LL2 - Neurovasculature of leg, ankle & foot

Question 1

contents of the tarsal tunnel from anterior to posterior?

Answer 1

Tom - tibialis posterior
Dick - flexor digitorum longus
And - posterior tibial artery
Very - posterior tibial vein
Nervous - tibial nerve
Harry - flexor hallucis longus

Question 2

what artery goes through the tarsal tunnel?

Answer 2

posterior tibial artery (continuation of popliteal artery)

Question 3

What is the continuation of the external iliac artery below the inguinal ligament?

Answer 3

femoral artery

Question 4

Through which structure does the femoral artery become the popliteal artery?

Answer 4

adductor hiatus (of the adductor magnus)

Question 5

Which artery runs through the interosseous membrane to enter the anterior compartment of the leg?

Answer 5

anterior tibial artery

Question 6

What artery lies deep in the popliteal fossa and gives rise to genicular branches?

Answer 6

popliteal artery

Question 7

Where does the posterior tibial artery split into the medial and lateral plantar arteries?

Answer 7

in the foot - after passing through the tarsal tunnel under the flexor retinaculum

Question 8

Which artery contributes to the deep plantar arch of the foot?

Answer 8

lateral plantar artery (with deep branch of dorsalis pedis (branch of anterior tibial artery))

Question 9

What is a key pulse point on the dorsum of the foot, and which artery is palpated?

Answer 9

dorsal pedis pulse; dorsal pedis artery from anterior tibial artery

Question 10

Which artery supplies the lateral and posterior compartments of the leg?

Answer 10

common fibular artery (branch of posterior tibial artery)

Question 11

Which artery is most likely to be palpated just lateral to the tendon of extensor hallucis longus at the ankle?
A. Fibular artery
B. Posterior tibial artery
C. Dorsalis pedis artery
D. Medial plantar artery

Answer 11

C. Dorsalis pedis artery

Question 12

The femoral artery becomes the popliteal artery after passing through which of the following structures?
A. Inguinal ligament
B. Popliteal fossa
C. Adductor canal
D. Adductor hiatus

Answer 12

D. Adductor hiatus

Question 13

Which artery supplies the anterior compartment of the leg?
A. Fibular artery
B. Posterior tibial artery
C. Anterior tibial artery
D. Lateral plantar artery

Answer 13

C. Anterior tibial artery (branch of popliteal - through interosseus membrane to anterior compartment)

Question 14

Which structure does not pass through the tarsal tunnel along with the posterior tibial artery?
A. Tibial nerve
B. Flexor hallucis longus tendon
C. Fibular artery
D. Flexor digitorum longus tendon

Answer 14

C. Fibular artery

Question 15

popliteal artery:
- a)__________ artery becomes the popliteal artery after it passes through the b)____________
- the popliteal artery runs centrally down as the floor of the c) ___________ & gives off d)__________ branches
- it pierces through the tendinous arch of the e)___________ muscle to lie between the superficial & deep compartments of the posterior leg muscles
- at this point it bifurcates into its f)______________ arteries

Answer 15

a) femoral artery
b) adductor hiatus
c) popliteal fossa
d) genicular branches (of the knee)
e) soleus muscle
f) anterior & posterior tibial arteries

Question 16

the posterior tibial artery is a branch of the a)__________ artery
- it gives rise to the b)__________ artery
- then, it continues inferiorly with the c)_______ nerve and eventually runs under the flexor retinaculum
- it reaches the sole of the foot and gives off d)_______ & _____________ arteries

Answer 16

a) popliteal artery
b) common fibular artery
c) tibial nerve
d) medial & lateral plantar arteries

Question 17

the anterior tibial artery travels with WHAT nerve before becoming the dorsal pedis artery

Answer 17

travels with the deep fibular nerve

Question 18

what tendon does the dorsalis pedis artery lie lateral to on the dorsum of the foot?

Answer 18

extensor hallucis longus

Question 19

Which vein arises from the medial side of the dorsal venous arch?

Answer 19

great saphenous vein

Question 20

path of the great saphenous:
- from the a)____________ side of the dorsal venous arch of the foot
- ascends b_________ to the medial malleolus - along medial leg & thigh
- pierces fascia lata at the c)__________ opening & drains into the d)__________ vein (within the femoral sheath)

Answer 20

a) medial side
b) anterior
c) saphenous opening
d) femoral vein

Question 21

path of the small saphenous vein:
- emerges from the a)_________ side of the dorsal venous arch of the foot
- travels posterior to the lateral malleolus & the b)_________ tendon
- ascends between heads of the c)__________ muscle
- drains into d)___________ vein

Answer 21

a) lateral
b) calcaneal/Achilles tendon
c) gastrocnemius
d) popliteal vein

Question 22

Which vein runs posterior to the lateral malleolus and ascends between the heads of gastrocnemius?

Answer 22

small saphenous vein

Question 23

Where does the small saphenous vein drain?

Answer 23

popliteal vein in the popliteal fossa

Question 24

What are varicose veins? How does the muscle pump affect varicose veins?

Answer 24

varicose veins = dilated/torturous superficial veins due to valve incompetence

effective muscle/venous pump promotes venous return - dysfunction/inactivity = pooling = worsens varicose veins

rhythmic contraction of lower limb muscles (mainly calves) compresses deep veins, helping blood return to the heart

Question 25

nerve root origins of the sciatic nerves?

Answer 25

L4-S3; sacral plexus

Question 26

path of the sciatic nerve?

Answer 26

from L4-S3 nerve roots - exits pelvis via greater sciatic foramen; inferior to piriformis - travels deep to gluteus maximus, down posterior thigh - splits into tibial & common fibular nerves (in/near popliteal fossa)

Question 27

path of tibial nerve?

Answer 27

- medial division of sciatic nerve - runs through popliteal fossa - deep to soleus via tendinous arch - supplies posterior leg compartment - enters foot via tarsal tunnel

Question 28

motor supply from tibial nerve?

Answer 28

Posterior thigh: long head of biceps femoris, semitendinosus, semimembranosus, hamstring part of adductor magnus Posterior leg: both superficial (gastrocnemius, soleus, plantaris) and deep compartments (tibialis posterior, FDL, FHL, popliteus) Foot: medial and lateral plantar nerves (intrinsic plantar foot muscles)

Question 29

path of common fibular nerve?

Answer 29

- lateral division of sciatic nerve - runs along biceps femoris, wraps around neck of fibula - splits into superficial & deep nerves motor supply: - short head of biceps femoris - superficial fibular nerve → lateral leg: fibularis longus & brevis (eversion) - deep fibular nerve → anterior leg: tibialis anterior, EDL, EHL, fibularis tertius; also EDB, EHB in foot (dorsum)