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Lower Extremity Anatomy II > Lecture 10 > Flashcards

Lecture 10 Flashcards

1
Q

Talus primary ossification center

A
  • Center of talar body

- Appears by 6-7th fetal month

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2
Q

Talus secondary ossification center

A
  • Not always present
  • Posterior process
  • Os Trigonum results if it does not fuse
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3
Q

Calcaneus ossification

A
  • Consistently has 2 ossification centers
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4
Q

Calcaneus primary ossification center

A
  • Center of calcaneus

- Appears 4-6th fetal month

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5
Q

Calcaneus secondary ossification center

A
  • Calcaneal apophysis
  • Contributes to calcaneal tuberosity and posterior surface
  • Appears around age 6-8
  • Fuses between 14-18
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6
Q

Cuboid ossification

A
  • Single primary center

- Usually present at birth (9th month)

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7
Q

Navicular ossification

A
  • Last foot bone to begin ossifiying
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8
Q

Navicular primary ossification center

A
  • Appears at the center around age 3
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9
Q

Navicular secondary ossification center

A
  • Not always present
  • Forms medial bone
  • Results in bipartite navicular if present and fails to fuse
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10
Q

Medial cuneiform primary ossification center

A
  • Appears at the center around age 2
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11
Q

Medial cuneiform secondary ossification center

A
  • Plantar in location

- Not always present

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12
Q

Intermediate cuneiform primary ossification center

A
  • Appears at the center around age 3
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13
Q

Lateral cuneiform primary ossification center

A
  • Appears at the center around age 1
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14
Q

1st metatarsal ossification

A
  • 1⁰: appears in the shaft during 10th intrauterine week
  • 2⁰: appears in the base around age 3 (proximal growth plate)
  • Fuses ~ 18 years of age
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15
Q

2nd, 3rd, and 4th metatarsal ossification

A
  • 1⁰: appears in the shaft during 9th intrauterine week
  • 2⁰: appears at the head between 3 and 4 years of age (distal growth plate)
  • Fuses ~ 18
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16
Q

5th metatarsal ossification

A
  • 1⁰: appears in the shaft during the 10th intrauterine week
  • 2⁰ : appears at the head between 3 and 4 years of age (distal growth plate)
  • Fuses ~ 18
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17
Q

5th metatarsal secondary ossification

A
  • Can be another 2⁰ in the styloid process

- Lack of fusion results in an os Vesalianum within the fibularis brevis tendon

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18
Q

Phalanges ossification

A
  • Considered long bongs
  • Develop by endochondral ossification
  • Except for tufts of the distal phalanges (intramembranous ossification)
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19
Q

Phalanges primary ossification center

A
  • Appears in the shaft of distal (9-12 intrauterine week)
  • Proximal (11th – 15th intrauterine week)
  • Middle (after 15th intrauterine week)
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20
Q

Phalanges secondary ossification center

A
  • Appear in the base between ages 2-8 (age 3 is average)

- Fuse by age 18

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21
Q

1st MTPJ Sesamoid bones

A
  • Begin ossification between years 7-8

- Medial sesamoid is usually larger than the lateral sesamoid of the 1st MTP joint

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22
Q

Tarsal bones present at birth

A
  • Talus
  • Cuboid
  • Calcaneus
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23
Q

Tarsal bones present by 1 year of age

A
  • Talus
  • Cuboid
  • Calcaneus
  • Lateral cuneiform
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24
Q

Tarsal bones present by 2 years of age

A
  • Talus
  • Cuboid
  • Calcaneus
  • Lateral cuneiform
  • Medial cuneiform
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25
Q

Tarsal bones present by 3 years of age

A
  • Talus
  • Cuboid
  • Calcaneus
  • Lateral cuneiform
  • Medial cuneiform
  • Intermediate cuneiform
  • Navicular
26
Q

Accessory ossicles are found within

A
  • Tendons
  • Joint capsules
  • High pressure areas
27
Q

Accessory ossicles

A
  • Easily mistaken for fractures
  • Some are derived from failure of union of 2ᵒ ossification center
  • Usually asymptomatic
  • Can become symptomatic
28
Q

Symptomatic accessory ossicles usually invovle

A
  • Fracture
  • Dislocation
  • Degeneration
  • AVN
  • Impingement
29
Q

Accessory navicular (4-21%)

A
  • Lack of fusion of a secondary ossification center of navicular tuberosity (type I and II)
30
Q

Type I accessory navicular (os tibiale externum, os navicular secundum)

A
  • Within posterior tibialis tendon at the insertion

- Proximal to navicular tuberosity

31
Q

Type II accessory navicular (prehallux, bifurcate hallux)

A
  • Connected to navicular tuberosity by cartilaginous bridge
  • Often bilateral
  • Large, located near navicular tuberosity
32
Q

