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Anatomy > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q

What are the bones of the leg?

A
  • Tibia
  • Fibula
  • Tarsal bones
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2
Q

The tarsal bones consist of..?

A 
– Talus
– Calcaneus
– Cuboid
– Navicular
– Three cuneiforms (Medial, Intermediate, Lateral)
– Metatarsals
– Phalanges
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3
Q

How many metatarsals are there?

A

5

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4
Q

The great/ big toe has how many phalanges, and each subsequent toes has how many?

A

Great toe: 2

Subsequent toes: 3

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5
Q

The fibula head sits _____ to the tibia

A

Sits behind/ posterior lateral

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6
Q

What are the blue surfaces on the posterior of the tibia?

A

The articular surfaces on the medial and lateral side of the tibia plateaus for the articulation of the medial and lateral condyles of the femur

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7
Q

What three structures form the ankle mortice for the articulation with the talus?

A
  • Lateral malleolus
  • Tibial pilon (plafond)
  • Medial malleolus
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8
Q

The ____ passes below the peroneal trochlea and the ___ passes above it

A
  • The peroneal longus passes below the peroneal trochlea

- The peroneal brevis passes above the peroneal trochlea

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9
Q

Where can we sometimes measure the navicular drop?

A

The navicular tuberosity

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10
Q

How to measure the navicular drop

A

If patients are sitting without any weight on their foot, you measure thee distance from the navicular tuberous to the floor and have the patient stand and put their boy weight through the lower extremity and remeasure the distance from the navicular tuberosity to the floor.

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11
Q

What does it mean if there’s a significant difference in the two navicular drop measurements?

A

It could indicate a navicular drop and a flat foot

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12
Q

The calcaneal tuberosity is the attachment of the ___

A

Achilles tendon

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13
Q

What is the projection of the calcaneus that forms the shelf for the tendon of flexialis longus?

A

Sustentaculum tali

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14
Q

What two bones form the transverse tarsal joints?

A

The navicular and cuboid

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15
Q

The connections between the mediate and intermediate lateral cuneiforms and the cuboid with the 1st-5th metatarsals is the…

A

Tarsometatarsal joint

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16
Q

The transverse tarsal joint is the joint between the ___ and the ___ and their articulation with the __ and the ____

A

The talus and the calcaneus and their articulations with the navicular and cuboid

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17
Q

The groove for peroneus longus passes ____

A

around the cuboid and inserts through the medial cuneiform and also the base of the 1st and 2nd metatarsal

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18
Q

What ligament covers the head of the talus and forms the inferior part of the joint surface for the talonavicular joint?

A

The plantar calcaneal navicular ligament (AKA spring ligament)

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19
Q

The leg runs from the ___ to the ____

A

Between the knee and ankle

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20
Q

The crural fascia has bony attachments that ____

A

divide the leg into 3 compartments

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21
Q

What are the three compartments of the leg?

A
  • Anterior intermuscular septum
  • Posterior intermuscular septum
  • Transverse crural septum
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22
Q

The anterior intermuscular septum separates the ____

A

anterior and lateral compartments

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23
Q

The posterior intermuscular septum separates the ___

A

The lateral and posterior compartments

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24
Q

The transverse crural septum separates the _____

A

posterior septum into a superficial and deep layer

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25
Q

The anterior compartment is supplied by the ____ and innervated by the ____

A

Supplied by the anterior tibial artery and innervated by the deep peroneal nerve

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26
Q

What are the muscles of the anterior leg?

A
  • Tibialis anterior
  • Extensor digitorum longus
  • Extensor hallicus longus
  • Peroneus/ fibular tertius
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27
Q

What does dorsiflexion of the tibialis anterior do to the foot and why?

A

It will bring the foot up, because it attaches to the medial surface of the foot. It also inverts the foot. So it turns the sole of the foot upwards or medially

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28
Q

The extensor digitorum longus is on the __ side of the tibialis anterior

A

lateral side

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29
Q

The extensor hallucis longus is housed ___

A

between the the tibialis anterior and the extensor digitorum longus

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30
Q

What is the hallux?

A

The big toe

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31
Q

How is the peroneus tertius able to help with eversion of the foot?

A

Because of its attachment to the lateral side of the foot.

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32
Q

What muscle is the most lateral compartment of the extensor digitorum longus?

A

The peroneus/ fibularis tertius

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33
Q

What does the retinacula do?

A

Helps maintain the location of the tendons and provides some activity

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34
Q

The anterior tibial artery changes its name to the ___ once it passes ____

A
  • Dorsalis pedia artery

- Once it passes underneath the retinacula and reaches the dorsum of the foot

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35
Q

Where can you take the pulse on the foot and how?

A

From the dorsalis pedis artery.

Put 3 fingers along the gap between the 1st and 2nd metatarsals. There is an ability to compare pulses and blood pressure by looking at the ankle brachial index to figure out what the compression is for the pressure within the dorsalis pedis compared to the arm

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36
Q

The dorsalis pedis artery supplies the dorsum of the foot, but it also pierces in between the ___

A

1st dorsal interosseous muscle

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37
Q

Where does the dorsalis pedis gain access to the sole of the foot?

