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Semester 2 Year 1 > Leg > Flashcards

Leg Flashcards

1
Q

Describe the location of the popliteal fossa

A

 Diamond shaped region behind the knee joint
 Bounded by biceps femoris, semimembranosus and tendon of semitendinosus and Lateral and medial heads of the gastrocnemius
 The adductor canal opens to the popliteal fossa through adductor hiatus

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2
Q

What does the popliteal fossa contain?

A 
- Popliteal artery and vein, with their
branches and tributaries (artery
slightly medial to Vein)
- Tibial nerve
- Common fibular nerve
- Posterior cutaneous nerve of the
thigh
- Terminal part of small saphenous
vein
- Lymph nodes
- Fat
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3
Q

What is at risk in the popliteal fossa in knee dislocation?

A

Popliteal Artery

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4
Q

What is at risk in the popliteal fossa during supracondylar fracture of the femur?

A

Popliteal artery

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5
Q

Describe “locking” of the knee

A

When standing, the knee joint is “locked” into position
• To reduce the amount of muscle work needed to maintain the standing
position
• Locking occurs in the last 30 degrees of extension
• Ligaments are tightened
• Flat surface of the femoral condyles are in contact with the tibia plateaus joint surfaces become larger
• Vastus medialis locks the knee, aided by Gluteus maximus, tensor fascia lata

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6
Q

What muscle unlocks the knee?

A

During flexion of the knee, femur must initially be rotated laterally
Popliteus laterally rotates the femur and un-locks the knee

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7
Q

Where is the origin and insertion of the popliteus?

A

Origin
Lateral surface of lateral condyle of femur and lateral meniscus

Insertion
Posterior surface of tibia, superior to soleal line

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8
Q

How many compartments are there in the leg?

A

3

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9
Q

What do extensions of the deep fascia do in the leg?

A

− form intermuscular septa that compartmentalize groups of muscles with similar functions and innervations.
− surround individual muscles and groups of vessels and nerves, forming an investing fascia

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10
Q

Describe the muscles found in the posterior compartment of the leg

A

 Superficial and deep flexor compartments
 Gastrocnemius, soleus and plantaris are in the superficial flexor compartment
 Superficial group muscles primarily flex the ankle but gastrocnemius also flexes the knee

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11
Q

What supplies the posterior compartment of the leg?

A

Posterior tibial artery and sural nerve

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12
Q

Describe the sural nerve

A

− sensory nerve
− Lateral cutaneous sural branch from the common fibular nerve
− Medial cutaneous sural branch from the tibial nerve
− May be used as nerve graft

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13
Q

What veins drain the posterior compartment?

A

Small (short) saphenous vein penetrates the deep fascia of the leg between the heads of the gastrocnemius muscle.
 Merges with deep veins to form the popliteal vein.

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14
Q

Describe the superficial flexors of the leg

A

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

Triceps surae
- propels the body forward off the planted foot during walking elevates the body upward onto the toes when standing

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15
Q

What is the origin and insertion of Gastrocnemius?

A

Origin
Lateral head: lateral condyle of femur Medial head: medial condyle of femur

Insertion
Posterior surface of calcaneus via calcaneal tendon

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16
Q

What is the origin and insertion of Soleus?

A

Origin
Posterior aspect of head of fibula, superior quarter of posterior surface of fibula, soleal line, and medial border of tibia

Insertion
Posterior surface of calcaneus via calcaneal tendon

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17
Q

What is the origin and insertion of Plantaris?

A

Origin
Inferior end of lateral supracondylar line of femur and oblique popliteal ligament

Insertion
Posterior surface of calcaneus via calcaneal tendon

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18
Q

What is the origin and insertion of Tibialis posterior?

A

Origin
Interosseous membrane, posterior surface of tibia inferior to soleal line, and posterior surface of fibula

Insertion
Tuberosity of navicular, medial cuneiform

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19
Q

What should be known about the flexors of the ankle?

A

 All flexors of the ankle are supplied by the tibial nerve except fibularis muscles (by superficial fibular [peroneal] nerve)
 The primary function of Tibialis posterior is to support the medial longitudinal plantar arch
 Tibialis posterior is the main inverter of the foot (when the foot is off the ground)
 Soleus is the most important muscle to remain upright at the ankle joint

20
Q

What are the deep flexors of the leg?

A

 Flexor hallucis longus, flexor digitorum longus and tibialis posterior are the deep flexors
 With the exception of tibialis posterior, deep flexors are extrinsic flexors of the toes

21
Q

Where do the posterior tibial artery and tibial nerve run?

A

Posterior tibial artery, accompanied by the tibial nerve, descends deep to the soleus muscle towards the medial malleolus.

22
Q

What is the origin and insertion of Flexor digitorum longus?

A

Origin
Medial part of posterior surface of tibia inferior to soleal line and by a broad tendon to fibula

Insertion
Bases of distal phalanges of lateral four toes

23
Q

What is the origin and insertion of Flexor hallucis longus?

A

Origin
Inferior two thirds of posterior surface of fibula and inferior part of interosseous membrane

Insertion
Base of distal phalanx of hallux

24
Q

What should be known about the extrinsic flexors of the toes?

