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1. What are the two groups of muscles in the posterior compartment of the leg?
→ Superficial group: Gastrocnemius, Soleus, Plantaris.
→ Deep group: Popliteus, Flexor digitorum longus, Tibialis posterior, Flexor hallucis longus.
2. What is the nerve supply of all muscles in the back of the leg?
→ Tibial nerve (L4–S3).
3. What is the main action of these muscles?
→ Plantar flexion of the ankle and flexion of the toes.
4. What is the strongest tendon in the human body?
→ Tendo calcaneus (Achilles tendon).
5. Which muscles form the tendo calcaneus?
→ Gastrocnemius, Soleus, and sometimes Plantaris.
6. Where is the tendo calcaneus inserted?
→ Posterior surface of the calcaneum.
7. Which artery runs with the tibial nerve in the back of the leg?
→ Posterior tibial artery.
8. Where can the posterior tibial pulse be felt?
→ Behind the medial malleolus, midway between the malleolus and tendo calcaneus.
9. What are the terminal branches of the posterior tibial artery?
→ Medial and lateral plantar arteries.
10. What is the chief artery of the lateral compartment?
→ Peroneal (fibular) artery.
11. What are the structures that pass beneath the flexor retinaculum (medial → lateral)?
→ Tibialis posterior, Flexor digitorum longus, Posterior tibial artery, Tibial nerve, Flexor hallucis longus.
👉 Mnemonic: “Tom, Dick And Very Nervous Harry.”
12. What is the clinical importance of the flexor retinaculum?
→ It forms the tarsal tunnel, whose compression produces tarsal tunnel syndrome.
13. Which muscle unlocks the knee joint?
→ Popliteus.
14. Which muscle maintains the medial longitudinal arch of the foot?
→ Tibialis posterior.
15. Which muscle maintains the transverse arch of the foot?
→ Peroneus longus.
16. Which artery gives the nutrient branch to the tibia?
→ Posterior tibial artery.
17. Which artery gives the nutrient branch to the fibula?
→ Peroneal (fibular) artery.
18. What is the “peripheral heart” of the body?
→ Soleus muscle, because its contractions pump venous blood upward against gravity.
19. What are the boundaries of the posterior compartment of the leg?
→ Anteriorly: Tibia, fibula, interosseous membrane.
→ Posteriorly: Deep fascia.
→ Laterally & medially: Intermuscular septa.
20. What are the main clinical conditions related to the back of the leg?
→ Tarsal tunnel syndrome, Achilles tendon rupture, posterior-compartment syndrome, calcaneal bursitis, and deep vein thrombosis.
21. What is the effect of tibial nerve injury?
→ Loss of plantar flexion and inversion; anesthesia over the sole; calcaneovalgus deformity.
22. Why is the sural nerve used for grafting?
→ It is superficial, purely sensory, and easily harvested with minimal morbidity.
23. What is the popliteal–plantar arterial continuity?
→ Popliteal → Posterior tibial → Lateral plantar → Plantar arch.
24. What is the importance of perforating branch of peroneal artery?
→ It joins the anterior tibial system, maintaining collateral supply around the ankle.
25. Why are calf muscles called the “triceps surae”?
→ Because gastrocnemius (two heads) + soleus (one head) = three-headed muscle of the leg.
1. The posterior compartment of the leg is supplied by which nerve?
A. Common peroneal nerve
B. Tibial nerve
C. Superficial peroneal nerve
D. Deep peroneal nerve
✅ Answer: B – Tibial nerve
→ It supplies both superficial and deep groups of posterior leg muscles.
2. The strongest tendon in the human body is:
A. Plantaris tendon
B. Flexor hallucis longus tendon
C. Tendo calcaneus
D. Tibialis posterior tendon
✅ Answer: C – Tendo calcaneus (Achilles tendon)
→ Formed by gastrocnemius, soleus, and plantaris.
3. The artery accompanying the tibial nerve in the back of leg is:
A. Anterior tibial artery
B. Posterior tibial artery
C. Peroneal artery
D. Popliteal artery
✅ Answer: B – Posterior tibial artery.
