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The Leg and Foot
The Leg and Foot
91
Anatomy
Graduate
07/13/2011

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Cards

Term
Tarsal Bones (7)
Definition
  • Calcaneus
  • Talus
  • Navicular
  • Cuboid
  • Medial Cuneiform
  • Intermediate Cuneiform
  • Lateral Cuneiform
Term
Calcaneus
Definition

 

 

      1. Articulations – Talus Superiorly; Cuboid Anteriorly
      2. Landmarks – Sustentaculum Tali; Fibular (peroneal) Trochlea; Calcaneal Tuberosity with Medial and Lateral Tubercles

 

Term
Talus
Definition
      1. Articulations – Tibia & Fibula Superiorly; Calcaneus Inferiorly; Navicular Anteriorly
      2. Landmarks – Body with Trochlea, Neck & Head; Posterior Process with Lateral & Medial Tubercles (creates groove for Flexor Hallucis Longus tendon)
Term
Navicular
Definition
      1. Articulations – Talus Posteriorly; Cuneiforms Anteriorly; Cuboid laterally
      2. Landmarks – Navicular Tuberosity
Term
Cuboid
Definition
      1. Articulations – Calcaneus Posteriorly; 3rd Cuneiform and Navicular Medially; 4th & 5th Metatarsal Bones Anteriorly
      2. Landmarks – Tuberosity of the Cuboid; Groove for Fibularis Longus Tendon
Term
Cuneiforms (3) - medial, intermediate, laterl
Definition
        1. Articulations – Navicular Posteriorly; Base of Appropriate Metatarsal Bones Anteriorly; Lateral Cuneiform with Cuboid Laterally
        2. Landmarks - None
Term
Metatarsals
Definition

  • Articulations – Proximally with Cuneiform and Cuboid; Distally with Proximal  Phalanges
  • Landmarks – Base, Body & Head; Tuberosity of 5th Metatarsal

 

Term
Phalanges
Definition
  • Articulations – Proximal with Metatarsal Heads; Interphalangeal
  • Landmarks – Base, Body & Head
Term
  • _____ – Extension of crural fascia to fibula. Separates the anterior compartment from the lateral compartment.
Definition
  • Anterior Intermuscular Septum – Extension of crural fascia to fibula. Separates the anterior compartment from the lateral compartment.
Term
  • _____ – Extension of crural fascia to fibula. Separates the lateral compartment from the posterior compartment.
Definition
  • Posterior Intermuscular Septum – Extension of crural fascia to fibula. Separates the lateral compartment from the posterior compartment.
Term
  • _____ – Passes across the calf from the fibula to the tibia, subdivides the posterior compartment into superficial and deep layers.
Definition
  • Deep Transverse Fascia – Passes across the calf from the fibula to the tibia, subdivides the posterior compartment into superficial and deep layers.
Term
  • _____ – Between the shafts of the tibia and fibula.  Provides areas for muscle attachments.
Definition
  • Interosseous Membrane – Between the shafts of the tibia and fibula.  Provides areas for muscle attachments.
Term

Muscles of the posterior compartment of the leg are divided into a superficial and deep group by the _____

Definition
Muscles of the posterior compartment of the leg are divided into a superficial and deep group by the transverse intermuscular septum (also called deep transverse fascia) 
Term

Superficial group of posterior compartment of the leg- composed of _____ and _____

Definition

Superficial group- composed of triceps surae (gastrocnemius and soleus) and plantaris

Term
Gastrocnemius
Definition
    1. Origin- 
      1. Medial Head: Immediately superior to medial condyle of femur (posterior aspect)
      2. Head: lateral condyle of Femur (lateral aspect)
    2. Insertion- Posterior surface of calcaneus via calcaneal tendon
    3. Innervation- tibial nerve S1, S2
    4. Function- plantarflexes ankle (most effectively when knee is extended), raises heel during walking, flexes leg at knee
Term
Soleus
Definition
    1. Origin- Head and proximal posterior surface of fibula; soleal line of tibia
    2. Insertion- Posterior surface of calcaneus via calcaneal tendon
    3. Innervation- tibial nerve S1, S2
    4. Function- plantarflexes ankle, steadies leg on foot in weightbearing
Term
Plantaris
Definition
    1. Origin- inferior end of lateral supracondylar line of femur
    2. Insertion- posterior surface of calcaneus; tendon blends with medial aspect of calcaneal tendon
    3. Innervation- tibial nerve S1, S2 
    4. Function weakly assists gastrocnemius
Term

Deep Group- composed of popliteus as well as  “Tom, Dick, and Harry”. .. “Tom” being _____ , “Dick” being _____ and “Harry” being _____.  This expression is useful in remembering the order (anterior to posterior) in which the tendons pass posterior to the medial malleolus, deep to the _____.

