L17: Musculo-neuro-vascular systems of the anterior and posterior compartments of the leg and popliteal fossa Flashcards

(60 cards)

1
Q

popliteal fossa

A

diamond shaped region at back of knee

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2
Q

popliteal fossa - boundaries

A
  • semimembranosus
  • biceps femoris (long head)
  • gastrocnemius (medial and lateral head)
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3
Q

popliteal fossa - floor + roof

A

floor:
- popliteal surface of femur
- oblique popliteal ligament
- popliteus and popliteal fascia

roof:
- skin and fasciae lata

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4
Q

popliteal fossa - contents

A

Superficial:
- small saphenous vein - drains the lateral superficial leg and joints the popliteal vein
Intermediate:
- tibial nerve
- common fibular [peroneal] nerve
Deep:
-popliteal artery
- popliteal vein
Fat
Lymphatic tissue

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5
Q

fascia of the leg

A

leg muscles and bones are covered by crural fascia
- it is continuous superiorly with fascia lata of thigh
- attached around knee to patellar ligament, tibial tuberosity, tibial condyles and head of fibula
- anteriorly blends with periosteum covering shin (tibia)

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6
Q

three compartments of leg

A
  • anterior compartment
  • lateral compartment
  • posterior compartment
    • superficial
    • deep
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7
Q

the leg is divided into 3 compartments by :

A
  • anterior intramuscular septa
  • posterior intramuscular septa
  • interosseous membrane
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8
Q

compartment syndrome

A
  • excessive swelling or bleeding within a compartment
  • usually after an injury
  • exerts pressure on anything within that compartment: nerves, muscles, arteries, and veins
  • can cause irreversible damage to all tissues in compartment
  • treated with emergency fasciotomy
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9
Q

anterior compartment muscles 4

A
  1. tibialis anterior
  2. extensor digitorum longus
  3. extensor hallucis longus
  4. fibularis [peroneus] tertius
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10
Q

anterior compartment muscles
action

A
  • dorsiflexion of foot
  • extension of toes
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11
Q

anterior compartment innervation

A

deep fibular nerve - is a branch of common fibular [peroneal] nerve

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12
Q

extensor retinacula of anterior compartment

A

these are thickened bands of crural fascia

superior extensor retinaculum: passes between distal tibia and fibula

inferior extensor retinaculum: y-shaped retinaculum, attached to: calcaneus and medial malleolus + planter aponeurosis

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13
Q

tibialis anterior; origin

A

tendon of tibialis anterior is prominent on dorsum of foot close to ankle

origin:
-lateral tibial condyle
-antero-supero-lateral surface of tibia
-interosseous membrane

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14
Q

tibialis anterior ; insertion

A

-medial and inferior surface of medial cuneiform
-base of 1st metatarsal

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15
Q

tibialis anterior; innervation + action

A

innervation: deep fibular nerve

actions: dorsiflexes ankle joint + inverts foot at subtalar joint

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16
Q

extensor digitorum longus; origin

A
  • lateral tibial condyle
  • superior 3/4 of anterior fibular and adjacent interosseous membrane
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17
Q

extensor digitorum longus; insertion

A
  • divides into 4 slips
  • slips insert into middle and distal phalanges via extensor expansions (digit 2-5)
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18
Q

extensor digitorum longus; innervation + actions

A

innervation: deep fibular nerve

actions: extends digits 2-5, dorsiflexes ankle

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19
Q

extensor expansions

A
  • triangular shaped expansions
  • over metatarsal phalangeal [MTP] joints
  • extensor digitorum longus [EDL], foot lumbricals and foot interossei insert into extensor expansions
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20
Q

extensor hallucis longus; origin

A
  • middle 1/2 of anterior fibula
  • adjacent interosseous membrane
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21
Q

extensor hallucis longus; insertion

A

dorsal aspect if base of distal phalanx of digit 1 [big toe]

