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anterior lateral leg
physical therapy gross anatomy anterior lateral leg
125
Anatomy
Graduate
10/11/2011

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Term
what is the prominent subcutaneous thing in shin?
Definition
tibia
Term
what is gerdy's tubercle?
Definition
distal attachment of IT band on superolateral surface of tibia
Term
which end of tibia is smaller?
Definition
distal end
Term
what/where is fibular notch?
Definition
facet on distal tibia for articulation with fibula
Term
what is the medial malleolus?
Definition
distal projection on tibia for articulation with talus
Term
what attaches to posterior intercondylar area of tibia?
Definition
posterior cruciate ligament
Term
what is the soleal line?
Definition
rough diagonal ridge on posterior tibia for attachment of soleus
Term
what are nutrient foramens?
Definition
little holes in bones for passage of arterie
Term
where are grooves for tibialis posterior and flexor digitorum longus?
Definition
on posterior aspect of medial malleolus
Term
what is function of fibula?
Definition
muscular attachment (not weight bearing)
Term
where is head of fibula?
Definition
proximal end
Term
where is apex of fibula?
Definition
most proximal part
Term
what does lateral malleolus do?
Definition
articulates with talus, helps stabilize ankle joint
Term
what is malleolar fossa?
Definition
shallow groove on posterior lateral malleolus for passage of fibularis longus and brevis tendons
Term
describe position of lateral malleolus relative to medial malleolus
Definition
lateral malleolus is more prominent, posterior, and distal than medial malleolus
Term
what are the 2 tibiofibular joints?
Definition
distal tibiofibular, proximal tibiofibular
Term
what type of joint is the proximal tibiofibular joint?
Definition
plane type synovial
Term
what type of joint is the distal tibiofibular?
Definition
fibrous: helps maintain ankle stability
Term
what joins the shafts of the tibia and fibula?
Definition
interosseous membrane
Term
describe the tarsals
Definition
7 bones: calcaneus, talus, navicular, medial/intermediate/lateral cuneiforms
Term
how many metatarsals are there?
Definition
5
Term
how many phalanges are there?
Definition
14
Term
there are 2 whats below the 1st metatarsal head?
Definition
sesamoid bones
Term
what covers the talus almost completely?
Definition
cartilage
Term
what is the trochlea of the talus?
Definition
superior articular facet
Term
what does the head of the talus articulate with?
Definition
navicular
Term
why are there small holes on neck of talus bone
Definition
for blood vessels
Term
what can occur if neck of talus is broken?
Definition
avascular necrosis
Term
what do medial and lateral posterior tubercles of talus do?
Definition
provide groove for flexor hallucis longus, which passes through on its way to insert on plantar surface of distal phalanx of hallus
Term
what is the heel bone?
Definition
calcaneus
Term
what is the subtalar joint?
Definition
where calcaneus artericulates with talus superiorly
Term
what does the calcaneus articulate with anteriorly
Definition
cuboid
Term
achilles tendon inserts onto posterior aspect of which bone?
Definition
calcaneus
Term
where is the calcaneal tuberosity
Definition
the bottom part of the heel that you step on
Term
what is the medially projecting boney shelf of the calcaneus?
Definition
sustentaculum tali
Term
what does the sustentaculum tali support?
Definition
head of the talus
Term
what joint is the sustentaculum tali a part of?
Definition
subtalar joint
Term
describe the path of the tendon of the flexor hallucis longus in the foot
Definition
passes between medial and lateral tubercles on posterior aspect of the talus then passes beneath the sustentaculum tali and inserts into distal phalanx of the hallux
Term
describe the cuboid
Definition
cube-shaped tarsal on lateral side of foot, articulates posteriorly with calcaneus and anteriorly with base of 4th and 5th metatasals
Term
where/what is the fibular sulcus?
Definition
on inferior surface of cuboid; groove for passage of fibularis longus tendon
Term
describe path of fibularis longus tendon in the foot
Definition
comes from lateral side and will then scoot over to medial side to act like a sling for the foot
Term
what type of joint is the ankle joint?
Definition
hinge type synovial
Term
what articulations are involved in the ankle joint?
Definition
articulation between distal tibia and fibula with talus
Term
where is the mortise?
Definition
at ankle joint, made by tibia and fibula
Term
what part of talus fits into mortise of ankle joint?
Definition
trochlea
Term
which part of trochlea of talus is wider and how does this affect ankle stability?
Definition
anterior part is wider, meaning that when anterior part of trochlea is in mortise (in dorsiflexion), the ankle is more stable
Term
which muscles produce dorsiflexion of the ankle?
Definition
anterior compartment muscles
Term
which muscles produce plantarflexion of the ankle?
