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MM Test 3 > B6.047 Popliteal Fossa, Leg, Foot > Flashcards

B6.047 Popliteal Fossa, Leg, Foot Flashcards

1
Q

roof of popliteal fossa

A

crural fascia

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2
Q

why is there so much fatty packing material in the popliteal fossa?

A

to prevent strangulation of the vessels and nerves when assuming a crouched or squatting position

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3
Q

crural fascia

A

deep, investing layer of the leg

continuous with fascia lata

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4
Q

floor of popliteal fossa

A

capsule of knee joint, bone, and popliteus muscle

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5
Q

major artery in popliteal fossa

A

femoral artery descends into fossa, and emerges as the popliteal artery

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6
Q

course of neurovascular bundle in popliteal fossa

A

passes from the thigh to the leg by traveling deep in the fossa
structures are posterior to popliteus muscle and pass anterior to (under) the tendinous arch of the soleus

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7
Q

contents of neurovascular bundle in popliteal fossa

A

popliteal artery (most anterior, deepest)
popliteal vein
tibial nerve

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8
Q

vein junction in fossa

A

small saphenous joins popliteal vein within fossa

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9
Q

sural nerve

A

formed from twigs of the tibial and common fibular

cutaneous nerve of the calf, lateral ankle, and foot

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10
Q

origin of tibial and common fibular nerves

A

branches of the sciatic

often split within the popliteal fossa

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11
Q

pulse pressure in the popliteal fossa

A

importance in EM and evaluation of peripheral vascular disease
particularly if no pulse detected in foot

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12
Q

swollen popliteal lymph nodes

A

requires examination of distal structures for evidence of inflammation or disease

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13
Q

popliteal hemorrhage

A

risk associated with fractures of the distal femur and severe knee injury
on rare occasions, arterial to venous popliteal fistula can form that severely compromises blood flow
can lead to leg amputation if not identified promptly

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14
Q

what makes up “compartments” in the leg

A

tough, robust fascial framework

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15
Q

interosseous membrane

A

binds tibia and fibula together
site of attachment of some muscles
helps to decrease energy output of standing

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16
Q

great saphenous vein

A

arises on medial foot

ascends to the thigh and empties into saphenous opening

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17
Q

nerve associated with great saphenous vein

A 
saphenous nerve (branch of femoral nerve)
cutaneous nerve
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18
Q

small saphenous vein

A

arises in the skin of the dorsal, lateral, and plantar foot

ascends the leg and typically empties into the popliteal fossa

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19
Q

fascial compartments in the leg

A

anterior
lateral
posterior (superficial and deep)

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20
Q

tendons of anterior leg muscles

A

all pass anterior to ankle joint

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21
Q

tendons of lateral leg muscles

A

all pass lateral to the ankle joint

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22
Q

tendons of “superficial” posterior compartment

A

all pass posterior to the ankle joint

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23
Q

tendons of “deep” posterior compartment

A

all pass medial to the ankle joint

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24
Q

muscles of the anterior compartment

A 
tibialis anterior
extensor hallicus longus
extensor digitorum longus
fibularis tertius (half of the population)
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25
Q

function of anterior muscles

A

dorsiflexion of foot at ankle
prevent toe stubbing
help smooth gait

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26
Q

innervation of anterior compartment

A

deep branch of the common fibular nerve

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27
Q

danger associated with common fibular nerve

A

lies close to the surface
susceptible to injury
loss of this nerve leads to pathological foot drop gait

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28
Q

lateral muscles

A

fibularis longus

fibularis brevis

29
Q

innervation of lateral muscles

A

superficial branch of common fibular nerve

30
Q

function of lateral muscles

A

evertors
critical to precise positioning of the foot on the ground and to maintain balance when walking or standing on uneven terrain

31
Q

posterior superficial muscles

A

gastrocnemius

soleus

32
Q

function of posterior superficial muscles

A

flex foot at the ankle joint

resist gravity and propel body forward during gait

33
Q

innervation of posterior superficial muscles

A

tibial nerve

34
Q

posterior deep muscles

A

tibialis posterior
flexor digitorum longus
flexor hallicus longus

35
Q

damage of tibialis posterior

A

surrounded on 3 sides by rigid structures
swelling and bleeding causes significant complications
hypertrophy of muscle leads to high compartmental pressure injury to motor nerves and occlusion of arteries

36
Q

orientation of tendons, nerve, and vessels at the flexor retinaculum

A

all deep to flexor retinaculum, posterior to medial epidcondyle
moving from epicondyle posterior and deep:
1. tibialis posterior
2. flexor digitorum
3. post. tibial artery and tibial nerve
4. flexor hallicus longus
tom, dick, and bloody nervous, harry

37
Q

branches of popliteal artery

A

anterior tibial artery (pierces to anterior side distal to the knee joint)
posterior tibial artery
-fibular artery