A

The first dorsal interosseous muscle

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38
Q

What houses all the flexor compartments through the tarsal tunnel?

A

Flexor retinaculum

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39
Q

Extensor for peroneum/fibularis tertius is housed within the ____

A

Tendon synovial sheaths

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40
Q

The lateral compartment of the leg is supplied by the ____ and innervated by the ___

A

Supplied by peroneal artery (branch off posterior tibial artery) and superficial peroneal nerve

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41
Q

What are the muscles of the lateral compartment of the leg?

A
  • Peroneus longus

- Peroneus brevis

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42
Q

Why can the peroneus longus cause eversion of the foot?

A

Becasue it passes behind the malleolus

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43
Q

What two muscles inserts at the base of the 1st metatarsal and the medial cuneiform to work like a sling for the sole of the foot?

A

The tibialis anterior and the peroneus longus

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44
Q

The peroneus brevis is deep to the _____

A

Peroneus longus

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45
Q

The tendon of the peroneus brevis forms a ____. One will pass inferior and the other superior to the ___

A

groove for the peroneus longus tendon. One will pass inferior and the other superior to the fibula trochlea or calcneal trochlea of the calcaneus bone

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46
Q

The posterior compartment of the leg is supplied by the ___ and innervated by the ____

A

Supplied by posterior tibial artery and innervated tibial nerve

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47
Q

What muscles are in the superficial compartment of the posterior compartment of the leg?

A

– Gastrocnemius
– Soleus
– Plantaris

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48
Q

What muscles are in the deep compartment of the posterior compartment of the leg?

A

– Flexor digitorum longus
– Flexor hallucis longus
– Tibialis posterior
– Popliteus

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49
Q

The ___ muscle is moreso in the popliteal fossa than in the posterior compartment of the leg

A

Popliteus

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50
Q

Unlike the gastrocnemius that helps with the flexion of the knee, the soleus doesn’t because it ____

A

Doesn’t pass behind the knee

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51
Q

This muscle is very short, with a very long tendon that travels all the way down to the calcaneus

A

The plantaris muscle

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52
Q

Why is the action of the flexor digitorum longus of the ankle plantarflexion?

A

Because it passes posterior to the medial malleolus

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53
Q

Unlike like in the anterior leg, the flexor hallicus in the posterior compartment is more ___ placed, so it is not sitting in the tibialis posterior, it is actually in the ___

A
  • Laterally placed.

- In the middle of the flexor digitalis longus and the flexor flexor hallicus longus

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54
Q

Why is the tibialis posterior such an important muscle?

A

Because it helps to plantiflex the foor, because its passing behind the medial malleolus. Also because its on the medial side of the foot, it will put it into inversion.

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55
Q

The tibialis posterior works with the ____ to ___

A

Works with the tibialis anterior to invert the foot, but the tibialis anterior will tend to dorsiflex and the tibialis plantaris will plantarflex

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56
Q

Tom, Dick, and Naughty Harry is an analogy for…

A
  • Tibialis posterior
  • Flexor digitorum longus
  • Posterior tibial artery/vein/tibial nerve
  • Flexor hallicus longus
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57
Q

___ passes deep into the lateral collateral ligament

A

Popliteus

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58
Q

The anterior tibial artery passes between the __ and ___. It descends down the ___

A

Anterior tibial artery passes between the tibia and fibula. It descends down the anterior compartment of the leg

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59
Q

_____ changes name to the dorsalis pedis artery when it reaches the dorsum of the foot.

A

The anterior tibial artery

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60
Q

The ___ artery descends a short way and gives off the ____ artery.

A

The posterior tibial artery.

Gives off the peroneal artery

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61
Q

The peroneal artery descends the _____ and supplies _____ and ____of the leg

A

Descends the lateral aspect of the posterior compartment, and supplies posterior and lateral
compartments of the leg.

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62
Q

The posterior tibial artery descends down the ____ compartment passing ___ to the medial malleolus and divides into the __ and ____ plantar arteries

A

The posterior tibial artery descends down the posterior compartment passing posterior to the medial malleolus and divides into the medial and lateral plantar arteries

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63
Q

The ___ and ___ arteries supplies the sole of the foot

A

The medial and lateral plantar arteries

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64
Q

In rare occasions, the posterior tibial artery passes deep to the ____ then into the ___

A

Deep to the popliteal muscle then into the interosseus membrane

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65
Q

What could be a reason that the tibial artery passes deep to the popliteal muscle?

