the leg and foot Flashcards
what type of joint is the proximal tibiofibular joint?
synovial plane and gliding
what are the reinforcing structures that support the proximal tibiofibular joint?
anterior and posterior ligament of the head of fibula
what holds together the middle tibiofibular joint?
interosseous membrane
what type of joint is the middle tibiofibular joint?
syndesmosis
what type of joint is the distal tibiofibular joint?
syndesmosis
what are the ligaments that support the distal tibiofibular joint?
transverse tibiofibular ligament and anterior/posterior tibiofibular ligaments
what are the 7 tarsal bones
- calcaneus
- talus
- navicular
- cuboid
- medial cuneiforms
- intermediate cuneiforms
- lateral cuneiforms
what is the name given to the big toe?
hallux
relative to the foot where is the calcaneus located?
at the heel
relative to the foot where is the talus located?
ankle bone
relative to the foot where is the cuboid bone located?
on lateral side
what type of bones are found in the hallux?
sesamoid bone
what is the function of having sesamoid bones in the big toe?
modify pressure along the hallux, reduce friction and alter the direction of muscle pull
what are common injuries that occur at the hallux?
- sesamoiditis
- sesamoid fractures
what are the arches seen in the foot?
medial longitudinal arch
lateral longitudinal arch
transverse arch
what is the keystone of the medial longitudinal arch?
the talus
what is the keystone of the lateral longitudinal arch?
cuboid
what is the keystone of the transverse arch?
intermediate cuneiform
what bones form the transverse arch?
cuboid and the 3 cuneiform bones
what roles do ligament play in the arches?
they provide passive support
how is dynamic stability in the feet obtained?
from the muscles of the leg and intrinsic foot
what are the ligaments involved in supporting the longitudinal arches?
- long plantar ligament
- short plantar ligament
- spring ligament
where does the long plantar ligament range?
from calcaneous to the base of metatarsals 3-5
where does the short plantar ligament range?
from calcaneous to cuboid bone
where does the spring ligament range from?
from calcaneous to navicular
what muscles act on the transverse arch in order to support it?
- tibialis posterior
- fibularis longus
what will flat foot lead to?
- everted foot
- may cause valgus of the knee
- may provoke over stretching of the calcaneal tendon
what is pes cavus?
high arched foot
what is pes planus?
flat foot
people with high arched feet will walk in what way?
they will walk much more on the lateral side of the foot
how is the ankle joint formed?
the lateral malleolus (fibula) and the media malleolus (tibia) will wrap around the Talus on either side allowing for the trochlear surface of the talus to articulate
what movement is permitted by the ankle joint?
dorsiflexion and plantar flexion
what is the deltoid ligament?
its the medial collateral ligament that supports the ankle joint
where does the deltoid ligament extend from?
from the tibia to talus and calcaneus
what medial collateral ligaments of the ankle joint limit plantar flexion?
tibionavicular ligament
anterior tibiotalar ligament
what medial collateral ligaments of the ankle joint limit dorsiflexion?
posterior tibiotalar
where does the lateral collateral ligament extend from?
from fibula to talus and calcaneus
what lateral ligaments will limit dorsiflexion of the ankle joint?
calcaneofibular and posterior talofibular
what lateral ligaments will limit plantat flexion of the ankle joint?
anterior talofibular
what type of joint is the interphalangeal joint of the foot?
hinge, synovial
what type of joint is the metatarsophalangeal joint?
condyle joint
what joint is formed between the tarsal bones and metatarsal bones?
tarsometatarsal joint
what is the joint formed between calcaneous and the cuboid bone?
what type of joint is it?
calcaneocuboid joint
synovial plane and gliding
what joint is formed between the navicular and cuneiforms? what type of joint is it?
cuneonavicular joint
plane and gliding synovial joint
what joint is formed between the talus and calcaneus? what type of joint?
anatomical subtalar joint
hinge joint
what are the reinforcing structures that support the subtalar joint?
posterior/medial/lateral talocalcaneal ligaments
what forms the talocalcaneonavicular joint?
the ball components of the talus inserts in the socket component between navicular and calcaneous
what type of joint is the talocalcaneonavicular joint?
modified ball and socket
what movements are permitted by the talocalcaneonavicular
inversion and eversion
what ligament created the floor of the talocalcaneonavicular joint?
sping ligament
what ligament helps suport the talocalcaneonavicular joint?
interosseous talocalcaneal ligaments
what does the deep fibular N. innervate on the dorsum of the foot?
sensory innervation to the space between digits 1 and 2
what does the saphenous N. innervate?
the medial side of the leg
what nerve innervated cutaneously the lateral leg and dorsum of the foot except fot the 5th digit and space between digitis 1-2?
superficial fibular N.
what does the common fibular N. branch off as?
deep fibular N.