38
Q

arteries of the knee

A

genicular arteries

39
Q

gastrocnemius blood supply and innervation

A

sural arteries and tibial nerve branches

sural arteries are end arteries with no collateral tributaries

40
Q

2 major arteries of posterior leg

A

posterior tibial artery (goes down to flexor retinaculum)
fibular artery
vary widely in diameter

41
Q

varicosities

A

common in superficial leg veins

caused by incompetent valves

42
Q

Osgood Schlatter disease

A

exceptional exertion of quadriceps muscles by young or adolescent athletes can place undue strain on the tibial tuberosity
can cause extreme pain and swelling
can also damage epiphysial growth plate situated near the tibial tuberosity, causing growth fialure

43
Q

housemaid/ surfers knee

A

form of bursitis, inflammation of the superficial, and subcutaneous infrapatellar bursae
results from excessive pressure and friction on the patella/tibial tuberosity caused by patient spending extended periods of time on knees

44
Q

bursitis of the calcaneal tendon

A

common complaint of long distance runners

45
Q

ruptured calcaneal tendon

A

severe, acute injury
affected foot cannot be flexed at the ankle against gravity (other posterior leg muscles aren’t sufficiently powerful)
walking only possible by exaggerated external rotation of the hip and passively swinging the lower limb forward by hip and spine rotation

46
Q

what allows leg muscle tendons to change the direction of pulling force at the ankle

A

retinacula

  • superior extensor retinaculum
  • inferior extensor retinaculum
  • fibular retinacula
  • flexor retinaculum
47
Q

flexor retinaculum

A

constrains the deep flexor tendons at the medial ankle

48
Q

superior extensor retinaculum

A

contains extensor muscle tendons (anterior leg group_

49
Q

plantar aponeurosis

A

flat ligament on sole that arises on calcaneous and extends to metatarsals
deep investing layer that forms a tough connective tissue boundary

50
Q

wear is the majority of weight bearing

A

sesamoid bones of 1st and 2nd metatarsal

50% of weight bearing

51
Q

skeletal components of the dorsal foot

A 
10 phalanges
5 metatarsals
5 tarsals (3 cuneiforms, 1 navicular, 1 cuboid)
talus
calcaneous
52
Q

sustentaculum tali

A

shelf of bone on calcaneous that supports Talus

53
Q

is the head of talus supported by bone?

A

no
hangs over
supported by spring ligament: plantar calcaneonavicular ligament

54
Q

planter fasciae components

A
  1. significant superficial fatty tissue, which cushions the foot
  2. plantar aponeurosis (connective tissue)
55
Q

muscles of the plantar foot

A

4 musculo-tendinous tissue layers

sensors of proprioception

56
Q

major arteries of the plantar foot

A

posterior tibial artery

  • lateral plantar artery
  • medial plantar artery
  • —plantar arch
57
Q

plantar innervation

A

arise from tibial nerve
lateral plantar nerve
medial plantar nerve
innervate all plantar muscles

58
Q

muscles of dorsal foot

A

extensor digitorum brevis

extensor hallicus brevis

59
Q

innervation of dorsal foot

A

deep fibular nerve

60
Q

major arteries of the dorsal foot

A

anterior tibial artery

  • dorsal artery of the foot
  • arcuate artery
61
Q

anastomoses of arteries in foot

A

perforating branch from the plantar arch goes up to the dorsal arch

62
Q

cutaneous innervation of the foot

A

saphenous = medial malleolus and medial arch
superficial fibular = lateral ankle and dorsal foot except inner half of big toe and 2nd toe
deep fibular nerve = inner half of big toe and 2nd toe
dorsal lateral cutaneous nerve of foot = lateral foot and a bit of plantar surface
medial plantar nerve = medial 3.5 toes and arch
lateral plantar nerve = lateral 1.5 toes and arch
medial calcaneal branch = heel

63
Q

ligaments of medial longitudinal arch

A 
passive support
-plantar aponeurosis
-short plantar ligament
-long plantar ligament
-plantar calcaneonavicular ligament (spring)
dynamic support
-tibialis posterior
-tibialis anterior
-flexor hallicus longus
-fibularis longus
-intrinsic plantar muscles
64
Q

function of talus

A

sits at the top of a bony arch

participates in 3 joints: ankle, sub talar, transverse talar

65
Q

flat foot etiology

A

collapse of medial longitudinal arch

due to dysfunction of the tibialis posterior

66
Q

structure that maintains the arch

A

spring ligament

collapse of this structure allows the head of the talus to fall and push aside the calcaneous and navicular bones

67
Q

what causes arch failure

A

duration of stress > severity of stress

professors&raquo_space; athletes

68
Q

plantar fasciitis

A

continuous overloading stress of the plantar fascia by running and jumping
leads to inflammation, pain, and swelling where the ligament attaches to the bone (calcaneous)

69
Q

dorsal artery pulse

A

important for evaluating peripheral vessel health

evaluated in diabetics particularly

MM Test 3 (31 decks)

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