12. Lower Limb II: Knee to Foot (HARC) Flashcards

1
Q

name for the KNEE CAP bone

A

PATELLA

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2
Q

2 LEG BONES

A

TIBIA (medial)
FIBULA (lateral)

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3
Q

part on the DISTAL end of the TIBIA:

A

MEDIAL MALLEOLUS

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4
Q

part on the DISTAL end of the FIBULA

A

LATERAL MALLEOLUS

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5
Q

2 parts on the DISTAL FEMUR

A

LATERAL CONDYLE
MEDIAL CONDYLE

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6
Q

what can you find on the LATERAL and MEDIAL CONDYLES of the FEMUR that are the attachment sites for ligaments
(TIPS, can feel)

A

LATERAL EPICONDYLE
MEDIAL EPICONDYLE

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7
Q

name for the BUMP (BIG) on the TIBIA

A

TIBIAL TUBEROSITY

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8
Q

3 types of BUMPS on BONES that muscles attach to :

A
  • Tubercle (small)
  • Tuberosity (middle)
  • Trochanter (big) (femur)

bigger bumps = more powerful muscles attach

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9
Q

name for SUPERIOR , FLAT part of TIBIA with 2 parts

A

TIBIAL PLATEAU

  • MEDIAL CONDYLE
  • LATERAL CONDYLE
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10
Q

name for the LINE found on the POSTERIOR surface of TIBIA

A

SOLEAL LINE

  • SOLEUS muscle attaches
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11
Q

which side of the TIBIA is the SOLEAL LINE found

A

POSTERIOR

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12
Q

3 parts of PROXIMAL FIBULA

A

APEX (projection)
HEAD
NECK

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13
Q

DISTAL FIBULA there is:

A

LATERAL MALLEOLUS

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14
Q

what is BETWEEN the FIBULA and TIBIA

A

INTEROSSEOUS MEMBRANE

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15
Q

JOINT between TIBIA and FIBULA

A

DISTAL & PROXIMAL
TIBIOFIBULAR JOINT

very little movement

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16
Q

the MEDIAL MALLEOLUS is a PALPABLE FEATURE of which BONE

A

TIBIA

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17
Q

what type of JOINT is the KNEE JOINT

A

SYNOVIAL
HINGE JOINT (UNIAXIAL)

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18
Q

what AXIAL is the KNEE JOINT

A

UNIAXIAL - 1 AXIS

(mainly) 1 MOVEMENT: FLEXION/EXTENSION

but also some rotation & translation

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19
Q

which BONES make up the KNEE JOINT

A

FEMUR
PATELLA
TIBIA

(NOT fibula)

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20
Q

2 ARTICULATIONS at the KNEE JOINT

A

TIBIOFEMORAL JOINT (main)
-between femur and tibia

PATELLOFEMORAL JOINT
- between femur and patella

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21
Q

what do you find in the KNEE JOINT
BETWEEN the FEMORAL and TIBIAL CONDYLES

A

MENISCI

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22
Q

which features add STABILITY to the KNEE JOINT

A
  • MENISCI
  • 4 major LIGAMENTS (2 pairs: cruciate, collateral)
  • muscles
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23
Q

the MENISCI are a PAIR of…

A

SEMILUNAR FIBROCARTILAGE DISCS in the knee joint

MEDIAL MENISCI
LATERAL MENISCI

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24
Q

Structure of MEDIAL MENISCI

A
  • C-SHAPED with wide base
  • well ANCHORED to TIBIA (firmly fixed down)

therefore LESS MOBILE
(MORE RISK to injury)

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25
Q

Structure of LATERAL MENISCI

A
  • ALMOST O SHAPE
    smaller gap
  • less firmly fixed down so MORE MOBILE (can move with femur)

LESS RISK to injury

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26
Q

which MENISCUS is at MORE RISK to INJURY and why

A

MEDIAL MENISCI

as it is LESS MOBILE

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27
Q

3 FUNCTIONS of the MENISCI

A
  1. INCREASE CONTACT AREA (main function)
    - increases up to 60%
  2. SHOCK ABSORBER
  3. PROPRIOCEPTION - ability to sense movement, action, and location (lots of proprioceptive fibres)
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28
Q

