Laboratory Identifications and Relations - Leg, Foot, Hip, Knee, and Ankle

Structural Basis of Medical Practice -- Gross Anatomy

The Pennsylvania State University College of Medicine

Note: This guide is not exhaustive.  The relations are incomplete.  The intent is to highlight observation through dissection.
  1. Inferior lateral genicular a. - immediately posterior to arcuate lig. and popliteus m.
  2. Inferior medial genicular a. - piercing popliteus fascia, coursing as much as an inch lower than the inferior lateral genicular a.
  3. Common peroneal n. - between lateral head gastrocnemius and peroneus longus, superficial to head and neck of fibula
  4. Plantaris m. and tendon - posterior to tibial n.
  5. Anterior tibial a. - deep to the fibular origin of soleus
  6. Posterior tibial a. - coursing anterior (deep) to the superior free edge of soleus
  7. Superficial peroneal n. - between peroneus longus and brevis
  8. Biceps tendon - inserting on head of fibula
  9. Anterior crual septa - attaching to fibula, anterior border of lateral compartment, lateral border of anterior compartment
  10. Posterior crual septa - attaching to fibula, posterior border of lateral compartment, anterior border (in part) of posterior compartment
  11. Peroneal a. - branches piercing the posterior crual septum
  12. Posterior tibial a. - medial to tibial n.
  13. Anterior tibial a. - medial to deep peroneal nerve (contrast the path of each structure into the anterior compartment)
  14. Deep peroneal n. - piercing anterior crural septum to enter anterior compartmetn
  15. Anterior tibial a. - passing superior to superior free edge of interosseus membrane
  16. Anterior tibial recurrent a. - deep to tibialis anterior
  17. Peroneus tertius - inserting on 5th metatarsal (where?)
  18. Anterior medial malleolar a. - superior to superior limb of inferior extensor retinaculum
  19. First dorsal metatarsal a. - medial to deep peroneal n., dorsal to first dorsal interosseus
  20. Inferior peroneal retinaculum - inferior to lateral malleolus, at level of the "stem" on inferior extensor retinaculum
  21. Superior peroneal retinaculum - attachment to lateral malleolus
  22. Medial tarsal a. - passing deep to tendon insertion of tibialis anterior
  23. Inferior extensor retinaculum - superior limb superior to medial malleolus, inferior limb inferior to medial malleolus
  24. Sustentaculum tali - forming groove for tendon of flexor hallucis longus, deep to tibial n. and posterior tibial a.v.
  25. Medial malleolus - forming groove for tibialis posterior
  26. perforating branch of peroneal a. - entering anterior compartment of leg by piercing interosseous membrane (might become dorsalis pedis)
  27. Communicating branch of peroneal a. - distal aspect of posterior compartment between peroneal and posterior tibial aa.
  28. Posterior tibial a. - descending in posterior compartment between flexor hallucis longus and tibialis posterior
  29. Peroneal a. - terminating as the lateral malleolar and calcaneal branches
  30. Medial calcaneal a. - branching from posterior tibial or lateral plantar aa.
  31. Lateral plantar a. - terminal branch of posterior tibial a., branching within flexor retinaculum (or inferior)
  32. Medial plantar a. - terminal branch of posterior tibial a., branching within flexor retinaculum (or inferior)
  33. Peroneus longus tendon - crossing lateral and inferior to peroneus brevis tendon
  34. Interosseous membrane - posterior border anterior compartment, anterior border posterior compartment
  35. Lateral Malleolus - "pully" for peroneus longus and brevis
  36. Transverse intermuscular septum - interveening between soleus and muscles of deep posterior compartment
  37. Extensor hood - lateral bands attaching to base of distal phalanx and middle band attaching to base of middle phalanx
  38. Tendon extensor hallucis brevis - crossing superficial to dorsalis pedis a.
  39. Dorsalis pedis a. - leaving the dorsum of foot between the heads of the first dorsal interosseus, branching of arcuate a. near base of metatarsals
  40. Arcuate a. - running transversely from medial to lateral dorsal to base of metatarsals, deep to long and short tendons
  41. dorsal venous arch - superficial to long and short tendons, becomes great saphenous v. on medial side and short saphenous v. on lateral side
  42. Lateral dorsal nerve of foot - representation of sural nerve extending onto dorsum of foot, superficial to tendons
  43. Deep peroneal n. - traveling with first dorsal metatarsal a. immediately dorsal to first dorsal interosseous
  44. Lateral tarsal a. - crossing transversely deep to the origins of extensor hallucis brevis and extensor digitorum brevis
