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Anatomy I > Week 4 Content > Flashcards

Week 4 Content Flashcards

1
Q

The muscles of the anterior thigh compartment are innervated by one nerve. Which is it?

A

Femoral nerve

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2
Q

What structures pass through the adductor hiatus and hence change their names to become the popliteal artery and vein, respectively?

A

Femoral artery and vein

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3
Q

The muscles in the medial thigh compartment are innervated by what nerve?

A

Obturator nerve

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4
Q

Why is the popliteal fossa of clinical importance?

A

It provides a point for assessing arterial blood flow to the leg and provides a useful palpation window to the back of the knee.

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5
Q

Which muscle stabilizes the knee joint by resisting lateral rotation of the tibia on the femur?

A

Popliteus

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6
Q

Which muscle causes inversion and plantar flexion of the foot and ankle and supports the medial arches of the foot?

A

Tibialis posterior

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7
Q

What is the nerve supply to the posterior compartment leg muscles?

A

Tibial nerve

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8
Q

Which part of the fibularis muscles has a tendon that passes anterior to the ankle joint?

A

Fibularis tertius

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9
Q

Where do fibularis brevis and longus insert?

A

Brevis inserts on the base of the 5th metatarsal whereas longus passes into the sole of the foot and inserts into the first metatarsal and medial cuneiform

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10
Q

What is the nerve supply to the lateral compartment muscles of the leg?

A

Superficial peroneal n.

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11
Q

What is the nerve supply to the anterior compartment of leg muscles?

A

Deep peroneal n.

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12
Q

What is the nerve supply to the muscles of the dorsum of the foot?

A

Deep peroneal n.

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13
Q

Which muscle assists with dorsiflexion of the foot and ankle. inversion of the foot, and provides medial arch support?

A

Tibialis anterior

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14
Q

What makes up the fourth layer of the muscles of the sole of the foot? What are their actions?

A

Dorsal Interossei muscles (DABS) - abduct toes 2-5

Plantar Interossei muscles (PADS) - adduct toes 3-5

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15
Q

What muscles make up the third layer of muscles of the sole of the foot? What are their actions?

A

Flexor hallucis brevis - flexes great toe, protects FHL tendon in between its sesamoid bones

Adductor hallucis - oblique and transverse heads both adduct great toe

Flexor digiti minimi brevis - flexes little toe

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16
Q

What muscles make up the second layer of muscles of the sole of the foot? What are their actions?

A

Quadratus plantae muscles - redirect the line of pull of the FDL, helps flex toes 2-5

Lumbricals - arise from the tendons pf FDL

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17
Q

What muscles make up the first layer of muscles of the sole of the foot? What are their actions?

A

Abductor hallucis - abducts and flexes the great toe

Flexor digitorum brevis - helps to flex the lateral 4 toes

Abductor digiti minimi - abducts the little toe

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18
Q

Which four muscles does the medial plantar nerve supply?

A

Abductor hallucis
Flexor digitorum brevis
Flexor hallucis brevis
1st Lumbrical

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19
Q

What is the basic function of the posterior compartment of the leg and the plantar muscles of the foot?

A

Flexion of the foot and toes, stabilization of the knee and arch of the foot

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20
Q

The tendons of the posterior compartment leg muscles enter the plantar surface of the foot through the tarsal tunnel. What other structures pass through the tarsal tunnel?

A

Tibial nerve and posterior tibial artery and veins

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21
Q

What nerve supplies the skin on the posterior aspect of the thigh and over the popliteal fossa?

A

Posterior femoral cutaneous (S1-S3)

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22
Q

What muscles make up the posterior component of the thigh?

A

Biceps femoris - short and long head
Semitendinosus
Semimembranosus

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23
Q

Describe OINA for biceps femoris.

A

O: ischial tuberosity (long head), linea aspera (short head)

I: head of the fibula via the common fibular tendon with some fibers reaching the tibia

N: tibial portion of sciatic (long head), common peroneal portion of sciatic (short head)

A: extend thigh (long head only) and flex knee (both heads)

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24
Q

Describe OINA for semitendinosus.

A

O: ischial tuberosity

I: medial surface of tibia inferior to the condyle, into Pes Anserine tendon

N: tibial n.

A: hip extension; knee flexion and medial rotation

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25
Q

Describe OINA for semimembranosus.

A

O: ischial tuberosity

I: medial condyle of tibia, posterior to semitendinosus attachment

N: tibial n.

