Knee and Shin Flashcards
which of the tibia and fibula is lateral? which is medial?
fibula is lateral
tibia is medial
which of the tibia or fibula is mainly used for weight bearing?
tibia
which of the tibia or fibula is mainly a site for muscle attachments?
fibula
what does the tibia have proximally?
lateral and medial condyles
what attaches at the tibial tuberosity?
patellar tendon of the leg
what is the medial distal projection of the tibia?
medial malleolus
what are tibfib attached by?
interosseus membrane
what two things does the tibia articulate with distally?
fibula and the talus
what is the area between the two proximal femoral facets of the tibia?
anterior and posterior intercondylar areas
what attaches in the anterior and posterior intercondylar areas?
cruciate ligaments (anterior and posterior)
is the knee joint weak or strong joint?
considered a weak mechanical joint…hence the many injuries
what muscle is most important in stabilizing the knee joint?
quadriceps
the quadriceps tendon expands laterally across the knee joint…what is this called?
patellar retinaculum
what are the medial and lateral ligaments of the knee called?
lateral and medial collateral ligaments
the medial collateral ligament fuses with what in the knee?
the medial meniscus…so if you injure one you likely will injure the other
name the two internal ligaments of the knee
anterior an dposterior cruciate ligaments
what do the cruciate ligaments join?
femur and tibia
is the ACL relaxed or tightened when knee is flexed?
relaxed
is the ACL relaxed or tightened when knee is extended ?
tight
what does the ACL prevent from happening?
knee hyperextension by femur sliding too far posteriorly
in other words it prevents the anterior displacement of the tibia
what position does ACL rupture occur in usually?
when knee is extended and it gets over rotated
what else often gets torn with the ACL? what is the name of this?
medial meniscus and MCL
called the unhappy triad
what is the sign of an ACL tear? explain
anterior drawer sign where you displace the tibia anteriorly from the femur
does the PCL relax or tighten during flexion of the knee?
tighten
what does the PCL prevent?
femur sliding anterior to tibia
or
tibia displacing posteriorly
what is the sign with PCL tears?
posterior drawer sign where tibia can be pushed posteriorly
what is the role of the knee menisci?
shock absorbers of the knee
what is the motion that injures the menisci of the knee?
torsional twisting of the knees
what is the issue with menisci? what does this lead to when injured?
dont have much blood supply so will need surgery more often
what is the medial meniscus firmly attached to?
MCL
what is between the LCL and the lateral meniscus?
popliteus muscle tendon
which of the medial and lateral meniscus is more mobile?
lateral
the popliteal artery gives off three branches…name them
anterior tibial
posterior tibial
fibular artery
what are the two branches of the sciatic nerve?
tibial nerve
common fibular nerve
where does the sciatic nerve branch?
at knee joint
tibial nerve innervates all the muscles in what leg compartment?
posterior
the common fibular nerve divides into what?
superficial fibular nerve
deep fibular nerve
what does the deep fibular nerve provide innervation to?
anterior compartment of the leg
what does the superficial fibular nerve provide innervation to?
deep compartment of the leg
name the four compartments of the lower leg
lateral compartment
anterior compartment
posterior deep compartment
superficial deep compartment
what divides the lower leg into compartments?
crural fascia
what is the biggest muscle in the superficial posterior group?
gastrocnemius
what muscle is deep to the gastrocnemius muscle in the superficial posterior group of muscles?
soleus
what do the soleus and gastrocnemius attach to? what is the tendon called?
calcaneal tuberosity…via the achilles tendon
is the gastrocnemius or soleus more fast twitch?
gastrocnemius
what is soleus more used for compared to gastrocnemius?
strolling…endurance movement
what is the plantaris muscle?
small muscle in the superficial posterior group of muscles…has a very long thin tendon
what is the tendon of the plantaris muscle often used for?
repairing a torn achilles tendon
what nerve innervates the gastrocnemius and soleus?
