Posterior Leg

Question 1

What are the attachments for flexor hallucis longus?

Answer 1

inferior 2/3 of posterior fibula
inserts into base of distal phalanx of great toe
(crosses deep to FDL tendon to do this!!)

Question 2

What are the septa that define the anterior compartment?

Answer 2

Anterior = deep (crural fascia)
lateral = anterior septum
posterior = interosseous membrane

Question 3

How does the posterior tibial artery end?

Answer 3

divides into medial and lateral plantar arteries

Question 4

On which bone is the groove for flexor hallucis longus tendon?

Answer 4

talus

Question 5

What is the fabella?

Answer 5

sesamoid bone that may be present on at lateral head of gastrocnemius m.
possibly provides leverage for muscle
painful fracture may accompany knee replacement

Question 6

What is the deepest muscle in the deep posterior compartment?

Answer 6

tibialis posterior

Question 7

What are the attachments for plantaris m?

Answer 7

lateral end of lateral supracondylar line
calcaneus via calcaneal tendon
(long tendon runs btw gastrocnemius and soleus)

Question 8

What are the attachments of tibialis posterior?

Answer 8

O: interosseous membrane, posterior tibia inferior to soleal line, posteromedial surface of fibula
I: tarsal and metatarsal bones (navicular tuberosity, cuneiforms, 2-4 metatarsal bases)

Question 9

What are the arteries participating in the genicular anastomosis?

Answer 9

superior lateral genicular a
superior medial genicular a
inferior lateral genicular a
inferior medial genicular a
anterior tibial recurrent A
circumflex fibular A
Descending branch of lateral femoral circumflex A
descending genicular A

Question 10

What are the septa that define the posterior superficial compartment?

Answer 10

Transverse suptum

posterior septum

Question 11

What is the action of the soleus m?

Answer 11

plantarflexion

Question 12

What muscles does the tibial n innervate?

Answer 12

All superficial and deep posterior compartment muscles:
gastrocnemius
soleus
plantaris
popliteus
flexor hallucis longus
flexor digitorum longus
tibialis posterior

Question 13

What are the actions of flexor digitorum longus?

Answer 13

flexes lateral 4 digits

plantarflexes foot at ankle joint

Question 14

When would you test the posterior tibial pulse?

Answer 14

to examine pts w/ occlusive peripheral arterial disease

Question 15

What are the actions of flexor hallucis longus?

Answer 15

flexes great toe

plantarflex foot at ankle

Question 16

How does the tibial nerve end?

Answer 16

divides into medial and lateral plantar nerves

Question 17

What are the muscles in the superficial posterior compartment of the leg?

Answer 17

gastrocnemius m.
soleus m.
plantaris m.

Question 18

What is the action of plantaris m?

Answer 18

weak plantarflexion and leg flexion

proposed to be a proprioceptive organ for foot position

Question 19

What is the order of tendons and neurovascular structures running medial of the calcaneous?

Answer 19

toward the calcaneous:
Tom, Dick, AN Harry
Tibialis Posterior T
Flexor digitorum longus T
Posterior Tibial A
Tibial N
Flexor Hallucis longus

Question 20

What are the septa that define the posterior deep compartment?

Answer 20

anterior border = interosseous membrane

Posterior border = transverse septum

Question 21

What does the popliteal a branch into past the knee?

Answer 21

anterior tibial a

posterior tibial a –> fibular a branches off posterior tibial a

Question 22

What are the actions of tibialis posterior m?

Answer 22

inversion

plantarflexion

Question 23

What are the attachments of popliteus m?

Answer 23

O: lateral surface of lateral femoral condyle and meniscus
I: posterior tibia (superior to soleal line)

Question 24

Where do you find the posterior tibial pulse?

What do you ask the pt to do?

Answer 24

btw medial malleolus and calcaneal tendon
Deep to flexor retinaculum
Important to have pt relax retinaculum by inverting foot!

Question 25

What are the muscles of the deep posterior crural compartment?

Answer 25

popliteus flexor hallucis longus flexor digitorum longus tibialis posterior

Question 26

What are the attachments of flexor digitorum longus?

Answer 26

``` posterior tibia (inferior to soleal line passes superficial to FHL distal phalanges of 2-5 ```

Question 27

What are the nerve and artery for all muscles of the posterior compartments of the leg?

Answer 27

tibial n | posterior tibial A.

Question 28

How does the fibular A end?

Answer 28

pierces interosseous membrane and anastomoses w/ anterior lateral malleolar A

Question 29

Where does the soleus m attach?

Answer 29

soleal line of tibia posterior head of fibula and superior 1/4 of posterior fibula Inserts to calcaneus via calcaneus tendon

Question 30

What is the action of gastrocnemius m?

Answer 30

plantar flexes ankle when knee is extended raises heel turing walking flexes leg at knee

Question 31

What is the long tendon of plantaris used for?

Answer 31

reconstructive surgery of hand tendons | its removal doesn't affect ankle or knee movements

Question 32

When is plantaris t ruptured?

Answer 32

violent ankle movements (sudden dorsiflexion) common in bball players, sprinters, ballerinas pain can be severe so pt can't bare weight

Question 33

What are the attachments of gastrocnemius muscle?

Answer 33

O lateral head: lateral condyle of femur O medial head: popliteal surface of femur, superior to medial condyle I: posterior surface of calcaneus via calcaneal tendon

Question 34

What are the septa that define the lateral compartment of the leg?

Answer 34

``` anteromedial = anterior septum posterior = posteror septum ```