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22
Q

extensor hallucis longus; innervation + action

A

innervation; deep fibular nerve

actions: extends digit 1 + dorsiflexes ankle

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23
Q

fibularis tertius; origin

A

aka peroneus tertius

origin:
- inferior 1/3 of anterior fibula
- adjacent interosseous membrane

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24
Q

fibularis tertius; insertion

A

dorsal surface of base of 5th metatarsal

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25
fibularis tertius; innervation + actions
innervation: deep fibular nerve actions: dorsiflexes ankle + aids with foot eversion
26
posterior compartment - superficial muscles 3
1. gastrocnemius 2. soleus 3. plantaris
27
posterior compartment - superficial muscles - innervation + actions
- all innervated by tibial nerve, a branch of popliteal nerve - all insert into achilles tendon -all plantarflex ankle - triceps sura: gastrocnemius and soleus
28
gastrocnemius; orgin
most superficial muscle in the posterior leg, it has 2 muscle bellies which unite at their tendon origin: -lateral head - lateral condyle of femur -medial head - popliteal surface if femur, above medial condyle
29
gastrocnemius; insertion
calcaneus via achilles tendon
30
gastrocnemius; innervation + actions
innervation: tibial nerve actions: plantar flexes ankle, raises heel during walking, flexes knee
31
soleus; origin
lies deep to gastrocnemius origin: - fibular: posterior head and proximal 1/4 of posterior fibula - soleal line and middle 1/3 of medial border of tibia
32
soleus; insertion
calcaneus via achilles tendon
33
soleus; innervation + actions
innervation: tibial nerve actions: plantar flexes ankle independent of knee position + stabilises leg on foot
34
plantaris; origin
lies between gastrocnemius and soleus, vestigial muscle- absent in 5-10% of people origin; - lateral supracondylar line of femur - oblique popliteal ligament
35
plantaris; insertion
calcaneus via achilles tendon
36
plantaris; innervation + actions
innervation: tibial nerve actions: weakly assists with plantar flexion of ankle and flexion of knee
37
flexor retinaculum of posterior compartment
- runs from medial malleolus to calcaneus - encloses the tarsal tunnel, a space between flexor retinaculum and bones underneath it - permits passage of plantar flexor tendons, nerves and vessels to sole of foot
38
muscles of deep posterior compartment 4
1. popliteus 2. tibial posterior 3. flexor digitorum 4. flexor hallucis longus all innervated by tibial nerve, a branch of the popliteal nerve
39
Tom, Dick And Very Nervous Harry (from medial to lateral)
Tibialis posterior flexor Digitorum longus tibial Artery tibial Vein flexor Hallucis longus
40
popliteus; origin
lateral femoral condyle and lateral meniscus
41
popliteus; insertion
posterior tibial surface, superior to soleal line
42
popliteus; innervation + actions
innervation: tibial nerve actions: weakly flexes knee, ''unlocks'' a fully extended knee to permit flexion, contraction externally rotates femur by ~5* on tibial plateau to permit flexion
43
tibialis posterior; origin
-Posterior tibia, inferior to soleal line -Posterior fibula - Adjacent interosseous membrane
44
tibialis posterior; insertion
-Inferior surface of navicular -Cuneiforms -Cuboid -Sustentaculum tali of calcaneus -Bases of metatarsals 2-4
45
tibialis posterior; innervation + actions
innervation: tibial nerve actions: inverts foot
46
flexor digitorum longus; origin
medial part of posterior tibial surface, inferior to soleal line
47
flexor digitorum longus; insertion
base of distal phalanges 2-5
48
flexor digitorum longus; innervation + actions
innervation: tibial nerve actions: flexes digits 2-5, plantarflexes ankle, supports longitudinal arches of foot
49
flexor hallucis longus; origin
-inferior 2/3 of posterior fibula -adjacent interosseous membrane
50
flexor hallucis longus; insertion
base of distal phalanx of great toe [hallux]
51
flexor hallucis longus; innervation + action
innervation: tibial nerve actions: flexes digit 1 at all joints, weakly plantarflexes ankle, supports medial longitudinal arch of foot
52
surface anatomy of posterior leg
popliteal fossa, gastrocnemius muscle [medial and lateral heads], soleus muscle, calcaneal [achilles] tendon, medial malleolus of tibia, lateral malleolus of fibula, calcaneus
53
popliteal artery divided into:
anterior and posterior tibial arteries
54
arterial supply to the anterior leg
anterior tibial artery supplies anterior compartment of leg - it reaches anterior compartment by passing through a gap in the superior interosseus membrane - it descends between tibialis anterior and extensor hallucis longus - descends deep to extensor retincula - after passing inferior extensor retinaculum, becomes known as dorsalis pedis artery
55
arterial supply to the posterior leg, 2
1. posterior tibial - passes through posterior compartment of leg and through tarsal tunnel - distal to tarsal tunnel it divides into medial and lateral plantar arteries - supplies posterior and lateral compartments of leg 2. fibular artery - descends in posterior compartment - supplies posterior compartment, perforating branches also supply lateral compartment
56
arterial pulses of lower limb
proximal to distal: - femoral artery - popliteal artery - posterior tibial artery - dorsalis pedis
57
venous drainage of the superficial leg
medial: great saphenous system, drains into femoral vein lateral: small saphenous system, drains into popliteal vein
58
venous drainage of the deep leg
anterior tibial vein: accompanies anterior tibial artery, drains anterior compartment, drains into popliteal vein posterior tibial vein: accompanies posterior tibial artery, drains posterior compartment, drains into popliteal vein fibular vein: accompanies fibular artery, drains into popliteal vein
59
varicose veins
failure of valves in superficial venous systems -great saphenous area -small saphenous area blood collects in superficial veins can cause: - pain, itching, swelling, bleeding can occur
60
sensory innervation of leg
- saphenous nerve - branch of femoral nerve - lateral sural cutaneous nerve - branch of fibular nerve - medial sural cutaneous nerve - branch of tibial nerve