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Anatomy I Take II > Exam 4 (Weeks 7 and 8) > Flashcards

Exam 4 (Weeks 7 and 8) Flashcards

1
Q

what provides cutaneous innervation to the posterior thigh and popliteal fossa

A

the posterior femoral cutaneous nerve (S1-3)

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2
Q

what supplies cutaneous innervation to the posterior medial aspect of the thigh

A

the anterior femoral cutaneous (L2-3)

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3
Q

what supplies cutaneous innervation to the posterior superior lateral area of the thigh

A

the lateral femoris cutaneous (L2-3)

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4
Q

what supplies cutaneous innervation to the head of the fibula

A

common peroneal and the lateral rural cutaneous (L4-S2)

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5
Q

which part of the sciatic nerve is more medial

A

the tibial portion

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6
Q

does the popliteal artery run anteriorly or posteriorly to the popliteus muscle

A

posteriorly.

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7
Q

Biceps Femoris OINA

A

O: Long head: ischial tuberosity
Short head: linea aspera
I: head of the fibula
N: LH: tibial N (because more medially placed)
SH: common peroneal N
A: to flex the knee (both) and extend the hip (just the long head)

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8
Q

where does the semitendinosis sit in relation to the semimembranosis

A

the semitendinosis sits on top of the semimembranosis

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9
Q

how can you tell the semimembranosis and the semitendinosis apart

A

the membranous is more muscular distally, and the tendinosis is more tendinous distally.

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10
Q

Semitendinosis OINA

A

O: ischial tuberosity
I: pes anserine (medial surface of the tibia, inferior to the condyle)
N: tibial portion of the sciatic
A: extend the hip and flex the knee and IR the leg

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11
Q

Semimembranosis OINA

A

O: ischial tuberosity
I: medial condyle of the tibia
N: tibial portion of the sciatic
A: extend the hip, flex the knee and IR leg

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12
Q

why does the posterior tibia have a pointed shape

A

because of the linea aspera

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13
Q

what goes through the holes in the adductor Magnus muscle

A

the profunda femoris artery branches

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14
Q

where does the femoral artery become the popliteal artery

A

at the adductor hiatus

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15
Q

what is the roof of the adductor canal (“sub sartorial canal”)

A

the sartorius

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16
Q

what nerve innervates the anterior compartment of the thigh

A

the femoral nerve

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17
Q

what arteries supply the anterior compartment of the thigh

A

the femoral artery and the profunda femoral artery

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18
Q

what are the boundaries of the popliteal fossa

A

the superior and lateral border: Biceps femoris
superior medial: semitendinosis and semimembranosis
interior lateral: lateral head GN
inferior medial: medial head GN

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19
Q

the popliteal fossa can be imagined as a baseball diamond. If there is a structure running from second base down to home, what would it be?
if there was a structure running from second to first base what would it be

A

from second to home, the tibial nerve

from second to first, the common peroneal nerve

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20
Q

what is the roof of the popliteal fossa, and what nerve and vein are found here?

A

the fascia lata is the roof, and here is where you have the branches of the posterior femoral cutaneous nerve and the lesser saphenous vein

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21
Q

what things make up the floor of the popliteal fossa

A

the popliteal surface of the femur, the capsule of the knee joint and the oblique popliteal ligament

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22
Q

what are the contents of the popliteal fossa (describe the location and or function of each of these structures)

A
  • the tibial nerve (medially and superficially)
  • the common peroneal nerve (which is the superior and lateral border)
  • the popliteal artery and vein (which are deep)
  • origins of the rural nerve (cutaneous nerve to the posterior leg and lateral aspect of the dorsum of the foot)
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23
Q

the popliteal artery is a continuation of the ____ artery. this changes at the _____.

A

femoral artery

changes at the adductor hiatus

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24
Q

as the popliteal artery passes through the fossa it changes at the inferior border. what kind of change is this

A

it divides here into the anterior tibial artery and the posterior tibial artery

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25
Q

what does the anterior tibial artery supply

A

the anterior compartment of the leg

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26
Q

what does the posterior tibial artery supply and give rise to

A

the posterior compartment and gives rise to the peroneal artery

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27
Q

what does the peroneal artery supply

A

the posterior and lateral compartment of the leg

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28
Q

the popliteal artery will give off branches at the superior and inferior parts of the fossa. these are the…

A

the superior and inferior genicular arteries (2 of each)

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29
Q

through what structure does the anterior tibial artery pass through

A

the interosseous membrane between the tibia and fibula

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30
Q

what do the genicular anastomoses do

A

they are branches of the popliteal artery that surround the knee and provide blood to the capsule and the patella and the surrounding bone.

