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Anatomy > Knee/Leg/Ankle > Flashcards

Knee/Leg/Ankle Flashcards

1
Q

knee joint type

A

hinge type synovial

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2
Q

knee joint stability

A

dependent on surrounding muscles/ligaments
-quadriceps femoris

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3
Q

knee joint articulations

A

tibia and femur
patella and femur

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4
Q

knee joint movements

A

flexion/extension
MR/LR (slight)

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5
Q

openings in knee joint capsule

A

posterior to allow for tendon of popliteus muscle

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6
Q

collateral ll.

A

fibular colateral l.
tibial colateral l.

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7
Q

fibular colateral l.

A

strong and cord like
taut with extension
lateral mensicus separated by t of popliteus muscle

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8
Q

tibial colateral l.

A

strong and flat
taut with extension
attaches to medial meniscus via deep fibers
more prone to injury

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9
Q

cruciate ll. rotation

A

limit MR to about 10 degrees
LR to nearly 60 degrees

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10
Q

anterior cruciate l.

A

weaker - poor blood supply
displacement and hyperextension:
-prevents posterior displacement of femur on tibia
-prevents anterior displacement of tibia on femur (flexed knee)
-resists hyper extension

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11
Q

posterior cruciate l.

A

-prevents anterior displacement of femur on tibia
prevents posterior displacement of tibia on femur
resists hyperflexion of knee

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12
Q

menisci

A

plates of fibrocartilage

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13
Q

menisci functions

A

shock absorbers
deepen tibial plateu

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14
Q

medial meniscus

A

C shaped
adheres to TCL
less mobile = more prone to injury

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15
Q

lateral meniscus

A

nearly circular
smaller and more moveable

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16
Q

causes of ACL rupture

A

hyperextension of knee
lateral blow at knee with weight on that limb

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17
Q

location of ACL rupture

A

most commonly in mid point of ligament
when knee flexed tibia slights anterior on fixed femur
-anterior drawer sign

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18
Q

PCL tear

A

not common
usually occur in conjunction with FCL and TCL injuries

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19
Q

causes of PCL tear

A

car accident
knee hits dashboard

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20
Q

mechanism of PCL tear

A

tibia slide posteriorly under fixed femur
posterior drawer sign

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21
Q

politeal fossa contents

A

adipose tissue
popliteal a. and v. (a. is deepest)
terminal part of small saphenous v. (drains to popliteal)
common fibular and tibial nerve (superficial)

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22
Q

popliteal artery

A

continuation of femoral a. after adductor hiatus
one of four places to take pulse
terminates by dividing into anterior and posterior tibial aa. at inferior border of popliteus

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23
Q

inferior tibiofibular joint type

A

compound fibrous joint (syndesmosis)

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24
Q

inferior tibiofibular joint talocrural stabilty

A

holds lateral maleolus against talus

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25
Q

inferior tibiofibular joint formed by

A

interosseus membrane (interosseus tibiofubular l.)
anterior inferior tibiofibular l.
posterior inferior tibiofibular l.

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26
Q

inferior tibiofibular joint movement

A

permits slight movement to accomodate wide portion of trochlea during dosriflexion

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27
Q

deep fascia (crural fascia)

A

attaches to anterior and medial borders of tibia
blends with preiosteum where it passes over bone

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28
Q

deep fascia 3 compartments

A

anterior
lateral
posterior

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29
Q

deep fascia transverse intermuscular septum

A

divides posterior compartment into superficial and deep

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30
Q

deep fascia retinacula

A

thickened bands of crural fascia
binds tendons proximal and distal to ankle joint
prevents bowstringing

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31
Q

different retinacula

A

superior/inferior extensor
superior/inferior fibular
flexor (cont of transverse intermuscular septum)

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32
Q

anterior compartment of leg

A

tibialis anterior
extensor hallucis longus
extensor digitorum longus
fibularis tertius

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33
Q

anterior compartment of leg common innervation

A

deep fibular n.

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34
Q

anterior compartment of leg common function

A

dorsiflexion

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35
Q

tibialis anterior

A

most medial and superficial dorsiflexor
lies against lateral surface of tibia
strongest dorsiflexor

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36
Q

tibialis anterior actions

A

dorsiflexion of foot
inversion of foot

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37
Q

tibialis anterior innervation

A

deep fibular n.

