Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Surgical Anatomy > Ankle and foot > Flashcards

Ankle and foot Flashcards

1
Q

Components of ankle joint

A

inferior surface of tibia - transfers weight
lateral and medial malleolus - stablises
Superior surface of talus - transfer wt to calcaneous and fore foot
Medial and lateral surface concave

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe the movement at the ankle joint

A

Tibia always in contact
Lateral malleolus changes in positions
Plantiflexion - joint relaxed and lateral malleolus not touch. Slight side movement possible
Dorsiflexion forces movement of fibula due to the talus being wider anteriorly and bigger then morest
Hinge joint = flex and extension only and supported by ligament due to this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe the ligaments of ankle

A

Deltoid ligament
- deep part: Posterior tibiotalar ligament
- Superficial part: Tibiocalcaneal ligament
attaches to the sustentaculum tali (Strongest), Anterior tibiotalar ligament, Tibionavicular ligament.
Lateral ligament
Posterior talofibular ligament
Anterior talofibular ligament
Calcaneofibular ligament
Posterior tibiofibular ligament
Anterior tibiofibular ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Joints of foots

A 
Talocalcaneal joint
Transfers wt
Talocalcanonavicular joint
transfers wt
Inversion and eversion
Ball and socket
head of talus is ball
Socket is form by the navicular, spring ligament and sustentaculum tali (at 2 sites)
Talus articulates with calcaneous in 3 areas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe the cutaneous nerves of dorsal foot

A

Superficial nerve - dorsum of foot
pathway - divides above the ankle into medial and lateral branches
Sural - lateral foot and ankle
pieces crura fascia halfway down the calf
Saphenous - medial up to 2 MTP joint
divides into anterior and posterior above the medial malleolus
Deep fibular nerve - lateral of 1st digit and medial of 2rd digit.
cross lateral to dorsals pedis and then arises

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Veins of dorsal of foot

A

Dorsal arch to greater and lesser saphenous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe the fascia of foot

A

Deep fascia over foot and thickening to produce reticulum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Tendons of the dorsal of foot

A 
Tibialis anterior
Extensor hallucus longest
Extensor digitorum longest
Fibularis tertius 
Each have a synovial sheath
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Muscles of dorsal foot

A 
Extensor hallucus brevis 
N - deep fibular nerve
Extensor digitorum brevis
N - deep fibular nerve
dorsal Interosseos muscle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Artery of dorsal foot

A

Dorsalis pedis - lateral to extensor hallucis longest and then between 1 and 2rd metatarsal and divides deep to anastomosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

describe the skin on the plantar surface

A

Thin in arch and toe
Thick in ball and pad.
Fat for shock absorption
Anchored to plantar aponeurosis to allow grip

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe the cutaneous innervation of plantar surface

A

Branches of tibial n
Medial calcanea nerve - heel of foot then divides
Medial plantar - Pink - Supplies the first plantar surface and 3 medial toe
Lateral plantar - Yellow. distal lateral surface and 1 and 1/2 toes
Saphenous - blue Medial proximal
Sural - Red. lateral proximal area.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Muscles of the 1st layer of plantar surface

A

Under plantar aponeurosis (o- calcaneous tubosity, inserts at digits, bifurcate to allow tendons through)
Abductor hallucis
Flexor digitoriumbrevis
Abductor digiti minimi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Describe the abductor hallucis

A

O medial tubercle of tuberosity of calcaneous + flexor retinaculum + plantar aponeurosis
I - medial side of base of proximal phalanx of 1st digit
N - Medial plantar nerve
A - Abd and flexes great toe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe Flexor digitorium brevis

A

O - Medial tubercle of tuberosity of calcaneous + plantar aponeurosis +intermuscular septa
I - Bother sides of phalanges of later four digits
N - Medial plantar nerve
A - Flexes lateral four digits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe Abductor digiti minimi

A

O - Medial and lateral tubercles of tuberosity of calcaneus +plantar aponeurosis + inter muscular septa
I - Lateral side of base of proximal phalanx of 5th digit
N - Lateral plantar nerve
A - Abd and flexes 5th digit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Muscles of 2rd layer of plantar aspect

A

Quadratus plantae
Lumbricals
Flexor Hallucis longus
Flexor digitorum longus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Describe Quadratus plantae

A

O - Medial surface and lateral margin of plantar surface of calcaneous
I - Posterolateral margin of tendon of flexor digitorum longus
N - lateral plantar nerve
A - assists flexor digitorium longus in flexing lateral four digits

