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Extremities > Exam 4- > Flashcards

Exam 4- Flashcards

1
Q

What kind of joint is the hip joint?

A

Ball and socket synovial joint.

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2
Q

The hip joint acts as a connection between what and what?

A

Lower extremity and the pelvic girdle

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3
Q

What connects the pelvic girdle and the lower extremity together?

A

The hip joint

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4
Q

When standing how is the body weight transmitted?

A

Through the hips to the femoral head and neck

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5
Q

What part of the “hip” is the articular surface

A

Femoral head

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6
Q

The femoral head is covered in _____?

A

Hyaline cartilage

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7
Q

Fibrocartilagenous lip with an inferior defect in the rim segment- or acetabular notch

A

Acetabular rim

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8
Q

The weight bearing surface covered by articular cartilage

A

Lunate surface

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9
Q

The lip of fibrocartilage that increases the depth of the acetabulum- it allows the acetabulum to “grip” the femoral head.

A

Acetabular labrum

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10
Q

This structure bridges the acetabular notch

A

Acetabular ligament

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11
Q

The non-articular part of the acetabulum is formed by the?

A

Ischium

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12
Q

The articular surface of the acetabulum and femoral head are most congruent when?

A

When the hip is flexed at 90 degrees, abducted 5 degrees and laterally rotated 10 degrees. Called the quadruped position.

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13
Q

When the hips are flexed at 90 degrees, abducted 5 degrees and laterally rotated 10 degrees this position is called?

A

Quadruped position

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14
Q

Ligamentum teres is also called _____ and is relaxed during ______. It is of little importance in adults but supplies blood during ____.

A
  • Round ligament
  • adduction
  • development
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15
Q

The joint capsule is formed by strong loose external fibrous layer and internal ______

A

Synovial membrane

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16
Q

What part of the joint capsule attaches proximally on the hip bone, to the rim of acetabulum, and tranverse acetabular ligament?

A

External fibrous layer

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17
Q

Distally the external fibrous layer attaches to the ____ in the _______ and the root of the _______. It is not attached to the neck of the femur.

A
  • Femoral neck
  • introtrochanteric line
  • greater trochanter
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18
Q

Regarding the joint capsule- the synovial membrane forms a ______ for the ______(muscle)

A
  • Bursa
  • obturator externus
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19
Q

Deep fibers on the posterior side of the joint capsule wind in circularly around the femoral neck. This is called?

A

Obicular zone

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20
Q

This ligament is Y shaped and attaches from the AIIS and introchanteric line- IT IS THE STRONGEST LIGAMENT IN THE BODY!!!

A

ILIOFEMORAL LIGAMENT

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21
Q

What is the strongest ligament in the body?

A

Iliofemoral ligament

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22
Q

(Extension or flexion) tightens the spiral ligaments anf fibers, constricts the capsule and pulls the femoral head into the acetabulum. This limit (action?) to 10-20 degrees beyond vertical.

A

Extension- extension

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23
Q

This action unwinds the spiral ligaments of the obicular zone and allows increasing hip mobility- giving greater range of motion.

A

Flexion

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24
Q

These are thickened parts of the fibrous layer form ligaments which pass a spiral fashion from the pelvis to the femur.

A

Orbicular zone

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25
Q

This hip joint prevents hyperextension of the hip while standing.

A

Iliofemoral ligament

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26
Q

This ligament of the hip joint is anterior and superior.

A

Iliofemoral ligament

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27
Q

This ligament comes from the obturator crest and merges with the fibrous joint capsule and blends with the medial part of the iliofemoral ligament.

A

Pubofemoral ligament

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28
Q

This ligament tightens during extension and abduction of the hip and prevents hyperabduction of the hip joint.

A

Pubofemoral ligament

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29
Q

This hip ligament is the WEAKEST and comes from the ischial part of the acetabular rim and spirals to the neck of the femur- medial to the base of the greater trochanter.

A

Ischiofemoral ligament

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30
Q

Where is the weakest hip joint located?

A

Posteriorly- ischiofemoral ligament

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31
Q

Identify

A
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32
Q

The muscles and ligaments pull the femoral head ____ into the acetabulum.

A

Medially

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33
Q

Medial and lateral rotaters of the thigh function to do what?

A

Function to pull the femoral head into the acetabulum

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34
Q

Which are weaker rotators but have stronger ligaments?

A

Medial rotators - located anteriorly are weaker and have poor mechanical advantage but associated ligaments are stronger.

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35
Q

The lateral rotators of the hip located _______ are _____ with more mechanical advantage but associated ligaments are ______

A
  • Posteriorly
  • stronger
  • weaker
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36
Q

This membrane lines the fibrous joint capsule and intercapsular boney surfaces not lined by articular cartliage.

A

Synovial membrane

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37
Q

What structures are located in the synovial folds or retinacula?

A

Subsynovial retinacular arteries- medial and a few lateral circumflex artery branches- these supply the femoral head and neck- main blood supply

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38
Q

The synovial membrane protrudes beyond the free margin of the joint capsule on the posterior side of the femoral neck and forms?

A

Forms a bursa for the obturator externus muscle

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39
Q

What releases the hamstring muscles allowing thigh flexion until it reaches the anterior abdominal wall?

A

Knee flexion

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40
Q

Why is hip extension limited by the iliofemoral ligament?

A

Because the fibrous capsule of the joint including the iliofemoral is TAUT

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41
Q

Which is freer in hip movements? Abduction or adduction

A

Abduction is freer- it can reach 60 degrees with the thigh extended and increases when the thigh is flexed

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42
Q

Which is more powerful in hip movements? Lateral or medial rotation?

A

Lateral rotation is more powerful than medial rotation

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43
Q

What is the strongest hip flexor muscles?

A

Iliopsoas

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44
Q

What muscle conducts adduction and flexion with regards to hip movement?

A

Adduction and extension are done by the hamstring part of the adductor magnus

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45
Q

Which muscle performs abduction and medial rotation with regards to hip movement?

A

Anterior portion of the gluteus medius and minimus

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46
Q

Which muscle is the primary extensor of the hip?

A

Gluteus maximus particularly when extending the thigh from a flexed postion. After the leg is straight the hamstring become the primary extensions.

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47
Q

Once the leg is straight which muscle becomes the primary extensor?

A

Extending the thigh is gluteus max and straight leg is hamstrings

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48
Q

What is blood supply to the femoral neck?

A

Medial and lateral cirucumflex arteries which arise from profunda femoris- femoral artery

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49
Q

With regards to the blood supply of the femoral neck which artery is usually the major supplier?

A

Medial circumflex

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50
Q

The artery to the femoral head is a branch of the ?

A

Obturator artery

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51
Q

The artery to the femoral head is important ? When

A

Developmentally

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52
Q

Nerves that supply the femoral neck include? What law is followed?

A
  • Femoral nerve (anterior)
  • obturator nerve (inferior)
  • nerve to quadratus femoris (posterior)
  • superior gluteal nerve (superiorly)
  • sciatic- direct innervation

hiltons law

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53
Q

Dislocations most often occur?

A

When the hip is flexed and medially rotated (riding in a car- dashboard compression of the knee)

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54
Q

Which are more common dislocations- anterior or posterior?