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31
Q

knee surgeries go from the anterior or posterior

A

the anterior to not disrupt all of this blood flow

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32
Q

what happens to the sciatic nerve at the superior end of the fossa

A

it splits out of its sheath into two separate tibial and common peroneal nerves

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33
Q

what is the most superficial component of the fossa, just under the roof

A

the tibial nerve

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34
Q

which nerve/nerves gives off genicular branches to supply the knee joint

A

the tibial nerve and the common peroneal nerve

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35
Q

the tibial nerve will descend into the posterior compartment of the leg ___ to the musculature

A

posterior

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36
Q

the tibial nerve gives off what branch (which ultimately forms the what)

A

the medial sural cutaneous nerve (eventually helps to form the sural nerve)

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37
Q

the common peroneal nerve leaves the popliteal fossa how? (in relation to the GN and head of fibula)

A

it leaves traveling superficially to the lateral head of the GN, then around the head of the fibula

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38
Q

at the head of the fibula, what happens to the common peroneal nerve

A

the common peroneal nerve branches into a superficial peroneal nerve and a deep peroneal nerve

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39
Q

what do the superficial and deep peroneal nerves supply

A

the superficial supplies the lateral compartment of the leg (the fibulas longus and brevis) and the deep supplies the anterior compartment of the leg.

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40
Q

the articulation of the talus is on what surface of the tibia and fibula

A

the anterior side of the tibia, and the posterior side of the fibula

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41
Q

what bones are the medial and lateral malleoli on

A

the medial malleolus is on the tibia and the lateral is on the fibula

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42
Q

what is Gerry’s tubercle

A

on the anterolateral tibia surface

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43
Q

what line is on the back of the tibia and what is its purpose

A

the soleal line, for soleus

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44
Q

what are the medial and lateral tibial plateaus for

A

the menisci

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45
Q

what three things make the ankle mortis

A

the lateral and medial malleolus and the tibial pilon

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46
Q

sacrospinous ligament is ___ to the sacrotuberous ligament

A

anterior

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47
Q

what inserts at the ankle mortis? where is this wider, anterior or posterior? and, in what position is it more stable

A

the ankle mortis is where the talus inserts, and it is wider anteriorly, so the ankle is more stable in DF

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48
Q

on the lateral calcareous, there is a fibular/peroneal trochlea. what passes around here

A

the fibulas brevis above this and the fibulas longus below it

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49
Q

where does the Achilles attach

A

the calcaneal tuberosity

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50
Q

what bone has a tuberosity for the tibialis posterior

A

the navicular

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51
Q

what is the most common triad we see

A

the ACL, MCL and the medial meniscus

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52
Q

how does the FHL pass in relation to the sustentaculum tali

A

medially and inferiorly

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53
Q

what makes up the transverse tarsal joint

A

the talus and navicular and the calcareous and cuboid

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54
Q

what is the tarsometatarsal joint

A

the joint between the intermediate, medial and lateral cuneiform and cuboid with the bases of the metatarsals

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55
Q

if you were to get hit, where would it be to tear ACL

A

from the front

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56
Q

how do we tear the ACL

A

a planted foot, then we are forced into an extension force. Non-contact

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57
Q

what is the spring ligament

A

the plantar calcaneonavicular ligament

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58
Q

what does the plantar calcaneonavicular ligament connect, and form the inferior part of

A

forms the inferior part of the capsule of the talonavicular joint, and connects the calcareous to the navicular

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59
Q

the groove in the cuboid is for the

A

peroneus longus

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60
Q

what bones form the arch

A

the tarsal bones

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61
Q

MTP joints are the connection between the…

A

metatarsals and the phalanges

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62
Q

what divides the leg into 3 compartments

A

the crural fascia

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63
Q

the anterior inter-muscular septum divides into

A

the anterior and lateral compartments

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64
Q

the posterior inter-muscular septum divides into

A

the lateral and posterior compartments

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65
Q

th transverse crural septum

A

separates into a superficial and deep layer int he posterior part

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66
Q

the layers of these fascia compartments come from the

A

fascia lata

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67
Q

what is the nerve and artery supply of the anterior compartment of the leg

A

the anterior tibial artery and the deep peroneal nerve

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68
Q

what are the muscles of the anterior compartment of the leg

A

the tibialis anterior, EDL, EHL and the peroneus tertius

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69
Q

what is the most commonly injured ligament in a lateral ankle sprain

A

the talofibular ligament

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70
Q

PF and INV are the most common ankle sprain mechanism. T?F

A

True

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71
Q

Tibialis Anterior OINA

A

O: superior 2/3 of the lateral surface of the tibia
I: medial cuneiform and the base of the first metatarsal
N: the deep peroneal
A: DF and INV

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72
Q

EDL OINA

A

O: superior 2/3 fibula
I: middle and distal phalanx of the lateral 4 toes
N: deep peroneal
A: extend the lateral 4 toes and DF

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73
Q

EHL OINA

A

O: middle 1/3 of the fibula
I: base of the distal phalanx of the great toe
N: deep peroneal
A: extend the hallux and DF

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74
Q

Peroneus Tertius OINA

A

O: distal end of the fibula
I: base of the 5th metatarsal
N: deep peroneal
A: DF and EVE

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75
Q

the anterior tibial artery travels with the ___ nerve and becomes the ____

A

deep peroneal nerve and becomes the dorsals pedis artery

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76
Q

the dorsals pedis artery travels between the what? and then it travels to the…

A

the dorsals pedis artery travels between the heads of the first dorsal interosseous muscle to get access to the sole of the foot