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Describe Lumbricals

A

O - tendons of flexor digitorum longus
I - medial aspect of expansion over lateral four digits
N - Medial one is medial plantar nerve and lateral three is lateral plantar nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Describe the muscles of the 3rd layer of plantar surface

A

Flexor hallucis brevis
Adductor hallucis
Flexor digiti minimi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Describe Flexor hallucis brevis

A

O plantar surfaces of cuboid and lateral cuneiforms
I Both sides of base of proximal phalanx of 1st digit
N- medial plantar
A - flexes great toe’s metatarsophalangeal joint
Description: Covers metatarsal 1, splits into two bellies,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Describe Adductor hallucis

A

O - from bases of metatarsal 2-4 and from fibulas longs tendon sheath (oblique) from a ligament across metatarsophalageal joints
I - Base of proximal phalanx of great toe, lateral side
N - Lateral plantar nerve S2-3
A - Helps maintain the transverse arch of foot weak adductor of great toe
Description: Oblique and transverse heads, deep to lumbricals

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Describe the flexor digiti minimi

A

O - Base of metatarsal 5 and tendon sheath of fibulas longs
I - base of proximal phalanx of toe 5
N - lateral plantar nerve
A - Flexes little toe at metatarsophalangeal joint
Description: covers metatarsal 5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Describe the contents of the 4th layer

A 
Plantar and dorsal interossei
O - Metatarsal
I - proximal digits
N Lateral plantar nerve
Tendon of fibulas longus
Tendon of tibialis posterior
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Ligament of plantar foot

A 
Long plantar ligament
O - Calcanous tubosity
I 4 metatarsal
Short plantar ligament (Calcaneocuboid)
O  - same
I - Cuboid bone
Spring ligament (plantar calcaeonavicular ligament
O - sustentaculum tali
I Navicular
Inmoble 
form joint
26
Q

Innervation of plantar foot

A 
Tibia nerve>medial and lateral plantar n
Lateral plantar 
Medical plantar nerve
Larger
Skin >muscles
Medial 3 digit
Didgt nerve supplies the great toe
27
Q

Arterial and veins supply of plantar foot

A

Posterior tibia artery > Medial and lateral artery
Medial plantar artery
Lateral plantar nerve
Curve medially to form an arch and joins dorsals pedis and form plantar arch
Gives raise to digit branches
Vena commatanie
Drain to deep veins unlike the dorsum which drain to superficial veins

28
Q

Describe the medial longitudinal arch

A

Bone: Calcaneous, talus, navicular, 3 cunieform and 3 metatarsal bases
Bone not stabilise - shape of bones in arch
Ligament - inadequate
Plantar aponeurosis
Spring ligament - head of talus
Interoessuous ligament particular the talus and calcaneous one
Muscle
Flexor hallucis longus - most important
Short muscle of the foot -1st layer
Tibialis posterior and anterior - weaker

29
Q

Describe the lateral arch

A

Calcaneous, talus, cuboid and 2 metatarsal bases - no stability
LIagment
Plantar aponeurosis - bow spring
Long and short plantar ligaments
Muscles
Fibularis longus Tendon - most important
Lateral 2 tendon of flexor digitorum longest
1st layer lateral muscles

30
Q

Describe the Transverse arch

A

Cuboid and 3 cuneiform and base of all 5 metatarsals - none
Ligaments
Ligament of metatarsal and cuneiform bone together
Transverse metatarsal ligament
Muscles
Fibularis longus tendon - most important.

31
Q

Components of the thoracic cage

A 
Sternum
Costal cartilage
Ribs
Thoracic vertebrae
Intervertebrae disc
32
Q

describe the sternum

A

Manubrium
Wider laterally
Jugular notch
Lateral is clavicular notch
Lateral to that is the costal cartilage attachment of 1st rib
Narrows inferiorly where it forms a synthesis with the body of sternum
Hyaline cartilage with fibrocartilage disc between. 2rdary cartilaginous joint.
2rd Rib articulation here
Body of stern
Flat and made of 4 bone that fuse at 25 yr old
lack of fusion of L to R =forament
Xiphoid process
Fuse to sternum at joint

33
Q

Describe the costal margin

A 
1-7 true 
1st is usually fused
2-7 ribs: Synovial joint with fibrocartilagous joint to allow movement.
Sternal costal ligament that strengthen the joint.
8-10 false
11-12 floating
Function
Allow movement during respiration
34
Q