A

Posterior dislocations are more common than anterior.

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55
Q

Which nerve is injured in association with posterior dislocations?

A

Sciatic nerve

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56
Q

This dislocation requires force to the hip in extension, abduction and lateral rotation- these injuries are accompanied by fractures of the acetabular margins and disruption of the acetabular labrum.

A

Anterior dislocation

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57
Q

This dislocation has the hip slightly flexed at the thigh and knee with medial rotation.

A

Posterior disclocation

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58
Q

This fracture is result of high energy trauma and a dislocation of the hip joint often accompanies this fracture.

A

Femoral head fracture

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59
Q

This fracture is adjacent to the femoral head in the neck between the head and the greater trochanter. These can damage the blood supply to the femoral head causing avascular necrosis.

A

Femoral neck fracture- also called neck of femur NOF- subcapital or intracapsular fracture.

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60
Q

What are the other names for the femoral neck fracture?

A
  • Neck of femur NOF
  • subcapital fracture
  • intracapsular fracture
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61
Q

This fracture denotes a break in the fracture line between the greater and lesser trochanter on the intertrochanteric line. It is the most common type of hip fracture.

A

Intertrochanteric fracture

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62
Q

This fracture involves the shaft of the femur immediately below the lesser trochanter and may extend down the shaft of the femur.

A

Subtrochateric fracture

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63
Q

Identify

A

Subcapital neck fracture

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64
Q

Identify

A

Intertrochanteric fracture- the most common

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65
Q

Identify

A

Subtrochanteric fracture

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66
Q

Identify

A

Transcervical neck fracture

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67
Q

Identify

A

Fracture of the greater trochanter- also avulsion

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68
Q

Identify

A

Fracture of the lesser trochanter

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69
Q

Identify elementary fracture

A

Posterior wall

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70
Q

Identify elementary fracture

A

Posterior column

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71
Q

Identify elementary fractures

A
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72
Q

Identify elementary fracture

A
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73
Q

Identify elementary fracture

A
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74
Q

Identify associated fractures

A

Posterior wall- posterior column

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75
Q

Identify associated fracture

A

Transverse posterior wall

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76
Q

Identify associated fracture

A
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77
Q

Identify associated fracture

A

Anterior with posterior hemi transvers

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78
Q

Identify associated fracture

A

Both columns

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79
Q
A
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80
Q

What type of joint is knee joint and what type of action does it provide?

A
  • Hinge joint
  • flexion and extension
  • accompanied by gliding and rolling in addition to rotation on vertical axis
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82
Q

Function of the knee is at risk when it is _____?

A

Hyperextended

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83
Q

These type of injuries are the most common cause of disabling injuries in football.

A

Hyperextended knee injury

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84
Q

The location of femorotibial articulation is?

A

Between lateral and medial femoral and tibial condyles

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85
Q

The location of femoropatellar articular surface is?

A

Between the patella and femur

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86
Q

This bone is NOT involved in the knee joint.

A

The fibula

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87
Q

How may articular surfaces does the knee have and what are they?

A
  • The knee has 3 articular surfaces
  • two femorotibial
  • one intermediate femoropatellar
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88
Q

The most important muscles in stabilizing the knee are?

A

Quadriceps femoris- especiallly the fibers of the vastus lateralis

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90
Q

How many bursas are in the knee? What are they?

A

Atleast 5 in the knee

  1. Medial head of gastroc and subtendinosus bursa
  2. Semimembranosus bursa
  3. Lateral head of gastroc and subtendinosus bursa
  4. Fibular collateral ligament bursa
  5. Biceps femoris tendon bursa
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91
Q

What tendons- ligaments- bones are attached to the fibrous capsule of the knee (anteriorly)

A

Quadriceps tendon- patella- and patellar ligament

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92
Q

What lines the internal aspects of the fibrous capsule and attaches to the sides of the patella and the edges of the cartilaginous menisci?

A

Synovial membrane

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93
Q

The knee cavity extends deep to _____ (muscle) as the _______ .

A
  • Vastus lateralis
  • suprapatellar bursae
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94
Q

Muscle fibers of vastus intermedius form the ______ muscle of the knee which attaches to the synovial membrane and retracts the bursa during knee extension

A

Articularis genu

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95
Q

The joint capsule of the knee is strengthened by 5 extracapsular ligaments- what are they?

A
  • Patellar
  • fibular collateral
  • tibial collateral
  • oblique popliteal
  • arcuate popliteal
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96
Q

This ligament is a part of the quadriceps tendon- connected to the tibial tuberosity- recieves aponeurotic expansions of vastus lateralis and medialis- important for maintaining the alignment of the patella.

The collateral ligaments are taut but become lax as the knee flexes allowing rotation of the knee.

A

Pateller ligament

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97
Q

This ligament extens from the lateral epicondyle of the femur to the lateral surface of the head of the fibula- the tendon of the popliteus passes under this ligament separating it from the lateral miniscus. This ligament splits the tendon of the biceps femoris.

A

Fibular (lateral) collateral ligament

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98
Q

This ligament extends from the medial epicondyle of the femur to the medial condyle and superior medial surface of the tibia. The deep fibers of this ligament are attached to the medial meniscus

A

Tibial (medial) collateral ligmanet

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99
Q

This ligament is an expansion of the tendon of semimembranosus that strengthens the joint capsule posteriorly. It arises from the medial tibial condyle and passes superolaterally to the central part of the posterior aspect of the joint capsule

A

Oblique popliteal ligament

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100
Q

This ligament strengthens the capsule posterolateral. It arises from the posterior aspect of the fibular head passes over the popliteal tendon and attaches to the posterior surface of the knee joint.

A

Arcuate popliteal ligament

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102
Q

These ligaments join the femur to the tibia crossing withing the joint but outside the articular cavity.

A

Cruciate ligaments

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103
Q

These ligaments cross each other obliquely

A

Cruciate ligaments

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104
Q

During medial rotation of the tibia on the femur this ligament winds around each other limiting the amount of medial rotation to 10 degrees.

A

Cruciate ligaments

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105
Q

With lateral rotation these ligaments unwind allowing 60 degrees of lateral rotation when the knee is flexed at 90 degrees

A

Cruciate ligaments

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106
Q

The cross over point of this ligament serves as an axis for?

A
  • cruciate ligament
  • axis for rotatory movements
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108
Q

What does the synovial membrane in the intercondylar region cover/ seperate?

A

Cover the cruciate ligaments and the infrapatellar fat pad seperating them for articular cavity.

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109
Q

The synovial membrane covering the cruciate ligaments creates ?

A

Median infrapatellar synovial fold

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110
Q

This fold is a vertical fold of synovial membrane creating a left and right femorotibial articular cavity.

A

Infrapaptellar synovial fold

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111
Q

The synovial joint of the knee can also be called?

A

Diarthrosis

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112
Q

What does the joint capsule include?

A

Includes synovial membrane and fibrous layer

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113
Q

Chart out internal iliac

A
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114
Q

Chart external iliac- femoral

A
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115
Q

What bursa is above the patella

A

Suprapetellar bursae

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116
Q

Which muscle fibers of vastus intermedius form the articular muscle of the knee which retracts the bursa during knee extension?

