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Anatomy of Lower Limbs > Knee, Leg, Ankle and Foot > Flashcards

Knee, Leg, Ankle and Foot Flashcards

1
Q

what muscles originate from the distal femur?

A

the medial and lateral heads of the gastrocnemius

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2
Q

which lines on the femur widen to form the floor of the popliteal fossa?

A

linea aspera

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3
Q

what type of bone is the patella?

A

sesamoid bone (the largest in the body of its kind)

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4
Q

what ligament does the patella lie within?

A

the tendon of the quadriceps femoris

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5
Q

what is the natural position of the patella?

A

supero-medially , posterior surface against the femur

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6
Q

position of tibia and fibula

A

tibia- medial

fibula- lateral

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7
Q

where does the tibia articulate?

A

with the medial distal femur at knee joint

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8
Q

what can be found at the tibia plateau?

A

medial and lateral condyles divided by the intercondylar region:

contain the ACL/PCL inferior attachments

anterior and posterior horns of the medial and lateral menisci

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9
Q

where does the patellar ligament attach?

A

anterior proximal tibia at the tibial tuberosity

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10
Q

where do the satoris, gracilis and semitendinous attach on the proximal tibia?

A

per anserinus

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11
Q

what line is found at the posterior proximal tibia?

A

soleal line

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12
Q

Is the fibula involved in the knee joint?

A

no, nor is it involved in weight bearing

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13
Q

what type of joint is the tibia-fibular joint?

A

synovial

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14
Q

what muscle attached to the lateral surface of the proximal fibula?

A

biceps femoris

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15
Q

what type of joint is the knee joint and what are its motions?

A

Largest synovial joint in the body; Hinge-type

Gliding, Rolling and Rotation

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16
Q

what are the ligaments of the knee joint?

A

ACL
PCL
Medial (Tibial) Collateral Ligaments
Lateral (Fibular) Collateral Ligaments

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17
Q

what are the fibrocartilginous menisci?

what do they do?

A

Medial Meniscus
Lateral Meniscus

Cartilaginous discs which accommodate changes in the shape of the articular surfaces during joint movements

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18
Q

what muscles are the extensors of the knee joint?

A

quadriceps

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19
Q

what are the flexors of the knee?

A 
Hamstrings
Sartorius
Gracilis
Popliteus
Gastrocnemius
Plantaris
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20
Q

what are the bursae around the knee?

A

Pre-patellar
Suprapatellar
Infrapatellar
Popliteus

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21
Q

what does the patella enable?

A

allows the pull of the quadriceps femoris muscle to be directed anteriorly over the knee to the tibia without tendon wear

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22
Q

what is the function of the intra-articular menisci?

A

Enable greater stability of the knee joint + Shock Absorber

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23
Q

where do the medial and lateral menisci attach?

A

Each with respective Anterior and Posterior Horns attaching to the Intercondylar Region of the Tibia

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24
Q

Which ligament is the medial meniscus attached to?

A

Tibial Collateral Ligament

Joint Capsule

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25
Q

why is the medial capsule more susceptible to injury compared to the lateral meniscus?

A

it is joint to the joint capsule

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26
Q

how do the menisci receive their nutrition?

A

Devoid of vasculature towards centre – Synovial fluid nutrient derived by hydrostatic pressure

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27
Q

how are the names of the cruciate ligaments derived?

A

from attachment position on Tibial Plateau

“cruciate” (Latin for “shaped like a cross”) because they cross each other in the sagittal plane between their femoral and tibial attachments

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28
Q

what is the superior and inferior attachment of the ACL?

A

Superior: Lateral Wall of Femoral Intercondylar Fossa

Inferior: Anterior Tibial Intercondylar region

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29
Q

what is the superior and inferior attachment of the PCL?

A

Superior: Medial Wall of Femoral Intercondylar Fossa

Inferior: Posterior Tibial Intercondylar region

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30
Q

ACL and PCL attachments

A

LAMP

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31
Q

how do you asses the ACL/PCL integrity?

A

ACL/PCL integrity

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32
Q

what are the bursae of the knee for?

A

Minimise friction generated

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33
Q

what type of tissue are the bursae?

where do they occur?

