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lower limb leg > leg > Flashcards

leg Flashcards

1
Q

borders of tibia (shaft)

A

3= ant, lateral, medial

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2
Q

surfaces of tibia (shaft)

A

medial, lateral, post

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3
Q

distal tibia surfaces

A

anterior, lateral, medial, posterior, inferior (plafond)

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4
Q

insertion of the soleus

A

soleal line

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5
Q

forms the mallelolar sulcus

A

tendons of tibialis post and FDL

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6
Q

btwn the condyles of the tibia

A

ant and post intercondylar fossa (depressions) and intercondylar eminence (raised area btwn condyles)

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7
Q

ant intercondylar fossa contents

A

medial meniscus, ant cruciate ligament, and lateral meniscus (ant to post)

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8
Q

post intercondylar fossa contents

A

post cruciate ligament, medial meniscus, lateral meniscus (from post to ant)

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9
Q

groove at inferior end of the tibia

A

for attachement of joint capsule

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10
Q

where deltoid ligament attaches to medial malleolus

A

ant + post colliculus + intercollicular sulcus

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11
Q

main func of fibula

A

primary function of fibula is for muscle attachments it is largely non-weight bearing

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12
Q

location/ attachement of lateral malleloar fossa

A

posterior= lateral malleolar fossa for posterior tibiofibular and posterior talofibular ligaments
*this is a great landmark for orienting the fibula!

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13
Q

4 borders shaft of fibula

A

borders= anterolateral, anteromedial (Interosseus crest, most constant), posterolateral, posteromedial

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14
Q

4 surfaces of fibula

A

Surfaces lie in btwn borders= btwn anterolateral/medial= anterior surface
In btwn posterolateral/medial= post
In btwn medials (posteromedial and anteromedial)= medial surface
In btwn laterals (anterolateral and posterolateral)= lateral surface

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15
Q

lateral surface of fibula origin

A

peroneus longus and brevis

-fibular head= biceps femoris and fibular collateral ligament

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16
Q

medial surface of tibia

A

shaft is subcutaneous = proximal portion attachment for IT band, semimeb, gracillis, Sartorius, semitend, quads, tibial collateral ligament

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17
Q

ant fibula surface

A

origin of extensor digitorum longus, extensor hallucis longus, peroneus tertius

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18
Q

lateral surface tibia

A

origin TA and EDL

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19
Q

post surface tibia

A

origin of soleus, flexor digitorum longus, tibialis posterior
insertion of popliteus

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20
Q

medial surface fibula

A

tib post

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21
Q

post surface fibula

A

soleus, FHL origins

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22
Q

soleal line + vertical line notes

A

Note: soleus originates from soleal line

origin of flexor digitorum longus & tibialis posterior are separated by the vertical line

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23
Q

shared compartments of tibia/fibula

A

ant fibula, lateral tibia

post tibia, medial + post fibula

lateral fibula, medial tibia

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24
Q

crural fascia

A 
Crural fascia (=deep fascia of the leg) forms intermuscular septa that divide the leg into compartments that share action, innervation, and blood supply
Very thick= helps w/ venous return 
Ant, post= intermuscular septum located laterally
Interosseus mb and transverse on the medial side
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25
Q

ant compartment

A

Action: dorsiflexion
Innervation: deep peroneal nerve
Blood supply: anterior tibial artery
tibialis ant, EDL, Peroneus Tertius, EHL, EHC

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26
Q

lateral compartment

A 
Action: eversion
Innervation: superficial peroneal nerve
Blood supply: perforating branches from anterior tibial and peroneal arteries
No neurovascular bundle (no artery)
PL, PB
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27
Q

deep post compartment

A

Action: plantarflexion of digits
Innervation: tibial nerve
Blood supply: posterior tibial and peroneal arteries
FDL, FHL, tibialis post,popliteus,

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28
Q

sup post compartment

A

Action: plantarflexion of ankle
Innervation: tibial nerve
Blood supply: posterior tibial artery
gastroc, soleus, plantaris

29
Q

compartment syndrome

A

trauma to structures within compartments may result in hemorrhage, edema, or inflammation
strength of crural fascia precludes outward swelling of tissues leading to compression of neurovasculature
treatment includes fasciotomy of affected compartment
if untreated, may to ischemia, necrosis, or atrophy of affected tissues

