Posterior Leg Anatomy Quiz

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Questions and Answers

Which of the following muscles is part of the superficial compartment of the posterior leg?

  • Tibialis posterior
  • Popliteus
  • Flexor hallucis longus
  • Soleus (correct)

What action is primarily performed by the gastrocnemius muscle?

  • Foot dorsiflexion
  • Knee extension
  • Hip flexion
  • Foot plantarflexion and knee flexion (correct)

Where does the gastrocnemius muscle originate?

  • Above the lateral femoral condyle (correct)
  • Soleal line
  • Head of the fibula
  • Medial malleolus

Which nerve is responsible for the innervation of the soleus muscle?

<p>Tibial nerve (D)</p> Signup and view all the answers

What is the common action of the muscles classified under the triceps surae?

<p>Foot plantarflexion (B)</p> Signup and view all the answers

Which artery is primarily responsible for the blood supply to the dorsum of the foot?

<p>Anterior tibial artery (B)</p> Signup and view all the answers

What is a key anatomical feature of the venous drainage in the lower limb?

<p>Deep veins accompany larger arteries throughout the limb. (C)</p> Signup and view all the answers

Which arterial anastomosis is known as the 'cruciate' anastomosis?

<p>Branches of the gluteal artery and upper perforating branch of profunda femoris artery (C)</p> Signup and view all the answers

Which of the following correctly describes the pathway of the long saphenous vein?

<p>Passes in front of the medial malleolus and travels up to drain into the femoral vein. (B)</p> Signup and view all the answers

What is the primary role of communicating veins in the venous drainage of the lower limb?

<p>Connecting superficial and deep veins separated by fascia. (A)</p> Signup and view all the answers

What is the primary action of the flexor hallucis longus (FHL)?

<p>Flexion of the first metatarsophalangeal joint and interphalangeal joint (B)</p> Signup and view all the answers

Which of the following muscles is NOT innervated by the tibial nerve?

<p>Tibialis anterior (C)</p> Signup and view all the answers

What happens as a result of weakness or rupture of the tibialis posterior muscle?

<p>Progressively pronated foot (A)</p> Signup and view all the answers

Which structure is NOT found under the flexor retinaculum?

<p>Flexor carpi ulnaris (D)</p> Signup and view all the answers

Which of the following correctly describes the blood supply path to the lower limb?

<p>Abdominal aorta --&gt; external iliac artery --&gt; femoral artery (C)</p> Signup and view all the answers

What is the action of the tibialis posterior muscle?

<p>Foot inversion and ankle joint plantarflexion (D)</p> Signup and view all the answers

Which option correctly identifies an action of the flexor digitorum longus?

<p>Flexion of the lesser four phalanges (C)</p> Signup and view all the answers

Which nerve provides cutaneous sensation to the medial aspect of the heel?

<p>Medial calcaneal branch (B)</p> Signup and view all the answers

What is the terminal pathway for venous drainage from the lower limb?

<p>Deep veins --&gt; external iliac vein --&gt; inferior vena cava (D)</p> Signup and view all the answers

Which nerve is responsible for innervating the skin on the posterior calf and lateral foot?

<p>Sural nerve (D)</p> Signup and view all the answers

What condition arises when the valves within veins become incompetent?

<p>Varicose veins (D)</p> Signup and view all the answers

Which statement about lymphatic drainage in the lower limb is correct?

<p>Superficial lymph glands are located near the inguinal ligament and popliteal fossa. (C)</p> Signup and view all the answers

Which nerve splits into the superficial and deep peroneal nerves in the leg?

<p>Common peroneal nerve (C)</p> Signup and view all the answers

What is a common consequence of blood pooling in the extremities?

<p>Oedema (C)</p> Signup and view all the answers

Which statement about the femoral nerve is correct?

<p>It is located beneath the inguinal ligament. (D)</p> Signup and view all the answers

Which nerve provides sensory innervation to the 1st webspace between the toes?

<p>Deep peroneal nerve (A)</p> Signup and view all the answers

Flashcards

Gastrocnemius

A large calf muscle with two heads originating above the knee joint, inserting onto the Achilles tendon.

Soleus

A deep calf muscle with a single origin on the fibula and soleal line, also inserting onto the Achilles tendon.

Triceps Surae

The combined action of the Gastrocnemius and Soleus muscles, creating a powerful plantarflexion force.

Plantaris

A small, vestigial muscle in the calf, sometimes absent.

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Muscular Equinus

A condition where the calf muscles become shortened, making it difficult to dorsiflex the foot.

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Anterior tibial artery

The anterior tibial artery supplies the front of the leg and foot. It originates from the popliteal artery and travels down the front of the shin. It continues as the dorsalis pedis artery in the foot, which branches into the metatarsal and plantar arteries supplying the toes.

