Unit 4- Posterior Leg Compartment Flashcards
The plantarflexor compartment is 4x (STONGER/WEAKER) than dorsi flexion and has much (SHORTER/LONGER) range of motion
Stronger
Longer
Superficial and deep compartments of the plantarflexor compartment is separated by:
Transverse muscular septum
The transverse septum extends ____ and forms:
Distally
Reinforcing fibers of the flexor retinaculum
Between the medial malleolus and calcaneous
Both compartments in the plantarflexor area are supples by the ____ nerve and ____ ____ vessels
Located where?
Tibial
Posterior tibial
Just anterior to the transverse intermuscular septum (in the deep compartment)
Superficial posterior compartment muscles
Gastrocnemius
Soles
Plantaris
The superficial post compartment muscles work together to:
Elevate the heel
Sup. Post muscles generate _____% of plantarflexion of the ankle joint
93
OINA for Gastrocnemius
OR: 2 heads
Lateral- Lateral condyle of femur
Medial- Medial condyle of femur
INS: Post calcaneal bone via calcaneal tendon
AC: Plantar flexes foot
Flexes leg
NS: Tibial nerve
2 actions of the gastrocnemius (CAN/CAN NOT) occur in the extreme simultaneously
Can not
For gastrocnemius: when knee is flexed, plantarflexion is:
Minimized
Vice versa- when plantar flexed, knee flexion is impaired - active insufficiency
Tendinitis of the calcaneal tendon results from:
Inflammation often exacerbated by running/walking on uneven surfaces or hills
The repetitive trauma of heel strike can result in:
Rupture of the gastrocnemius tendon
OINA for soleus
OR: Post head of fibula
Soleal line of tibia
INS: Post calcaneal bone via calcaneal tendon
AC: Plantar flexes foot
Helps maintain posture
NS: Tibial nerve
Soleaus is (ACTIVE/INACTIVE) when standing quietly
Active
The soleus contracts ______ and _____ with foot dorsiflexors to maintain balance
Cooperatively and antagonistically
Workhorse of plantarflexion
Soleus
Is the soleus able to plantarflex when knee is fully extended?
Yessss
When the foot is planted, the posterior and inferomedial direction of soleal fibers pulls the leg bones ______;
Posteriorly
This counteracts the pull of the center of gravity as it passes anterior to the leg bone axis
The gastrocnemius and soleus form what muscle??
Triceps surae (3 heads, 1 tendon)
What forms the Achilles’ tendon?
The distal insertion of gastrocnemius and soleus forming the calcaneal tendon tat inserts on the calcaneal tuberosity
Achilles’ tendon rupture takes place wher?
A couple inches above the joining of the tendon and the calcaneous
What can cause Achilles rupture?
When the calf muscle contracts or tightens the calf muscle and suddenly pushes off the foot, such as in basketball, racquet sports or other activities
Symptoms of Achilles rupture
Pain
Swelling
Inability to stand on tiptoes
Look at slide 11
Will type up later- its too much right now
Slide 11
OINA for plantaris
OR: Lateral supracondylar line of femur
INS: calcaneus bone (sometimes fuses with calcaneal tendon)
AC: Plantar flexes foot (weak) Flexes leg (weak)
NS: Tibial nerve
The ___ nerve and ___ _____ vessels pass deep to the superficial post leg muscles
Tibial
Post tibial
What muscle is absent in about 10% of individuals?
Plantaris
The plantaris has a high density of _____ ____ an may simply be a:
Proprioceptive
Kinesthetic sensory organ
What does the plantaris tendon run between?
Gastrocnemius and soleus
What tendon is often mistaken as a nerve?
Plantaris
What bursa is between the skin and calcaneal tendon?
Subcutaneous calcaneal bursa
Where is the deep bursa of the calcaneal tendon located?
Between the tendon and calcaneus
Deep post compartment muscles
Popliteus
Flexor digitorum longus
Flexor hallicus longus
Tibialis posterior
OINA for popliteus
OR: Lateral condyle of femur
Tendinous attachment to lateral meniscus
INS: post tibia- above soleal line
AC: Minimal flexion of the knee
Medial rotates the leg
May pull lateral meniscus post during knee flexion
Unlocks knee
NS: Tibial nerve
What forms the distal part of the floor of the popliteal fossa?
Popliteus
OINA for flexor hallicus longus
OR: Inf 2/3rd of post fibula
Inf interosseous membrane
INS: Base of distal phalanx, digit I
AC: Flexes digit I
Plantar flexes foot
Inverts foot
NS: tibial nerve
The flexor hallicus longus tendon enters the foot with the tendons of the ____ and ____
It passes post to the ____ ____ to a groove on the _____ _____ and inferior groove on the _______ ____.
FDL and TP
Distal tibia
Posterior talus
Talar shelf
OINA for flexor digitorum longus
OR: Middle portion of post tibia- inf to soleal line
Fascia of tibialis post muscle
INS: Distal phalanges of digits II—V
AC: Flexes digit II-V (grip ground during walking)
Plantar flexes foot
Inverts foot
Helps support longitudinal arches
NS: Tibial nerve
Along with FHL and TP tendons, the FDL tendon passes post to the ____ _____ passing deep To the _____ ______.
Medial malleolus
Flexor retinaculum
The diagonal pull of FDL is reduced by the ____ ____ muscle that is attached to the post aspect of the FDL tendons
quadratus plantae
OINA for tibialis post
OR: Post tibia - below soleal line
Post interosseous membrane
INS: Navicular bone
Cuneiform I
Tendon expands to: Cuneforms II, III and base of metacarpals II, III, IV
AC: plantar flexes foot
inverts foot
Adducts foot
Maintain medial longitudinal arch during weigh bearing
NS: tibial nerve
Deep muscles of the ankle
Tibial posterior
Flexor digitorum longus
Flexor hallucis longus
(Think Tom Dick and Harry)
Calcaneal tendon
post tibial art is a branch of the
Popliteal artery
Post tibial art passes between what?
The deep and superficial post compartments just deep to the transverse IM septum
Also passes post to the medial malleolus
The post tibial art divides into :
Medial and lateral plantar arteries
What does the tibial art run with?
The tibial nerve
Branches of the post tibial art
Fibular
Communicating
Post medial malleolar
Medial calcaneal
Branches of the medial calcaneal
Medial plantar
Lateral plantar
Fibular artery arises at the ________ border of the ____ and _____ arch
Inferior
Popliteus and soleus
Review slide 23- will add later
Slide 23
OR of tibial nerve
L4-5
S1-3
Tibial nerve is the larger of the terminal branches of the:
Sciatic nerve
The tibial nerve runs through the ____ ____ with the _____ artery and vein.
Popliteal fossa
Popliteal
The tibial nerve passes between:
And deep to:
Heads of gastrocnemius and deep to the tendinous arch of the soleus
The tibial nerve supplies:
All the muscles of the post compartment
Where does the tibial nerve lie?
Between the FHL and FDL
The tibial nerve is post and inf to the ____ ____
It divides into the:
Medial malleolus
Medial and lateral plantar nerves
The medial sural cutaneous nerve joins with the:
To form the:
Sural communicating branch
Sural nerve
What the the sural nerve serve?
The skin of the lateral and posterior inf 1/3rd of the leg and lateral foot
Tibial articular branches serve the:
Knee
Medial calcaneal branches serve the:
Skin of the heel
What does the peroneal retinaculum cover?
Structures that poss post to the lateral malleolus
What does the flexor retinaculum cover?
Structures that pass post to the medial malleolus
Look into extensor retinaculum
Slide 31
