Clinical Anatomy Of The Lower Limb 3 Flashcards

1
Q

Lateral ligament of the ankle is…

A

Composed of 3 separate ligaments

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2
Q

The medial/deltoid ligament of the ankle is…

A

Large, strong and triangular in shape and composed of 4 separate ligaments

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3
Q

Inversion injuries stress…

A

The lateral ligaments

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4
Q

What ligament is most commonly injured in inversion injury?

A

Anterior talofibular and calcaneofibular most commonly torn

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5
Q

Describe the medial tarsal tunnel

A

The gateway to the foot

  • found on the posters medial side of the ankle. Structures from the posterior leg enter the plantar foot
  • formed by medial malleolus of the tibia, medial, and posterior surfaces of the talus, medial surface of the calcaneous, inferior surface of the sustentaculum of the calcaneous.

Covered by flexor retinaculum

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6
Q

What are the contents of the carpal tunnel?

A

Tom: tibialis posterior

Dick: flexor digitorum longus

And: posterior tibial artery

Very: posterior tibial vein

Very: posterior tibial vein

Nervous: tibial nerve

Harry: flexor hallucis longus

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7
Q

What are the bones of the foot?

A
  • 7 tarsal bones
  • 5 metatarsal bones
  • 14 phalanges
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8
Q

What are arches of the foot?

A
  • Bones of the foot do not lie in a horizontal plane. Instead, they form longitudinal and transverse arches relative to the ground
  • Arches absorb and distribute downward forces from the body during standing and moving on different surfaces
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9
Q

What are the ligaments that support the arches?

A

Plantar calcaneoavicular (spring ligament)

  • plantar calcaneocuboid (short plantar ligament)
  • long plantar ligaments
  • plantar aponeurosis
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10
Q

What muscles provide dynamic support to the arch?

A
  • tibialis anterior
  • tibialis posterior
  • fibularis longus
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11
Q

What is hallux valgus?

A

A foot deformity in which there is a lateral deviation of the great toe in the transverse plane. It is caused by pressure from the footwear and degenerative joint disease

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12
Q

What is Hallux varus?

A

A foot deformity in which there is medial deviation of the great toe in the transverse plane. It is caused by excessive recession of a bunion

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13
Q

What do each layer of muscle of the foot consist of?

A

Layer 1- abductor hallucis, flexor digitorum brevis, abductor digiti minimi

Layer 2- quadratus plantae, 1st, 2nd, 3rd and 4th lumbricals

Layer 3- flexor hallucis, adductor hallucis, flexor digiti minimi brevis

Layer 4- dorsal interossei, planter interossei

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14
Q

What are the innervation of LAFF muscles?

A

Innervated by medial plantar, all other muscles Innervated by lateral plantar

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15
Q

What is the function and innnervation of the abductor digiti minimi?

A
  • abducts the little toe

- lateral plantar nerve

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16
Q

What is the function of the planter aponeurosis?

A

Supports the longitudinal arch of the foot

-protects deeper structures in the sole

17
Q

What is the function and innervation of the flexor digitorum brevis?

A
  • flexes the digits

- medial plantar nerve

18
Q

What is the function and innervation of the abductor hallucis?

A

Abducts the big toe

Medial plantar nerve

19
Q

What is the function and innervation of the lumbricals?

A
  • flexion at the MTP and extension at IP
  • 1st: medial plantar
  • 2nd - 4th lateral plantar
20
Q

What is the function and innervation of the quadratus plantae?

A

Assist in flexion of digits

-lateral plantar nerve

21
Q

What is the function and innervation of the flexor digiti minimi brevis?

A
  • flexes little toe

- lateral plantar nerve

22
Q

What is the function & innervation of flexor hallucis brevis?

A

Flexes big toe

Medial plantar nerve

23
Q

What is the function & innervation of adductor hallucis?

A
  • adducts the big toe

- lateral plantar nerve

24
Q

Describe the deep veinous drainage of lower limb

A
  • located in and drains the compartments of the lower limb

- Runs with the corresponding arteries (same name and usually paired)

25
Q

Describe the superficial veinous drainage of the lower limb

A
  • located in the skin and superficial fascia of the lower limb
  • usually visible to the naked eye
  • veinous stripping
  • veinous cutdown
26
Q

Describe superficial lymphatic drainage of the lower limb

A

Follows the path of the veinous drainage of the limb

Superficial drainage:
-lateral foot
-postero-lateral leg
These above are popliteal lymph drainage

-Anterior-medial foot
-antero-medial leg
-thigh
These above are vertical group of superficial inguinal lymph nodes

27
Q

Describe deep lymphatic drainage of the lower limb

A

Leg and foot to popliteal nodes, then to deep inguinal

  • thigh to deep inguinal nodes
  • receives tributaries from the superficial groups and eventually drain into the external iliac nodes
28
Q

Describe the varicose veins

A

Deep veins to fascia-pressure rises when muscles contract= “muscular pump”

Superficial veins are outside deep fascia-not exposed to compression forces when muscles contract

29
Q

What are the functions for valves in veins?

A
  • assist with veinous return by preventing retrograde flow

- prevent flow from deep veins to superficial vein

30
Q

What causes varicose veins?

A

Superficial veins and perforating branches with insufficient valves can cause a varicose vein

When large numbers of superficial vein valves become insufficient- there is continuous excess flow through superficial veins(from deep to superficial) - pressure in the superficial veins rises leading to the mechanical injury of small vessels, inflammation and fibrosis and could cause venous ulcers

31
Q

What does chronic veinous insufficiency lead to?

A

Pigmentation,fibrosis, ulceration

32
Q

Summarize the dermatome of the lower limb

A

Dermatomes in the lower limb and regions that can be tested for sensation and are reasonably autonomous(have minimal overlap) are:

  • over the inguinal ligament-L1
  • lateral side of the thigh-L2
  • lower medial side of the thigh-L3
  • Medial side of the great toe (digit 1)-L4
  • medial side of digit 2-L5
  • little toe- (digit V)- S1
  • back of the thigh-S
  • skin over the gluteal fold- S3
33
Q

Contrast the upper and lower limb

A

Upper limb- lumb buds rotate laterally

  • freely mobile shoulder joint
  • loose glenohumeral articulation
  • limb not for support
  • weaker and narrow
  • movements between radius and ulna

Lower limb:
Limb buds rotate medially

-limited movement at hip joint

  • tight-fit hip joint
  • limb fir support and locomotion
  • stronger and large
  • no movement between tibia & fibula