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MSK > foot > Flashcards

foot Flashcards

1
Q

where is dorsalis pedis artery palpated

A

between the tendons of the hallucis logus and extensor digitorium longus to the second toe

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2
Q

what is dorsalis pedis a continuation of

A

anterior tibial artery

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3
Q

what is structure is more deppeis from the ovelrying skin of the popliteal fossa

A

poplieal artery is the deepest thing in the popliteal fossa

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4
Q

whats superfical in the popliteal fossa (more superfical to the popliteal artery

A

the polital vein, tibila and common peroneal nerves and short saphernous vein

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5
Q

what muscle prevents against this

A

vastus medialis

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6
Q

what are the bones of the foot

A

tarsal bones = 7 irregualr shaped bones proximal aspect of the foot

meta tarsals = 5 metatarsals one for each toe connect the phalanges to the tarsal bones

phalanges

bones of the toe, 2/3 (proximla, middle and distal) except big toe wc onl has 2

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7
Q
A
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8
Q

what are the regionsof the foot

A

hindfoot = talus and calcaneus

midfoot = navicaular , cuboid and cunieforms

forefoot = metatarsals and phlanges

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9
Q

describe the talus

A
  • the most superior bone of the foot and has 3 articualtions
  • superiorly = ankle jonint between teh alus tbia and fibula
  • inferiorly subtalar joint bw it and the calcaneus
  • anteriorly talonavicular joint bw it nd the navlaular
  • F = transmit forces rfi the tibia to the calcanoeus (eheel bone)
  • the trochlear portion of the talus is the region wc articualtes with the tibia and fibula
    • wider anteriorly compared with posterioly and this shape provides addition stability to the dorsiflexed ankle
      *
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10
Q

what is attathced to the talus?

A

no muscles just ligaments

this ameans that theres a hgih chage of avascualr necrosis that can occur if taus is fracturesd sicne the b. suply is aslo retrograde just like the scaphoid boen fo the hand

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11
Q

describe the calcaneus

A

infeior to the talus and is part of the subtlr join

aka heel bone

anteriorly articulaiton = calcaneocuboid joint bt it and cuboid

funtion is take the full weightof the body and thats why is protrudes posteriorly whe the heel touches the ground . this is the calcaneus tuberosity and is whete the Achillies tendon attaches

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12
Q

proximal row of the tarsal bones

A

tlaus and calcaneus

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13
Q

intermediate row of the tarsal bones

A

navcualr ( taonavilcaur joint

cuboid (calcaneocuboid joint)

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14
Q

navicular bone

A

wc artiualtes with the with talus bine in the talonavilaur joint but it also articualte with the cuneiform bones anterirly wc then articualte with the metaatarsal there are

it also articualtes wit the cunodial bone laterlly

ot as a tuberoisty wc is the insrtion of th etibialis posterioe tendon

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15
Q

describe the distal row of tarsals

A

cuneiforms and the cuboidal

cuboidal articualtes with teh calcanueus posteriorly and medialy with tehlateral cuneiorm and anteoroly with the 45metatarsal

it has a groove fro the tendon of penoneus (fibularis ) lngus

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16
Q

whats special about the cunieforms

A

tibialis psoterior and peroneus (fibularis) longus and tibilais anteior all insert into the medial cuneiform

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17
Q

joint betwent the met and tarsal? and tarsals and adjascent meta ta and meta tar and proximal phal

A

phalanx = mtatarsophlangea;

adjacent =intermetarsal

tar and met = tarsometatarsal

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18
Q

describe the ankle joint

A

hungje joint allowing for dorsiflexion and plantar felxion

tibular and fibular held ogether bu the tijiofibuilar ligaments at distal tiiofiilar joint , together they form a mortise, a breacket sahped socket wehre the trochlea of the talus fits into

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19
Q

what movements are permitted bu the ankklejoint and what movements are strogner and why

A

dosriflexion andplantarfelxion

the anterior trochlaerof the tlaus is broader than the posterior

so disoriflexion the antior aspect is held well in teh mortise and so more stable but opppste in teh plantflexion becaue tht eposteior trahoclar is more narrow =less tbale

20
Q

what muscles contribute to dorsiflexion

A

anterior compartment of the leg

tibilais anteirr, extensor halluics longus, extensor digitorium lingus and pectoneus tertius

21
Q

what limitesdisriflexion

A

the mucles fo the posterior compartment

22
Q

describe the anterior compartemen of the leg

A

tiilais anterior, extensor digitorium lognus , extensor hallucis lgus , peroneus tertius

f = dorsiflexionand invert the footat ankle joint

but the extensors an also extend the toes

IN = deep peroneal nerve

B = anterior tiial artery

23
Q

tibilalis anterior

A

strongest in dorsiflexion adn to test ask patiet to stand on their heels with the forefoot raised offthe ground

O= lateral surface of the tibia

I= medial cuneiform ad base of 1st meta

F = dorsiflexion and inversion of foot

IN = deep peroneal nerve

B = anteiror tibial artery

24
Q

extensor digitorium longus

A

lateral to adn deep to the tibilais anteriorm but you can palpate the tendon on the dorsum of the foot

O = lateral condyle of the tibia and medial surface of the fibuka,the fibres then converge into 1 tendon wc passes deeo to the extensor retinacula of the ankle, wc splits into tendons on dorsum of the foot

I = middle and distal phalanges of the 2-5th toe

F = dorsiflexion adnd extension of the toes

IN =deep fibular nerve

b+ anteiror tibial artery

25
Q

extesnor hallucis longus

A

deep to both edl and ta

O = medial surface of the fibular shaft , tendon crossesanteior to anjle joint belwo te extnsor reticaculum and