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77
Q

what is the tendon at the base of the 5th metatarsal

A

the peroneus tertius

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78
Q

why would a tendon be housed in a synovial sheath

A

so it can move around without much friction

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79
Q

the fibular retinaculum surrounds what tendons, and where is it anchored and what does it separate

A

surround the peroneus brevis and longus, attaches at the peroneal trochlear on the calcaneous and separates it into compartments (superior and inferior)

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80
Q

what is in the superior portion of the fibular retinaculum and where does it attach

A

the peroneus brevis and it attaches to the base of the 5th metatarsal

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81
Q

what is in the inferior portion of the fibular retinaculum, and where does it attach

A

the peroneus longus, which goes through the groove on the cuboid

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82
Q

the flexor retinaculum allows for passage of structure to the ____ and forms the _______

A

to the sole of the foot

forms the tarsal tunnel

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83
Q

Extensor Digitorum Brevis OINA

A

O: calcaneous
I: long extensor tendons of digits 2-4
N: deep peroneal
A: extend the toes (2-4)

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84
Q

Extensor Hallucis Brevis OINA

A

O: calcaneous
I: base of the proximal phalanx of the hallux
N: deep peroneal
A: extension of the hallux, only at the MTP joint, not between the phalanges

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85
Q

The EDB sits under the tendons of the …

A

EDL

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86
Q

is the EHB more medially or laterally placed

A

medially

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87
Q

what is the only structure to help extend the little toe

A

the EDL

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88
Q

the lateral compartment is supplied by what nerve and artery

A

the peroneal artery (a branch of the posterior tibial artery) and the superficial peroneal nerve

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89
Q

what muscles are in the lateral compartment

A

the peroneus longus and brevis

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90
Q

Peroneus Longus OINA

A

O: superior 2/3 fibula
I: base of the 1st metatarsal and medial cuneiform
N: superficial peroneal nerve
A: EVE and PF (because it passes behind the lateral malleolus)

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91
Q

Peroneus Brevis OINA

A

O: the distal end of the fibula
I: the base of the 5th metatarsal
N: superior peroneal nerve
A: EVE and PF

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92
Q

what separates the fibulas above and the fibulas longus below

A

the trochlear notch of the calcaneous

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93
Q

what supplies the posterior compartment of the leg (nerve and artery)

A

the posterior tibial artery and the tibial nerve

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94
Q

what are the muscles of the posterior compartment (superficial and deep compartments)

A

the superficial: GN, soleus, plantaris

deep: FDL, FHL, tibialis posterior and popliteus

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95
Q

Gastrocnemius OINA

A

O: lateral head, lateral condyle of femur, medial head, medial condyle femur
I: calcaneous
N: tibial nerve
A: PF and flex the leg

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96
Q

Soleus OINA

A

O: posterior surface of the tibia and fibula (along the soleal line)
I: calcaneous (via the Achilles tendon)
N: tibial nerve
A: PF

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97
Q

the soleus has an opening for the ___

A

tibia nerve and popliteal A and V

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98
Q

the calcaneal tendon is also known as the

A

achilles tendon

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99
Q

which head of the GN is shorter

A

the lateral head is shorter

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100
Q

the plantaris is behind what head of the GN. where does it become tendinous?

A

behind the medial head. and becomes tendinous between the GN and soleus

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101
Q

plantaris OINA

A

O: lateral condyle of the femur
I: calcaneous
N: tibial nerve
A: PF and leg flexion

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102
Q

FDL OINA

A

O: tibia
I: distal phalanx of the lateral 4 toes
N: tibial nerve
A: flex the toes (lateral 4) and PF

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103
Q

what is the muscular part of the popliteal fossa

A

the plantaris

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104
Q

what in the foot helps to redirect/realign the tendons of the FDL in the sole of the foot to give it a better line of pull

A

the quadratus plantae

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105
Q

where does the tibialis posterior insert? what bone is the groove it passes on

A

it inserts on the medial cuneiform, navicular tuberosity and the groove is on the medial malleolus

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106
Q

there is a groove on the talus for the ____

A

FHL

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107
Q

the FDL passes through the ___ ____ and divides into he 4 tendons

A

tarsal tunnel

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108
Q

the FHL goes above or below the FDL

A

below

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109
Q

the FHL passes between two sesamoid bones. What muscle houses these bones

A

the FHB

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110
Q

FHL OINA

A

O: fibula
I: distal phalanx of the hallux
N: tibial nerve
A: flex the hallux and PF

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111
Q

Tibialis Posterior OINA

A

O: tibia, fibula and interosseous membrane
I: navicular, cuboid, cuneiform and base of the 2-4 metatarsals
N: tibial nerve
A: PF and INV

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112
Q

what nerves innervate the anterior lateral and posterior compartments

A

the anterior compartment is the deep peroneal nerve the lateral is the superficial peroneal nerve and the posterior is the tibial nerve

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113
Q

what bones do the FDL and FHL come off of

A

the FHL comes off the fibula and the FDL comes off the tibia.