TYPES/PAIRS of LIGAMENTS in the KNEE JOINT:

A
  • CRUCIATE LIGAMENTS
  • COLLATERAL LIGAMENTS
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29
Q

what are the 2 CRUCIATE LIGAMENTS in the KNEE JOINT

(‘cruciate’ = ‘crossed’)

A

ACL - ANTERIOR CRUCIATE LIGAMENT
attaches to anterior tibia
PCL - POSTERIOR CRUCIATE LIGAMENT
attaches to posterior tibia

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30
Q

FUNCTION of the CRUCIATE LIGAMENTS ACL & PCL

A

RESIST EXCESSIVE TIBIAL TRANSLATION (limit movement)

ACL: RESIST EXCESSIVE ANTERIOR TIBIAL TRANSLATION
PCL: RESIST EXCESSIVE POSTERIOR TIBIAL TRANSLATION

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31
Q

how to TEST for CRUCIATE ACL/PCL FUNCTION and what results mean

A

TEST FOR INJURY
hold thigh and calf. pull anteriorly to test ACL and push posteriorly to test PCL (LACHMAN TEST)

if ACL TEAR:
EXCESS anterior MOVEMENT of TIBIA

if PCL TEAR:
EXCESS posterior MOVEMENT of TIBIA

if CRUCIATE are FUNCTIONING: LIMIT THE MOVEMENT

excessive = >5mm

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32
Q

which CRUCIATE TEAR is MORE COMMON and what is it CAUSED by:

treatment?

A

ACL TEAR

  • caused by MEDIAL ROTATION with a FIXED LEG
    usually when RUNNING FORWARD

usually NON-IMPACT injury

TREATMENT BY RECONSTRUCTION - TENDON AUTOGRAFT

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33
Q

what are the 2 COLLATERAL LIGAMENTS
(where are they attached to/from)

A

MEDIAL COLLATERAL LIGAMENT
(from Medial Epicondyle of femur to medial surface of Tibia)

LATERAL COLLATERAL LIGAMENT
(from Lateral Epicondyle of femur to the Head of the Fibula)

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34
Q

where are the 2 COLLATERAL LIGAMENTS

A

EITHER SIDE of the KNEE JOINT

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35
Q

FUNCTION of the COLLATERAL LIGAMENTS - MEDIAL & LATERAL

A

STABILILE the KNEE
in the CORONAL PLANE

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36
Q

Which COLLATERAL LIGAMENT is THICKER & STRONGER

A

MCL
MEDIAL COLLATERAL LIGAMENT

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37
Q

which COLLATERAL LIGAMENT is MORE COMMONLY INJURED
and why

A

MCL
MEDIAL COLLATERAL LIGAMENT

much MORE FORCE on the MEDIAL SIDE

38
Q

which COLLATERAL LIGAMENT is THIN and EXTRACAPSULAR

A

LCL
LATERAL COLLATERAL LIGAMENT

39
Q

how is the LATERAL COLLATERAL LIGAMENT in FLEXION

A

LOOSE

therefore LESS LIKELY TO INJURE

40
Q

3 TYPES of BONES in the FOOT

A

TARSALS
METATARSALS
PHALANGES

41
Q

name the TARSALS in the FOOT

A

CALCANEOUS (heel bone)
TALUS (forms ankle joint)
NAVICULAR
CUBOID

CUNEIFORM BONES:
LATERAL CUNEIFORM
INTERMEDIATE CUNEIFORM
MEDIAL CUNEIFORM

42
Q

How are the METATARSALS in the FOOT names

A

1-5

1 at medial end
5 at lateral end

43
Q

How are the PHALANGES named

A

1st DIGIT (big toe)
2nd DIGIT
3rd DIGIT
4th DIGIT
5th DIGIT (little toe)

44
Q

3 parts in each PHALANGE

A

DISTAL
INTERMEDIATE
PROXIMAL

BUT only DISTAL & PROXIMAL in 1ST DIGIT (big toe)

45
Q

name of the ANKLE JOINT

A

TALOCRURAL JOINT

between TALUS and LEG (TIBIA & FIBULA)