A

The athletes experience

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66
Q

What causes anterior shin pain>

A

The excessive use of the popliteal muscle. This prevents blood flow (lifting toes during running)

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67
Q

The ___ artery enters into the first dorsal interosseus to get to the sole of the foot

A

The dorsalis pedis artery

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68
Q

The saphenous nerve supplies the ____

A

skin on the medial side of the leg and foot

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69
Q

The saphenous nerve originates from the ____ and descends through the ____

A

Originates from the femoral nerve and descends through the adductor canal

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70
Q

The sural nerve originates from the ___ and ____

A

Originates from the Sciatic tibial and common peroneal nerves

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71
Q

The sural nerve supplies the skin of the ____

A

posterior and lateral aspects of the leg and foot

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72
Q

The superficial peroneal nerve innervates the ____

A

The skin on the distal third of the anterior surface of the leg and the dorsum of the foot

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73
Q

The deep peroneal nerve innervates the ____

A

The skin of the first interdigit space

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74
Q

The ____ nerve passes superficial to the gastrocnemius

A

The sural nerve

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75
Q

The sural nerve also supplies the ___ and the ____ border of the foot

A

The lateral achilles tendon and the lateral border of the foot

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76
Q

What are the cutaneous nerves of the leg?

A

Saphenous
Sural
Superficial peroneal
Deep peroneal

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77
Q

The motor tibial nerve travels with the _____ down the back of the leg

A

Posterior tibial artery

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78
Q

The tibial nerve passes posterior to the ____ and divides into ___ and ____ in the sole of the foot

A

Posterior to the medial malleolus and divides into medial and lateral plantar nerves in the sole of the foot

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79
Q

The deep peroneal nerve supplies ___ to the anterior compartment of the leg

A

Supplies muscular innervation to the anterior compartment of the leg

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80
Q

The deep peroneal nerve runs with the ____ artery and ends with branches innervating the ____

A

The deep peroneal nerve runs with the anterior tibial artery and ends with branches innervating the ankle joint and skin between the first and second digits

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81
Q

The tibial nerve passes under the soleus to innervate the ____

A

To the reflexor hallus longus, reflexor digitorium longus and the tibialis posterior

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82
Q

The tibial nerve goes through the ____ giving off the medial and lateral plantar nerve

A

Goes through the tarsal tunnel

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83
Q

The superficial branch goes to the ____ compartment

A

Anterior compartment

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84
Q

A common peroneal (fibular) nerve injury occurs with ___

A

Occurs with excessive valgus forces damage superficial and deep branches

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85
Q

A common peroneal (fibular) nerve injury prevents ____

A

Prevents eversion and dorsiflexion (AKA foot drop)

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86
Q

The superficial peroneal supplies innervation to the muscle of the ___ compartment of the leg

A

Lateral

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87
Q

The superficial peroneal nerve innervates the skin along the ____

A

The skin along the distal aspect of the anterior surface of the leg, dorsum of the foot and digits 3 to 5.

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88
Q

The motor nerves of the leg are…

A

The tibial nerve, deep and superficial peroneal nerves

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89
Q

What is plantar aponeurosis?

A

A thickening of the plantar fascia, similar to the found in the palm of the hand

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90
Q

The plantar fascia/aponeurosis acts as a ___

A

Strong tie for the longitudinal arches of the foot

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91
Q

The plantar fascia/aponeurosis attaches posteriorly to the ____ and anteriorly to the ____

A
  • Posteriorly to the medial process of the calcaneus.

- Anteriorly to the heads of the metatarsals

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92
Q

____ forms a mini trampoline to give normal weight bearing surface of foot

A

Plantar aponeurosis/fascia

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93
Q

What is the windlass mechanism?

A

The mechanical model that describes the manner the plantar aponeurosis and the plantar fascia supports the foot during normal weight bearing activities and gives information on bio-mechanical stresses placed on the aponeurosis

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94
Q

A windlass test directly stretches the ____

A

The planrtar aponeurosis.

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95
Q

A windlass test is effective in examining dysfunction of the ____

A

Plantar fascia. (plantar fascitis)

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96
Q

What are the forces that contribute to the flattening of the medial longitudinal arch?

A
  • Vertical forces from body weight
  • Ground forces from the calcaneous
  • Metatarsal heads
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97
Q

Why doesn’t the windlass mechanism occur when shoes are being worn?

A

Because shoes prevents toe flexion and extension

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98
Q

The plantar fascia has tensile strength which helps prevent ____ and helps maintain ____

A
  • Spreading of calcaneus and metatarsals.

- Maintain medial longitudinal arch and prevents foot collapse

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99
Q

Great toe dorsiflexion and arch height increasing causes what in the plantar fascia?

A

Causes the plantar fascia to tighten like a cable, winding up around the metatarsal head. Shortening the distance between the calcaneous an d the metatarsals to elevate medial longitudinal arch

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100
Q

What all is part of the passive support for the arch of the foot

A

The plantar fascia, plantar aponeurosis, plantar calcaneonavicular ligament

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101
Q

The short plantar ligament is more ___ placed and the long plantar ligament is more ___ placed

A

The short plantar ligament is more laterally placed and the long plantar ligament is more medially placed

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102
Q

The short and long plantar ligament supports the ___

A

Medial longitudinal arch

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103
Q

What ligament is commonly known as the spring ligament?

A

The plantarcalconeonavicular ligament

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104
Q

What functions as active support of the foot?

A

The tibialis anterior and posterior tendon, and the peroneus longus tendon

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105
Q

What causes plantar fasciitis?