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114
Q

what goes through the tarsal tunnel

A

tibialis posterior, FDL, tibial nerve, a and v, and FHL

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115
Q

the FDL passes ____ to the FHL

A

superficially

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116
Q

Popliteus OINA

A

O: upper end of the tibia
I: lateral condyle of the femur
N: tibial nerve
A: medial rotation of the knee and knee flexion

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117
Q

how does the anterior tibial artery travel and where does it go

A

through the tibia and fibula and descends down the anterior compartment of the leg

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118
Q

the anterior tibial artery changes names when it gets to the dorsum of the foot. what does it turn into. what does it go between to get to the sole of the foot

A

changes to the dorsalis pedis, and goes between the first interosseous to get to the sole of the foot

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119
Q

the anterior tibial artery travels with the ____ nerve

A

the deep peroneal nerve

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120
Q

the posterior tibial artery gives off a branch which descends along the lateral aspect of the posterior compartment of the leg and supplies the posterior and lateral compartments. what is the name of this branch

A

the peroneal artery

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121
Q

the posterior tibial artery passes ___ to the medial malleolus

A

posteriorly

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122
Q

the posterior tibial artery divides into the

A

medial and lateral plantar arteries

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123
Q

the posterior tibial artery gives off a branch at the proximal leg known as the

A

circumflex fibular artery

124
Q

the anterior tibial artery passes through the

A

interosseous membrane

125
Q

the posterior tibial artery also gives off the ____ which supplies that lateral compartment of the leg

A

the peroneal artery

126
Q

why is it bad if the popliteal artery gives off the anterior tibial artery before the popliteus

A

the anterior tibial artery can be trapped and blood flow to the anterior compartment can be constricted.

127
Q

the anterior tibial artery travels with the what nerve

A

deep peroneal

128
Q

the anterior tibial artery then divides into the

A

dorsalis pedis artery

129
Q

what cutaneous innervation does the saphenous nerve supply. what is it a branch of, and where does it travel

A

the medial side of the leg and foot

branch off the femoral nerve, and descends through the adductor Canal

130
Q

what cutaneous innervation does the sural nerve supply. what is it a branch of, and where does it travel, where is it found

A

supplies to the skin of the posterior and lateral leg and foot. its a branch off the tibial and common peroneal nerves. it is found on the outer surface of the GN and soleus. it penetrates the deep fascia and supplies the lateral achilles and foot

131
Q

superficial peroneal nerve cutaneous innervation and what makes it special

A

the skin on the dorsal third of the anterior surface of the leg, and of the dorsum of the foot (digits 3-5). YOU CAN PALPATE THIS

132
Q

which nerve can you palpate in the foot

A

the superficial peroneal nerve

133
Q

cutaneous innervation of the deep peroneal nerve

A

skin of the first interdict space between he first and second toe.

134
Q

the tibial nerve travels with which artery

A

the tibial nerve travels with the posterior tibial artery.

135
Q

the tibial nerve passes ___ to the medial malleolus

A

posteriorly

136
Q

the deep peroneal nerve supplies motor to what compartment

A

the anterior compartment

137
Q

what kind of stress can produce a common peroneal nerve injury

A

a varus stress

138
Q

how does a common peroneal nerve injury present

A

foot drop (toes don’t clear the ground during swing phase)

139
Q

what supplies motor innervation to the lateral compartment

A

the superficial peroneal nerve

140
Q

the plantar aponeurosis helps with which arch

A

the longitudinal

141
Q

where does the plantar fascia attach

A

the calcaneous and the head of the metatarsals

142
Q

how is weight distributed during walking

A

heel strike, weight on heel, then lateral border of foot then into great toe. not much at all on the arches

143
Q

how is the plantar aponeurosis bound to the heads of the metatarsals

A

through the superficial metatarsal transverse ligaments

144
Q

what is special about the superficial metatarsal transverse ligaments

A

they allow spaces for the plantar digital nerve and artery and veins.

145
Q

the medial longitudinal arch is also known as the what? and where is it and what flattens it

A

from the calcareous to the metatarsal heads, like the plantar aponeurosis. known as the truss arch and it flattens with body weight on the tibia, or even ground forces.

146
Q

the plantar fascia maintains what arch and prevents what from happening to the foot

A

maintains the median longitudinal arch and prevents foot collapse

147
Q

describe the windlass mechanism

A

this is when you DF the great toe, the plantar fascia will pull the calcaneous and metatarsal heads together, elevating the medial longitudinal arch

148
Q

what provides passive support for the medial arch

A

the plantar aponeurosis, the short and long plantar ligaments, and the plantar calconavicular “spring” ligament.

149
Q

what provides active support to the longitudinal arch of the foot (kinda like a sling)

A

the tibialis posterior and anterior tendons on the medial side, and the peroneus longus tendon in the lateral side.

150
Q

describe plantar fascitis

A

inflammation of the plantar fascia, and if there is a lot where it attaches on the calcaneous, a heel spur can develop

151
Q

what muscles are in the first layer of the sole of the foot

A

the Abductor hallucis, the FDB and the ABD digits minimize quinti

152
Q

Abductor Hallucis OINA

A

O: medial calcaneous, and plantar aponeurosis
I: proximal phalanx of the hallux
N: medial plantar nerve
A: ABD and flexion of the hallux at the MTP joint

153
Q

FDB OINA

A

O: medial calcaneous and plantar aponeurosis
I: middle phalanges of the lateral 4 toes
N: medial plantar nerve
A: flexion of toes 2-5 at the MTP and PIP joints.

