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BIOM20002 - HSF > Lecture 25 - Lower Limb 1 > Flashcards

Lecture 25 - Lower Limb 1 Flashcards

0
Q

What does the patella do?

A

Increases leverage for leg extensor muscles

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1
Q

What are the bones of the lower limb?

A 
Pelvic girdle
Femur
Tibia
Fibula
Bones of the foot
- tarsal
- metatarsal
- phalanges
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2
Q

What are the features of the pelvic girdle?

A
  • Complete ring
  • Connects the spine and the femur
  • Protects viscera
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3
Q

Describe the similarities and differences between the Tibia and Fibula, and the Ulna and Radius?

A

Similarities: linked by interosseus membrane

Differences: not lateral rotation of the tibia and fibula

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4
Q

What are the similarities and differences of the bones of the hand and the bones of the feet?

A

Similarities: same arrangement

Differences: bones of foot are much bigger, due to the greater weight that they must support

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5
Q

Which bone of the shin is weight bearing?

A

Tibia

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6
Q

The flexor compartments of the lower limb are oriented …

A

Posteriorally

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7
Q

The lower limb and upper limbs are rotated … degrees relative to each other

A

180 degrees

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8
Q

Describe the orientation of the femur

A

Angulated

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9
Q

Compare the features of the big toe and the thumb

A

Thumb: opposable

Big toe: non-opposable

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10
Q

Which bones make up the pelvic girdle?

A

Hip bone:

  • Ileum
  • Pubic
  • Ischeum

Sacrum

Coccyx

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11
Q

What is the name of the canal through the pelvis?

A

Pelvic inlet

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12
Q

Describe the sexual dimorphisms of the pelvis

A

Female:
- wider pelvic inlet

Male:
- longer sacrum and coccyx

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13
Q

Where do the gluteal muscles attach?

A

Ilium of hip bone

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14
Q

Where do the adductor muscles of the leg attach?

A

Pubis

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15
Q

Where do the hamstrings attach?

A

Ischeum

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16
Q

Describe the important features of three femur

A 
Head
Necks
Shaft
Tuberosities
Distal end
Trabeculae
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17
Q

Describe the trabeculae in the head of the femur

A

Highly organised beams of cancellous bone, so organised to resist static forces and pull of the muscle

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18
Q

What is the name of the region of the tibia that articulates at the knee joint?

A

Tibia plateau

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19
Q

What is important about the different aspects of the shaft of the tibia?

A

Anterior aspect: subcutaneous, can be felt just under the skin

Posterior: muscle attachments

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20
Q

Which features of the bones of the shin create a socket for the ankle joint?

A

The medial malleolus of the tibia

The lateral malleolus of the fibula

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21
Q

What happens on the shaft of the fibula?

A

Muscle attachments

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22
Q

What are the names of the two important tarsals?

A

Talus

Calcaneus

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23
Q

How many metatarsals are there?

A

5

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24
Q

Which are the phalanges?

A

Two rows of bones on the tips of the toes

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25
Q

Where are the sesamoid bones of the foot?

What are their function?

A

They are on the underside of the first metatarsal

They form a tunnel to prevent compression of the tendons that run along the bog toe

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26
Q

What are the unique features of the foot?

A

Non-opposable big toe

Arched foot

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27
Q

Which planes does the hip joint allow?

A

All three

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28
Q

What type of joint is the hip joint?

A

Ball and socket

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29
Q

Which ligament reinforces the hip joint capsule?

Where is this ligament, and what does it do?

A

Ileofemoral ligament

It is located in front of the joint
It confers stability when there is flexion of the hip joint

30
Q

What is the name of the artery that runs down near the head of the femur?

A

Femoral artery

31
Q

Which position of the hip joint represents the greatest stability?
Why?

A

The capsule + ligament unwinds during flexion –> unstable

The capsule + ligament spirals during extension –> greatest stability

32
Q

Describe how dislocation of the hip may occur

A

Cross legs
Force applied to the knee –> force transmitted up to the hip joint
Dislocated posteriorly

33
Q

What structures are in danger in hip dislocation?

A

Sciatic nerve

34
Q

Where does fracture of the femur normally occur?

A

Between the neck and the top of the shaft

35
Q

In which age group are hip fractures common?

A

Elderly (due to falls)

36
Q

What are the external features of fracture of the femur?

A

Leg is shorter and externally rotated

37
Q

In terms of blood supply, what may happen after a fracture of the femoral neck?

A

Avascular necrosis of the femoral head due to tearing of the vessels that run along the femoral neck

38
Q

What are the two joints at the knee?

A

Tibiofemoral

Patellofemoral

39
Q

Which type of joints are the joints of the knee?

