1. Lower Extremity KNEE AND ANKLE BIOMECHANICS, FOOT OSTEOLOGY AND MUSCULATURE

2. Objectives  Describe the gross anatomy for each system (circulatory, muscular, nervous, and skeletal) in the lower extremity.  Integrate the systems to discuss the lower extremity stability and mobility functions.  Analyze common injuries in the lower extremities.  For each muscle, describe how the attachment sites result in an action around a joint.  For each muscle, identify the innervation (peripheral nerve and nerve roots).

3. Flexor Tendons  Tom, Dick, and Nervous Harry

4. Neurovasculature and Sheaths  Tibial n & post tibial artery course  Synovial sheaths

5. Foot structure

6. Foot joints  Subtalar (talocalcaneal)  Transverse tarsal joint  Talonavicular and calcaneocuboid joints

8. Foot ligaments  Subtalar (talocalcaneal)  Weak capsule  Interosseus talocalcaneal ligaments  Strong in tarsal sinus  Transverse tarsal joint  Talonavicular and calcaneocuboid joints  Plantar calcaneonavicular ligament (spring ligament)  Long plantar ligament  Short plantar ligament

11. Clinical Relevance  Hallux Valgus  Pes planus (flatfeet)

13. Plantar Fascia

14. Compartments

15. Dorsum Musculature

16. Foot musculature  Layer 1 – superficial  Abductors  Digitorum brevis  Layer 2  Digitorum longus tendons and associated muscles  Layer 3  Flexor brevises  Adductor hallucis  Layer 4 – deep  Interossei

17. Sensory testing

18. Fluid flow

19. Your patient has no sensation in the light green area in the image. Which nerve is likely damaged? A. saphenous nerve. B. medial plantar nerve. C. sural nerve. D. superficial fibular nerve. E. deep fibular nerve.