Lower limb

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created 2 weeks ago by YumikoKono
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updated 5 days ago by YumikoKono
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anatomy
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1

What (7) muscles compose the posterior compartment of the leg? What nerve innervates the entire posterior leg compartment?

  • gastrocnemius (lateral and medial heads), soleus, plantaris, popliteus, tibialis posterior, flexor digitorum longus, and flexor hallicus longus
  • tibial nerve
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gastrocnemius

prox. attach:

  • lateral head: lateral condyle of femur
  • medial head: popliteal surface of femur

dist. attach: posterior calcaneus (calcaneal tendon)

innerv.: tibial nerve (S1, S2)

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soleus

prox. attach: medial border of tibia, superior posterior fibula, and head of fibula

dist. attach: posterior calcaneus (calcaneal tendon)

innerv.: tibial nerve (S1, S2)

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plantaris

prox attach: inferior supracondylar line

dist. attach: posterior calcaneus (calcaneal tendon)

innerv.: tibial nerve (S1, S2)

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popliteus

prox. attach: lateral femoral condyle

dist. attach: posterior tibial surface

innerv.: tibial nerve (L4, L5, S1)

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tibialis posterior

prox. attach: interosseous membrane, posterior tibia, and fibula

dist. attach: tuberosity of navicular, also cuneiforms, cuboid, and bases of metatarsals 2-4

innerv.: tibial nerve (L4, L5)

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flexor digitorum longus

prox. attach: posterior tibia, inferior to soleal line

dist. attach: base of distal phalanx of lateral 4 digits

innerv.: tibial nerve (S2, S3)

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flexor hallucis longus

prox. attach: posterior fibula, inferior interosseous membrane

dist. attach: base of distal phalanx of great toe

innerv.: tibial nerve (S2, S3)

9

What (4) muscles compose the anterior compartment of the leg? What nerve innervates the entire anterior leg compartment?

  • tibialis anterior, extensor digitorum longus, extensor hallucis longus, and fibularis tertius
  • deep fibular nerve
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tibialis anterior

prox. attach: lateral condyle, superolateral tibia, and interosseous ligament

dist. attach: medial cuneiform and base of 1st metatarsal

innerv.: deep fibular nerve (L4, L5)

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extensor digitorum longus

prox. attach: lateral condyle, superior fibula, and interosseous ligament

dist. attach: middle and distal phalanges of lateral four digits

innerv.: deep fibular nerve (L4, L5)

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fibularis tertius

prox. attach: inferior 1/3 fibula and interosseous ligament

dist. attach: dorsal 5th metatarsal

innerv.: deep fibular nerve (L4, L5)

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extensor hallucis longus

prox. attach: middle anterior fibula and interosseous ligament

dist. attach: dorsal base of distal phalanx of great toe

innerv.: deep fibular nerve (L4, L5)

14

What (2) muscles compose the lateral compartment of the leg? What nerve innervates the entire lateral leg compartment?

  • fibularis longus and fibularis brevis
  • superficial fibular nerve
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fibularis longus

prox. attach: head of fibula and superior 2/3 of lateral fibula

dist. attach: base of 1st metatarsal and medial cuneiform

innerv.: superficial fibular nerve (L5, S1, S2)

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fibularis brevis

prox. attach: inferior 2/3 of lateral fibula

dist. attach: lateral base of 5th metatarsal

innerv.: superficial fibular nerve (L5, S1, S2)

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What is Concentric contraction [C]? What is Eccentric contraction [E]?

[C]: muscle shortens while generating force

[E]: muscle lengthens while generating force

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What muscles are involved in heel strike? Is Concentric contraction [C] or Eccentric contraction [E] involved?

(A) Heel strike:

  • Lower forefoot: Ankle dorsiflexors [E]
    • (3) tibialis anterior, extensor hallucis longus, extensor digitorum longus
  • Decelerate: Hip extensors [C]
    • (5) gluteus maximus, adductor magnus, biceps femoris, semitendinosus, semimembranosus
  • Maintain arch: Intrinsic and extrinsic muscles of the foot
    • plantar intrinsic: four layers (sandwich: 1&3; 2m2t: 2&4)
    • dorsal intrinsic: two layers (superfical: extensor hallucis brevis and extensor digitorum brevis; deep: dorsal interossei)
    • extrinsic: long tendons of foot
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What muscles are involved in loading response? Is Concentric contraction [C] or Eccentric contraction [E] involved?

(B) Loading response:

  • Accept weight: Knee extensors [E]
    • (4) rectus femoris, vastus lateralis, vastus medialis, vastus intermedius
  • Decelerate: Ankle plantarflexors [E]
    • (4) gastrocnemius, plantaris, soleus, tibialis posterior
  • Stablilize pelvis: Hip abductors [E]
    • (4) gluteus maximus, gluteus medius, gluteus minimus, tensor fasciae latae
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What muscles are involved in midstance? Is Concentric contraction [C] or Eccentric contraction [E] involved?

(C) Midstance:

  • Stabilize knee: Knee extensors [E] (quadriceps)
  • Control dorsiflexion: Ankle plantarflexors [E]
  • Stabilize pelvis: Hip abductors [E]
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What muscles are involved in terminal stance? Is Concentric contraction [C] or Eccentric contraction [E] involved?

(D) Terminal stance:

  • Accelerate mass: Ankle plantarflexors [E]
  • Stabilize pelvis: Hip abductors [E]
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What muscles are involved in pre-swing? Is Concentric contraction [C] or Eccentric contraction [E] involved?

(E) Pre-swing:

  • Accelerate mass: Extrinsic and intrinsic foot muscles [C]
  • Decelerate thigh: Hip flexors [E]
    • (5) psoas major, psoas minor, iliacus, rectus femoris, sartorius
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What muscles are involved in initial and mid-swing? Is Concentric contraction [C] or Eccentric contraction [E] involved?

(F) Initial swing:

  • Accelerate thigh: Hip flexors [C]
  • Clear foot: Ankle dorsiflexors [C]

(F) Mid-swing:

  • Clear foot: Ankle dorsiflexors and Knee flexors [C]
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What muscles are involved in terminal swing? Is Concentric contraction [C] or Eccentric contraction [E] involved?

(G) Terminal swing:

  • Decelerate thigh: Hip extensors [E]
  • Decelerate leg: Knee flexors [E]
    • (6) biceps femoris, semimembranosus, semitendinosus, gastrocnemius, plantaris, sartorius
  • Position foot: Ankle dorsiflexors [C]
  • Extend knee: Knee extensors [C]