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38
Q

extensor hallucis longus

A

lies deep between tibialis anterior and extensor digitorum longus at its superior attachment
rises to surface in distal 1/3 of leg

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39
Q

found between extensor hallicus longus and tibialis anterior

A

deep fibular n.
anterior tibial a.

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40
Q

what does anterior tibial a become when it passes below extensor retinaculum

A

dorsalis pedis a.
1/4 places to take pulse in lower limb

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41
Q

extensor hallucis longus actions

A

extension of great toe
dorsiflexion of foot

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42
Q

extensor hallucis longus innervation

A

deep fibular nerve

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43
Q

extensor digitorum longus

A

most lateral of anterior compartment muscles
forms 4 tendons that attach to phalanges

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44
Q

extensor digitorum longus actions

A

extension of lateral 4 digits
dorsiflexion of foot

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45
Q

separated part of extensor digitorum longus

A

fibularis teritius

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46
Q

fibularis teritius

A

separated part of extensor digitorum longus
not always present
look for 5th tendon going to dorsum of 5th metatarsal
actions: dorsiflexion and aids in eversion of foot

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47
Q

extenosor digitorum longus

A

deep fibular n.

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48
Q

compartment syndromes

A

facial compartments are closed spaces
end proximally and distally at joints

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49
Q

causes of compartment syndromes

A

hemmorage and edema
inflammation of muscles
-increases intra-compartmental pressure

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50
Q

compartment syndromes results of high pressure

A

compresses arteries
threatens function and viability of tissues

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51
Q

compartment syndromes signs

A

structures distal to compressed areas can become ischemic
loss of pulse distally is a sign of arterial compression
temp may also be decreased

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52
Q

tibialis anterior sprain (chin splints)

A

mild form of anterior compartment syndrome
called exertional compartment syndrome

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53
Q

tibialis anterior sprain (chin splints) mechanism of injury

A

repetitive microtrauma
overexertion by untrained person

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54
Q

tibialis anterior sprain (chin splints) results

A

small tears in periosteum of tibia and/or fleshy attachements to deep fascia

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55
Q

tibialis anterior sprain (chin splints) symptoms

A

edema and pain in distal 2/3 of tibia
enough swelling can decrease blood flow to area

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56
Q

which anterior compartment muscles cross the ankle

A

all of them (have to to dorsiflex)

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57
Q

lateral compartment of leg muscles

A

fibularis longus - helps steady foot when standing
fibularis brevis - lies deep to fibularis longus

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58
Q

lateral compartment of leg muscles common function

A

eversion of foot
weak plantar flexion of foot

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59
Q

lateral compartment of leg muscles common innervation

A

superficial fibular n.

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60
Q

lateral compartment of leg muscles called in clinics

A

peroneus

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61
Q

fracture of 5th metatarsal causes

A

sudden violent inversion of ankle
common in tenis/basketball

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62
Q

fracture of 5th metatarsal and fibularis brevis m

A

can fracture or avulse 5th metatarsal

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63
Q

fracture of 5th metatarsal symptoms

A

pain and edema around 5ht metatarsal

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64
Q

fracture of 5th metatarsal misdiagnosis

A

often diagnosed as ankle inversion sprain

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65
Q

posterior compartment of leg compartments

A

superficial (3 muscles) and deep (4 muscles)

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66
Q

posterior compartment of leg muscles common innervation

A

tibial n.

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67
Q

posterior compartment of leg muscles common function

A

plantarflexion

68
Q

gastrocnemius m

A

most superficial of posterior leg

69
Q

gastrocnemius heads

A

medial and lateral

70
Q

gastrocnemius joints crossed

A

knee and ankle

71
Q

gastrocnemius m. function most effictevely when

A

knee is extended
if knee is fully flexed will not plantar felx

72
Q

gastrocnemius actions

A

plantarflexion with knee extended
flexion of leg

73
Q

gastrocnemius innervation

A

tibial n.

74
Q

soleus m.

A

deep to gastrocnemius
“workhorse” of plantarflexion

75
Q

soleus actions

A

plantarflexion independent of knee postion

76
Q

accessory soleus

A

present 3% of time
medial to calcneal t.

77
Q

soleus innervation

A

tibial n. q

78
Q

plantaris m.

A

absent 5-10% of time
small fat muscle belly, long skinny tendon

79
Q

plantaris m. actions

A

weak plantarflexion
may function in proprioception (high density of mm spindles)

80
Q

plantaris m. innervation

A

tibial n.