Definition

Deep Group- composed of popliteus as well as  “Tom, Dick, and Harry”. .. “Tom” being tibialis posterior, “Dick” being flexor digitorum longus and “Harry” being flexor hallucis longus.  This expression is useful in remembering the order (anterior to posterior) in which the tendons pass posterior to the medial malleolus, deep to the flexor retinaculum.

Term
Popliteus
Definition
    1. Origin- lateral aspect of lateral condyle of femur; lateral meniscus
    2. Insertion- posterior surface of tibia, superior to soleal line
    3. Innervation- tibial nerve L4, L5, S1
    4. Function- weakly flexes knee; “unlocks knee” (external rotation of femur on fixed tibia)
Term
Tibialis Posterior
Definition
    1. Origin- interosseous membrane, posterior tibia inferior to soleal line (lateral to flexor digitorum longus), posterior fibula
    2. Insertion- tuberosity of navicular, cuneiforms, cuboid, bases of metatarsals 2-4
    3. Innervation- tibial nerve L4, L5
    4. Function- plantarflexes ankle, inverts foot, helps maintain medial longitudinal arch height during stance phase of gait (eccentric action)
Term
Flexor Digitorum Longus
Definition
    1. Origin- posterior tibia inferior to soleal line (medial to tibialis posterior)
    2. Insertion- bases of distal phalanges 2-5
    3. Innervation- tibial nerve S2, S3
    4. Function- flexes digits 2-5, plantarflexes ankle, supports longitudinal arches (passive tension)
Term
Flexor Hallucis Longus
Definition
    1. Origin- inferior 2/3 of posterior fibula, interosseous membrane
    2. Insertion- base of distal phalanx of great toe
    3. Innervation- tibial nerve S2, S3
    4. Function- flexes great toe, plantarflexes ankle, supports medial longitudinal arch (passive tension)
Term

Neurovascular Relationships of Posterior Compartment- the _____ nerve and _____ vessels are located between the deep and superficial groups of muscles, deep to the _____

Definition

Neurovascular Relationships of Posterior Compartment- the tibial nerve and posterior tibial vessels are located between the deep and superficial groups of muscles, deep to the transverse intermuscular septum

Term
Tibial nerve- the larger terminal branch of the sciatic nerve.  From the popliteal fossa, it passes deep to the tendinous arch of soleus.  It descends posterior to the medial malleolus, immediately posterior to the posterior tibial artery.  In the sole of the foot, it divides into medial and lateral plantar nerves.
Definition
_____ nerve- the larger terminal branch of the sciatic nerve.  From the popliteal fossa, it passes deep to the tendinous arch of soleus.  It descends posterior to the medial malleolus, immediately posterior to the posterior tibial artery.  In the sole of the foot, it divides into ______
Term
_____ Nerve-receives contributions from tibial nerve via medial sural cutaneous nerve and the common fibular nerve via the _____ branch of the lateral sural cutaneous nerve.  It travels superficially with small saphenous vein and provides cutaneous innervation to the posterolateral leg and lateral foot.
Definition
Sural Nerve-receives contributions from tibial nerve via medial sural cutaneous nerve and the common fibular nerve via the sural communicating branch of the lateral sural cutaneous nerve.  It travels superficially with small saphenous vein and provides cutaneous innervation to the posterolateral leg and lateral foot.
Term
_____ artery- is a branch of the popliteal artery and begins at the inferior border of popliteus.  After it gives off the fibular artery, it continues distally, traveling with the tibial nerve.  It passes posterior to the medial malleolus between flexor digitorum longus and the tibial nerve.  It then divides into _____ branches.
Definition
Posterior tibial artery- is a branch of the popliteal artery and begins at the inferior border of popliteus.  After it gives off the fibular artery, it continues distally, traveling with the tibial nerve.  It passes posterior to the medial malleolus between flexor digitorum longus and the tibial nerve.  It then divides into medial and lateral plantar branches.
Term
_____ artery- branch of posterior tibial artery; travels deep to flexor hallucis longus; gives off muscular branches to the posterior and lateral compartments; anastomoses with _____ artery (branch of dorsalis pedis) via perforating branch.
Definition
Fibular artery- branch of posterior tibial artery; travels deep to flexor hallucis longus; gives off muscular branches to the posterior and lateral compartments; anastomoses with arcuate artery (branch of dorsalis pedis) via perforating branch.
Term