  45. Superficial transverse metatarsal ligament - transverse fibers distal aspect of plantar aponeurosis, superficial (inferior) to common digital aa.
  46. Medial calcaneal nerve - branching from lateral plantar nerve (or tibial n.) near flexor retinaculum
  47. Medial plantar nerve - medial to quadratus plantae, extending anteriorly between abductor hallucis and quadratus plantae
  48. Tendon of flexor digitorum longus - medial to quadratus plantae, corssing medial and inferior to tendon of flexor hallucis longus
  49. Lateral plantar n. - crossing middle compartment deep to flexor digitorum brevis and superficial to quadratus plantae
  50. Deep branch lateral plantar a. - passing deep to lumbricals, passing deep to oblique head of adductor hallucis, crossing plantar side of  base of metatarsals
  51. Medial plantar n. - branches to abductor hallucis, flexor digitorum brevis, first lumbrical, and flexor hallucis brevis
  52. Plantar metatarsal aa. - branching from plantar arch, extending distally on plantar side side of interosseus mm
  53. Plantar proper digital aa. - terminal branching of plantar metatarsal aa.
  54. Long plantar ligament - creating floor of interosseous tunnel for the tendon of peroneus longus, extending to base of metatarsals
  55. Short plantar ligament (plantar calcaneocubiodal lig.) - medial to long plantar lig., extending to, but not crossing, groove of cubiod bone
  56. Spring ligament (plantar calcaneonavicular lig.) - medial and posterior to short plantar lig., transverse fiber orientation, attachment to sustentaculum tali
  57. Deltoid lig. - extending from medial malleolus to calcaneous, talus, and navicular bone
  58. Collateral ligs. - capsular thickenings on sides of metatarsophalangeal and interphalangeal joints
  59. Tendons of lumbricals - crossing plantar surface of adductor hallucis transverse head, crossing inferior to deep transverse metatarsal lig. (thus, flex MP), inserting on lateral side of extensor hood distal to interosseous insertions (thus, extend IPs)
  60. Tendon flexor digitorum longus - "splitting" tendon flexor digitorum brevis, inserting on base of distal phalanx
  61. Tendon peroneus longus - observed through "window" removed from long plantar lig.
  62. Tendon of iliopsoas - supporting anterior hip joint, inserting on lesser trochanter
  63. Iliofemoral lig. - arising from anterior inferior iliac spine deep to straight head rectus femoris, long stem extending to lesser trochanter, short stem attaching along intertrochanteric line
  64. Pubofemoral lig. - transverse fibers extending from pubic pectin to intertrochanteric line
  65. Joint capsule - attachements along intertrochanteric line
  66. Acetabular labrum - complete circle around acetabular rim, connection to bone disrupted at transverse acetabular notch, attached to transverse acetabular ligament
  67. Transverse acetabular lig. - "bridge" across acetabular notch, forms osseofibrous foramen transmitting a. ligament of head of femur
  68. Infrapatellar synovial fold - "tent" covering anterior surface of anterior cruciate lig.
  69. Coronary ligaments - securing menisci to tibial plataeu
  70. Tendon popliteus - deep to fibular collateral lig.
  71. Transverse genicular lig. - anterior connection between menisci
  72. Oblique popliteal lig. - expansion of tendonous insertion semimembranosus, extending obliquely from medial to lateral, posterior capsular specialization
  73. Arcuate lig. - posterior capsular specializatoin, "arcs" over the popliteus muscle as this muscle becomes extracapsular
  74. Tibial collateral lig. - attachment to medial meniscus, extending from medial femoral condyle to tibial condyle
  75. Fibular collateral lig. - extends from lateral femoral condyle to head of the fibula
  76. Tendon of popliteus - crossing lateral knee deep to fibular collateral ligment, superficial to lateral meniscus
  77. Inferior lateral genicular a. - deep to fibular collateral lig., superficial to tendon of popliteus
  78. Inferior medial genicular a. - deep to tibial collateral lig.
  79. Superior medial genicular a. - deep to long tendon of adductor magnus, superior to adductor tubercle
  80. Superior lateral genicular a. - piercing the most inferior extent of the lateral intermuscular septum
  81. Anterior cruciate lig. - extending from medial posterior aspect of later femoral condyle to anterior tibial intercondylar area
  82. Posterior curciate lig. - extending from lateral posterior aspect of medial femoral condyle to posterior tibial intercondylar area
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The Structural Basis of Medical Practice