Unit 2_The Leg Flashcards
What joint does not have an articulation with the femur?
Tibiofemural Joint
What ligaments surround the Superior Proximal Tibiofibular (TF) Joint and its capsule?
Anterior and Posterior Superior Tibiofibular Ligaments
What ligaments surround the Inferior (Distal) Tibiofibular (TF) Joint and its capsule?
Anterior and Posterior Inferior Tibiofibular Ligaments
What syndemosis surrounds the Middle Tibiofibular (TF) Joint?
Interosseous membrane
What is the distal expansion included on the fibula?
Lateral Malleolus
What is the distal expansion included on the tibia?
Medial Malleolus
What is the function of the Lateral Malleolus of the fibula?
Block excess eversion motion
Since the bellies of the muscles in the leg are found in the leg, and the tendons are in the foot and ankle, what kind of muscles are the muscles of the leg?
Extrinsic muscles
What is extension of the foot and ankle called?
Dorsiflexion
What is flexion of the foot and ankle called?
Plantar flexion
What movement includes turning the sole of your foot in?
Inversion
What movement includes turning the foot out (lateral)?
Eversion
What is formed from the tensor fascia latae, is thick and dense, and forms compartments for the muscles in the leg?
Crural Fascia
What muscle compartment in the leg is large, bulky, has more muscle mass than any other compartment and has superficial and deep layer?
Posterior Compartment
What separates the superficial and deep layers of the posterior compartment muscles in the leg?
Transverse Intermuscular Septum
What muscles are found in the anterior compartment of the leg and support dorsiflexion/eversion?
Tibialis Anterior m (Inversion)
Extensor Digitorum Longus m
Extensor Hallucis Longus m (Inversion)
Fibularis Tertius
What anterior muscle of the leg is the bulk of the anterior compartment, has attachments at both the tibia and fibula, attaches distally at the medial side of the foot, functions as dorsiflexion of the foot and ankle, and performs inversion?
Tibialis Anterior m (Inversion)
What anterior muscle of the leg has attachments at the lateral tibial condyle and fibular head, distally attaches via 4 tendons to toes 2-5 middle/distal phalanges, and functions as dorsiflexion of the foot, ankle and toes?
Extensor Digitorum Longus m
What anterior muscle of the leg takes its proximal attachment off the fibula, crosses the dorsum of the ankle, ends at the distal phalange on the great toe, and assists with dorsiflexion of the foot, ankle, and great toe?
Extensor Hallucis Longus m
What anterior muscle of the leg is distally attached to the base of the 5th metatarsals and assists with dorsiflexion and slight eversion?
Fibularis Tertius
What muscles are found in the lateral compartment of the leg and support eversion?
Fibularis Longus
Fibularis Brevis
What lateral muscle of the leg attaches proximally at the lateral aspect of the fibula, is higher/more proximal than it’s companion muscle, the tendon comes around the lateral malleolus, attaches at the plantar surface of the medial side of the foot, supports the arch of the foot, and supports eversion?
Fibularis Longus
What lateral muscle of the leg attaches proximally at the lateral aspect of the fibula, stops at the lateral side of the foot, and supports eversion?
Fibularis Brevis
What muscles are found in the posterior superficial compartment of the leg and assist with plantar flexion?
Gastrocnemius
- Medial Head
- Lateral Head
Soleus
Plantaris
What posterior superficial muscle of the leg attaches proximally to the medial/lateral condyles and attaches distally to the achilles tendon (tendocalcaneus)?
Gastrocnemius
- Medial Head
- Lateral Head
What posterior superficial muscle of the leg does not support the knee but is an important plantar flexor, assists gastrocnemius, proximally attaches to the posterior superior aspect of the tibia, blends with the achilles tendon to attach to the calcaneus (heel bone), and assists with ankle plantar flexion?
Soleus
What posterior superficial muscle of the leg lays flat on top of Soleus, runs between gastrocnemius and soleus, blends in with the achilles tendon, assists with plantar flexion and has responsibilities at the knee?
Plantaris
What posterior superficial muscles of the leg insert into the Achilles tendon (Tendocalcaneus), form the “Triceps Surae” and common tendon to attach on the posterior calcaneus?
Gastrocnemius
Soleus
Plantaris
What is included at the attachment of the achilles tendon to the calcaneal tuberosity to reduce friction?
Retro-calcaneal bursa
What muscles are found in the posterior deep compartment of the leg to support plantar flexion?
Popliteus
Tibialis Posterior (Inversion)
Flexor Digitorum Longus
Flexor Hallucis Longus
What posterior deep muscle of the leg attaches proximally at the lateral femoral condyle and distally to the medial posterior tibia, creating medial tibial rotation to allow knee flexion by contracting/unlocking the knee? “Screw home mechanism”
Popliteus
What posterior deep muscle of the leg is large, is deep to the triceps surae muscles, attaches proximally at the fibular head and posterior tibia, and travels down behind the medial malleolus to attach to the navicular/medial side of the foot, supports the arch, and supports inversion?
Tibialis Posterior
What posterior deep muscle of the leg attaches proximally a third of the way down the tibia, and travels down behind the medial malleolus, around the medial calcaneus, and forms tendons to attach to the 2-5 toes/phalanges and support the arch?
