MUSCLES OF THE ANTERIOR AND LATERAL COMPARTMENTS OF THE LEG

Transcription

1 MUSCLES OF THE ANTERIOR AND LATERAL COMPARTMENTS OF THE LEG

2 THE LEG IS THE PART OF THE LOWER EXTERMITY FROM THE KNEE TO THE ANKLE. THE LEG CONTAINS THE TIBIA AND THE FIBULA, THE TIBIA ARTICULATES WITH THE FEMUR SUPERIORLY AND THE TALUS INFERIORLY. THE FIBULA IS NOT WEIGHT BEARING, BUT SERVES ONLY FOR MUSCLE ATTACHMENTS

3 THE LEG IS DIVIDED INTO 3 COMPARTMENTS: ANTERIOR, LATERAL AND POSTERIOR. MUSCLES ARE SURROUNDED BY DEEP FASCIA WITH INWARD EXTENSIONS TO DIVIDE THE COMPARTMENTS.

4 THE ANTERIOR COMPARTMENT IS THE DORSI FLEXOR COMPARTMENT AND IS INNERVATED BY THE DEEP FIBULAR NERVE MUSCLES OF THE ANTERIOR COMPARTMENT OF THE LEG: TIBIALIS ANTERIOR EXTENSOR DIGITORUM LONGUS EXTENSOR HALLUCIS LONGUS

5 TIBIALIS ANTERIOR JUST LATERAL TO THE TIBIA STRONG TENDON LOCATED LATERAL TO THE MEDIAL MALLEOLUS STRONGEST DORIFLEXOR AND INVERTOR OF THE FOOT

6 EXTENSOR DIGITORUM LONGUS MOST LATERALLY PLACED MUSCLE IN THE UPPER PORTIONS OF THE ANTERIOR COMPARTMENT DIVIDES INTO 4 TENDONS TO EACH OF THE LATERAL TOES INSERTS BY WAY OF AN EXTENSOR EXPANSION HOOD

7 EXTENSOR HALLUCIS LONGUS HALLUX - GREAT TOE DEEPLY PLACE BETWEEN THE TIBIALIS ANTERIOR AND THE EXTENSOR DIGITORUM LONGUS NEAR THE ANKLE THE TENDON EMERGES AND INSERTS INTO THE EXTENSOR EXPANSION OF THE BIG TOE

8 SHIN SPLINTS : EDEMA AND PAIN IN THE AREA OF THE DISTAL 2/3 OF THE TIBIA ANTERIOR TIBIALIS STRAIN RESULTS FROM MICRO TEARS IN THE COVERING OF THE TIBIA RESULTS FROM INJURY OR ATHLETIC OVERUSE OF THE MUSCLES IN THE ANTERIOR COMPARTMENT ESPECIALLY THE TIBIALIS ANTERIOR MUSCLE FOOT DROP RESULTS FROM INJURY TO THE DEEP FIBULAR NERVE THE FOOT CAN NOT BE DORSIFLEXED

9 MUSCLE OF THE LATERAL COMPARTMENT OF THE LEG THE MUSCLES OF THE LATERAL COMPARTMENT PLANTAR FLEX AND EVERT THE FOOT THESE MUSCLES ARE INNERVATED BY THE SUPERFICIAL FIBULAR/PERONEAL NERVE FIBULARIS LONGUS FIBULARIS BREVIS

10 FIBULARIS / PERONEUS LONGUS SUPERFICIAL OF THE TWO MUSCLES ORIGINATES MORE SUPERIORLY ON THE FIBULA LONG TENDON PASSES POSTERIOR TO THE LATERAL MALLEOLUS, CROSSES THE FOOT TO INSERT ON THE MEDIAL SIDE SUPPORTS THE ARCHES OF THE FOOT

11 FIBULARIS / PERONEUS BREVIS DEEP TO THE LONGUS ORIGIN MORE DISTAL ON THE FIBULA TENDON PASSES BEHIND THE LATERAL MALLEOLUS ALONG WITH THE LONGUS TENDON INSERTS ON THE TUBEROSITY OF THE FIFTH METATARAL

12 LATERAL COMPARTMENT - PLANTAR FLEXION AND EVERSION SUPERFICIAL FIBULAR NERVE ANTERIOR COMPARTMENT - DORSIFLEXION AND INVERSION DEEP FIBULAR NERVE

13 POSTERIOR COMPARTMENT OF THE LEG

14 LEG IS DIVIDED INTO 3 COMPARTMENTS EACH COMPARTMENT HAS A SPECIFIC ACTION AND INNERVATION ANTERIOR COMPARTMENT: DORSIFLEXORS OR EXTENSORS AND INVERTERS - INNERVATED BY THE DEEP FIBULAR / PERONEAL NERVE LATERAL COMPARTMENT: EVERTORS AND HELP WITH PLANTAR FLEXION - INNERVATED BY THE SUPERFICIAL FIBULAR / PERONEAL NERVE POSTERIOR COMPARTMENT: PLANTAR FLEX THE FOOT AND FLEX THE TOES, INVERT THE FOOT - INNERVATED BY THE TIBIAL NERVE

