7. Knee, leg, ankle, foot Flashcards

1
Q

Where name is given to the distal end of the fibula and tibia?

A

Malleolus

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2
Q

Name the 2 regions of the tibia that articulate with the knee joint?

A

Medial and lateral tibial plateaus

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3
Q

Where are sesamoid bones found in the foot?

A

Inferior side of head of 1st metatarsal - within the 2 tendons of FHB

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4
Q

Name and describe the position of the 7 bones of the body of the foot

A
Most dorsal: inferior = calcaneus, superior = talus
In front of this:
- medial = navicular
-lateral = cuboid
in front of this: 3 cuneiforms
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5
Q

What action do the muscles of the anterior leg carry out?

A

Dorsifexion (true extension)

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6
Q

Recall the neurovascular supply of the anterior compartment of the leg

A

Deep peroneal nerve

Anterior tibial artery

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7
Q

Recall the muscles of the anterior compartment of the leg

A

TA
EDL
EHL

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8
Q

Recall the proximal and distal attachments of the muscles of the anterior compartment of the leg

A
PA:
TA and EDL = lateral condyle 
EHL = middle part of ant fibula
DA:
TA = medial cuneiform, 1st metatarsal
EDL = middle and distal phalanges
EHL = distal phalanx of hallux
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9
Q

Recall the neurovascular supply of the lateral compartment of the leg

A

Superficial peroneal nerve

Peroneal artery

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10
Q

Recall the muscles of the lateral compartment of the leg

A

Peroneus longus and brevis

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11
Q

Which muscles of the thigh act across the knee?

A
TFL
Sartorius
Quads
Gracilis
All hamstrings
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12
Q

What is the action of PL and PB?

A
Evert foot (sole away from midline)
Plantarflexion
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13
Q

What is the path of PL and PB?

A

Behind lateral malleolus and attaches to metatarsals

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14
Q

Recall the position of EDB

A

Intrinsic muscle of dorsal compartment of foot, attaching to extensor expansions

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15
Q

Recall the muscles of the superficial posterior compartment of the leg

A

Gastrocnemius
Soleus
Plantaris

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16
Q

Recall the attachments of the gastrocnemius

A

PA: medial and lateral heads attach to condylar region
DA: two bellies combine to form a tendon that attaches at calcaneus = Achilles’

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17
Q

Which muscles are known as the “triceps surae”?

A

2 heads of gastrocnemius and soleus

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18
Q

Which muscles form the Achilles’ tendon?

A

Triceps surae

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19
Q

Recall the muscles of the deep compartment of the leg

A

Popliteus
FDL
FHL
Tibialis posterior

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20
Q

Recall the paths of the tendons of the deep posterior compartment of the leg

A

Pass below the medial malleolus and tendons pass to sole of foot

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21
Q

Where does the tibialis posterior muscle distally attach and act?

A

DA = medial metatarsal

Acts across ankle joint –> plantarflexion

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22
Q

What is the function of the muscles of the deep posterior comparement of the leg?

A

Plantarflexion

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23
Q

Recall the nerve supply to the sole and dorsum of the foot

A
Sole = tibial nerve
Dorsum = common peroneal nerve
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24
Q

What is the main function of the intrinsic muscles of the foot?