4. The pulse of posterior tibial artery is palpated:
A. In front of medial malleolus
B. Behind lateral malleolus
C. Behind medial malleolus
D. Over dorsum of foot
✅ Answer: C – Behind medial malleolus (between malleolus and tendo calcaneus).
5. The muscle that unlocks the knee joint is:
A. Popliteus
B. Soleus
C. Gastrocnemius
D. Tibialis posterior
✅ Answer: A – Popliteus
→ Rotates femur laterally on tibia to initiate flexion.
6. The chief plantar flexors of the foot are:
A. Tibialis anterior and extensor digitorum longus
B. Gastrocnemius and soleus
C. Tibialis posterior and peroneus tertius
D. Flexor digitorum longus and tibialis anterior
✅ Answer: B – Gastrocnemius and soleus.
7. Which muscle supports the medial longitudinal arch of the foot?
A. Peroneus longus
B. Tibialis posterior
C. Tibialis anterior
D. Flexor digitorum longus
✅ Answer: B – Tibialis posterior.
8. The peroneal artery is a branch of:
A. Anterior tibial artery
B. Posterior tibial artery
C. Popliteal artery
D. Lateral plantar artery
✅ Answer: B – Posterior tibial artery.
9. Which muscle forms the floor of the popliteal fossa?
A. Gastrocnemius
B. Soleus
C. Popliteus
D. Plantaris
✅ Answer: C – Popliteus.
10. Which of the following muscles is absent in some individuals?
A. Soleus
B. Plantaris
C. Gastrocnemius
D. Tibialis posterior
✅ Answer: B – Plantaris.
11. Which of the following muscles does NOT cross the ankle joint?
A. Gastrocnemius
B. Soleus
C. Tibialis posterior
D. Flexor hallucis longus
✅ Answer: A – Gastrocnemius
→ Acts on knee and ankle through Achilles tendon but its fleshy belly does not cross ankle directly.
12. The artery supplying the lateral compartment of leg is:
A. Anterior tibial artery
B. Peroneal artery
C. Posterior tibial artery
D. Dorsalis pedis artery
✅ Answer: B – Peroneal artery.
13. Which of the following structures passes deep to the flexor retinaculum?
A. Peroneus longus
B. Tibialis anterior
C. Tibialis posterior
D. Peroneus brevis
✅ Answer: C – Tibialis posterior.
14. The muscle forming the “peripheral heart” of the leg is:
A. Gastrocnemius
B. Soleus
C. Plantaris
D. Tibialis posterior
✅ Answer: B – Soleus
→ Helps venous return by compressing deep veins.
15. Which nerve supplies the heel (calcaneal) region of the foot?
A. Saphenous nerve
B. Medial plantar nerve
C. Sural nerve
D. Medial calcanean branch of tibial nerve
✅ Answer: D – Medial calcanean branch of tibial nerve.
16. Which structure lies deepest in the tarsal tunnel (posterior → anterior)?
A. Tibialis posterior
B. Flexor digitorum longus
C. Tibial nerve
D. Flexor hallucis longus
✅ Answer: D – Flexor hallucis longus.
17. Injury to the tibial nerve in the posterior leg causes:
A. Foot drop
B. Calcaneovalgus deformity
C. Eversion deformity
D. Clubfoot
✅ Answer: B – Calcaneovalgus deformity (loss of plantar flexion + inversion).
18. Which artery supplies the fibula?
A. Posterior tibial artery
B. Peroneal artery
C. Anterior tibial artery
D. Dorsalis pedis artery
✅ Answer: B – Peroneal artery.
19. The venous drainage of the lateral side of foot is mainly through:
A. Great saphenous vein
B. Small saphenous vein
C. Anterior tibial vein
D. Peroneal vein
✅ Answer: B – Small saphenous vein.