3 Parts of the foot: 

 

Definition
  • Hindfoot- talus, calcaneus
  • Midfoot- navicular, cuboid, cuneiforms
  • Forefoot- metatarsals, phalanges
Term
  • _____ Surface – thin; continuous with the inferior extensor retinaculum proximally and the plantar fascia posteriorly and laterally; _____ is medial specialization and _____ and _____ are lateral specializations.
  • _____ Surface – thick; centralized region is the _____ (clinically known as “_____”) which gives off vertical septa that divides the sole of the foot into medial, central and lateral compartments.
Definition
  • Dorsal Surface – thin; continuous with the inferior extensor retinaculum proximally and the plantar fascia posteriorly and laterally; flexor retinaculum is medial specialization and superior and inferior fibular retinacula are lateral specializations.
  • Plantar Surface – thick; centralized region is the plantar aponeurosis (clinically known as “plantar fascia”) which gives off vertical septa that divides the sole of the foot into medial, central and lateral compartments.
Term
Plantar Muscles  - layer 1 (3)
Definition
  • abductor hallucis
  • flexor digitorum brevis
  • abductor digiti minimi
Term
Plantar muscles - layer 2 (2)
Definition
  • quadratus plantae
  • lumbricals
Term
Plantar muscles - layer 3 (3)
Definition
  • flexor hallucis brevis
  • adductor hallucis
  • flexor digiti minimi brevis
Term
Plantar muscles - layer 4 (2)
Definition
  • plantar interossei (3)
  • dorsal interossei (4)
Term
Abductor Hallucis
Definition
    1. Origin- medial tubercle of calcaneal tuberosity, flexor retinaculum, plantar aponeurosis
    2. Insertion- medial side of proximal phalanx of great toe
    3. Innervation- medial plantar nerve S2, S3
    4. Function- abducts and flexes great toe at MP joint
Term
Flexor Digitorum Brevis
Definition
    1. Origin- medial tubercle of calcaneal tuberosity, plantar aponeurosis, intermuscular septa
    2. Insertion- both sides of middle phalanges 2-5
    3. Innervation- medial plantar nerve S2, S3
    4. Function- flexes lateral four digits
Term
Abductor Digiti Minimi
Definition
    1. Origin- medial and lateral tubercles of calcaneal tuberosity, plantar aponeurosis, intermuscular septa
    2. Insertion- lateral side of base of proximal phalanx of 5th digit
    3. Innervation- lateral plantar nerve S2, S3
    4. Function- abducts and flexes 5th digit
Term
Quadratus Plantae
Definition
    1. Origin- medial surface and lateral margin of plantar calcaneus
    2. Insertion- posterolateral aspect of FDL tendon
    3. Innervation- lateral plantar nerve S2, S3
    4. Function- assists FDL in flexes lateral 4 digits (straightens pull of FDL tendon)
Term
Lumbricals (4)
Definition
    1. Origin- tendons of FDL
    2. Insertion- medial aspect of expansion over lateral four digits
    3. Innervation
      1. medial one- medial plantar nerve; S2, S3
      2. lateral three- lateral plantar nerve; S2, S3
    4. Function- flexes digits at MP joint, extends digits at IP joint
Term
Flexor Hallucis Brevis
Definition
    1. Origin- plantar surface of cuboid and lateral cuneiforms
    2. Insertion- both sides of base of proximal phalanx of great toe (sesamoids in tendons)
    3. Innervation- medial plantar nerve S2, S3
    4. Function- flexes great toe at MP joint
Term
Adductor Hallucis
Definition
    1. Origin
      1. Oblique head- bases of metatarsals 2-4
      2. Transverse head- plantar ligaments of MP joints
    2. Insertion- lateral side of base of proximal phalanx of great toe
    3. Innervation- lateral plantar nerve S2, S3
    4. Function- adducts 1st digit, helps maintain transverse longitudinal arch
Term
Flexor Digiti Minimi Brevis
Definition
    1. Origin- base of 5th metatarsal
    2. Insertion- base of proximal phalanx of 5th digit
    3. Innervation- lateral plantar nerve S2, S3
    4. Function-  flexes 5th digit at MP joint
Term
Plantar Interossei (3)
Definition
    1. Origin- bases and medial sides of metatarsals 3-5
    2. Insertion- medial sides of bases of phalanges 3-5
    3. Innervation- lateral plantar nerve S2, S3
    4. Function- adducts digits 3-5 (toward 2nd digit) and flexes digits 3-5 at MP joints
Term
Dorsal Interossei (4)
Definition
    1. Origin- adjacent sides of metatarsals 1-5
    2. Insertion- 
      1. 1st- medial side of proximal phalanx of second digit
      2. 2-4th- lateral sides of proximal phalanges 2-4
    3. Innervation- lateral plantar nerve S2, S3
    4. Function- abduct digits 2-4 (digit 2 abducts both medially and laterally) and flexes digits 2-4 at MP joints
Term
Nerves/Arteries of the foot
Definition
  • medial and lateral plantar nerves
  • medial and lateral  plantar arteries
Term