15 POSTERIOR COMPARTMENT DIVIDED INTO A SUPERFICIAL AND DEEP GROUP SUPERFICIAL: GASTROCNEMIUS SOLEUS GASTROCNEMIUS AND SOLEUS TOGETHER MAKE UP THE TRICEPS SURAE

16 GASTROCNEMIUS MOST SUPERFICIAL HAS 2 HEADS OF ORIGIN CROSSES 2 JOINTS; FLEXES THE LEG AND PLANTAR FLEXES THE FOOT INSERTS WITH THE SOLEUS VIA THE CALCANEAL TENDON OR ACHILLE S TENDON INTO THE CALCANEUS VERTICAL FIBERS PRODUCE RAPID MOVEMENTS: RUNNING AND JUMPING

17 ACHILLE S TENDON - CALCANEAL TENDON

18 SOLEUS DEEP TO GASTROCNEMIUS PLANTAR FLEXES THE FOOT, IT DOES NOT ACT ON THE KNEE JOINT ANTIGRAVITY MUSCLE ACTING WITH THE EXTENSORS OF THE LEG TO MAINTAIN BALANCE SLOW BUT STRONG PLANTAR FLEXOR

19 MUSCLES IN THE DEEP COMPARTMENT OF THE POSTERIOR LEG FLEXOR DIGITORUM LONGUS FLEXOR HALLUCIS LONGUS TIBIALIS POSTERIOR

20 FLEXOR DIGITORUM LONGUS ONE OF THE THREE VERTICALLY PLACED MUSCLES IN THE DEEP LEG - MOST MEDIAL MUSCLE USUALLY THE SMALLEST OF THE THREE TENDON HOOKS BEHIND THE MEDIAL MALLEOUS INSERTS INTO LATERAL 4 TOES TENDONS PASS THROUGH BREVIS TENDONS (LIKE HAND)

21 FLEXOR HALLUCIS (BIG TOE) LONGUS MOST LATERALLY PLACED DEEP MUSCLE USUALLY MUCH LARGER THAN THE FLEXOR DIGITORUM LONGUS USED AS THE PUSH OFF MUSCLE DURING WALKING, RUNNING AND JUMPING HOOKS BEHIND THE MEDIAL MALLEOLUS

22 TIBIALIS POSTERIOR DEEPEST AND CENTRALLY LOCATED MUSCLE IN THE DEEP COMPARTMENT LIES BETWEEN FDL AND FHL PASSES BEHIND THE MEDIAL MALLEOLUS TO INSERT ON THE PLANTAR SURFACE OF THE FOOT INVERTS, PLANTAR FLEXES AND ADDUCTS THE FOOT

23 *THE TENDONS OF TIBIALIS POSTERIOR, FLEXOR DIGITORUM LONGUS AND FLEXOR HALLUCIS LONGUS ALL HOOK BEHIND THE MEDIAL MALLEOLUS REMEMBER TOM, DICK AN HARRY (AN- ARTERY AND NERVE - TIBIAL NERVE) *NOTE THAT THE ARRANGEMENT OF THE MUSCLES IN THE POSTEIOR LEG IS NOT THE SAME

24 TIBIALIS POSTERIOR FLEXOR DIGITORUM LONGUS FLEXOR HALLUCIS LONGUS MEDIAL ANKLE

25 TP FDL FHL FLEXOR RETINACULUM MEDIAL SIDE OF THE FOOT

26 MUSCLES OF THE FOOT

27 THE FOOT: IMPORTANT IN SUPPORT OF THE WEIGHT OF THE BODY AND LOCOMOTION PART OF THE FOOT FACING THE GROUND IS THE PLANTAR SURFACE PART OF THE FOOT FACING SUPERIORLY IS THE DORSUM THE DEEP FASCIA OF THE FOOT IS CALLED THE PLANTAR FASCIA (PLANTAR APONEUROSIS): HOLDS THE FOOT TOGETHER, HELPS TO PROTECT THE PLANTAR SURFACE OF THE FOOT FROM INJURY, HELPS TO SUPPORT THE ARCHES

28 MUSCLES OF THE FOOT - THE INTRINSIC MUSCLES DORSUM: EXTENSOR DIGITORUM BREVIS INNERVARTED BY THE DEEP FIBULAR NERVE

29 EXTENSOR DIGITORUM BREVIS FORMS 4 TENDONS TO TOES 1-4, NOT USUALLY TO THE LITTLE TOE TENDON TO THE BIG TOE CALLED EXTENSOR HALLUCIS BREVIS EXTENSOR HALLUCIS BREVIS

