The Leg And Foot

Front 1

Describe the flow of arterial blood through the leg and foot

Back 1

- External iliac artery crosses the inguinal ligament to become the femoral artery.
- From the femoral artery, the deep femoral artery branches off and from the deep femoral, the medial and lateral circumflex arteries branch off
- femoral artery becomes the popliteal artery as it passes into the popliteal fossa after passing through the adductor hiatus on the adductor magnus muscle.
- the popliteal artery then splits into the anterior tibial and posterior tibial artery
- the anterior tibial artery moves through the ankle joint to become the dorsalis pedus
- posterior tibial artery branch includes the fibular artery

Front 2

Describe how the popliteus muscle unlocks the knee to allow flexion of the leg

Back 2

To unlock the extended one joint to enable flexion of the leg at the knee, the popliteus medially rotates the tibia when the foot is off the ground, or laterally rotates the femur when the foot is planted on the ground.

Front 3

Name the compartments of the leg, list their muscles, actions, innervations and blood supply

ANTERIOR LEG

Back 3

Tibialis anterior: dorsiflexes and inverts foot
Extensor hallucis longus: extends big toe
Extensor digitorum longus: extends toe digits 2-5

Hint 3

Posterior tibial artery

Deep fibular nerve

Front 4

Describe the bony structures that articulate at the ankle joint where plantarflexion and dorsiflexion occur

Back 4

The ankle joint is a synovial joint formed by the distal ends of the tibia and fibula and the talus. The lateral malleolus on the fibula and the medial malleolus on the tibia articulate with the talus of the foot.

Front 5

Describe or draw the tendons, artery and nerve that pass through the tarsal tunnel

Back 5

Through the tarsal tunnel, from anterior to posterior are the:
(T)ibialis posterior tendon
flexor (D)igitorum longus tendon
posterior tibial (A)rtery
tibial (N)erve
flexor (H)allucis longus tendon

Tom, Dick, And Nervous Harry

Front 6

Describe or draw the ligamentous support of the ankle joint and explain which ligaments are most likely to be injured in a plantarflexion-inversion sprain

Back 6

On the medial side of the ankle joint, there is a deltoid ligament. ON the lateral side, there are 3 distinct ligaments:

Anterior talofibular ligament attaches to the anterior part of the talus and the lateral malleolus of the fibula. The calcaneofibular ligament attaches to the calcaneus and the lateral malleolus of the fibula. The posterior talofibular ligament attaches to the posterior part of the talus and the lateral malleolus of the fibula.

The anterior talofibular ligament and the calcaneofibular ligament are most likely to be injured in a plantar flexion-inversion sprain bc those will be the ligaments under the most strain.

Delta ligament injuries are much less common because it is much stranger compared to the lateral ligaments.

Front 7

Name the structure that is inflamed in "plantar fascitis".

Back 7

plantar aponeurosis is an extension of the calcaneal tendon and acts as a lever for gastrocnemius and soles muscles and is thus involved heavily in plantar flexion (i.e. walking, running)

Front 8

Describe the sensory and motor impairments that results from anterior compartment syndrome of the leg.

Back 8

Anterior compartment syndrome is the increase of pressure within the anterior muscle compartment of the leg. The increase in pressure can compromise the vasculature of the compartment and thus cause potential muscle death.

Motor impairments include the inability to extend toes and dorsiflex the foot. The sensory impairments include not having sensation at the first web space (between the big toe and the second toe). You would also have an absent dorsalis pedis pulse.

Front 9

Describe the sensory and motor impairments that results from compression of the common fibular nerve.

Back 9

The common fibular nerve gives off a rural branch which innervates the skin. The superficial fibular nerve innervates the muscles of the lateral compartment of the leg and the skin of the lateral anterior part of the leg and dorsum of foot. The deep fibular nerve innervates the muscles of the anterior compartment and the skin of the first webspace.

Compression of nerve will result in absence of feeling in the lateral anterior part of the leg and the dorsal part of your foot. You will also not be able to dorsiflex your foot or extend your toes.

Front 10

Describe how one would quickly test the motor function of the tibial nerve.

Back 10

The tibial nerve innervates the muscles of the posterior compartment of the leg and the sole of the foot. The posterior muscles of the leg are the gastrocnemius, soleus, popliteus, flexor digitorum longus, tibialis posterior, and flexor hallicus longs.

So in order to test the motor function of the tibial nerve, you would then test to see if a person can plantar flex his foot, flex his leg, invert his foot, and flex his toes.

Front 11

Describe how one would quickly test the L4, L5 and S1 dermatomes

Back 11

L4- medial side of the leg and foot
L5- dorsum of foot
S1- lateral side of foot

Front 12

Name the compartments of the leg, list their muscles, actions, innervations and blood supply

POSTERIOR LEG

Back 12

Gastrocnemius: plantarflexes the foot and Leg Flexion
Plantaris: plantar flexes the foot and flexes leg
Soleus: plantarflexion only
Flexor digitorum longus: flexes toe digits 2-5
Flexor hallucis longus: flexes the big toe
Popliteus: rotates the tibia medially (foot off ground) or femur laterally (feet on the ground) to allow for flexion of the leg
Tibialis posterior: plantarflexion and inversion of foot (attaches to plantar surface of the medial tarsal bones)

Hint 12

Posterior tibial artery

Tibial nerve

Front 13

Name the compartments of the leg, list their muscles, actions, innervations and blood supply

LATERAL LEG

Back 13

Fibularis longus: plantarflexes and everts foot
Fibularis brevis: plantarflexes and everts foot

Hint 13

Common fibular artery

Superficial fibular nerve

Front 14

Extra information

Back 14

1) abduction of toes is moving the toes away form the 2nd toe and adduction is vice versa
2) interosseus membrane is a fibrous ligament connecting the tibia to the fibula
3) muscles of leg are separated by crural fascia into anterior, posterior, and lateral compartments.
4) Flexor retinaculum: holds in place at the medial ankle the long tendons of the deep muscles (flexor halluces longus, flexor digitorum longus, and tibialis posterior
5) Medial head of gastrocnemius muscle attaches to medial femoral condyle while the lateral head attaches to the lateral femoral condyle
6) Long tendons of the anterior compartment are held in place at the ankle by the extensor retinaculum
7) The deep veins of the lower limb parallel the arteries and are named similarly. Veins on the dorsum of the foot empty into the great saphenous vein, a superficial vein on the medial side of the lower limb.
8) Lymphatic vessels in the lower limb drain to lymph nodes located in the popliteal fossa and femoral triangle