_____ Nerve- innervates four muscles and is cutaneous to most of the sole of the foot.

Definition
Medial Plantar Nerve- innervates four muscles and is cutaneous to most of the sole of the foot.
Term
_____ Nerve- innervates all other muscles in the sole of the foot and is cutaneous to the lateral aspect of the sole of the foot.
Definition
Lateral Plantar Nerve- innervates all other muscles in the sole of the foot and is cutaneous to the lateral aspect of the sole of the foot.
Term
____ & _____ Arteries-branches of the posterior tibial artery which divides after passing deep to the flexor retinaculum and abductor hallucis. They run parallel to the similarly named nerves.  The deep plantar arterial arch is formed primarily from the _____ artery and is completed by anastomoses from the medial plantar artery and deep plantar artery (branch of dorsalis pedis)
Definition
Medial & Lateral Plantar Arteries-branches of the posterior tibial artery which divides after passing deep to the flexor retinaculum and abductor hallucis. They run parallel to the similarly named nerves.  The deep plantar arterial arch is formed primarily from the lateral plantar artery and is completed by anastomoses from the medial plantar artery and deep plantar artery (branch of dorsalis pedis)
Term

 

_____ – Straining and inflammation of the plantar aponeurosis due to high impact activities with poor footwear.  Results in pain on the plantar surface of the heel and the medial aspect of the foot.

 

Definition
Plantar Fasciitis – Straining and inflammation of the plantar aponeurosis due to high impact activities with poor footwear.  Results in pain on the plantar surface of the heel and the medial aspect of the foot.
Term

 

_____ – Compressive irritation of the medial plantar nerve as it passes deep to the flexor retinaculum or curves deep to the abductor hallucis due to repetitive eversion of the foot.  Results in aching, burning, numbness, and tingling on the medial side of the sole.

 

Definition
Medial Plantar Nerve Entrapment – Compressive irritation of the medial plantar nerve as it passes deep to the flexor retinaculum or curves deep to the abductor hallucis due to repetitive eversion of the foot.  Results in aching, burning, numbness, and tingling on the medial side of the sole.
Term

 

Muscles of the anterior compartment of the leg- tendons of these muscles are held in place by thickenings  of the crural fascia at the ankle, the _____ (superior and inferior).

 

Definition

Muscles of the anterior compartment of the leg- tendons of these muscles are held in place by thickenings  of the crural fascia at the ankle, the extensor retinacula (superior and inferior).