Definition
posterior compartment muscles, some from lateral group
Term
why is the movement of the ankle joint complex?
Definition
medial and lateral malleolus aren't straight on
Term
what are the 3 lateral ankle ligaments?
Definition
anterior talofibular, calcaneofibular, posterior talofibular
Term
how are the anteior talofibular, calcaneofibular, and posterior talofibular ligaments positioned in relation to one another?
Definition
90 degrees apart
Term
what do the anterior talofibular, calcaneofibular, and posterior talofibular ligaments arise from?
Definition
distal fibula
Term
what is the function of the anterior talofibular, calcaneofibular, and posterior talofibular ligaments?
Definition
they become tight to prevent you from rolling your ankle by over-inverting
Term
what is the most commonly injured ankle ligament?
Definition
anterior talofibular ligament
Term
when is the anterior talofibular ligament injured?
Definition
when someone lands with foot plantarflexed and inverted, talus becomes instable (bc it's in plantarflexion), and easily rolls causing disruption of the lateral ligaments
Term
what are the medial ankle ligaments?
Definition
anterior tibiotalar, tibionavicular, tibiocalcaneal, posterior tibiotalar
Term
what are the medial ankle ligaments collectively referred as?
Definition
deltoid ligaments
Term
which set of ligaments is stronger, lateral or medial ankle ligaments?
Definition
medial are stronger
Term
during hypereversion, what happens to deltoid ligaments in children vs. adults?
Definition
children tear ligaments during over eversion, adults will break medial malleolus bc tendons are so strong
Term
what is the action of the anterior compartment muscles?
Definition
dorsiflexion
Term
what is the action of the lateral compartment muscles?
Definition
eversion
Term
what does the common fibular nerve come from?
Definition
sciatic nerve
Term
what does common fibular nerve do after branching from sciatic nerve?
Definition
courses around head of fibula (vulnerable to injury) and divides into 2 branches: superficial fibular and deep fibular
Term
superficial fibular nerve innervates which compartment?
Definition
lateral compartment
Term
deep fibular nerve innervates which compartment?
Definition
anterior compartment
Term
what are the anterior compartment muscles?
Definition
tibialis anterior, extensor hallucis longus, extensor digitorum longus, fibularis tertius
Term
what is the action of the tibialis anterior?
Definition
powerful dorsiflexor of foot
Term
what innervates tibialis anterior?
Definition
deep fibular nerve L4, 5
Term
what is the action of the extensor hallucis longus?
Definition
extends hallux (picks up big toe) and dorsiflexes foot
Term
what is the innervation to the extensor hallucis longus?
Definition
deep fibular nerve L5, S1
Term
what is the action of the extensor digitorum longus?
Definition
extends digits and dorsiflexes foot
Term
what is the innervation to the extensor digitorum longus?
Definition
deep fibular nerve L5, S1
Term
what is the action of the fibularis tertius?
Definition
dorsiflexion and everts foot
Term
what is the innervation to the fibularis longus?
Definition
deep fibular nerve L5, S1
Term
describe the extensor expansion
Definition
long extensor tendons insert into the extensor expansion on the dorsum of the digits, lumbricals and interoosei insert into the exansions and assist/balance movement
Term
describe the superior extensor retinaculum
Definition
superior to the malleoli, binds long extensors to prevent bowstringing, made of thickened crural fascia
Term
describe inferior extensor retinaculum
Definition
Y shaped band of thickened crural fascia; attaches laterally to calcaneus and surrounds tendons of extensor digitorum longus and fibularis tertius
Term
what are the 3 muscles on the dorsum of the foot?
Definition
extensor hallucis brevis, extensor digitorum brevis, dorsal interossei
Term
describe the extensor digitorum brevis and extensor hallucis brevis
Definition
muscles arise from calcaneus and insert into the extensor expansion; assist with toe dorsiflexion; innervated by deep fibular nerve
Term
what causes drop foot?
Definition
when muslces in the anterior compartment of the leg become weakened or paralyzed
Term
how do patients with drop foot compensate?
Definition
steepage gait = hyperflexion of hip to raise leg/foot during swing phase of gait
Term
how do you hear a drop foot?
Definition
patients have an audible slap when their foot hits the ground
Term
injury to what nerve causes drop foot?
Definition
common fibular nerve or deep fibular nerve
Term
injury to what part of what bone can traumatize the common fibular nerve?
Definition
head of fibula
Term
what are the 2 muscles in the lateral compartment?
Definition
fibularis longus, fibularis brevis
Term
describe path of fibularis longus tendon in the foot
Definition
passes through cuboid or fibular groove and inserts into medial cuneiform and 1st metatarsal base
Term
where does fibularis brevis insert?
