Workbook - The leg Flashcards
What is the larger, medial bone in the leg?
Tibia.
What shape is a cross-section of the tibia?
Triangular.
-medial, lateral and posterior surfaces
Where is the soleal line and what attaches to it?
On the posterior surface of the proximal tibia.
-soleus muscle
Where is the tibial tuberosity and what attaches to it?
On the anterior surface of the proximal tibia.
-patellar ligament
What is acute osteomyelitis?
Inflammation of longer bones due to new infection in the bone.
-predominantly in children
What is a common site for acute osteomyelitis?
Proximal end of the tibial shaft.
Why is the tibia the commonest long bone to be fractured?
- Superficial and unprotected ant/med
- Particularly slender in lower 1/3.
What is a compound injury?
Break in continuity of bone that pierces skin.
-dirt/bacteria can enter
What is the smaller, lateral bone in the leg?
Fibula.
What does the fibula articulate with proximally?
Lateral condyle of tibia.
-does not form knee joint
What does the fibula articulate with distally?
Anchored to tibia by fibrous joint.
What is the interosseous membrane in the leg?
Fibrous joint that unites the tibia and fibula.
What is the function of the interosseous membrane in the leg? (2)
- Separates muscles into anterior and posterior compartment
- Site of attachment for muscles
How many foramina are there in the interosseous membrane?
Two.
What is the function of the 2 foramina in the interosseous membrane?
SUPERIOR - anterior tibial vessels pass through to anterior leg
INFERIOR - anterior fibular vessels (perforation branches) pass through
What is another name for fibular?
Peroneal.
How many compartments are there in the leg?
Three.
-anterior/posterior/lateral
What divides the leg into 3 compartments?
- Interosseous membrane
- 2 intermuscular septae
- Attachment of deep fascia to periosteum
What are the muscles of the anterior compartment of the leg? (4)
- Tibialis anterior (most med)
- Extensor hallucis longus
- Extensor digitorum longus
- Fibularis tertius
Which muscle is not present in everyone?
Fibularis tertius.
-considered part of extensor digitorum longus
Which muscle is lateral to tibialis anterior and partially covered by it?
Extensor hallucis longus.
What is the nerve supply to the anterior compartment of the leg?
Deep fibular nerve.
-branch of common fibular
What is the blood supply to the anterior compartment of the leg?
Anterior tibial artery.
How many extensor retinaculum are there on the leg?
Two.
- superior and inferior
- both on anterior ankle
What is the function of the retinaculum?
Holds tendons in place and stabilises them.
What are the main functions of the anterior compartment of the leg? (3)
- Dorsiflex foot
- Extend toe
- Invert foot
Where are the origins and insertions of extrinsic muscles of the foot?
Origins - leg
Insertions - foot
Where are the origins and insertions of intrinsic muscles of the foot?
Origins - foot
Insertions - foot
What are the extrinsic extensors of the foot? (2)
- Extensor hallucis longus
- Extensor digitorum longus
What is the function of fibularis tertius?
- Dorsiflexion
- Eversion of the foot (unlike other ant compartment muscles)
Which artery is deep to extensor digitorum longus?
Anterior tibial artery.
What is the course of the anterior tibial artery?
Arises from the popliteal artery
|»_space; passes from post to ant compartment of leg via superior hiatus in interosseous membrane
What are the muscles in the lateral compartment of the leg? (2)
- Fibularis (peroneus) longus
- Fibularis (peroneus) brevis
Where do the tendons of fibularis longus and brevis pass at the ankle?
Posterior to the lateral malleolus.
Where does fibularis longus tendon pass of the plantar foot, and where does it insert?
Travels medially across sole.
- inserts on lateral side of distal medial cuneiform and base of metatarsal 1
What is the nerve supply to the muscles of the lateral compartment of the leg?
Superfical fibular nerve (L5-S2).
-branch of common fibular
What are the main actions of the lateral compartment of the leg?
- Evert the foot
- Plantar flex foot (longus)
Where is the common fibular nerve vulnerable to injury?
As it courses around the neck of the fibula.
What are the consequences of injuring the common fibular nerve at the neck of the fibula?
- Foot drop (lose ability to dorsiflex)
- Characteristic gait
- Paralysis of ant and lat compartments of leg
What does the common fibular nerve innervate?
MOTOR
- short head of biceps femoris
- branches to lat & ant compartments of leg
SENSORY
- skin over upper lat and lower post/lat leg
- branches to skin over ant/lat leg and dorsum of foot
How many muscles are there in the posterior compartment of the leg?
Seven.
What are the subcompartments of the leg, and what separates them?
Superficial and deep.
-separated by transverse intermuscular septum
What are the muscles of the superficial posterior compartment of the leg? (3)
- Gastrocnemius
- Soleus
- Plantaris
Which muscles in the superficial posterior compartment of the leg are able to function as flexor of the knee as well as plantarflexors of the ankle? (2)
- Gastrocnemius
- Plantaris
What are the muscles of the deep posterior compartment of the leg? (4)
- Popliteus
- Flexor digitorum longus
- Flexor hallucis longus
- Tibialis posterior
What artery and nerve run in the deep posterior compartment of the leg?
- Posterior tibial artery
- Tibial nerve
Which tendons of the deep posterior compartment run posterior to the medial malleolus? (3)
ANT >> POST: -Tibialis posterior -flexor Digitorum longus (-Neurovascular bundle) -flexor Hallucis longus
(Tom Dick and Nervous Harry)
Which artery and nerve are in the neurovascular bundle that passes posterior to the medial malleolus?
- Posterior tibial artery
- Tibial nerve
What is the arterial supply to the anterior compartment of the leg?
Anterior tibial artery.
Where does the anterior tibial artery originate?
From the popliteal artery in the posterior compartment of the leg.
How does the aterior tibial artery enter the anterior compartment of the leg from the posterior compartment of the leg?
Through an aperture in the interosseous membrane.
What is the route of the anterior tibial artery in the anterior compartment of the leg?
Descends on interosseous membrane
» between tendons of tibialis anterior and extensor hallucis longus
» passes anrterior to distal tibia
» dorsalis pedis artery in dorsal foot
» gives rise to lat and med malleolar arteries
What meets the anterior tibial artery at the interosseous membrane and descends down the anterior leg with it?
Deep fibular nerve.
What is the most superficial muscle in the calf (posterior leg)?
Gastrocnemius.
What muscle are the tibial vessels and nerve deep to?
Soleus.
What is the common insertion of the superficial muscles of the posterior leg?
Calcaneus (heel bone).
-via the calcaneal tendon
What is another name for the calcaneal tendon?
Achilles tendon
Tendocalcaneus
Where does the great saphenous vein enter the femoral vein?
In the superior thigh, immediately inferior to the inguinal ligament.
What nerve accompanies the great saphenous vein in the lower leg?
Saphenous nerve.
-medial leg and foot
Which artery supplies blood to adductor brevis?
Obturator artery.
The branches of which artery supply blood to the knee joint?
Genicular branches of the popliteal artery.
What is another name for the fibular artery?
Peroneal artery.
Which artery passes through the adductor canal (from the anterior thigh to the posterior thigh)?
Femoral artery.
-along with femoral vein, saphenous nerve and nerve to vastus medialis
Which artery is a direct continuation of the external iliac artery?
Femoral artery.