A: hip extension; knee flexion and medial rotation

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26
Q

Describe the boundries of the popliteal fossa.

A

Superior lateral - biceps femoris

Superior medial - semitendinosus and semimembranosus

Inferior lateral - lateral head of gastroc

Inferior medial - medial head of gastroc

Roof - fascia lata with branches of posterior femoral cutaneous nerve and the lesser saphenous vein

Floor - popliteal surface of femur, capsule of knee joint, oblique popliteal ligament

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27
Q

Describe the contents of the popliteal fossa.

A

Tibial nerve down the middle, superficially

Common peroneal nerve along the superolateral boundary

Popliteal artery and vein, deep in fossa

Origins of the sural nerve (S1, S2)

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28
Q

Describe the sural nerve, including its origins and functions.

A

Origin: a peripheral nerve formed by the union of the medial sural cutaneous nerve (a branch off the tibial n.) and the lateral sural cutaneous nerve (a branch off the common peroneal n.)

Function: cutaneous innervation to the posterior leg and lateral aspect of the dorsum of the foot

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29
Q

Describe the popliteal artery, including its origin, location, branching, and functions.

A

A continuation of the femoral artery after it passes through the adductor hiatus

Passes through popliteal fossa and branches at the inferior borders of popliteal fossa at the junction of inferior medial and lateral boundaries (medial and lateral heads of gastrocnemius) into:

  • Anterior tibial artery, which passes through the interosseus membrane anterolaterally and supplies the anterior compartment of the leg
  • Posterior tibial artery, which supplies the posterior compartment and gives rise to the peroneal artery which supplies the posterior and lateral compartments of the leg

Within the popliteal fossa, the popliteal artery branches into superior and inferior genicular arteries which supply the knee

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30
Q

Describe genicular anastomoses, including their functions and clinical significance.

A

These are branches of the popliteal artery that surround the knee, supplying the knee capsule, patella, and surrounding bone

Include the superior medial and lateral genicular arteries, and the inferior medial and lateral genicular arteries

Any surgery to the knee is done ANTERIORLY to not disrupt the rich blood supply in the posterior popliteal area

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31
Q

Describe the overall innervation of the popliteal fossa.

A

Sciatic nerve ends at the superior angle of the popliteal fossa as it leaves its fascial sheath and divides into 2 nerves:

  • Tibial n., through the tibial condyles
  • Common peroneal n., laterally around the fibular head
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32
Q

Describe the tibial nerve.

A

Most superficial component of the popliteal fossa, travels right along the roof

Gives off several genicular branches for innervation of the knee joint

Descends to the posterior compartment of the leg to innervate posterior musculature (gastrocnemius, soleus, plantaris, FDL, FHL, tibialis posterior, popliteus)

Gives off the medial sural cutaneous nerve to help form the sural nerve

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33
Q

Describe the common peroneal nerve.

A

Leaves the popliteal fossa passing superficially to the lateral head of the gastroc, passing over the posterior aspect of the head and neck of the fibula

After passing the fibular head, it divides into a superficial peroneal nerve and supplies innervation to the lateral compartment of the leg (peroneus longus and brevis) and a deep peroneal nerve that supplies the anterior leg (tibialis anterios, EDL, EHL, peroneus tertius)

Also gives off several genicular branches for innervation of the knee joint

Gives off lateral sural cutaneous nerve which joins with the medial sural cutaneous nerve to form the sural nerve

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34
Q

What are the components of the ankle mortice? When is the ankle the most stable in the ankle mortice?

A

Lateral malleolus of fibula, medial malleolus of tibia, and the tibial pilon make up area for talus attachment

Ankle is more stable in the ankle mortice during dorsiflexion rather than plantarflexion because the body of the talus is wider anteriorly than posteriorly

35
Q

Describe the components of the crural fascia in the leg.

A

Anterior intermuscular septum - separates anterior and lateral compartments

Posterior intermuscular septum - separates lateral and posterior compartments

Transverse crural septum - separates posterior septum into a superficial and deep layer

36
Q

Describe the anterior compartment of the leg, including its contents, innervation, and blood supply.

A

Supplied by anterior tibial artery and deep peroneal n.

Muscles - tibialis anterior, EDL, EHL, peroneus tertius

37
Q

Describe OINA for tibialis anterior.

A

O: superior 2/3 lateral surface of tibia

I: medial cuneiform and base of 1st metatarsal

N: deep peroneal n.