81
Q

“student’s/freshman nerve”

A

plantaris m. (looks like nerve)

82
Q

popliteus m

A

tendon emerges form posterior aspect of knee joint capsule

83
Q

popliteal fossa

A

forms inferior part of floor

84
Q

popliteus m actions

A

weak flexion of leg
unlocks knee by rotating femur 5 degrees on fixed tibia
medially rotates tibia of unplanted limb

85
Q

popliteus m inervation

A

tibial n.

86
Q

tibialis posterior

A

“Tom”
deepest muscles of deep posterior compartment
between flexor digitorum and flexor halluicis (cross under flexor digitorum longus)
tendon passes immediately posterior to medial maleols

87
Q

tibialis posterior important for

A

supporting medial longitiuduinal arch of foot
supports talar head

88
Q

tibialis posterior actions

A

plantarflexion of foot
inversion of foot

89
Q

tibialis posterior innervation

A

tibial n.

90
Q

flexor digitorum longus

A

on medial aspect of leg
tendon crosses tibialis posterior m . superior to medial malleolus
tendon then passes posterior to medial malleolus
tendon then crosses flexor halluicis longus t. in foot

91
Q

flexor digitorum longus actions

A

“DICK”
flexion of digits 2-5
plantar flexion of foot

92
Q

flexor digitorum longus innervation

A

tibial n.

93
Q

flexor hallucis longus

A

“Harry”
powerful flexor of great toe
most lateral muscle of deep post compartment
tendon passes posterior to medial malleolus and inferior to sustentaculum tali (bone on calcaneous)

94
Q

flexor hallucis longus actions

A

flexion of great toe
plantar flexion of foot

95
Q

flexor hallucis longus innervation

A

tibial n.

96
Q

tom dick and harry

A

relationships of tendons and neruovascular strucutures to medial malleolus
ONLY applies as they pass posterior to medial maleolus, deep to flexor retinaculum

97
Q

which t is found inferior to sustentaculum tali

A

flexor hallucis longus

98
Q

anterior tibial a. origin

A

popliteal artery

99
Q

anterior tibial a.

A

passes ant. through proximal gap in IOM

100
Q

anterior tibial a. runs with

A

deep fibular n.

101
Q

anterior tibial a. changes name

A

at ankle joint

102
Q

anterior tibial a. termination

A

dorsalis pedis a.
one of 4 places to take pulse in lower limb

103
Q

posterior tibial a. origin

A

popliteal artery

104
Q

posterior tibial a.

A

runs deep in posterior compartment with tibial n.
A in TDANH
deep to flexor retinaculum and posterior to medial maleolus between dick and posterior tibial v.

105
Q

posterior tibial a.

A

one of 4 places to take pulse in lower limb

106
Q

posterior tibial a. termination

A

medial and lateral plantar aa.

107
Q

small saphenous v. origin

A

lateral aspect of dorsal venous arch

108
Q

small saphenous v. runs with

A

sural n.

109
Q

small saphenous v. path

A

ascends posterior to lateral maleolus
ascends between heads of gastrocnemius

110
Q

small saphenous v. termination

A

drains into popliteal v.

111
Q

varicose veins

A

more common in women than men
can affect small or great saphenous vv. or any tributaries

112
Q

normal valves vs incompetent valves

A

normal- allow blood to flow toward heart while keeping from flowing away
incompetent - blood flows inferiorly and vein becomes dilated (varicose), become thick and rope like

113
Q

varicose veins symptoms

A

pain
swelling
restless leg
burning, itching skin
phlebitis
skin ulcers

114
Q

deep vein thrombosis venous stagnation due to

A

major surgery (material released during)
incompetent fascia
external pressure on veins
muscular inactivity

115
Q

other contributing factors to DVT

A

age and previous history
varicose vv.
smoking and obesity
estrogen usage or pregnancy

116
Q

classic signs of DVT

A

calf discomfort
edema
foot pain
warmth and inflammation

117
Q

DVT may partially or fully block blood flow causing

A

pooling at distal site
chronic swelling and pain

118
Q

pulmonary embolism

A

large thrombus broken free and traveled to lung
can cause pulmonary artery and death
can kill within hours

119
Q

post hip surgery dvt

A

thrombi often form in thigh
more likely to lead to PE

120
Q

post knee surgery dvt

A

most thrombi occur in calf

121
Q

common fibular nerve

A

branch of sciatic nerve
wraps around fibular neck (very superficial)
supplies skin of upper lateral leg

122
Q

common fibular nerve gives rise to

A

sural comminucating branch
joins with medial sural cutaneous n. to form sural n.

