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MSK > 12 - Posterior Leg and Popliteal Fossa > Flashcards

12 - Posterior Leg and Popliteal Fossa Flashcards

1
Q

What is the popliteal fossa?

A

A diamond shaped space behind the knee through which important structures pass through to get to the lower limb and foot

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2
Q

What are the borders of the popliteal fossa?

A

Superior Medial: Semitendinosus and semimembranosus
Superior Lateral: Biceps Femoris
Inferior Medial and Lateral: Medial and lateral heads of gastrocnemius

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3
Q

What are the contents of the popliteal fossa?

A

Popliteal artery and vein, tibial nerve AND common peroneal nerves (CPN veers left to fibular head so doesn’t really run through middle of fossa)

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4
Q

What is the deepest structure in the popliteal fossa, closest to the knee joint/tibia & femur?

A

The popliteal artery - this means it is the structure at most risk during a knee injury (most anterior)

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5
Q

Where does the small saphenous nerve run?

A

Above fascia q

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6
Q

What is a knee dislocation?

A

Is where a tibia and femur dissociate as the tibia is driven backwards. Emergency due to contents of popliteal fossa/neurovascular structures at risk
Most common due to dashboard injuries
Image vessels to see if they are leaky (CS) and still patent

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7
Q

What are the muscles of the superficial posterior compartment of the leg?

A

Plantaris
Gastrocnemius
Soleus

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8
Q

What muscles make up triceps surae?

A

The medial and lateral heads of gastrocnemius and soleus. NOT plantaris

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9
Q

What is the muscle in the posterior compartment that not everyone has/is residual?

A

Plantaris

  • Is a small muscle with a long tendon often used for a muscle or tendon graft
  • sits between gastroc and soleus
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10
Q

Gastrocnemius?

A

O:
Lateral - lateral condyle of FEMUR
Medial - medial condyle of femus
I: Posterior calcaneus via the calcaneal tendon/achilles tendon

> plantarflex ankle and flex knee

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11
Q

Soleus

A

O: Superior fibula and soelal line of tibia
I: Calcaneal tendon to posterior calcaneus

> only plantarflexes ankle

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12
Q

What is the nerve supply to all of the posterior compartment muscles?

A

Tibial Nerve

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13
Q

Plantaris

A

O: Superior and deep to lateral head gastroc on the lateral condyle of FEMUR
I: Medial Calcaneal Tendon

> plantarflexes ankle

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14
Q

What are the muscles of the deep posterior compartment?

A

Mostly mirrors anterior compartment

  • Tibialis Posterior
  • Flexor Digitorum Longus
  • Flexor Hallucis Longus
  • Popliteus
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15
Q

Tibialis Posterior?

A

O: Posterior tibia, fibula and interosseous membrane
I: navicular and medial cuneiform

> joins with tibialis anterior to INVERT and plantarflexes

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16
Q

Flexor Digitorum Longus

A

O: Middle half of TIBIA
I: Distal phalanges of lateral 4 toes

> plantarflexion and flexes toes
tendon doesn’t always go to little toe

17
Q

Flexor Hallucis Longus

A

O: Inferior 2/3 fibula and interosseous membrane
I: Distal phalanx of big toe

> plantarflexion and flex big toe

18
Q

Popliteus

A

O: Lateral condyle of the femur
O: Posterior superior tibia

> medially rotates tibia

19
Q

How do FDL and FHL run?

A

FDL runs from medial tibia to lateral toes

FHL runs from lateral fibula to medial big toe

20
Q

Where does the posterior compartment neurovascular bundle run?

A

In a fascial plane between the superficial and deep compartment (tibial nerve, peroneal and posterior tibial artery)

21
Q

Where do the superficial structures run in the cross section of a leg?

A
  • great saphenous vein and saphenous nerve run medially

- small saphenous vein and SURAL nerve run more laterally and posteriorly

22
Q

What does the posterior tibial artery terminate in?

A

Goes around the medial malleolus and into the sole of the foot
> bifurcates into the medial and lateral plantar arteries
> there is communication between the plantar arteries and dorsalis pedis to ensure good blood flow to the foot (good as is most distal structure so runs out first)

23
Q

Lumbosacral Plexus spinal nerves?

A

L2-S2/S3

24
Q

Femoral Nerve?

A
  • L2-L4
  • anterior compartment of thigh
  • branches into the saphenous nerve
25
Q

Obturator Nerve?

A
  • L2-L4
  • medial compartment of thigh
  • NO branches
26
Q

What is the myotome of adduction?

A

L4

27
Q

What are the spinal levels of the saphenous nerve?

A

L3 L4

28
Q

What are the spinal levels of the sciatic nerve?

A

L4-S3

29
Q

What are the spinal levels of the tibial nerve?

A

S1 S2 (plantarflexion/posterior comp)

30
Q

What are the spinal levels of the deep peroneal nerve?

A
  • anterior leg/dorsiflexion

- L4/L5

31
Q

What are the spinal levels of the superficial peroneal nerve?

A
  • lateral leg/eversion

- L5/S1

32
Q

What are the spinal levels of the tibial nerve?

A
  • posterior comp/plantarflexion

- S1/S2

33
Q

What are the spinal levels of the superior gluteal nerve?

A
  • hip abductors

- L4/L5/S1

34
Q

What are the spinal levels of the inferior gluteal nerve?

A
  • gluteus maximus
  • hip extension
  • L5/S1/S2
35
Q

Name the order of structures going behind the medial malleolus from anterior to posterior

A 
- Tom Dick And Very Naughty Harry 
Tibialis posterior
flexor Digitorum longus
posterior tibial Artery 
posterior tibial Vein
tibial Nerve 
flexor Hallucis longus
36
Q

Achilles Tendon Injuries?

A
  • is the most commonly injured tendon
  • often when going from stationary position to fast
  • injury can occur at musculotendinous junction, tear the tendon, where it attaches to the calcaneous/pull off bone, or you can tear the muscle
  • presentation is the inability to ‘push off’ or plantarflex
  • is a loud and painful injury
37
Q

Can you find 4 pulses in the lower limb? What are the landmarks?

A 
1. Femoral Artery
> half way along inguinal ligament from ASIS to Pubic Tubercle
2. Popliteal Artery 
> need to relax hamstrings, gastroc and soleus as is deep
3. Dorsalis Pedis
> in line with 2nd MT
4. Posterior Tibial Artery
> posterior to medial malloelus

MSK (29 decks)

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