Superficial fibular N.
what does the deep fibular N. innervate?
anterior leg
relative to the leg, where does the tibal nerve pass?
posterior to the leg
what branches originate from the tibial N.
lateral plantar N. and medial Plantar N.
what does the medial plantar N. innervate?
the plantar surface of the foot digits 1-2-3 and half of 4
what does the lateral plantar N innervate?
the plantar surface of the foot digits 4-3
what ligament is responsible for separating the anterior and posterior compartment of the subtalar joint?
the interosseous talocalcaneal ligaments
what movements are permitted at the subtalar joint?
eversion and inversion of the foot
what ligament forms the floor of the subtalar joint?
plantar calcaneonavicular ligament
what happens during an inversion ankle sprain?
the medial side of the sole is tilted up causing for pressure to be applied to the LCL which may cause for it to tear
what happens during eversion ankle sprain
lateral sole of foot is tilited up, causes for tear of the MCL
what is the most common type of ankle sprain?
inversion ankle sprain
what nerve is responsible for the motor innervation of the posterior leg?
tibial N.
what branch of the tibial nerves are responsible for the cutaneous innervation of the plantar surface?
lateral plantar N.
medial plantar N.
what nerve wraps around the head and neck of the fibula?
common fibular N.
what nerve is responsible for the cutaneous innervation of the lateral leg and dorsum of the foot?
superficial fibular N.
what region is cutaneously innervated by the deep fibular N.?
the space between digits 1 and 2
what Nerve is responsible for the motor innervation of the anterior leg?
deep fibular N.
what nerve originates from the femoral N and will innervate the medial leg and medial border of the foot?
saphenous N.
what Nerve is responsible for the sensory innervation of the 3.5 medial digits of the foot along with the medial plantar foot?
Medial Plantar N
what nerve is responsible for the sensory innervation of the 1.5 Lateral digits of the plantar foot?
lateral plantar N.
how do the medial and lateral plantar N. branch off into?
they branch off into the common plantar nerve at the metatarsals and then bifurcate at the phalanges into the plantar digital N.
what muscles compose the anterior compartment of the leg? (4)
- tibialis anterior
- extensor hallucis longus
- extensor digitorum longus
- fibularis tertius
what nerve is responsible for innervating the anterior compartment of the anterior compartment of the leg?
deep fibular N.
what vascular structure is responsible of providing blood supply to the anterior compartment of the leg?
anterior tibial A and V.
what muscles compose the lateral compartment of the leg?
- fibularis longus
- fibularis brevis
what nerve is responsible for innervating the lateral compartment of the anterior compartment of the leg?
superficial fibular N.
what is the common action shared by the muscles of the anterior compartment of the leg?
dorsiflexion of the foot
Tibialis Anterior
Origin
Insertion
Action
Origin: Lateral tibial condyle and tibial shaft
Insertion: medial cuneiform
Action: dorsiflexion and inversion
extensor hallucis longus
Origin
Insertion
Action
Origin: fibula and interosseous membrane
Insertion: distal phalanx of hallux
Action: dorsiflexion and extension of big toe
extensor digitorum longus
Origin
Insertion
Action
Origin: Lateral tibial condyle, head of fibula and interosseous membrane
Insertion: dorsum of lateral 4 toes
Action: dorsiflexion and extension of toes 2-5
what is the function of the extensor retinaculum?
allows to hold in place the muscles of the anterior compartment of the leg, additionally involved in the dorsiflexion of the foot
what is the name of the retnaculum found on the foot?
superior/inferior extensor retinaculum
how could the inferior flexor retinaculum be described?
open medially, Y shape, will merge together on the lateral side
how can the muscles of the anterior compartment be defined?