Term
Muscles of the Anterior Compartment of the leg (4)
Definition
  • tibialis anterior
  • extensor digitorum longus
  • extensor hallucis longus
  • fibularis tertius
Term
Tibialis Anterior
Definition
    1. Origin- lateral condyle of tibia, superolateral surface of tibia, interosseous membrane 
    2. Insertion- medial cuneiform, base of 1st metatarsal
    3. Innervation- deep fibular nerve; L4, L5
    4. Function- dorsiflexion of ankle, inversion of foot
Term
Extensor Digitorum Longus
Definition
    1. Origin- lateral condyle of tibia, medial fibula, interosseous membrane 
    2. Insertion- middle and distal phalanges 2-5
    3. Innervation- deep fibular nerve L5, S1
    4. Function- extension of  toes 2-5, dorsiflexion of ankle
Term
Extensor Hallucis Longus
Definition
    1. Origin- middle part of anterior fibula, interosseous membrane
    2. Insertion- base of distal phalanx of great toe
    3. Innervation- deep fibular nerve L5, S1
    4. Function- extension of great toe, dorsiflexion of ankle
Term
Fibularis Tertius - separated part of extensor digitorum longus, shares its synovial sheath
Definition
    1. Origin- inferior 1/3rd of anterior fibula, interosseous membrane
    2. Insertion- dorsal aspect of base of 5th metatarsal
    3. Innervation- deep fibular nerve L5, S1
    4. Function- dorsiflexion of ankle, eversion of foot; may be a physiologic “strain gauge” to help prevent inversion ankle sprains (???)
Term
Nerves/Arteries of Anterior Compartment of leg
Definition
  • anterior tibial artery
  • deep fibular nerve
Term

 

  • _____ Artery: is a branch of the popliteal artery.  It begins inferior to popliteus and passes anteriorly through a gap in the superior part of the interosseus membrane and descends between tibialis anterior and extensor digitorum longus.  At the ankle joint, as it emerges below inferior extensor retinaculum, it becomes _____

 

Definition
  • Anterior Tibial Artery: is a branch of the popliteal artery.  It begins inferior to popliteus and passes anteriorly through a gap in the superior part of the interosseus membrane and descends between tibialis anterior and extensor digitorum longus.  At the ankle joint, as it emerges below inferior extensor retinaculum, it becomes dorsalis pedis artery.  
Term

 

  • _____ Nerve: is one of the terminal branches of the common fibular nerve.  It enters the anterior compartment between fibularis longus and the neck of the fibula and then travels with the anterior tibial artery.  

 

Definition
  • Deep Fibular Nerve: is one of the terminal branches of the common fibular nerve.  It enters the anterior compartment between fibularis longus and the neck of the fibula and then travels with the anterior tibial artery.  
Term
_____- an inability to actively dorsiflex the foot resulting from injury to the deep fibular nerve.  If the common fibular nerve is injured at the fibular neck, an inability to evert the foot also results.
Definition
Foot Drop- an inability to actively dorsiflex the foot resulting from injury to the deep fibular nerve.  If the common fibular nerve is injured at the fibular neck, an inability to evert the foot also results.
Term
“_____”- usually results from an unaccustomed increase in walking/running activity; lay term that refers to either…
  • anterior tibialis strain 
  • medial tibial stress syndrome- inflammation/microtrauma of the medial tibia and/or overlying periosteum
Definition
“Shin Splints”- usually results from an unaccustomed increase in walking/running activity; lay term that refers to either…
  • anterior tibialis strain 
  • medial tibial stress syndrome- inflammation/microtrauma of the medial tibia and/or overlying periosteum
Term
Muscles of the Lateral Compartment of the leg (2)
Definition
  • fibularis longus
  • fibularis brevis
Term
Fibularis Longus
Definition
    1. Origin- head and superior 2/3 of lateral fibula
    2. Insertion- base of 1st metatarsal; medial cuneiform
    3. Innervation- superficial fibular nerve; L5, S1, S2
    4. Function- eversion of foot, plantarflexion of ankle
Term
Fibularis Brevis
Definition
    1. Origin- inferior 2/3 of lateral fibula
    2. Insertion- base of 5th metatarsal tuberosity
    3. Innervation- superficial fibular nerve; L5, S1, S2
    4. Function- eversion of foot, plantarflexion of ankle
Term

 

  • Vasculature of the lateral compartment of the leg is primarily derived from _____ artery.  The proximal portion of the lateral compartment also receives blood from a _____ artery.  Unlike the other two compartments of the leg, the lateral compartment does not have an artery running through it.

