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MSK 2 > Leg and Knee > Flashcards

Leg and Knee Flashcards

1
Q

tibia vs fibula

A

tibia is larger, weight bearing and articulates w/ femoral condyles

fibula- smaller and more lateral, mainly for muscular attachment and ankle stabilization

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2
Q

tibial tuberosity

A

attachment site for patellar tendon

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3
Q

medial malleolus

A

medial projection of distal tibia

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4
Q

anterior intercondylar area and posterior intercondylar area fn

A

ACL and PCL attachment

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5
Q

describe knee joint structure

A

largest synovial joint but mechanically weak- needs lots of muscles and ligaments

primaryly hinge joint, although some gliding, rolling, rotation

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6
Q

most important muscles for knee stabilization

A

quads

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7
Q

patellar retinaculum

A

expansion of quad tendon around anterior aspect of knee

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8
Q

ligaments helping strong fibrous capsule around knee

A

LCL
MCL
oblique popliteal (expansion of semimembranosus tendon)
arcuate popliteal (arches over popliteus)

LCL and MCL more clinically relevant

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9
Q

LCL

A

from lateral femoral condylyle to head of fibula, easily palpable

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10
Q

MCL

A

flat band like

deep fibers attached to medial meniscus

MCL and medial meniscus commonly injured simultaneously

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11
Q

role of cruciate ligaments

A

join femur and tibia, added stability

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12
Q

describe ACL role

A

slightly relaxed when knee is flexed, tighter when extended

prevents femur from sliding posteriorly on tibia and helps prevent knee hyperextension (injuries tend to happen in extended position)

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13
Q

ACL rupture injuries, physical exam finding, concurrent terars

A

usually sports related w/ extension and over rotation

tibia can be manually displaced anteriorly, anterior drawer sign

often as unhappy triad- usually w/ tears of medial meniscus and MCL

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14
Q

PCL role

A

tightens during knee flexion, prevents femur from sliding anteriorly on tibia

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15
Q

menisci strucuture and fn

A

fibrocartilagenous plates on superior articular surface of tibia

shock asorbers, deepen joint cavity

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16
Q

menisci injuries

A

usually during torsional twisting- limited blood supply so wont heal on their own

17
Q

contrast medial and lateral menisci

A

medial- larger and c shaped, attached to MCL fibers

lateral- smaller and circular, more mobile and therefore less likely to get injured and not fused to LCL (popliteus tendon is b/w these structures)

18
Q

PCL injuries

A

force on antior of tibia during flexion

19
Q

two main branches of sciatic nerve

A

tibial and common fibular

20
Q

contrast tibial and fibular nerves

A

tibial- thru popliteal fossa, innervates muscles in posterior compartment

common fibular- divides into superficial (lateral compartment) and deep (anterior compartment)

21
Q

3 main compartments of leg

A

anterior- deep fibular

lateral- superficial fibular

posterior (technically 2, superificial and deep)- tibial nerve

22
Q

superficial posterior muscles, fn

A

plantarflexors of ankle joint

gastrocnemius- 2 heads and crosses two joints, rapid plantar flexion

soleus- deep to gastroc, powerful but slow plantarflexor

plantaris- long thin tendon, maybe proprioception, used for grafts

tibial nerve S1,2 (S1 S2 I’m taller than you; help stand on toes)

23
Q

triceps surae

A

2 heads of gastroc and soleus muscle- has a common tendon forming achilles tendon inserting into calcaneal tuberosity

24
Q

deep posterior compartment muscles, fn

A

plantarflex the ankly, flex toes and invert foot

all innervated by tibial,

tibialis posterior- inserts into several pedal bones and support longitudinal arch, inversion of foot and plantarflexion

flexor digitorum longus- divides into 4 tendons w/i foot, inserts into base of distal planages and flexes toes

flexor hallucis longus- “push off” muscle, inserts distal phalanx and flexes big toe

25
Q

deep posterior muscles entry into foot

A

tendons pass trhur tarsal tunnel along w/ sciatic nerve

26
Q

Tom, Dick and Harry muscles and nerve roots of tibial nerve

A

tibialis posterior (L4,5), flexor digitorum longus (S2,3), flexor hallucis longus (S2,3)

27
Q

tarsal tunnel structures

A

from medial to lateral

tom, dick AN’ (posterior tibial Artery and tibial Nerve) harry underneath flexor retinaculum

28
Q

common fibular nerve branches into which compartments, sensory innervation

A

divides into branches after coursing around head of fibula

superficial- lateral compartment, sensory to dorsum of foot

deep fibular nerve- anterior compartment and sensory b/w big and second toe

29
Q

lateral compartment muscles

A

eversion of foot

fibularis longus- tendon passes thru groove in cuboid, inserts into medial cuneiform and 1st metatarsal

fibularis brevis- inserts base of 5th metatarsal

superficial fibular nerve (L5, S1)

30
Q

anterior compartment muscles

A

dorsifexion of foot/toes

tibialis anterior- powerful, primary dorsiflexor

extendosr digitorum longus- extends digits, inserts into extensor expansion on toes, also dorsiflexes

extensory hallucis longus- extends hallux, also dorsiflexion

deep fibular nerve- L4,5 and S2

(fibularis tertius dorsiflexes and everts)

31
Q

neurovasculature of anterior compartment

A

deep fibular nerve and anterior tibial artery go b/w anterior compartment muscles, cross anterior to ankle and onto foot

anterior tibial artery becomes dorsalis pedis artery, vascularize foot

32
Q

drop foot

A

anterior muscles weak or paralyzed- trauma to common fibular nerve or deep fibular erve or L4/5 disc herniation

compensate w/ steppage gait- hyperflexion of the hip to raise foot during swing phase of gait, often w/ audible slap

33
Q

cause of common fibular nerve injury

A

fracture of head of fibula

34
Q

compartment syndrome

A

can happen in any muscular compartment- swelling compresses neurovasculature w/i compartment, causing diminished pulse, pain, extreme pain in anterior compartment muscles

from trauma, overuse

35
Q

location of dorsalis pedis, patho

A

palpated lateral to EHL tendon, diminshed pulse can mean occlusive disease or anterior compartment syndrome

36
Q

ankle joint bones, stability

A

hinge synovial

b/w distal tibia and fibula and the talus- distal tibia and fibula form a “mortise” for the trochlea of the talus

anterior surface of trochlea is wider than posterior- more stable in dorsiflexion

37
Q

lateral ankle ligaments (3)

A

anterior talofibular*(most commonly injured during sprain)
calcaneofibular
posterior talofibular

stabilize during inversion, 90 degrees apart and arise from distal fibula

38
Q

medial ankle ligaments

A

deltoid ligaments- stronger than lateral, stabilize during eversion and arise from medial malleolus

stronger than bone, will evulse medial malleolus before tearing

39
Q

lateral ankle sprain

A

usually anterior talofibular, when pts land w/ foot plantarflexed and inverted

talus becomes unstable w/i ankle mortise and easily twists or rolls, disrupting lateral ligaments

MSK 2 (6 decks)

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