tibial nerve
what are the nerve roots of the tibial nerve that innervate the calf muscles
S1 and S2
name the three muscles of the deep posterior group
flexor hallucis longus
flexor digitorum longus
tibialis posterior
what is the action of the popliteus?
flexor of the knee…unlocks it when extended
what are the three actions of the deep posterior group of lower leg muscles?
plantarflex the ankle
flex the toes
invert the foot
what is the main action of the flexor hallucis longus?
flex big toe
what is the main action of the flexor digitorum longus?
flexes toes
what is the main two actions of the tibialis posterior?
plantarflex and invert foot
what gap do the tibialis posterior, flexor hallucis longis, and flexor digitourm pass through into the foot?
tarsal tunnel
is the tarsal tunnel on lateral or medial side of the foot
medial
what roots of the tibial nerve innervate tibialis posterior?
L45
what roots of the tibial nerve innervate flexor digitorum longus?
S23
what roots of the tibial nerve innervate flexor hallucis longus?
S23
what are the branches of the popliteal artery that serve the knee?
genicular arteries
name the three branches of the popliteal artery as it goes into the lower leg
anterior tibial artery
posterior tibial artery
fibular artery
the anterior tibial artery feeds what compartment of the leg?
anterior leg compartment
the posterior tibial artery feeds what compartment of the leg?
posterior leg muscles
the fibular artery feeds what compartment of the leg?
lateral compartment
which branch of the popliteal artery goes into the tarsal tunnel?
posterior tibial artery
name the five things that traverse the tarsal tunnel
tibialis posterior tendon flexor digitorum longus tendon posterior tibial artery tibial nerve flexor hallucis longus tendon
the superficial fibular nerve provides sensation to what portion of the foot?
dorsum or top of foot
the deep fibular nerve provides sensation to what portion of the foot?
between big toe and 2nd toe
name the two muscles in the lateral compartment of the lower leg
fibularis longus
fibularis brevis
what is the action of the fibularis longus and brevis?
evertors of the foot
describe the passage of the fibularis brevis tendon in the foot?
through the groove on the bottom of the cuboid bone and inserts into base of 1st metatarsal
where does the tendon of the fibularis brevis insert?
base of 5th metatarsal
what nerve innervates the fibularis longus and brevis?
superficial fibular nerve
what nerve roots innervate the fibularis longus and brevis?
L5 and S1
name the three muscles of the anterior compartment of the lower leg
tibialis anterior
extensor hallucis longus
extensor digitorum longus
what nerve innervates the anterior muscles of the lower leg?
deep fibular nerve
what nerve roots innervate the anterior leg muscles of the lower leg?
L45 and S1
the anterior tibial artery becomes what in the foot?
dorsalis pedis artery
if you cannot feel the dorsalis pedis pulse…what does this likely mean for patient?
occlusive vascular disease in more proximal vessels of the leg
what causes drop foot?
muscles of anterior compartment are weakened or paralyzed
what type of injury can lead to a drop foot?
disc herniation affecting L45 roots
when someone walks with drop foot what happens?
hyperflex hip to swing leg through gate cycle and foot slaps the ground because cant dorsiflex foot and prevent hard drop
what nerves can be damaged and lead to drop foot?
deep fibular nerve or common fibular nerve
what are the five Ps of compartment syndrome?
pallor parasthesia pulselessness paralysis pain out or proportion
what causes compartment syndrome?
excessive swelling in a muscular compartment of the lower leg that leads to neurovasculature being compressed
what makes up the articulation of the ankle joint?
distal tibia and fibula and the talus
what does the distal part of the tibia and fibula form around the talus?
mortise
is the trochlea of the talus wider posteriorly or anteriorly?
anteriorly
since the talus is wider anteriorly, is the ankle more stable is dorsiflexion or plantarflexion?
dorsiflexion because wider part gets farther into the mortise
what are the three ligaments of the lateral ankle?
anterior talofibular
calcaneofibular
posterior talofibular
the medial ligaments of the ankle are called what?
deltoid ligaments
what is the most common lateral ankle ligament to be sprained?
anterior talofibular ligament
