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Lower limb 2, Dorsal and plantar veins of the foot, Circumflex femoral…
Lower limb 2
Muscles
Leg and feet
Tibialis Anterior
- Proximal attachment:Lateral surface of the tibia & lateral tibial condyle
- Distal attachment: Medial cuneiform and the base of 1st metatarsal
- Innervation: Deep fibular nerve
- Blood supply: Anterior fibular artery
- Action: Inversion and dorsiflexion of foot
Extensor digitorum longus
- Proximal attachment:Upper tibia and fibula, interosseus membrane
- Distal attachment: Dorsal surface, base of 2-5 toes
- Innervation: Deep fibular nerve
- Blood supply: Anterior fibular artery
- Action: Extends 2-5 toes, dorsiflex foot
Extensor hallucis longus
- Proximal attachment:Middle shaft of fibula and interosseus membrane
- Distal attachment: Base of 1st distal phalanx
- Innervation: Deep fibular nerve
- Blood supply: Anterior fibular artery
- Action: Extension of big toe, inversion, dorsiflexion of foot
Fibularis tertius
- Proximal attachment:Anterior surface of the
fibula & tibiofibular ligament
- Distal attachment: Base of 5th metatarsal
- Innervation: Deep fibular nerve
- Blood supply: Anterior fibular artery
- Action: Dorsiflexion and eversion of foot
Fibularis longus (peroneus longus)
- Proximal attachment:Head of fibula and lateral epicondyle of tibia
- Distal attachment: Medial cuneiform and the base of 1st metatarsal
- Innervation: Superficial branch of peroneal nerve
- Blood supply: Fibular artery
- Action: Plantarflexion and eversion of foot
Fibularis brevis (peroneus brevis)
- Proximal attachment:distal 2/3 of fibular shaft
- Distal attachment: Tuberosity of base of 5th metatarsal
- Innervation: Superficial branch of peroneal nerve
- Blood supply: fibular artery
- Action: Plantarflexion and eversion of foot
Gastrocnemius
- Proximal attachment:lateral and medial femur epicondyles
- Distal attachment: Calcaneal tendon to the calcaneus
- Innervation: tibial nerve
- Blood supply: Sural and posterior tibial artery
- Action: plantarflexes ankle
Plantaris
- Proximal attachment:Lateral supracondylar line of the femur
- Distal attachment: Calcaneal tendon to the calcaneus
- Innervation: tibial nerve
- Blood supply: sural artery
- Action: plantarflexes the ankle
Soleus
- Proximal attachment:Soleal line of tibia and proximal fibular
- Distal attachment: Calcaneal tendon to calcaneus
- Innervation: Tibial nerve
- Blood supply: sural and posterior tibial artery
- Action: Inversion and flexion of foot
Popliteus
- Proximal attachment:Lateral condyle of the femur & lateral meniscus
- Distal attachment: Just superior to
soleal line on the tibia
- Innervation: Tibial nerve
- Blood supply: Sural artery
- Action: laterally rotates the femur on the tibia
Tibialis Posterior
- Proximal attachment:Posterior surface of tibia and fibula, interosseus membrane
- Distal attachment: Navicular tuberosity, base of metatarsals
- Innervation: Tibial nerve
- Blood supply: Posterior tibial artery
- Action: Inversion and plantarflexion of foot
Flexor digitorum longus
- Proximal attachment: medial surface of tibia
- Distal attachment: base of 2-5 distal phalanges
- Innervation: Tibial nerve
- Blood supply: Posterior tibial artery
- Action: Flexes 2-5 toes
Flexor hallucis longus
- Proximal attachment: posterior surface of fibula
- Distal attachment: base of 1st distal phalanx
- Innervation: Tibial nerve
- Blood supply: Posterior tibial and fibular artery
- Action: Flexes great toe
Abductor hallucis
- Proximal attachment: Calcaneal tuberosity, plantar aponeurosis,
- Distal attachment: proximal phalanx of 1st toe
- Innervation: plantar medial or lateral nerve
- Blood supply: medial or lateral artery
- Action: abduct big toe
Abductor digiti minimi
- Proximal attachment: Calcaneal tuberosity, plantar aponeurosis,
- Distal attachment: proximal phalanx of 5th toe
- Innervation: plantar medial or lateral nerve
- Blood supply: medial or lateral artery
- Action: abduct and flexes 5th toe
Flexor digitorum brevis
- Proximal attachment: Medial tubercle of
plantar calcaneus and plantar aponeurosis
- Distal attachment: Medial and lateral sides of middle phalanges 2nd to 5th toes
- Innervation: plantar medial or lateral nerve
- Blood supply: medial or lateral artery
- Action: flexes 2-5 toes
Lumbricals
- Proximal attachment: Arise form the
tendons of flexor digitorum longus
- Distal attachment: Proximal phalanx
of 2nd to 4th toes
- Innervation: plantar medial or lateral nerve
- Blood supply: medial or lateral artery
- Action: Flex the metatarsophalangeal joint
Joints
Knee
Femur; Tibia and fibula
- Menisci, stabilizes joint as they increase the surface area via concave surface, and absorbs
shocks
- Anterior and posterior cruciate ligament
- Media and lateral collateral ligament
- Unhappy triad made up of medial meniscus, anterior cruciate ligament and medial collateral ligament. Common injury
- Blood supply via genicular branches
Ankle
Tibia, fibula and talus
- Mortise, where the head of talus fits into the arch formed by tibia and fibula
- Media and lateral collateral ligaments (collective identification)
- Movements only dorsiflexion and plantaflexion
Arches of foot
Transverse arch
- Metatarsal bases
- cuboid
- Three cuneiform bones
Medial longitudinal arch
- calcaneus
- talus
- navicular
- three cuneiforms
- first three metatarsal bones
- Supported by tibialis posterior
- Supporting ligaments are plantar ligament and medial collateral ligaments of the ankle
Lateral longitudinal arch
- Calcaneus
- cuboid
- 4th and 5th metatarsal bones
Shapes
- Normal
- Flatfoot (pes planus)
- High arch (pes cavus)
Blood supply
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Veins
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Deep
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Superior & Inferior gluteal veins
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Leg Anterior (FEET, lateral to medial)
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Sole of feet, superficial muscles
Popliteal fossa
- Most superficial is the tibial nerve
- Next layer is the popliteal vein
- deepest of 3 is the popliteal artery
- Common fibular nerve goes with the biceps femoris
- May see plantaris
- Small saphenous vein runs posterior surface of gastrocnemius
- Small nerve called the sural nerve runs alongside the small saphenous vein
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