30
Q

tibialis ant

A

Tibialis anterior
Origin: lateral surface of tibia, interosseous mb
Insertion: Medial plantar border of medial cuneiform and 1st metatarsal
Action: Dorsiflexion (shared w/ other ant compartment muscles) & inversion of ankle, supination of intertarsal joints (anything that inserts medially)

31
Q

EDL

A

Extensor digitorum longus
Origin: Anterior surface of fibula, proximal tibia, interosseous mb
Insertion: Extensor expansion of digits 2–5
Action: Extension of MP joints of digits 2–5, dorsiflexion and eversion (going to lateral side) of ankle, pronation of intertarsal joints

32
Q

peroneus tertius

A

Peroneus tertius
Origin: Inferior 1/3 of anterior surface of fibula
Insertion: Base of 5th metatarsal (NOT TUBEROSITY)
Action: Dorsiflexion and eversion of ankle, pronation of intertarsal joints

33
Q

EHL

A

Extensor hallucis longus
Origin: Anterior surface of fibula, interosseous mb
Insertion: Dorsal base of distal phalanx of hallux= don’t blend w/ extensor expansion
Action: Extension of 1st MP and ankle joints, supination of intertarsal joints

34
Q

extensor hallucis capsularis (EHC)

A

Extensor hallucis capsularis= accessory tendon in midshaft of 1st met= goes to joint capsule
Origin: Extension of extensor hallucis longus tendon
Insertion: Medial surface of 1st MP joint capsule
Action: Pull capsule out of MP joint to prevent entrapment

35
Q

PL

A

Peroneus longus= superficial to PB
Origin: Superior 2/3 of lateral surace of fibula
Insertion: Lateral base of medial cuneiform and 1st metatarsal
Action: Plantar flexion and eversion of ankle, pronation of intertarsal joints (go post to lateral malleoli= plantarflex)

36
Q

PB

A

Origin: Inferior 2/3 of Lateral surface of fibula
Insertion: Tuberosity of 5th metatarsal
Action: Plantar flexion and eversion of ankle, pronation of intertarsal joints

37
Q

gastroc

A

Origin: Medial head: medial condyle of femurLateral head: lateral condyle of femur
Insertion: Middle 1/3 of posterior calcaneus via tendo calcaneus
Action: Plantar flexion of ankle, supination of intertarsal joints, flexion of knee
Doesn’t attach to tibia at all

38
Q

sesamoid in lateral head of gastroc

A

fabella

39
Q

soleus

A

Origin: Posterior surface of head and shaft of fibula, soleal line of tibia
Insertion: Middle 1/3 of posterior calcaneus via tendo calcaneus
Action: Plantar flexion of ankle

40
Q

plantaris

A

Origin: Lateral supracondylar line of femur
Insertion: Middle 1/3 of posterior calcaneus
Action: Plantarflexion of ankle, flexion of knee

41
Q

FDL

A

Flexor digitorum longus= most medial
Origin: Posterior tibial shaft medial to vertical line, distal to soleal line
Insertion: Plantar base of distal phalanges of digits 2–5
Action: Flexion of DIP joints, plantar flexion of ankle, supination of intertarsal joints

42
Q

FHL

A

Flexor hallucis longus= most lateral
Origin: Post surface of fibula, interosseous mb
Insertion: Plantar base of distal phalanx of hallux
Action: Plantarflexion of ankle

43
Q

tibialis posterior

A

Tibialis posterior= deepest and in the middle (leg)
Origin: Posterior surface of tibia lateral to vertical line, interosseous membrane, medial surface of fibula
Insertion: Navicular tuberosity, sustentaculum tali, all three cuneiforms, bases of metatarsals 2–4
Action: Plantarflexion of ankle, supination of intertarsal joints

44
Q

popliteus

A

Popliteus
Origin: Lateral condyle of femur
Insertion: Posterior surface of tibia proximal to soleal line
Action: Flexion & rotation (“unlocking”) of the knee
laterally rotates femur when leg is fixed
medially rotates tibia when leg is free

