Knee and Leg Flashcards

1
Q

Gastrocnemius Proximal?

A
  1. Medial Head: Popliteal surface of Femur

2. Lateral Head: Lateral Condyle of Femur

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2
Q

Gastrocnemius Distal?

A

Calcaneus (achilles or calcaneal tendon)

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3
Q

Gastrocnemius Action?

A
  1. Plantar Flexes Ankle
  2. Flexes Knee
  3. Raises heel when walking
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4
Q

Gastrocnemius Nerve?

A

Tibial

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5
Q

Soleus Proximal?

A
  1. Soleal Line of Tibia
  2. Posterior Head of Fibula
  3. Tendinous arch
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6
Q

Soleus Distal?

A

Calcaneus (achilles tendon)

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7
Q

Soleus Action?

A

Plantar Flexes Ankle

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8
Q

Soleus Nerve?

A

Tibial

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9
Q

Plantaris Proximal?

A
  1. Supracondylar line of Femur

2. Oblique popliteal ligament

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10
Q

Plantaris Distal?

A

Calcaneus (achilles tendon)

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11
Q

Plantaris Action?

A
  1. Weakly Plantar Flexes Ankle

2. Weakly Flexes Knee

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12
Q

Plantaris Nerve?

A

Tibial

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13
Q

Popliteus Proximal?

A
  1. Lateral Femoral Epicondyle

2. Lateral Meniscus (joint capsule)

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14
Q

Popliteus Distal?

A

Superior to Soleal Line on posterior surface of Tibia

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15
Q

Popliteus Action?

A
  1. Tibia fixed: Laterally rotates Femur on Tibia 5 degrees and unlocks (flexes) knee
  2. Femur fixed: Medially rotates Tibia on Femur and unlocks (flexes) knee
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16
Q

Popliteus Nerve?

A

Tibial

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17
Q

Tibialis Posterior Proximal?

A
  1. Posterior Tibia inferior to Soleal line

2. Interosseus Membrane

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18
Q

Tibialis Posterior Distal?

A
  1. Navicular Tuberosity
  2. Plantar surface of Cuneiforms, Cuboid, and sustentaculum tali of calcaneus
  3. Bases of 2nd-4th Metatarsals
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19
Q

Tibialis Posterior Action?

A
  1. Inversion of foot
  2. Plantar Flexes Ankle
  3. Maintains arch of foot
  4. Functionally: Resists Hyperpronation
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20
Q

Tibialis Posterior Nerve?

A

Tibial

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21
Q

Flexor Digitorum Longus Proximal?

A

Posterior Surface of Tibia inferior to Soleal Line

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22
Q

Flexor Digitorum Longus Distal?

A

Plantar Surface of the bases of 2nd-5th Distal Phalanges

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23
Q

Flexor Digitorum Longus Action?

A
  1. Primarily Flexes 2nd-5th Toes
  2. Plantar Flexes Ankle
  3. supports longitudinal arch of foot
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24
Q

Flexor Digitorum Longus Nerve?

A

Tibial

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25
Q

Flexor Hallucis Longus Proximal?

A
  1. Posterior, Inferior 2/3 Fibula

2. Interosseus Membrane

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26
Q

Flexor Hallucis Longus Distal?

A

Plantar Surface of base of Distal Phalanx of Hallux

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27
Q

Flexor Hallucis Longus Action?

A
  1. Flexes Hallux
  2. Weakly Plantar Flexes Ankle
  3. Supports medial longitudinal arch of foot
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28
Q

Flexor Hallucis Longus Nerve?

A

Tibial

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29
Q

Peroneus (Fibularis) Longus Proximal?

A
  1. Head of Fibula

2. Superior lateral surface of Fibula

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30
Q

Peroneus (Fibularis) Longus Distal?

A
  1. Base of lateral side of 1st Metatarsal

2. Medial Cuneiform

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31
Q

Peroneus (Fibularis) Longus Action?

A
  1. Everts and Horizontally Abducts Foot
  2. Weakly Plantar Flexes Foot
  3. Maintains arch of foot
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32
Q

Peroneus (Fibularis) Longus Nerve?

A

Superficial Fibular

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33
Q

Peroneus (Fibularis) Brevis Proximal?

A

Inferior lateral surface of Fibula

34
Q

Peroneus (Fibularis) Brevis Distal?

A

Tuberosity on Lateral Aspect of Base of 5th Metatarsal

35
Q

Peroneus (Fibularis) Brevis Action?