A

Articlaris genu

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117
Q

This ligament extends from the medial epciondyle of the femur to the medial condyle and superior medial surface of the tibia- the deep fibers of this ligament are attached to the medial meniscus.

A

Tibial collateral ligmanet (medial) TCL

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118
Q

This ligament is a reflected expansion of the tendon of semimenbranosus that strengthens the joint capsule posteriorly. It comes from the medial tibial condyle and passes superiolaterally to the central part of the posterior aspect of the joint capsule.

A

Oblique popliteal ligament- OPL

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119
Q

This ligament stengthens the capsule posterlateral. It comes from the posterior aspect of the fibular head and passes superomedially over the popliteal tendon and attaches to the posterior surface of the knee joint.

A

Arcuate popliteal ligament

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120
Q

Name the two cruciate ligaments- which is weaker- which is stronger?

A
  • The two cruciate ligaments are Anterior Cruciate Ligament ACL and Posterior Cruciate Ligament PCL
  • ACL is weaker than PCL
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121
Q

This ligament limits the posterior rolling of the femoral condyles on the tibial plateau during flexion conversting it to rotation. It also prevents posterior displacement of the femur on the tibia and hyperextension of the knee joint.

A

Anterior cruciate ligament ACL

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122
Q

When the knee joint is flexed at a right angle (90 degree) the tibia cannot be pulled anteriorly because it is being held by the ?

A

ACL- anterior cruciate ligament

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123
Q

This cruciate ligament limits the anterior rolling of the femur on the tibial plateau during extension, converting it to rotation. Also prevents anterior displacement of the femur on the tibia or posterior displacedment of the tibial on the femur- helps prevent hyperflexion of the knee

A

Posterior cruciate ligament PCL

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124
Q

In the weight bearing flexed knee the _____ is the main stabilizing factor for the femur.

A

PCL

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125
Q

The _____ is under tension when the knee is extended

A

ACL

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126
Q

The _____ is under tension when the knee is flexed.

A

PCL

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127
Q

These are cresent shaped plates of fibrocar. On the articular surface of the tibia that serve to deepen the joint surface and provide shock absorption.

A

Menisci of the knee

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128
Q

Where are menisci thickest? Where are they located or attached?

A

They are thicker at their outer margins and taper to thin inner margins. They are attached at their ends to the interconylar area of the tibia and external margins attached to the fibrous joint capsule.

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129
Q

These are capsular fibers that attach the margins of the menisci to the tibial condyles.

A

Coronary ligaments

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130
Q

This ligament joins the anterior margins of the menisci together.

A

Transverse (genicular) ligament

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131
Q

This meniscus is C-shaped- the anterior horn attached to the anterior intercodylar area anterior to the ACL attachment- the posterior end “ “ anterior to the attachment of the PCL

A

Medial meniscus

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132
Q

This meniscus is firmly adherent to the deep surface of the tibial collateral ligament

A

Medial meniscus

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133
Q

This meniscus is nearly circular, smaller and more mobile thant the medial meniscus.

A

Lateral meniscus

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134
Q

This muscle tendon separates the lateral meniscus from the fibular collateral ligament.

A

Popliteus tendon

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135
Q

The popliteus tendon separates the lateral meniscus from ?

A

Fibular collateral ligament

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136
Q

This ligament joins the lateral meniscus to the PCL and the medial femoral condyle

A

Meniscofemoral ligament

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137
Q

What does stability of the knee depend on?

A
  • Strength and action of surrounding muscles and tendons.
  • Ligaments connecting the femur and tibia
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138
Q

The subcutaneous prepatellar bursae and infrapatellar bursae are located ? What do they allow?

A
  • They are located at the convex surface of the joint allowing the skin to be able to move freely during knee movements.
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139
Q

What are the 4 busae that communicate with the articular cavity of the knee joint?

A
  • Suprapatellar bursa
  • popliteus bursa
  • anserine bursa
  • gastrocneius bursa
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141
Q

Identify

A
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142
Q

The fibrous layer of knee joint capsule has an opening posterior the the lateral tibial condyle to allow? Inferiorly how does the fibrous layer attach?

A
  • Popliteus tendon to pass out of the joint capsule and attach to the tibia
  • inferiorly the layer attaches to the margins of the articular surface of the tibia called the tibial plateau
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147
Q

What are the main movements of the knee- and “some” of this action?

A

Flexion and extension- and some rotation can occur when knee if flexed.

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155
Q

These ligaments are considered intra-articular ligmants

A
  • cruciate-
  • menisci,
  • popliteus tendon
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161
Q

what does the joint capsule in the knee consist of?

A
  • External fibrous layer
  • internal synovial membrane

that line the internal surfaces of the articular cavity not covered by articular cartilage

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191
Q

How many bursae are around the knee joint?

A

There are 12

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194
Q

The arteries around the knee are called?

A

Perigenicular anastomoses

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196
Q

Regarding the nerve supply to the knee- what law applies?

A

Hiltons law- the nerves supplying the muscles acting on the knee also innervate the joint.

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197
Q

Articular branches of the _____ nerve supply the anterior knee

A

Femoral nerve

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198
Q

Posterior knee innervation is supplied by?

A

Tibial nerve

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199
Q

This nerve supplies the lateral aspect of the knee?

A

The common fibular nerve

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200
Q

What other two nerves supply genicular articular branches?

A

Obturator and saphenous nerves

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202
Q

When the leg is ____ with the foot on the ground the knee passively ____ because of medial rotation of the femur on the tibia- this allows weight bearing without muscular exertion by the leg muscles.

A
  • Extended
  • locks
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203
Q

To “unlock” the knee the _____ (muscle) contracts rotating the femur laterally ____ degrees on the tibial platau allowing flexion to occur.

A
  • Popliteus
  • 5 degrees
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204
Q

This nerve is a part of the femoral nerve and runs through the adductor canal

A

Saphenous nerve

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205
Q

Identify

A
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206
Q

Superficial fibular nerve becomes?

A

Dorsal digital nerve

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207
Q

The dorsal lateral cutaneous nerve of foot is termination of?

A

Sural nerve

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208
Q

This nerve comes from the deep fibular nerve

A

Common proper- dorsal digital nerve

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209
Q

Superficial fibular nerve runs ____ to lateral comparment of the leg- it divides into ____ and _____ nerve.

A
  • Superficial
  • medial and intermediate dorsal cutaneous nerves
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210
Q

Superficial fibular nerve becomes the _______ and supplies (3 things)

A
  • Dorsal digital nerve
  • cutaneous- anterolateral leg- dorsum of the foot- dorsal digits
  • EXCEPT FOR LATERAL 1ST TOE AND MEDIAL 2ND TOE
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211
Q

What is the “exception” for the dorsal digitial nerve supply?

A

Does not supply lateral 1st toe or the medial 2nd toe

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212
Q

The deep fibular nerve supplies?

A
  • Cutaneous- supplies the lateral 1st and medial 2nd toe
  • motor- intrinsic muscles of the dorsum of the foot and tarsometatarsal joints.
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213
Q

The medial sural cutaneous nerve joins with the _____ from the common fibular nerve to form the _____ nerve.

A
  • Sural communicating branch
  • sural nerve
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214
Q

The sural nerve terminates as the lateral cutaneous nerve of the foot and supplies?