I=to base of distal phaland of gret big toe

f = dors. and extnsion of the toe

IN = deep fibular nerve

B = anterior fiular artery

26
Q

peroneus tertius

A

not present in all individuals

O =medial surface f the fibual incferior tho to the origiom of the EDL , tedon gos beneath the extesnor retinaulcu

I = base of the5th metatarsal

f= eversion and assists in dorsiflexion of the foot

IN =deep peroneal nerve

b = ant. tib. artery

27
Q

what contributes to plantarflexion

A

posterior compartment of the leg

28
Q

posteiror compartement of the leg

A

superficial and deep

f = plantarfelxion an dinversion

IN = tibial nerve

29
Q

superficial psterior compa

A

calf shape mjsucles

all insert inot calcaneal tendon - achilles tendon

but to minimise the fricition they hae 2 burse associated wuth the calcaneal tendon

30
Q

bursae of the calceanal tendon

A

subcutaenous calcanela skin and cal tend

deep calcaneal - tendon adn cal

31
Q

gastrocnemius

A

most supefical posteriorleg muscle

O= lateral of gastocnemius orginates from the lateral femoral conydle and medial head frmedia condyle, two heads converge together and combine tendon with soleus and planataris

I= calcaenal tendon

f = invesionad planta also assistts knee flexion

iN- tibial

32
Q

plantaris

A

small. muscle absenct in 10% of people

O = lateral supracondyle line

I= runs between gastroneumis nd soleus inserts into ctedno

F =platna andinversio but lso weak knee flxor

IN= tibial nerve

used in graft surgery

33
Q

soleus

A

O= soleal line

I= cal tendon

F = plantar

In= tibial nerve

34
Q

whats te deep posterior leg compartment

A

4 mslce ; popliteus acts on knee joint only, tibialis posteroir, flexor hallcuis longus,flexor digitorium ligus

35
Q

popliteus

A

superiorly and posteriorly

;lies posterior to knee joint

O = tibial prxomail to soleal line

I = passes supralaterally and insrts into the lateral consule of femr and posterior horn of lateral neiscus

F lateral rotating of femus , unloing knee joint so fexion can occur

IN= tibial nerve

36
Q

tibialis posterior

A

deepest

O = intesooseus membrane

I= tend wc enters sole of fot by passing posterior to the malleoulus and insets on the navicualr nnd medial cuniform

F = inversio and planta and maintains the medial arch of foot

IN= tibial

37
Q

flexor digitorium longus

A

medially. located in deep psoteior leg

O= medial surface of tibia and enters sole of foot psoterior to medial malloeus

I= corsses superfila to fhl and divides ito 4 and iserts onto base f the distal phalanx of each of teh four digits

F = flexes the lateral four toes and assists with plantar flexion of ankle and inversionof the midfoot

In= tibial

38
Q

Fhallucis longus

A

lateral side of posteiror (medial FDL)

O= posterior surface of fibula paases psoterios to meda malleous and

I = base of the distal phalanx of gret toe

IN- tibial

f= flex toe and plantarand inversion

39
Q

what are the ligament sof the ffoot

A

anterior talofibular bteween lateral mellous ad neck of femur (most common to get ripped)

postieror talofibular ligament bw malloea fossa and lateral tubercule of the talus

calcaneofibular ligaemnt bw tip of lateral malleolus and lateral surface of the calcaneus

f = assist inversion

40
Q

what ligaemnts involve in everesion

A

deltoid (medial) and its fibures attatch to the talus calcanoues and naviucular

41
Q

inversion ligaments

A

anterior and osteiro talofibular

calcaenofibular

42
Q
A
43
Q

what are the arches if the foot

A

medial longitudinal arch = most clincial significant , forme by nvicular, talus, calc, three cuneiforms and medial 3 meta

plantar aponeurosis and spring ligament , tibialia anterir andpeoneu s longus tendons play a roe i maintaing shape of arch

lateral longituidianl arch = d calcaneus cuboiud and latera 2,contation of the pernous brevis uscle help support this lateral longit ach

44
Q

compartment syndrome whats the long and short term cnsequences

A

short - idue to increased pressure = v perfusion of muscle, ischaemia resleases mediatoes wc icrease capillary permeability ad exacerbate the risj in presure if untreaed you get rhabdomyolysis (musel necrosis) ad acute kideney ijry. neurovasucalr signs ae late to develp if intracompaortmetn roesrue excees arterial pressre thers a loos of peripheral pulse increased capillary refill time, nerve fires are suspceitp to ischemia -> think nerers do get distal paraesthiesa precedesmusce loss

long= rhabdomyolyis and kidney injury

volkmann’s ischamic contracture =permanent painful and siablig contracture of the affected musce group

45
Q

ankle fracture

A
  • fracture disoalctions common usally inversio /everesion accident + conside co-morbitiy,
  • if blister fracture then surgey need tobe dealyed untl bisters heal , but seomtiems the skill is necrotic and so healing take time
  • open fracture when skin breged reuqires sutgery and debridgment to reduce riskof osteomyelitis (infection of the bone)
    • with ankle frcature usually a lgimtn is teared or sometimes all, all you ned to knoe is 1 = stable, 2 -=unstable 3 = unstbaleand dislacted, 1 is treated with aircast boot or friboblast cast
      • talus shift is hwn the syndesmois meial or lateral ligaments are ripped anjel mortise becomes unstbale an shifts
        *
46
Q

sprained anjle

A

due to the tear 1 + ligaemnts oof nakle joint and 90% heal with res t and time, but sometimes they needs ruegry

increased risk = running on uneven surface, weak muscel, high heels eak joints

excessrotation/inv/ever

nist cinnib us unversioninjuty affectng plantflexied weightbearing foot and ATFligament most at rsik

47
Q

chille tendon rupture

A

men 30-50

MSK (17 decks)

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