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TABLE OF CONTENTS
1. Tibia and Fibula

Leg 2. Osteology, Interosseous Membrane, and
Interosseous Space
3. Posterior Compartment Muscles
4. Anterior Compartment Muscles and Retinacula
5. Arteries, Veins, and Nerves
6. Practice Questions
7. Muscle Functions
8. Blood Supply and Innervations
9. Clinical - Injury to Triceps Surae Muscle
10. Clinical - Fracture of the Fibular Neck
O TL NE
Fe e e e Fe e eT
B e
Fe e eT
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Fe e e
Fe e eF e
ge
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REVIEW OUTLINE
Chapter 11:
1. Muscles 3. Veins
● Gastrocnemius ● Great Saphenous
● Plantaris ● Dorsal Venous Arch
Leg ●
●
●
Soleus
Popliteus
Tibialis Posterior
4. Nerves
● Sciatic
● Flexor Digitorum Longus
● Tibial
● Flexor Hallucis Longus
● Common Fibular (Peroneal)
● Fibularis Longus ● Superficial Fibular (Peroneal)
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●
●
Fibularis Brevis
Fibularis Tertius
● Deep Fibular (Peroneal)
● Sural
● Tibialis Anterior
● Extensor Digitorum Longus
● Extensor Hallucis Longus 5. Miscellaneous
● Calcaneal Tendon and
2. Arteries Tuberosity
● Medial Malleolus
● Popliteal
● Lateral Malleolus
● Posterior Tibial
● Anterior Tibial ● Interosseus Membrane
● Superior Extensor Retinaculum
● Fibular (Peroneal)
● Inferior Extensor Retinaculum
AfraTafreeh.com https://upload.wikimedia.org/wikipedia/commons/a/a9/811_Tibia_and_fibula.jpg
Top
BOTTOM
https://upload.wikimedia.org/wikipedia/commons/4/4a/Gray439-Musculus_popliteus.png
https://upload.wikimedia.org/wikipedia/commons/6/66/Gray438-Musculus_plantaris.png
ftp.qai
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0dg
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https://upload.wikimedia.org/wikipedia/commons/0/0e/1123_Muscles_of_the_Leg_that_Move_
the_Foot_and_Toes_c.png
TOM
DICK
AND
VERY
NERVOUS
HAL
https://upload.wikimedia.org/wikipedia/commons/9/92/Gray442.png
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https://upload.wikimedia.org/wikipedia/commons/b/b1/Hot_dog_with_mustard.png
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https://upload.wikimedia.org/wikipedia/commons/0/0e/1123_Muscles_of_the_Leg_that_Move_
the_Foot_and_Toes_c.png
https://upload.wikimedia.org/wikipedia/commons/a/aa/1123_Muscles_of_the_Leg_that_Move_
the_Foot_and_Toes_a.png
BREVIS IS THE BUN

https://upload.wikimedia.org/wikipedia/commons/5/5f/Gray1241.png
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AfraTafreeh.comhttps://upload.wikimedia.org/wikipedia/commons/2/25/Extensor_hallucis_longus.png
FLEXORS
V
EXTENSORS
SHIN SPLINTS
https://upload.wikimedia.org/wikipedia/commons/2/25/Extensor_hallucis_longus.png
SUPERIOR EXTENSOR
RETINACULUM
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INFERIOR EXTENSOR
RETINACULUM
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https://upload.wikimedia.org/wikipedia/commons/3/36/Popliteal_branches_from_posterior_labeled.png
https://upload.wikimedia.org/wikipedia/commons/9/9d/Anterior_tibial_artery.png
LATERALUIEWL
https://upload.wikimedia.org/wikipedia/commons/4/4e/Gray581.png
GREAT SAPHENOUS
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I
i SMALL SAPHENOUS
1
I
AfraTafreeh.com https://upload.wikimedia.org/wikipedia/commons/4/43/Gray835.png
https://upload.wikimedia.org/wikipedia/commons/thumb/e/e9/Gray826and831.svg/400px-Gray826and831.svg.png
https://upload.wikimedia.org/wikipedia/commons/9/95/Gray836.png
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REVIEW OUTLINE
Chapter 11:
1. Muscles 3. Veins
● Gastrocnemius ● Great Saphenous
● Plantaris ● Dorsal Venous Arch
Leg ●
●
●
Soleus
Popliteus
Tibialis Posterior
4. Nerves
● Sciatic
● Flexor Digitorum Longus
CAN YOU DRAW THE
● Tibial
● Flexor Hallucis Longus
● Common Fibular (Peroneal)
● Fibularis Longus
TENDONS E MUSCLES OF
● Superficial Fibular (Peroneal)
● Fibularis Brevis
● Deep Fibular (Peroneal)
TOM DICK E HAL
● Fibularis Tertius
● Sural
● Tibialis Anterior
● Extensor Digitorum Longus
● Extensor Hallucis Longus 5. Miscellaneous
WHAT DOTHE ANT EPOST TIBIAL ● Calcaneal Tendon and
FIBULAR ART 2. Arteries
●
Tuberosity
Medial Malleolus
● Popliteal
VASCULARIZE ● Posterior Tibial
● Lateral Malleolus
● Anterior Tibial ● Interosseus Membrane
● Fibular (Peroneal)
REVIEW OUTLINE
1. Function
Leg 2. Muscles
• Gastrocnemius
• Plantaris
• Soleus
• Popliteus
• Tibialis posterior
• Flexor digitorum longus
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• Flexor hallucis longus
• Fibularis (peroneus) brevis
• Fibularis (peroneus) longus
• Fibularis (peroneus) tertius
• Tibialis anterior
• Extensor hallucis longus
• Extensor digitorum longus
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GASTROCNEMIUS O
I FLEXESLEG
PLANTARIS
ANTAR Ion
I SOLEUS
I
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https://upload.wikimedia.org/wikipedia/commons/5/53/Eversion_and_inversion.jpg
POPLITEUS
TIBIALIS POSTERIOR
P FLEXOR DIGITORUM LONGUS