A
  • Cutaneous- lateral and posterior inferior 1/2 of the leg- lateral part of the foot
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217
Q

The medial plantar nerve supplies? Cutaneous and motor?

A
  • Cutaneous- medial sole of foot- plantar surface of medial 3 1/2 digits
  • motor- 1st lumbrical and flexor hallucis brevis
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218
Q

This nerve is the most posterior branch of the tibial nerve.

A

Lateral plantar nerve

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219
Q

This nerve runs under the abductor hallucis

A

Lateral plantar nerve

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220
Q

The lateral plantar nerve runs _______ between the ___ and ____ layers of the plantar muscles medial to the _______ artery. It then divides into ____ and ____ and the _______ branch dives deep between _____ and _____ plantar muscle layers.

A
  • Anteriorly
  • 1st and 2nd layers
  • plantar artery
  • superficial and deep branches
  • Deep branch
  • 3rd and 4th layer
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221
Q

The lateral plantar nerve supplies? Cutaneous? Motor?

A
  • Cutaneous- lateral sole of the foot- plantar surface of lateral 1 1/2 digits
  • motor- intrinsic foot muscles not done by the medial plantar nerve
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222
Q

Both ____ and ____ nerves supply calcaneal branches.

A

Sural and tibial nerves

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223
Q

Identify

A
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224
Q

These arteries are often the major source of blood supply to the forefoot

A

Dorsal arteries of the foot

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225
Q

This artery is a direct continuation of the anterior tibial artery.

A

Dorsalis pedis

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226
Q

This artery begins midway between the malleoli and runs anterio-,medially deep to the inferior extensor retinaculum

A

Dorsalis pedis- dorsal artery of the foot

227
Q

The dorsal pedis runs between the tendons of ________and ________to the _________ and then splits into the __________ and _________.

A
  • Extensor hallicus longus
  • extensor digitorum longus
  • 1st interosseous space
  • 1st dorsal metatarsal
  • deep plantar artery
228
Q

The deep plantar artery passes between the heads of the _____ and joins the lateral plantar artery to form the _______ arch.

A
  • 1st interosseous
  • deep plantar arch
229
Q

the dorsalis pedis begins midway between the _____ and runs anterio-medially deep to the _________. (structure)

A
  • Malleoli
  • inferior extensor retinaculum
230
Q

The dorsalis pedis runs between the _____ and _____ tendons to the _______ space and then splits into the _____ and ______ (artery)

A
  • Extensor hallicus longus
  • extensor digitorum longus
  • 1st dorsal metatarsal
  • deep plantar artery
231
Q

This artery is the MAJOR source of blood supply to the forefoot.

A

Dorsalis pedis

232
Q

The deep plantar artery comes from ?

A

Dorsalis pedis which comes from anterior tibial artery

233
Q

The deep plantar artery passes between the heads of the ______ and joins the ______ artery to form the ______

A
  • Head of the 1st interosseous
  • lateral plantar artery
  • deep plantar arch
234
Q

This dorsal metatarsal artery splits to supply both sides of the great tow and medial 2nd toe.

A

1st dorsal metatarsal artery

235
Q

The lateral tarsal artery branch of the dorsal artery of the foot runs laterally beneath the _____ and comes together with other branches.

A

Extensor digitorum brevis

236
Q

The _______ crosses the bases of lateral 4 metatarsals under the extensor tendons to reach the lateral aspect of the _____.

A
  • Arcuate artery
  • forefoot
237
Q

The arcuate artery gives rise to ______,____ and ____ arteries, connected to the plantar metatarsal arteries through _____. Each _______ artery divides into _____ branches.

A
  • 2nd, 3rd and 4th dorsal metatarsal arteries
  • perforators
  • dorsal metatarsal
  • 2 dorsal digital branches
238
Q

The posterior tibial artery divides under the ______ forming terminal branches that pass under _____ (muscle) to form _____ and _____ arteries

A
  • Flexor retinaculum
  • abductor hallicus
  • medial and lateral plantar arteries
239
Q

The smaller of the 2 branches of the posterior tibial is?

A

Medial plantar artery

240
Q

What does the medial plantar artery supply? Muscles and cutaneous?

A
  • Muscles- muscles of the great toe- deep branches
  • cutaneous- skin on the medial sole and digital branches- superficial branches
241
Q

This artery is the larger of the 2 branches of the posterior tibial.

A

Lateral plantar artery

242
Q

The lateral plantar artery runs between the _____ and ______ . It arches medially across the foot with the deep branch of the ______ nerve. It forms the ______ with the _____ artery which comes from the dorsal artery of the foot.

A
  • Flexor digitorum brevis
  • quadratus plante
  • deep branch of the lateral plantar nerve
  • deep plantar arch
  • deep planter artery
243
Q

The deep plantar arch gives rise to ____ and _____ branches.

A
  • 4 plantar metatarsal arteries
  • 3 perforating branches
244
Q

The plantar metatarsal arteries provide______ arteries.

A

Plantar digital arteries

245
Q

These arteries provide most of the blood to the distal toes.

A

Plantar metatarsal arteries

246
Q

Identify

A
247
Q

Venous drainage comes from _____ and accompany arteries and are (named or not named) for these arteries.

A
  • Deep veins
  • named
248
Q

The superficial and deep lymphatic system converge and travel with _____ vein to ______ nodes and from there drain ____ to the _____ nodes.

A
  • Great saphenous vein
  • superficial inguinal nodes
  • centrally
  • deep inguinal nodes
249
Q

The venous drainage of the foot is done through the ?

A

Superficial venous system

250
Q

The superficial plantar venous network drains to the ______ forming the ______ vein which becomes the _______.

A
  • Medial part of the foot
  • medial marginal vein
  • great saphenous
251
Q

The lateral dorsal venous arch forms _____ vein which forms the ______.

A
  • Lateral marginal vein
  • small saphenous vein
261
Q

The medial plantar nerve which is a terminal branch of the tibial nerve runs between _____ and ______

A
  • Abductor hallicus
  • flexor digitorum brevis
262
Q

The medial plantar nerve runs over or under which retinaculum?

A

Runs under the flexor retinaculum

263
Q
A
264
Q

What portion of the foot distrubutes the weight?

A

The talas

265
Q

The foot is located _____ to the _____ joint.

A
  • Distal
  • talocrural joint
266
Q

This structure forms a platform for supporting the body and locomotion.

A

The foot

267
Q

How many/ what bones are included in the foot?

A
  • 7 tarsal bones
  • 5 metatarsal bones
  • 14 phalanges
268
Q

What are the 3 functional parts of the foot?

A
  • Hindfoot
  • midfoot
  • forefoot
269
Q

The ankle is a ?

A

Joint

270
Q

The skin on the dorsum of the foot is thicker or thinner?

A

Thinner

271
Q

Skin on the plantar surface of the foot is thicker or thinner>

A

Thicker- with fat in fibrous septa creating efficient shock absorbing pad especially over the heel

272
Q

The medial compartment of the sole is covered by ?

A

Medial plantar fascia

273
Q

The entral compartment of the sole is under or deep to what?

A

Plantar aponeurosis

274
Q

The lateral compartment of the foot is covered by?