A

Sacs of fibrous tissue lined with synovial membrane and filled with fluid (synovia)

Occur where parts move over one another
E.g. Around joints, where ligaments/tendons pass over bone

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34
Q

what is the inflammation of the bursae and what are the causes?

A

Bursitis

  • Repetitive injury/pressure/friction
  • Infection
  • Inflammatory conditions

show typical signs of inflammation and restrict joint movment

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35
Q

how is the fibrous membrane of the knee joint formed?

A

Formed by extensions from tendons of the surrounding muscles

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36
Q

what does the fibrous membrane of the knee joint enclose?

A

Encloses the articular cavity and intercondylar region

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37
Q

what is the function of the collateral ligaments?

A

stabilise the hinge-like motion of the knee

there is a lateral/fibular and a medial/tibial

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38
Q

what does the full extension of the knee (locked out) enable us to do?

A

reduces the amount of muscle work need to maintain the standing position

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39
Q

what are the changes that take place when the knee is locked?

A

1) Shape of the femoral condyles – flatter/broader anteriorly stabilises the joint
2) Medial rotation of the femur on the tibia – tightens ligaments (‘Locking’ mechanism)
3) Body’s line of centre of gravity is anterior to the knee joint

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40
Q

what muscle unlocks the knee?

A

?popliteus

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41
Q

what is the popliteal fossa?

A

Diamond-shaped space posterior to the knee join

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42
Q

what is contained in the popliteal fossa?

A
  • Popliteal artery/vein
  • Short saphenous vein (becomes Popliteal vein)
  • tibial nerve
  • common perineal nerve
  • popliteal lymph nodes
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43
Q

what are the boundaries of the popliteal fossa?

A
  • Floor: Knee Capsule; Femur/Tibia
  • Roof: deep fascia
  • semitendinous
  • biceps femoris long head
  • gastrocnemius medial head and lateral head
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44
Q

where is the small saphenous vein contained?

A

in the superficial fascia

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45
Q

what are the bones of the foot?

A
  • tarsals (7)
  • metatarsals (5)
  • phalanges
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46
Q

where are the sesamoid bones of the foot located?

A

within Flexor Hallucis Brevis; on the head of the 1st metatarsal (ball of the foot)

the FH longus transverses throught these

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47
Q

what type of joint is the ankle joint?

what movement does it enable?

A

synovial, hinge-like joint

Dorsi-/Plantarflexion

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48
Q

what is the meeting point of the tibia/fibula with the talus of the foot called?

A

mortice

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49
Q

what are the faces of the mortice?

A
  • Roof – Inferior Surface of Distal Tibia
  • Medial Side – Medial Malleolus of Tibia
  • Lateral Side – Lateral Malleolus of Fibula
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50
Q

what ligaments stabilise the ankle?

A

medial (deltoid) and lateral ligaments

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51
Q

medial ligament attachments

A

to medial malleolus and
Anterior/Posterior Tibiotalar
Tibionavicular
Tibiocalcaneal

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52
Q

lateral ligament of ankle attachments

A

lateral malleolus and
Anterior/Posterior Talofibular
Calcaneofibular

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53
Q

which ligament is most commonly sprained

A

lateral ligaments
- occur during over-inversion injuries

tearing of the ligament

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54
Q

what is the subtler joint?

A

joint between the large posterior calcaneal facet and the inferior surface of the talus

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55
Q

action at subtler joint

A

gliding and rotation

Thus, enables foot Inversion/Eversion

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56
Q

what stabilises the subtalar joint

A

Lateral, Medial, Posterior & Interosseous talocalcaneal ligaments

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57
Q

what type of joint is the Proximal Tibiofibular Joint?

A

synovial

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58
Q

what type of joint it the Distal Tibiofibular Joint?

A

Fibrous Joint

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59
Q

what are the motions of the posterior compartment of the leg?

A

Flexion of the knee
Plantarflexion
Foot inversion
Toes flexion

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60
Q

what is the innervation to the posterior compartment of the leg?

A

tibial

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61
Q

what are the superifical posterior muscles of the leg?

A

Gastrocnemius
Soleus
Plantaris

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62
Q

where do the superficial posterior muscles of the leg insert? via which tendon?

A

Insert into calcaneus via ‘Achilles tendon’

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63
Q

what muscles make up the triceps surae?