45
Q

sciatic nerve

A

tibia and common peroneal= do most of the leg

46
Q

blood supply to leg

A

branches of the popliteal artery

47
Q

tibial nerve compartment

A

Tibial nerve does post compartment

Medial and lateral plantar nerves come from here

48
Q

common peroneal compartment

A

goes lateral

49
Q

sural nerve

A

sural nerve = medial sural cutaneous (from tibial) + communicating branch of lateral sural cutaneous (from common peroneal)
medial sural cutaneous continues on as sural
lateral sural cutaneous continues on w/ same name

follows small saphenous vein into foot, becoming the lateral dorsal cutaneous

50
Q

saphenous nerve

A

saphenous nerve is a branch of the femoral
follows the great sapheonous vein into the foot
Main job is to supply ant and post medial leg
Travels w/ femoral artery and femoral vein= then pierces thru fascia in femoral canal to follow great saphenous= wont go thru the adductor hiatus w/ the femoral artery and vein

51
Q

common peroneal nerve branches

A

Splits into superficial and deep peroneal nerves + lateral sural cutaneous
Recurrent articular branch= branch of deep peroneal= travels up to innervate the knee= proprio and sensory to knee
Follows ant tibial recurrent artery
eventually splits into intermediate/medial dorsal cutaneous nerves from perforating peroneal and lateral/medial terminal branches from deep peroneal

52
Q

motor innervation deep peroneal

A

tibialis anterior
extensor digitorum longus
extensor hallucis longus
peroneus tertius

53
Q

motor innervation superficial peroneal

A

PL and PB

54
Q

motor innervation tibial nerve

A 
popliteus
gastrocnemius
soleus
plantaris
flexor digitorum longus
flexor hallucis longus
tibialis posterior
55
Q

common peroneal nerve injury

A

Common Peroneal Nerve is most commonly injured nerve in the lower limb
vulnerable in fracture of fibular neck and knee dislocation
results in unopposed plantarflexion and inversion = foot drop

56
Q

superficial/deep peroneal nerve injury

A

Injury to only the superficial or deep peroneal nerve is rare but compartment syndromes may cause entrapment of either nerve= cant dorsiflex b/c whole ant compartment is gone

57
Q

tibial nerve injury

A

injury to tibial nerve is rare but will most frequently happen in the popliteal fossa or as a result of compartment syndromes (lacerations too)

58
Q

form an anastomosis around the knee

A

genicular a

59
Q

sural arteries

A

muscular branches from the popliteal to the popliteus, soleus, and gastrocnemius

60
Q

anterior tibial artery branches/ location

A 
main blood supply to anterior compartment of the leg
Branches:
Posterior tibial recurrent
Anterior tibial recurrent
Circumflex fibular
Anterior medial malleolar
Anterior lateral malleolar
61
Q

post tibial recurrent artery variation

A

1st branch off ant tibial before it pieres interossues mb
40%= off tibial
32%= from post tibial artery

62
Q

circumflex fibular variation

A

can come off ant tib (nl) or peroneal

63
Q

ant medial/lateal malleloar arteries anastamose w?

A

lateral and medial tarsals and perofrating peronel

come off ant tibial

64
Q

post tibial artery branches/location

A 
main blood supply to posterior compartment
Branches:
Peroneal
nutrient
posterior lateral malleolar
lateral calcaneal
Nutrient artery to tibia
Posterior medial malleolar
Posterior lateral malleolar
Communicating= btwn peroneal and post tib
Medial calcaneal
Medial plantar
Lateral plantar
65
Q

largest branch post tibi artery

A

Main largest branch= peroneal artery (on lateral aspect of leg near fibula)
Main branches= nutrient artery to the fibula= pierces fibula thru nutrient foramen to supply interior of the bone
Lateral calcaneal and post lateral malleolar

66
Q

superficial veins

A

great saphenous (medial) and small saphenous (lateral)

67
Q

deep veins

A

popliteal vein follows popliteal artery
distal to popliteal fossa deep veins form venae comitantes that follow arteries and take the same names
From deep veins of the leg

68
Q

popliteal artery

A

post to knee= continuation of femoral artery in the thigh

Terminal branches in the leg= ant and post tibial arteries

69
Q

ant surface of distal tibia is continuous w/ what surface of the tibial shaft?

A

the lateral surface

lower limb leg (1 decks)

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