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A FLEXOR HALLUCIS LONGUS
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https://upload.wikimedia.org/wikipedia/commons/5/53/Eversion_and_inversion.jpg
FIBULAR IS LONGUS
P FIBULAR IS BREVIS
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https://upload.wikimedia.org/wikipedia/commons/2/25/Extensor_hallucis_longus.png https://upload.wikimedia.org/wikipedia/commons/5/53/Eversion_and_inversion.jpg
TIBIALIS ANTERIOR
EXTENSOR HALLUCIS LONGUS
H If Extensorbeartorumconaus
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DORSIFLEXION
FIBULAR IS TERTIUS
i
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DO THE POSTERIOR LEG MUSCLES

PLANTAR FLEX OR DORSIFLEX THE ANKLE
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INVERTS FOOT
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REVIEW OUTLINE
1. Function
Leg 2. Muscles
• Gastrocnemius
• Plantaris
Review Questions •
•
Soleus
Popliteus
• Can you name the function(s) for • Flexor digitorum longus
all of the muscles listed? • Flexor hallucis longus
REVIEW OUTLINE
1. Blood Supply
Leg 2. Innervation
3. Muscles
• Gastrocnemius
• Plantaris
• Soleus
• Popliteus
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POPLITEAL A
RAlGenIcucarA
superior
MEDIAL
GASTROCNEMIUS
SYEIEEun.EE
INFERIORLATERAL
INFERIORMEDIAL
Geneculara Genecurana
mi
I
I
PLANTARIS
my
TIBIALA
MF SOLEUS
gmPERFORATING
BRANCHOFFIBULARA
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POPLITEAL A
POPLITEUS
TIBIALIS POSTERIOR
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FEE
l
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POPLITEAL A
FLEXOR DIGITORUM LONGUS
FLEXOR HALLUCIS LONGUS
EÉE
PEE
FIBULARA
PERFORATING
BRANCHOFFIBULAR A
V
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FIBULAR IS LONGUS
FIBULARIS BREVIS
LAYIEI.EE AfraTafreeh.com
I
FIBULARA
PERFORATING
BRANCH
A
OFFIBULAR
V
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A
POPLITEAL
EXTENSOR HALLUCIS LONGUS
EXTENSOR DIGITORUM LONGUS

my
j
FIBULARIS TERTIUS
UnÉIIÉÉÉYInRA
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14
is
si
sa
s
S4 GASTROCNEMIUS
FIBULARISLONGUS
POPLITEUS
PLANTARIS
SOLEUS
AfraTafreeh.com FLEXORHALLUCIS
LONGUS
TIBIALISPOSTERIOR
FIBULARN TIBIALN
FLEXORDIGITORUM
FIBULARIS BREVIS
LONGUS
SUPERFICIAL DEEP
FIBULARN
mum
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TIBIALISANTERIOR
EXTENSORDIGITORUM
LONGUS
LONGUS
FIBULARIS
TERTIUS
SUPERFICIAL DEEP
FIBULARN
REVIEW OUTLINE
1. Blood Supply
Leg 2. Innervation
3. Muscles
Review Questions • Gastrocnemius
• Plantaris
• Can you name the blood supply • Soleus
and innervation for all of the • Popliteus
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muscles listed?
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REVIEW OUTLINE
1. Rupture of the Calcaneal (Achilles) Tendon

