Leg Script

Question 1

What does the straight leg test access? Which other test can be used?

Answer 1

It access whether or not a patient has a herniated intervertebral disc in the lumbar region of his/her spine, which causes sciatica

Another test that could be used is the crossed leg raising test

Question 2

All of the leg muscles lie deep to the deep fascia of the leg, which is called the __________

Answer 2

crural fascia.

Question 3

All of the anterior leg muscles are innervated by the ___________nerve. As a group, what is their function?

Answer 3

Deep fibular

As a group, they dorsiflex the foot and extend the toes.

Question 4

What is dorsiflexion?

Answer 4

Extension or flexion of the foot at the ankle

Question 5

All of the lateral leg muscles are innervated by the _____________ nerve. As a group, what is their function?

Answer 5

superficial fibular

As a group, they pronate and plantarflex the foot.

Question 6

All of the deep posterior leg muscles are innervated by the _________ nerve. As group what is their function?

Answer 6

tibial

As a group, they plantarflex the foot and flex the toes.

Question 7

. All of the superficial posterior leg muscles are innervated by the __________. What is their function?

Answer 7

Tibial nerve

As a group, they plantarflex the foot.

Question 8

Course of the tibial nerve

Answer 8

1. Descends from its origin through the popliteal fossa into the back of the leg
2. Descends through the leg deep to the intermuscular septum that separates the deep posterior muscular compartment of the leg from the superficial posterior muscular compartment
3. Extends behind and below the medial malleolus to enter the sole of the foot on its medial side.

Question 9

Course of the common fibular nerve

Answer 9

1. Descends from its origin through the popliteal fossa
2. Curves around the lateral side of the neck of the fibula as it enters the leg
3. Ends in the vicinity of the neck of the fibula by dividing into its two terminal branches: the deep fibular and superficial fibular nerves.

Question 10

Course of deep fibular nerve

Answer 10

1. Descends through much of its course in the leg anterior to the interosseous membrane.
2. Extends from the leg into the foot by passing in front of the ankle joint.

Question 11

Course of the superior fibular nerve

Answer 11

1. Begins deep to the lateral leg muscles
2. Passes between the two lateral leg muscles as it descends through the leg
3. Descends within the subcutaneous tissues on the lateral side of the distal half of the leg.

Question 12

What is the function of the superior fibular nerve?

Answer 12

The superficial fibular nerve provides sensory innervation to the skin on the distal half of the anterolateral side of the leg.

Question 13

What are the two chief supinators of the foot?

Answer 13

Tibialis anterior

Tibialis posterior

Question 14

_________ is the spinal nerve which provides most of the nerve fibers that control extension of the big toe.

Answer 14

L5

Question 15

In the lower anterior part of the leg and in front of the ankle joint there are two thickenings of the crural fascia called the __________.

Answer 15

Superior and inferior extensor retinacula

Question 16

Foot drop

Answer 16

Results from a loss of the walking gait roles of the foot’s chief dorsiflexors

In foot drop, the person cannot dorsiflex the foot during the first half of the swing period nor maintain the ankle in an almost neutral position during the latter half of the swing period in preparation for heel strike.

Question 17

How can person compensate for loss of foot dorsiflexion?

Answer 17

a person can compensate for the loss of foot dorsiflexion action by raising the foot higher than normal (through increased flexion of the thigh at the hip) during the swing period. The exaggerated raising of the foot during the swing period produces an abnormal gait called a high steppage gait.

Question 18

Chief pronators of the foot

Answer 18

Fibularis longus and brevis

Question 19

How does unlocking of the knee joint occur? What is the purpose of this?

Answer 19

Unlocking of the knee joint occurs either by external rotation of the femur or internal rotation of the tibia.

When flexion of the leg begins from the anatomical position, an unlocking rotation movement occurs in the knee joint during the first few degrees of flexion.

Question 20

_________ muscle is responsible for the unlocking rotation movement.

Answer 20

Popliteus

Question 21

The tendons of insertion of soleus, plantaris, and gastrocnemius pass directly behind the ankle joint and fuse with each other to form the __________.

Answer 21

Achilles tendon

Question 22

Where does the Achilles tendon insert?

Answer 22

onto the tuberosity of the calcaneus

Question 23

The Achilles tendon reflex test assesses spinal cord reflex activity in the _____ and ______ spinal cord segment levels.

Answer 23

S1; S2

Question 24

____ and____ arethe spinal nerves which provide most of the nerve fibers that control plantarflexion of the foot.

Answer 24

S1; S2

Question 25

Gastrocnemius and soleus help defin which actions of the walking gait? During which phase?

Answer 25

Ankle Rocker and Forefoot rocker ## Footnote Gastrocnemius and soleus thus help define the _ankle rocker_ action during the **mid stance phase** through their restraint of forward movement of the leg at the ankle joint. Gastrocnemius and soleus thus help define the _forefoot rocker_ action during the **terminal stance phase** through their continued restraint of forward movement of the leg at the ankle joint.

Question 26

In the lower part of the \_\_\_\_\_\_\_\_\_\_, the popliteal artery divides into its two terminal branches: the anterior and posterior tibial arteries.