154
Q

Abductor Digiti Minimi Quinti OINA

A

O: lateral calcaneous and plantar aponeurosis
I: proximal phalanx of the 5th digit
N: lateral plantar nerve
A: ABD and flex the little toe at the MTP joint

155
Q

what do the medial and plantar nerves supply

A

the medial plantar nerve is the great toe, the space between toes and between the 3-4 toe
lateral plantar nerve is the lateral surface of the foot and the lateral surface between the 4-5 toe

156
Q

there are two tendons and two muscles in the second layer, what are they

A

the FDL tendon, the FHL tendon, the quadratus plantae and the lumbricals

157
Q

FDL tendon OINA

A

O: tibia
I: distal phalanx of the lat 4 toes
N: tibial nerve
A: flexion of the lat 4 toes at MTP, PIP and DIP joints

158
Q

FHL tendon OINA

A

O: fibula
I: distal phalanx of the great toe
N: tibial
A: flexion of the hallux at the MTP and IP joint

159
Q

Quadratus Plantae OINA

A

O: plantar surface of the calcaneous
I: tendon of the FDL
N: lateral plantar nerve
A: redirect the line of pull for the FDL tendon

160
Q

Lumbricals OINA

A

(between FDL tendons)
O: medial borders of the tendons of the FDL
I: bases of the proximal phalanx of 2-5 and dorsal digital expansions
N: medial 1, medial plantar nerve. the lateral 3 by the lateral plantar nerve
A: flexion of the MTP joint, (and extension of the DIP, PIP) lateral 4 toes.

161
Q

This layer muscles

A

FHB, flexor digiti quinti and adductor hallucis

162
Q

FHB OINA

A

O: plantar surface of the cuboid and lateral cuneiform
I: medial and proximal phalanx of the great toe (has the sesamoid bones)
N: medial plantar nerve
A: flexion of the great toe

163
Q

Flexor Digiti Quinti OINA

A

O: base of the 5th metatarsal
I: proximal phalanx of the 5th toe
N: lateral plantar nerve
A: flexion of the 5th toe (little toe)

164
Q

Adductor Hallucis OINA (each head)

A

O: oblique head: base of the 2-4 metatarsals
transverse head: plantar lig of the lateral 4 MTP
I: lateral base of the proximal phalanx of the hallux
N: lateral plantar nerve
A: ADD great toe and assists in maintaining the transverse arch of the foot

165
Q

what muscle helps maintain the transverse arch of the foot

A

adductor hallucis

166
Q

fourth layer muscles

A

PADS (plantar interosseous)

DABS (dorsal)

167
Q

Plantar Interossei (PADS) OINA

A

O: medial surface of the 3-5 metatarsals
I: medial sides of the proximal phalanx of the 3-5 digits and extensor expanse
N: lateral plantar nerve
A: ADD the line of the second toe

168
Q

Dorsal Interossei (DABS) OINA

A

O: adjacent sides of two metatarsals
I: #1: medial side of the second digit
#2: lateral side of the second digit
#3: lateral side third digit
#4: lateral side of the fourth digit
N: lateral plantar nerve
A: ABD from the line of the second toe.

169
Q

what passes through the first dorsal interossei to become what

A

the dorsalis pedis artery passes between these two muscular heads and gives rise to the dorsal arch

170
Q

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

A

inferior to the malleolus, divides into the medial and lateral plantar nerves. THINK TOM DICK AND NAUGHTY HARRY

171
Q

what four muscles does the medial plantar nerve supply

A

the ABD hallucis, the FHB and the FDB and the 1st, most medial lumbrical

172
Q

what is the sensory innervation of the medial plantar nerve

A

the skin of the medial side of the foot and the first three and a half digits

173
Q

what muscles does the lateral plantar nerve innervate and what is the sensory pattern

A

all the other muscles of the sole of the foot. and it provides sensory to the lateral foot and lateral 1 and a 1/2 toes

174
Q

what is the cutaneous supply of the medial and lateral side of the foot

A

medial: saphenous nerve
lateral: superficial peroneal and sural nerve

175
Q

what nerves are easy to palpate on the dorsum of the foot

A

the intermediate and medial dorsal cutaneous nerves

176
Q

the sural nerve goes around the ___ aspect of the calcaneous

A

lateral surface

177
Q

what is the continuation of the anterior tibial artery. …supplies what and gives rise to what?