• Muscles of the Triceps Surae
Injury to • Innervation to the Triceps Surae
• Clinical Manifestations
Triceps Surae
Muscle 2. Injury to the Tibial Nerve in the Popliteal Fossa
Rupture of the Calcaneal (Achilles) Tendon Bootcamp.com
Triceps Surae Muscle Innervation

Tibial n.
Gastrocnemius (2 heads)
Soleus Calcaneal (Achilles) tendon
Plantaris (may be absent)
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Ruptured Normal
Clinical Manifestations
• Inability to plantarflex the foot
• Pain & swelling around heel/

ankle
• Inability to ”push off” injured

leg while walking
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Injury to Tibial Nerve in the Popliteal Fossa Bootcamp.com
Clinical Manifestations
• Inability to plantarflex the foot &

weakened inversion*
• Inability to stand on toes
• Calcaneovalgus
o Opposing muscles dorsiflex & evert
the foot
▪ Tibialis anterior*, EHL, EDL
(dorsiflexion)
▪ Fibularis longus & brevis (eversion)
Knowledge Check Bootcamp.com
A patient presents to your clinic complaining of painful swelling in the distal calf.
Upon physical examination, they are unable to plantar flex at the ankle.
1. Which tendon was likely ruptured?

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A. Tibialis posterior
B. Calcaneal
C. Fibularis longus
D. Tibialis anterior
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A patient presents to your clinic complaining of painful swelling in the distal calf.
Upon physical examination, they are unable to plantar flex at the ankle.
1. Which tendon was likely ruptured?
A. Tibialis posterior
B. Calcaneal
C. Fibularis longus
D. Tibialis anterior
2. The calcaneal (Achilles) tendon contains tendons from the triceps surae
muscle. Which 3 muscles make up the tricep surae structures? Select all that
apply.
• Medial head of gastrocnemius

• Lateral head of gastrocnemius
• Plantaris
• Soleus AfraTafreeh.com
3. The triceps surae muscles are innervated by which nerve?
A. Sciatic nerve
B. Common fibular nerve
C. Deep fibular nerve
D. Superficial fibular nerve
E. Tibial nerve
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2. The calcaneal (Achilles) tendon contains tendons from the triceps surae
muscle. Which 3 muscles make up the tricep surae structures? Select all that
apply.
• Medial head of gastrocnemius

• Lateral head of gastrocnemius
• Plantaris
• Soleus
3. The triceps surae muscles are innervated by which nerve?
A. Sciatic nerve
E. Tibial nerve
A patient presents with a Baker’s cyst (fluid-filled swelling at the back of the knee)
causing compression of the tibial nerve within the popliteal fossa.
1. Which muscles could possibly be affected in this case? Select all that apply.
• Plantarflexors
• Dorsiflexors
• Evertors AfraTafreeh.com
• Invertors
2. What position will the foot be in if those muscles aren’t receiving proper
innervation?
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A patient presents with a Baker’s cyst (fluid-filled swelling at the back of the knee)
causing compression of the tibial nerve within the popliteal fossa.
1. Which muscles could possibly be affected in this case? Select all that apply.
• Plantarflexors
• Dorsiflexors
• Evertors
• Invertors
2. What position will the foot be in if those muscles aren’t receiving proper
innervation?
Dorsiflexed & elevated

References Bootcamp.com
Slide 2
• Ruptured Tendon: <a href="https://commons.wikimedia.org/wiki/File:Rupture_tendon_achil%C3%A9en.jpg">Grook
Da Oger</a>, <a href="https://creativecommons.org/licenses/by-sa/3.0">CC BY-SA 3.0</a>, via Wikimedia
Commons
• Calf Muscles: <a href="https://commons.wikimedia.org/wiki/File:Gray438.png">Henry Vandyke Carter</a>, Public
domain, via Wikimedia Commons
Slide 3
• Popliteal Fossa: <a href="https://commons.wikimedia.org/wiki/File:Sobo_1909_718.png">Dr Johannes Sobotta</a>,
Public domain, via Wikimedia Commons
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• Tibial Nerve: <a href="https://commons.wikimedia.org/wiki/File:Gray832-b.png">Henry Vandyke Carter</a>, Public
domain, via Wikimedia Commons
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REVIEW OUTLINE
1. Rupture of the Calcaneal (Achilles) Tendon

• Muscles of the Triceps Surae
Injury to • Innervation to the Triceps Surae
Triceps Surae
Muscle 2. Injury to the Tibial Nerve in the Popliteal Fossa
REVIEW OUTLINE
1. Affected Nerves
Fracture of 2. Affected Muscles
the Fibular AfraTafreeh.com

3. Foot Drop
Neck 4. X-Ray Imaging

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Fracture of the Fibular Neck Bootcamp.com
Common fibular (peroneal) n.
Superficial fibular (peroneal) n.
Deep fibular (peroneal) n.
Fibula
Tibia
Superficial fibular (peroneal) n.
inability to evert the foot & extend toes
Deep fibular (peroneal) n.
inability to dorsiflex the foot & extend toes

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Foot Drop
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You are working at an outpatient clinic when a 64-year-old woman presents with
an altered gait. She is displaying an inability to lift the foot off the ground during
the swing phase of gait. While taking her history, she indicates that she suffered
from a proximal fibular fractures 6 months ago.
Based on the patient’s history, the fibular fracture most likely will lead to damage
to which nerve?
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A. Sciatic nerve
E. Tibial nerve
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You are working at an outpatient clinic when a 64-year-old woman presents with
an altered gait. She is displaying an inability to lift the foot off the ground during
the swing phase of gait. While taking her history, she indicates that she suffered
from a proximal fibular fractures 6 months ago.
Based on the patient’s history, the fibular fracture most likely will lead to damage
to which nerve?
A. Sciatic nerve
E. Tibial nerve
2. The common fibular nerve supplies which compartment of the leg? Select all
that apply.
• Anterior
• Posterior
• Lateral
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3. The patient’s foot drop is a result of an inability to do which actions?
• Dorsiflexion
• Plantarflexion
• Eversion
• Inversion
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2. The common fibular nerve supplies which compartment of the leg? Select all
that apply.
• Anterior
• Posterior
• Lateral
3. The patient’s foot drop is a result of an inability to do which actions?
• Dorsiflexion
• Plantarflexion
• Eversion
• Inversion
References Bootcamp.com
Slide 2
• Bones: <a href="https://commons.wikimedia.org/wiki/File:Tibia_fibula_svg_hariadhi.svg">Hariadhi</a>, <a
href="https://creativecommons.org/licenses/by-sa/4.0">CC BY-SA 4.0</a>, via Wikimedia Commons
• Muscles: <a
href="https://commons.wikimedia.org/wiki/File:1123_Muscles_of_the_Leg_that_Move_the_Foot_and_Toes.jpg">Open
Stax</a>, <a href="https://creativecommons.org/licenses/by/4.0">CC BY 4.0</a>, via Wikimedia Commons
Slide 3
• Muscles: <a
href="https://commons.wikimedia.org/wiki/File:1123_Muscles_of_the_Leg_that_Move_the_Foot_and_Toes.jpg">Open
AfraTafreeh.com
Stax</a>, <a href="https://creativecommons.org/licenses/by/4.0">CC BY 4.0</a>, via Wikimedia Commons
• Foot Drop: <a href="https://commons.wikimedia.org/wiki/File:Foot_drop.jpg">Pagemaker787</a>, <a
Slide 4
• <a href="https://commons.wikimedia.org/wiki/File:Maisonneuve_fracture_Fibula.JPG">RotorMotor2</a>, <a
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REVIEW OUTLINE
1. Affected Nerves
Fracture of 2. Affected Muscles
the Fibular 3. Foot Drop
Neck 4. X-Ray Imaging

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AfraTafreeh.

1. Tibia and Fibula

BREVIS IS THE BUN

P FLEXOR DIGITORUM LONGUS

A FLEXOR HALLUCIS LONGUS

EXTENSOR HALLUCIS LONGUS

DO THE POSTERIOR LEG MUSCLES

FLEXOR DIGITORUM LONGUS

FLEXOR HALLUCIS LONGUS

EXTENSOR HALLUCIS LONGUS

EXTENSOR DIGITORUM LONGUS

1. Rupture of the Calcaneal (Achilles) Tendon

Triceps Surae Muscle Innervation

Soleus Calcaneal (Achilles) tendon

Plantaris (may be absent)

• Inability to plantarflex the foot

• Pain & swelling around heel/

• Inability to ”push off” injured

• Inability to plantarflex the foot &

• Inability to stand on toes

1. Which tendon was likely ruptured?

1. Which tendon was likely ruptured?

• Medial head of gastrocnemius

3. The triceps surae muscles are innervated by which nerve?

• Medial head of gastrocnemius

3. The triceps surae muscles are innervated by which nerve?

Dorsiflexed & elevated

1. Rupture of the Calcaneal (Achilles) Tendon

Fracture of 2. Affected Muscles

the Fibular AfraTafreeh.com

Neck 4. X-Ray Imaging

Common fibular (peroneal) n.

Superficial fibular (peroneal) n.

Deep fibular (peroneal) n.

Superficial fibular (peroneal) n.

inability to evert the foot & extend toes

Deep fibular (peroneal) n.

inability to dorsiflex the foot & extend toes

3. The patient’s foot drop is a result of an inability to do which actions?

Fracture of 2. Affected Muscles

the Fibular 3. Foot Drop

Neck 4. X-Ray Imaging

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