A

Gastrocnemius + Soleus = Triceps Surae

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64
Q

what are the deep posterior muscles of the leg?

A

Popliteus
Tibialis Posterior
Flexor Digitorum Longus
Flexor Hallucis Longus

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65
Q

action of gastrocnemius

A

Plantarflexion, Knee Flexion

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66
Q

proximal attachment of gastrocnemius

A

Medial Head – Superior to medial femoral condyle

Lateral Head - Superior to lateral femoral condyle

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67
Q

distal attachment of gastrocnemius

A

Calcaneal tendon

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68
Q

action of plantaris

A

Plantarflexion, Knee Flexion

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69
Q

proximal attachment of plantaris

A

Inferior part of lateral supracondylar line of femur

70
Q

distal attachment of plantaris

A

Calcaneal tendon

71
Q

action of soleus

A

Plantarflexion

72
Q

proximal attachment of soleus

A

Soleal line and medial border of tibia

Posterior fibular head

73
Q

distal attachment of soleus

A

Calcaneal tendon

74
Q

function of popliteus

A

Stabilises knee joint and limits lateral rotation of tibio-femoral joint

75
Q

proximal attachment of popliteus

A

Lateral femoral condyle

76
Q

distal attachment of popliteus

A

Posterior surface of tibia

77
Q

action of tibialis posterior

A

Plantarflexion, Foot Inversion, Support of Medial Arch

78
Q

Proximal attachment of tibialis posterior

A

Posterior interosseous membrane

Tibia/Fibula

79
Q

Distal attachment of tibialis posterior

A

Navicular Tuberosity

Medial Cuneiform

80
Q

action of flexor hallucis longus

A

Flexion of Great Toe

81
Q

Proximal attachment of flexor hallucis longus

A

Posterior interosseous membrane

Fibula

82
Q

Distal attachment of flexor hallucis longus

A

Plantar surface of Base of Distal Phalanx of Great Toe

83
Q

action of flexor digitorium longus

A

Flexion of Lateral 4 Toes

84
Q

proximal attachment of flexor digitorium longus

A

Medial Tibia

85
Q

distal attachment of flexor digitorium longus

A

Plantar surfaces of Base of Distal Phalanx of Lateral 4 Toes

86
Q

motions of lateral compartment of the leg

A

Foot eversion

Plantarflexion

87
Q

innervation to lateral compartment of the leg

A

Superficial Peroneal Nerve

Branch of Common Peroneal Nerve

88
Q

muscles of the lateral compartment of the leg

A

Fibularis longus

Fibularis brevis

89
Q

actions of fibularis longus

A

Foot Eversion, Plantarflexion, Support arches of foot

90
Q

Proximal attachment of fibularis longus

A

Upper lateral surface/Head of fibula

91
Q

Distal attachment of fibularis longus

A

Base of 1st Metatarsal
Medial cuneiform

(The tendon of Peroneus Longus grooves the lateral malleolus, hooks around the calcaneal trochlea, grooves cuboid and then inserts at the undersurface of MEDIAL CUNEIFORM and BASE of METATARSAL I)

92
Q

actions of fibularis brevis

A

Foot Eversion

93
Q

Proximal attachment of fibularis brevis

A

Lower 2/3 of lateral surface of fibula

94
Q

Distal attachment of fibularis brevis

A

Base of 5th Metatarsal

95
Q

motions of anterior compartment of the leg

A

Dorsiflexion
Toes extension
Foot inversion

96
Q

innervation to anterior compartment of the leg

A

Deep Peroneal Nerve

Branch of Common Peroneal Nerve

97
Q

muscles of the anterior compartment of the leg

A

Tibialis Anterior
Extensor Hallucis Longus
Extensor Digitorum Longus
Peroneus Tertius

