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The leg and ankle
The Anatomy of the Leg and Ankle Region
| Question | Answer |
|---|---|
| What are the three compartments of the leg? | Anterior, lateral, and posterior |
| What divides the compartments? | The intermuscular septa and the interosseus membrane between the tibia (medial) and fibula (lateral) |
| A LARGE opening exists at the UPPER part of the interosseus membrane to permit the passage of the ___ ___ vessels into the ___ compartment. | anterior tibial; anterior |
| A SMALL opening exists in the LOWER part of the interosseus for passage of the ____ branch of the ___ ___ into the ____ compartment | perforating; fibular artery; anterior |
| In the region of the ankle joint, the deep fascia is thickened to form a series of ____ which serve to keep the long tendons in position and act as modified pulleys | retinacula |
| What are the three sets of retinacula? | Superior and inferior extensor retinacula; flexor retinaculum; superior and inferior fibular retinacula |
| What is compartment syndrome? | Increased pressure within closed myofascial spaces --> decreased O2 perfusion --> damages cells |
| What are some common sites of compartment syndrome? | Leg, forearm, foot, hand, and thigh |
| What are internal and external factors that could lead to compartment syndrome? | External: reduce size of compartment (e.g. cast, splint); Internal: increased volume within space (e.g. bleeding or fracture inflammation) |
| * * What are the muscles of the anterior compartment of the leg? | tibialis major, extensor digitorum longus, extensor hallucis longus, and fibularis tertius |
| * * What provides blood supply to the anterior compartment of the leg? | Anterior tibial artery |
| * * What provides innervation to the anterior compartment of the leg? | Deep fibular nerve |
| * * What is the general action of the muscles of the anterior compartment? | Dorsiflexion; some evert or invert foot; some extend toes |
| * * What is the nerve and action of the tibialis anterior? | Deep fibular nerve; dorsiflexes AND inverts foot |
| * * What is the nerve and action of the extensor digitorum longus? | Deep fibular nerve; dorsiflexes AND extends lateral four toes |
| * * What is the nerve and action of the extensor hallucis longus? | Deep fibular nerve; extends great toe, dorsiflexes foot |
| * * What is the nerve and action of the fibularis tertius? | Deep fibular nerve; dorsiflexes AND everts foot (assists the lateral compartment) |
| * * Describe the course of the anterior tibial artery | Supplies anterior compartment of leg; smaller branch of popliteal artery from lower border of popliteus muscle; passes through superior opening in interosseous membrane; descends accompanied by deep fibular nerve; becomes dorsalis pedis AT ANKLE |
| * * Describe the course of the deep fibular nerve | From common fibular nerve; passes over neck of fibula within substance of fibularis longus muscle; enters anterior compartment and runs downward on anterior surface of interosseus membrane with anterior tibial artery; enters foot along with dorsalis pedis |
| * What are the muscles of the lateral compartment of the leg? | Fibularis longus and fibularis brevis |
| * What is the blood supply to the lateral compartment of the leg? | Branches of the fibular (peroneal) artery |
| * What is the nerve supply of the lateral compartment of the leg? | Superficial fibular nerve |
| * What is the group action of the lateral compartment of the leg? | Eversion (and plantar flexion) of the foot |
| * * What is the nerve and action of the fibularis longus? | |
| What are the three compartments of the leg? | Anterior, lateral, and posterior |
| What divides the compartments? | The intermuscular septa and the interosseus membrane between the tibia (medial) and fibula (lateral) |
| A LARGE opening exists at the UPPER part of the interosseus membrane to permit the passage of the ___ ___ vessels into the ___ compartment. | anterior tibial; anterior |
| A SMALL opening exists in the LOWER part of the interosseus for passage of the ____ branch of the ___ ___ into the ____ compartment | perforating; fibular artery; anterior |
| In the region of the ankle joint, the deep fascia is thickened to form a series of ____ which serve to keep the long tendons in position and act as modified pulleys | retinacula |
| What are the three sets of retinacula? | Superior and inferior extensor retinacula; flexor retinaculum; superior and inferior fibular retinacula |
| What is compartment syndrome? | Increased pressure within closed myofascial spaces --> decreased O2 perfusion --> damages cells |
| What are some common sites of compartment syndrome? | Leg, forearm, foot, hand, and thigh |
| What are internal and external factors that could lead to compartment syndrome? | External: reduce size of compartment (e.g. cast, splint); Internal: increased volume within space (e.g. bleeding or fracture inflammation) |
| * * What are the muscles of the anterior compartment of the leg? | tibialis major, extensor digitorum longus, extensor hallucis longus, and fibularis tertius |
| * * What provides blood supply to the anterior compartment of the leg? | Anterior tibial artery |
| * * What provides innervation to the anterior compartment of the leg? | Deep fibular nerve |
| * * What is the general action of the muscles of the anterior compartment? | Dorsiflexion; some evert or invert foot; some extend toes |
| * * What is the nerve and action of the tibialis anterior? | Deep fibular nerve; dorsiflexes AND inverts foot |
| * * What is the nerve and action of the extensor digitorum longus? | Deep fibular nerve; dorsiflexes AND extends lateral four toes |
| * * What is the nerve and action of the extensor hallucis longus? | Deep fibular nerve; extends great toe, dorsiflexes foot |
| * * What is the nerve and action of the fibularis tertius? | Deep fibular nerve; dorsiflexes AND everts foot (assists the lateral compartment) |