20. The muscle that flexes the great toe and maintains the medial arch is:
A. Flexor hallucis longus
B. Flexor digitorum longus
C. Tibialis posterior
D. Soleus
✅ Answer: A – Flexor hallucis longus.
1. What are the two groups of muscles in the back of leg?
→ Superficial group: Gastrocnemius, Soleus, Plantaris.
→ Deep group: Popliteus, Flexor digitorum longus, Tibialis posterior, Flexor hallucis longus.
2. What is the nerve supply of all muscles of the back of the leg?
→ Tibial nerve (L4–S3).
3. What is the chief action of the posterior compartment muscles?
→ Plantar flexion of foot and flexion of toes.
4. Name the strongest tendon in the body.
→ Tendo calcaneus (Achilles tendon).
5. Which muscles form the tendo calcaneus?
→ Gastrocnemius, Soleus, and sometimes Plantaris.
6. Into which bone is the tendo calcaneus inserted?
→ Posterior surface of the calcaneum.
7. What is the function of the soleus muscle?
→ Powerful plantar flexion and maintenance of upright posture (“peripheral heart”).
8. What is the function of the gastrocnemius muscle?
→ Plantar flexion of foot and flexion of knee.
9. What is the function of plantaris?
→ Weak plantar flexion; assists knee flexion.
10. Which muscle unlocks the knee joint?
→ Popliteus.
11. What is the function of the popliteus muscle?
→ Lateral rotation of femur on tibia during flexion (unlocking of knee).
12. Which muscles maintain the medial longitudinal arch of foot?
→ Tibialis posterior and flexor hallucis longus.
13. Which muscle maintains the lateral longitudinal arch of foot?
→ Peroneus longus and flexor digitorum longus.
14. Which artery runs along with the tibial nerve in the posterior compartment?
→ Posterior tibial artery.
15. Where can the posterior tibial pulse be felt?
→ Behind the medial malleolus, between the malleolus and tendo calcaneus.
16. What are the terminal branches of posterior tibial artery?
→ Medial and lateral plantar arteries.
17. What are the main branches of peroneal artery?
→ Muscular, nutrient to fibula, perforating, communicating, and lateral calcaneal.
18. Which structure lies deepest under the flexor retinaculum?
→ Flexor hallucis longus tendon.
19. What is the order of structures passing under the flexor retinaculum?
→ Tibialis posterior, Flexor digitorum longus, Posterior tibial artery, Tibial nerve, Flexor hallucis longus.
👉 Mnemonic: “Tom, Dick And Very Nervous Harry.”
20. What is tarsal tunnel syndrome?
→ Compression of tibial nerve under the flexor retinaculum, causing pain and numbness in sole.
21. Which muscle acts as a “peripheral heart”?
→ Soleus muscle.
22. What are the main actions of flexor hallucis longus?
→ Flexion of great toe, plantar flexion of ankle, maintenance of medial arch.
23. What are the main actions of tibialis posterior?
→ Plantar flexion, inversion, and maintenance of medial longitudinal arch.
24. What happens when the tibial nerve is injured in the leg?
→ Loss of plantar flexion and inversion; anesthesia of sole; calcaneovalgus deformity.
25. Why is the sural nerve used for nerve grafting?
→ Because it is superficial, purely sensory, and easily accessible with minimal functional loss.
26. What is the importance of peroneal artery in occlusion of posterior tibial artery?
→ Provides collateral circulation to the foot through its perforating and communicating branches.
27. What is the main function of tendo calcaneus?
→ Transmits the powerful contraction of calf muscles to the heel, enabling walking, running, and jumping.
28. What is the function of plantaris tendon in reconstructive surgery?
→ Used for tendon grafts due to its long, slender form.
29. What is the clinical significance of posterior compartment tightness?
→ May lead to posterior-compartment syndrome or restricted dorsiflexion.
30. What is the surface marking of posterior tibial artery?
→ From midpoint between medial malleolus and tendo calcaneus to midway between medial malleolus and heel.
This completes the Viva Voce section for the Back of Leg, covering all key anatomical, functional, and clinical points.
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