A
  1. Everts and Horizontally Abducts Foot

2. Weakly Plantar Flexes Foot

36
Q

Peroneus (Fibularis) Brevis Nerve?

A

Superficial Fibular

37
Q

Tibialis Anterior Proximal?

A
  1. Lateral Tibial Condyle and Anterolateral Surface of Tibia

2. Interosseous Membrane

38
Q

Tibialis Anterior Distal?

A
  1. Medial and Plantar Surface of Base of 1st Metatarsal

2. Medial and Plantar Surface of 1st Cuneiform

39
Q

Tibialis Anterior Action?

A
  1. Dorsiflexes Foot

2. Helps Invert and Horizontally Adduct Foot

40
Q

Tibialis Anterior Nerve?

A

Deep Fibular (Peroneal)

41
Q

Extensor Hallucis Longus Proximal?

A
  1. Middle and Anterior surface of Fibula

2. Interosseus Membrane

42
Q

Extensor Hallucis Longus Distal?

A

Dorsal surface of base of Distal Phalanx of Hallux

43
Q

Extensor Hallucis Longus Action?

A
  1. Extends Distal Phalanx of Big Toe
  2. Weakly Dorsiflexes Foot
  3. Weakly Inverts and Adducts Foot
44
Q

Extensor Hallucis Longus Nerve?

A

Deep Fibular (Peroneal)

45
Q

Extensor Digitorum Longus Proximal?

A
  1. Lateral Condyle of Tibia
  2. Superior medial surface of Fibula
  3. Interosseus Membrane
46
Q

Extensor Digitorum Longus Distal?

A

Dorsal Surface of the Bases of the Middle and Distal Phalanxes of the 2nd-5th digits

47
Q

Extensor Digitorum Longus Action?

A
  1. Extends Lateral 4 Toes

2. Weakly Dorsiflexes and Everts Foot

48
Q

Extensor Digitorum Longus Nerve?

A

Deep Fibular (Peroneal)

49
Q

Peroneus (Fibularis) Tertius Proximal?

A
  1. Distal 1/3 of Anterior Fibula

2. Interosseous membrane

50
Q

Peroneus (Fibularis) Tertius Distal?

A

Dorsal Surface of the Base of the 5th Metatarsal

51
Q

Peroneus Tertius Action?

A

Weakly Dorsiflexes and Everts Foot

52
Q

Peroneus Tertius Nerve?

A

Deep Fibular (Peroneal)

53
Q

Superior Tibiofibular joint?

A
  • Connects Lateral Condyle of Tibia to Head of Fibula
  • Move together with inferior tibiofibular joint to dorsiflex
  • Plane type synovial joint enclosed in joint capsule
  • enhanced by posterior and anterior ligaments of fibular head
54
Q

Inferior Tibiofibular joint?

A
  • Connects Lateral Malleolus of Fibula and lateral surface of distal Tibia
  • Syndesmosis joint- slides and glides, no fluid between bones, minimal movement
  • enhanced by interosseous membrane and reinforced by anterior and posterior tibiofibular ligaments
55
Q

Knee joint? Actions?

A
  • largest and most superficial joint
  • hinge, synovial joint
  • Flexes (hamstrings) and extends (quads) with some medial and lateral rotation
56
Q

Knee Joint articulations?

A
  1. Lateral Femorotibial: between lateral condyles of femur and Tibia
  2. Medial Femorotibial: between medial condyles of femur and tibia
  3. Femoropatellar: posterior patella and inferior and distal femur
57
Q

Knee Joint capsule?

A
  • external fibrous layer with internal lining of synovial membrane
  • anterior: quads tendon, patella, patellar ligament
  • intercondylar area: intrapatellar synovial fold and fat pad
58
Q

Knee bursa function?

A
  • sac lined synovial membrane which secretes fluid
  • cushion and reduces friction
  • 12 surround knee
59
Q

Popliteus bursa?

A
  • between popliteus muscle and lateral tibial condyle
  • communicates with knee joint along with supra patellar bursa
  • allow fluid circulation but could transmit inflammation (bursitis)
60
Q

Housemaid’s knee?

A
  • bursitis in Subcutaneous Prepatellar Bursa

- between skin and front of patella

61
Q

Preacher’s knee?

A

bursitis in Subcutaneous infrapatellar bursa

62
Q

External knee ligaments (extra capsular)?

