Anatomy clinical correlates: Leg and ankle

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Anatomy clinical correlates: Leg and ankle

Prerequisite basic sciences

Prerequisite basic sciences

Anatomy clinical correlates: Anterior and posterior abdominal wall

Anatomy clinical correlates: Inguinal region

Anatomy clinical correlates: Peritoneum and diaphragm

Anatomy clinical correlates: Viscera of the gastrointestinal tract

Anatomy clinical correlates: Other abdominal organs

Appendicitis: Pathology review

Complications during pregnancy: Pathology review

Diverticular disease: Pathology review

Gallbladder disorders: Pathology review

GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review

Inflammatory bowel disease: Pathology review

Mood disorders: Pathology review

Pancreatitis: Pathology review

Anatomy clinical correlates: Female pelvis and perineum

Cervical cancer: Pathology review

Complications during pregnancy: Pathology review

Uterine disorders: Pathology review

Anatomy clinical correlates: Heart

Anatomy clinical correlates: Mediastinum

Anatomy clinical correlates: Pleura and lungs

Anatomy clinical correlates: Thoracic wall

Aortic dissections and aneurysms: Pathology review

Coronary artery disease: Pathology review

Deep vein thrombosis and pulmonary embolism: Pathology review

GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review

Pleural effusion, pneumothorax, hemothorax and atelectasis: Pathology review

ECG cardiac infarction and ischemia

Pigmentation skin disorders: Pathology review

Skin cancer: Pathology review

Papulosquamous and inflammatory skin disorders: Pathology review

Anatomy clinical correlates: Pleura and lungs

Anatomy clinical correlates: Thoracic wall

GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review

Lung cancer and mesothelioma: Pathology review

Nasal, oral and pharyngeal diseases: Pathology review

Obstructive lung diseases: Pathology review

Pneumonia: Pathology review

Tuberculosis: Pathology review

Chest X-ray interpretation: Clinical sciences

Amnesia, dissociative disorders and delirium: Pathology review

Cerebral vascular disease: Pathology review

Dementia: Pathology review

Electrolyte disturbances: Pathology review

Mood disorders: Pathology review

Hypothyroidism: Pathology review

Mood disorders: Pathology review

Anatomy clinical correlates: Facial (CN VII) and vestibulocochlear (CN VIII) nerves

