L8.1 - Leg, bones and muscles Flashcards
What do the medial and lateral tibial plateau come together to form?
Tubercles of intercondylar eminence
Patella - posterior medial and lateral facet makes contact with the _ of the tibia
Condyles
Is the tibia or fibula more likely to be fractured?
Tibia
Osgood–Schlatter disease
Aka apophysitis of the tibial tubercle, or Lannelongue’s disease, is an inflammation of the patellar ligament at the tibial tuberosity. It is characterized by a painful lump just below the knee and is most often seen in young adolescents - it is caused by the sliding off of unfused epiphyses.
Where do most tibial fractures occur?
At junction of middle and inferior thirds - bone narrowest and poor blood supply.
*aka boot-top fracture in skiers
Tibial fractures are often comminuted - what does this mean?
Bone completely breaking off, producing multiple bone splinters - leads to displacement of fibula and endangers common fibular nerve
Pott’s fracture
A fracture of the lower end of the fibula, usually involving a dislocation of the ankle
In the thigh fascia is aka fascia lata, in the leg, it is known as _. They are continuous with each other.
Crual fascia
In the leg, intermuscular septa form 3 compartments - what are they?
1) Anterior - DF + invertors
2) Lateral - Evertors
3) Posterior - PF + invertors
Crural fascia is continous with _ superiorly, _ anteriorly, _ inferiorly, _ deep to it
Superiorly - fascia lata
Anteriorly - Periosteum of tibia
Inferiorly - Ankle retinaculae
Deep to it - intermuscular septa
Ankle retinaculae - what type and how many are there?
1 Flexor - medial malleolus to calcaneous
2 Extensor - (sup) connects tibial and fibular malleolus, (inf) y shaped fibres where one is on medial malleolus and one is on calcaneous and they both insert on the lateral calcaneus
2 Fibular (lateral) - (sup) goes from lat malleolous to calcaneus, (inf) the stem of Y that is continuing onto calcaneus
Which compartment of the leg gets compartment syndrome usually? What structures are affected?
Anterior - lymphatics, veins, arteries, nerves (+ vessels to nerves - ischaemia of nerve)
Treatment for compartment syndrome?
Fasciotomy to decompress it
Symptoms of compartment syndrome?
Pain (on exertion), pale, pulse-less, paraesthesia (lack of sensation)
Common fibular nerve passes behind ____
Neck and head of fibula
If common fibular nerve is damaged, what actions are affected?
DF, eversion - leading to foot drop (dragging feet) or steppage gait/swinging gait/waddling gait
What does the superficial fibular nerve supply?
Muscles then skin of distal leg and dorsum of foot
What does deep fibular nerve supply?
Pierces anterior intermuscular septum to anterior compartment
Common peroneal nerve is compressed at?
Lateral knee
Where are the venous sinuses in the posterior leg muscles?
Soleus
Achillies tendinitis
Achilles tendinitis is an overuse injury of the Achilles tendon, the band of tissue that connects calf muscles at the back of the lower leg to your heel bone. Achilles tendinitis most commonly occurs in runners who have suddenly increased the intensity or duration of their runs.
Virchow’s triad - think about an old man named virchow on a plane
1) Hemodynamic changes - Tendency for blood to pool downwards
2) Endothelial injury/disfunction - Aging causes laxity of vessels
3) Hypercoagulability - In times of great inactivity - blood coagulates and thrombosis could go up to heart and lodge in lungs