Flexor Digitorum Longus
What posterior deep muscle of the leg is feathery, attaches laterally off the posterior fibula, and travels down behind the medial malleolus, around the medial calcaneus, to get underneath the foot to the plantar surface to head to the distal phalanges of the great toe to support great toe flexion?
Flexor Hallucis Longus
What posterior deep muscles in the leg pass deep to the medial malleolus in a reliable orientation along with arteries, veins and nerves?
Superficial –> Deep
Tibialis Posterior (Superficial)
Flexor Digitorum Longus
Posterior Tibial Artery & Vein
Tibial Nerve
Flexor Hallucis Longus (Posterior)
“Tom Dick and Very Nervous Harry”
What covers the flexors of the foot and ankle?
Flexor Retinaculum / Tarsal Tunnel
What occurs when an individual’s arch decreases over time and the foot becomes in a relative position of eversion, creating stress on the flexor retinaculum, compressing the structures inside of the tarsal tunnel/deep to the flexor retinaculum, including the tibial nerve which innervates every muscle of the plantar foot, allowing significant muscle weakness of intrinsics and tingling/pain?
Tarsal Tunnel Syndrome
What nerve provides motor innervation to the posterior compartment of the leg?
Sciatic Nerve –> Common Fibular Nerve –> Tibial Nerve
What nerve provides motor innervation to the anterior compartment of the leg?
Deep Fibular Nerve
(Sciatic Nerve –> Common Fibular Nerve –> Deep Fibular Nerve)
What occurs when there’s an inability to dorsiflex the foot due to injury to the deep fibular nerve?
Drop foot
What nerve provides motor innervation to the lateral compartment of the leg?
Superficial Fibular Nerve
(Sciatic Nerve –> Common Fibular Nerve –> Superficial Fibular Nerve)
What can be impacted if there’s a high fibular/fibular head fracture?
Common Fibular Nerve
What can occur when there’s swelling/inflammation in an area of the leg and there’s compression causing nerve death?
Compartment Syndrome
What nerve provides motor innervation to the posterior compartment of the leg, lies deep to Soleus m and lays on top of the deep compartment muscles?
Tibial Nerve
What peripheral nerves provide cutaneous innervation to the posterior leg?
Sciatic Nerve – > Tibial Nerve –> Medial Sural Cutaneous Nerve
Sciatic Nerve –> Common Fibular Nerve –> Lateral Sural Cutaneous Nerve
Medial Sural Cutaneous Nerve + Lateral Sural Cutaneous Nerve = Sural Nerve (Lateral aspect of the foot)
What peripheral nerve provides cutaneous innervation to the medial leg?
Femoral Nerve –> Saphenous Nerve (medial knee/medial leg)
What peripheral nerves provide cutaneous innervation to the medial leg?
Common Fibular Nerve – > Lateral Sural Nerve (Lateral/Anterolateral Leg)
Common Fibular Nerve –> Superficial Fibular Nerve (Lower 1/2 of Anterior Leg)
Femoral Nerve –> Saphenous Nerve (Medial/Anteromedial Leg)
Common Fibular Nerve – > Deep Fibular Nerve (Great Toe/Second Toe)
What is the primary arterial supply to the lower limb?
Femoral Artery
What artery reappears in the popliteal fossa?
Femoral Artery –> Popliteal Artery
What do the following muscles border?
Superolateral: Biceps Femoris
Superomedial:
Semitendinosus
Semimembranosus
Inferolateral: Lateral Head of Gastrocnemius
Inferomedial: Medial Head of Gastrocnemius
Popliteal Fossa
Where are the following contents found?
Popliteal Artery
Popliteal Vein
Tibial Nerve
Genicular Arteries
Popliteal Fossa
What are the divisions of the popliteal artery?
Anterior Tibial Artery
Posterior Tibial Artery
What division of the popliteal artery supplies the Anterior Musculofascial Compartment of the leg?
Anterior Tibial Artery
What nerve does the anterior tibial artery run with in the anterior compartment of the leg?
Deep Fibular Nerve
What division of the popliteal artery supplies the Posterior Musculofascial Compartment of the leg?
Posterior Tibial Artery
What artery passes over the upper margin of the Interosseous Membrane and enters the Anterior Musculofascial Compartment?
Anterior Tibial Artery
What does the Anterior Tibial Artery become when it crosses the true ankle joint and is used as a pulse check point?
Dorsalis Pedis Artery
How do you palpate the pulse of the dorsalis pedis?
Ask patient to lift the great toe so the Extensor Hallucis Longus is visible and step laterally and palpate dorsalis pedis
What is a branch of the Popliteal Artery that enters and supplies the Posterior Musculofascial Compartment of the leg?
Posterior Tibial Artery
What is a branch of the Popliteal Artery that enters and supplies the Lateral Musculofascial Compartment of the leg?
Fibular Artery
What are the terminal branches of the Posterior Tibial Artery?
Medial Plantar Artery
Lateral Plantar Artery
What nerves travel with the Medial/Lateral Plantar Arteries?
Medial Plantar Nerve
Lateral Plantar Nerve