 

Definition
  • Vasculature is primarily derived from perforating branches of the fibular artery.  The proximal portion of the lateral compartment also receives blood from a perforating branch of the anterior tibial artery.  Unlike the other two compartments of the leg, the lateral compartment does not have an artery running through it.
Term

 

  • _____ Nerve: is one of the terminal branches of the common fibular nerve.  The_____ nerve approaches the lateral compartment by crossing the lateral head of gastrocnemius and wrapping around the neck of the fibula before dividing.  The _____ nerve descends through the lateral compartment between fibularis longus and brevis before becoming cutaneous anteriorly on the distal half of the leg.  It supplies skin anterolaterally on the distal half of the leg and a substantial portion of the dorsum of the foot.

 

Definition
  • Superficial Fibular Nerve: is one of the terminal branches of the common fibular nerve.  The common fibular nerve approaches the lateral compartment by crossing the lateral head of gastrocnemius and wrapping around the neck of the fibula before dividing.  The superficial fibular nerve descends through the lateral compartment between fibularis longus and brevis before becoming cutaneous anteriorly on the distal half of the leg.  It supplies skin anterolaterally on the distal half of the leg and a substantial portion of the dorsum of the foot.
Term
Muscles of the dorsum of the foot (2)
Definition
  • extensor digitorum brevis
  • extensor hallucis brevis
Term
Extensor digitorum brevis
Definition
    1. Origin- calcaneus, interosseous talocalcaneal ligament, inferior extensor retinaculum
    2. Insertion- extensor digitorum longus tendons to digits 2-4
    3. Innervation- deep fibular nerve L5, S1
    4. Function- aids EDL in extension of digits 2-4
Term
Extensor Hallucis Brevis
Definition
    1. Origin- calcaneus, interosseous talocalcaneal ligament, inferior extensor retinaculum
    2. Insertion- base of proximal phalanx of great toe
    3. Innervation- deep fibular nerve L5, S1
    4. Function- aids EHL in extension of great toe at MP joint
Term
The anterior tibial artery gives off _____ and _____ arteries to supply the ankle joint.  The anterior tibial artery changes names inferior to the extensor retinaculum and becomes the _____ artery.  It gives off _____ and _____ arteries and the arcuate artery along the dorsum of the foot and ends as the _____ artery.  The deep plantar artery penetrates into the plantar aspect of the foot between digits 1 and 2 to contribute to the plantar arterial arch.  The dorsalis pedis pulse can be palpated on the dorsum of the foot lateral to the extensor hallucis longus tendon.
Definition
The anterior tibial artery gives off medial and lateral malleolar arteries to supply the ankle joint.  The anterior tibial artery changes names inferior to the extensor retinaculum and becomes the dorsalis pedis artery.  It gives off medial and lateral tarsal arteries and the arcuate artery along the dorsum of the foot and ends as the deep plantar artery.  The deep plantar artery penetrates into the plantar aspect of the foot between digits 1 and 2 to contribute to the plantar arterial arch.  The dorsalis pedis pulse can be palpated on the dorsum of the foot lateral to the extensor hallucis longus tendon.
Term

The deep fibular nerve divides along the dorsum of the foot into a _____ branch which innervates muscles on the dorsum of the foot and a _____ branch which is cutaneous to the dorsal base of 1st and 2nd digits.


Definition

The deep fibular nerve divides along the dorsum of the foot into a lateral branch which innervates muscles on the dorsum of the foot and a medial branch which is cutaneous to the dorsal base of 1st and 2nd digits.