A: dorsiflexion and inversion of the foot

38
Q

Describe OINA for extensor digitorum longus.

A

O: superior 2/3 of fibula

I: middle and distal phalanges of the lateral 4 toes

N: deep peroneal n.

A: dorsiflexion of the foot and extension of the toes

39
Q

Describe OINA for extensor hallucis longus.

A

O: middle 1/3 of fibula

I: base of distal phalanx of hallux

N: deep peroneal n.

A: dosriflexion of the foot and extension of the hallux

40
Q

Describe OINA for peroneus tertius.

A

O: distal end of fibula

I: base of 5th metatarsal

N: deep peroneal n>

A: dorsiflexion of the foot and eversion of the foot

41
Q

What are the functions of the extensor retinacula?

A

Fascial bands of foot holding tendons in place

Superior extensor retinaculum and inferior extensor retinaculum

Both hold tendons of EDL, EHL, tibialis anterior, and peroneus tertius, as well as the anterior tibial artery and dorsalis pedis artery

42
Q

What are the functions of the flexor retinaculum?

A

Allows passageway into sole of foot, forms the roof of the tarsal tunnel

Medially placed

43
Q

What are the functions of the fibular retinaculum?

A

Covers peroneus longus and brevis, anchoring them at the peroneal tubercle

Laterally placed

44
Q

Describe OINA for extensor digitorum brevis.

A

O: calcaneus

I: long extensor tendons of digits 2-4

N: deep peroneal n.

A: extension of digits 2-4

45
Q

Describe OINA for extensor hallucis brevis.

A

O: calcaneus, more medially placed than EDB

I: base of proximal phalanx of hallux

N: deep peroneal n.

A: extension of big toe at the proximal phalanx

46
Q

Describe the lateral compartment of the leg, including its contents, innervation, and blood supply.

A

Supplied by the peroneal artery (branch off posterior tibial artery) and superficial peroneal nerve

Muscles - peroneus brevis and longus

47
Q

Describe OINA for peroneus longus.

A

O: superior 2/3 of fibula

I: undersurface (base) of 1st metatarsal and medial cuneiform, blending with the insertion of the tibialis anterior

N: superficial peroneal n.

A: eversion and plantarflexion

48
Q

Describe OINA for peroneus brevis.

A

O: distal end of the fibula

I: base of the 5th metatarsal

N: superficial peroneal n.

A: eversion and plantarflexion

49
Q

Describe the posterior compartment of the leg, including its contents, innervation, and blood supply.

A

Supplied by the posterior tibial artery and tibial nerve

Muscles: superficial (gastrocnemius, soleus, plantaris) and deep (FDL, FHL, tibialis posterior, popliteus)

50
Q

Describe OINA for gastrocnemius.

A

O: lateral head from lateral condyle of femur, medial head from medial condyle of femur

I: calcaneus via calcaneal (Achilles’) tendon

N: tibial n.

A: plantarflexion of foot, knee flexion

51
Q

Describe OINA for soleus.

A

O: posterior surface of fibula and tibia, along soleal line

I: calcaneus via calcaneal tendon

N: tibial n.

A: plantarflexion of the foot only

52
Q

Describe OINA for plantaris.

A

O: lateral condyle of femur

I: calcaneus next to achilles tendon via a long, thin tendinous strap

N: tibial n. in popliteal fossa

A: plantarflexion of the foot, knee flexion; but more involved in proprioception because it is mainly tendinous

53
Q

Describe OINA for flexor digitorum longus.

A

O: tibia

I: distal phalanx of lateral 4 digits

N: tibial n.

A: flexion of digits 2-5 at MTP, PIP, and DIP joints, and plantarflexion of the foot

54
Q

Describe OINA for flexor hallucis longus.

A

O: fibula

I: distal phalanx of big toe

N: tibial n.

A: flexion of hallux at MTP and IP joints, and plantarflexion of the foot

55
Q

Describe OINA for tibialis posterior.

A

O: tibia, fibula, and interosseus membrane between FHL and FDL

I: navicular, cuneiform, cuboid, and base of metatarsals 2-4

N: tibial n.

A: inversion and plantarflexion of the foot

56
Q

What passes through the tarsal tunnel, from anterior to posterior?

A 
Tibialis posterior
Flexor digitorum longus
posterior tibial artery/vein
Tibial nerve
Flexor hallucis longus
57
Q

Describe OINA for popliteus.

