Anatomy of the leg and foot

Question 1

Function of the foot

Answer 1

Support body weight

Stability/ standing

Locomotion/ propulsion (lever)

Shock asborption

Question 2

Bones of the leg

Answer 2

Fibula

Tibia

• lateral malleolus
• medial malleolus

Question 3

Bones of the foot

Answer 3

Tarsal

Metatarsals

Phalanges

Sesamoid bones

Question 4

Tarsal bones

Answer 4

Calcaneous

Talus

Cuboid

Navicular

Cuneiforms

Question 5

Movement of the foot

Answer 5

Dorsiflexion/ extension

Plantarflexion/ flexion

Eversion

Inversion

Supination

Question 6

Joints of the foot

Answer 6

Ankle joint
- dorsiflexion/ plantarflexion

Intertarsal joints

• invert/ evert
• supinate/ pronate

Metatarsophalangeal joints

• extension/ flexion
• limited abduction/ adduction

Interphalangeal joints
- extension/ flexion

Question 7

Ankle

Answer 7

Articulation between the thalus and tibia/ fibula

Synovial hinge joint

Question 8

Ankle

Answer 8

Stabilised by collateral ligaments

Lateral ligament- lateral malleolus to talus/ calcaneous

Medial/ deltoid ligament- medial malleolus to talus/ calcaneous/ navicular

Question 9

Clinical: ankle

Answer 9

Injury to lateral ligament (usually anterior talofibular ligament)

Question 10

Subtalar joint

Answer 10

Between talus and calcaneous (and navicular)

Allows inversion/ eversion during locomotion

Question 11

Transverse tarsal joint

Answer 11

Between forefoot and hindfoot

Allows pronation/ supination (eversion/ inversion of forefoot)

Important for standing on uneven ground

Question 12

Plantar aponeurosis

Answer 12

Thickening of deep fascia

Protects underlying structures

Supports longitudinal arch

Question 13

Clinical: plantar aponeurosis

Answer 13

Plantar fasciitis (inflammation due to overuse)

Question 14

Arches of the foot

Answer 14

Longitudinal and transverse arches

Function

• shock absorbers during locomotion
• act as springboards
• distribution of weight (to calcaneous and ball of foot)

Question 15

Longitudinal arches

Answer 15

Lateral and medial arches

Supported by long tendons, intrinsic plantar muscles, intrinsic ligaments and plantar aponeurosis

Question 16

Clinical: longitudinal arches

Answer 16

Fallen medial longitudinal arch can lead to pes planus (flat feet)

Question 17

Transverse arch

Answer 17

Supported by long tendons

Question 18

Muscle compartments

Answer 18

Anterior
- extend/ invert foot

Posterior
- flex/ invert foot

Lateral
- evert foot

Question 19

Anterior compartment of leg

Answer 19

Three muscles

Extend and invert foot

Origin: tibia and fibula

Supplied by deep fibular nerve

Tibialis anterior
- extends/ inverts foot

Extensor digitorum longus
- extends lateral 4 toes

Extensor hallucis longus
- extends great toe

Question 20

Extensor digitorum longus

Answer 20

Middle and distal phalanges

Question 21

Tibialis anterior

Answer 21

Medial cuneiform and 1st metatarsal

Question 22

Extensor hallucis longus

Answer 22

Distal phalanx of great toe

Question 23

Posterior compartment of leg- superficial group

Answer 23

Flex foot and leg

Supplied by tibial nerve

Plantaris

Soleus

Gastrocnemius

Tendo calcaneous

Question 24

Posterior compartment of leg- deep group

Answer 24

Flex and invert foot and flex toes

Origin: tibia and fibula

Supplied by tibial nerve

Flexor digitorum longus

Tibialis posterior

Flexor hallucis longus

Question 25

Flexor digitorum longus

Answer 25

Distal phalanges

Question 26

Flexor hallucis longus

Answer 26

Distal phalanx of great toe

Question 27

Tibialis posterior

Answer 27

Medial cuneiform and navicular

Question 28

Lateral compartment of leg

Answer 28

Evert foot Supplied by superficial fibular nerve Fibularis longus - everts and plantar flexes foot Fibularis brevis

Question 29

Lateral long tendons of the foot

Answer 29

Extensor retinaculum Fibular retinaculum Extensor digitorum longus Extensor hallucis longus Fibularis longus/ brevis

Question 30

Medial long tendons of the foot

Answer 30

Flexor retinaculum Tibialis anterior Tibialis posterior Flexor digitorum longus Flexor hallucis longus

Question 31

Intrinsic muscles of the foot

Answer 31

Many layers - dorsal extensors- 1 layer - plantar flexors/ abductors/ adductors- 4 layers

Question 32

Blood supply

Answer 32

Posterior compartment - popliteal artery - anterior tibial artery - posterior tibial artery - fibular artery

Question 33

Tarsal tunnel

Answer 33

Contents - tibialis posterior - flexor digitorum longus - posterior tibial artery/ vein - tibial nerve - flexor hallucis longus

Question 34

Clinical: tarsal tunnel

Answer 34

Pulse and tarsal tunnel syndrome

Question 35

Blood supply: anterior compartment

Answer 35

Anterior tibial artery Dorsalis pedis - sites behind the extensor hallucis longus tendon Anastomosis with deep plantar arch

Question 36

Clinical: dorsalis pedis artery

Answer 36

Pulse

Question 37

Nerve supply to the leg

Answer 37

Supplied by the terminal branches of the sciatic nerve Tibial- posterior compartment Deep fibular- anterior compartment Superficial fibular- lateral compartment

Question 38

Clinical: tibial nerve

Answer 38

Tarsal tunnel syndrome

Question 39

Tibial nerve

Answer 39

Motor: posterior compartment of leg and plantar intrinsic muscles

Question 40

Common fibular nerve

Answer 40

Motor - deep: anterior compartment of leg and dorsal intrinsic muscles - superficial: lateral compartment of leg

Question 41

Clinical: common fibular nerve

Answer 41

Trauma to common fibular nerve (foot drop)

Question 42

Cutaneous nerves

Answer 42

Common fibular nerve Superficial fibular nerve Deep fibular nerve Saphenous nerve (femoral nerve) Sural nerve (tibial nerve) Medial/ lateral plantar nerves (tibial) supply sole of foot