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Title: Lower Limb pt 1
Description: these notes contain information on the Ankle, Foot and compartments of the leg. with the important ligamentous structures, muscluture (with actions) and a short lost of common pathologies in that region.
Description: these notes contain information on the Ankle, Foot and compartments of the leg. with the important ligamentous structures, muscluture (with actions) and a short lost of common pathologies in that region.
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Lower Limbs
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Leg
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Tibia (Weight bearing as the femoral condyle sits on the tibial plateau)
Fibula (longer bone)
Foot
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Talus
Navicular
Cuboid
Cuneiform (Lateral, intermediate, lateral)
Calcaneus
Metatarsals
Phalanges
Joints
Inferior tibiofibular joint:
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Type – fibrous (sydesmosis)
Articular surfaces: Triangular convex surface of fibula and triangular surface of tibia
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Strong interosseus ligament (continuous with interosseus membrane) 2
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Blood supply: peroneal and anterior tibial arteries
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(L4- S2)
Movement: In DF, the trochlea surface of the talus causes a separation of the tib and fib
with increased tension in the interosseus membrane and transverse ligaments
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Talocrural Joint:
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Type: synovial hinge joint
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Movement: one degree of freedom- PF & DF
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(Inversion)
- Dorsiflexion is associated with abduction and pronation (Eversion)
Capsule: Fibrous capsule surrounds joint and attaches to the Post
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(thin and weak in the front and back to allow movements)
Ligaments: Deltoid ligament medially
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(anterior and posterior talofibular ligament, calcaneofibular)
Subtalar (Articulation of the talus and calcaneus)
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Structure and function:
▪ 3 articulations
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Capsule: lined by synovial membrane, strengthened externally by fibrous layer
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▪ Interosseus ligament which binds the talus and calcaneous together and sits
in the sinus tarsi (cavity between talus and calcaneus) and is very durable
and strong
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Nerve supply:
▪ plantar aspect from the medial or lateral plantar nerve
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Blood supply: Posterior tibial and fibular arteries
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In the lower
limb the Interosseus Membrane is between the tibia and fibula
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Intermuscular septa – any of the aponeurotic sheets separating various muscles of the
extremities
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The lower leg and its muscles are split into 4
compartments: anterior, lateral, deep posterior and
superficial posterior
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Anterior compartment
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)
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Extensor Hallucis Longus
(Dorsi Flexor) (O – middle anterior surface of
fibula, interosseus margin
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1)
Extensor Digitorium Longus
(Dorsi Flexor)(O – lateral condyle of tibia & superior surface of fibula, interosseus
membrane
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I –medial & plantar surfaces of 1st metatarsal & medial cuneiform
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Deep Peroneal Nerve
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Lateral Compartment
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Deep Posterior
Muscles
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Tibialis posterior
(Plantar- flexion, inversion)(O – Lateral portion of posterior, proximal tibia, interosseus
membrane, medial portion of posterior, proximal half of fibula, I – navicular tuberosity,
cuneiforms, cuboid, 2-4 metatarsals, sustentaculum tali of calcaneus)
Flexor Hallucis longus
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Tibial Nerve
Posterior Tibial Vessels
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Muscles
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Soleus
(Plantar flexes the foot) (O- Proximal ½ of posterior surface of tibia along popliteal line,
proximal 1/3 of posterior fibula, I – posterior calcaneus via calcaneal tendon)
Gastrocnemius
•
(Plantar flexes the foot) (O- medial head: medial condyle of femur and area just above
condyle, Lateral head: Lateral condyle of femur and area just above condyle, I – posterior
calcaneus via the calcaneal ligament)
Plantaris
(Plantar flexes the foot) (O- inferior lateral supracondylar ridge of the femur just above the
lateral head of the gastroc’, I – Posterior calcaneus via calcaneal tendon)
Neurovascular
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Sural nerve
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Lateral Ligaments
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Nerves of the foot and ankle
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Common peroneal/fibular
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(goes anteriorly)
Tibial (branches to plantar nerve in bottom of the foot)
Blood Supply
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Popliteal
Anterior Tibial
Posterior Tibial
Dorsalis Pedis
All part of the deltoid
ligament structure
Tarsal Tunnel
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The
tunnel is covered with a thick ligament
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(arteries, tendons, veins and nerves)
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The tarsal tunnel is made up of two compartments an upper(tibiotalar) and a lower (talocalcaneal)
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Floor: medial surfaces of the tibia, talus and calcaneus
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Posterior tibial artery and vein
Tibial Nerve: divides further into the medial and lateral
plantar nerves within the tunnel
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The tarsal tunnel is divided by the fibrous septa joining the flexor
retinaculum to the calcaneum, forming four separate compartments
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Tarsal tunnel syndrome
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Short list of common injuries
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Impingement:
▪ Conditions causing painful restriction at tibiotalar joint caused by osseous or
soft tissue over growth
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Loose body: a loose body in the ankle causing impingement, pain
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Ligament sprains:
▪ ATFL 1st
▪ CFL 2nd
▪ Injury to the PTFL is only in severe ankle sprains often accompanied by
fractures, dislocation or both
...
Title: Lower Limb pt 1
Description: these notes contain information on the Ankle, Foot and compartments of the leg. with the important ligamentous structures, muscluture (with actions) and a short lost of common pathologies in that region.
Description: these notes contain information on the Ankle, Foot and compartments of the leg. with the important ligamentous structures, muscluture (with actions) and a short lost of common pathologies in that region.