Lower Limb Muscles
Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo in Handbook of Muscle Variations and Anomalies in Humans, 2022
In a sample of 124 legs from 65 cadavers, Sobel et al. (1990) found fibularis quartus in 27 legs (21.8%). In 17 out of the 27 legs (63%), it originated from the belly of fibularis brevis and inserted into the peroneal trochlea. In 1 out of the 27 legs (3.7%), the muscle originated from fibularis brevis and inserted onto the fibularis longus tendon (fibularis accessorius). In another leg (3.7%), the muscle originated from the fibularis brevis muscle and inserted onto its tendon. In one leg (3.7%), the muscle originated from fibularis longus and inserted into the fibularis longus tendon. In one leg (3.7%), the muscle originated from fibularis longus and inserted into fibularis brevis. In two legs (7.4%), the muscle presented as fibularis digiti minimi (see the entry for this muscle). In two legs (7.4%), fibularis quartus originated from fibularis longus and inserted onto the peroneal trochlea. In three legs (11.1%), the muscle originated from fibularis brevis and inserted onto the lateral retinaculum.
Lower Limb
Rui Diogo, Drew M. Noden, Christopher M. Smith, Julia Molnar, Julia C. Boughner, Claudia Barrocas, Joana Bruno in Understanding Human Anatomy and Pathology, 2018
Two fibular muscles make up the lateral compartment of the leg: the fibularis longus more laterally and fibularis brevis more medially (Plate 5.12). As these muscles pass lateral to the ankle joint, they logically evert the foot, and although they derive evolutionarily and developmentally from an ancestral/common extensor group, as noted above, they actually flex (plan-tarflex) the foot. As its name indicates, the fibularis longus is longer than the fibularis brevis. It originates more proximally from the fibula than the fibularis brevis—and distally—it passes with the brevis deep to the superior and inferior lateral retinacula and then continues all the way through the plantar surface of the foot to insert onto metatarsal 1 and the medial cuneiform (the fibularis brevis inserts onto metatarsal 5). Therefore, apart from everting and flexing (plantarflexing) the foot, the fibularis longus also supports the plantar arches of the foot.
Lower limb
David Heylings, Stephen Carmichael, Samuel Leinster, Janak Saada, Bari M. Logan, Ralph T. Hutchings in McMinn’s Concise Human Anatomy, 2017
Muscles of the leg have actions mostly seen at the ankle and foot joints. Which statement is anatomically accurate?Flexor hallucis longus passes most laterally behind the medial malleolus to run and attach to the proximal phalanx of the big toe and only flexes the metatarsophalangeal joint.Flexor digitorum longus passes posterior to the medial malleolus to run obliquely across the foot, splitting to attach to the middle phalanx of each, and flexes only the joints it crosses.Tibialis posterior runs posterior to the medial malleolus to attach to the tuberosity of the navicular and flexes and inverts the ankle.Fibularis longus attaches to the base of the fifth metacarpal and will flex and invert the foot.Tibialis anterior attaches to the tuberosity of the navicular and allows flexion and inversion of the ankle joint.
Dry needling equilibration theory: A mechanistic explanation for enhancing sensorimotor function in individuals with chronic ankle instability
Published in Physiotherapy Theory and Practice, 2021
Jennifer F. Mullins, Arthur J. Nitz, Matthew C. Hoch
The addition of DN to the fibularis longus muscle within a traditional rehabilitation plan demonstrated superior self-reported outcomes in individuals with CAI (Salom-Moreno et al., 2015). In this study, subjects who received DN treatment in addition to traditional balance exercises reported significantly greater improvements 8 weeks after their last DN treatment and four weeks after their last exercise treatment over traditional exercise alone. Furthermore, DN MTrPs of the fibularis longus muscle in individuals with CAI improved ankle strength, balance, and hop testing outcomes (Rossi et al., 2017). These subjects demonstrated immediate improvement following a single treatment without additional rehabilitative care. These studies together demonstrate that DN treatment has already demonstrated the ability to have enhanced or stand-alone improvements in both clinician- and patient-oriented outcomes in individuals with CAI.
Great toe drop following knee ligament reconstruction: A case report
Published in Physiotherapy Theory and Practice, 2020
David A Boyce, Chantal Prewitt
At the apex of the popliteal fossa, the sciatic nerve (L4-S3 ventral rami) splits into a CFN laterally and a tibial nerve medially. Proximally, the CFN is located between the tendon of the biceps femoris and the lateral head of the gastrocnemius muscle, which then wraps around the fibular neck and enters the fibular tunnel deep to fibularis longus muscle before splitting into the superficial fibular nerve (SFN) and deep fibular nerve (DFN). The DFN innervates the anterior compartment muscles of the leg: tibialis anterior (TA), EDL, EHL, and peroneus tertius. As it descends, the DFN travels between the EDL and TA proximally, then between the EHL and TA distally before crossing the ankle to provide motor innervation to the EDB and extensor hallucis brevis muscles as well as cutaneous innervation to the skin between the first and second toes (Figures 1 and 2). The SFN innervates the lateral compartment muscles of the leg (i.e., fibularis longus and fibularis brevis) and ends distally as the cutaneous SFN to provide sensory innervation to the dorsum of the foot with the exception of the skin between the first two toes (Dumitru, Amato, and Zwarts, 2002; Jenkins, 2008). It should also be noted that about 28% of individuals have an accessory fibular nerve branch of the SFN that supply the EDB (Dumitru, Amato, and Zwarts, 2002; Kimura, 2001; Preston and Shapiro, 2013). Incidence of nerve injury after knee arthroscopy is reported as occurring at a rate of 0.06–2.5% (Sanders, Rolf, McClelland, and Xerogeanes, 2007; Small, 1986, 1988). Of those, the most commonly injured mixed nerve is the CFN (Small, 1986). Consequently, knowing the anatomical pathway of the CFN and its branches provides a better understanding of the potential risks for nerve injury. Research has shown that there are variations in the anatomical location where CFN is split into two main branches. The split can be proximal to the knee joint (10%) or inferior to the knee joint but proximal to the fibular neck (8.6%) (Deutsch, Wyzykowski, and Victoroff, 1999). Anatomical variations in nerve distribution can consequently increase the risk of nerve damage during knee arthroscopy. Reports on injury to the DFN after arthroscopic surgery were linked with an anatomical variation of the CFN as it is divided into the DFN and SFN proximal to the fibular head instead of its standard split distal to the fibular neck (Deutsch, Wyzykowski, and Victoroff, 1999; Rodeo, Sobel, and Weiland, 1993). We could speculate that such anatomical difference was a possible cause of the postsurgery problems observed in this case report. Complications such as CFN palsy can result as this nerve is also superficial thus more prone to injury (Ryan et al., 2003; Steward, 2008). Additionally, procedures involving proximal fibula and tibia osteotomies or fibular graft harvest have resulted in foot drop due to injured CFN or DFN (Bauer et al., 2005; Gibson, Barnes, Allen, and Chan, 1986; Kirgis and Albrecht, 1992; Shingade, Jagtap, and Ranade, 2004). However, paralysis of just one muscle innervated by the DFN after knee arthroscopy remains a rare occurrence as it has only been reported once in the literature (Estrella and Eufemio, 2008).
Related Knowledge Centers
- Ankle
- Fibula
- Malleolus
- Muscle
- Superficial Fibular Nerve
- Lateral Compartment of Leg
- Fibularis Muscles
- Cuneiform Bones
- Metatarsal Bones
- Lateral Condyle of Tibia