A

The failure of the arches of the foot, which leads an irritation of the plantar fascia and inflammation of the plantar fascia to the calcaneous

106
Q

What muscles are in the first layer of the sole of the foot?

A
  • Abductor hallucis (medial)
  • Flexor digitorum brevis (intermediate)
  • Abductor digiti (minimi) quinti (lateral)
107
Q

The medial plantar nerve becomes the ___

A

Digital nerves to supply great, second, third, and half of the fourth toe

108
Q

The lateral plantar nerve typically innervates the ___

A

Skin of the 5th toe and the other half of the fourth toe

109
Q

What muscles and tendons are in the second layer of the sole of the foot?

A
  • Flexor digitorum longus tendon
  • Flexor hallicus longus tendon
  • Quadratus plantae
  • Lumbricals (4)
110
Q

The flexor hallucis longus tendon passes through ___

A

A tunnel made by the flexor digitorum brevis in the 1st layer of the foot

111
Q

What are the muscles of the 3rd layer of the sole of the foot?

A
  • Flexor hallucis brevis
  • Flexor digiti quinti
  • Adductor hallucis
112
Q

What are the muscles of the 4th layer of the sole of the foot?

A
  • Plantar interossei (3)

- Dorsal interossei (4)

113
Q

What does the sesamoid bones in the flexor hallucis brevis do?

A

Provide a cushion for the tendon of the flexor hallucis longus

114
Q

The tendon of the flexor hallucis longus passes ___ to the flexor hallucis brevis

A

Superficial

115
Q

____ to the medial malleolus, the tibial nerve divides into ___ and ____ plantar nerves

A
  • Inferior

- Medial and lateral plantar nerves

116
Q

The medial plantar nerves provides motor innervation to the __

A
  • Abductor hallucis
  • Flexor hallucis
  • Flexor digitorum brevis
  • Medial Lumbrical
117
Q

The medial plantar nerves provides sensory innervation to the __

A

Skin of the medial sole and medial 3 and a half digits

118
Q

The lateral plantar nerves provides motor innervation to the __

A

All other muscles of foot

119
Q

The lateral plantar nerves provides sensory innervation to the __

A

Skin of the lateral sole and lateral 1½ digits

120
Q

____ nerve provides cutaneous innervation the medial side of the dorsum of the foot

A

Saphenous nerve

121
Q

What nerve innervates the medial side of the ankle and the medial dorsum of the foot?

A

Saphenous nerve

122
Q

The ____ nerve innervates the space between the 1st and 2nd digits

A

Deep peroneal nerve

123
Q

The ____ nerve innervates the dorsum of the foot, apart from a small lateral part that is innervated by the ___

A

Superficial peroneal nerve

Sural nerve

124
Q

The heel is supplied by the _____

A

Calcaneal branch of the tibial nerve

125
Q

The sural nerve travels along the medial side of the ____

A

Achilles tendon

126
Q

The ____ nerves on the dorsum of the foot, are the ones that can be tweaked and played with

A

Intermediate dorsal cutaneous nerve

127
Q

Inferior to the medial malleolus, the _____ artery divides into medial plantar and lateral plantar arteries

A

Posterior tibial artery

128
Q

The ______ artery is a continuation of the anterior tibial artery supplying the dorsum of the foot

A

Dorsalis pedis artery

129
Q

The dorsalis pedis artery divides into the ____

A

The deep plantar artery and the arcuate artery

130
Q

The arcuate artery is on the ___ of the foot gives rise to the digital arteries for digits ___ on the dorsum of the foot

A

On the surface of the foot Digits 2-5

131
Q

The anterior tibial artery has to pass underneath the ____ and the ____ into the ___- to become the dorsalis pedis artery

A

Underneath the extensor retinaculum and the ankle joint, into the dorsum of the foot

132
Q

The deep plantar artery dives in between the ____ to get ____ and form the ___

A

Dives in between the 1st dorsai interossei muscle to get into the sole of the foot and form the deep plantar arch

133
Q

The medial plantar artery supplies the ___

A

Medial side of the sole

134
Q

The medial plantar artery runs___

A

distally between the abductor hallucis and the flexor digitorum brevis

135
Q

The medial plantar artery is between layers ___ and ___ of the muscles of the foot

A

Between layers 1 and 2

136
Q

The lateral plantar artery runs laterally between ___ to ___

A

Flexor digitorum breis and quadratus plantae (1st and 2nd muscle layers) to the base of the 5th metatarsal

137
Q

The lateral plantar artery turns medially at ____ and heads between ____ to the ____ as the ___

A

The lateral plantar artery turns medially at the base of the 5th metatarsal and heads between the 3rd and 4th layers to the base of the 1st metatarsal as the plantar arch

138
Q

What type of joint is the sacroiliac joint?

A

A synovial joint

139
Q

___ is the articulation between the sacrum and ilium

A

The sacroiliac joint

140
Q

The concave sacral surface of the SI joint is covered with ____ and its convex iliac surface line within ____

A

The concave sacral surface of the SI joint is covered with thick hyaline cartilage and its convex iliac surface line within fibrocartilage

141
Q

The compression of the SI joint allows it to resist shear. What are the structures that compresses it?