A

the dorsalis pedis artery which supplies the dorsum of the foot, and gives rise to the digital arteries of the digits 2-5

178
Q

medial plantar artery supplies what part of the foot and runs distally between what two muscles

A

medial sole of the foot. runs between the ABD hallucis and the FDB

179
Q

what two layers does the medial plantar artery run

A

between the first and second layer. The first layer is comprised of the FDB, ABD hallucis and the ABD digiti minimi quinti. the second layer houses two tendons and two muscles. Tendons of the FDL and FHL and the Quadratus plantae and the lumbricals

180
Q

the medial plantar artery form an arch under the first toe to meet up with the ___ artery

A

deep plantar artery through the interdigit space

181
Q

the lateral plantar nerve runs between what two muscles and what two layers

A

runs between the first and second layers, between the FDB and the quadratus plantae

182
Q

the lateral plantar nerve will turn ___ at the base of the ___ metatarsal to start heading between layers __ and __ to the base of the ___ metatarsal. It then becomes the ______

A

medially at the base of the 5th metatarsal, and head between layers 3-4 to the base of the first metatarsal. Becomes the plantar arch.

183
Q

the plantar arch will join the branches of the ____ which comes off of the ___ artery

A

deep plantar branches of the dorsalis pedis

184
Q

the plantar arch gives rise to the…

A

metatarsal and digital arteries to give blood to tarsal bones, digits 1-5 and the surrounding muscles

185
Q

what kind of joint is the SI joint. what bones does it connect

A

a synovial

between the sacrum and the ilium

186
Q

in the SI joint, the sacrum and ilium have different kinds of cartilage on them. what are they

A

the sacrum is lined with hyaline cartilage and the ilium is lined with fibrous cartilage

187
Q

what helps the sacrum and ilium interlock

A

the irregular surfaces of the bones.

188
Q

what is the shape of the sacral surfaces and the iliac surfaces

A

the sacral surfaces are concave, covered in hyaline cartilage and the iliac surface is convex, and is fibrocartilage

189
Q

does the SI joint have a lot or a little bit of motion

A

a very little 1.6mm translation and 4 degrees rotation

190
Q

what helps to prevent some shear that happens at the SI joint

A

the interosseous SI lig, posterior and anterior SI lig and the sacrotuberous and sacrospinous ligaments and muscles

191
Q

interosseous membrane

A

strong and massive, unites the sacral and iliac tuberosities

192
Q

the posterior SI ligament provides

A

stability

193
Q

the posterior SI ligament blends with the ___ ligament

A

sacrotuberous

194
Q

the iliolumbar goes from the what to what

A

the TP L5-S1 and the ilium

195
Q

the sacrotuberous and the sacrospinous ligaments help to prevent ___ of the sacrum

A

nutation, or anterior rotation

196
Q

which is more superficial, the sacrotuberous or sacrospinous ligament

A

the sacrotuberous is more superficial to the sacrospinous

197
Q

what ligament is called the Y ligament

A

the iliofemoral ligament

198
Q

what muscle helps to pull the ilium and squeeze the SI joint like a nutcracker

A

the TA

199
Q

describe some of the shear and torque forces that are happening on the SI joint and how they are overcome

A

so, the sacrum is being nutated by ground forces and also the weight of the body coming down on it. This is trying to pitch it forward. Additionally, there is shear going straight down on the SI joint because if body weight. The form and force closure overcomes these. This form and force closure gives you stability from the form (bones) and the force from the muscles. gives you a self locking mechanism and kind of wedges the sacrum in between the hip bones.

200
Q

what are some of the biomechanics of the SI joint

A

there is very limited mobility. maybe 2 degrees worth.

201
Q

what is SI dysfunction

A

it is really impaired loading transfer.

202
Q

describe nutation

A

it is anterior rotation of the sacrum. the top of the sacrum falls over the bottom.

203
Q

what restrains nutation

A

the sacrotuberous ligament

204
Q

what enhances nutation

A

the biceps femoris attachment to the ischial tuberosity

205
Q

describe counternutation

A

posterior motion (relative to the ilium)

206
Q

what restrains counternutation, and what enhances it

A

restrained by the long dorsal SI lig

enhanced by the lats thru the thoracolumbar fascia

207
Q

how do you want the SI joint when you are transferring body weight during stance

A

we want the SI joint locked (nutated- gives more effective load transfer)

208
Q

true/false: the nutated sacrum gives more effective load transfer

A

true

209
Q

during the heel strike, what position is the sacrum in. why?

A

in a nutated position because the force down the spine and ground reaction forces through the femur. this also causes the ilium to rotate posteriorly in relation to the anterior rotation of the sacrum.

210
Q

what three things control the amplitude of nutation of the sacrum

A
  1. coactivation of the pelvic floor muscles
  2. sacral multifidi
  3. biceps femoris.
211
Q

when the glut max contracts on one side, the ___ lat contracts which compresses the SI joint

A

opposite

212
Q

what compresses the SI joint anteriorly

A

the EO and IO

213
Q

what kind of joint is the hip joint

A

synovial, ball and socket. the head of the femur in the acetabulum

214
Q

the acetabulum is deepened by the

A

labrum

215
Q

where does the labrum attach

A

the boney rim of the acetabulum and the transverse acetabular ligament

216
Q

the transverse acetabular ligament spans the acetabular ___ and creates the acetabular ___

