Describe the route of the deep veins in the lower leg

A

Accompany major arteries in same vascular sheath

Dorsal venous arch => ant tibial
Medial and plantar veins => post tibial and fibular

Both join popliteal vein

21
Q

Describe the joints found at the tibia and fibula

A

Synovial joint between tibia and fibula

Intraosseus membrane (syndesmoses), allow some movement

  • Foramen at proximal side => passage of ant tibial to ant side
  • Foramen at distal side => passage of perforating fibular artery

Fibrous joint at distal side, prevent movement at ankle joint

22
Q

Describe the osteology of the tibia and fibula from the anterior side

A

Tibial tuberosity, patella tendon attaches here
Anterior crest, deep fascia attachment

Lateral malleolus on fibula
Medial malleolus on tibia

23
Q

Describe the osteology of the fibula and tibia from the posterior side

A

Diagonal soleus line, soleus attaches here

24
Q

Name the foot bones found in the hind foot and the mid foot

Describe the joints found here

A

Talus, articulates with the malleoli and tibia (dorsiflexion and plantarflexion)
-Synovial talonavicular joint

Calcaneus, heel bone
-Synovial calcaneocuboidal joint

Navicular,
-ball and socket with talus, 3 cuneifonavicular joints

Cuneiform (medial, mediolateral, lateral)

Cuboid,

  • Calcaneal cuboid joint
  • 2 tarsometatarsal joints (synovial) with M4, 5
25
Q

How would you name each part of the forefoot

Describe the joints found here

A

Metatarsals

  • Base and head
  • M1-5 from medial => lateral

Metatarsalphalangeal joints
Inter phalange always joints

Phalanges

  • Toe 1, proximal and distal only
  • Toe 2-5, proximal, medial and distal
26
Q

What is the retinaculum

Describe the retinaculum found on the dorsal, medial and lateral side of the foot and what tendons they keep down

A

Bands of deep fascia to hold tendons down

Dorsal (Fibularis tertius, extensor digitorum longus, extensor hallucis longus, Tibialis anterior)

  • Superior extensor retinaculum
  • Inferior extensor retinaculum

Lateral (Fibularis longus and brevis)

  • Superior fibular retinaculum
  • Inferior fibular retinaculum

Medial (Tibialis posterior, flexor digitorum longus, flexor hallucis longus)
-Flexor retinaculum

27
Q

Describe the pathway of the superficial fibular branch of the common fibular nerve

Describe the cutaneous innervation of the leg and foot

A

Common fibular => lateral cutaneous
Common => deep and superficial fibular

Superficial => fibularis longus and brevis branches

Superficial => lateral and medial cutaneous branch

Lateral cutaneous supplies upper leg
Medial and lateral cutaneous supply lower leg and foot minus webbing between toe 1 and 2

28
Q

Describe the pathway for the deep fibular branch of the common fibular nerve

Describe the cutaneous innervation of the leg and foot

A

Common fibular branches into deep and superficial fibular

Deep => branch to tibialis anterior
Deep => branches to extensor hallucis longus, extensor digitorum longus and Fibularis tertius

In foot => branches to extensor digitorum brevis and extensor hallucis brevis
Deep => dorsal digital cutaneous

Dorsal digital cutaneous supplies webbing between toe 1 and 2

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