A

The interosseus ligament, the joint capsule, and strong posterior ligaments protecting the networks of adjacent nerves.

142
Q

What muscles contract and co-contract to provide stabilization for the SI joint during movement?

A

Gluteus medius, gluteus maximum, and hamstrings

143
Q

What is the Interrosseous SI ligament?

A

A massive, strong ligament that unites the sacral and iliac tuberosities

144
Q

What is the posterior sacroiliac ligament? AKA long/short dorsal SI

A

Composed of short and long fibers that connect the sacrum and ilic posteriorly. It blends with the sacrotuberous ligament

145
Q

What is the anterior/ventral SI ligament

A

Tranverse fibers that support the anterior and inferior portion of the SI joint

146
Q

____ ligament is an accessory ligament of the SI joint. It supports the L5-S1 joint.

A

Iliolumbar ligament

147
Q

_____ & ____ ligaments helps support the SI joint by preventing upward/forward movement (nutation) of the sacrum

A

Sacrotuberous & sacrospinous ligament

148
Q

The posterior SI ligament runs from the ____ to the ____

A

The posterior SI ligament runs from the PSIS to the sacrum

149
Q

What happens to the SI joint when the tranverse abdominis muscle contracts?

A

It pulls the ilium together, and help close the SI joint down, providing some compression on the joint to overcome torque and shear forces

150
Q

What is nutation and what causes it to want to happen?

A

The forward movement of the sacrum. This is caused by the body weight landing on the anterior surface of the sacrum and wanting to tilt it.

151
Q

What is the ground reaction force and what does it do?

A

A force coming from the ground straight up to the femur, attaching to the acetabulum of the hip. Because it is anterior to the active motion, it forces the ilium to move in the opposite direction so in a sense there is a tightening up at the SI joint, because the sacrum nutates

152
Q

What allows the SI joint to overcome shear forces?

A

The combination of form and force closure

153
Q

Under normal circumstances, SI joint mobility is ____

A

Very limited

154
Q

What is SI dysfunction?

A

A result of impaired load transfer through the SI joints

155
Q

Why does a person with an SI joint injury have a problem standing on the affected side?

A

Because they need to tighten up their SI joint to allow it to transfer the load of their body through the SI joint down through the lower extremities to the floor and its that lack of transfer and load transfer that causes the signs and symptoms

156
Q

How does the SI joint lock home and become solid to accept weight?

A

Nutation of the sacrum is restrained by the sacrotuberous ligament, and is further enhanced by the action of biceps femoris’ attachment to the ischial tuberosity. Also the semimembranosus and semitendinosus as they attach to the ischial tuberosity

157
Q

What is counternutation of the sacrum?

A

The posterior motion of the sacrum relative to the iliac

158
Q

Counternutation of the sacrum is restrianed by the ____ and is further enhanced by the action of the ____ through its attachment via thoracolumbar fascia

A

Long dorsal sacroiliac joint/ posterior sacroiliac joint.

By the action of latissimus dorsi

159
Q

What happens to the SI joint while walking?

A

The leg that we are standing on has to have a tightened SI joint and the opposite leg has to have an unlocked SI joint, so it can be able to move freely

160
Q

What is going on during heel strike?

A

Weight starts coming down through the leg and as it comes down through the spine, its going to force nutation of the sacrum, posterior movement of the iliac, and screwed on mechanism of the SI joint that is restrained. Also by the action of the bicep femoris which will help it pull back and provide some support

161
Q

Load transfer through the pelvic girdle is more effective when the sacrum is ____

A

Nutated

162
Q

Amplitude of sacral nutation is controlled by ____

A

Co-activation of the pelvic floor muscles and sacral multifidus.

163
Q

____ can prevent the sacrum from moving too far back

A

The pelvic floor muscles

164
Q

The cross bracing mechanism of the ___ and ___ muscles provide force closure for the SI joint

A

Latissimus dorsi and gluteus maximus

165
Q

____ has a very large socket that completely covers the head (ball) of the femur. this is a joint that sacrifices mobility for stability. its a much more stable joint b/c its a small ball with a big socket.

A

The hip joint

166
Q

The hip joint is a synovial joint of the ___ variety

A

Ball and socket

167
Q

The hip joint is the articulation of the ____

A

Articulation of the head of the femur and the acetabulum of the os coxa

168
Q

The acetabulum is deepened by the ____, which attaches to the bony rim at the SI joint and the transverse acetabular ligament

A

Acetabular labrum

169
Q

The transverse acetabular ligament spans the acetabular notch creating the ____

A

The acetabular foramen

170
Q

What is the acetabular foramen and what does it do?

A

The hollow opening underneath the transverse acetabulum ligament to get into the acetabulum fossa.

It provides passage of blood vessels and nerves to joint cavity

171
Q

The femur is attached to the transverse acetabular ligament and the acetabular labrum by the ____. The attachment of the ligament is marked in the femur by a small depression called the ____

A

The femur is attached to the transverse acetabular ligament and the acetabular labrum by the ligament of the head of the femur/ligamentum teres femoris.