Describe the thoracic vertebrae

A 
Body - heart shaped
Articular facet
Demi facet
Vertebrae arch
pedicle
lamina
Spinous process
Transverse process
Facet for tubercle of rib
Vertebrae foramen
35
Q

Describe Thoracic ribs

A

Head - widen with superior and inferior facet
Neck - narrow between head and tubercle
Tubercle
Facet and attachment of costotransverse ligament
Inferior edge
Costal groove - neurvascular bundle.
anterior end - cup shaped and costal cartilage here
Superior and inferior margin for muscles attachment except the 1st and 12th rib
1st rib = half the length and boarder and curved only articulate with T1 not C7
10-12 ribs only one facet as it only articulates with one vertebrae
11-12 ribs are short and have no neck or tubercle thus no articulation with transverse process

36
Q

Describe the joints of thoracic cage

A

Costal joint - discussed above
Costovertebral joints
Head of rib articulates with superior facet of it’s own vertebrae and inferior facet of vertebrae above it.
Supported by interarticular ligament to IVD
Costotransverse joint (only on ribs 3-9) (1-2, 10-11-12 have larger ROM due to absence of this joint)
Transverse process articulates with tubercle of it own rib
Supported by costotransverse ligament and lateral costotransverse ligament (tubercle) and superior costotransverse ligament (neck of rib to transverse process of vertebrae above).

37
Q

Muscles of anterior thoracic wall

A 
External intercostal
Internal intercostal
Innermost intercostal
Subcostal
Transversus thoracis
38
Q

Describe the external intercostal

A

Hands in pocket
Elevates ribs during forced inspiration
at the costal cartilage the muscle turns into the external intercostal membrane (aponeurosis)

39
Q

Describe Internal intercostal

A

hands in opposite pockets
Interosseous part - depresses rib
Interchandral part - elevates ribs
Runs from sternum to angle of the rib where it become the internal intercostal membrane

40
Q

Describe the innermost intercostal

A

same as internal intercostal muscle. Neurovascular bundle travels between.

41
Q

Describe the subcostal

A

Lay on angle of the rib. Not always present and cross 2-3 ribs

42
Q

Describe the transverses thoracis

A

4 to 5 splits
O - Xphoid process and posterior surface of lower sternum
I - internal surface of costal cartilages 2-6. Fan out

43
Q

Describe the neurovascular bundle of the intercostal spaces

A

Sit in subcostal groove between internal intercostal muscle and innermost
Tube insertion position
Blocks need to be done and multiple levels due to innervation lap out
Intercostal nerve from spinal roots of T1-11,
intervertebral foramen then communications of sympathy chain (SNS and PNS)
Branches
Intercostal nerve - inferior margin of rib
Collateral branch - superior margin of rib
Lateral cutaneous branches (lateral thoracic wall) piece the external muscle and internal intercostal muscle then branch into posterior and anterior branch to supply lateral wall (not in first space)
Anterior cutaneous branches piece the external muscle aponeurosis and internal intercostal muscle then branch into medial and lateral branch to supply anterior and lateral wall. (not in first space)

44
Q

Describe the areas that the nerve 5-12 supply

A 
Skin
Abdominal muscles
Intercostal muscle
subcostal
Transversus thorscis
Serratus posterior
45
Q

Describe the dermatomes of the thorax

A

The thoracic and abdomen wall is supplied by intercostal and subcostal nerve
Umbilicus = T10
Nipple level = T4-5
Collar = C3
below collar but above sternal angle is C4
No overlap between C4 and T2

46
Q

Arteries that supply thoracic wall

A

Branches of subclavian A: Internal thoracic artery and Supreme intercostal arteries
Posterior intercostal artery
Subcostal artery
axillary artery

47
Q

Describe the internal thoracic artery

A

lays lateral to the sternum running inferiorly
supplies
anterior intercostal arteries to spaces 1-6
collateral branch - travel superior to rib
Larger than the posterior, anastomosis
Pericardium
Thymus
sternum
2-4 intercostal artery supplies breast?
Terminal branch - divides into superior epigastric and musculophrenic arteries at the 6th intercostal space

48
Q

Describe the supreme intercostal arteries

A

supplies the 1st and 2rd intercostal spaces
there is no posterior intercostal branch at this level. the supreme branches from this subclavian and then head posterior prior to wrapping anterior to for fill a similar role as the posterior intercostal artery

49
Q

Describe the posterior intercostal artery

A

travel in costal groove sandwich between the veins and nerve
give collateral artery as well
close to the angle of the rib the arteries enter the costal grooves, where they lie between the intercostal vein and nerve. At first the arteries run in the endothoracic fascia between the parietal pleura and the internal intercostal membrane then run between the two muscles.

