Leg&Foot 2
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Transcript of Leg&Foot 2
![Page 1: Leg&Foot 2](https://reader036.fdocuments.us/reader036/viewer/2022081414/54bd8c644a7959d4438b46ce/html5/thumbnails/1.jpg)
Triceps surae; Gastrocnemius
Action Flex the knee, plantar flex
the ankle
Origin Condyles of the femur,
posterior surfaces
Insertion Calcaneus via calcaneal
tendon
Innervation Tibial (S1-2)
![Page 2: Leg&Foot 2](https://reader036.fdocuments.us/reader036/viewer/2022081414/54bd8c644a7959d4438b46ce/html5/thumbnails/2.jpg)
Triceps surae; soleus
Action Plantar flex the ankle
Origin Soleal line, post. surface of
tibia and prox. post. surface of fibula
Insertion Calcaneus via calcaneal
tendon
Innervation Tibial (S1-2)
![Page 3: Leg&Foot 2](https://reader036.fdocuments.us/reader036/viewer/2022081414/54bd8c644a7959d4438b46ce/html5/thumbnails/3.jpg)
Gastrocnemius and Soleus- standing
Ask pt. to stand on her toe
Palpate the posterior leg, sculpting out the gastrocnemius’s oval head
Move distal to the gastrocnemius and palpate the distal portion of soleus
Both muscles blend into the calcaneal tendon
( Triceps surae)
![Page 4: Leg&Foot 2](https://reader036.fdocuments.us/reader036/viewer/2022081414/54bd8c644a7959d4438b46ce/html5/thumbnails/4.jpg)
Gastrocnemius and Soleus- standing
Accessible from an
anterior direction
Locate tibial shaft
Slide medially off the
shaft and feel the
wad of muscle
![Page 5: Leg&Foot 2](https://reader036.fdocuments.us/reader036/viewer/2022081414/54bd8c644a7959d4438b46ce/html5/thumbnails/5.jpg)
Gastrocnemius and Soleus- prone
Bend the knee to 90°
When the knee is flexed, gastronemius muscle is ineffectual as a plantar flexor
Isolate the soleus by asking pt. to gently plantar flex against your resistance
![Page 6: Leg&Foot 2](https://reader036.fdocuments.us/reader036/viewer/2022081414/54bd8c644a7959d4438b46ce/html5/thumbnails/6.jpg)
Plantaris
Action Weak plantar flexion of the
ankle, weak flexion of the knee
Origin Lateral condyle of the femur
Insertion Calcaneus via calcaneal
tendon
Innervation Tibial (S1-2)
![Page 7: Leg&Foot 2](https://reader036.fdocuments.us/reader036/viewer/2022081414/54bd8c644a7959d4438b46ce/html5/thumbnails/7.jpg)
Plantaris
Prone with knee flexed
Locate the head of fibula
Move thumb medial into
the popliteal space b/w
gastrocnemius heads
Slowly sink into the tissue
of the posterior knee
![Page 8: Leg&Foot 2](https://reader036.fdocuments.us/reader036/viewer/2022081414/54bd8c644a7959d4438b46ce/html5/thumbnails/8.jpg)
Test for gastrocnemius and plantaris
• Patient:Patient: Standing
• Test:Test: Rising on toes,
pushing the body
weight directly
upward
• Pressure:Pressure: Body
weight
![Page 9: Leg&Foot 2](https://reader036.fdocuments.us/reader036/viewer/2022081414/54bd8c644a7959d4438b46ce/html5/thumbnails/9.jpg)
Test for soleus
![Page 10: Leg&Foot 2](https://reader036.fdocuments.us/reader036/viewer/2022081414/54bd8c644a7959d4438b46ce/html5/thumbnails/10.jpg)
Test for soleus
• Patient:Patient: Prone with the knee flexed at least 90°
• Fixation:Fixation: The examiner supports the leg, proximal to the ankle
• Test:Test: Plantar flexion of the ankle, without inversion or eversion of the foot
• Pressure:Pressure: Against the calcaneus, pulling the heel in a caudal direction.
