Lower Limb 4: The Leg Flashcards Preview

C&M Term 2 > Lower Limb 4: The Leg > Flashcards

Flashcards in Lower Limb 4: The Leg Deck (46):
1

What is acute osteomyelitis?

Bone infection caused by bacteria
affects the long bones of the legs

2

Why is the tibia the commonest long bone to be fractured?

very superficial antero-medially
particularly slender in its lower 1/3

3

What is a compound injury?

an open fracture
occurs where there is a break in the skin around a broken bone

4

Function of the interosseus membrane?

unites the tibia and fibula
separates the muscles of the anterior and posterior compartment
serves as a site for muscle attachement

5

What is the function of the two foramina in this membrane?

to allow anterior tibial vessels through
allow perforating branch of fibular artery through

6

what are the compartments of the leg and what structures separate them?

Anterior (extensor), Posterior (flexor), Lateral (fibular)

separated by interosseus membrane
2 intermusclar septae between fibula and deep fascia
attachment of deep fascia to periosteum of anterior and posterior borders of the tibia

7

what are the specific functions of the compartments of the leg?

Anterior - dorsiflex ankle, extend toe, invert foot
Posterior - plantarflex ankle, flex toes, invert foot
Lateral - evert foot

8

What are the muscles of the anterior compartment of the leg?

Tibialis Anterior
Extensor Digitorum Longus
Extensor Hallucis Longus
Fibularis Tertius (aka Peroneus Tertius)

9

What is the innervation and blood supply of the anterior compartment of the leg?

Deep Fibular Nerve L4, L5, S1

Anterior Tibial artery

10

What is the function of a retinaculum in a limb?

Hold tendons in place and stabilise them

11

What is the origin and insertion of Tibialis Anterior?

Origin: Lateral tibial condyle, upper 2/3 of tibial shaft, interosseus membrane

Insertion: medial and intermediate cuneiform, base of 1st metatarsal

12

What is the action of Tibialis Anterior?

Dorsiflex ankle
invert foot
support medial arch

13

What is the origin and insertion of Extensor Hallucis Longus

Origin: Middle medial fibula and interosseus membrane

Insertion: Upper surface of base of distal phalynx of great toe

14

What is the function of Extensor Hallucis Longus?

Extend big toe
dorsiflex ankle

15

What is the origin and insertion of Extensor Digitorum Longus?

Origin: Lateral fibular condyle, upper 2/3 medial fibula, interosseus membrane

Insertion: 4 tendons come from inferior extensor retinaculum and extend to middle and distal phalanges of toes 2-5

16

What is the function of Extensor Digitorum Longus?

Extend toes 2-5
Dorsiflex ankle

17

Where is Fibularis Tertius?

deep and lateral to extensor hallucis longus and extensor hallucis brevis
this muscle is not present in all individuals

18

What is the function of Fibularis Tertius?

Assist in dorsiflexion and eversion of the foot

19

What happens to the popliteal artery in the leg?

Bifurcates in anterior tibial and posterior tibial
anterior tibial enters into anterior compartment through a hiatus in the interosseus membrane

20

How does the deep fibular nerve arise?

In popliteal fossa, tibial nerve gives off a branch, the common fibular nerve
this in turn gives off a branch in the lateral leg, the deep fibular nerve, which supplies the anterior compartment

21

What does the deep fibular nerve innervate?

all muscles of anterior compartment of the leg
muscles of dorsum of the foot (EDB, EHB)
first 2 dorsal interossei
skin between 1st and 2nd toes

22

What are the muscles of the lateral compartment of the leg?

Fibularis (peroneus) Longus
Fibularis (peroneus) Brevis

23

Where do the tendons of the lateral compartment pass?

Posterior to the lateral malleolus

24

What are the functions of fibularis longus and brevis?

Longus: Eversion + plantarflexion of the foot
also supports transverse arch of the foot

Brevis: Eversion of the foot

25

What is the innervation of the lateral compartment of the leg?

Superficial Fibular Nerve L5, S1, S2

a branch of the common fibular nerve

26

What is the origin and insertion of fibularis longus?

Origin: Superior lateral fibula +lateral tibial condyle

Insertion: Under surface of distal medial cuneiform + base of 1st metatarsal

27

What is the origin and insertion of fibularis brevis?

Origin: Lower 2/3 lateral fibular shaft

Insertion: lateral tubercle of metatarsal 5

28

why is the common fibular nerve prone to injury?
What are the consequences of such an injury?

Becomes quite superficial as it passes around the neck of the fibula

paralysis of dorsiflexion muscles resulting in foot drop, alteration of gait to compensate
loss of sensation on dorsum of foot and lateral leg
paralysis of anterior and lateral compartments of the leg

29

How is the posterior compartment of the leg divided?

Separated into superficial and deep compartments by the transverse intermuscular septum

30

What are the muscles of the superficial posterior compartment?

Gastrocnemius
Soleus
Plantaris

31

What is the innervation to the superficial posterior compartment?

Tibial Nerve, L5, S1, S2

32

What is the origin of gastrocnemius?

2 heads: upper lateral femoral condyle and medial femoral condyle

33

What is the origin of soleus?

It is deep to gastrocnemius
soleal line and medial tibia, posterior fibula, neck and shaft

34

What is the common insertion of gastrocnemius and soleus?

They unite to form the calcaneal (achilles) tendon, inserts onto posterior of calcaneus

35

What is the origin and insertion of plantaris?

Origin: lateral supracondylar ridge of femur

Insertion: Medial to calcaneal tendon

36

What is the common action of the superficial posterior compartment?

Plantarflex foot at ankle
flex leg at knee (apart from soleus)

37

What are the contents of the deep posterior compartment?

4 Muscles:
Popliteus
Flexor Hallucis Longus
Flexor Digitorum Longus
Tibialis posterior

Posterior tibial artery
Tibial nerve

38

What is the origin and insertion of Popliteus?

Origin: Popliteal groove on lateral femoral condyle

Insertion: Posterior surface of medial proximal tibia, attached to lateral meniscus

39

What is the action of popliteus?

Medially rotate tibia on the femur if the femur is fixed (sitting)
Laterally rotates femur on tibia if tibia is fixed (standing)
unlocks the knee to allow flexion

40

What is the origin and insertion of flexor hallucis longus?

Origin: Posterior, inferior lower 2/3 fibula + interosseus membrane

Insertion: Plantar surface, distal phalanx of great toe

41

What is the action of flexor hallucis longus?

Flex great toe

42

What is the origin and insertion of flexor digitorum longus?

Origin: Medial Posterior tibia

Insertion: 4 tendons into plantar surface bases of distal 2-5 phalanges

43

What is the action of flexor digitorum longus?

Flex toes 2-5

44

What is the origin and insertion of tibialis posterior?

Origin: Posterior 2/3 interosseus membrane

Insertion: tuberosity of navicular, medial 1st cuneiform

45

What is the function of tibialis posterior?

Invert foot
Plantarflex foot
support medial arch when walking

46

How do the tendons of the deep posterior compartment travel to the foot?

Pass posterior to the medial malleolus
Tom, Dick and Nervous Harry
Tibialis Posterior (tom)
flexor Digitorum Longus (Dick)
posterior tibial Artery (and)
tibial Nerve (nervous)
flexor Hallucis Longus (Harry)

Tom closest to medial malleolus, Harry furthest posterior