| * * Describe the course of the anterior tibial artery | Supplies anterior compartment of leg; smaller branch of popliteal artery from lower border of popliteus muscle; passes through superior opening in interosseous membrane; descends accompanied by deep fibular nerve; becomes dorsalis pedis AT ANKLE |
| * * Describe the course of the deep fibular nerve | From common fibular nerve; passes over neck of fibula within substance of fibularis longus muscle; enters anterior compartment and runs downward on anterior surface of interosseus membrane with anterior tibial artery; enters foot along with dorsalis pedis |
| * * What are the muscles of the lateral compartment of the leg? | Fibularis brevis and fibularis longus |
| * * What is the blood supply to the lateral compartment of the leg? | The fibular artery (branch of the popliteal) |
| * * What is the nerve supply of the lateral compartment of the leg? | The superficial fibular nerve |
| * * What is the major action of the muscles of the lateral compartment of the leg? | Eversion (and plantar flexion) of the foot |
| * * What is the nerve and action of the fibularis longus? | Superficial fibular nerve; everts and plantar flexes the foot |
| * * What is the nerve and action of the fibularis brevis? | Superficial fibular nerve; everts and plantar flexes the foot |
| * * What is the path of the common fibular nerve? | Leaves popliteal fossa by crossing lateral head of the gastronemius muscle; becomes subcutaneous as it winds around NECK OF FIBULA; divides into superficial and deep branches within lateral compartment in substance of the fibularis longus muscle |
| * * Where do the branches of the common fibular nerve go? | Anterior branch goes DEEP into anterior compartment; Superficial branch stays in the lateral compartment |
| * * What area of the common fibular nerve's path is it exposed to damage? | As it becomes subcutaneous as it winds around neck of the fibula |
| * Describe the path of the superficial fibular nerve (what muscles is it between as it descends)? | Descends in lateral compartment and lies between fibularis longus and brevis muscles, then between fibularis brevis and extensor dgitorum longus-->pierces deep fascia and becomes subcutaneous in distal third leg |
| * What are the arteries of the lateral compartment of the leg? | There are no named arteries except for muscular branches of the fibular artery |
| * What are the muscles of the posterior compartment of the leg? | Superficial: Gastrocnemius, plantaris, soleus; Deep: Popliteus, flexor digitorum longus, flexor hallucis longs, and tibialis posterior |
| * What is the nerve and blood supply of the posterior compartment of the leg? | Tibial nerve and the posterior tibial artery |
| What is the group action of the muscles of the posterior compartment of the leg? | Plantar flexion |
| * * Describe the nerve and action of the gastrocnemius muscle | tibial nerve; plantar flexes the foot at the ankle joint and flexes knee joint (acts on 2 joints); NOTE: gastrocnemius bellies plus soleus = triceps surae (main plantar flexor of the foot!) |
| * * Describe the nerve and action of the soleus muscle | tibial nerve; plantar flexes foot. NOTE: gastrocnemius bellies plus soleus = triceps surae (main plantar flexor of the foot!) |
| * * Describe the nerve and action of the plantaris | tibial nerve; medial rotation of the tibia if leg is free, lateral rotation of the femur if foot is on ground |
| * * Describe the nerve and action of the flexor digitorum longus? | Tibial nerve; flexes toes and plantar flexes foot |
| * * Describe the nerve and action of the flexor hallucis longus | Tibial nerve; flexes toes and plantar flexes the foot |
| * * Describe the nerve and action of the tibialis posterior | Tibial nerve; INVERTS and plantar flexes the foot |
| * Describe the path of the tibial nerve | Passes down from popliteal fossa between heads of gastrocnemius->deep to soleus->goes down LATERAL side of POSTERIOR TIBIAL ARTERY->passes BEHIND medial malleolus onto plantar surface of foot->divides into MEDIAL and LATERAL plantar nerves |
| * Describe the path of the popliteal artery | Accompanies tibial nerve deep to gastrocnemius and soleus; gives off genicular and sural arteries; terminates by dividing into anterior and posterior tibial arteries at lower border of popliteus muscle |
| * Describe the path of the posterior tibial artery | Runs down with tibial nerve; passes posterior to medial malleolus; divides into medial and lateral plantar arteries that accompany corresponding nerves |
| * * What are the major branches of the posterior tibial artery? | Nutrient artery of the tibia (largest nutrient artery in the body) and the FIBULAR ARTERY (largest branch of the posterior tibial) |
| * * Where does the fibular artery run? | Descends between tibialis posterior and flexor hallucis longus->main blood supply for flexor hallucis longus and lateral compartment muscles |
| * * * Describe the structures behind the medial malleolus (deep to the flexor retinaculum) from medial to lateral (or from front to back) | Tibialis posterior tendon, flexor digitorum longus tendon, posterior tibial artery, tibial nerve, flexor hallucis longus (Tom Dick ANd Harry) |
| * * * List the structures behind the lateral malleolus DEEP to the fibular retinacula; SUPERFICIAL to the fibular retinacula | Fibularis longus (below) and fibularis brevis (above); Sural nerve and small saphenous vein |
| * What retinacula is found on the anterior aspect of the ankle? | The extensor retinacula (medial to lateral) |
| * What is deep to the extensor retinacula (medial to lateral)? What is superficial (medial to lateral)? | Tibialis anterior, extensor hallucis longus, anterior tibial artery, deep fibular nerve, extensor digitorum longus, fibularis tertius. Saphenous nerve and great saphenous vein (ANTERIOR to medial malleolus), superficial fibular nerve. |
Created by:
karkis77
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