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Posterior tibial artery

The posterior tibial artery supplies the back of the leg and foot. It originates from the popliteal artery and descends behind the tibia. It branches into the medial and lateral plantar arteries, forming the plantar arch in the foot.

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Superficial veins in the lower limb

The superficial veins in the lower limb run close to the skin and drain the superficial tissues. These veins are not as deep as the arteries.

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Deep veins in the lower limb

The deep veins in the lower limb run alongside the arteries and typically travel in pairs close to the arteries. These veins are referred to as 'venae comitantes.'

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Communicating veins

These veins connect the superficial and deep venous systems in the lower limb. They are present in the fascial layer surrounding the muscles. These veins allow blood flow between the superficial and deep venous systems.

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Venous Drainage of the Lower Limb

The venous system of the lower limb is responsible for returning deoxygenated blood from the legs to the heart. It consists of a network of superficial and deep veins. The superficial veins, like the great saphenous vein, lie closer to the skin and primarily drain blood from the skin and subcutaneous tissues. The deep veins, like the femoral vein, run alongside major arteries and drain blood from the muscles and bones. Both superficial and deep veins are connected by perforator veins.

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Popliteal Vein

The popliteal vein is a deep vein located behind the knee. It receives blood from the veins of the calf and then drains into the femoral vein.

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Varicose Veins

Varicose veins are abnormally enlarged and twisted veins, usually in the legs. They often occur when the valves in the veins become weak or damaged, causing blood to pool in the veins.

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Lymphatic Drainage of the Lower Limb

The lymphatic system is a network of vessels that drain excess fluid and waste products from tissues and help fight infections. Lymphatic drainage follows a similar path to the venous drainage in the lower limb.

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Sciatic Nerve

The sciatic nerve is the largest nerve in the body, extending from the lower back to the leg. It divides into the tibial nerve and the common peroneal nerve, which supply different regions of the leg and foot.

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Femoral Nerve

The femoral nerve originates from the lumbar plexus and supplies the muscles of the anterior thigh and the skin of the anterior and medial thigh.

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Obturator Nerve

The obturator nerve is a branch of the lumbar plexus that supplies the muscles of the medial thigh and the skin on the medial thigh.

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Tibial Nerve

The tibial nerve originates from the sciatic nerve and supplies the muscles of the posterior leg and the plantar surface of the foot.

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Popliteus muscle

The popliteus muscle is a small muscle located in the posterior compartment of the knee joint. It originates from the lateral condyle of the femur and inserts into the lateral meniscus and the soleal line of the posterior tibia. It is innervated by the tibial nerve. Its primary action is to rotate the knee joint medially and laterally.

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Flexor hallucis longus (FHL)

The flexor hallucis longus (FHL) is a muscle located in the deep posterior compartment of the leg. It originates from the lower two-thirds of the fibula and inserts into the distal phalanx of the big toe. It is innervated by the tibial nerve and its actions include flexion of the big toe joint (MTPJ) and interphalangeal joint (IPJ) as well as flexion of the ankle joint.

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Flexor digitorum longus (FDL)

The flexor digitorum longus (FDL) is a muscle located in the deep posterior compartment of the leg. It originates from the posterior surface of the tibia and inserts into the distal phalanges of the lesser four toes. It is innervated by the tibial nerve. Its actions include plantarflexing the lesser toes and the foot, as well as stabilizing the toes during walking.

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Tibialis posterior (TP)

The tibialis posterior (TP) is a muscle located in the deep posterior compartment of the leg. It originates from the interosseous membrane and the tibia and fibula, and inserts into the navicular tuberosity and all tarsal bones except the talus. It is innervated by the tibial nerve. Its actions include inverting the foot and plantarflexing the ankle joint.

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Flexor retinaculum

The flexor retinaculum is a thick band of tissue located in the ankle that holds the tendons of the deep posterior compartment muscles in place. It also helps to prevent these tendons from being damaged.

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Popliteal fossa

The popliteal fossa is a diamond-shaped area located at the back of the knee. It is formed by the hamstrings and the gastrocnemius muscles. Various blood vessels and nerves, including the popliteal artery and vein and tibial nerve, pass through this region.

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Femoral artery

The femoral artery is a major artery that supplies blood to the leg and foot. It originates from the external iliac artery and travels through the femoral triangle and adductor canal before entering the popliteal fossa.

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Study Notes

Posterior Leg Anatomy

  • The posterior leg is divided into two sub-compartments: superficial and deep.
  • The superficial compartment comprises muscles like gastrocnemius, soleus, and plantaris.
  • Gastrocnemius (two heads) and soleus combine to form triceps surae.
  • The deep compartment includes popliteus, flexor hallucis longus (FHL), flexor digitorum longus (FDL), and tibialis posterior (TP).

Gastrocnemius Muscle

  • Originates from two heads: above the medial and lateral femoral condyles.
  • The heads join at the mid-leg.
  • Insertion is on the tendo Achilles (calcaneal tendon).
  • Innervated by the tibial nerve.
  • Actions are foot plantarflexion and knee flexion.