30 EXTENSOR HALLUCIS BREVIS - PART OF EXTENSOR DIGITORUM BREVIS

31 PLANTAR: 4 LAYERS* 1) ABDUCTOR HALLUCIS FLEXOR DIGITORUM BREVIS ABDUCTOR DIGITI MINIMI 2) QUADRATUS PLANTAE LUMBRICLES 3) FLEXOR HALLUCIS BREVIS ADDUCTOR HALLUCIS FLEXOR DIGITI MINIMI BREVIS 4) INTEROSSEI; PLANTAR, DORSAL *MUSCLES ARE OF LITTLE IMPORTANCE INDIVIDUALLY

32 INNERVATION OF THE PLANTAR MUSCLES OF THE FOOT TIBIAL NERVE DIVIDES INTO: 1) MEDIAL PLANTAR NERVE (SUPERFICIAL AND MEDIAL MUSCLES) 2) LATERAL PLANTAR NERVE (LATERAL AND DEEP MUSCLES)

33 PLANTAR SURFACE OF THE FOOT LAYER 1 ABDUCTOR HALLUCIS LIES ALONG THE MEDIAL BORDER OF THE FOOT ABDUCTS THE BIG TOE PLANTAR FASCIA

34 FLEXOR DIGITORUM BREVIS FLEXES THE LATERAL 4 TOES TENDONS SPLIT AND ATTACH TO THE MIDDLE PHALANGES; ALLOW THE PASSAGE OF THE LONG FLEXOR TENDONS TO THE DISTAL PHALANGES (SIMILAR TO THE HAND)

35 ABDUCTOR DIGITI MINIMI LIES ALONG THE LATERAL BORDER OF THE FOOT ABDUCTS AND FLEXES THE LITTLE TOE

36 FIRST LAYER OF MUSCLES: ABDUCTOR HALLUCIS FLEXOR DIGITORUM BREVIS ABDUCTOR DIGITI MINIMI

37 LAYER 2 DEEP TO LAYER 1 CONTAINS 2 MUSCLES AND 2 TENDONS QUADRATUS PLANTAE INSERTS INTO THE TENDON OF THE FLEXOR DIGITORUM LONGUS

38 LUMBRICALS 4 SMALL MUSCLES, SIMILAR TO THE HAND ARISE FROM THE TENDONS OF THE FLEXOR DIGITORUM LONGUS (THE SAME TENDON INTO WHICH THE QUADRATUS PLANTAE INSERTS) INSERT INTO TOES 2-5

39 SECOND LAYER OF MUSCLES: QUADRATUS PLANTAE LUMBRICALS

40 LAYER 3 CONTAINS 3 MUSCLES FLEXOR HALLUCIS BREVIS HAS 2 HEADS: MEDIAL AND LATERAL THE TENDON OF THE FLEXOR HALLUCIS LONGUS SEPARATES THE 2 HEADS

41 ADDUCTOR HALLUCIS HAS 2 HEADS, AN OBLIQUE AND TRANSVERSE THE 2 HEADS COMBINE TO INSERT INTO THE LATERAL SIDE OF THE PROXIMAL PHALANX OF THE BIG TOE

42 FLEXOR DIGITI MINIMI BREVIS SMALL MUSCLE JUST MEDIAL TO THE ABDUCTOR DIGITI MINIMI

43 THIRD LAYER OF MUSCLES: FLEXOR HALLUCIS BREVIS ADDUCTOR HALLUCIS FLEXOR DIGITI MINIMI BREVIS

44 LAYER 4 THE DEEPEST LAYER CONTAINS THE INTEROSSEI: THE PLANTAR AND DORSAL PLANTAR INTEROSSEI THESE MUSCLES ADDUCT (PAD) MOVE TOWARD THE 2ND TOE, THE AXIS IN THE FOOT ADDUCT

45 DORSAL INTEROSSEI ABDUCT THESE MUSCLES ABDUCT (DAB) THERE ARE 4 MUSCLES WHICH MOVE THE TOES AWAY FROM THE AXIS, THE 2ND TOE

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47 INNERVATIONS? ABDUCTOR DIGIT MINIMI ABDUCTOR HALLUCIS FLEXOR DIGITORUM BREVIS PLANTAR FASCIA

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49 INNERVATIONS? TENDON OF FLEXOR HALLUCIS LONGUS LUMBRICAL QUADRATUS PLANTAE TENDON OF FLEXOR DIGITORUM LONGUS

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51 ADDUCTOR HALLUCIS FLEXOR HALLUCIS BREVIS FLEXOR DIGITI MINIMI BREVIS INNERVATIONS?