123
Q

common fibular nerve termination

A

deep and superficial fibular nn.

124
Q

deep fibular nerve compartment

A

anterior

125
Q

deep fibular nerve origin

A

common fibular n.

126
Q

deep fibular nerve runs with

A

anterior tibial a.

127
Q

deep fibular nerve sensory zone

A

flip flop zone

128
Q

deep fibular nerve termination

A

lateral branch of deep fibular (motor)
medial branch of deep fibular (sensory)

129
Q

superficial fibular n. compartment

A

lateral compartment

130
Q

superficial fibular n. origin

A

common fibular n.

131
Q

superficial fibular n. sensory to

A

inferolateral leg and dorsum of foot

132
Q

superficial fibular n. termination

A

intermediate dorsal cutaneous n,.
medial dorsal cutaneous n.

133
Q

tibial n.

A

branch of sciatic n.

134
Q

tibial n. innervation

A

all muscles in posterior compartment of leg

135
Q

tibial n. path

A

passes posterior to medial maleolus between flexor digitorum longus and flexor hallucis longus tt.

136
Q

tibial n. termination

A

medial plantar n.
lateral plantar n.

137
Q

injury to common fibular n.

A

most commonly injured nerve in lower limb due to superficial location

138
Q

injury to common fibular n. mechanism of injury

A

fracture of fibular neck or stretched with knee dislocation; kick boxing

139
Q

injury to common fibular n. muscles affected

A

all those in anterior and lateral compartments of leg

140
Q

injury to common fibular n. sign

A

foot drop - plantar flexors are unopposed
unopposed inversion makes limb too long, toes wont clear ground

141
Q

injury to common fibular n. sensory loss

A

anterolateral leg and majority of dorsum of foot

142
Q

injury to tibial n. in popliteal fossa

A

superficial here
rarely injured in leg as it lies deep to gastrocnemius and soleus m.

143
Q

injury to tibial n. in popliteal fossa affected mm.

A

posterior compartment of leg
intrinsic mm of foot
unable to plantarflex foot or flex toes

144
Q

injury to tibial n. in popliteal fossa n. sensory loss

A

plantar surface of foot

145
Q

injury to tibial n. at ankle mechanism of injury

A

trauma to or around medial maleolus
compression/crushing

146
Q

injury to tibial n. at ankle affected mm

A

intrinsic mm of foot

147
Q

injury to tibial n. at ankle sensory loss

A

plantar surface of foot

148
Q

ankle (talocrural) joint

A

hinge-type synovial

149
Q

ankle (talocrural) joint articulations

A

talus with tibia superiorly and medially
talus with fibia laterally

150
Q

ankle (talocrural) joint movements

A

dorsi and plantar flexion

151
Q

ankle (talocrural) joint joint capsule

A

weak anteriorly and posteriorly
strengthened medially and laterally by collateral ligaments

152
Q

ankle (talocrural) joint stable position

A

dorsiflexion - wedges wide, portion of talus between two malleoli

153
Q

ankle (talocrural) joint unstable position

A

plantar flexion - narrow, anterior part of talus is between two malleoli, allows for wobble

154
Q

lateral collateral l of ankle function

A

reinforces joint laterally

155
Q

lateral collateral l of ankle resists

A

inversion

156
Q

lateral collateral l of ankle composed of 3 ligaments

A

anterior talofibular - weak, commonly torn
calcaneofibular - cord like
posterior talofibular - thick and strong

157
Q

medial collateral l of ankle function

A

reinforces medially

158
Q

medial collateral l of ankle resists

A

eversion

159
Q

medial collateral l of ankle composed of 4 ligaments

A

tibionavicular l
anterior tibiotalar
posterior tibiotalar
tibiocalcaneal
(form deltoid l. together)

160
Q

ankle sprain common type

A

inversion
injures lateral ligaments

161
Q

ankle sprain most commonly torn

A

anterior talofibular
sever may injure calcaneofibular l

162
Q

ankle sprain may fracture

A

lateral malleolus

163
Q

ankle sprain less common

A

eversion sprains less common, but often more serious

164
Q

eversion ankle sprain ligaments injured

A

deltoid l

165
Q

everison ankle sprain medial malleolus

A

may avulse of fracture as deltoid l very strong

Anatomy (5 decks)

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