Soleus Muscle

  • Situated deep to gastrocnemius.
  • Originates from the upper 1/3rd of the fibula and soleal line.
  • Inserts into the tendo Achilles.
  • Innervated by the tibial nerve.
  • Action is foot plantarflexion.
  • It's an active muscle during gait, engaging heavily from forefoot loading to toe-off.

Plantaris Muscle

  • A small muscle of little clinical relevance.
  • Originates from above the lateral supracondylar line of the femur.
  • Inserts into the Achilles tendon.
  • Action includes very weak knee flexion and ankle plantarflexion.

Deep Posterior Compartment

  • The muscles in this compartment include popliteus, FHL, FDL, and tibialis posterior.
  • The popliteus forms the floor of the popliteal fossa.
  • Popliteus' origin/insertion occurs on the lateral condyle of the femur and posterior tibia, respectively.
  • Popliteus innervation is by the tibial nerve.
  • Popliteus action is medial/lateral rotation of the knee joint.

Flexor Hallucis Longus (FHL)

  • Origin/insertion: lower 2/3rds of the fibula/interosseous membrane (wrapping around the medial malleolus).
  • Passes between sesamoids.
  • Inserts onto the distal phalanx of the great toe (hallux).
  • Innervation by the tibial nerve.
  • Actions are 1st MTPJ/IPJ flexion and hallux (great toe) flexion.

Flexor Digitorum Longus (FDL)

  • Origin/insertion: posterior tibia (wrapping round medial malleolus).
  • Passes laterally into plantar foot, divides into tendons.
  • Inserts into distal phalanges of the lesser four toes.
  • Innervated by the tibial nerve.
  • Action includes plantarflexion of lesser four toes and foot plantarflexion.

Tibialis Posterior (TP)

  • Origin/insertion: interosseous membrane and fibular/tibial sides, inserting onto the navicular tuberosity and the tarsal bones (excluding talus).
  • Innervation from the tibial nerve.
  • Action is foot inversion and plantarflexion.
  • Pathology includes potential weakness/rupture leading to progressively pronated feet.

Structures Under Flexor Retinaculum

  • Tibialis posterior (TP)
  • Flexor digitorum longus (FDL)
  • Artery
  • Vein
  • Nerve
  • Flexor hallucis longus (FHL)
  • These structures are arranged in anterior to posterior order.

Nerve Supply: Tibial Nerve

  • The tibial nerve branches out from the sciatic nerve.
  • It passes deep to the triceps surae, behind the medial malleolus, beneath the flexor retinaculum.
  • It ultimately branches into medial and lateral plantar nerves, also featuring branches to muscles and the skin.

Nerve Supply: Common Peroneal

  • The common peroneal nerve originates from the sciatic nerve and wraps around the lateral neck of the fibula.
  • It supplies the knee joint (articular) and posterior/posterolateral areas of the leg.
  • It branches into superficial peroneal and deep peroneal nerves.

Nerve Supply: Sural Nerve

  • The sural nerve combines branches from both tibial and common peroneal nerves.
  • It runs down the posterior calf with the short saphenous vein.
  • It supplies the skin on the posterior calf, heel, and lateral foot.

Nerve Supply: Femoral Nerve

  • The femoral nerve emerges from the lumbar plexus and travels through the inguinal ligament and sartorius/adductor canal.
  • It splits into branches providing motor function to anterior thigh muscles.
  • It also includes sensory branches supplying the skin over the anterior and medial aspects of the thigh with the saphenous nerve going to the medial side.

Nerve Supply: Obturator Nerve

  • Passes through the obturator foramen and features anterior and posterior branches.
  • Supplies muscles in the thigh's adductor compartment, along with the overlying skin.

Blood Supply

  • External iliac artery's branch, the femoral artery, traverses the femoral triangle and creates branches into profunda femoris.
  • Profunda femoris branches further into perforating and circumflex arteries.
  • Branches from the popliteal, anterior, and posterior tibial arteries further supply the lower limb.

Venous Drainage

  • Superficial veins drain the skin and superficial fascia. Deep veins accompany arteries (venae comitantes). Communicating veins exist.
  • The dorsal venous arch helps drain the lateral foot.
  • Long saphenous veins drain the medial side of the foot and leg.
  • There are two venae comitantes accompanying each of the lower limb arteries providing deep drainage.

Lymphatic Drainage

  • Follows general pattern of superficial and deep veins.
  • Lymph nodes exist near the inguinal ligament and popliteal fossa.

Summary of Posterior Leg

  • This detailed study summary covers the complexities of posterior leg anatomy.
  • It includes meticulous descriptions of muscles, nerves, and their functions.
  • It emphasises essential aspects of blood and lymphatic systems involved in leg function.

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