40
Q

Describe the range of movement of the knee joints

A

Extended: little rotation

Flexed: quite large range of movement possible

Thus, not a pure hinge joint

41
Q

Which structures stabilise the knee joint?

A

Menisci: medial and lateral
Cruciate ligaments: anterior and posterior
Collateral ligaments: medial and lateral

42
Q

Are the bones of the knee joint congruent?

Why / why not?

A

Incongruent

The chondyle of the femur is round, and the head of the tibia is flat

43
Q

When is the knee joint most susceptible to injury?

Why?

A

Rotation of the joint when flexed

Extended knee joint is the most stable because the ligaments are taut

45
Q

Are the cruciate ligaments intrinsic of extrinsic?

A

Extrinsic: don’t reinforce capsule

But they are intracapsular

45
Q

What is the function of the ACL and PCL?

A

ACL: prevent forward movement of the tibia relative to the femur
PCL: prevent backwards movement of the tibia relative to the femur

46
Q

Describe the position of the anterior and posterior collateral ligaments

A

Anterior : goes to lateral epichondyle of femur

Posterior : goes to medial epichondyle of femur

47
Q

What is the name for the end of the meniscus?

48
Q

Is the meniscus the same thickness the whole way through?

Why / why not?

A

No, it is thicker on the outer surfaces and thinner towards the middle.

This creates a socket for the femur

49
Q

What is the Ruckman’s injury?

A

Tearing of the PCL

The tibia is pushed back

50
Q

What can also occur when there is PCL injury?

A

Haemarthrosis

  • tearing of the synovial membrane, which has a rich blood supply
  • blood doesn’t come from the ligament
51
Q

How is a torn ACL repaired?

A

Before:
Piece of tendon of the patella taken

Now:
Piece of tendon from hamstring

52
Q

What are the collateral ligaments of the knee?

A

Medial and lateral

53
Q

Compare the function of the medial and lateral collateral ligaments

A

Medial: prevent movement of the femur laterally

Lateral: prevent movement of the femur medially

54
Q

What is the unhappy triad?

A

Three things injured

  • ACL
  • Medial meniscus
  • Medial collateral ligament
55
Q

Are the cruciate ligaments fused with their corresponding menisci?

A

Medial collateral ligament: fused with medial meniscus

Lateral collateral ligament: separated from lateral meniscus by Popliteus

56
Q

What is the Popliteus?

A

A muscle tendon, separating the lateral collateral ligament from the lateral meniscus

57
Q

Compare Vargus and Valgus

A

Valgus: knock kneed

Vargus: bow legged

58
Q

What are the functions of the menisci in the knee joint?

A
  • shock absorb
  • increase congruence by 1/3rd
  • spread synovial fluid
59
Q

When the meniscus of the knee is torn around the periphery, what happens?

A

Locking of the knee in the flexed position

60
Q

Describe the Bursae in the knee joint

A

There are many Bursae in the knee
Most non-communicating
One communicating

61
Q

Why is the communicating bursa of the knee important?

A

Continuous with the synovial cavity of the knee

When there is injury of the knee joint, there will be effusion and haemarthrosis into this bursa as well.

Useful indication of the extent of damage for a physician

62
Q

What is the patellofemoral joint?

A

Connecting the patella with the femur

63
Q

Where is the patellofemoral joint?

A

It is within the knee joint cavity

64
Q

Which three things stabilise the patellofemoral joint?

A
  1. Vastus medialis of quadriceps
  2. Patellar retinaculum
  3. Extended epicondyle lip of femur –> increase depth of groove
65
Q

Where does the patella sit and move around?

A

Sits in the groove

Runs up and down the groove in extension and flexion

66
Q

What is the Q angle?

A

This is the way that the patella is being pulled, due to:

  • quadriceps pulling patella laterally
  • being pulled down by patellar tendon
67
Q

In which instances is the patella more prone to subluxation / dislocation?

A
  • Weakened Vastus medialis

- increased Q angle

68
Q

Describe ankle inversion and eversion

A

Inversion: joint moves laterally

Eversion: joint moves medially

69
Q

What is normally happening in ankle sprain?

A

Dorsi flexion and inversion of the ankle

Tear of the lateral collateral ligament

70
Q

Which are the two ligaments at the ankle joint?

A

Medial and lateral

71
Q

Which collateral ligament of the ankle is more frequently damaged? Why?

A

Lateral CL

It is much weaker than the medial CL, because it exists in three discrete bands

72
Q

What are the protruding parts of the bones of the leg that form a socket at the ankle joint?

A

Lateral malleolus (fibula)

Medial malleolus (tibia)

73
Q

Which malleolus is longer?

What function does this confer?

A

The lateral malleolus is longer and thus gives more support

BIOM20002 - HSF (60 decks)

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