A

notch

foramen

217
Q

what does the acetabular foramen allow the passage of

A

allows the passage of blood vessels and nerves to the joint cavity

218
Q

what kind of cartilage forms the acetabulum in a child

A

the triradate cartilage

219
Q

at what age do the pubis and the ischium fuse together

A

9

220
Q

what structure competes the acetabulum

A

the labrum

221
Q

through what structure does the artery to the head of the femur travel

A

through the ligamentum trees femoris (the ligament to the head of the femur)

222
Q

what ligament spans the acetabular notch

A

the transverse acetabular ligament

223
Q

what artery sends a branch to the head of the femur

A

the obturator artery

224
Q

what kind of membrane lines the acetabular fossa

A

synovial membrane

225
Q

how does the femur attach

A

via the ligamentum terms femoris

226
Q

ligaments of the head of the femur resist what motion, why

A

they resist extension, because when they are in extension, the ligaments get tight. and they unwind in flexion

227
Q

what is the angle of wiberg

A

the angle between the vertical (body weight) and the plane of the acetabulum, also helps determine the amount of a rim for adequate WB and support

228
Q

what is the zone orbicularis

A

the thickening around the neck of the femur

229
Q

the acetabular fossa is lined by what

A

a synovial membrane

230
Q

the ligament of the head of the femur comes from what

A

the transverse acetabular ligament

231
Q

a break in Shentons line indicated a fracture to the

A

neck of the femur

232
Q

over the pubic rim, there is a bursa for what muscle

A

the iliopsoas

233
Q

what attaches to the AIIS

A

the rectus femoris

234
Q

what are the four thickenings around the head and neck of the femur

A

the iliofemoral ligament (Y)
ischiofemoral ligament
pubofemoral ligament
zona orbicularis

235
Q

which of the ligaments of the head of the femur restrict excessive extension and abduction

A

the iliofemoral and ischiofemoral both present extension and the pubofemoral prevents abduction

236
Q

the iliopsoas inserts onto the…

A

lesser trochanter

237
Q

there is a bursa under the zone orbicularis for the

A

obturator externus

238
Q

what part of the femur is not covered in synovial membrane, and is good for load bearing

A

the neck

239
Q

what is the blood supply to the hip

A

the medial and lateral femoral circumflex arteries and the artery to the head of the femur

240
Q

what is the innervation of the hip joint

A

the femoral, obturator, superior gluteal nerve and the nerve to QF

241
Q

the obturator artery has three branches… what are they

A

the anterior and posterior branch and the branch to the head of the femur

242
Q

what kind of joint is the knee joint

A

a synovial hinge joint

243
Q

the articulation of the surface of the femur is larger than the tibia. what does this mean

A

this means that there most be some sliding that happens here so the femur can stay in contact with the tibia

244
Q

what are some extra-capsular ligaments of the knee

A

the patellar ligament, the LCL and the MCL

245
Q

describe the locations of the LCL and MCL and their relationship with the joint capsule

A

the MCL goes from the medial epicondyle of the femur to the medial tibia and blends with the capsule
the LCL goes from the lateral epicondyle to the lateral fibula and doesn’t really blend

246
Q

which femoral epicondyle is taller

A

the lateral

247
Q

from the posteriolateral surface of the lateral femur to the anteriomedial surface of the tibia

A

the ACL

248
Q

from the medial femur to the posteriolateral tibia

A

PCL

249
Q

transverse ligament of the meniscus goes from the

A

anterior portion of each meniscus to the other

250
Q

anterior to posterior, what attaches at the pes anserine

A

the sartorius, gracilis, and the semitendinosis

251
Q

what runs between the capsule and the LCL

A

the popliteus

252
Q

the ACL and PCL are extra___ and intra___

A

extrasynovial but intracapsular

253
Q

what are the shapes of the medial and lateral menisci

A

the medial is C shaped and the lateral is more O shaped

254
Q

describe the portions and locations of the two portions of the meniscofemoral ligament

A

the Wrisburg portion is from the posterior lateral meniscus to the PCL
the Humphrey is from the posterior lateral meniscus to the ACL

255
Q

what two things do the coronary ligaments hold together

A

the menisci and the tibia

256
Q

what tests can be done to determine the integrity of the ACL and PCL and are there any visual clues

A

the ACL is the anterior drawer test and the posterior drawer for the PCL. The PCL you may notice a posterior sag sign, because the tibia fell back. This is because the tibia moves back on the femur

257
Q

how are the MCL and LCL damaged

A

the MCL is damaged with a blow to the lateral side, or a valves producing force. the LCL is hurt with a virus force or a blow to the medial side

258
Q

arcuate popliteal ligament

A

y shaped, from the tibia to the lateral epicondyle of the femur

259
Q

oblique popliteal ligament

A

below the arcuate ligament

260
Q

does the arcuate ligament go over or under the popliteus

A

over

261
Q

true or false: the oblique popliteal ligament runs parallel to the popliteus

A

true

262
Q

what are the bursa of the knee

A

the suprapetellar, popliteus, GN, subcutaneous prepatellar and infra-patella and deep infra-patella

263
Q

inflammation of which bursa is the bakers cyst

A

the popliteus bursa

264
Q

describe the path of the ACL

A

from the anterior intercondylar ares of the tibia to the posterior part of the medial side of the lateral epicondyle of the femur