The attachment of the ligament is marked in the femur by a small depression called the fovea capitis

172
Q

Extension of the of the hip is considered a _____ position for the joint

A

Close pack position

173
Q

Flexion of the of the hip is considered a _____ position for the joint

A

Open- pack

174
Q

What is retinacula?

A

The piece of synovial membrane that lines the neck of the femur

175
Q

___ is where the attachment of the hip ligaments occur

A

The intertrochanteric line

176
Q

____ is a fluid filled bursa(sac) that prevents rubbing of the bone

A

Bursa of the iliopsoas

177
Q

____ extends from the anterior inferior iliac spine and acetabular rim to the intertrochanteric line anteriorly. It is taut in extension and prevents hyperextension of the hip in standing

A

Iliofemoral ligament / Y-ligament

178
Q

____ extends from the cetabulum posteriorly and spirals superior-laterally to the neck of the femur and greater trochanter. It helps prevent hyperextension. and becomes taut in medial rotation and extension (it is superior and posterior to the Y-ligament)

A

Ischiofemoral ligament

179
Q

_____ extends from the pubic part of the acetabulum and superior ramus to the lower part of the intertrochanteric line. It is taut in extension and abduction and helps prevent excessive abduction, but also prevents excessive extension

A

Pubofemoral ligament

180
Q

____ are capsualr fibers that encircle the neck of the femur

A

Zona orbicularis

181
Q

What are the 2 extensions of the hip joint synovial capsule that serve as bursae?

A
  • Anterioly: the opening creates a bursa under the tendon of the iliapsoas
  • Posterioly: the opening in the capsule creates a bursa for the tendon of obturator externus muscle
182
Q

What supplies blood to the hip joint?

A
  • Medial and lateral femoral circumflex arteries

- Artery to the head of the femur

183
Q

What innervates the hip joint?

A
  • Anterioly: femoral nerve
  • Medially: obturator nerve
  • Posterioly: superior gluteal nerve
  • Posterioly and inferiorly: nerve to quadratus femoris
184
Q

Where does the artery to the head of the femur come from and what does it line up with?

A

Comes from the obtuator artery via the acetabular branch and lines up with the fovea capitis

185
Q

____ branch of the obturator artery passes underneath the transverse acetabulum ligament and winds its way through the ligament of the head of the femur

A

Acetabular branch

186
Q

What is the deep socket and the small ball of the hip joint?

A

Acetabulum is the deep socket and the Femoral head is the small ball

187
Q

____ joint is the largest synovial joint in the body and is of the hinge variety, with a small amount of rotation. It allows flexion and extension. It is the most frequently injured joint

A

The knee joint

188
Q

The knee joint is the articulation between the __ and ___ condyles. The articular surface of the ___is larger than the surface of the ___. Therefore sliding must occur for them to maintain contact with one another

A

The knee joint is the articulation between the femoral and tibial condyles. The articular surface of the femur is larger than the surface of the tibia. Therefore sliding must occur for them to maintain contact with one another

189
Q

What are the external (extracapsular: outside of the joint capsule) ligaments of the knee joint?

A
  • Patellar ligament
  • Fibular (lateral) collateral ligament
  • Tibial (medial) collateral ligament
190
Q

____ is a continuation of the quadriceps tendon. It strengthens the anterior capsule of the knee

A

The patellar ligament

191
Q

____ extends from the lateral epicondyle of the femur to the lateral surface of the head of the fibula. It is only partially fused with the capsule on the superior end to allow structures pass underneath it and it strengthens the lateral capsule. It is a narrow and rounded ligament

A

Fibular (lateral) collateral ligament

192
Q

____ extends from the medial epicondyle of the femur to the medial surface of the tibia. It strengthens the fibrous capsule and is completely intrinsic, meaning that it blends in with the fibrous capsule. It is a broad and flat ligament

A

Tibial (medial) collateral ligament

193
Q

The ___ condlye is taller than the ___ condyle

A

The lateral femur condyle is taller than the medial tibial condyle

194
Q

What is the location of the ACL and the PCL

A

In the midjoint space.

  • Intercapsular: inside the joint
  • Extrasynovial: outside the synovium
195
Q

What do you use to test the ACL integrity and how is it done?

A

That anterior drawer test.

  • Place thumbs on each side of the tendon
  • Pull the proximal head of the tibia anteriorly
  • If there is an excessive translation of the tibia(hard/firm end feel), then the ACL has an injury
196
Q

What is a sag/lag sign?

A

When there is an excessive anterior glide, due to a lax PCL and fallen tibia

197
Q

What do you use to test the PCL integrity and how is it done?

A
  • Posterior drawer test.