46
Q

4 JOINTS in the FOOT

A

SUBTALAR JOINTS: Talo-calcaneal joint, Talo-calcaneao-navicular joint

TARSO-METATARSAL JOINTS
(between tarsals and metatarsals)

METATARSOPHALANGEAL JOINT
(between metatarsals and proximal phalanges)

INTERPHALANGEAL JOINTS
(between the Phalanges)

47
Q

what TYPE of JOINT is the TALOCRURAL JOINT (ANKLE)

A

SYNOVIAL
HINGE JOINT

48
Q

what axial is the TALOCRURAL JOINT

A

UNIAXIAL - ONE MOVEMENT ONLY:

DORSIFLEXION/PLANTARFLEXION

49
Q

is DORSIFLEXION at the ankle joint a flexion or extension

A

EXTENSION

50
Q

is PLANTARFLEXION at the ankle joint a flexion or extension

A

FLEXION

51
Q

which ANKLE JOINT MOVEMENT is MORE STABLE

A

DORSIFLEXION

due to WIDE ANTERIOR of the TALUS

52
Q

which ANKLE JOINT MOVEMENT has MORE RISK of INJURY

A

PLANTARFLEXION

(can move more due to narrow posterior of talus)

53
Q

what is the reason for bones being MORE CONGRUENT (in agreement) in DORSIFLEXION hence MORE STABILITY

than in PLANTARFLEXION

A

IRREGULAR SHAPE of the TALUS BONE

  • WIDE ANTERIOR
    fills joint space - restricting movement
  • NARROW POSTERIOR
54
Q

what MOVEMENTS occur by the SUBTALAR JOINT of the FOOT

A

INVERSION / EVERSION

55
Q

there is more MOVEMENT in INVERSION or EVERSION

A

INVERSION

56
Q

ANKLE LIGAMENTS: MEDIAL & LATERAL

NAME of the MEDIAL LIGAMENT

A

DELTOID LIGAMENT

57
Q

how do the MEDIAL & LATERAL ANKLE LIGAMENTS DIFFER

A

MEDIAL:
- SINGLE
-THICK, STRONG ligament
Deltoid ligament
- more STABLE

LATERAL:
- NUMEROUS
- THINNER, WEAKER

MORE HYPERINVERSION INJURIES

58
Q

HYPERINVERSION INJURIES are MORE COMMON in which ANKLE LIGAMENTS

A

LATERAL LIGAMENTS

59
Q

HALLUCIS in a muscle name means it attaches where

A

BIG TOE

60
Q

TERTIUS in a muscle means it is

A

the THIRD muscle
(there are 2 others of the same type)

61
Q

name for the BACK of the KNEE

A

POPLITEAL FOSSA

62
Q

3 COMPARTMENTS of the LEG (calf)

A

ANTERIOR
LATERAL
POSTERIOR

Generally have:
- Common function for muscles
- Common nerve supply
- Common blood supply

63
Q

COMPARTMENTS of the LEG are DIVIDED by THICK FASICA: (2)

A

INTERMUSCULAR SEPTUM
INTEROSSEUS MEMBRANE

64
Q

FUNCTION of the MUSCLES in the LATERAL COMPARTMENT of the LEG

A

EVERSION of ankle

65
Q

LATERAL COMPARTMENT of LEG MUSCLES:
(EVERTORS)

A
  • FIBULARIS LONGUS
  • FIULARIS BREVIS
66
Q

LATERAL compartment muscles (FIBULARIS LONGUS, FIULARIS BREVIS) PASS INTO the FOOT from BEHIND…

A

BEHIND the MEDIAL MALLEOLUS

67
Q

the FIBULARIS BREVIS (EVERTOR MUSCLE) attaches to which bone in the FOOT

A

5th METATARSAL

68
Q

the FIBULARIS LONGUS (EVERTOR MUSCLE) attaches to which bone in the FOOT

A

1st METATARSAL
- goes around/across the foot

69
Q

FUNCTION of the LEG MUSCLES in the ANTERIOR COMPARTMENT

A
  • DORSIFLEXION & INVERSION of ankle
  • EXTENSION of TOES
70
Q

which muscle in the ANTERIOR LEG is the PRIMARY DORSIFLEXOR & PRIMARY INVERTOR

A

TIBIALIS ANTERIOR (important muscle)

