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LCRS Y2: Anatomy of the limbs > 7. Knee, leg, ankle, foot > Flashcards

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
Q

How many layers of muscles are there in the sole of the foot?

A

4

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26
Q

Recall the key intrinsic muscles of each layer of the sole of the foot, and the muscles of the dorsum of the foot

A
  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
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27
Q

Recall the boundaries of the popliteal fossa

A

Biceps femoris
Semimembranosus
Medial and lateral heads of gastrocnemius

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28
Q

Recall the key contents of the popliteal fossa

A

Popliteal artery and vein
Tibial and common peroneal nerve
Short saphenous nerve
Popliteal lymph nodes

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29
Q

What are the tibial and common peroneal nerves branches of and where do they begin?

A

Sciatic nerve

Divides just superior to popliteal fossa

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30
Q

What do branches of the tibial and common peroneal nerves join to form?

A

Sural nerve

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31
Q

Recall the ligaments of the knee joint

A

Ant and post cruciate ligaments

Med and lat collateral ligaments

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32
Q

Recall the 5 components of the extensor mechanism of the knee

A 
Quadriceps
Quadriceps tendon
Patella
Patellar ligament
Tibial tuberosity
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33
Q

Recall the arrangement of the femoral condyles anteriorly and posteriorly

A 
Anteriorly = lie at a horizontal axis
Posteriorly = there is an intercondylar fossa
34
Q

Recall the location of the cruciate ligaments

A

WITHIN the knee

35
Q

Recall the attachments of the posterior anterior cruciate ligaments

A

Anterior attaches anteriorly on tibia and goes posteirorly, posterior = opposite - they cross over = cruciate

36
Q

Is the fibula medial or lateral?

37
Q

What are menisci?

A

C-shaped cartilaginous structures in the knee that help to form the articulation between tibia and fibula - allow a degree of shape change

38
Q

Recall how the attachments of the medial and lateral collateral ligaments differ

A

Lateral is distinct from knee joint whereas medial is attached to medial meniscus

39
Q

What are bursae?

A

Little sacs of synovial fluid

40
Q

What is inflammation of the bursa known as?

41
Q

What is “weaver’s bottom”?

A

Inflammation of bursa that lies between ischium and gluteus maximus

42
Q

Recall 3 key bursae of the knee joint

A

Pre-patellar (subtendinous and subcutaneous)

Popliteal

43
Q

What is the role of ligaments of the proximal tibiofibular joint?

A

Limit movement

44
Q

Differentiate the types of joints in the distal and proximal tibiofibular joint

A 
Proximal = synovial
Distal = fibrous
45
Q

Which ligament is often referred to as the deltoid ligament?

A

Tibiocalcaneal

46
Q

Which bone bears the weight in the ankle joint?

47
Q

Which ligaments of the ankle are commonly damaged by over-inversion?

48
Q

Name the 3 arches of the foot

A

Medial longitudinal
Lateral longitudinal
Transverse metatarsal

49
Q

What mechanisms are in place to maintain arches of foot

A

Ligaments, plantar aponeurosis, tendons (eg. FHL)

50
Q

Which ligament is often known as the “spring ligament”?

A

Calceonavicular

51
Q

Recall the branches of the popliteal trifurcation and what they supply

A

Ant. tibial = ant comp
Post. tibial = post comp
Peroneal = lateral comp

52
Q

Recall the arteries at the ankle

A

Posterior tibial - sole of foot via medial and lateral plantar
Dorsalis pedis = dorum of foot, digits

53
Q

Summarise the superficial and deep venous drainage of the leg

A

Superficial: dorsal arch, long and short saphenous, perforating veins
Deep: deep calf veins, popliteal, femoral, external iliac, sapheno-femoral junction, VC of PF

54
Q

Recall the path of the common peroneal nerve

A

Winds around nexk of fibula before branching

55
Q

What is clinically significant about the sural nerve

A

= “spare part” for nerve repair

56
Q

What are the significant sensory nerves in the leg

A

SAPHENOUS NERVE = lots of anterior and medial calf
Superficial peroneal
Tibial
Medial and lateral plantar

57
Q

Recall the joint at which plantar and dorsiflexion occur

58
Q

Recall the joint at which inversion and eversion occur

A

Subtalar joint

59
Q

What does the subtalar joint consist of?

A

Talo-calcanear, talo-navicular and calcaneo-cuboid joints

60
Q

What is the popliteal artery a branch of and where does it begin?

A

Superficial femoral artery

SFA runs through adductor hiatus, becomes popliteal posteriorly to knee

61
Q

Where do each of the main branches of the popliteal artery cross the ankle joint?

A

Post. tibial = medial malleolus
Ant. tibial = front of ankle
Peroneal = ?

62
Q

Where does the long saphenous vein consistently lie?

A

2cm above and 2cm medial to the medial malleolus

63
Q

Recall the segmental motor nervous control of knee flexion and extension

A 
Flexion = L5, S1
Extension = L3, 4
64
Q

Recall the segmental motor nervous control of ankle plantar and dorsiflexion

A

PF: S1, 2
DF: L4,5

65
Q

Recall the segmental sensory supply to the region

A

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
Q

What does the tibial nerve supply motor innervation to?

A

All muscles of the posterior compartment of the leg

67
Q

Where does the tibial nerve divide and what does it divide into?

A

Behind medial malleolus

Medial and lateral plantar nerves

68
Q

What is supplied by the plantar nerves?

A

All the intrinsic muscles of the foot except EDB

69
Q

Why does the positioning of the common peroneal nerve make it vulnerable to damage?

A

Winds around neck of fibula = vulnerable positioning

70
Q

What is supplied by the common peroneal nerve? Identify branches.

A

Anterior (deep) and lateral (superficial) compartments of the leg

71
Q

What is the role of the saphenous nerve?

A

Sensory supply to strip of skin on inner border of leg and ankle

72
Q

What is the role of the sural nerve

A

SENSORY to lateral leg and foot

73
Q

Recall the sensory supply to the foot

A 
Dorsum = mostly superficial peroneal, with the base of the 2nd toe and hallux = deep
Sole = medial and lateral plantar nerves
74
Q

What mnemonic can be used to remember the relative positioning of the muscles of the deep muscles of the posterior compartment of the leg?

A 
Tom Dick And Very Naughty Harry
Tibialis Posterior
eDl
Artery (posterior tibial)
Vein (posterior tibial)
Nerve (tibial)
eHl
75
Q

Recall the phases of the gait cycle

A

Swing and stance

76
Q

Recall the beginning and end points of the stance phase of locomotion

A 
Beginning = heel strike
End = Push off by forefoot as a result of plantarflexion
77
Q

Recall the beginning and end points of the swing phase of locomotion

A

Beginning: Push off by forefoot

End = heel strike

78
Q

Recall the relative time spent by the limb in the stance and swing phases during walking

A

Stance phase = 60%

Swing phase = 40%

79
Q

How does the proportion of stance: swing phase of the gait differ between walking and running?

A

In running the stance phase is significantly reduced

80
Q

Which element of the gait cycle uses the most energy?

A

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
Q

By what mechanism is the free limb thrust forward faster than the rest of the body during walking?

A

Hip flexion

82
Q

Which muscles contract to end the swing phase?

A

Hip extensors

Knee flexors

LCRS Y2: Anatomy of the limbs (7 decks)

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