Self Lecture Clinically Important Aspects of Lower Limb Anatomy Part-4

Drusama220

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ANTEROLATERAL COMPARTMENTS OF LEG
Muscles-of-the-Anterior-Leg.jpg
In this topic, we'll briefly cover important clinical aspects, nerve injuries, pathological diseases, and medical interventions regarding the Anterolateral Compartments of the Leg in the Lower Limb Anatomy. This series of articles will be helping you as handy notes, in memorizing important clinical conditions while studying the Lower Limb Anatomy.

I - INJURY TO COMMON PERONEAL NERVE:

  • Damage to the common peroneal (fibular) nerve may occur as a result of a fracture of the head or neck of the fibula because it passes behind the head of the fibula and then winds laterally around the neck of the fibula.
  • The nerve damage results in
  1. Foot drop (loss of dorsal extension)
  2. Loss of sensation on the dorsum of the foot and lateral aspect of the leg
  3. Paralysis of all muscles in the anterior and lateral compartments of the leg (dorsal extensors and evertor muscles of the foot).

II - INJURY TO SUPERFICIAL & DEEP PERONEAL NERVE:
  • Damage to the superficial peroneal (fibular) nerve causes no foot drop but does cause loss of eversion of the foot.
  • Damage to the deep peroneal (fibular) nerve results in foot drop (loss of dorsal exon) and hence a characteristic high-stepping gait.

III - COMPENSATORY GAITS IN FOOT DROP:
  • There are three means of compensating foot drop
  • Waddling gait
  • Swing out gait (in which long limb is swung out laterally to allow toes to clear the ground)
  • Steppage gait (in which extra flexion is employed at hip and knee to raise the foot as high to keep toes from hitting the ground)

IV - ANTERIOR TIBIAL COMPARTMENT SYNDROME:
  • Anterior tibial compartment syndrome is characterized by ischemic necrosis of the muscles of the anterior compartment of the leg.
  • It occurs presumably as a result of compression of arteries (anterior tibial artery and its branches) by swollen muscles following excessive exertion.
  • It is accompanied by extreme tenderness and pain on the anterolateral aspect of the leg.

V - SHIN SPLIT:
  • Shin splint is a painful condition of the anterior compartment of the leg along the thin bone (tibia) caused by swollen muscles in the anterior compartment, particularly the tibialis anterior muscle, following athletic overexertion.

VI - CHARLEY HORSE:
  • Muscle cramp (“charley horse”) is a sudden, involuntary, painful contraction of muscles of the lower limb.
  • It is caused by muscle fatigue from prolonged sitting, overexertion, dehydration, and depletion or imbalance of salt and minerals (electrolytes) such as calcium, sodium, potassium, and magnesium as well as a poor blood supply to leg muscles.
  • The most commonly affected muscles are the calf muscle, hamstrings, and quadriceps.
  • The cramp goes away within a few minutes, or it can be treated by a gentle stretch and massage of the cramped muscle, pain relievers, and muscle relaxers.

VII - INTERMITTENT CLAUDICATION:
  • Intermittent claudication is a condition of limping caused by ischemia of the muscles in the lower limbs, chiefly by the calf muscles, and is seen in occlusive peripheral arterial diseases particularly in the popliteal artery and its branches.
  • The main symptom is leg pain that occurs during walking and intensifies until walking is impossible, but the pain is relieved by rest.

VIII - GREAT SAPHENOUS VEIN:
  • The great saphenous vein accompanies the saphenous nerve, which is vulnerable to injury when collected surgically.
  • It is commonly used for coronary artery bypass surgery, and the vein should be reversed so its valves do not obstruct blood flow in the graft.

IX - NERVE GRAFTS:
  • The sural nerve is used for nerve grafts to repair nerve defects.

X - THROMBOPHLEBITIS:
  • Thrombophlebitis is a venous inflammation with thrombus formation that occurs in the superficial veins in the lower limb, leading to pulmonary embolism. However, most pulmonary emboli originate in deep veins, and the risk of embolism can be reduced by anticoagulant treatment.

XI - VARICOSE VEINS:
  • A varicose vein has a larger diameter than normal and is elongated and tortuous.
  • It develops in the superficial veins of the lower limb because of reduced elasticity and incompetent valves in the veins or thrombophlebitis of the deep veins.
(In the next article, we'll cover the clinically important aspects of the Posterior Compartment of Leg in Lower Limb Anatomy. Stay tuned.)