![Page 11: Leg&Foot 2](https://reader036.fdocuments.us/reader036/viewer/2022081414/54bd8c644a7959d4438b46ce/html5/thumbnails/11.jpg)
Popliteus
Prone with knee
flexed
Explore the posterior
surface of the tibia by
pushing the overlying
edge of the soleus
and gastrocnemius to
the side
![Page 12: Leg&Foot 2](https://reader036.fdocuments.us/reader036/viewer/2022081414/54bd8c644a7959d4438b46ce/html5/thumbnails/12.jpg)
Test for popliteus
• Patient:Patient: Sitting with the knee flexed at a right angle and with leg in lateral rotation of tibia on femur
• Test:Test: Medial rotation of the tibia on femur
• Resistance:Resistance: Seldom is resistance or pressure applied.
![Page 13: Leg&Foot 2](https://reader036.fdocuments.us/reader036/viewer/2022081414/54bd8c644a7959d4438b46ce/html5/thumbnails/13.jpg)
Peroneus longus and brevis
Locate the head of
fibula and the lateral
malleolus
Peroneal bellies are
located b/w these
landmarks
Ask pt. to alternately
evert and relax her
foot
![Page 14: Leg&Foot 2](https://reader036.fdocuments.us/reader036/viewer/2022081414/54bd8c644a7959d4438b46ce/html5/thumbnails/14.jpg)
Test for peroneus longus & brevis
• Patient:Patient: Supine, with the extremity medially rotated, or side-lying (on the opposite side)
• Fixation:Fixation: The examiner supports the leg, above the ankle joint
• Test:Test: Eversion of the foot, with plantar flexion of the ankle joint
• PressurePressure: Against the lateral border and sole of the foot, in the direction of inversion of the foot and dorsiflexion of the ankle joint
![Page 15: Leg&Foot 2](https://reader036.fdocuments.us/reader036/viewer/2022081414/54bd8c644a7959d4438b46ce/html5/thumbnails/15.jpg)
Anterior compartment
1. Tibialis anterior
2. Extensor
digitorum longus
3. Extensor hallucis
longus
![Page 16: Leg&Foot 2](https://reader036.fdocuments.us/reader036/viewer/2022081414/54bd8c644a7959d4438b46ce/html5/thumbnails/16.jpg)
Tibialis anterior
Action Invert the foot , dorsifelx
the ankle
Origin Prox. lat. surface of tibia
and interosseous membrane
Insertion Medial cuneiform and
base of 1st metatarsal
Innervation Deep peroneal
![Page 17: Leg&Foot 2](https://reader036.fdocuments.us/reader036/viewer/2022081414/54bd8c644a7959d4438b46ce/html5/thumbnails/17.jpg)
Tibialis anterior
Supine
Locate the shaft of
the tibia and slide off
it laterally
Ask pt. to dorsiflex
his ankle and palpate
its long, inch-wide
belly
![Page 18: Leg&Foot 2](https://reader036.fdocuments.us/reader036/viewer/2022081414/54bd8c644a7959d4438b46ce/html5/thumbnails/18.jpg)
Test for tibialis anterior
![Page 19: Leg&Foot 2](https://reader036.fdocuments.us/reader036/viewer/2022081414/54bd8c644a7959d4438b46ce/html5/thumbnails/19.jpg)
Test for tibialis anterior
• Patient:Patient: Spine or sitting (with knee flexed if any gastrocnemius tightness is present)
• Fixation:Fixation: The examiner supports the leg, just above the ankle joint
• Test:Test: Dorsiflexion of the ankle joint and inversion of the foot, without extension of the great toe
• Pressure:Pressure: Against the medial side, dorsa surface of the foot, in the direction of plantar flexon of the ankle joint and eversion of the foot