A

Thin skin and subcutaneous tissue and plantar fascia

275
Q

Hindfoot includes (bones)

A

Talus and calcaneus

276
Q

The midfoot includes (bones)

A
  • Navicular
  • cuboid and 3 cuneiform
277
Q

Forefoot includes (bones)

A
  • Metatarsals
  • phalanges
278
Q

How is plantar aponeurosis formed?

A

Central thick fascia arises from calcaneous- forms 5 bands- becomes continuous with the digital sheaths- the aponeurosis crosses the head of metatarsals forming superficial transverse metatarsal ligament

279
Q

Superficial transverse metatarsal ligament is located ? And formed by?

A
  • Located at the heads of the metatarsal
  • formed by aponeurosis crossing the heads
280
Q

Compartments of the sole are created by

A

The mid and forefoot vertical intermuscular septa

281
Q

What and how many compartments are there in the sole?

A
  • 5 compartments
  • medial
  • central
  • lateral
  • interosseous
  • dorsal
282
Q

The medial compartment includes?

A
  • Abductor hallicus
  • flexor hallicus brevis
  • tendon of the flexor hallicus longus
  • medial plantar nerves and vessels
283
Q

The central compartment of the sole includes?

A
  • Flexor digitorum brevis
  • tendon of the flexor digitorum longus
  • quadratus plante
  • lumbricals
  • adductor hallicus
  • lateral plantar nerves and vessels
284
Q

The lateral compartment of the sole includes?

A
  • Abductor digiti minimi
  • flexor digiti minimi brevis
285
Q

The interosseous compartment of the sole is encased in?

A

Plantar and dorsal interossei fascia

286
Q

The lateral compartment of the foot includes what muscles?

A
  • Abductor digiti minimi
  • flexor digiti minimi brevis
287
Q

What is the interosseous compartment encased in?

A

It is encased in the plantar and dorsal interossei fascia

288
Q

What structures are included in the interosseous compartment?

A
  • Includes metatarsals- dorsal and plantar interosseous muscles- deep plantar and metatarsal vessels
289
Q

Where is the dorsal compartment located?

A

Located between the dorsal fascia and tarsal and metatarsal bones.

290
Q

The dorsal compartment includes?

A
  • Extensor hallucis brevis
  • extensor digitorum brevis
  • dorsal neurovascular structures
291
Q

How many arches of the foot are there?

A
  • 3- arches
  • two longitudinal and one tranvsers
294
Q

How many layers are there of plantar muscles?

A

There are 4 layers of plantar muscles

295
Q

These types of muscles support the body weight while maintaining the arches of the foot.

A

Plantar muscles

296
Q

These muscles are most active in fixing the foot and or increasing the pressure applied to the ground by various aspects of the sole or order to maintain balance

A

Plantar muscles

297
Q

These muscles refine the efforts of the long muscles producing eversion/inversion and flexion/extension to create a stability for the lower extremity.

A

Plantar muscles

298
Q

What are the muscles in the 1st layer?

A
  • Abductor hallicus
  • flexor digitorum brevis
  • abductor digiti minimi
299
Q

1st layer- abductor hallicus- innervation and action

A
  • Innervation- medial plantar nerve
  • action- abducts and flexes 1st digit
300
Q

1st layer- flexor digitorum brevis innervation - action

A
  • Innervation- medial plantat nerve
  • actions- flexes digits 2-5
301
Q

1st layer- abductor digiti minimi- innervation - action

A
  • Lateral plantar nerve
  • abducts and flexes the 5th digit
302
Q

Layer 2- quadratus plantae innervation- action

A
  • Lateral plantar nerve
  • assists FDL in flexing lateral 4 digits
303
Q

Layer 2- lumbricals- innervation- action

A
  • Medial one- medial plantar nerve and lateral 3 lateral plantar nerve
  • action- flex proximal phalanges, extend middle and distal phalanges of lateral 4 digits
304
Q

Layer 3- flexor hallicus brevis- action- innervation

A
  • Innervation- medial plantar nerve
  • action flexes proximal 1st phalanx
305
Q

Layer 3- adductor hallicus- innervation- action

A
  • innervation- deep branch of lateral plantar nerve

action- adduct 1st digit, assists in transverse arch of foot

306
Q

Layer 3- flexor digiti minimi brevis- action- innervation

A
  • Innervation- Superficial branch of lateral plantar nerve
  • action- flexes proximal phalanx of 5th digit
307
Q

Layer 4- plantar interossei- innervation- action

A
  • Innervation- lateral plantar nerve
  • action- adducts 2-4 digits and flexes MTP joints
308
Q

Layer 4- dorsal interossei- innervation- action

A
  • Innervation- lateral plantar nerve
  • action- abduct digits 2-4 and flex MPT joints
309
Q

Insertion of the interossei muscles into the dorsal expansion hoods allow the digits to (action)

A

Flex the MTP joints and extend the IP joints

311
Q

Where are the superficial neurovascular planes located?

A
  • Superficial layer between the 1st and 2nd layers
312
Q

Where is the deep neurovascular plane located?

A

Deep between the 3rd and 4th layers

313
Q

The tibial nerve divides posterior to the medial malleolus into the?

A
  • Medial plantar nerve
  • lateral plantar nerve
314
Q

The medial and lateral plantar nerve supplies?

A

Supplies the intrinsic muscles of the plantar aspect of the foot

315
Q

What is plantar faasciitis?

A

Inflammation and strain of the plantar aponeurosis

318
Q

Plantar fasciitis is tender to palpation at the ______ tubercle of the _____ (bone) and the medial surface of the _____ (bones)

A
  • Medial tubercel
  • calcaneous
  • calcaneous
332
Q

An actual arch support makes the muscles (stronger or weaker) ?

A

Weaker

333
Q
A
350
Q

How many neurovascular planes are in the foot?

A

There are 2 found between the layers of plantar muscles.

356
Q

Pain is located on the plantar surface of the heel and medial foot.

A

Plantar fasciitis

357
Q

Tender to palpation at the medial tubercle of the calcaneus and medial surface of the calcaneous- pain increase with passive extension of great tow and dorsiflexion of the ankle

A

Plantar fasciitis

359
Q
A
360
Q

This bone is the “weight” bearing bone of the leg.

A

Tibia

361
Q

The tibia forms the ____ malleolus of the ankle joint.

A

Medial malleolus

362
Q

This bone is “non-weight bearing bone” and provides muscular attachment.

A

Fibula

363
Q

The fibula forms the ____ malleolus of the ankle joint.

A

Lateral malleolus

364
Q

This structure joins the tibia and fibula and has no significant role in force transmission.

A

Interosseous membrane

365
Q

Anterolateral tibial tubercle is also called?

A

Gerdy tubercle

366
Q

Identify

A

Opening for anterior tibial vessels

367
Q

The leg is divided into how many compartments?

A

3 compartments- anterior, lateral and posterior

368
Q

The leg compartments are divided by what structures?

A
  • Anterior and posterior intermuscular septa
  • interosseous membrane
370
Q

This compartment lies between the tibia and the fibula- anterior to the interosseous membrane.

A

Anterior compartment- flexor compartment

374
Q

These nerves are not in the same compartment as the fibular vessels.

