Attachments and Function
What is the proximal attachment of fibularis brevis?
Distal 2/3 fibular, anterior and posterior intermuscular septum
What contributes to loss of dorsiflexion ROM with knee EXTENDED?
Gastrocnemius
What 4 ligaments make up the deltoid ligament and where do they proximally attach to?
Anterior tibiotalar
Posterior tibiotalar
Tibiocalcaneal
Tibionavicular
They all proximally attach to the medial malleolus
Which ligament rarely gets injured? What usually happens before this ligament gets damaged?
Deltoid ligament
Likely to have a fracture of the fibular with an eversion sprain before stressing the deltoid ligament
Tibialis anterior
Proximal: lateral condyle, tibial shaft, interosseous membrane, intermuscular septum
Distal: medial cuneiform, base of 1st metatarsal
What are the four muscles that perform DF?
Tibialis anterior
Extensor digitorum longus, extensor hallucis longus, fibularis tertius
What contributes to loss of dorsiflexion ROM with knee FLEXED?
Soleus and posterior talocrural joint capsule
What ligament is the most commonly injured?
Anterio Talofibular ligament (ATFL)
What nerve commonly gets injured with lateral ankle sprain?
Sural nerve
Extensor hallucis longus
Proximal: medial side in middle of fibula, interosseous membrane
Distal: dorsal distal phalanx of big toe
What muscles perform ankle inversion and what muscle perform ankle eversion?
Inversion: tibialis anterior and tibialis posterior
Eversion: Fibularis brevis and fibularis longus
What muscles limit plantarflexion?
Tibialis anterior, extensor hallucis longus, and extensor digitorum longus
What is the spring ligament and what is it’s function?
Plantar calcaneonavicular ligament
Maintains the medial arch of the foot
What ligaments are affected with a high ankle sprain?
Interosseous ligament
Anterior tibiofibular ligament
Anterior talofibular ligament (ATFL)
Calcaneofibular ligament
Fibularis longus
Proximal: proximal 2/3 of lateral fibula, anterior and posterior intermuscular septum
Distal: base of the 1st metatarsal and medial cuneiform
What does the gastrocnemius and soleus form into and where does it attach?
The gastrocnemius and soleus forms the Achilles tendon and attaches to the middle of the 3 facets on the posterior calcaneus
What muscles protect the medial side of the ankle?
Tibialis posterior, flexor hallucis longus, and flexor digitorum longus
What ligament connects the calcaneus to the cuboid/navicular?
Bifurcate ligament (Y-shaped band)
If your patient was in a motorcycle accident and slide across the pavement on the lateral side of their leg, what nerve can be damage?
Superficial fibular (peroneal) nerve
Also injured in older adults and athletes who get hit in the shin
Flexor hallucis longus
Proximal: distal 2/3 posterior tibia, interosseous membrane, posterior intermuscular septum, and tibialis posterior fascia
Distal: plantar base of distal phalanx of big toe (travels between the 2 sesamoid bones)
What is the proximal AND distal attachments of tibialis posterior?
Proximal: interosseous membrane, upper 2/3 adjacent tibia and fibular
Distal: navicular tuberosity, medial cuneiform, bases of 2-4th metatarsals
What muscles protect the lateral side of the ankle?
Fibularis longus and fibularis brevis
Cervical ligament
What are the 5 P’s in compartment syndrome?
Pain
Pulselessness
Palsy (Paralysis)
Paraesthesia
Palor
Gastrocnemius
Proximal: medial head: medial femoral condyle; lateral head: lateral femoral condyle and supracondylar line
Distal: Forms Achilles tendon with tendon of soleus to attach into the middle of the 3 facets on the posterior calcaneus