98
Q

actions of tibialis anterior

A

Dorsiflexion, Foot Inversion, Support of medial arch of foot

99
Q

Proximal attachment of tibialis anterior

A

Lateral Tibia

Anterior interosseous membrane

100
Q

Distal attachment of tibialis anterior

A

Medial Cuneiform

Base of 1st Metatarsal

101
Q

actions of extensor hallucis longus

A

Extension of Great Toe, Dorsiflexion

102
Q

Proximal attachment of extensor hallicus longus

A

Medial Fibula

Anterior Interosseous Membrane

103
Q

Distal attachment of extensor hallicus longus

A

Dorsal surface of Base of Distal Phalanx of Great Toe

104
Q

actions of extensor digitorum longus

A

Extension of Lateral 4 Toes, Dorsiflexion

105
Q

Proximal attachment of extensor digitorum longus

A

Medial Fibula

Lateral Tibial Condyle

106
Q

Distal attachment of extensor digitorum longus

A

Dorsal surface of Bases of Distal & Middle Phalanges of Lateral 4 Toes
via Dorsal Digital Expansions

107
Q

actions of fibularis/peroneal tertius

A

Dorsiflexion, Eversion of Foot

108
Q

Proximal attachment of fibularis teritus

A

Distal, Medial Fibula

109
Q

Distal attachment of fibularis tertius

A

Dorsal surface of Base of 5th Metatarsal

110
Q

what muscle tendons are found in the dorsal of foot?

A

Extensor Digitorum Brevis/Longus

Extensor Hallucis Brevis/Longus

111
Q

what are the 4 layers of the sole of the foot?

A

from superificial to deep:

  • 1st Layer: Abductor hallucis, Abductor digiti minimi, FDB
  • 2nd Layer: Quadratus plantae, Lumbrical
  • 3rd Layer: Adductor halluces, FHB, FDMB
  • 4th Layer: 4 Dorsal / 3 Plantar interossei
112
Q

what is the quadratus plantae?

A

It acts to aid in flexing the 2nd to 5th toes (offsetting the oblique pull of the flexor digitorum longus) and is one of the few muscles in the foot with no homolog in the hand.

113
Q

what are the arches of the foot?

A

Medial/Lateral Longitudinal Arches & Transverse Arch

114
Q

what is the function of the foot arches?

A

Absorb and distribute downward forces when standing/different surface types

115
Q

what help support the arches of the foot?

A

Long tendons and Intrinsic muscles support arches

116
Q

main arterial branches of the knee

A 
Femoral
Popliteal
Lateral circumflex femoral artery 
Circumflex peroneal artery
Anterior tibial artery (recurrent branch)
117
Q

how does the popliteal artery enter the posterior compartment of the leg?

A

The popliteal artery passes into the posterior compartment of the leg between the gastrocnemius and popliteus muscles

118
Q

what does the popliteal artery pass under as it goes down inferiorly?

A

inferiorly it passes under the tendinous arch formed between the fibular and tibial heads of the soleus muscle

119
Q

what happens when the popliteal artery enters the deep region of the posterior compartment?

A

immediately divides into an anterior tibial artery and a posterior tibial artery

120
Q

where does the femoral artery come through to form the popliteal artery?

A

Adductor Hiatus

121
Q

what is the arterial supply to the superficial posterior compartment?

A

Sural arteries (2 come off the popliteal)

122
Q

what is the arterial supply to the deep posterior compartment?

A

Posterior Tibial Artery

123
Q

where does the posterior tibial artery enter the foot?

A

Enters Sole of Foot via Tarsal Tunnel posterior to Medial Malleolus

124
Q

what is the arterial supply to the lateral compartment?

A

posterior tubular artery produces the peroneal artery which descends down the lateral part of the posterior compartment

branches of the peroneal artery penetrate intermuscular septum into lateral compartment

125
Q

what is the arterial supply to the anterior compartment?

A

Anterior Tibial Artery

126
Q

what arteries anatomise with the posterior tibial and peroneal arteries around the ankles?

A

Anterior Medial/Lateral Malleolar Arteries

127
Q

what does the anterior tibial artery become in the dorsum?

A

Dorsalis Pedis Artery

128
Q

what are the deep veins of the leg?

A
  • Venae comitantes of arteries (Calf; Profunda femoris)
  • Popliteal
  • Femoral
129
Q

what are the superificial veins of the leg?

A

Great/Small Saphenous Veins

130
Q

what connects the superficial venous system to the deep?

A

perforating veins

131
Q

origin of great saphenous vein

A

Medial Side of Dorsal Venous Arch

132
Q

where does the great saphenous vein ascend?

A

Anterior to Medial Malleolus

Medial side of leg, knee and thigh

133
Q

where does the great saphenous vein drain into?

