Anterior and Lateral Compartments of Leg Flashcards

1
Q

What are the compartments of the leg and how are they formed?

A

Anterior, lateral and posterior

These are formed by the tibia, fibula, interosseous membrane and the ant/posterior intermuscular septae

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2
Q

Which leg compartment is most at risk for compartment syndrome and why?

A

The anterior compartment, as there is little space, and it is bound rigidly by deep fascia, interosseous membrane and the tibia/fibula bones.

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3
Q

What are the muscles of the anterior leg compartment

A

Tibialis Anterior
Extensor Digitorum Longus
Extensor Hallicus longus
Peroneus tertius

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4
Q

What is the interosseous membrane?

A

Thick sheet of tissue, like deep fascia. Strongly binds tibia and fibula and divides leg into ant/post compartments.

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5
Q

What is the function of the anterior compartment?

A

Dorsiflex (extensor)

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6
Q

What is the origin and insertion of the Tibialis ant.?

Actions?

A

Origin: Superior lateral tibia and interosseous membrane
Insertion: Medial cuneiform and base of the 1st metatarsal

Dorsiflexion and inversion at subtalar joint

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7
Q

What is the origin and insertion of the extensor digitorum Longus? Actions?

A

Origin: Superior fibula and interosseous membrane
Insertion: Lateral four digits

Dorsiflexion and extension of digits

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8
Q

What is the origin and insertion of the extensor hallicus longus? Action?

A

Origin: middle ant fibula and interosseous membrane
Insertion: Great toe

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9
Q

What is the peroneus tertius

A

Random little muscle that originates on the inferior fibula and inserts onto the base of the 5th metatarsal. As it crosses the ankle joint it dorsiflexes and also slightly everts foot.

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10
Q

What muscles are within the lateral compartment?

A

Peroneus Longus

Peroneus Brevis

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11
Q

Where does the peroneus Longus originate and insert? And what does this mean for movement?

A

Origin: Superior lateral fibula
Insertion: Medial cuneiform and base of 1st metatarsal

This muscle inserts in the same area as tibialis anterior, and therefore does the opposing action to EVERT the foot, as well as weakly plantaflex

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12
Q

Where does the peroneus brevis originate and insert?

A

Origin: inferior fibula
Insertion: Base of 5th metatarsal

Weak dorsiflexor and slightly everts foot (with peroneus tertius)

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13
Q

Name the four retinaculums of the foot

A

Superior extensor retinaculum
Inferior extensor retinaculum
These pin down the tendons of the anterior (extensor) muscles.

Superior Peroneal Retinaculum
Inferior Peroneal Retinaculum
These pin down the tendons of the peroneal (lateral) muscles

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14
Q

What is the clinical purpose of Retinaculum?

A

Holds down tendons to prevent bowstringing of muscles and tendons. If not held in place tendons could rub on bone (eg peroneal tendons on distal fibula) and snap.

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15
Q

Where would you find a pulse for foot?

A

Dorsalis Pedis pulse: just lateral to EHL tendon on dorsal surface of 2nd metatarsal

Posterior Tibial Artery pulse: arch of foot

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16
Q

What are the three main arteries that trifurcate off the popliteal artery to supply the leg?

A

Peroneal Artery: supplies lat. compartment
Anterior Tibial Artery: supplies anterior compartment
Posterior Tibial artery: supplies posterior compartment

17
Q

What is interesting clinically about the anterior tibial artery?

A

It passes anteriorly through the interosseous membrane to supply ant. comp. At the ankle joint it crosses deep to the EHL tendon (midway through malleoli) to become Dorsalis Pedis. DP can be used to find a pulse ( that isn’t always around boob)

18
Q

What does the sciatic nerve bifurcate into at the popliteal fossa?

A

Common peroneal (runs laterally around femur) and tibial nerve (stays post)

19
Q

What are the two lateral compartment muscles

A

Peroneus Longus

Peroneus Brevis

20
Q

Dorsal Foot Muscles are? And what is their common origin?

A

Extensor Digitorum Brevis
Extensor Hallucis Brevis

They originate at the inferior extensor retinaculum and calcaneous

21
Q

Extensor digitorum brevis
Extensor hallicus brevis
insertion and action

A
  • Base of big toe (extension of great toe)

- phalanges of lateral four toes (extension of toes)

22
Q

What are the five p’s of compartment syndrome?

A

1) Pain
2) Pallor
3) Pulseless
4) Paresthesia (nerve cut off)
5) Paralysis

23
Q

Why would you get paresthesia in C S?

A

When the pressure builds to a certain level and cuts off the nerve supply to the limb

24
Q

What would be the appearance of a lower extremity if suffering long term from CS?

A

Grey and dusky. Pallor due to arterial supply being cut off.

25
Q

Where could you check for Compartment syndrome

A

In the 2nd meta tarsal of the foot, as there is no arterial supply you will not find a dorsalis pedis pulse.

26
Q

What is the order in which the blood vessels will be compressed?

A
1st Veins (weaker walled vessels) 
2nd Arteries