leg
what does the deep branch of the common fibular nerve innervate?
anterior compartment of the leg and dorsum of foot become cutaneous only for the skin between the first and second toe
what does the anterior tibial artery supply?
anterior compartment of the leg and the dorsum of the foot
where does the sciatic nerve divide?
apex of popliteal fossa
compartment syndrome
arises when pressure within the fascial sheaths surrounding muscles increase causing compression of the encased structures
Where are the common fibular or superficial fibular nerves most likely to be injured?
as they pass laterally around the neck of the fibula
extensor retinaculum
holds tendons of extensor muscles in place
interosseous membrane
dense connective tissue connecting tibia and fibula; gap at superior end allows structures to enter anterior portion of leg from the posterior portion
what is the primary action of the anterior compartment of the leg?
dorsi flexion at the ankle joint
what is the primary action of the lateral compartment of the leg?
eversion of the foot
posterior tibial pulse
felt on the posterior surface of the medial malleolus, between it and the medial border of the calcaneal tendon
What is the saphenous nerve a branch of?
femoral nerve
What bone is the lateral malleolus on?
fibula
what provides arterial supply to the fibula?
fibular artery
what does damage to the common fibular nerve cause?
fibular nerve palsy (lateral and anterior compartments of the leg) foot drop
What muscles are innervated by the superficial fibular nerve?
fibularis longus and brevis
What action in addition to plantarflexion is performed by the gastrocnemius?
flexion of the knee
the tendons of which muscles in the deep posterior compartment cross below the medial malleolus?
flexor digitorum longus & flexor hallucis longus
the tendons of which muscles in the deep posterior compartment cross above the medial malleolus?
flexor digitorum longus & tibialis posterior
what passes through the sustentaculum tali of the calcaneous?
flexor hallucis tendon
what 2 muscles are in the lateral compartment of the leg?
1) fibularis longus 2) fibularis brevis
what 3 muscles are found in the superficial posterior compartment of the leg?
1) gastrocnemius 2) soleus 3) plantaris
what are the 4 muscles of the deep posterior compartment of the leg?
1) popliteus 2) tibialis posterior 3) flexor hallicus longus 4) flexor digitorum longus
what 4 muscles are in the anterior compartment of the leg?
1) tibialis anterior 2) extensor hallucis longus 3) extensor digitorum longus 4) fibularis (peroneus) tertius
When does the femoral artery become the popliteal artery?
after passing through the adductor hiatus
what does the popliteal artery divide into?
anterior and posterior tibial arteries
Does the crural fascia completely surround the leg?
No. It is continuous with the periosteum of the tibia on the medial surface of the tibia. It is absent over the medial surface of the tibia which is subcutaneous.
What nerve runs between the two heads of the fibularis longus?
deep fibular nerve
What does the tibial nerve innervate?
Posterior compartment of the leg (deep to the gastrocnemius muscles, through the arch of the soleus)
in a supracondylar fracture of the femur, which way is the distal fragment displaced? Why?
Posteriorly, because the flexing force of the gastrocnemius is no longer balanced by extensors of the knee (the quadriceps femoris) which are attached higher up on the femur.
what innervates the anterior compartment of the leg?
deep fibular nerve
What actions other than eversion of the foot do the muscles in the lateral compartment perform?
The fibularis longus and the fibularis brevis both pass behind the lateral malleolus and thus behind the axis of movement of the ankle joint, making them plantarflexors.
in addition to plantarflexion,what other actions do the muscles in the deep group of the posterior compartment of the leg have?
The names of two of them tell you their actions. The flexor hallucis longus flexes the big toe. The flexor digitorum longus flexes the four lateral digits. The tibialis posterior inverts the foot. All the muscles of the deep group also help to maintain the longitudinal arch of the foot.
What actions other than dorsiflexion do the muscles of the anterior compartment perform?
The tibialis anterior also inverts the foot. The extensor hallucis longus extends the big toe. The extensor digitorum longus extends the lateral four digits and everts the foot. The fibularis tertius everts the foot. All are dorsiflexors of the ankle.
What are shin splints (tibialis anterior strain)?
This is a lay term for the painful condition which often results from lengthy, vigorous exercise, particularly in people who live sedentary lives. Swollen muscles in the anterior compartment of the leg (which has relatively rigid walls) cause reduced blood flow and cramps. small tears in the periostem covering the shaft of the tibia
What is the triceps surae?