A

Fibular nerves - superficial and deep

375
Q

List all the major nerves of the leg?

A
  • Sciatic
  • common fibular
  • superficial fibular (lateral compartment)
  • deep fibular (anterior compartment
  • tibial (posterior compartment)
376
Q

All the nerves of the leg come from which nerve?

A

The sciatic

377
Q

From the sciatic comes which two nerves?

A
  • Common fibular
  • tibial nerve
378
Q

What compartment is innervated by the superficial fibular?

A

Lateral compartment

379
Q

What compartment is innervated by the deep fibular?

A

Anterior compartment

380
Q

What compartment is innervated by the tibial nerve?

A

Posterior compartment

381
Q

Which nerve innervates the lateral compartment?

A

Superficial fibular

382
Q

Which nerve innervated the anterior compartment

A

Deep fibular nerve

383
Q

Which nerve of the leg innervates the posterior compartment?

A

Tibial nerve

384
Q

Identify

A
385
Q

Thickened fascia at the ankle is a structure called?

A

Anterior retinaculum

386
Q

Anterior retianculum includes ?

A
  • Superior extensor retinaculum
  • inferior extensor retinaculum
387
Q
  • This retinaculum moves from the fibula to the tibia before (proximal) to the malleoli
A

Superior extensor retinaculum

388
Q

This retinaculum is Y shaped deep fascia band at the ankle

A

Inferior estensor retinaculum

389
Q

Where does the inferior extensor retinaculum extend from and to?

A

The inferior extensor retinaculum extends from the anterior superior calcaneous TO the tibial malleolus and plantar aponeurosis.

390
Q

Which tendons are encompassed by the anterior retinaculum?

A
  • Fibularis tertius
  • extensor digitorum longus
  • extensor hallicus longus
  • tibialis anterior tendon
391
Q

What is another name for anterior retinaculum?

A

Extensor retinaculum

397
Q

What are the muscles/dorsiflexors of the anterior compartment?

A
  • Tibialis anterior
  • extensor digitorum longus
  • extensor hallucis longus
  • fibularis tertius
398
Q

What action helps in prevention of catching the toes when walking?

A

Dorsiflexion

399
Q

The anterior compartment of the leg has what kind of muscles?

A

Flexor compartment- dorsiflexors of the ankle and extensor of the toes

400
Q

Draw bone to show origin, insertion of tibialis anterior

A
  • Origin- lateral condyle
  • insertion- medial cuneiform bone/ base of the 1st metatarsal
401
Q

Action of tibialis anterior is?

A
  • Dorsiflexes the foot at the ankle
  • inversion of the foot
402
Q

Innervation of the tibialis anterior is?

A

Deep fibular nerve

403
Q

This muscle is the largest muscle of the anterior compartment

A

Tibialis anterior

404
Q

This muscle is the strongest dorsiflexor of the foot

A

Tibialis anterior

405
Q

This muscle of the leg is antagonized by the tibialis posterior except when they work synergistically in foot inversion.

A

Tibialis anterior

407
Q

Tibialis anterior is the strongest dorsiflexor of the foot except when?

A

When tibialis posterior is working synergistically in foot inversion

408
Q

The origin and insertion of extensor digitorum longus is?

A
  • Origin- lateral condyle- anterior surface of fibula- upper interosseous membrane
  • insertion- extensor expansion- medial and lateral slips to distal phalanx- central slip to middle phalanx
409
Q

The action of extensor digitorum longus is?

A
  • Extends lateral 4 toes (toes 5, 4, 3, and 2)
  • dorsiflexes the foot
410
Q

The nerve that innervates extensor digitorum longus is?

A

Deep fibular nerve

411
Q

Which muscle is the MOST lateral muscle of the anterior compartment?

A

Extensor digitorum longus

412
Q

This muscle is tucked between tibialis anterior and extensor digitorum longus

A

Extensor hallucis longus

413
Q

Origin and insertion of extensor hallucis longus

A
  • Origin- anterior middle portion of fibula and the interosseous membrane
  • insertion- distal phalanx of digit 1
414
Q

The action of extensor hallucis longus?

A
  • Extends digit 1 (big toe) which main function
  • dorsiflexes the foot
415
Q

The nerve that innervates the extensor hallucis longus is?

A

Deep fibular nerve

416
Q

The artery that supplies blood for the extensor hallucis longus is?

A

Anterior tibial artery

417
Q

This muscle is covered by Extensor digitorum longus and tibialis anterior.

A

Extensor hallucis longus

418
Q

Origin and insertion of fibularis tertius?

A
  • Origin- anterior inferior 1/3 of fibula- interosseous membrane
  • insertion- base of 5th metatarsal
419
Q

Action of fibularis tertius

A
  • EVERSION of foot
  • dorsiflexes foot
420
Q

Innervation of fibularis terius?

A

Deep fibular nerve

421
Q

The fibularis tertius usually is a part of and runs with this muscle?

A

Extensor digitorum longus

422
Q

Fibularis tertius is a stronger evertery or dorsiflexor?

A

Stronger everter (look ar the location)

423
Q

This muscle plays a role in protecting the anterior talofibular ligament.

A

Fibularis tertius

424
Q

The anterior compartment is enclosed by what type of fascia- a continuation of what?

A

Deep fascia of the leg a continuation of fascia of the thigh

425
Q

This nerve is a terminal branch of the common fibular.

A

Deep fibular nerve

426
Q

List the muscles innervated by the deep fibular nerve. (4)

A
  • Tibialis anterior
  • extensor hallucis longus
  • extensor digitorum longus
  • fibularis terius
  • extensor digitorum brevis
427
Q

List the muscles innervated by the superficial fibular nerve

A
  • Fibularis longus
  • fibularis brevis
428
Q

This nerve arises between the fibularis longus muscle and the fibular neck.

A

Deep fibular nerve

429
Q

The deep fibular nerve joins (artery) between the (2 muscles) and supplies all of the anterior compartment structures.

A
  • Anterior tibial artery
  • tibialis anterior and extensor digitorum longus
430
Q

This nerve arises between the fibularis longus muscle and the fibular neck. It joins with the anterior tibial artery between the tibularis anterior and extensor digitorum longus and supplies all anterior compartment structures.

A

Deep fibular nerve

431
Q

The anterior tibial artery begins at the _________ border of the ______ muscle. It passes anterior to the _______ and descends on the anterior surface of the membrane between the _____ and _____ with the _____. Distally it becomes the ______ artery of the foot and enters the 1st interosseous space and divides into the ____ and ____ arteries.

A
  • The anterior tibial artery begins at the inferior border of the popliteus muscle. It passes anterior to the interosseous membrane and descends on the anterior surface of the membrane between the tibialis anterior and extensor Hallicis longus with the deep fibular nerve. Distally it becomes the dorsal artery of the foot and enters the 1st interosseous space and divides into the plantar and arcuate arteries.
432
Q

Describe the anterior artery route down to the foot.

A

The anterior tibial artery begins at the inferior border of the popliteus muscle. It passes anterior to the interosseous membrane and descends on the anterior surface of the membrane between the tibialis anterior and extensor digitorum longus with the deep fibular nerve. Distally it becomes the dorsal artery of the foot and enters the 1st interosseous space and divides into the plantar and arcuate arteries.