71
Q

PAIR of TOE EXTENSORS in the ANTERIOR LEG:

A
  • EXTENSOR HALLUCIS LONGUS (big toe)
  • EXTENSOR DIGITORUM LONGUS
72
Q

EVERTOR muscle in the ANTERIOR COMPARTENT

A

FIBULARIS TERTIUS

73
Q

which LEG COMPARTMENT is the LARGEST

A

POSTERIOR

74
Q

FUNCTIONS of the SUPERFICIAL layer of the POSTERIOR COMPARTMENT of the leg

A

PLANTARFLEXION of ankle

FLEXION of the KNEE

75
Q

MUSCLES in the SUPERFICIAL LAYER of the POSTERIOR LEG

A
  • TRICEPS SURAE (‘3 headed muscle of the calf’):
    GASTROCNEMIUS (2 HEADS)
    SOLEUS (1 HEAD) (on soleal line)
  • PLANTARIS
    (back of the knee joint, very long tendon going all the way down)
76
Q

MUSCLES in the TRICEPS SURAE of the POSTERIOR LEG

A
  • GASTROCNEMIUS (2 HEADS)
  • SOLEUS (1 HEAD)
77
Q

MUSCLES in the TRICEPS SURAE of the POSTERIOR LEG (GASTROCNEMIUS & SOLEUS) DISTALLY FUSE to become…

A

the CALCANEAL TENDON
(aka ACHILLES TENDON)

78
Q

MUSCLES in the TRICEPS SURAE of the POSTERIOR LEG (GASTROCNEMIUS & SOLEUS) are powerful…

A

PLANTARFLEXORS

(GASTROCNEMIUS is also a KNEE FLEXOR)

79
Q

is the PLANTARIS part of the CALCANEAL TENDON

A

NO

  • NEXT TO IT

assists in PLANTARFLEXION & KNEE FLEXION

80
Q

FUNCTIONS of the DEEP layer of the POSTERIOR compartment of the LEG

A
  • PLANTARFLEXION
    & INVERSION
  • FLEXION of TOES
81
Q

MUSCLE in DEEP POSTERIOR LEG for PLANTARFLEXION & INVERSION

A

TIBIALIS POSTERIOR
(homologous to tibialis anterior - dorsiflexion & inversion in anterior)

82
Q

PAIR of TOE FLEXORS in the DEEP POSTERIOR leg

A
  • FLEXOR DIGITORUM LONGUS (digits 2-5)
  • FLEXOR HALLUCIS LONGUS (big toe)
83
Q

TOE FLEXORS in DEEP POSTERIOR leg ( flexor digitorum longus, flexor hallucis longus) TENDONS ENTER THE FOOT behind…

A

enter the foot BEHIND the MEDIAL MALLEOLUS
(TARSAL TUNNEL)

84
Q

DEEP POSTERIOR leg:
POPLITEUS muscle function

A

MEDIAL ROATION of the KNEE
(‘unlocks’ knee for flexion)

85
Q

DEEP POSTERIOR leg: where is the POPLITEUS MUSCLE

A

in the POPLITEAL FOSSA (back of knee)

86
Q

ANTERIOR COMPARTMENT of the leg (dorsiflexion & inversion) is INNVERATED by which NERVE

A

DEEP FIBULA NERVE

87
Q

POSTERIOR COMPARTMENT of leg (plantarflexion) is INNERVATED by which NERVE

A

TIBIAL NERVE

88
Q

LATERAL COMPARTMENT of leg (eversion) is INNVERVATED by which NERVE

A

SUPERFICIAL FIBULAR NERVE

89
Q

MEDIAL and LATERAL MENISCI of knee are connected by..

A

TRANSVERSE LIGAMENT

90
Q

ACL, PCL, MEDIAL COLLATERAL LIGAMENT & LATERAL COLLATERAL LIGAMENT are which STABILISERS of the KNEE

A

PRIMARY

91
Q

what are the SECONDARY STABILISERS of the KNEE

A

thigh & leg MUSCLES

92
Q

which muscle is PRIMARILY RESPONSIBLE for DORSIFLEXION and INVERSION of the FOOT

A

TIBIALIS ANTERIOR