Cardiomyopathies: Pathology review

Cerebral vascular disease: Pathology review

Heart blocks: Pathology review

Supraventricular arrhythmias: Pathology review

Valvular heart disease: Pathology review

Ventricular arrhythmias: Pathology review

Vertigo: Pathology review

ECG axis

ECG cardiac hypertrophy and enlargement

ECG intervals

ECG normal sinus rhythm

ECG QRS transition

ECG rate and rhythm

Kidney stones: Pathology review

Sexually transmitted infections: Vaginitis and cervicitis: Pathology review

Sexually transmitted infections: Warts and ulcers: Pathology review

Urinary tract infections: Pathology review

Central nervous system infections: Pathology review

Nasal, oral and pharyngeal diseases: Pathology review

Pneumonia: Pathology review

Shock: Pathology review

Urinary tract infections: Pathology review

Anatomy clinical correlates: Anterior blood supply to the brain

Anatomy clinical correlates: Temporal regions, oral cavity and nose

Central nervous system infections: Pathology review

Cerebral vascular disease: Pathology review

Headaches: Pathology review

Traumatic brain injury: Pathology review

Vasculitis: Pathology review

Anatomy clinical correlates: Arm, elbow and forearm

Anatomy clinical correlates: Axilla

Anatomy clinical correlates: Bones, fascia and muscles of the neck

Anatomy clinical correlates: Bones, joints and muscles of the back

Anatomy clinical correlates: Clavicle and shoulder

Anatomy clinical correlates: Foot

Anatomy clinical correlates: Hip, gluteal region and thigh

Anatomy clinical correlates: Knee

Anatomy clinical correlates: Leg and ankle

Anatomy clinical correlates: Median, ulnar and radial nerves

Anatomy clinical correlates: Wrist and hand

Seronegative and septic arthritis: Pathology review

Apnea, hypoventilation and pulmonary hypertension: Pathology review

Deep vein thrombosis and pulmonary embolism: Pathology review

Heart failure: Pathology review

Nephrotic syndromes: Pathology review

Renal failure: Pathology review

Anatomy clinical correlates: Anterior and posterior abdominal wall

Anatomy clinical correlates: Bones, joints and muscles of the back

Anatomy clinical correlates: Vertebral canal

Aortic dissections and aneurysms: Pathology review

Back pain: Pathology review

Anatomy clinical correlates: Inguinal region

Anatomy clinical correlates: Male pelvis and perineum

Penile conditions: Pathology review

Prostate disorders and cancer: Pathology review

Testicular and scrotal conditions: Pathology review

Testicular tumors: Pathology review

Anatomy clinical correlates: Pleura and lungs

Coronary artery disease: Pathology review

Obstructive lung diseases: Pathology review

Pleural effusion, pneumothorax, hemothorax and atelectasis: Pathology review

Bronchodilators: Beta 2-agonists and muscarinic antagonists

Bronchodilators: Leukotriene antagonists and methylxanthines

Pulmonary corticosteroids and mast cell inhibitors

Anatomy clinical correlates: Ear

Anatomy clinical correlates: Temporal regions, oral cavity and nose

Nasal, oral and pharyngeal diseases: Pathology review

Sexually transmitted infections: Vaginitis and cervicitis: Pathology review

Assessments

Anatomy clinical correlates: Leg and ankle

USMLE® Step 1 questions

0 / 7 complete

USMLE® Step 2 questions

0 / 8 complete

Questions

USMLE® Step 1 style questions USMLE

of complete

USMLE® Step 2 style questions USMLE

of complete

A 40-year-old man comes to the office for evaluation of right heel pain. He was playing tennis with his son when he experienced a sharp, stabbing pain of his right heel with an associated “popping” sound. The patient has been unable to ambulate since the injury occurred. Past medical history is significant for type 2 diabetes mellitus which is adequately managed with metformin. Vitals are within normal limits. Physical examination demonstrates a palpable gap two centimeters proximal to the right heel. The right leg does not yield plantar flexion with squeezing of the calf. Which of the following is the most likely cause of this patient’s condition?  

Transcript

When it comes to the clinical correlates of the leg and ankle, there is so much more than just rolling our ankle or banging our shin bone. There are a variety of clinical conditions that affect these structures, and it's not until these conditions occur that we remember the importance of our lower limbs. So we hope you get a kick out of this video learning the clinical conditions affecting the leg and ankle!

First up, let’s discuss tibial nerve injury. The tibial nerve is the medial and larger branch of the sciatic nerve, and it often splits from the common fibular nerve at the apex of the popliteal fossa, eventually dividing into the medial plantar nerve and lateral plantar nerve which provide motor and sensory information to the foot.

Tibial nerve injuries can occur either proximally, at the popliteal fossa, or distally at the tarsal tunnel which is more common. Injury at the popliteal fossa is rare as the nerve is protected deep within soft tissue at this level. Mechanisms that may cause injury at the popliteal fossa are deep penetrating trauma, knee surgery, compression from a tumor or a Baker's cyst, and posterior knee dislocation.

An injury at the popliteal fossa affects the innervation of both the lower leg and the foot. Individuals can present with weakness in plantarflexion, inversion, and toe flexion of the foot, due to decreased innervation to the muscles in the deep compartments of the lower leg. Additionally, those affected can present with their foot in a calcaneovalgus position, or more simply in dorsiflexion and eversion. Injury at this level also impairs innervation to the intrinsic muscles of the foot and can also cause paresthesia to the sole of the foot.

On the other hand, there are distal tibial nerve injuries, most commonly at the tarsal tunnel. Distally the tibial nerve passes through the tarsal tunnel, between the medial malleolus and calcaneus deep to the flexor retinaculum. Injury at the tarsal tunnel can be caused by fractures or dislocations involving the talus, calcaneus, or medial malleolus.

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