Label the following nerves and artery of the anterior leg.
Label the following muscles and tendons.
Label the following muscles of the leg.
Fill in the labels for the nerves and add on labels for the veins and arteries.
Label the following structures of the popliteal fossa.
Label the following structures of the leg.
Label the inferior view of the foot.
Label the following.
Tom, Dick and A Very Nervous Harry
Label what nerves supplying the following parts of the foot.
Label what dermatomes supply each part of the foot.
What are the three parts of the foot and the bones involved in each part?
- Hindfoot: Calcaneus and Talus
- Mid-foot: Navicular, Cuboid and Cuneiforms
- Forefoot: Metatarsals and Phalanges
What are the three articulations of the talus?
- Ankle joint (talocrural): superior between talus, tibia and fibula
- Subtalar joint: inferior between talus and calcaneus
- Talonavicular joint: anteriorly between talus and navicular
What is an issue with talus fracture and why?
- Avascular necrosis as no muscle attachments improving vascularity and blood supply is retrograde
What are the different joints of the calcaneus?
- Subtalar: Superior
- Calcaneocuboid: Anterior
Takes full weight of body when heel is on the ground and is marked by the calcaneal tuberosity
What are the different rows of the tarsals?
Proximal: Calcaneus and Talus
Distal: Cuneiform and Cuboid
What are the different joints in the forefoot?
Explain the makeup of the ankle joint and what movement occurs here?
- Only plantar and dorsiflexion
- Joint more stable in dorsiflexion as anterior part of talus is wider
- Synovial hinge joint
What are the ligaments supporting the ankle joint?
- Anterior talofibular: between lateral malleolus and neck of talus
- Posterior talofibular: Between malleolar fossa and lateral tubercle of talus
- Calcaneofibular: Between lateral malleolus and lateral calcaneus
- Deltoid: Fans from medial malleolus to talus, calcaneus and navicular. Stronger and resists eversion
What muscles are involved in dorsiflexion and plantarflexion?
Dorsiflexion: Tibialis anterior, Extensor hallucis longus, extensor digitorum longus, peroneus tertius
Plantarflexion: Gatrocnemius, Soleus, Plantaris, Tibialis Posterior
What joint does inversion and eversion of the foot occur in and what muscles allow this?
- Subtalar, calcaneocuboid and talocalcaneonavicular NOT ankle
- Mainly occurs in subtalar, no flexion whatsover only in/eversion here
- Eversion: Lateral muscles (brevis and longus) and peroneus tertius from anterior
- Inversion: Tibialis anterior and posterior
What are the arches of the foot?
What is the medial arch of the foot maintained by?
- Calcaneus, talus, navicular, three cuneiforms, spring ligament (plantar calcaneonavicular), tibialis anterior and peroneus longus tendons
- Muscle support: TA, PL, tibialis posterior, peroneus longus and flexor hallucis longus
What is the lateral longitudinal arch maintained by?
- Formed: Calcaneus, Cuboid and lateral two metatarsals
- Support: Contraction of fibularis brevis
- Arch flattens when standing and bones lock together, ligaments binding so they become and immobile pedestal
What muscles are in the anterior compartment of the leg, what are they innervated by and what is the blood supply?
What are the origins and insertions of the muscles in the anterior compartment? (all passing under extensor retinacula)
- TA: origin at lateral surface of anterior tibia, and inserts on medial cuneiform and base of first metatarsal
- EDL: origin lateral condyle of tibia, medial fibula and interosseous membrane and inserts on middle and distal phalanges of dorsal four toes
- EHL: origin at medial fibula and crosses anterior to ankle joint to insert on base of distal phalanx of great toe
- Fibularis Tertius: origin at medial fibula, inferior to EDL, and inserts on base of 5th metatarsal
What are the muscles in the lateral compartment of the leg, the blood supply, the nerve supply and the action of the muscles?
- Fibularis longus (superficial) and Fibularis brevis (deep)
- Nerve: Superficial peroneal nerve
- Blood: Fibular artery
- Action: Both evert the foot and prevent excess inversion. Longus plantarflexes and supports medial and transverse arches. Brevis supports lateral arch.
What is the innervation and blood supply of the posterior muscles of the leg, and the action they have?
- Tibial nerve
- Posterior tibial artery
- Collectively plantarflex and invert the foot
- Superficial and deep compartment separated by fascia
What are the muscles of the superficial posterior compartment, what are their actions, origins and insertions?
- Plantaris: origin at lateral supracondylar line of femur and blends to calcaneal tendon. Can be harvested to use for a tendon elsewhere
- Gatrocnemius: origin from each femoral condyle and blends to calcaneal tendon to insert on calcaneal tuberosity
- Soleus: origin at tibial soleal line and proximal fibula, inserting to calcaneal tendon
What is the anatomy of the calcaneal tendon?
- Formed from blending of tendons of superficial posterior muscles
- Deep and superficial bursae