A

Shock absorbers that adjust to uneven surfaces

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25
How many layers of muscles are there in the sole of the foot?
4
26
Recall the key intrinsic muscles of each layer of the sole of the foot, and the muscles of the dorsum of the foot
1. AHL, FDB, ADM 2. Quadratus plantae, tendons of FHL and FDL, lumbricals 3. FHB, Adductor hallucis, FDM 4. Plantar and dorsal innterossei Dorsum: EDB EHB
27
Recall the boundaries of the popliteal fossa
Biceps femoris Semimembranosus Medial and lateral heads of gastrocnemius
28
Recall the key contents of the popliteal fossa
Popliteal artery and vein Tibial and common peroneal nerve Short saphenous nerve Popliteal lymph nodes
29
What are the tibial and common peroneal nerves branches of and where do they begin?
Sciatic nerve | Divides just superior to popliteal fossa
30
What do branches of the tibial and common peroneal nerves join to form?
Sural nerve
31
Recall the ligaments of the knee joint
Ant and post cruciate ligaments | Med and lat collateral ligaments
32
Recall the 5 components of the extensor mechanism of the knee
``` Quadriceps Quadriceps tendon Patella Patellar ligament Tibial tuberosity ```
33
Recall the arrangement of the femoral condyles anteriorly and posteriorly
``` Anteriorly = lie at a horizontal axis Posteriorly = there is an intercondylar fossa ```
34
Recall the location of the cruciate ligaments
WITHIN the knee
35
Recall the attachments of the posterior anterior cruciate ligaments
Anterior attaches anteriorly on tibia and goes posteirorly, posterior = opposite - they cross over = cruciate
36
Is the fibula medial or lateral?
Lateral
37
What are menisci?
C-shaped cartilaginous structures in the knee that help to form the articulation between tibia and fibula - allow a degree of shape change
38
Recall how the attachments of the medial and lateral collateral ligaments differ
Lateral is distinct from knee joint whereas medial is attached to medial meniscus
39
What are bursae?
Little sacs of synovial fluid
40
What is inflammation of the bursa known as?
Bursitis
41
What is "weaver's bottom"?
Inflammation of bursa that lies between ischium and gluteus maximus
42
Recall 3 key bursae of the knee joint
Pre-patellar (subtendinous and subcutaneous) | Popliteal
43
What is the role of ligaments of the proximal tibiofibular joint?
Limit movement
44
Differentiate the types of joints in the distal and proximal tibiofibular joint
``` Proximal = synovial Distal = fibrous ```
45
Which ligament is often referred to as the deltoid ligament?
Tibiocalcaneal
46
Which bone bears the weight in the ankle joint?
Tibia
47
Which ligaments of the ankle are commonly damaged by over-inversion?
Slides
48
Name the 3 arches of the foot
Medial longitudinal Lateral longitudinal Transverse metatarsal
49
What mechanisms are in place to maintain arches of foot
Ligaments, plantar aponeurosis, tendons (eg. FHL)
50
Which ligament is often known as the "spring ligament"?
Calceonavicular
51
Recall the branches of the popliteal trifurcation and what they supply
Ant. tibial = ant comp Post. tibial = post comp Peroneal = lateral comp
52
Recall the arteries at the ankle
Posterior tibial - sole of foot via medial and lateral plantar Dorsalis pedis = dorum of foot, digits
53
Summarise the superficial and deep venous drainage of the leg
Superficial: dorsal arch, long and short saphenous, perforating veins Deep: deep calf veins, popliteal, femoral, external iliac, sapheno-femoral junction, VC of PF
54
Recall the path of the common peroneal nerve
Winds around nexk of fibula before branching
55
What is clinically significant about the sural nerve
= "spare part" for nerve repair
56
What are the significant sensory nerves in the leg
SAPHENOUS NERVE = lots of anterior and medial calf Superficial peroneal Tibial Medial and lateral plantar
57
Recall the joint at which plantar and dorsiflexion occur
Ankle
58
Recall the joint at which inversion and eversion occur
Subtalar joint
59
What does the subtalar joint consist of?
Talo-calcanear, talo-navicular and calcaneo-cuboid joints
60
What is the popliteal artery a branch of and where does it begin?
Superficial femoral artery | SFA runs through adductor hiatus, becomes popliteal posteriorly to knee
61
Where do each of the main branches of the popliteal artery cross the ankle joint?
Post. tibial = medial malleolus Ant. tibial = front of ankle Peroneal = ?
62
Where does the long saphenous vein consistently lie?
2cm above and 2cm medial to the medial malleolus
63
Recall the segmental motor nervous control of knee flexion and extension
``` Flexion = L5, S1 Extension = L3, 4 ```
64
Recall the segmental motor nervous control of ankle plantar and dorsiflexion
PF: S1, 2 DF: L4,5
65
Recall the segmental sensory supply to the region
L3 to the knww, L4 to the floor L5 to dorsum of hallux S1 to lateral side of foot S1 to sole of foot
66
What does the tibial nerve supply motor innervation to?
All muscles of the posterior compartment of the leg
67
Where does the tibial nerve divide and what does it divide into?
Behind medial malleolus | Medial and lateral plantar nerves
68
What is supplied by the plantar nerves?
All the intrinsic muscles of the foot except EDB
69
Why does the positioning of the common peroneal nerve make it vulnerable to damage?
Winds around neck of fibula = vulnerable positioning
70
What is supplied by the common peroneal nerve? Identify branches.
Anterior (deep) and lateral (superficial) compartments of the leg
71
What is the role of the saphenous nerve?
Sensory supply to strip of skin on inner border of leg and ankle
72
What is the role of the sural nerve
SENSORY to lateral leg and foot
73
Recall the sensory supply to the foot
``` Dorsum = mostly superficial peroneal, with the base of the 2nd toe and hallux = deep Sole = medial and lateral plantar nerves ```
74
What mnemonic can be used to remember the relative positioning of the muscles of the deep muscles of the posterior compartment of the leg?
``` Tom Dick And Very Naughty Harry Tibialis Posterior eDl Artery (posterior tibial) Vein (posterior tibial) Nerve (tibial) eHl ```
75
Recall the phases of the gait cycle
Swing and stance
76
Recall the beginning and end points of the stance phase of locomotion
``` Beginning = heel strike End = Push off by forefoot as a result of plantarflexion ```
77
Recall the beginning and end points of the swing phase of locomotion
Beginning: Push off by forefoot | End = heel strike
78
Recall the relative time spent by the limb in the stance and swing phases during walking
Stance phase = 60% | Swing phase = 40%
79
How does the proportion of stance: swing phase of the gait differ between walking and running?
In running the stance phase is significantly reduced
80
Which element of the gait cycle uses the most energy?
Loading response in stance phase: when the heel strikes the ground and begins to assume most of the body's weight. Use energy for eccentric contraction of dorsiflexors
81
By what mechanism is the free limb thrust forward faster than the rest of the body during walking?
Hip flexion
82
Which muscles contract to end the swing phase?
Hip extensors | Knee flexors