A

O: upper end of tibia

I: lateral condyle of femur, tendon passes deep to LCL

N: tibial n. in popliteal fossa

A: rotation of knee joint, knee flexion

58
Q

Describe the arterial supply of the leg, starting from the femoral artery and working inferiorly.

A

Femoral artery (which comes from external iliac artery) branches posteriorly into the profunda femoris which is the main supply to the thigh. Profunda femoris has perforating branches that travel through perforations in the adductor magnus.

Anteriorly, the femoral artery travels through the adductor canal and turns into the popliteal artery after passing through the adductor hiatus, where it then branches into superior and inferior genicular ateries.

After exiting the popliteal fossa, the popliteal artery branches into the anterior and posterior tibial arteries. The anterior tibial artery passes through the interosseus membrane to supply the anterior leg, and the posterior tibial artery travels inferiorly and gives off the peroneal artery laterally.

After reaching the dorsum of the foot, the anterior tibial artery becomes the dorsalis pedis, and the posterior tibial artery becomes the medial and lateral plantar nerves (after passing the compartment posterior to the medial malleolus)

59
Q

Describe the cutaneous supply of the lower leg.

A

Saphenous nerve - supplies skin on medial side of leg and foot; originates from femoral n. and descends through adductor canal

Sural nerve - originates from tibial and common peroneal nerves from medial and lateral sural cutaneous nerves; supplies skin of the posterior and lateral leg and foot

Superficial peroneal nerve - skin on the distal third of the anterior surface of the leg and dorsum of the foot

Deep peroneal nerve - dorsal surface of skin of the first interdigit space

60
Q

Describe the motor innervation of the lower leg.

A

Tibial nerve travels with the posterior tibial artery down the leg. As it passes posterior to the medial malleolus, it divides into medial and lateral plantar nerves (before passing through the tarsal tunnel)

Deep peroneal nerve supplies the anterior compartment of the leg. It runs with the anterior tibial artery and ends with branches innervating the ankle joint and skin between the first and second digits

Superficial peroneal nerve supplies innervation to the lateral compartment (peroneus longus and brevis) and the skin on the anterior surface of the leg, dursum of the foot, and digits 3-5

61
Q

Describe how common peroneal nerve injury can occur and its implications.

A

Common with varus stress, in which a blow to the medial knee stretches and opens up the lateral aspect of the knee, causing damage to the LCL and common peroneal nerve.

Can also be injured from direct blow to the lateral side

Because CPN supplies the lateral leg which houses the peroneals, injury to the CPN can result in the inability to dorsiflex or lift the great toe, resulting in foot drop and the inability to clear the ground during swing phase. Poeple with this will have to excessively flex their hips during the swing phase.

62
Q

Describe the plantar aponeurosis.

A

Just deep to the skin, plantar aponeurosis is a thickening of the plantar fascia, similar to that found in the palm of the hand

Acts as a strong tie for the longitudinal arches of the foot

Attaches posteriorly to the medial process of the calcaneus, and anteriorly to the heads of the metatarsals

Very involved in the windlass mechanism of the foot

Bound to metatarsal heads via the superficial transverse metatarsal ligament

63
Q

True or false: plantar digital nerves and arteries pass through gaps in the superficial transverse metatarsal ligament to reach their destinations.

A

True

64
Q

Internal and external forces cause flattening of which arch of the foot?

A

Medial longitudinal arch

65
Q

Describe the windlass mechanism.

A

When great toe dorsiflexes, arch height increases and plantar fascia tightens

Acts to prevent foot collapse with tensile strength during weight-bearing activities

66
Q

Describe passive and active support for the arches of the foot.

A

Passive: plantar aponeurosis, plantar calcaneonavicular (spring) ligament, long plantar ligament, short plantar ligament

Active: tibialis anterior and posterior tendons and peroneus longus tendon form a sling-like structure to raise the longitudinal arch

67
Q

Name the muscles in the first layer of the foot.

A

Abductor hallucis
Flexor dgitorum brevis
Abductor digiti minimi (quinti)

68
Q

Describe OINA for abductor hallucis.

A

O: medial calcaneus and plantar aponeurosis

I: proximal phalanx of hallux

N: medial plantar n.

A: abduct and flex hallux at MTP joint

69
Q

Describe OINA for flexor digitorum brevis.

A

O: medial calcaneus and plantar aponeurosis

I: middle phalanges of lateral 4 toes

N: medial plantar n.