A
  • Patellar: quads tendon to tibial tuberosity
  • MCL: medial epicondyle of femur to medial condyle of tibia
  • LCL: lateral epicondyle of femur to fibular head
  • Oblique popliteal (posterior)
  • arcuate popliteal: runs over popliteus muscle (posterior)
63
Q

Internal knee ligaments (intra-articular)?

A
  • ACL

- PCL

64
Q

Anterior Cruciate Ligament (ACL)? Function?

A
  • from anterior intercondylar area and inserts on medial side of lateral condyle of femur
  • poor blood supply, weaker and shorter
  • prevents posterior rolling and displacement of femur on fixed Tibia during flexion
  • prevents posterior displacement of femur on tibia.
65
Q

Posterior Cruciate Ligament (PCL)? Function?

A
  • from posterior intercondylar area and inserts on anterior lateral surface of medial condyle of Femur
  • limits anterior rolling of the femur on the tibia during extension; prevents anterior displacement of femur on the tibia
66
Q

ACL and PCL test?

A

Anterior and Posterior Drawer test

  • patient lies supine with knees bent, physician stabilizes foot and has thumbs on either side of patellar ligament and ensures hamstring muscle is relaxed
  • ACL: force applied anterior
  • PCL: force applied posterior
  • positive if over 5mm of movement
67
Q

Medial Menisci?

A
  • C shaped
  • larger
  • attached to MCL
68
Q

Lateral Menisci?

A
  • Circular, attaches to joint capsule
  • thicker external edge
  • smaller and movable
  • posterior meniscofemoral ligament
69
Q

Coronary Ligaments?

A

-fix menisci to Tibial plateau

70
Q

Transverse Ligaments?

A

connect anterior edges of medial and lateral menisci so they can move together

71
Q

Crural Fascia? Functions?

A
  • deep fascia in leg (fascia lata in thigh)
  • protection
  • form Flexor (medial), Extensor (anterior), and Fibular (lateral) Retinaculum to hold tendons in place
  • Deep fascia divides muscles into compartments (Intermuscular septa of leg)
  • helps guide venous blood up the leg
72
Q

Blood supply to knee?

A

Genicular Anastomoses:

  • Superior Medial
  • Superior Lateral
  • Middle
  • Inferior Lateral
  • Inferior Medial
73
Q

Blood Supply to lower leg?

A
  1. Anterior: Anterior Tibial Artery becomes Dorsal Artery of foot
  2. Lateral: branches of Anterior Tibial and Fibular Artery
  3. Posterior: Posterior Tibial Artery (divides into medial and lateral plantar) and Fibular Artery
74
Q

Innervation of lower leg?

A

Anterior: Deep Fibular Nerve (2 branches into foot)
Lateral: Superficial Fibular Nerve (cutaneous distally)
Posterior: Tibial Nerve

75
Q

Knee Joint Innervation?

A

Hilton’s Law

  • nerve supplies to both the muscles and joint it moves
  • articular branches of Femoral nerve, Tibial, Common Fibular, and Obturator nerves
76
Q

Cutaneous Nerves of the leg?

A
  • Saphenous nerve: anterior medial
  • Lateral Sural: from common fibular nerve, gets lateral part of leg
  • Superfical Fibular: becomes dorsal digital nerves, gets dorsum of foot
  • Deep Fibular Nerve: space in between first two toes
77
Q

Veins of the leg?

A
  • Great Saphenous: anterior, union of dorsal venous arch and dorsal digital vein of great toe, drains into Femoral Vein
  • Small saphenous: posterior, union of dorsal venous arch and dorsal digital vein of small toe (anastomose with great saphenous), drains into Popliteal Vein
  • Perforating vein: drain blood from superficial to deep
78
Q

Varicose Veins?

A
  1. leaflets of valves do not close properly

2. superficial veins become enlarged b/c blood cannot be pushed back into deep veins

79
Q

Common Fibular Nerve injury?

A
  • nerve wraps around neck of Fibula, fracture to Fibula injures it
  • car bumper nerve
  • crushed, stretched
  • loss of skin sensation and foot drop when severed
80
Q

The Unhappy Triad?

A
  • Classical (O’Donoghue): tears of ACL, MCL, and Medial Meniscus
  • More common acute injury: tears of ACL, MCL, and lateral meniscus with or without medial meniscus injury
81
Q

Suprapatellar bursa?

A
  • between quad tendon and distal femur

- communicates with knee joint

82
Q

Functions of compartments of the leg?

A
  1. Anterior- Dorsiflex
  2. Lateral- Evert
  3. Posterior- Plantar flex