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Medicine Year 1 - Semester 2 - Part 2 > Leg > Flashcards

Leg Flashcards

1
Q

What is the popliteal fossa ?

A

Recess behind the knee, transition area between thigh and leg.

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2
Q

State the boundaries of the popliteal fossa

A

Biceps femoris

Semi Tendinosis & Membranous

Gastrocnemius : medial and lateral heads

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3
Q

State the roof of the popliteal fossa

A

Fascia Lata

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4
Q

State the floor of the popliteal fossa

A

Intracondylar area of femur
Posterior joint capsule
Popliteus muscle

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5
Q

State the contents of the popliteal fossa

A

Popliteal artery and vein
Tibial nerve

Common fibular nerve
Posterior cutaneous nerve of the thigh

Terminal part of the small saphenous vein

Lymph nodes
Fat

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6
Q

What is at risk during knee dislocation and supracondylar fracture of femur ?

A

Popliteal artery

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7
Q

Popliteal artery feature

A

Deepest and most medial structure in the popliteal fossa.

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8
Q

When standing describe the knee ?

A

The knee joint is locked into position
- ‘screw home mechanism’ - passive

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9
Q

When does locking occur ?

A

Locking occurs in the last 30 degrees of extension

Ligaments are tightened

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10
Q

Describe the screw home mechanism - locked knee

A

Flat surface of the femoral condyles are in contact with the tibia plateus

Therefore the joint surface becomes larger.

Large lateral condyle pivots medially to the condyle posteriorly. - MEDIAL ROTATION OF THE FEMUR

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11
Q

Action of full extension

A

Medial rotation of the femur

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12
Q

In full extension, which muscles support the locked position

A

Vastus medialis

Gluteus maximus and tensor fascia lata
(via the iliotibial tract)

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13
Q

What do gluteus maximus and tensor fascia lata insert into ?

A

The iliotibial tract

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14
Q

Popliteus muscle - nerve supply

A

Tibial nerve
L4-S1

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15
Q

Open Chain

A

Tibia laterally rotates to lock the knee

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16
Q

Closed Chain

A

The distal end of the limb is fixed, e.g. in walking.

The femur medially rotates to lock the knee.

Tibia is fixed

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17
Q

How can you unlock the knee ?

A

To unlock the knee, the femur must be laterally rotated on tibia - before flexion can occur.

This is done via popliteus muscle, which laterally rotates the femur.

