Lower Extremity Anatomy > Posterior Leg: Part 2 > Flashcards

Posterior Leg: Part 2 Flashcards

(90 cards)

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1
Q

Deep compartment muscles

A
  • Deep transverse intermuscular septum of the leg

- Separates from superficial

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2
Q

Popliteus (structural classification)

A
  • Partially intracapsular
  • Partially extracapsular
  • Covered by fascia derived from semimembranosus
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3
Q

Popliteus origin

A
  • Lateral femoral condyle (popliteal groove)

- Posterior aspect of lateral meniscus

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4
Q

Popliteus insertion

A
  • Posterior aspect of proximal tibia, superior to soleal line
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5
Q

Popliteus innervation

A
  • Tibial nerve
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6
Q

Popliteus blood supply

A
  • Posterior tibial artery

- Medial inferior genicular artery

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7
Q

Popliteus function

A
  • Unlocks knee by:
  • Laterally rotating femur on tibia
  • Medially rotating tibia on femur
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8
Q

Flexor hallucis longus

A
  • Most lateral muscle in deep posterior compartment
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9
Q

Flexor hallucis longus origin

A
  • Inferior 2/3 of posterior fibula
  • Intermuscular septum

- Deep fascia

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10
Q

Flexor hallucis longus insertion

A
  • Plantar aspect of base of distal phalanx of hallux
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11
Q

Flexor hallucis longus pathway

A
  • Through groove on posterior tibia/talus
  • Inferior to sustentaculum tali, through the flexor retinaculum
  • Between fibular/tibial sesamoids
  • Inserts plantar aspect of base of distal phalanx (hallux)
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12
Q

Flexor hallucis longus innervation

A
  • Tibial nerve
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13
Q

Flexor hallucis longus blood supply

A
  • Posterior tibial artery

- Fibular artery

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14
Q

Flexor hallucis longus function

A
  • Flex (plantarflex) hallux at interphalangeal and metatarsophalangeal joint
  • Can help plantarflex and invert foot
  • Important during push-off of gait
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15
Q

Flexor digitorum longus

A
  • Most medial deep compartment muscle

- Tendon is palpable around medial malleolus

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16
Q

Flexor digitorum longus origin

A
  • Posterior tibia, inferior to soleal line
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17
Q

Flexor digitorum longus insertion

A
  • Plantar aspect of the bases of distal phalanges, digits 2-5
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18
Q

Flexor digitorum longus pathway

A
  • Through tibial groove
  • Medial to sustentaculum tali, through the flexor retinaculum
  • Plantar foot: splits into 4 slips (at cuneiforms)
  • Slips pass along plantar surface of lesser metatarsals and phalanges to insertion
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19
Q

Flexor digitorum longus innervation

A
  • Tibial nerve
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20
Q

Flexor digitorum longus blood supply

A
  • Posterior tibial artery
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21
Q

Flexor digitorum longus function

A
  • Flex (plantarflex) digits, distal and proximal interphalangeal joints, and MTPs
  • Help with ankle plantarflexion
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22
Q

Flexor digitorum longus tendon crosses

A
  • Superficial to FHL tendon in sole of foot
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23
Q

Master knot of Henry

A
  • Connective tissue between the FHL and FDL
  • FHL is dorsal (superior) to FDL
  • FDL is plantar (inferior) to FHL
  • Inferior to navicular tuberosity
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24
Q

