Clinical anatomy of the lower limb Flashcards
What are the most common pelvic disorders?
Pelvic and actetabular fractures
What are the most common hip disorders?
Arthritis
Paeds: DDH, Perthes, SUFE
Trochanteric bursitis
Hip fractures
What are the most common knee disorders?
Arthritis Extensor mechanism injury Patellar instability Meniscal injuries Cruciate injuries Collateral ligament injuries
What are the most common foot and ankle disorders?
Ankle arthritis Talipes Equinus Tarsal coalation Hallux valgus Hallux rididus Morton's neurome Pes planus dusfuction Plantar fasciitis Ankle, MT fractures
What bone produces the medial malleolus?
Tibia
What bone produces the lateral malleolus?
Fibula
What is contained within the hind foot?
Talus and calcaneous
What is contained within the mid foot?
Navicular, cuneiforms, cuboid
What is contained within the forefoot?
MTs and everything else distal
What is the movement of the talus navicular joint?
Rotational movement
What is the movement by the tarsometatarsal joints?
Abduction and adduction
What is the function of the acetabular labrum?
Increases the amount the femoral head is capsured, important stabiliser
What is the main blood supply to the head and neck of femur?
Medial and lateral circumflex arteries
Mostly medial artery
A little from obturator artery
What muscles are the hip flexors?
Iliopsoas
Where does the iliacus originate and insert?
Origin: iliac crest
Insertion: lesser trochanter of femur
Where does the psoas major originate and insert?
Origin: transverse processes of L1-5
Insertion: Lesser trochanter of femur
What are the secondary hip flexors and extensors of the knee?
Rectus femoris
Sartorius
Where does the rectus femoris originate and insert?
Origin: ASIS
Insertion: Tibia via patella tendon
Where does the sartorius originate and insert?
Origin: ASIS
Insertion: Tibia
What are the hip adductors of the hip?
Adductor brevis Adductor longus Adductor magnus Pectineus Gracilis
Where do the hip adductors originate and insert?
Origin: inferior pubic rami
Insertion: Linea aspea, pectineal line, tibia
What are the hip abductors?
Gluteus minimus
Gluteus medius
Tensor fascica latae
Where do the gluteus minimus and medius orginate and insert?
Origin: iliac wing
Insertion: greater trochanter of femur
Where does the tensor fascia latae originate and insert?
Origin: iliac crest
Insertion: lateral tibia via IT band
What is the main hip extensor?
Gluteus maximus
Where does the gluteus maximus originate and insert?
Origin: posterior aspect of ilium
Insertion: IT band
What are the hip extensors and knee flexors?
Hamstrings:
Biceps femoris
Semimembranosus
Semitendinosus
Where does the biceps femoris originate and insert?
Origin: Long head; ischial tuberosity, short head; linea aspera
Insertion: fibula head
Where does the semimebranosus originate and insert?
Origin: ischial tuberosity
Insertion: posterior tibia
Where does the semitendinosus originate and insert?
Origin: ischial tuberosity
Insertion: medial tibia
Where will true hip pain present?
In the groin
What is the function of hte collateral ligaments in the knee?
Resist varus and valgus
What is the function of the ACL?
Resists anterior translation and external rotation of the tibia on the femur
What is the function of the PCL?
Resists posterior translation of the tibia on the femur
What are the important functions of the meniscus ligaments?
Load transfer
Increase femero-tibial conformity
Stabilise the knee during movement
Lubricate the knee
How can the meniscus tear?
Bucket handle tear
Radial tear
What are the main knee extensors?
Quadriceps muscle
What is the common insertion of the quads?
Tibia via patellar tendon
What is the extensor mechanism of the knee?
Quadriceps muscle Quadriceps tendon Patella Patella tendon Tibial tubercle
What factors can lead to patellar instabilty?
Genu valgum
Femoral head anteversion
Weak quadriceps (vastus medialis)
Ligamentous laxity
What muscles are included in the anterior compartment of the leg?
Tibialis anterior, extensor hallucis longus, extensor digitorum longus, fibularis tertius
What muscles are included in the lateral compartment of the leg?
Fibularis longus
Fibularis brevis
What muscles are included in the deep post comp of leg?
Tibialis posterior, flexor hallucis longus, flexor digitorum longus, popliteus
What muscles are included in the superficial post comp of the leg?
Gastrocnemius, soleus, plantaris
What nerve supplies the anterior comp of the leg?
Deep fibular nerve
What nerve supplies the lateral comp of the leg?
Superficial fibular nerve
What nerve supplies the deep posterior comp of the leg?
Tibial nerve
What nerve supplies the superficial post comp of the leg?
Tibial nerve
What muscles plantarflex the ankle?
Gastrocnemius, soleus, plantaris
What muscle dorsiflexes the ankle?
Tibialis anteiror
What movement occurs at the tibio-talar joint?
Dorsiflexion and plantarflexion
What movement occurs at the subtalar joint?
Eversion and inversion
What is the medial ankle ligaments?
Deltoid ligament
What is the lateral ankle ligament?
Lateral ligament complex
What tendon supports the medial arch of the foot?
Tibialis posterior tendon
What are some clinical issues associated with the medial arch?
Tib post dysfunction
Pain on medial aspect
Flattening of foot
What ligament supports the medial arch?
Spring ligament; calcaneonavicular ligament
Where does the plantar fascia originate and insert?
Tuberosity of calcaneus
Heads of metatarsals
What clinical issue can arise from the plantar fascia?
Plantar fasciitis`