Term

 

Proximal Tibiofibular Joint

 

Definition

Proximal Tibiofibular Joint

  • Plane type of synovial joint
  • Head of fibula and lateral condyle of tibia
  • Articular capsule and anterior & posterior ligaments of the head of the fibula
  • Slight movement during dorsiflexion & plantarflexion of the foot
Term
Distal Tibiofibular Joint
Definition
  • Fibrous joint (syndesmosis)
  • Inferior tibia and fibula
  • Interosseous membrane and anterior & posterior inferior tibiofibular ligaments
  • No movement; integrity of this articulation is essential for stability of the ankle joint
Term
Lateral L. Complex - 3 parts; weaker than medial ligament
Definition
  • Anterior Talofibular Ligament
  • Posterior Talofibular Ligament
  • Calcaneofibular Ligament
Term
Medial L. Complex ("Deltoid L.") - 4 parts
Definition
  • Tibionavicular Ligament
  • Anterior Tibiotalar Ligament
  • Posterior Tibiotalar Ligament
  • Tibiocalcaneal Ligament
Term
Dorsiflexion is limited by:
Definition
    • passive resistance of the triceps surae and by the medial and lateral ligaments.
Term
Plantar flexion is limited by:
Definition
  • medial and lateral ligaments.
Term
Subtalar Joint.
Definition
  • Articulation between the talus and calcaneus.
  • Ligaments
    • Medial and lateral ligaments of ankle- assist in retaining the talus on the calcaneus
    • Talocalcaneal Interosseous Ligament
  • Movements
    • Inversion- Performed by tibialis anterior and posterior; resisted by lateral ankle ligaments
    • Eversion- performed by fibularis longus, brevis and tertius; resisted by deltoid ligament
Term
_____ (“_____”) ligament- Extends from the sustentaculum tali of the calcaneus to the navicularcritical for integrity of talocalcaneonavicular joint; supports the head of the talus, preventing downward displacement of the talus between the navicular and calcaneus (supports medial longitudinal arch)
Definition
Plantarcalcaneonavicular (“spring”) ligament- Extends from the sustentaculum tali of the calcaneus to the navicular; critical for integrity of talocalcaneonavicular joint; supports the head of the talus, preventing downward displacement of the talus between the navicular and calcaneus (supports medial longitudinal arch)
Term
_____ Ligament- Extends from the calcaneus to the cuboid and metatarsalsforms floor of tunnel for the tendon of fibularis longussupports the calcaneocuboid joint inferiorly (supports lateral longitudinal ligament)
Definition
Long Plantar Ligament- Extends from the calcaneus to the cuboid and metatarsals; forms floor of tunnel for the tendon of fibularis longus; supports the calcaneocuboid joint inferiorly (supports lateral longitudinal ligament)
Term
_____ (_____) Ligament- Deep to the long plantar ligament, extends form the calcaneus to the cuboidforms roof of tunnel for the tendon of fibularis longussupports the calcaneocuboid joint inferiorly (supports lateral longitudinal arch)
Definition
Short Plantar (calcaneocuboid) Ligament- Deep to the long plantar ligament, extends form the calcaneus to the cuboid; forms roof of tunnel for the tendon of fibularis longus; supports the calcaneocuboid joint inferiorly (supports lateral longitudinal arch)
Term
Medial Longitudinal Arch
Definition
  • Higher and more important than the lateral longitudinal arch
  • composed of the calcaneus, talus, navicular, 3 cuneiforms, and 3 metatarsals
  • The talar head is the keystone of the medial longitudinal arch
  • Supported by the tibialis anterior and posterior
Term
Lateral Longitudinal Arch
Definition
  • Flatter than the medial longitudinal arch, rests on ground during standing
  • Composed of the calcaneus, cuboid, and lateral 2 metatarsals
Term
Transverse Arch
Definition
  • Runs from side to side
  • Composed of the cuboid, cuneiforms, and bases of the metatarsals
  • The medial and lateral parts of the longitudinal arch serve as pillars for the transverse arch
  • Supported by the “stirrup” effect of fibularis longus and tibialis posterior tendons
Term

 

  • _____ – Nearly always an inversion injury
    • Lateral Ligament – Damaged by excessive or rapid inversion.  Most commonly the anterior talofibular ligament is sprained.  May be accompanied by a fracture of the fibula.
    • Medial Ligament – Damaged by excessive or rapid eversion.  