A

Femoral vein inferior to inguinal ligament

Sapheno-femoral junction

134
Q

origin of the small saphenous vein

A

Lateral Side of Dorsal Venous Arch

135
Q

where does the small saphenous vein ascend?

A

Posterior surface of leg

136
Q

where does the small saphenous vein drain into?

A

Penetrates deep fascia –>Popliteal Vein

Popliteal vein proximal to knee become femoral vein

137
Q

what innervates the knee extensors i.e. quadriceps?

A

femoral nerve

138
Q

what innervates the knee flexors i.e. hamstrings

A

sciatic nerve

139
Q

what innervates the Posterior Compartment + Foot Intrinsic Muscles?

A

Tibial Nerve

140
Q

what innervates the anterior compartment?

A

Common Peroneal Nerve (Deep Branch)

141
Q

what innervates the lateral compartment?

A

Common Peroneal (Superficial Branch)

142
Q

pathway of sciatic nerve

A

Traverses from the Pelvic Cavity into Gluteal Region via

Greater Sciatic Foramen

143
Q

where does the sciatic nerve lie in the buttock?

A

inferior and medial quadrant of the buttock

144
Q

what is the region of the sciatic nerve in the buttock used for?

A

Safe Area’ for IM Ventrogluteal Gluteal Injections

145
Q

what does the sciatic nerve supply?

A

Supplies all muscles below the knee

146
Q

which intrinsic foot muscle is NOT innervated by the tibial nerve?

A

extensor digitorium brevis

innervated by deep peroneal nerve

147
Q

what does the tibial nerve divide into behind the medial malleolus?

A

Medial plantar nerve

Lateral plantar nerve

148
Q

where does the sural nerve originate from?

A

Originates high in the leg between two heads of gastrocnemius

149
Q

where is the sural nerve formed from?

A

Formed from branch of Tibial Nerve + Common Peroneal

150
Q

what is the cutaneous innervation of the sural nerve?

A

Lower Posterolateral Leg

Lateral Foot/Little Toe

151
Q

what is a use of the sural nerve?

A

Harvested for Nerve Repair

152
Q

where does the common peroneal nerve descend from?

A

Descends around the neck of the fibula

153
Q

what types of injury is the common peroneal susceptible to?

A

Fibular Fracture

Knee Joint Dislocation

154
Q

what is the presentation of common Peroneal nerve palsy?

A

foot drop

155
Q

what does the common peroneal nerve divide into?

A

Deep Peroneal Nerve

Superficial Nerve

156
Q

what transverse the tarsal tunnel?

A 
Tibialis Posterior
Flexor Digitorum Longus
Posterior Tibial Artery, Posterior Tibial Vein
Tibial Nerve
Flexor Hallucis Longus

[Tom, Dick And Very Naught Harry]

157
Q

what forms the tarsal tunnel?

A

Formed by Flexor Retinaculum on posteromedial side of ankle (behind Medial Malleolus

158
Q

motor segmental supply to hip flexion

A

L2, L3

159
Q

motor segmental supply to hip extension

A

L4, L5

160
Q

motor segmental supply to knee extension

A

L3, L4

161
Q

motor segmental supply to knee flexion

A

L5, S1

162
Q

motor segmental supply to ankle dorsiflexion

A

L4, L5

163
Q

motor segmental supply to ankle plantar flexion

A

S1, S2

164
Q

motor segmental supply and the action of the muscle

A
  • Most muscle groups are supplied by two adjacent spinal cord segments.
  • Muscles with the same primary action on a joint have similar segmental innervation.
  • The muscles causing the opposing movements are supplied by the two spinal cord segments below.
165
Q

dermatomes of the leg

A

L3 to the Knee
L4 to the Floor

L5 – Great Toe
S1 – Lateral Dorsum of Foot/Sole
S2 – Most of the Posterior Leg/Thigh

166
Q

L3 dermatome

A

knee

167
Q

L4 dermatome

A

floor (foot)

168
Q

L5 dermatom

A

great toe

169
Q

S1 dermatome

A

Lateral Dorsum of Foot/Sole

170
Q

S2 dermatome

A

Most of the Posterior Leg/Thigh

Anatomy of Lower Limbs (1 decks)

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