Answer 26

popliteal fossa

Question 27

Course of Anterior Tibial arteries

Answer 27

1. Extends from the deep posterior muscle compartment of the leg into the anterior muscle compartment by **passing between the tibia and fibula** through the gap above the interosseous membrane of the leg. 2. Lies through most of its descent in the leg anterior to the interosseous membrane. 3. Upon passing deep to the **inferior extensor retinaculum**, the anterior tibial artery ends in front of the ankle joint (and midway between the malleoli) as the origin of the **dorsalis pedis**

Question 28

Upon passing deep to the inferior extensor retinaculum, the anterior tibial artery ends in front of the ankle joint as the origin of the \_\_\_\_\_\_\_\_.

Answer 28

dorsalis pedis

Question 29

Where can pulsations of the dorsal pedis be palpated?

Answer 29

On the dorsum of the foot immediately lateral to the insertion tendon of **extensor hallucis longus**

Question 30

Course of the posterior tibial artery

Answer 30

1. Descends through the deep posterior muscle compartment of the leg 2. Descends behind and then extends underneath the **medial malleolus** in company with the **tibial nerve** to enter into the sole of the foot. 3. Ends deep to the **flexor retinaculum** upon division into its two terminal branches: the medial and lateral plantar arteries.

Question 31

Where can the pulsations of the posterior tibial artery be palpated?

Answer 31

The pulsations of the posterior tibial artery can be palpated **posteroinferiorly** to the **medial malleolus** (the pulsations are most easily palpated if the foot is both dorsiflexed and inverted).

Question 32

Peripheral atherosclerotic occlusive disease

Answer 32

is a condition in which medium or larger arteries of the limbs become occluded by **plaques.** The most common initial symptom of the disease in a lower limb is muscular pain or fatigue that occurs with exercise but abates with rest; such a symptom is called **intermittent claudication.**

Question 33

Occlussions of the external iliac artery diminish blood supply to which part of the body?

Answer 33

. Occlusions of the external iliac artery diminish blood supply to almost **all** the lower limb’s muscles, and thus produce exertion-dependent pain extending distally from the buttock.

Question 34

Occlusions in the femoral artery immediately proximal to the origin of the deep artery diminish blood supply where is the body?

Answer 34

Occlusions in the femoral artery immediately proximal to the origin of the deep artery of the thigh diminish blood supply to **thigh and leg muscles**, and thus produce exertion-dependent pain extending distally from the thigh.

Question 35

Occlusions in the femoral artery immediately distal to the origin of the deep artery causes pain where? Occlusion of which other artery causes the same pain?

Answer 35

Occlusions in the femoral artery distal to the origin of the deep artery of the thigh or occlusions in the popliteal artery produce exertion-dependent **pain in the leg muscles.**

Question 36

What are the largest superficial veins of the lower limb?

Answer 36

Great saphenous vein Small saphenous vein

Question 37

Course of the great saphenous vein

Answer 37

1. It begins as the **medial extension** of the **dorsal venous arch of the foot**, and curves upward into the leg by passing in front of the medial malleolus. 2. As the great saphenous vein ascends the lower limb, it extends through the **anteromedial** side of the leg, the **posteromedial** side of the knee, and finally the **anteromedial** side of the thigh. 3. The great saphenous vein ends by passing through an opening called the **saphenous opening in the fascia lata** overlying the upper anterior part of the thigh and then uniting with the femoral vein.

Question 38

The _______________ is the prominent, curved vein in the superficial fascia of the dorsum of the foot.

Answer 38

dorsal venous arch of the foot

Question 39

Which tissues of the lower limb are drained by the tributaries of the great saphenous vein?

Answer 39

The tributaries of the great saphenous vein drain all the superficial tissues of the lower limb **except** for those of the lateral side of the foot and the posterolateral side of the leg.

Question 40

Coronary artery bypass surgery

Answer 40

A surgical procedure in which segments of a patient’s great saphenous vein are frequently used to construct a vascular bypass around a site of coronary arterial occlusion

Question 41

Why is the great saphenous vein commonly used for a coronary artery bypass surgery?

Answer 41

* It can be readily resected from the leg * Its diameter closely approximates that of the coronary arteries and their major branches * Its wall bears a comparatively high content of elastic tissue.

Question 42

Course of the small saphenous vein

Answer 42

1. Begins as the **lateral extension** of the dorsal venous arch of the foot 2. Curves upward into the leg by passing behind the **lateral malleolus** 3. Ascends the posterolateral aspect of the leg and then commonly ends by uniting with the **popliteal vein.**

Question 43

Which tissues are drained by the tributaries of the small saphenous vein?

Answer 43

The tributaries of the small saphenous vein drain the superficial tissues of the **lateral side of the foot** and **posterolateral side of the leg.**

Question 44

The valves of superficial veins are oriented to ensure net blood flow away from \_\_\_\_\_\_\_\_\_\_\_tissues.

Answer 44

cutaneous

Question 45

The perforating veins arise from __________ veins, extend into deeper regions of the limb, and end by anastomosis with \_\_\_\_\_\_\_\_\_\_-veins.

Answer 45

superficial; deep

Question 46

The valves of perforating veins oriented to ensure net blood flow in what direction?

Answer 46

From supericial veins to deep veins

Question 47

The valves of deep veins are oritented to ensure net blood flow in what direction?

Answer 47

Toward the heart

Question 48

What is the most common cause of sciatia?

Answer 48

The most common cause of sciatica is herniation of an intervertebral disc in the **lumbar region** of the spine.