- Same as the anterior drawer test, but the proximal head of the tibia will be pushed posteriorly

198
Q

___ causes knee abduction and strain or a tear in the MCL. If enough force is applied along with or rotation, it can tear the ACL and damage the medial menincus

A

Valgus- producing force

199
Q

____ is a blow to the medial knee that causes excessive adduction and LCL strain/tear and in rare occasions a PCL tear

A

Varus- producing force

200
Q

____ strengthens the posterior capsule. It is a y-shaped ligament that inserts into the intercondylar area of the tibia and the posterior aspect fo the lateral epicondyle of the femur

A

Arcuate popliteal ligament

201
Q

____ is an expansion of the tendon of the semimembranosus muscle. It strengthens the posterior capsule

A

Oblique popliteal ligament

202
Q

____ capsular bursae is an extension of the synovial capsule between the femur and quadriceps tendon

A

Suprapatellar capsular bursae

203
Q

____ capsular bursae is the extension of the synovial capsule between the popliteus and lateral condyle of the tibia. If swollen, it results in a baker’s cyst or popliteal bursitis

A

Popliteus capsular bursae

204
Q

_____ capsular bursae is an extension of the synovial capsule between the medial head of the gastroc and femur. It is also the bursa over the lateral head of the gastroc

A

Gastrocnemius capsular bursa

205
Q

_____ capsular bursae is between the skin and the patella

A

Subcutaneous prepatellar

206
Q

_____ capsular bursa is between the skin and the tibial tuberosity

A

Subcutaneous infrapatellar capsular bursa

207
Q

____ capsular bursa is between the patellar ligament and the tibia

A

Deep infrapatellar capsular bursa

208
Q

What is a clergyman’s/housemaid’s knee?

A

Infrapatellar knee bursitis caused by kneeling and can be prevented with knee protection

209
Q

What are the two internal (intracapsular) extrasynovial ligaments?

A

ACL and PCL

210
Q

_____ arises from the anterior intercondylar area of the tibia and extends superiorly, posteriorly, and laterally to attach to the posterior part of the medial side of the lateral condyle of the femur. It prevents posterior displacement of the femur on the tibia and hyperextension of the knee joint

A

ACL

211
Q

____ arises from the posterior aspect of the intercondylar are of the tibia and passes superiorly and anteriorly on the medial side of the ACL to the anterior part of the lateral side of the medial condyle of the femur. It prevents anterior displacement of the femur on the tibia or posterior displacement of the tibia.

A

PCL

212
Q

____ is the main stabilizer of the flexed knee during gait

A

PCL

213
Q

What is a menisci and what is its function?

A

Two fibrocartilaginous discs that functions to deepen the shallow articular fossae of the tibia

214
Q

____ meniscus is C shaped, firmly attached to the tibial collateral ligament and is attached along the periphery of the tibial condyle by the coronary ligaments and to the joint capsule. It is also a site of common injury, because there is no freedom of movement during pinching down actions

A

Medial meniscus

215
Q

What are the characteristics of the lateral meniscus?

A
  • O shaped
  • Attached to the tibial condyles via the coronary ligament
  • Is separated away from the fibular collateral ligament by the tendon of popliteus muscle
216
Q

_____ is a strong tendinous extension of the lateral meniscus that attaches to the PCL and medial condyle of the tibia

A

Posterior meniscofemoral ligament

217
Q

The ___ third (pink zone) of each meniscus is well supplied with blood, while the ____ third (white zone) is not well supplied

A

The lateral third of each meniscus is well supplied with blood, while the medial third is not well supplied

218
Q

What is typically done if there is an injury in the medial 1/3 of the meniscus?

A

A meniscectomy

219
Q

What is typically done if there is an injury in the lateral 1/3 of the meniscus?

A

A meniscus repair

220
Q

What artery supplies blood to the knee joint?

A

Genicular branches from the popliteal artery and the posterior tibial artery

221
Q

What nerves innervate the knee joint?

A
  • Obturator
  • Femoral
  • Tibial
  • Common peroneal
222
Q

____ is a true extension = plantarflexion, because of the extensor padding for the lower extremity

A

Talocrural (ankle) joint

223
Q

____ joint is the articulation of the tibia and fibula with the talus. It is a synovial-hinge type joint that allows both dorsiflexion and plantarflexion. It is more stable in dorsiflexion than plantar flexion due to a wider talus bone anteriorly than posteriorly

A

Talocrural joint

224
Q

What are the 2 places that the tibia articulates with the talus?

A
  • Its inferior surface forms the roof of the malleolar(ankle) mortise, transferring the body’s weight to the talus.
  • Its medial malleolus articulates with the medial surface of the talus; fibula articulates with the lateral talus
225
Q

What does the extensor tone do?

A
  • Extends the hip
  • Extends the knee
  • Plantarflex foot
226
Q

What does the flexor withdrawal response do?

A
  • Flex the hip
  • Flex the knee
  • Dorsiflex the ankle
227
Q

What is the function of the wider part of the talus?

A

Dorsiflexion. It wedges to ankle mortice and stabilize it

228
Q

What is the function of the narrower posterior part of the talus?

A

Plantarflexion. Narrower posterior part of the talus is between the ankle mortice, looser/ more lateral play

229
Q

What two joints make up the transverse tarsal joint?

A

Talonavicular and calcaneocuboid joint

230
Q

What is a midfoot-lisfranc injury/fracture?