433
Q

The deep fascia that the anterior compartment is enclosed by is denser or thinner superiorly?

A

Densor superiorly

434
Q

What is the location of the lateral compartment of the leg?

A
  • Lateral surface of the fibula and anterior and posterior intermuscular septa with deep fascia of the leg.
435
Q

The nerve that runs through the lateral compartment of the leg is?

A

Superficial fibular nerve

436
Q

What are the muscles that are in the lateral compartment?

A
  • Fibularis longus
  • fibularis brevis
437
Q

The lateral compartment ends at what location of the leg?

A

The lateral compartment ends at the superior fibular retinaculum. The compartment runs from the tip of the fibula to the calcaneus bone.

438
Q

Fibularis longus origin and insertion

A
  • Origin- head and upper 2/3 of fibula
  • insertion- medial cuneiform and 1st metatarsal
439
Q

Fibularis longus action?

A
  • Everts the foot- AB-ducts the foot
440
Q

Innervation of fibularis longus is?

A

Superificial fibular nerve

441
Q

What is unique about fibularis longus tendon insertion?

A

The long tendon wraps around the lateral side of the foot using the lateral malleolous as a sling or trochlea then it crosses the plantar surface (bottom of foot) and inserts on medial cumeform and metartarsal 1.

442
Q

This structure forms a trochlea or sling for tendon of fibularis longus.

A

Lateral malleolus forms a trochlea or sling.

443
Q

Origin and insertion of fibularis brevis

A
  • Origin- distal 2/3 of lateral fibula
  • insertion- base of metatarsal 5
444
Q

The action of fibularis brevis?

A
  • Everts the foot- AB-ducts the foot
445
Q

Innervation of fibularis brevis

A

Superficial fibular nerve

446
Q

What is the unique path that the fibularis brevis tendon takes?

A

The tendon descends deep to the fibularis longus, passes behind the lateral malleolus and runs forward to insert on jthe lateral tuberosity of the base of the 5th metatarsal.

447
Q

Whose tendon descends deep to the fibularis longus?

A

Fibularis brevis

448
Q

This tendon passes BEHIND the lateral malleolus and inserts on the lateral tuberosity of the 5th metatarsal.

A

Tendon of fibularis brevis

449
Q

The small size of the anterior compartment and its tight fascia borders gives increase risk for what?

A

Compartment syndrome

450
Q

Identify

A
  • Blue- fibularis longus
  • yellow- fibularis brevis
  • orange- extensor digitorum longus
  • red- extensor hallucis longus
  • green- tibialis anterior
451
Q

The course of this nerve sweeping around the fibular head and neck puts it at risk for compression neuropathy by simply ______ while supine?

A
  • Common fibular nerve
  • crossing the legs
452
Q

Compression of this nerve in bedridden and concomitant indivisuals can cause paralysis of the anterior and lateral comparments of the leg

A

Fibular nerve compression

453
Q

Paralysis of the lateral and the anterior compartments of the leg due to compression of the fibular nerve can result in what kind of damage?

A

Can result in profound foot drop which can impair gait.

455
Q

If you were hit by a car- what nerve would be at risk of damage losing function in the anterior and lateral compartments not allowing dorsiflexion?

A

Common fibular nerve- sits on the lateral side same heigth as a bumper of a car.

456
Q

This compartment of the leg is 4x stronger than dorsiflexion and has much longer range of motion.

A

Plantar flexor compartment (posterior compartment)

457
Q

The posterior compartment of the leg is a superficial and deep compartment seperated by what?

A

Seperated by the tranvers muscular septum.

458
Q

Where does the transverse muscular septum extend?

A

Between the medial malleolus and calcaneous

459
Q

Both posterior compartments are supplied by what vessels? Su

A

Supplied by the tibial nerve and posterior tibial vessels

460
Q

The “superficial postertior compartment” includes what muscles?

A
  • Gastrocnemius
  • soleus
  • plantaris
461
Q

Which leg compartment works together to elevate the heel?

A

Superficial posterior compartment

463
Q

Gastrocnemius origin and insertion

A
  • Origin- 2 heads- lateral- lateral condyle of femur/ medial head- medial condyle of femur
  • insertion- posterior calcaneal bone via calcaneal tendon
464
Q

Gastroc action

A

Pllantar flexes foot (dorsal extension) - flexes leg

465
Q

Gastroc innervation is?

A

Tibial nerve

467
Q

Soleus is under _______ and together they form the calcanial _____ which elevates the heel.

A
  • Gastroc
  • calcanial tendon
468
Q

Write out gastrocnemius origin- insertion- action and innervation.

A
473
Q

Soleus origin and insertion?

A
  • Origin- posterior head of fibula/ soleal line of tibia
  • insertion- posterior calcaneal tendon/bone
474
Q

Soleus action-

A
  • Plantar flexes the foot
  • helps maintain posture
  • active when standing quietly- keeps balance
475
Q

Soleus innervation

A

Tibial nerve

476
Q

Blood supply for soleus muscle

A

Posterior tibial

479
Q

This muscle is the WORKHORSE of plantarflexion. It is able to plantarflex even with the knee fully extended.

A

Soleus

480
Q

When the foot is planted which direction does the soleal fibers pull the leg bones.?

A

Posteriorly due to the posterior and inferomedial direction of the soleal fibers-

481
Q

The soleus leg bone pull counteracts the pull of?

A

Center of gravity as it passes anterior to the leg bone axis

484
Q

Where does the calcaneal tendon insert? What is another name for the calcaneal tendon?

A
  • Inserts on the calcaneal tuberosity
  • achilles tendon
485
Q

Where does the achilles tendon rupture usually occur?

A

A couple of inches above the joining of the tendon and calcaneous

488
Q

Plantaris origin and insertion

A
  • Origin- lateral supracondylar line of femur
  • insertion- calcaneus bone and sometimes fuses with the calcaneal tendon
490
Q

Innervation of plantaris

A

Tibial nerve

492
Q

This muscle of the leg is absent in 10 % of the population.

A

Plantaris

493
Q

This muscle has a high density of propioceptive fibers and may simply be a kinesthetic sensory organ.

A

Plantaris

494
Q

The tendon of this muscle runs between gastroc and soleus.

A

Plantaris

495
Q

This tendon of this muscle is often mistake as a nerve

A

Plantaris

496
Q

List TOM DICK ANd HARRY muscles- tendons

A
  • Tibialis posterior
  • flexor digitorum longus tendon
  • A- artery
  • N- nerve (d is nothing)
  • Flexor hallucis longus
497
Q

Where is the subcutaneous calcaneal burse located in the foot?

A

Between the skin and calcaneal tendon

498
Q

Where is the DEEP bursa of the calcaneal tendon located on the foot?

A

Located between the tendon and calcanius

499
Q

Other names for calcaneal bursa and deep calcaneal bursa.

A
  • Retroachilles bursa
  • retrocalcaneal bursa
500
Q

The deep posterior compartment has how many muscles and what are they?

