ATTR 219 1st Edition Lecture 6Fibula-distal end is lateral malleolus-shaft is twisted into a triangular shape-bound to the tibia by tibiofibular syndesmosis -articulates with lateral surface to talus in ankle mortice-bears little weight, if anyMuscles of Lower Leg-divided into compartments: anterior, lateral or peroneal, deep and superficial posteriorAnterior Compartment-action-dorsiflex foot and extend toes-innervation by deep peroneal nerve-nerve accompanied by anterior tibial artery-terminal brach of popliteal- Tibialis Anterior-Origin: lateral condyle, upper 2/3 of lateral tibia, interosseous membrane and deep fascia-Inserts: medial cuneiform, base of 1st metatarsal -Action: dorsiflexes and inverts foot (do this to see anterior tibilus)- Extensor HallucisLongus-Origin: mid half of anterior fibula; adjacent interosseous membrane-Inserts: base of distal phalanx of 1st toe-Action: extends 1st toe and dorsiflexion of foot- Extensor DigitorumLongus-Origin: lateral condyle of tibia, upper ¾ of anterior fibula, interosseousmembrane and deep fascia-Inserts: base of middle and distal phalanges of lateral 4 toes; dorsiflexion and everts foot- Peroneus Tertius (also known as fibularistertius)These notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.-Origin: lower 1/3 of anterior fibula and adjacent interosseous membrane -Inserts: base of 5th metatarsal (styloid process)-Action: dorsiflexion and everts footLateral Compartment-contains two muscles that produce foot eversion and plantar flexion-innervated by superficial peroneal nerve- Peroneus Longus-Origin: head and upper 2/3 of lateral fibula-Inserts: medial cuneiform and base of 1st metatarsal-Action: plantar flexion and everts foot, tendon of muscle runs in plantar groove of cuboid- Peroneus Brevis-Origin: lower 2/3 of lateral fibula -Inserts: base of 5th metatarsal -Action: plantar flexies, everts foot, tendon runs above peroneal tubercle and peroneus longus runs belowPosterior Compartments-divided into superficial and deep group-primary action is plantar flexion of foot, ankle and toes-innervation by tibial nerve-posterior tibial artery is the blood supply*Superficial Group*:- Gastroc (2 heads)-Origin: (1) medial head- medial condyle and adjacent femur(2) lateral head- lateral condyle and adjacent femur-Inserts: Achilles tendon to posterior calcaneus -Action: plantar flexes the foot and ankle; flexes the lower leg- Soleus-Origin: head and upper 1/3 of posterior fibula, soleal line and middle 1/3 of medial border of tibia-Inserts:Achilles tendon to posterior calcaneus-Action: plantar flexes the foot and ankle- Plantaris-Origin: lateral supracondylar line of femur-Inserts: Achilles tendon-Action: weak assistant in plantar flexion of foot and ankleDeep Group- Popliteus-Origin: lateral condyle of femur-Inserts: posterior tibia above soleal line-Action: internal rotation of tibia on femur; flexes lower leg- Flexor HallucisLongus-Origin: lower 2/3 of posterior fibula and adjacent interosseous membrane-Inserts: base of distal phalanx of 1st toe-Action: flexes 1st toe, assists in plantar flexion and inversion of foot/ankle-artery: peroneal- Flexor DigitorumLongus-Origin: posterior tibial below soleal line-Inserts: base of distal phalanx of lateral 4 toes-Action: flexes lateral 4 toes; assists in plantar flexion and inversion of foot and ankle-Artery: posterior tibial- Tibiolus Posterior-Origin: posterior surface of interosseous membrane, lateral/posterior tibia below soleal line upper ¾ of medial fibula-Inserts: navicular tuberosity sustentaculumtali, cuboid, 3 cuneiform, base of 2-4 metatarsals-Artery: peronealStructures of Posterior Lower Leg-Order of structures passing posterior/inferior to medial malleolus - Tibialis Posterior (TOM)- Flexor Digitorum (DICK)- Posterior Tibial Artery (AND)- Tibial Nerve (NERVOUS)- Flexor Hallucis (HARRY)Nerves- Tibial nerve- largest terminal branch of the sciatic-enters between two heads of gastro and runs adjacent to posterior tibial artery-splits and becomes medial and lateral plantar artery- Common peroneal is smaller terminal branch of sciatic-winds around the neck of fibula -between fibula and peroneus longus will divide into two terminal branches-superficial and deep peroneal nerve- Superficial peroneal nerve: innervates anterior compartment-lies anterior to interosseous membrane-adjacent to anterior tibial artery-ends on dorsum of foot between 1st and 2nd toesArteries- Anterior Tibial Artery:-anterior to interosseous membrane and adjacent to deep peroneal nerve-continuous on dorsum as dorsalis depus artery- Posterior Tibial Artery:-accompanies tibial nerve in posterior compartments-splits under flexor retinaculum into medial and lateral plantar artery-can be palpated between medial malleolus and calcaneus - Peroneal Artery-larger branch of posterior tibial artery-deep to flexor halluces ligament and supplies peroneal
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