50
Q

Describe subcostal artery

A

supplies the 12th rib space and muscles of anterolateral abdominal wall
travel along the inferior border of 12th rib

51
Q

Describe the venous drainage of thorax

A

each level has 1 posterior and 2 anterior veins
Anterior
drains into the muscophrenic and internal thoracic vessels
Posterior
1st intercostal vein drains straight into the brachicephelic vein bilaterally
Right 2rd and 3rd intercostal vein join to form the superior intercostal vein and drain into the azygos
2-3rd can drain either to brachiocephalic or accessory hemiazygos vein
4-8rd space drains to accessory hemiazygos vein
Hemiazygos starts in the abdomen at the L renal vein.
Left first rib can do either brachiocephalic or accessory hemiazygos vein
Others
Superficial vein radiate from umbilicus. if below the umbilicus they drain to great saphenous.
If above lateral thoracic then axillary
or to portal system

52
Q

Boundaries and contents of superior apertures

A

Bourdaries: anterior jugular notch, clavicular notches of manlunum, 1st rib and vertebrae body
Contents: Trachea, oesophagus, great vessels, nerve.

53
Q

boundaries and contents of inferior apertures

A

Boudaries: xiphisternal joint anterior, costal margins and 12th rib posterior
Closed by diaphragm

54
Q

Position of chest tube

A

Chest tube: 4th intercostal space in anterior axillary line.
Avoids the long thoracic nerve and liver
inserted superior to the 5th rib

55
Q

Describe the structure of diaphragm

A

Muscluar - radiate
anterior - horizontal
Posterior ventral
central Tendon - at level of xiphisternum

56
Q

describe the structures that pass through the diaphragm

A

T8 = IVC
Via the central tendon. When diaphragm contracts the opening is opened and increase venous return to heart.
R phrenic n and Lymph vessel pass
T10 = Oesophagus
Muscular part
Anterior and posterior vagal trunks pass as well
vein and lymph as well
T12 = Aorta
Pass behind the median arcuate ligament
azygous vein and thorax duct
Hemiazygos vein passing through the L crura
Splenic nerve piece each crura
Sympathic trunk passing behind the medial arcuate ligament
subcostal nerve and vessel pass under the lateral arcuate ligament
Left phrenic nerve pieces the L dome lateral to pericardium
Neurovascular bundles T 7 to T 11 that pass between digitation of of the attachment to costal margins
Superior epigastric pass between the xiphisternum and costal margins of the diaphragm

57
Q

Describe the attachment of diaphragm

A

Crura - attaches to L1-3 on R and L1-2 on L
R crura divides to the left to surround the oesophagus and together with L form the median arcuate ligament.
Lateral to mid line is the medial and lateral arcuate ligament that anchor the diaphragm to posterior wall. This allows the psoas major and quadrates lumborum muscles to pass.

58
Q

Describe the blood supply of diaphragm

A

From the lower 5 intercostal and subcostal arteries

Abdominal side is supplied by inferior phrenic arteries from the aorta

59
Q

Innervation of diaphragm

A

Phrenic nerve (C3,4,5)
Descend posteriolateral to internal jugular veins
Descend anterior to root of lungs on the surface of pericardium
R is associated with venous- descends Posterior to SVC, R artium of heart and then passes through the IVC of diaphragm
L is associated with arterial - descends between the carotid and subclavium arteries and lays of aortic arch and then the Left auricle and ventricle and pieces diaphragm lateral to pericardium through the muscles
Both divide into anterior, posterior and lateral branches

60
Q

Describe the function of diaphragm

A

Inspiration
Opens IVC increase venous return
Sphincter to oesophagus

61
Q

describe the movement of thorax

A

Increase in diameter in all three planes.
Pump- handle movements
Direction of movement. A-P.
Joint: Manbosternum joint, Costovertebral joints
True ribs
Muscles: Intercostal
Bucket handle movement
Direction of movement:Lateral, transverse
Joint: 8-12 ribs
Muscles: abdominal muscle hold 12th rib
Diaphragm
Direction of movement: vertical
Muscles: Diaphragm
Quiet inspiratory: intercostal and scalene
Deep inspiratory: Accessory muscles added
Expiratory : Abdominal muscle

Surgical Anatomy (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions