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Lower Extremity Anatomy > LEA Clinical of the Leg > Flashcards

LEA Clinical of the Leg Flashcards

1
Q

Common Fibular Nerve

A
  • From sciatic nerve

- Passes around fibular neck

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2
Q

Common Fibular Nerve enters lateral compartment by

A

passing through posterior intermuscular septum

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3
Q

common fibular nerve bifurcates into what terminal branches

A

deep fibular

superficial fibular

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4
Q

deep fibular nerve passes through

A

anterior intermuscular septum to enter anterior compartment

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5
Q

common fibular nerve is susceptible to injury

A
  • as it passes around fibula
  • prolonged compression (from tight cast, sitting/sleeping position)
  • trauma
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6
Q

injury to the common fibular is associated with

A
  • Footdrop (increased tripping with gait) (b/c deep fibular)
  • Weak dorsiflexion, toe extension, eversion
  • Steppage gait
  • Loss of sensation, distal anterolateral leg, dorsum of foot, 1st web space
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7
Q

broken fibula causes damage to

A

peroneal nerve (common fibular)

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8
Q 
Which of the following have a footdrop associated with weakness with dorsiflexion?
Common fibular nerve lesion?
Deep fibular nerve lesion?
Superficial nerve lesion?
Sciatic nerve lesion?
L4 spinal nerve lesion?
A 
Common Fibular- yes
Deep Fibular- yes
Sciatic Nerve- yes
L4 Spinal nerve- yes
NOT Superficial nerve lesion.
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9
Q

Transmalleolar axis

A

Line passing between the center of the medial and lateral malleoli
relation to line passing through knee joint axis

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10
Q

Transmalleolar axis measures

A

tibial torsion

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11
Q

normal tibial torsion

A

children: -10 - 0 degrees
infants more negative, more internal rotation
Adults (reached by 8-10 yrs): 10-15 degrees external rotation

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12
Q

can obtain tibial torsion by measuring transmalleolar angle

A

Patient prone.
Line through the longitudinal axis of the thigh
and a line perpendicular to the most prominent point of the malleoli.

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13
Q

obtain tibial torsion by using thigh foot angle

A

Patient prone. Line bisecting foot and line bisecting thigh

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14
Q

Kager Triangle

A

Radiolucent (dark) triangle seen on lateral radiographs

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15
Q

Kagar Fat Pad

A

pre calcaneal, pre achilles fat pad

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16
Q

Obliterated Kager triangle

A
  • Achilles pathology (tearing, inflammation)
  • Calcaneal frx
  • FHL tendon pathology
  • Accessory soleus muscle
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17
Q

Boundaries of tarsal tunnel

A
  • Medial: flexor retinaculum (laciniate ligament) and abductor hallucis
  • Lateral: calcaneus, posterior talotibial and calcaneotibial ligaments
  • Porta pedis is the distal margin of the tunnel
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18
Q

the porta pedis is the distal margin of

A

the tarsal tunnel

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19
Q

Tarsal Tunnel Syndrome

A
  • Compressive neuropathy of tibial nerve or its branches within the tarsal tunnel
  • porta pedis is also an entrapment site
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20
Q

tarsal tunnel syndrome causes altered sensation and pain over

A

medial and plantar foot, medial ankle (tibial nerve distribution)

21
Q

tarsal tunnel syndrome can cause _____ with prolonged compression

A

Atrophy of intrinsic foot muscles

22
Q

Tinel sign

A
  • is present with tarsal tunnel syndrome

- pain with tapping, percussing the nerve in tunnel

23
Q

Symptoms of tarsal tunnel syndrome reproduced with

A

sustained dorsiflexion of ankle and MTPJs and eversion of ankle;
Also can be reproduced with sustained plantarflexion and inversion.

24
Q

treatment of tarsal tunnel syndrome

A

conservatively or surgically

25
Q

Ankle Blocks

A

Used for procedures of the foot, pain relief, when a more local is not possible, etc

26
Q

Ankle blocks avoid

A
  • general anesthesia
  • motor block of the leg muscles and sensory of the leg
  • avoid releasing anesthesia into vessels, avoid puncturing nerves (anesthesia is released around the nerve)
27
Q

landmarks are key with ankle blocks so ____ can be used to help

A
  • ultrasounds

- nerve stimulators

28
Q

Most of the foot is innervated by

A

nerves derived from the sciatic nerve, except 1 (saphenous)

29
Q

5 nerves located at the ankle provide

A
  • sensory innervation to the foot

- 3 superficial and 2 deep

30
Q

3 superficial sensory nerves to the foot

A
  1. saphenous
  2. sural
  3. superficial fibular
31
Q

2 deep sensory nerves to the foot

A
  1. posterior tibial

2. deep fibular

32
Q

Posterior tibial nerve block

via the medial calcaneal branches, medial plantar, lateral plantar nerves

A

Plantar foot, medial heel, toe tips

33
Q

sural nerve block

A

Lateral ankle, lateral heel, lateral foot, lateral 5th digit

34
Q

deep fibular nerve block

A

1st web space

35
Q

superficial fibular nerve block

A

most of the dorsum of the foot and toes

36
Q

saphenous nerve block

A

medial foot

37
Q

at the level of the malleoli which nerves are subcutaneous and which are deep to retinacula

A

-Saphenous, superficial fibular, sural are subcutaneous
-Deep fibular and posterior tibial are deep and become more superficial distally)
[-Where they are blocked depends on procedure]

38
Q

Deep fibular nerve

A

deeply located at the ankle deep to deep fascia

39
Q

landmarks of the deep fibular nerve

A

EHL, EDL, TA tendons, medial malleolus

40
Q

perimalleolar: deep fibular nerve

A

lateral to EHL,

level of the superior aspect of medial malleolus

41
Q

mid tarsal: deep fibular nerve

A

lateral to EHL, medial to dorsalis pedis artery pulse

42
Q

Superficial fibular nerve landmarks

A

Subcutaneous between lateral malleolus and EHL tendon

43
Q

perimalleolar: Superficial fibular nerve

A

between superior aspect of lateral malleolus and EHL

Anesthesia is administered in the area between the 2 landmarks

44
Q

Perimalleolar: Sural Nerve

A

Subcutaneous, between Achilles tendon and superior aspect of lateral malleolus
(Anesthesia is administered between the 2 landmarks)

45
Q

Perimalleolar: Posterior Tibial nerve

A

deep to the deep fascia, posterior to medial malleolus

46
Q

Posterior Tibial Nerve is posterior to posterior tibial pulse where ?

A

midway between superior aspect of medial malleolus and Achilles tendon

47
Q

Perimalleolar: Saphenous Nerve

A

subcutaneous

between TA tendon and medial malleolus

48
Q

During a saphenous Nerve block ___ is nearby and can be punctured easily

A

Saphenous vein

49
Q

body and sustentaculum tali

A

Tibia, talus, calcaneus

Lower Extremity Anatomy (16 decks)

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