 

Definition
  • Ankle Sprains – Nearly always an inversion injury
    • Lateral Ligament – Damaged by excessive or rapid inversion.  Most commonly the anterior talofibular ligament is sprained.  May be accompanied by a fracture of the fibula.
    • Medial Ligament – Damaged by excessive or rapid eversion.  
Term
  • _____ (“_____”) – Foot deformity characterized by lateral deviation of the great toe.
Definition
  • Hallux Valgus (“bunion”) – Foot deformity characterized by lateral deviation of the great toe.
Term
  • _____ (“_____”) – often congenital, but may result from “fallen arches” (usually the medial parts of the longitudinal arches) or rupture of the tibialis posterior tendon
Definition
  • Pes Planus (“flatfeet”) – often congenital, but may result from “fallen arches” (usually the medial parts of the longitudinal arches) or rupture of the tibialis posterior tendon
Term
Dermatomes of the lower extremity (7)
Definition

L1- inguinal region

L2- proximal anterior thigh

L3- medial knee

L4- medial ankle

L5- dorsum of foot

S1- lateral foot/ankle

S2- posterior calf

Term

Cutaneous Distribution of Peripheral Nerves in the Lower Extremity

Thigh and Gluteal Regions

1. Subcostal Nerve- 

2. Iliohypogastric Nerve-

3. Ilioinguinal Nerve- 

4. Genitofemoral Nerve-

5. Lateral Femoral Cutaneous Nerve- 

6. Anterior Femoral Cutaneous Nerves (from femoral n.)- 

7. Obturator Nerve-

8. Posterior Femoral Cutaneous Nerve-

9. Cluneal Nerves (from dorsal primary rami except inferior cluneal nerves from posterior femoral cutaneous nerve)- 

Definition

 

Cutaneous Distribution of Peripheral Nerves in the Lower Extremity

Thigh and Gluteal Regions

1. Subcostal Nerve- inferior to anterior iliac crest

2. Iliohypogastric Nerve- superolateral quadrant of the buttock

3. Ilioinguinal Nerve- femoral triangle region

4. Genitofemoral Nerve-femoral triangle and genital regions

5. Lateral Femoral Cutaneous Nerve- anterolateral  and lateral thigh

6. Anterior Femoral Cutaneous Nerves (from femoral n.)- anterior and anteromedial thigh

7. Obturator Nerve-proximal medial thigh

8. Posterior Femoral Cutaneous Nerve-posterior thigh

9. Cluneal Nerves (from dorsal primary rami except inferior cluneal nerves from posterior femoral cutaneous nerve)- buttock

 

Term

 

 

Cutaneous Distribution of Peripheral Nerves in the Lower Extremity

 

Leg Region

1. Saphenous Nerve (from femoral) – 

2. Sural Nerve (from both tibial and common fibular) – 

3. Common Fibular Nerve – 

4. Superficial Fibular Nerve – 

5. Deep Fibular Nerve –  

6. Medial Plantar Nerve (from tibial) – 

7. Lateral Plantar Nerve (from tibial) – 

 

Definition

Cutaneous Distribution of Peripheral Nerves in the Lower Extremity

Leg Region

1. Saphenous Nerve (from femoral) – Medial leg & foot.

2. Sural Nerve (from both tibial and common fibular) – Posterior & lateral leg; lateral foot.

3. Common Fibular Nerve – Lateral part of posterior leg and the knee joint.

4. Superficial Fibular Nerve – Distal 1/3rd of anterior leg and dorsum of foot.

5. Deep Fibular Nerve – 1st interdigital cleft. 

6. Medial Plantar Nerve (from tibial) – Medial side of sole of foot and sides of 1st 3 digits.

7. Lateral Plantar Nerve (from tibial) – Sole lateral to a line splitting 4th digit.

Term
_____ Vein – Ascends on medial surface of leg (passes anterior to medial malleolus, posterior to medial femoral condyle, passes through saphenous opening in fascia lata to enter femoral vein).
Definition
Great Saphenous Vein – Ascends on medial surface of leg (passes anterior to medial malleolus, posterior to medial femoral condyle, passes through saphenous opening in fascia lata to enter femoral vein).
Term

 

_____Vein – Ascends on posterior surface of leg (passes posterior to lateral malleolus, along the lateral border of the calcaneal tendon, between the two heads of the gastrocnemis, into the popliteal vein in the popliteal fossa).

 

Definition
Small Saphenous Vein – Ascends on posterior surface of leg (passes posterior to lateral malleolus, along the lateral border of the calcaneal tendon, between the two heads of the gastrocnemis, into the popliteal vein in the popliteal fossa).
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