A: flexes toes 2-5 at MTP and PIP joints

70
Q

Describe OINA for abductor digiti minimi.

A

O: lateral calcaneus and plantar aponeurosis

I: proximal phalanx of 5th digit

N: lateral plantar n.

A: abduct and flex little toe at MTP

71
Q

Name the muscles in the second layer of the foot.

A

Flexor digitorum longus tendon
Flexor hallucis longus tendon
Quadratus plantae
Lumbricals

72
Q

Describe OINA for quadratus plantae.

A

O: plantar surface of calcaneus

I: tendon of the FDL to redirect its line of pull

N: lateral plantar n.

A: redirect line of pull of the tendons of the FDL

73
Q

Describe OINA for the lumbricals (4).

A

O: medial borders of tendons of the FDL

I: bases of proximal phalanxes 2-5 and dorsal digit expansions

N: medial 1 by the medial plantar n., lateral 3 by the lateral plantar n.

A: flexes the MTP and extends the PIP and DIP of the lateral 4 toes

74
Q

Name the muscles of the third layer of the foot.

A

Flexor hallucis brevis
Flexor digiti quinti
Adductor hallucis

75
Q

Describe OINA for flexor hallucis brevis.

A

O: plantar surface of cuboid and lateral cuneiform

I: medial and lateral proximal phalanx of big toe, with sesamoid bones in the tendon

N: medial plantar n.

A: flexes the great toe; sesamoids hold FHL tendon in place

76
Q

Describe OINA for flexor digiti quinti.

A

O: base of the 5th metatarsal

I: proximal phalanx of the 5th toe

N: lateral plantar n.

A: flex the little toe

77
Q

Describe OINA for adductor hallucis.

A

O: oblique head from the base of metatarsals 2-4, transverse head from the plantar ligaments of the lateral 4 MTP joints

I: lateral base of the proximal phalanx of hallux

N: lateral plantar n.

A: adducts great toe, assists in maintaining transverse arch of foot

78
Q

Name the muscles of the fourth layer of the foot.

A 
Plantar interossei (3)
Dorsal interossei (4)
79
Q

Describe OINA for plantar interossei (3).

A

PADS

O: medial sides of metatarsals 3-5

I: medial sides of proximal phalanxes 3-5 and extensor expansions

N: lateral plantar n.

A: adduct to the line of the second toe

80
Q

Describe OINA for dorsal interossei (4).

A

DABS

O: adjacent sides of the metatarsals

I: #1 to medial side of 2nd digit
   #2 to lateral side of 2nd digit
   #3 to lateral side of 3rd digit
   #4 to lateral side of 4th digit

N: lateral plantar n.

A: abduct toes 2-4 to line of 2nd toe

81
Q

Describe OINA for dorsal interossei (4).

A

DABS

O: adjacent sides of the 2 metatarsals

I: #1 to medial side of 2nd digit
   #2 to lateral side of 2nd digit
   #3 to lateral side of 3rd digit
   #4 to lateral side of 4th digit

N: lateral plantar n.

A: abducts from line of the 2nd toe

82
Q

Describe the innervation of the foot.

A

Inferior to the medial malleolus, the tibial nerve divides into medial and lateral plantar nerves, though often this division occurs above the medial malleolus.

Medial plantar nerve supplies motor to abductor hallucis, FHB, FDB, and medial lumbrical, and sensory to skin of the medial sole and digits 1-3 and half of 4

Lateral plantar nerve supplies motor to all other foot muscles and sensory to the skin of the lateral sole and digit 5 and half of 4

83
Q

Describe the arterial supply to the foot.

A

After medial malleolus, tibial artery divides into medial and lateral plantar arteries.

Medial plantar artery supplies the medial side of the sole and runs distally between abductor hallucis and FDB, between layers 1 and 2.

Lateral plantar artery runs laterally between FDB and quadratus plantae (between layers 1 and 2) and turns medially at the bast of the 5th metatarsal and heads between 3rd and 4th layers to the base of the 1st metatarsal as the plantar arch, which forms the deep plantar branch of the dorsalis pedis and gives rise to metatarsal and digit arteries for supply of blood to tarsal joints, digits 1-5, and surrounding musculature.

Anterior tibial artery becomes dorsalis pedis artery, which then branches into the deep plantar artery and the arcuate artery.

Arcuate artery gives rise to digital arteries for digits 2-5.

Anatomy I (14 decks)

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