they are all found anterior to the lateral malleolus
fibularis tertius
Origin
Insertion
Action
Origin: fibula
Insertion: dorsal surface of metatarsal 5
Action: dorsiflexion and foot eversion
Fibularis Longus
Origin
Insertion
Action
Origin: head of proximal fibula
Insertion: medial cuneiform and plantar surface of metatarsal 1
Action: plantar flexion and eversion of the foot
what is commonly shared between the muscles of the lateral compartment of the leg?
their functions, responsible for plantar flexion and eversion of the foot
fibularis brevis
Origin
Insertion
Action
Origin: fibula
Insertion: metatarsal 5
Action: plantar flexion and eversion of the foot
relative to the lateral malleolus, where do the muscles of the lateral compartment of the leg pass?
posterior to lateral malleolus
the blood supply of the lateral compartment of the leg is provided by?
branches of the fibular v and A.
what are the muscles that compose the superficial posterior compartment of the leg?
gastrocnemius
soleus
plantaris
what are the muscles that for the deep posterior compartment of the leg?
tibialis posterior
flexor digitorum longus
flexor hallucis longus
what nerve passes through the deep posterior compartment of the leg?
tibial n.
What is responsible for providing blood supply to the deep posterior compartment of the leg?
posterior tibial A. and v.
Along with the fibular A.
gastrocnemius (medial and lateral heads)
origin
insertion
action
origin: supracondylar ridges of the femus
insertion: calcaneous via calcaneal tendon
action: knee flexion and plantar flexion
what do the medial and lateral heads of gastrocnemius form?
the inferior medial and lateral borders of the popliteal fossa
Plantaris
origin
insertion
action
origin: distal lateral femus
insertion: calcaneous
action: weak knee flexion and weak plantar flexion (not much function)
soleus
origin
insertion
action
origin: soleal line (tibia) and head of fibula
insertion: calcaneous via calcaneal tendon
action: plantar flexion
what is the common function shared by the muscles of the posterior leg?
plantar flexion of the foot
tibialis posterior
origin
insertion
action
origin: tibia and fibula, interosseous membrane
insertion: broad plantar surface, insertion along the tarsals
action: plantar flexion and inversion
how does tibialis posterior travel in the leg?
it begins on the medial side but want to insert on the medial plantar surface of the foot
flexor digitorum longus
origin
insertion
action
origin: posterior tiba
insertion: distal phalanges of lateral 4 toes
action: plantar flexion and toe flexion (digits 2-5)
where do the tendons of the muscles of the deep posterior compartment of the leg pass?
posterior to the medial malleolus
flexor hallucis longus
origin
insertion
action
origin: distal fibula
insertion: plantar surface of distal hallux
action: ankle plantar flexion and flexion of the hallux
how does Flexor digitorum longus travel in the foot?
it will start medially and go laterally,
this causes it to criss cross with tibialis posterior proximal to medial malleolus
where does the Flexor hallucis longus cross the flexor digitorum longus?
distal to the medial mallelous in the sole plantar portion of the hoot
when does the common fibular N. split into the superficial and deep fibular n?
once it passes the head and neck of the fibula, deep to fibularis longus and fibularis brevis muscles it splits. the superficial will peak out and the deep will continue its trail
how does the popliteal A. terminate as?
it will boiferate below the knee joint into anterior and posterior tibial A.
what A. supplies the posterior compartment of the leg?
posterior tibial a.
what A. supplies the anterior compartment of the leg?
the anterior tibial A.
what A. originates from the posterior tibial A. and what does it supply?
the fibular A. will supply the lateral compartment of the leg and extends from the posterior tibial A.
where would the anterior tibial A. and the deep fibular N. be found in the leg?
they would be found between the tibialis anterior and the extensor hallucis longus muscles
what A. will travel along with the tibial nerve in the posterior compartment of the leg?
posterior tibial A
deep to what structures do the posterior Tibial A and Tibial N. travel?
deep to soleus (posterior superficial muscle of the leg)
what is the mneumonic to recall the components of the tarsal tunnel?
Tom Dick And Very Nervous Harry
relative to what do the tendons, A. and N. run in the tarsal tunnel?
posterior to the medial malleolus
what are the components of the tarsal tunnel?
Tibialis posterior flexor Digitorum Longus posterior tibial A. posterior tibial V. tibial N. flexor hallucis longus
what is the use of the sustentaculum tali of calcaneus?
this boney bump serves as an extended pully to fo flexor hallucis longus to produce a stronger flexion of the big toe