Triceps surae is a name sometimes given to the soleus and the two heads of the gastrocnemius.
Does the superficial fibular nerve have a cutaneous branch?
Yes. It supplies most of the skin of the anterior surface of the leg and the dorsum of the foot.
Does the deep fibular nerve have a cutaneous branch?
Yes. It supplies the skin between the first two toes.
fasciotomy
a surgical incision through the fascia to relieve tension or pressure
fibular artery
branch of the posterior tibial artery
calcaneal branches
branches of the tibial nerve the innervate the skin of the heel of the foot
calcaneal tendon reflex
causes plantarflexion of the ankle joint tests s1 and s2 nerve roots
what surrounds the leg?
crural fascia; connected to the tibia
What is the crural fascia?
deep fascia of the leg
What nerve innervates the fibularis tertius?
deep fibular nerve
what happens when the anterior tibial artery crosses the ankle joint?
it becomes the dorsalis pedis artery
What is the action of the popliteus muscle?
it unlocks the knee joint at the beginning of flexion of the extended knee. It does this by rotating the tibia medially. When the foot is fixed, it is a lateral rotator of the femur. It also flexes the knee.
lateral plantar nerve
lateral 1 and 1/2 digits
medial plantar nerve
medial 3 and 1/2 digits, and large portion of plantar portion of foot
what does the tibial nerve divide into?
medial and lateral plantar nerves
What does the saphenous nerve innervate?
medial leg and ankle
what does the superficial branch of the common fibular nerve innervate?
muscles of the lateral compartment of the leg (fibularis longus and brevis) become cutaneous to the lateral aspect of the leg, ankle, and the majority of the dorsum of the foot
Does the soleus flex the knee joint?
no. it does not cross the knee joint
trajectory of the saphenous nerve
only branch of the femoral nerve that travels distal to the knee
What attaches to the tibial tuberosity?
patellar ligament
what is the primary action of the posterior compartment of the leg?
plantar flexion of the foot
What does the fibular artery supply?
posterior compartment AND the lateral compartment of the leg via perforating branches
what supplies the posterior compartment of the leg?
posterior tibial artery and fibular artery
dorsalis pedis pulse
pulse felt on the dorsal surface of the foot, just lateral to the extensor hallucis longus tendon
what contributes to the sural nerve
receives contributions from the tibial and common fibular nerve (medial and lateral cutaneous nerves)
What does the sural nerve innervate?
runs right along the small saphenous vein cutaneous innervation to posterior aspect of the leg
what are the branches of the common fibular nerve?
superficial and deep branch
what innervates the lateral compartment of the leg?
superficial fibular nerve
Is there an artery for the lateral compartment?
there is no single artery within the lateral compartment. The muscles are supplied by small muscular branches that are mostly derived from the fibular artery.
What bone is the medial malleolus on?
tibia
What is the innervation of the popliteus?
tibial nerve
what innervates the posterior compartment of the leg?
tibial nerve
what structures and in what order do the muscles and nerves pass posterior to the medial malleolus?
tibialis posterior flexor digitorum longus posterior tibial artery and vein tibial nerve flexor hallucis longus Tom Dick And a Very Nervous Harry
trajectory of the posterior tibial artery
travels down the posterior compartment of the leg and wraps around the medial malleolus to help supply to the plantar surface of the foot
trajectory of the anterior tibial artery
travels in a gap in the interosseous membrane to get to the anterior compartment of the leg
trajectory of the tibial nerve
travels straight down in a vertical fashion on the posterior leg and wraps posterior the medial malleolus passes below the arch of the soleus
what nerve is responsible for innervating the lower limb?
two divisions of the sciatic nerve (tibial l4-s3) & common fibular l4-s2)
where is the common fibular nerve most vulnerable?
when it wraps around the neck of the fibula
groove in cuboid bone
where tendon of the fibularis longus crosses
trajectory of the common fibular nerve
wraps around the lateral aspect (on the neck of the fibula) descends obliquely along the lateral side of the popliteal fossa to the head of the fibula, where it lies between the tendon of the medial biceps femoris and lateral head of the gastrocnemius muscle.