265
Q

are the cruciate ligaments intra or extra synovial

A

extra

266
Q

what does the ACL prevent

A

the posterior displacement of the femur on the tibia or the anterior translation of the tibia on the femur. also prevents hyperextension

267
Q

describe the path of the PCL

A

from the posterior part of the intercondylar area of the tibia to the lateral side of the medial epicondyle of the femur

268
Q

does the PCL run medially or laterally to the ACL

A

medially

269
Q

what is the main stabilizer of the flexed knee during gait

A

the PCL

270
Q

what motion does the PCL resist

A

anterior displacement of the femur on the tibia or posterior displacement of the tibia on the femur

271
Q

what kind of cartilage are the menisci made of

A

fibrocartilage

272
Q

how are the menisci attached to the tibial condyles

A

through the coronary ligaments

273
Q

what is the shape of both of the menisci

A

the medial is c shaped and the lateral is o shaped

274
Q

why is the lateral menisci and LCL separated unlike the MCL

A

because of the popliteus running between

275
Q

what is the strong tendinous extension of the lateral meniscus that attaches to the PCL and medial condyle of the femur

A

the posterior meniscofemoral ligament

276
Q

which portions of the menisci are well supplied blood

A

the lateral 1/3 is well supplied (red zone), and the medial 1.3 is not

277
Q

what are some of the arteries that completely surround the knee

A

the superior and inferior medial and lateral vehicular branches

278
Q

what innervates the knee

A

obturator, femoral, tibial and common peroneal

279
Q

what other arteries supply the knee

A

the fibular artery, the anterior tibial and the anterior recurrent artery

280
Q

what does the highest vehicular branch anastomoses with

A

the lateral femoral cutaneous artery

281
Q

what kind of joint is the talocrural joint

A

between the tibia fibula and talus. this is a synovial hinge joint

282
Q

in which position is the talocrural joint the most stable

A

DF because the talus is wider in the from then the back

283
Q

the ankle mortise is also known as the

A

tibial plofonda or the tibial pilon

284
Q

what makes up the ankle mortise

A

the articulation between the tibia and the roof of the talus, makes the ankle mortise

285
Q

where is the subtler joint

A

between the talus and the calcaneous

286
Q

what joints form the transverse tarsal joint

A

the calcaneocuboid and talonavicular joint

287
Q

Lisfranc Fx is a break to the

A

mid foot joint, between the cuboid, cuneiform and the metatarsals

288
Q

there are three ligaments that come from the lateral malleolus, what are they (the lateral collateral ligaments)

A

the anterior and posterior talofibular ligament and the calcaneofibular ligament

289
Q

the bifurcate ligament is made up of the

A

calcaneonavicular and calcaneocuboid ligaments

290
Q

what are the four medial collateral ligaments, that attach to the medial malleolus

A

the tibionavicular
anterior and posterior tibiotalar ligaments
the tibiocalcaneal

291
Q

what runs under the sustentaculum tali

A

the FHL

292
Q

the plantar calcaneonavicular ligament is also known as the

A

spring ligament

293
Q

what is the blood supply of the ankle joint

A

the mallard branches of the fibular and the anterior and posterior tibial arteries

294
Q

what is the innervation of the ankle

A

the tibial and deep peroneal nerve

295
Q

what is the deltoid ligament made up of

A

the anterior and posterior tibiotalar ligaments, the tibiocalcaneal ligament and the tibionavicular ligament

296
Q

the short plantar ligament is superficial or deep to the long plantar ligament

A

deep

297
Q

where does the spring ligament go

A

between the sustentaculum tali and the navicular tuberosity

298
Q

what makes up the lateral collateral ligament

A

the anterior and posterior talofibular ligament and the calcaneofibular ligament

299
Q

there are two ligaments that attach the calcaneous and the cuboid, what are they

A

the dorsal calcaneocuboid and the bifurcate ligament

300
Q

what kind of joint it the subtler joint, what bones does it join and what motion does it allow

A

it allows the INV and EVE, between the talus and the calcaneous and it is a synovial

301
Q

the transverse tarsal joint is made of two joints, what are they

A

the talocalcaneonavicular joint and the calcaneocuboid joint

302
Q

what kind of joint is the talocalcaneonavicular joint. and what special ligament lives here

A

a synovial ball and socket

the spring ligament

303
Q

what kind of joint is the calcaneocuboid joint and what ligaments live here

A

a synovial

the long and short plantar ligaments

304
Q

what do the long and short planter ligaments support

A

the longitudinal arch

305
Q

the transverse tarsal joint is supported dorsally by the…

A

bifurcated ligament (calcaneocuboid and the calcaneonavicular) ad the dorsal talonavicular ligament

306
Q

blood supply of the foot

A

the medial and lateral plantar arteries, which come from the posterior tibial artery. also from the dorsalis pedis artery which comes from the anterior tibial artery

307
Q

what is the innervation of the foot

A

the medial and lateral plantar nerves (from the tibial nerve)
the medial and intermediate dorsal cutaneous nerve (from the superficial peroneal nerve)
and the deep peroneal nerve (between the first two toes)

Anatomy I Take II (7 decks)

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