Block 3: Knee and Leg TBL Flashcards

1
Q

What type of joint is the knee?

A

synovial joint with hinge

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2
Q

F(x) of the knee joint

A

hinge joint that allows for flexion and extension

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3
Q

What are the articulations of the knee joint?

A

b/w femur & tibia (weight bearing)

b/w patella and femur

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4
Q

Briefly describe the anatomy of the knee joint

A
  • Synovial hinge joint
  • 2 articulations
  • 2 fibrocartilaginous mensici on either side
  • Supporting Ligaments
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5
Q

Describe the fibrocartilaginous menisci of the knee joint

location, f(x)

A

location: one medial, one lateral

f(x): accomodate for change in shape of the articular surfaces during joint movement

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6
Q

What are the supporting ligaments of the knee joint?

A
  • 2 collateral ligaments
  • 2 cruciate ligament s
  • Patellar Ligament
  • Transverse Ligament of the Knee
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7
Q

Describe the collateral ligaments of the knee

location
f(x)
name

A

location: on either side of the knee joint
f(x): stabilize the hinge joint on the knee
names: fibular collateral tibial collateral

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8
Q

Describe the cruciate ligaments of the knee

location
f(x)
names

A

location: connecting the tibia and the femur
f(x): (anterior): prevent anterior displacement of tibia; (posterior): restricts posterior displacement

anterior and posterior cruciate ligaments

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9
Q

Describe the patellar ligament

A

most anterior ligament; inferior extension of the quadriceps ligament

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10
Q

F(x) of the transverse ligament of the knee

A

connecting the 2 menisci

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11
Q

Describe the vascular supply of the knee

A

genicular anastamoses around the knee (supplied by genicular branches of femoral and popliteal arteries)

These branches form an anastamotic network around the joint

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12
Q

What is the innervation of the knee joint?

A

obturator
femoral
tibial
commonf ibular nerves

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13
Q

What is the f(x) of the posterior compartment of the leg

A

flexors

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14
Q

Contents of the superficial group of the posterior leg compartment

A

gastrocnemius, soleus, plantaris

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15
Q

Describe the gastrocnemius muscle

A

2 heads (lateral and medial) that come together to form the calf

In the lower leg, the fibers join the soleus to become the calcaneal tendon

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16
Q

Contents of the deep group of the posterior leg

A

popliteus, flexor hallucis longus, flexor digitorum longus, tibialis posterior

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17
Q

Arteries of the posterior compartment of the leg

A

popliteal artery, anterior tibial artery, posterior tibial artery

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18
Q

Nerves of the posterior compartment of the leg

A

tibial nerve

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19
Q

Tibial Nerve is a branch of

A

sciatic nerve

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20
Q

What does the tibial nerve innervate?

A

deep muscles in the posterior compartment of the leg, superficial muscles in the posterior compartment of the leg

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21
Q

Describe the course of the tibial nerve

A
  1. descends into the posterior compartment from the popliteal fossa
  2. passes under tendinous arch b/w fibular and tibial heads of soleus muscle
  3. leaves posterior compartment of the leg at the ankle by passing through the tarsal behind the media lmalleolus
  4. enters the foot to supply most intrinsic muscles and skin
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22
Q

Gastrocnemius

Innervation, F(x), Significant Notes

A

Innervation: tibial nerve
f(x): plantarflexes the foot, flexes the knee
note: medial and lateral heads join w/ soleus to form calceneal tendon

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23
Q

Plantaris

Innervation, F(x), notes

A

Innervation: tibial nerve
f(x): plantarflexes foot, flexes knee
note: small muscle belly and thin, long tendon

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24
Q

Soleus

Innervation, F(x), notes

A

Innervation: tibial nerve
f(x); plantarflex the foot
notes: on the inferior end, it narrows to join the calcaneal tendon