Tibialis posterior

A
  • Deepest muscle of deep posterior compartment

- Tendon is palpable around medial malleolus

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25
Tibialis posterior origin
- Posterior tibia inferior to soleal line - Posterior aspect of fibula anterior to medial crest - Interosseous membrane
26
Tibialis posterior insertion
- Navicular tuberosity - Plantar aspect of all cuneiforms - Base of metatarsals 2-4 - Can also insert into plantar aspect of cuboid and 1st,5th metatarsal bases (all tarsals except for talus)
27
Tibialis posterior pathway
- Posterior to tibia in a groove with FDL - Inferior to medial malleolus, through the flexor retinaculum - Passes superior to sustentaculum tali
28
Tibialis posterior innervation
- Tibial nerve
29
Tibialis posterior blood supply
- Posterior tibial artery | - Fibular artery
30
Tibialis posterior function
- Inverts and adducts the foot | - (supinate subtalar and midtarsal joints)
31
Synovial tendon sheaths of deep compartment muscles
- Flexor hallucis longus sheath - Flexor digitorum longus sheath - Tibialis posterior sheath
32
All proximal synovial tendon sheaths of deep compartment muscles
- Pass within the flexor retinaculum (laciniate ligament)
33
Flexor hallucis longus PROXIMAL sheath
- Begins about the distal tip of the medial malleolus - Surround tendon posterior to medial malleolus and inferior to sustentaculum tali - Ends at knot of Henry - Begins and ends most distally
34
Flexor hallucis longus DISTSAL sheath
- Surround tendon from the hallux met head to proximal phalanx
35
Flexor digitorum longus PROXIMAL sheath
- Begins posterior to medial malleolus, little proximal to FHL sheath - Ends proximal to master knot of Henry
36
Flexor digitorum longus DISTAL sheath
- All 4 tendons of digits 2-5 from the metatarsophalangeal joint to middle phalanges
37
Tibialis posterior sheath
- Begins about 4cm proximal to tip of medial malleolus - Ends at porta pedis - Begins and ends most proximally
38
Tibial nerve (L4-S3) pathway
- Passes deep to tendinous arch of soleus | - Innervates all posterior compartment muscles
39
Tibial nerve (L4-S3) gives off
- Medial sural cutaneous (S1,2) - Muscular branches - Medial calcaneal branches - Medial/lateral plantar nerves
40
Medial sural cutaneous (S1,2) nerve
- Joins with fibular communicating nerve to form sural nerve
41
Medial calcaneal branches (from tibial nerve)
- Pierce through flexor retinaculum (laciniate ligament) | - Supply skin in the medial calcaneal region
42
Terminal branches of tibial nerve
- Medial plantar nerves | - Lateral plantar nerves
43
Popliteal artery
- Continuation of femoral (deep in popliteal fossa) | - Supplies knee joint and surrounding musculature
44
Popliteal artery pulse
- Difficult to feel | - Easier more superior and medial to midline
45
Popliteal artery pathway
- Passes into posterior leg compartment | - Deep through fibrous arch of soleus
46
Branches of popliteal artery
- Superior medial/lateral genicular - Sural arteries - Middle genicular - Inferior medial/lateral genicular - Anterior/posterior tibial (terminal branches)
47
Superior lateral genicular artery
- Passes deep to and biceps femoris
48
Superior medial genicular artery
- Passes deep to medial hamstring muscles/adductor magnus above medial femoral condyle
49
Sural arteries (muscular branches of popliteal) supply
- Gastrocnemius - Soleus - Plantaris
50
Middle genicular artery
- Pierces oblique popliteal ligament | - Supplies internal knee structures
51
Inferior lateral genicular artery
- Passes deep to gastrocnemius/plantaris - Superficial to popliteus - Passes around lateral tibial condyle
52
Inferior medial genicular artery
- Follows along superior border of popliteus toward medial tibial condyle
53
Anterior tibial artery
- Terminal branch of popliteal - Branches off popliteal artery near inferior border of popliteus - Passes through superior opening of interosseous membrane - Enters anterior compartment
54
Branches of anterior tibial artery
- Anterior tibial recurrent | - Posterior tibial recurrent
55
Posterior tibial recurrent artery
- Branches off before entering the anterior compartment - Passes deep to popliteus - Joins with genicular anastomosis
56
Anterior tibial recurrent artery
