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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
Q

State the muscles of the superficial posterior compartment

A

Gastrocnemius
Soleus
Plantaris

PLANTAR FLEXOR COMPARTMENT

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26
Q

What supplies the posterior compartment of the leg ?

A

Tibial nerve
S1,2

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27
Q

Gastrocnemius

A

Femoral attachment - weak flexor of knee

Powerful plantar flexor

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28
Q

Soleus

A

Tibial attachment - soleal line
Postural action

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29
Q

Plantaris

A

Freshman’s nerve

30
Q

Triceps surae

A

Gastrocnemius and Soleus (sometimes plantaris) are collectively called triceps surae

31
Q

Function of triceps surae

A

Pushes the body forward off the planted foot during walking.

Elevates the body upward onto the toes when standing.

32
Q

Insertion of triceps surae

A

Calcaneal tendon

33
Q

Calcaneal tendon

A

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
Q

Where does calcaneal tendon commonly rupture ?

A

Weakest part is the middle 3rd due to relatively poor vascularity.

35
Q

Treatment for calcaneal tendon rupture

A

Fluoroquinolons
Corticosteroid use
Dialysis

36
Q

Signs of calcaneal tendon rupture

A

No power of plantarflexion against resistance.

Tender gap

37
Q

Test for calcaneal tendon rupture

A

Thompson’s test
Calf-squeeze test
For complete Achilles rupture

38
Q

State the muscles found in the deep posterior compartment of the leg

A

Flexor hallucis longus

Flexor digitorum longus

Tibialis posterior

39
Q

Flexor hallicus longus
S2,3

A

deep posterior compartment

  • inserts into distal phalanx of hallux
40
Q

Flexor digitorum longus
S2,3

A

deep posterior compartment

  • inserts into distal phalanx of toes
41
Q

Tibialis posterior
L4,5

A

deep posterior compartment

  • inserts into Tuberosity of Navicular + Medial cuneiform
  • Inversion (plantar flexion)
  • Supports medial longitudinal arch of foot
42
Q

Tibialis posterior feature

A

deepest muscle in the deep posterior compartment

43
Q

Function of tibialis posterior

A

Inversion - plantar flexion

44
Q

Location of posterior tibial artery and tibial nerve

A

Descends deep to the soleus muscle towards the medial malleolus

45
Q

Nerve supply to the posterior compartment of the leg

A

Tibial nerve

46
Q

Flexor hallicus longus function

A

Important function in walking

Supports the medial longitudinal plantar arch

47
Q

Flexor digitorum longus function

A

Supports the medial and lateral longitudinal plantar arches

48
Q

Primary function of tibialis posterior

A

Support the medial longitudinal plantar arch

Also main INVERTER of the foot

49
Q

Function of soleus muscle

A

The most important muscle to remain upright at the ankle joint

50
Q

Calcaneal tendon reflex

A

Elicited by striking the calcaneal tendon briskly

tests S1 and (S2) nerve roots

51
Q

What nerve supplies the anterior compartment of the leg ?

A

Deep fibular nerve

52
Q

Muscles of the anterior compartment of the leg

A

Tibialis anterior
Extensor hallicus longus
Extensor digitorum longus
Fibularis (peroneus) tertius

53
Q

Tibialis anterior

A

Medial cuneiform, 1st metatarsal - insertion

Inversion and Dorsiflexion
Supports medial longitudinal arch of foot

L4,5

54
Q

Extensor hallucis longus

A

L5, S1

55
Q

Extensor digitorum longus

A

L5, S1

56
Q

Fibularis (peroneus) tertius

A

L5,S1

Base of 5th metatarsal - insertion

Dorsiflexion and eversion

57
Q

Where does the deep fibular (peroneal) nerve arise from ?

A

Arises between fibularis longus muscle and the neck of fibula.

58
Q

Location of the deep fibular nerve

A

Descends between tibialis anterior and extensor hallucis longus on the interosseous membrane.

  • Accompanied by anterior tibial vessels
59
Q

What nerve supplies the lateral compartment of the leg ?

A

Superficial peroneal (fibular) nerve

60
Q

State the muscles of the lateral compartment of the leg

A

Fibularis brevis
Fibularis longus

61
Q

Where do the muscles of the lateral compartment of the leg arise from ?

A

Both arise from the fibula and pass posterior to the lateral malleolus.

62
Q

Function of the lateral compartment of the leg

A

Both evert the foot - and plantar flex

63
Q

Insertion of fibularis brevis

A

Inserts onto 5th metatarsal

64
Q

Insertion of fibularis longus

A

Longus inserts into the 1st metatarsal

  • Lateral longitudinal arch support
65
Q

Where does the superficial fibular nerve arise from ?

A

Arises between fibularis longus and neck of fibula.

Descends in lateral compartment of the leg.

At distal 1/3rd of leg, becomes cutaneous

66
Q

Function of sural nerve

A

Purely sensory
May be used as nerve graft

Innervates skin of posterolateral leg and lateral border of foot

67
Q

Where does the sural nerve arise from ?

A

Lateral cutaneous sural branch - from the common fibular nerve

Medial cutaneous sural branch - from the tibial nerve

68
Q

What does the sural nerve run alongside ?

A

Small saphenous vein

69
Q

Where does the small (short) saphenous vein arise from ?

A

Arises from lateral side of dorsal venous arch.

Penetrates the deep fascia of the leg between the heads of the gastrocnemius muscle.

70
Q

What does the small saphenous vein go on to form ?

A

Popliteal vein

71
Q

Compartment syndrome

A

Increased pressure within a compartment

Can be due to bleeding or oedema

72
Q

Symptoms of compartment syndrome

A

Pallor
Pulselessness
Pain
Paralysis
Paraesthesia

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

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