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25
Popliteus Innervation, f(x),
innervation: tibial nerve | f(x): stabilizes the knee joint by resisting lateral rotation of the tibia on the femur; unlocks the knee joint
26
Flexor Hallucis Longus Innervation, f(x), notes
innervation: tibial nerve f(x): flexes the great toe note: very active during toe off phase of walking
27
Flexor Digitorum Longus Innervation, f(x), notes
innervation: tibial nerve | f(x): flexes lateral 4 toes involved w/ gripping the ground during walking
28
Tibialis Posterior Innervation, f(x)
innervation: tibial nerve | f(x): inversion & plantarflexion of the foot
29
What is the nerve of the posterior compartment
tibial nerve
30
What does the tibial nerve give rise to?
1. branches that supply all the muscles in the posterior compartment of the leg 2. sural nerve & medial calcaenal nerve (cutaneous nerves)
31
Sural Nerves f(x)
supplies skin on the lower posterolateral surface of the leg and the lateral side of the foot, little toe
32
Medial Calcaneal Nerve f(x)
innervates the skin on the medial surface and sole of the heel
33
Crural Fascia
deep fascia of the leg, continuous w/ the facia lata superiorly (after the knee joint, the fascia lata is then the crura fascia)
34
Small Saphenous Vein
arises from the lateral end of the dorsal venous arch of the foot; pierces the deep fascia in the popliteal fossa and drains into the popliteal vein
35
Interosseous Membrane
membrane b/w the tibia and fibula
36
Fasciotomy
cutting of the fascia; good treatment for compartment syndrome
37
Compartment Syndrome
swelling within a fascia enclosed muscle compartment in the limb
38
Achilles Tendon aka attaches formed by
aka calcaneal tendon attaches to the sole of the foot formed by convergence of the medial and lateral head of the gastrocnemius w/ the soleus muscle
39
Flexor Retinaculum
thick strip of connective tissue that spans the bony depression formed by the malleolus, medial & posterior surfaces of the calcaneus, & the interior surface of the sustenaculum tali
40
Achilles Tendon Reflex Testing Purpose Method
purpose: part of lower extremities exam method: a tap on the calcanea tendon posterior to the ankle (tendon of gastrocnemius & soleus) tests S1 and S2 spinal cord levels
41
What is the main arterial supply of the leg?
popliteal artery
42
Popliteal Artery supplies how does it enter the posterior compartment? branches
supplies: leg and foot enters: from the popliteal fossa behind the knee branches: anterior and posterior tibial divisions
43
Anterior Tibial artery supplies
anterior compartment of the leg
44
Posterior tibial artery supplies
posterior compartment of the leg
45
Branches of the posterior tibial aertery
circumflex artery, fibular artery
46
Describe Achilles Rupture due to occurs in diagnosis
due to sudden or direct trauma occurs in healthy tendons, but can also occur if there are certain conditions that predispose you to it (ex: tendinopathy) diagnosis: pt. describes as being "shot" or "kicked" behind the ankle
47
What are the muscles of the anterior compartment of the leg?
tibialis anterior extensor hallucis longus extensor digitorum longus fibularis tertius
48
What is the arterial supply to the anterior compartment of the leg?
anterior tibial artery
49
What is the innervation of the anterior compartment of the leg?
deep fibular nerve
50
What are the muscles of the lateral compartment of the leg?
fibularis longus | fibularis brevis
51
What is the arterial supply to the lateral compartment of the leg?
no major artery, supplied by branches of the fibular artery
52
What is the innervation of the lateral compartment of the leg?
superficial fibular nerve
53
Deep fibular nerve innervates
anterior compartment of the leg
54
Fibularis Longus anatomy action innervation
anatomy: arises in the lateral compartment but its tendons cross under the foot to attach to bones on the medial side action: everts and plantarflexes the foot; supports arches of the foot innervation: superficial fibular nerve
55
Fibularis Brevis anatomy action innervation
anatomy: deep to longus action: eversion of foot innervation: superficial fibular nerve
56
Tibialis Anterior anatomy action innervation
anatomy: most anterior & medial of the muscles in the anterior compartment; muscle fibers converge in lower 1/3 of leg to form a tendon action: dorsiflexion of foot and ankle joint, inversion of foot, dynamic support of medial arch of foot innervation: deep fibular nerve
57
Extensor Hallucis Longus anatomy action innervation
anatomy: lies next to and is overlapped by the tibialis anterior action: extension of the great toe, dorsiflexion of the foot innervation: deep fibular nerve
58
Extensor Digitorum Longus anatomy action innervation
anatomy: most posterior & lateral of the muscles in the anterior compartment of leg action: extends the toes, dorsiflexes the foot @ anle joint innervation: deep fibular nerve
59
Fibularis Tertius anatomy: action innervation
anatomy: normally considered part of the exensor digitorum longus action: dorsiflexion and eversion of the foot innervation: deep fibular nerve
60
Deep Fibular Nerve Innervates
all muscles of the anterior compartment continues to dorsal aspect of the foot where it innervates the extensor digitorum brevis, contributes to innervation of the first 2 dorsal interossei muscles, supplies skin b/w 2nd and great toes
61
Superficial Fibular Nerve innervates
lateral compartment of the leg
62
What are the branches of the common fibular nerve?
cutaneous branches deep fibular nerve superficial fibular nerve
63
What are the cutaneous branches of the common fibular nerve
sural communicating nerve | lateral sural cutaneous nerve
64
Sural Communicating Nerve innervates
skin over the lower posterolateral side of the leg
65
Lower sural cutaneous nerve innervates
skin over the upper lateral leg
66
Superficial Fibular Nerve innervates
fibularis longus and fibularis brevis supplies all dorsal areas of foot and toe
67
What is the arterial supply for the anterior leg
anterior tibial artery
68
Describe the origin of the anterior tibial artery
from the popliteal artery in the posterior compartment, then passes into the anterior compartment of the leg
69
anterior tibial artery gives rise to
anterior medial malleolar artery & anterior lateral malleolar artery
70
What is the arterial supply of the lateral compartment of the leg?
no major arteries pass through the lateral compartment, so supply is from branches from the fibular artery in the posterior compartment of the leg
71
Intermuscular Septa
fascial layers between the compartments