A

A fracture through the metatarsal joint

231
Q

What are the 3 ligaments that attach the lateral malleolus to the talus and calcaneus and are called the lateral collateral ligaments?

A
  • Anterior talofibular ligament
  • Posterior talofibular ligament
  • Calcaneofibular ligament
232
Q

____ runs from the lateral malleolus to the neck of the talus

A

Anterior talofibular ligament

233
Q

____ runs from the lateral malleolus to the lateral tubercle of the posterior process of the talus

A

Posterior talofibular ligament

234
Q

______ runs from the lateral malleolus to the lateral surface of the calcaneus

A

Calcaneofibular ligament

235
Q

_____ consists of four parts that attach the medial malleolus to the talus, calcaneous, and navicular

A

Medial collateral ligaments (deltoid)

236
Q

What are the parts of the medial collateral ligament (deltoid)

A
  • Tibionavicular ligament
  • Anterior tibiotalar ligament
  • Posterior tibiotalar ligament
  • Tibiocalcaneal ligament
237
Q

What are the muscles that supports the medial ankle?

A
  • Tibialis posterior
  • Flexor digitorum longus
  • Flexor hallucis longus
238
Q

What supplies blood to the ankle?

A

Malleolar branches of the fibular, and anterior and posterior tibial arteries

239
Q

What is the innervation of the ankle?

A

Tibial nerve and deep peroneal nerve(division of the common peroneal nerve)

240
Q

What are the structures that many joints of the foot involve?

A
  • Tarsals, metatarsals, and phalanges
241
Q

What are the important intertarsal joints and what do they allow?

A
  • Subtalar (talocalcaneal) joint.

They allow inversion and eversion of the foot. When combined with other joints, they allow pronation & supination, which allows for flexible, moldable platform for weight bearing, so it provides a good grip

242
Q

Other intertarsal joints, tarsometatarsal joints, and intermetatarsal joints are relatively ____ and are so tightly joined by ligaments that ____ movement occurs between them

A

Other intertarsal joints, tarsometatarsal joints, and intermetatarsal joints are relatively small and are so tightly joined by ligaments that *only slight” movement occurs between them

243
Q

A grade 1 lateral collateral ligament- inversion sprain is a tear to what ligament?

A

Anterior talofibular ligament tear

244
Q

A grade 2 lateral collateral ligament- inversion sprain is a tear to what ligament?

A

Anterior calcaneofibular ligament tear

245
Q

A grade 3 lateral collateral ligament- inversion sprain is a tear to what ligament?

A

Anterior talofibular ligament

  • Posterior talofibular ligament
  • Calcaneofibular ligament
246
Q

____ joint is the articulation of the talus and calcaneous, is synovial, and permits the inversion and eversion of the foot, allows the calcaneous to rock underneath the talus

A

The subtalar joint

247
Q

What are the two joints that the transverse/midtarsal joint consist of..?

A

Talocalcaneonavicular and calcaneocuboid joints

248
Q

What type of joint is the talocalcaneonavicular joint?

A

Synovial ball and socket joint

249
Q

What is the plantar calcaneonavicular ligament/spring ligament?

A

A subset of the talocalcaneonavicular joint, that is a band that extends from the sustentaculum tali to the posterior surface of the navicular bone

250
Q

____ plays an important role in maintaining the longitudinal arch of the foot?

A

The plantar calcaneonavicular ligament or spring ligament

251
Q

____ joint is a synovial joint that has a long plantar and short plantar component

A

Calcaneocuboid joint

252
Q

Characteristics of the long plantar ligament of the calcaneocuboid joint

A
  • Plantar surface of the calcaneous to the cuboid and second, third, and fourth metatarsal head
  • It forms a tunnel for passing tendons and helps support the longitudinal arch of the foot
253
Q

Characteristics of the short plantar ligament/ plantar calcaneocuboid ligament of the calcaneocuboid joint

A
  • Plantar surface of the calcaneours to the cuboid

- Assists with longitudinal arch an joint support

254
Q

The transverse tarsal joint is supported dorsally by the ___

A

By the bifurcated ligament and the dorsal talonavicular ligament

255
Q

What are the bifurcated ligament?

A
  • Calcaneocuboid

- Calcaneonavicular

256
Q

Flexion and extension of the foot occur in the…

A

In the forefoot at the metatarsaphalangeal and interphalangeal joints

257
Q

All bones of the foot proximal to the MTP joints are united by ___

A

United by dorsal and plantar ligaments

258
Q

The bones of the MTP and IP joints are united by…

A

By the lateral and medial collateral ligaments

259
Q

What is the blood supply of the foot/ joints in the foot

A

– Medial and Lateral Plantar Arteries – from posterior tibial artery

– Dorsalis pedis and arcuate arteries – from anterior tibial artery

260
Q

What provides the innervation of the foot/ joints in the foot

A

– Medial and lateral plantar nerves – from tibial nerve

– Medial and intermediate dorsal cutaneous nerves – from superficial peroneal nerve

– Deep peroneal nerve

Anatomy (9 decks)

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