Conference 9:Leg, Ankle, Foot

Question 1

Name the structures that are located posterior to the medial malleolus, in order beginning anteriorly

Answer 1

1. Tibialis posterior 2. Flexor digitorum longus 3. posterior tibial artery 4. posterior tibial vein 5. tibial nerve 6. flexor hallucis longus

Question 2

Where can you locate the pulse point for the posterior tibial artery at the ankle ?

Answer 2

2-3 cm posterior and inferior to medial malleolus

Question 3

What makes up the roof of the tarsal tunnel?

Answer 3

flexor retinaculum

Question 4

What makes up the floor of the tarsal tunnel?

Answer 4

deltoid ligament of the ankle & subtalar joints

Question 5

what structure is subcutaneously located anterior to the medial malleolus

Answer 5

great saphenous vein

Question 6

Name the structures that are located ANTERIOR to the ankle joint, in order beginning medially

Answer 6

tibialis anterior extensor hallucis loncus dorsalis pedis artery and DEEP FIBULAR NERVE extensor digitorum longus

Question 7

What structures are located posteriorly to the lateral malleolus

Answer 7

fibularis brevis fibularis longus

Question 8

Name three ankle ligaments

Answer 8

anterior talofibular ligament calcaneofibular ligament posterior talofibular ligament

Question 9

Answer 9

1. anterior talofibular
2. calcaneofibular
3. posterior talofibular

Question 10

What should you think of if you see anteromedial thigh/leg sensory defect and/or knee extension motor issues?

Answer 10

problem with femoral nerve

Question 11

Patient has hip joint pain or loss of sensation around lower medial thigh. Patient also has difficulty adducting the hip. What are you worried about?

Answer 11

Obturator nerve issues

Question 12

Patient has tingling on lower posterior leg and plantar side of foot. Thoughts?

Answer 12

Tibial nerve issue

Question 13

Patient presents with difficulty extending the hip, flexing the knee and ankle. Abductinon and Adduction of the toes is weak. Patient is having trouble inverting the foot, as well as MP IP joint flexion, IP joint extension. What could explain all of these symptoms?

Answer 13

Tibial nerve issue.

Question 14

Patient has diminished sensaiton on posterior thigh and upper leg. What could cause that?

Answer 14

lesion of posteiror cutaneous nerve of thigh

Question 15

Patiet is having issue with ankle dorsiflexion, as well as foot inversion, and MP joint extension. What nerve do you suspect has been lesioned? What sensory deficits would confirm your diagnosis.

Answer 15

Lesion of the deep fibular nerve.

Sensory deficits could include diminished sensation of the webbed space on the dorsum of the foot between great toe and second toe.

Question 16

What is the standard clinical presentation of a superficial fibular nerve lesion?

Answer 16

Weakness in foot eversion (motor) and loss of sensation of lower anterior leg and most of the dorsum of the foot (sensory)

Question 17

Main spinal segment for hip flexion

Answer 17

L2

Question 18

Main spinal cord segment for knee extension

Answer 18

L3

Question 19

Main spinal cord segment for ankle dorsiflexion

Answer 19

L4

Question 20

Spinal cord segment for great toe extension

Answer 20

L5

Question 21

Spinal cord segment for hip extension

Answer 21

S1

Question 22

Main spinal cord segment for knee flexion

Answer 22

S1

Question 23

Main spinal cord segment for ankle plantar flexion

Answer 23

S1

Question 24

Patient presents with diminished sensation on lateral thigh. What nerve has been lesioned?

Answer 24

lateral cutaneous n. of thigh

Question 25

Answer 25

1. Cuniform
2. Navicular
3. Transverse tarsal joint
4. Subtalar joint
5. Cuboid
6. metatarsals
7. Phalanges