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Lower Extremity Anatomy > 7) Clinical of the Leg > Flashcards

7) Clinical of the Leg Flashcards

1
Q

Common fibular nerve root level

A

L4-S2

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2
Q

Path of Common fibular nerve

A

From sciatic
Around fibular neck
Enters lat compartment through post IM septum

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3
Q

Common fibular nerve bifurcates into

A

Deep fibular nerve

Superficial fibular nerve

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4
Q

Deep fibular nerve path

A

Through anterior IM septum into anterior compartment

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5
Q

Potential injury to common fibular nerve around fibula?

A 
Prolonged compression (tight cast, sitting/sleeping position)
Trauma
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6
Q

Common fibular nerve injury associated with

A

Footdrop (increased tripping with gait)

Weak dorsiflexion, toe extension, eversion

Steppage gait

Loss of sensation (distal anterolateral legdorsum of foot, 1st web space)

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7
Q

Transmalleolar axis

A

Line between center of medial and lateral malleoli in relation to line passing through knee joint axis

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8
Q

The transmalleolar axis measures

A

Tibial torsion

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9
Q

Normal childhood tibial torsion

A

-10 to 0 degrees

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10
Q

Normal adult tibial torsion

A

10 to 15 degrees of external rotation

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11
Q

Transmalleolar angle

A

Patient prone

Line through longitudinal axis of thigh and line perpendicular to most prominent point of malleoli

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12
Q

Thight foot angle

A

Patient prone

Line bisecting foot and line bisecting thigh

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13
Q

Kager triangle

A

Radiolucent triangle on lateral radiograhs

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14
Q

The Kager fat pad is also known as

A

Pre-calcaneal fat pad

Pre-Achilles fat pad

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15
Q

What are 4th pathologies that can obliterate Kager’s triangle?

A

Achilles (tearing/inflammation)
Calcaneal facture
FHL tendon pathology
Accessory soleus muscle

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16
Q

Boundaries of the tarsal tunnel?

A

Medial: Flex Ret (laciniate lig) and abductor hallucis
Lateral: Calcaneus, posterior talotibial and calcaneotibial ligs
Distal margin: Porta pedis

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17
Q

Medial boundary of the tarsal tunnel

A 
Flexor retinaculum (laciniate ligament)
Abductor hallucis
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18
Q

Lateral boundary of the tarsal tunnel

A

Calcaneus
Posterior talotibial ligament
Calcaneotibial ligament

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19
Q

Distal margin of the tarsal tunnel

A

Porta pedis

20
Q

Tarsal tunnel syndrome

A

Compressive neuropathy of tibial nerve or branches within the tarsal tunnel (porta pedis also entrapment site)

21
Q

TTS causes altered sensation and pain over

A 
Medial and plantar foot
Medial ankle (tibial nerve distribution)
22
Q

Prolonged compression from TTS can lead to

A

Atrophy of intrinsic foot muscles

23
Q

With TTS, what sign is present?

A

Tinel sign, characterized by pain with tapping, percussing the nerve in tunnel

24
Q

TTS symptoms ca be reproduced with

A

Sustained dorsiflexion of the ankle and MTPJs and eversion of the ankle
Also: sustained plantarflexion and inversion

25
Q

Treatment for TTS

A

Conservatively and surgically

26
Q

Ankle blocks are used for

A

Procedures of the foot
Pain relief
When more local is not possible

27
Q

Advantage of ankle block is no need for

A

General anesthesia
Motor block of leg muscles
Sensory block of leg

28
Q

When performing an ankle block, the following should be avoided

A 
Releasing anesthetic into blood vessels
Puncturing nerves (anesthetic should be released AROUND the nerve)
29
Q

5 nerves at the ankle provided sensory innervation to the foot. They are:

A 
3 superficial (saphenous, sural, superficial fibular)
2 deep (posterior tibial, deep fibular)
30
Q

Posterior tibial (med calc branches, med plantar, and lat plantar) provides innervation ti

A

Plantar foot
Medial heel
Toe tips

31
Q

Sural nerve provides innervation to

A

Lateral ankle
Lateral heel
Lateral foot
Lateral 5th digit

32
Q

Superficial fibular nerve provides innervation to

A

Most of the dorsum of the foot and toes

33
Q

Saphenous (from FEMORAL) provides innervation to

A

Medial foot

34
Q

At the level of the malleoli, what nerves are superficial?

A

Saphenous
Superficial fibular
Sural

35
Q

At the level of the malleoli, what nerves are deep to the retinacula but more superficial distally?

A

Deep fibular

Posterior tibial

36
Q

Landmarks for Deep fibular nerve

A

EHL
TA tendons
Medial malleolus
Deep at ankle (deep to deep fascia)

37
Q

Deep fibular nerve location at Perimalleolar level

A

Lateral to EHL

Level of sup aspect of Med malleolus

38
Q

Deep fibular nerve location at Midtarsal level

A

Lateral to EHL

Medial to dorsalis pedis artery pulse

39
Q

Superficial fibular nerve is subcutaneous at what location?

A

Between Lat malleolus and EHL tendon

40
Q

Superficial fibular nerve location at Perimalleolar level

A

Between Super aspect of Lat malleolus and EHL

41
Q

Anesthesia for Superficial fibular nerve is administered where?

A

Between Lat malleolus and EHL

42
Q

Sural nerve location at Perimalleolar level

A

Between Achilles tendon and Sup aspect of Lat malleolus

Subcutaneous

43
Q

Anesthesia for Sural nerve is administered where?

A

Between Achilles tendon and Sup aspect of Lat malleolus

44
Q

Posterior tibial nerve location at perimalleolar level

A

Deep to deep fascia

Posterior to Med malleolus

45
Q

Posterior tibial nerve is found between

A

Superior asp of Med malleolus and Achilles tendon (posterior to posterior tibial pulse)

46
Q

Saphenous nerve location at Perimalleolar level

A

Subcutaneous between TA tendon and medial malleolus

47
Q

Caution with Saphenous nerve?

A

Saphenous vein nearby and punctured easily

Lower Extremity Anatomy (9 decks)

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