Type III accessory navicular

A
  • Prominent navicular tuberosity (cornuate navicular

- A fused type II

33
Q

Os supranaviculare (1-3.5%)

A
  • Also called Piries bone, os talonavicular dorsale

- Located proximal dorsal aspect of navicular

34
Q

Os Peroneum (20-70%)

A
  • Located within the tendon of peroneus longus (lateral to fibular sulcus/groove of cuboid, lateral to cuboid)
  • Commonly bilateral
  • Can cause degeneration of peroneus longus tendon
  • Can form joint with cuboid tuberosity
35
Q

Os Vesalinum (0.1-1%)

A
  • Found within tendon of peroneus brevis at insertion on styloid process of 5th metatarsal
  • Unfused secondary ossification center
  • Seen on AP and medial oblique xray
36
Q

Os Trigonum (7-25%)

A
  • Located posterior to talus
  • Lack of fusion of secondary ossification center of the lateral tubercle
  • Can cause posterior impingement and tenosynovitis of FHL
37
Q

Os sustentaculi (0.3-1%)

A
  • Located on posterior aspect of sustentaculum tali
38
Q

Os calcaneum secundarius (~1%)

A
  • Located at anterior process of calcaneus

- Can mimic bifurcate ligament avulsion fracture

39
Q

Os subtibiale (rare)

A
  • Near posterior colliculus of medial malleolus
40
Q

Os Supratalare/os astraglus (~1%)

A
  • Located dorsal to neck of talus
41
Q

Os Intercuneiforme (1-2%)

A
  • Located between cuneiforms dorsally

- Usually between medial and intermediate

42
Q

Os Intermetatarseum (~4-5%)

A
  • Between bases of metatarsals
  • Most common between 1st and 2nd; 4th and 5th
  • Can form a synovial joint with neighboring bone or fuse to them
43
Q

Accessory sesamoid bones

A
  • Most common at the IPJ of the hallux and the MTPJ of the 5th digit
44
Q

Ankle joint innervation

A
  • Deep fibular nerve
  • Accessory deep fibular when present
  • Tibial nerve
  • Saphenous nerve
  • Sural nerve
45
Q

Subtalar joint innervation

A
  • Tibial nerve
  • Lateral dorsal cutaneous (sural)
  • Medial plantar
  • Deep fibular
  • Accessory deep fibular when present
46
Q

Talocalcaneonavicular joint innervation

A
  • Medial plantar

- Deep fibular

47
Q

Calcaneoucuboid joint innervation

A
  • Lateral plantar
  • Sural
  • Deep fibular
  • Accessory deep fibular when present
48
Q

Cuneocuboid and cuboidonavicular joint innervation

A
  • Lateral plantar

- Deep fibular

49
Q

1st and 2nd cuneonavicular, medial intercuneiform, cuneometatarsal 1-2 innervation

A
  • Deep fibular

- Plantar side: Medial plantar

50
Q

3rd cuneonavicular, 3rd cuneometatatarsal, lateral intercuneiform innervation

A
  • Deep fibular

- Lateral plantar

51
Q

Cuboid, metatarsal 4,5 innervation

A
  • Sural
  • Superficial fibular
  • LPN
52
Q

Dorsal innervation of intermetatarsal joint

A
  • Deep fibular nerve
53
Q

Plantar innervation of intermetatarsal joint

A
  • Deep branch of lateral plantar (between 2nd/3rd and 3rd/4th met bases)
  • Superficial branch of LPN (between 4th/5th met base)
54
Q

MTP joint and IP joint innervation

A
  • Branches from the dorsal and plantar digital nerves that pass by the joint
  • 2-4th MTP joints can also receive innervation from deep branch of LPN
55
Q

Talocrural in OPEN kinetic chain

A
  • Roll and slide in opposite directions

- Calcaneus and foot moving on talus

56
Q

Talocrural joint in CLOSED kinetic chain

A
  • Roll and slide of mortise on the trochlea

- Talus, forefoot is fixed, calcaneus is mostly fixed

57
Q

Pronation in OPEN kinetic chain involves

A
  • Dorsiflexion
  • Abduction
  • Eversion
58
Q

Supination in OPEN kinetic chain involves

A
  • Plantarflexion
  • Adduction
  • Inversion
59
Q

Pronation in CLOSED kinetic chain involves

A
  • Plantarflexion (talus)
  • Adduction (talus)
  • Eversion (calcaneus)
  • Tibia internal rotation
60
Q

Supination in CLOSED kinetic chain involves

A
  • Dorsiflexion (talus)
  • Abduction (talus)
  • Inversion (calcaneus)
  • Tibia external rotation

Lower Extremity Anatomy II (9 decks)

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