A

 All muscles in the posterior compartment of the leg are supplied by the tibial nerve
 Flexor hallucis longus has a very important function in walking
 Flexor hallucis longus supports the medial longitudinal plantar arch
 Flexor digitorum longus supports both the medial and lateral longitudinal plantar arches

25
Q

How and why would one elicit the ankle (achilles) reflex?

A

 Elicited by striking the calcaneal tendon briskly

 Tests the S1 and S2 nerve roots

26
Q

What muscles are found in the anterior compartment of the leg?

A

 Tibialis anterior, Extensor hallucis longus and Extensor digitorum longus are the muscles of the anterior compartment
 With the exception of tibialis anterior, they all act on the toes
 Fibularis [peroneus] tertius is part of extensor digitorum longus

27
Q

What artery supplies the anterior compartment of the leg?

A

Anterior tibial artery

28
Q

What nerve is found in the anterior compartment of the leg?

A


Deep fibular nerve arises between fibularis longus and neck of fibula

Descends between tibialis anterior and extensor hallucis longus on the interosseal membrane
– Accompanied by anterior tibial vessels

29
Q

Describe the path of the anterior tibial artery

A

 Descends on the anterior surface of the interosseal membrane.
 Accompanied by deep fibular [peroneal] nerve
 Supplies the muscles in the anterior compartment of the leg (dorsiflexors).
 At ankle, it becomes the dorsalis pedis artery.

30
Q

What is the origin and insertion of the tibialis anterior?

A

Origin
Lateral condyle and superior-lateral surface of

Insertion
Medial cuneiform and base of 1st metatarsal
tibia and interosseous membrane

31
Q

What should one know about the extensors of the ankle?

A

 Extensor of the ankle = Dorsiflexor
 Tibialis anterior, as with all muscles in the anterior compartment of the leg is supplied by the deep fibular [peroneal] nerve
 Tibialis anterior inverts the foot
 Tibialis anterior supports the medial longitudinal arch of the foot

32
Q

What are the extensors of the ankle?

A

Tibialis anterior

Extensor hallucis longus , Extensor digitorum longus, Fibularis [peroneus] tertius: They have other primary actions. Once the primary action has been achieved they can extend the ankle

33
Q

What are the extrinsic extensors of the toes?

A

Extensor hallucis longus
Extensor digitorum longus
Fibularis tertius

34
Q

What is the origin and insertion of Extensor hallucis longus?

A

Origin
Middle part of anterior surface of fibula and interosseous membrane

Insertion
Dorsal aspect of base of distal phalanx of great toe (hallux)

35
Q

What is the origin and insertion of Extensor digitorum longus?

A

Origin
Lateral condyle of tibia and superior 2/3 of anterior surface of fibula and interosseous membrane

Insertion
Middle and distal phalanges of lateral four digits

36
Q

What is the origin and insertion of Fibularis tertius?

A

Origin
Inferior third of anterior surface of fibula and interosseous membrane

Insertion
Dorsum of base of 5th metatarsal

37
Q

What nerves supply the extrinsic extensors of the toes?

A

All are supplied by the deep fibular [peroneal] nerve

38
Q

What muscles are found in the lateral compartment of the leg?

A

Fibularis longus and fibularis brevis occupy the lateral compartment of the leg

39
Q

What artery supplies the lateral compartment of the leg?

A

Supplied primarily by the branches of anterior tibial artery

40
Q

What nerve passes through the lateral compartment of the leg?

A

 Superficial fibular nerve arises between fibularis longus and neck of fibula
 Descends in lateral compartment of the leg
 At distal 1/3 of leg, becomes superficial

41
Q

Discuss inversion and eversion of the foot

A

 The fibular muscles evert and plantar flex the foot
 Tendons of fibular muscles pass behind the lateral malleolus
 Tendon of the fibularis longus passes through the sole (lateral longitudinal arch support)

42
Q

What muscles are responsible for inversion of the foot?

A

Tibialis anterior

Tibialis posterior

43
Q

What muscles are responsible for eversion of the foot?

A

Fibularis [peroneus] longus

Fibularis [peroneus] brevis

44
Q

What is the origin and insertion of Fibularis [peroneus] longus?

A

Origin
Fibula and intermuscular septum

Insertion
Medial cuneiform and 1st metatarsal

45
Q

What is the origin and insertion of Fibularis [peroneus] brevis?

A

Origin
Fibula and intermuscular septum

Insertion
5th metatarsal

46
Q

What should one know about the muscles of the lateral compartment off the leg?

A

 Peroneal muscles are supplied by superficial fibular [peroneal] nerve
 Fibularis longus supports the lateral longitudinal plantar arch
 Fibularis longus allows standing on one leg
 Fibularis brevis acts against transverse plantar arch

47
Q

What is compartment syndrome?

A 
 Increased pressure within a compartment
 Acute (medical emergency!!) or chronic
 Can be due to bleeding or oedema
 What are the symptoms?
 What are the complications?

Semester 2 Year 1 (82 decks)

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