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18
Q

State some other rotators of the knee

A

Pes anserinus muscles
Biceps femoris

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19
Q

Pes anserinus muscles function

A

Medially rotates the tibia
External femur insertion

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20
Q

Biceps femoris muscle function

A

Laterally rotates the tibia
Internal femur insertion

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21
Q

State the muscular compartments of the leg

A

Anterior compartment
Lateral compartment

Posterior compartment - superficial/deep

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22
Q

Function of anterior compartment of the leg

A

Dorsiflexors of the foot and toes

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23
Q

Function of lateral compartment of the leg

A

Evertors of the foot

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24
Q

Function of posterior compartment of the leg

A

Plantar flexors of the foot and toes

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25
State the muscles of the superficial posterior compartment
Gastrocnemius Soleus Plantaris PLANTAR FLEXOR COMPARTMENT
26
What supplies the posterior compartment of the leg ?
Tibial nerve S1,2
27
Gastrocnemius
Femoral attachment - weak flexor of knee Powerful plantar flexor
28
Soleus
Tibial attachment - soleal line Postural action
29
Plantaris
Freshman's nerve
30
Triceps surae
Gastrocnemius and Soleus (sometimes plantaris) are collectively called triceps surae
31
Function of triceps surae
Pushes the body forward off the planted foot during walking. Elevates the body upward onto the toes when standing.
32
Insertion of triceps surae
Calcaneal tendon
33
Calcaneal tendon
Achilies tendon Thickest, strongest tendon in the body. Inserts on posterior surface of the calcaneus. Bursae subcutaneously and between deep surface and calcaneus. (retrocalcaneal burase)
34
Where does calcaneal tendon commonly rupture ?
Weakest part is the middle 3rd due to relatively poor vascularity.
35
Treatment for calcaneal tendon rupture
Fluoroquinolons Corticosteroid use Dialysis
36
Signs of calcaneal tendon rupture
No power of plantarflexion against resistance. Tender gap
37
Test for calcaneal tendon rupture
Thompson's test Calf-squeeze test For complete Achilles rupture
38
State the muscles found in the deep posterior compartment of the leg
Flexor hallucis longus Flexor digitorum longus Tibialis posterior
39
Flexor hallicus longus S2,3
deep posterior compartment - inserts into distal phalanx of hallux
40
Flexor digitorum longus S2,3
deep posterior compartment - inserts into distal phalanx of toes
41
Tibialis posterior L4,5
deep posterior compartment - inserts into Tuberosity of Navicular + Medial cuneiform - Inversion (plantar flexion) - Supports medial longitudinal arch of foot
42
Tibialis posterior feature
deepest muscle in the deep posterior compartment
43
Function of tibialis posterior
Inversion - plantar flexion
44
Location of posterior tibial artery and tibial nerve
Descends deep to the soleus muscle towards the medial malleolus
45
Nerve supply to the posterior compartment of the leg
Tibial nerve
46
Flexor hallicus longus function
Important function in walking Supports the medial longitudinal plantar arch
47
Flexor digitorum longus function
Supports the medial and lateral longitudinal plantar arches
48
Primary function of tibialis posterior
Support the medial longitudinal plantar arch Also main INVERTER of the foot
49
Function of soleus muscle
The most important muscle to remain upright at the ankle joint
50
Calcaneal tendon reflex
Elicited by striking the calcaneal tendon briskly tests S1 and (S2) nerve roots
51
What nerve supplies the anterior compartment of the leg ?
Deep fibular nerve
52
Muscles of the anterior compartment of the leg
Tibialis anterior Extensor hallicus longus Extensor digitorum longus Fibularis (peroneus) tertius
53
Tibialis anterior
Medial cuneiform, 1st metatarsal - insertion Inversion and Dorsiflexion Supports medial longitudinal arch of foot L4,5
54
Extensor hallucis longus
L5, S1
55
Extensor digitorum longus
L5, S1
56
Fibularis (peroneus) tertius
L5,S1 Base of 5th metatarsal - insertion Dorsiflexion and eversion
57
Where does the deep fibular (peroneal) nerve arise from ?
Arises between fibularis longus muscle and the neck of fibula.
58
Location of the deep fibular nerve
Descends between tibialis anterior and extensor hallucis longus on the interosseous membrane. - Accompanied by anterior tibial vessels
59
What nerve supplies the lateral compartment of the leg ?
Superficial peroneal (fibular) nerve
60
State the muscles of the lateral compartment of the leg
Fibularis brevis Fibularis longus
61
Where do the muscles of the lateral compartment of the leg arise from ?
Both arise from the fibula and pass posterior to the lateral malleolus.
62
Function of the lateral compartment of the leg
Both evert the foot - and plantar flex
63
Insertion of fibularis brevis
Inserts onto 5th metatarsal
64
Insertion of fibularis longus
Longus inserts into the 1st metatarsal - Lateral longitudinal arch support
65
Where does the superficial fibular nerve arise from ?
Arises between fibularis longus and neck of fibula. Descends in lateral compartment of the leg. At distal 1/3rd of leg, becomes cutaneous
66
Function of sural nerve
Purely sensory May be used as nerve graft Innervates skin of posterolateral leg and lateral border of foot
67
Where does the sural nerve arise from ?
Lateral cutaneous sural branch - from the common fibular nerve Medial cutaneous sural branch - from the tibial nerve
68
What does the sural nerve run alongside ?
Small saphenous vein
69
Where does the small (short) saphenous vein arise from ?
Arises from lateral side of dorsal venous arch. Penetrates the deep fascia of the leg between the heads of the gastrocnemius muscle.
70
What does the small saphenous vein go on to form ?
Popliteal vein
71
Compartment syndrome
Increased pressure within a compartment Can be due to bleeding or oedema
72
Symptoms of compartment syndrome
Pallor Pulselessness Pain Paralysis Paraesthesia

Medicine Year 1 - Semester 2 - Part 2 (53 decks)

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