4 - Knee, Leg, Ankle Joint, and Foot Flashcards
What is Genu Valgum of the medial condyle of the tibia?
Genu - knee
Valgus - turned outward, ankle relative to the knee.
Also called “knock-knees”
Exaggerated inward angling ankle at the knee.
What is Genu Varum of the medial condyle of the tibia?
Genu - knee
Varum - bent inward, ankle relative to the knee
“bow leg”
An exaggerating outward angling at the knee.
Where do supracondylar fractures of the distal femur go?
Distal fragment is displaced posteriorly by the gastrocnemius spasm.
This jeopardizes the large and important popliteal neuro-vascular structures, which lie adjacent to the femur.
What is “housemaid’s knee” and what is it caused by?
Prepatellar bursitis.
Inflammation due to repeated abuse of the prepatellar bursa, which is superficial to the patella and deep to the epithelium.
What causes reduced knee mobility upon extension (“stiff knee”)?
Postinflammatory adhesions in the suprapatellar bursa, located between the quadriceps femoris tendon and the femur.
What do effusions of the knee joint distend?
The The suprapatella bursa, between the quad femoris tendon and the femur.
Causes suprapatellar bursitis or “water on the knee” and on exam the patella appear to float over the femur.
What is the function of the posterior cruciate ligament (PCL)?
It’s the key stabilizer of the knee joint, and tightens maximally upon flexion.
Describe the PAIN acronym for the PCL?
It attaches to the:
P: posterior aspect of the tibia and courses
A: anteriorly and
IN: internally (medially) to attach to the medial condyle of the femur.
What happens when someone has a torn PCL? How can it be recognized?
Perceived instability; individual descending stairs will lead with the opposite leg for each step.
Abnormal passive posterior displacement of the tibia relative to the femur (posterior drawer sign).
What is the function of the anterior cruciate ligament (ACL)?
Key stabilizer of knee joint; inserts posteriorly on the femur and tightens maximally upon extension and provides a pivot around which rotation occurs during terminal phase of extension.
Explain the APEX acronym for the ACL?
It attaches to the
A: anterior aspect of the tibia and courses
P: posteriorly and
EX: externally (laterally) to attach to the medial condyle of the femur
What happens when the ACL is torn? How can this be recognized?
Often wont be noticed, except the knee suddenly gives way b/c the leg will not lock upon full extension.
Abnormal passive anterior displacement of the tibia relative to femur. (anterior drawer syndrome).
What is the “unhappy triad” caused by?
Semiflexed leg with violent abduction and lateral rotation that occurs as a result of “clipping” in football of the “caught edge” falling in skiing.
What are the three elements of the unhappy triad? What is each torn by?
- Medial collateral ligament: excessive abduction. Attached to joint capsule so medial capsular liaments are torn too.
- ACL: torn from displacement of tibia
- Lateral miniscus: compressive forces.
What are the two superficial veins of the leg and what do they each drain into?
Great saphenous: drains into the femoral vein
Small saphenous: drains into popliteal vein.
What are the major superficial nerves of the leg?
Saphenous nerve, which is the terminal branch of the femoral nerve, and the
Sural nerve, which is a branch of the tibial nerve.
What is the function of the superficial fibular nerve?
Provides primary nerve supply to the skin of the dorsum of the foot.
What are the muscles in the anterior compartment of the leg? What innervates them and what artery feeds them?
Tibialis anterior, extensor hallucis longus, extensor digitorum longus, fibularis tertius.
Nerve: deep fibular nerve (L4,5, S1)
Artery: Anterior tibial
What are the muscles in the lateral compartment of the leg? What innervates then and what artery feeds them?
The fibularis longus and fibularis brevis.
Nerve: Superficial fibular
Artery: Branches of the fibular
What are the muscles of the posterior/superficial muscles of the leg? What innervates then and what artery feeds them?
Gastrocnemius, soleus, plantaris. These three form the achilles tendon.
Nerve: Tibial (L5, S1, S2)
Artery: Posterior tibial
What are the muscles of the posterior/deep compartment of the leg?
Popliteus, flexor hallicus longus, flexor digitorum longus, and tibialis posterior.
Nerve: Tibial (L5, S1, S2)
Artery: posterior tibial
What is the action of the muscles in the anterior part of the leg?
Extensors.
Dorsiflex and invert the foot, and extend the toes.
What happens to the anterior tibial artery after it passes deep to the extensor retinaculum?
It becomes the dorsalic pedis artery.
What is the action of the muscles in the posterior compartment of the leg?
Flexors.
They plantar flex the ankle and flex the toes.
Some also invert the foot and flex the knee.
What bones make up the medial arch of the foot? What is its function? What ligament helps stabilize it?
Medial longitudinal: calcaneus, talus, all cunieforms, and 1, 2, and 3rd metatarsals. Highest, most mobile and shock absorbing.
Plantar calcaneonavicular (spring) ligament.
what bones make up the lateral longitudinal arch of the foot? What is it’s function? What ligaments help support this arch?
Lateral longitudinal: calcaneus, cuboid, 4 and 5th metatarsals. Weight bearing.
Long and short planter ligaments.
What bones make up the transverse posterior arch of the foot?
Transverse: posterior arch- distal row of tarsals and bases of all metatarsals. Anterior arch: heads of all five metatarsals.