A
  • 4 muscles
  • popliteus
  • flexor digitorum longus
  • flexor hallicus longus
  • tibialis posterior
502
Q

Popliteus origin and insertion

A
  • Origin- lateral condyle of femur/ tendinous attachment to lateral meniscus
  • insertion- posterior tibia- above the soleal line
503
Q

Action of popliteus

A
  • Minimal flexion of the knee
  • medial rotates the leg
  • may pull lateral meniscus posteriorly during knee flexion
  • unlocks the knee- bent knee activates other muscles.
504
Q

What is the nerve and blood supply for the deep posterior compartment?

A
  • Nerve is tibial nerve
  • blood supply- fibular artery and posterior tibial
505
Q

This muscle forms the distal part of the floor of the popliteal fossa

A

Popliteus

506
Q

Flexor hallucis longus origin and insertion

A
  • Origin- inferior 2/3rds of posterior fibula/ inferior interosseous membrane
  • insertion- base of distal phalanx, and digit 1
507
Q

Action of flexor hallicus longus is?

A
  • Flexes digit 1
  • plantar flexes the foot
  • inverts the foot
509
Q

The tendon of flexor hallucis longus enters the foot with what other tendons?

A
  • Tendons of flexor digitorum longus and tibialis posterior
510
Q

The tendon of flexor hallucis longus passes (anterior or posterior) to the tibia to a groove on the talar shelf?

A

Posterior

511
Q

Flexor digitorum longus origin- insertion

A
  • Origin- middle portion of posterior tibia- inferior to soleal line/ fascia of tibialis posterior muscle
  • insertion- distal phalanges of digits 2-5
512
Q

Action of flexor digitorum longus?

A
  • Flexes digit 2-5 (grips the ground) during walking
  • Plantar flexes the foot
  • inverts the foot
  • helps support longitunial arches
514
Q

Along with FHL and TP tendons the FDL tendon passes (anteriorly or posteriorly) to the medial malleolus passing deep to the flexor retinaculum.

A

Posteriorly

515
Q

The diagonal pull of flexor digitorum longus is reduced by ______ (muscle) that is attached to the posterior aspect of the flexor digitorum longus tendons.

A

Quadratus plantae

516
Q

Tibialis posterior origin and insertion

A
  • Origin- posterior tibia- below soleal line/ posterior interosseous membrane
  • insertion- navicular bone- cuneiform I- base of metatarsal 2-4 (not 5)
517
Q

Tibialis posterior action

A
  • Plantar flexes foot
  • inverts the foot
  • adducts the foot
  • maintains medial longitudinal arch during weight bearing
518
Q

Identify- show acronym

A
519
Q

The posterior tibial artery is a branch of the _______. It passes between the ____ and _____ compartments under the _______ (structure). At medial malleolus it divides into ______ and ______ arteries and runs with the ______ nerve.

A
  • Popliteal artery
  • deep and superficial posterior compartments
  • transvers intermuscular septum
  • medial and lateral plantar arteries
  • tibial nerve
520
Q

List the branches of the tibial artery as it travels down to the foot.

A
  • Fibular
  • communicating branches
  • posterior medial mallleolar
  • medial cancaneal- medial plantar- lateral plantar
521
Q

This artery descends boliquiely toward the fibula and moves to the medial side of the fibula usually within the flexor hallicus longus.

A

Fibular artery

522
Q

This artery is the nutrient artery of the fibula- lateral malleolus and lateral calcaneal branches.

A

Fibular artery

523
Q

These branches of the fibular artery pierce the interosseous membrane and pass to the dorsum of the foot.

A

Perforating branches of the fibular artery

524
Q

Where does the nutrient artery of the tibia originate from?

A

From the anterior or posterior tibial artery

525
Q

The sural nerve comes from ?

A

Common fibular and tibial nerve

526
Q

Peroneal retinaculum covers structures that pass posterior to the ?

A
  • Lateral malelous
527
Q

The flexor retinaculum covers structures that pass posterior to the ?

A

Medial maleolus

528
Q

Extensor retinaculum or anterior retinaculum includes ?

A

A superior and inferior band

529
Q

Regarding the anterior compartment muscles of the leg: dorsiflexion has how much power of plantar flexion?

A

25%

530
Q

This ACT is the main function of clearing the toes during swing phase of normal gait and forefoot touch-down after heel strike.

A

Dorsiflexion

531
Q

What is dorsiflexion?

A

The main function of clearing the toes during swing phase of normal gait and forefoot touch-down after heel strike.

532
Q

The swing phase of normal gait is called?

A

Concentric

533
Q

The forefoot touch-down after heel strike is called?

A

Eccentric

536
Q
A
543
Q

Tibialis anterior is the largest muscle of what compartment?

A

The anterior compartment

561
Q

What is the most commonly injured ligament with a sprained ankle?

A

Talofibular ligament

570
Q

The lateral compartment of the leg houses what kind of muscles?

A

It is the everter and abduction compartment

586
Q

What is the main role of fibularis brevis in “ambulation” (walking)

A

To balance the tendency toward foot inversion.

591
Q

What exposure can put the common fibular at risk of injury or permenant damage?

A

Lateral exposure

599
Q

The superficial posterior comparment generates ______ of the plantarflexion of the ankle joint.

A

93%

603
Q

Origin and insertion of soleus

A
  • Origin- posterior head of fibula- and soleal line of tibia
606
Q

There are two actions that the gastroc CANNOT occur in the extreme simultaneously. What are they?

A
  • With the knee flexed- plantarflexion is minimized
  • when plantar flexed- knee flexion is impaired active insufficiency
607
Q

Regarding the gastroc. With the plantar flexed, the knee flexion is impaired- what is this impairment called?

A

Active insufficiency

608
Q

Inflammation often exacerbated by running or walking on uneven surfaces or hills is called?

A

Tendonitis of the calcaneal tendon

609
Q

The repetitive trauma of heel strike can result in rupture of ?

A

Calcaneal/ achilles tendon

614
Q

This muscle is active when standing quietly.

A

Soleus

615
Q

With which muscles does the soleus act cooperatively anatgonistically with and for what reason?

A

With dorsiflexors to maintain balance

619
Q

Triceps surae are in what region and consist of what muscles?

A
  • Sural region
  • gastroc and soleus
620
Q

How many head and tendons does triceps surae have?

A
  • 3 heads and 1 tendon- gastroc has 2 heads- and soleus 1 head- all combine into common calcaneal tendon.
623
Q

Why does rupture of achilles tendon occur and what action is prevented?

A

It occurs when muscle contracts or tightens the calf muscle and then suddenly pushes off the foot- as in basketball etc. injured person experiences pain, swelling and inability to stand on tiptoes.

624
Q

You would see more ruptures of the achilles in (men or woman) ?

A

Middle aged men- due to over or underuse of muscle

626
Q

The action of plantaris is?

A
  • Plantar flexes the foot (weak)
  • flexes the leg (weak)
628
Q

The tibial nerve and posterior tibial vessels pass (above or under) the plantaris muscle?

A

The vessels pass under

638
Q

Of the 4 deep compartment muscles which muscle is DEEP to the other 3?

A

Tibialis posterior

645
Q

Innervation of flexor hallucis longus is ?

A

Tibial nerve

650
Q

This muscle helps support the longitudinal arches.

A

Flexor digitorum longus

650
Q
A

Extremities (7 decks)

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