- Branches right after passing through superior opening in the interosseous membrane - Passes superiorly - Anastomose with inferior genicular arteries
57
Branches of posterior tibial artery (deep posterior compartment)
- Circumflex fibular artery | - Fibular artery
58
Circumflex fibular artery
- Wraps around neck of fibula | - Joins with inferior genicular arteries
59
Fibular artery
- Descends posterior to fibula
60
Venous drainage of deep posterior compartment
- Anterior/posterior tibial vein > Tibial vein > Popliteal vein > Femoral vein
61
Posterior tibial artery is located
- Between FHL and FDL | - Superficial to TP (in the deep compartment)
62
Posterior tibial artery pathway
- Passes posterior to medial malleolus | - Divides into its terminal branches posterior to medial malleolus (tarsal tunnel)
63
Posterior tibial pulse
- Between medial malleolus and Achilles tendon
64
Branches of posterior tibial artery
- Circumflex fibular (not always) - Muscular branches - Nutrient artery of tibia - Fibular artery - Posterior medial malleolar branch - Artery to tarsal canal - Medial plantar artery - Lateral planter artery
65
Nutrient artery of tibia enters
- Inferior to soleal line
66
Terminal branches of posterior tibial artery
- Medial plantar artery | - Lateral plantar artery
67
Fibular (peroneal) artery pathway
- Descends between FHL and TP | - Posterior to lateral malleolus
68
Branches of fibular (peroneal) artery
- Muscular branches - Nutrient artery of fibula - Perforating branch of fibular (peroneal) - Fibular communicating - Posterior lateral malleolar arteries - Lateral calcaneal arteries
69
Nutrient artery of fibula is located
- Around mid-shaft
70
Perforating branch of fibular (peroneal) artery
- Passes through inferior opening in the interosseous membrane (5 cm superior to lateral malleolus) - Enters anterior ankle region
71
Fibular communicating artery
- Joins with posterior tibial (posterior, very inferior leg)
72
Flexor retinaculum (Laciniate ligament)
- Thickening of crural fascia - Anchors flexor tendons - Tendons pass through retinaculum in separate compartments surrounded by their synovial sheaths
73
Flexor retinaculum (Laciniate ligament) attaches to
- Distal and posterior medial malleolus | - Medial calcaneus
74
Tarsal tunnel
- Passageway between posterior leg and plantar foot | - Septae divide into 4 compartments
75
Compartments of tarsal tunnel
- 1 for neurovascular bundle - 3 for tendons - Tendons are surrounded by synovial sheaths through compartments
76
Tarsal tunnel boundaries
- Medial: flexor retinaculum (laciniate ligament) and abductor hallucis - Lateral: calcaneus, posterior talotibial and calcaneotibial ligaments
77
Tarsal tunnel MEDIAL boundary
- Flexor retinaculum (laciniate ligament) | - Abductor hallucis
78
Tarsal tunnel LATERAL boundary
- Calcaneus - Posterior talotibial ligament - Calcaneotibial ligament
79
Tarsal tunnel content (anterior to posterior, or medial to lateral)
- Tibialis posterior tendon - Flexor digitorum tendon - Posterior tibial artery and vein - Tibial nerve - Flexor hallucis longus tendon (inferior to sustentaculum tali)
80
Posterior leg (medial to lateral)
- FDL - TP - FHL
81
Posterior to medial malleolus in tarsal tunnel (medial to lateral)
- TP - FDL - FHL
82
Distal to Master Knot of Henry
- TP - FHL - FDL
83
Flexor digitorum accessorius longus
- Accessory muscle - Found 3-12% of the time - Content of the tarsal tunnel if present - Crowds tarsal tunnel
84
Flexor digitorum accessorius longus origin (variable)
- Tibia or fibula - Crural fascia - Proximal FDL
85
Flexor digitorum accessorius longus insertion
- FDL tendon around master knot of Henry - (or) - Quadratus plantae
86
Flexor digitorum accessorius longus bloody supply
- Blood and nerve supply same as posterior compartment muscles - (Posterior tibial artery) - (Tibial nerve)
87
If flexor digitorum accessorius longus crowds tarsal tunnel, it can cause
- Tarsal tunnel syndrome | - FHL tenosynovitis
88
Porta pedis
- Canal that is formed by the abductor hallucis muscle and calcaneus
89
Porta pedis is a passageway for
- Medial/lateral plantar arteries, veins, nerves to/from the medial ankle - Potential site of entrapment
90
Tarsal tunnel location
- Posteromedial ankle | - From proximal flexor retinaculum to porta pedis
Lower Extremity Anatomy
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