Lower Limb 4

Question 1

What is the popliteal fossa?

Answer 1

Fat filled, diamond shaped space posterior to the knee joint

Question 2

What are the borders of the popliteal fossa?

Answer 2

Upper medial - semimembranosus
Upper lateral - biceps femoris
Lower - medial and lateral heads of gastroc

Question 3

What are the contents of the popliteal fossa?

Answer 3

Fat
Posterior cutaneous nerve of the thigh
Tibial and common fibular nerves
Popliteal artery and vein and their branches
Termination of the small saphenous vein
Popliteal lymph nodes and lymphatic vessels

Question 4

What is a popliteal aneurysm?

Answer 4

Abnormal dilatation of part/all of the popliteal artery

Question 5

Collectively the muscles of the posterior compartment of the leg do what?

Answer 5

Plantarflex and invert the foot

Question 6

What muscles are in the superficial posterior leg group?

Answer 6

Gastrocnemius
Plantaris
Soleus

Question 7

What is the action of gastrocnemius?

Answer 7

Flexes the ankle and the knee

Essential for a walking gait

Question 8

What innervates the posterior compartment of the leg?

Answer 8

Tibial nerve

Question 9

What is the action of plantaris?

Answer 9

Weakly assists the gastrocnemius in plantarflexing the ankle
Function mainly proprioceptive

Question 10

What artery supplies all the muscles of the posterior compartment of the leg?

What is it a branch of?

Answer 10

Posterior tibial artery

Branch of popliteal artery

Question 11

What are the deep muscles of the posterior compartment of the leg?

Answer 11

Popliteus
Tibialis posterior
Flexor digitorum longus
Flexor hallicus longus

Question 12

What is the action of popliteus?

Answer 12

Weak knee flexor

Question 13

What is the action of tibialis posterior?

Answer 13

Unlocks knee from extended position, plantar flexes ankle, inverts foot

Question 14

What is the action of flexor digitorum longus?

Answer 14

Flexes 4 digits, plantarflexes ankle

Question 15

What is the action of flexor hallucis longus?

Answer 15

Flexes big toe, weakly plantar flexes the ankle

Question 16

Where do all the posterior leg muscles pass?

Answer 16

(Apart from popliteus) pass to sole of foot posterior to the medial malleolus

Question 17

How can you remember the structures passing behind the medial malleolus?

Answer 17

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

Question 18

What is the function of the foot?

Answer 18

Supports body weight, plays role in locomotion

Question 19

What are the tarsal bones?

Answer 19

Calcaneus, talus, navicular, cuboid, intermediate, medial and lateral cuneforms

Question 20

What is plantar fasciitis?

Answer 20

Presenting as heel pain generally brought on by overuse (e.g. running) or increase in weight

Question 21

Where does eversion/inversion occur?

Answer 21

Subtalar joints

Ball and socket joint between the talus and navicular allow foot to pivot from side to side

Joint between the talus and calcaneus allow the foot to slide from side to side

Some movement also at traverse tarsal joints

Question 22

Why is inversion/eversion important?

Answer 22

For coping with walking on uneven ground/balancing on one leg

Question 23

Muscles of the foot are arranged into how many layers?

Answer 23

4

Question 24

What is the action of the muscles of the foot?

Answer 24

Flexion of the toes - essential for the push off the ground phase of the gait cycle

Question 25

What muscles are in layer 1 of the foot and what is this layer deep to?

Answer 25

Deep to plantar fascia Abductor hallucis Flexor digitorum brevis Abductor digiti minimi

Question 26

What muscles are in layer two of the foot?

Answer 26

Quadratus plantae Lumbricals Tendons of FDL also pass through this layer

Question 27

What do the lumbricals attach to?

Answer 27

FDL

Question 28

What is the nervous supply to the foot?

Answer 28

Two terminal branches of the tibial nerve - the medial and lateral plantar nerves

Question 29

What is the arterial supply to the foot?

Answer 29

Posterior tibial artery terminal branches - medial and lateral plantar arteries

Question 30

What are the arches of the foot?

Answer 30

2 longitudinal | 1 transverse

Question 31

What is the function of the arches of the feet?

Answer 31

Distribute body weight and act as shock absorbers Body weight acting vertically downwards on the talus forces the navicular and calcaneus apart Force resisted by muscle tendons crossing the joint and the calcaneonavicular ligament (spring ligament)

Question 32

What does the spring ligament do?

Answer 32

Help maintain the medial longitudinal arch and contributes to the subtalar joints

Question 33

What are the passive factors maintaining the integrity of the foot arches?

Answer 33

Shape of united bones Plantar aponeuosis Long plantar ligament Short plantar ligament

Question 34

What are the dynamic factors maintaining the integrity of the foot arches?

Answer 34

Intrinsic muscles of the foot Long flexor tendons Tendon of tibialis anterior and fibularis longus

Question 35

What is pes planus due to?

Answer 35

Dysfunction of the dynamic or passive factors maintaining the integrity of the foot arches