Definition
base of 5th metatarsal
Term
what is the action of fibularis longus and brevis?
Definition
eversion
Term
what innervates fibularis longus and brevis?
Definition
superficial fibular nerve L5, S1
Term
what is the superior fibular retinaculum?
Definition
band of crural fascia that courses from tip of lateral malleolus to calcaneus which helps bind down fibular tendons
Term
what is inferior fibular retinaculum?
Definition
band of fascia from the lateral surface of the calcaneus to superior surface of calcaneus the helps superior fibular retinaculum bind down fibular tendons
Term
describe path of common fibular nerve
Definition
courses around head of fibula, divides into deep and superficial branches
Term
describe path of deep fibular nerve
Definition
travels with anterior tibial artery and supplies all anterior compartment muscles and extensor digitorum brevis, terminates as cutaneous nerve between 1st and 2nd toes
Term
describe path of superficial fibular nerve
Definition
from common fibular nerve, supplies lateral compartment muscles and then pierces crural fascia in distal leg as medial and intermediate dorsal cutaneous nerves
Term
what nerve provides cutaneous innervation between 1st and 2nd toes?
Definition
deep fibular nerve, L4 L5
Term
what nerve provides cutaneous innervation to most of the dorsum of the foot?
Definition
superficial fibular nerve L4, L5, S1
Term
what nerve innervates lateral cutaneous side of foot
Definition
sural
Term
what nerve provides cutaneous innervation to medial side of leg and foot?
Definition
saphenous
Term
describe path of anterior tibial artery
Definition
pierces interosseous membrane, courses with deep fibular nerve and vascularizes anterior compartment, crosses ankle and becomes dorsalis pedis artery
Term
describe path of dorsalis pedis artery
Definition
from anterior tibial artery, divides into arcuate artery which makes a superficial arch in foot and then gives rise to deep plantar artery which pierces 1st dorsal interosseous muscle and goes into plantar aspect of foot
Term
what is the farthest pulsating artery from the heart?
Definition
dorsalis pedis artery
Term
where can the pulse of the dorsalis pedis artery be palpated?
Definition
just lateral to extensor hallucis longus tendon
Term
what is the innervation to knee extensors?
Definition
L34
Term
what is the innervation to knee flexors?
Definition
L5S1
Term
what is the innervation to inverters?
Definition
L45
Term
what is the innervation to everters?
Definition
L5S1
Term
what is the innervation to hip flexors?
Definition
L23
Term
what is the innervation to hip exensors?
Definition
L5S1
Term
what is the innervation to dorsiflexors?
Definition
L45
Term
what is the innervation to plantor flexors?
Definition
S12
Term
what are the arteries of the hip joint
Definition
medial and lateral circumflex arteries, acetabular branch of obturator artery
Term
what is the result of trauma, thrombosis, or laceration that results in avascular necrosis of the hip?
Definition
severe degenerative joint disease that may require joint replacement
Term
what are common etiologies of avascular necrosis of the femoral head?
Definition
trauma, alcoholism, long-term systemic steroid use
Term
what happens when the femoral head has avascular necrosis?
Definition
sclerosis of the femoral head, femoral head can collapse and cause shortening of limb
Term
what is legg-calve-perthes disease?
Definition
spontaneous avascular necrosis of femoral head that occurs in children (mostly boys) ages 3-11, can lead to degenerative joint disease later in life
Term
what is congenital hip dislocation?
Definition
baby is born with femoral head not in acetabulum
Term
how common is congenital hip displacement and is it more common in boys or girls?
Definition
1:1000, boys more common thangi girls
Term
how would a radiologist determine the presence of congenital dislocation?
Definition
by utilizing the position of the tri-radiate cartilage and the femur
Term
what are hilgenreiner's horizontal line and perkins vertical line?
Definition
lines to create quadrants about the developing acetabulum and hip joint
Term
in which hip quadrant should the developing femoral head be found?
Definition
lower inner quadrant
Term
what should acetabular index be in a normal hip?
Definition
30 degrees or less
Term
what is shenton's line?
Definition
line between obturator foramen and medial aspect of femur (curved)
Term
what 2 tests rule out congenital hip dislocation?
Definition
ortolani's maneuver and barlow's maneuver
Term
describe ortolani's maneuver
Definition
examiner lifts and abducts thigh to bring femoral head from its dislocated position into the acetabulum - causes a clunk when head re-seats into acetabulum
Term
describe barlowe's maneuver
Definition
barlowe test discovers instability in non-dislocated hip; baby's thigh is adducted with gentle downward pressure. Dislocatable hip would be felt as head slips out of acetabulum
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