Leg Script Flashcards
What does the straight leg test access? Which other test can be used?
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
All of the leg muscles lie deep to the deep fascia of the leg, which is called the __________
crural fascia.
All of the anterior leg muscles are innervated by the ___________nerve. As a group, what is their function?
Deep fibular
As a group, they dorsiflex the foot and extend the toes.
What is dorsiflexion?
Extension or flexion of the foot at the ankle
All of the lateral leg muscles are innervated by the _____________ nerve. As a group, what is their function?
superficial fibular
As a group, they pronate and plantarflex the foot.
All of the deep posterior leg muscles are innervated by the _________ nerve. As group what is their function?
tibial
As a group, they plantarflex the foot and flex the toes.
. All of the superficial posterior leg muscles are innervated by the __________. What is their function?
Tibial nerve
As a group, they plantarflex the foot.
Course of the tibial nerve
- Descends from its origin through the popliteal fossa into the back of the leg
- 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
- Extends behind and below the medial malleolus to enter the sole of the foot on its medial side.
Course of the common fibular nerve
- Descends from its origin through the popliteal fossa
- Curves around the lateral side of the neck of the fibula as it enters the leg
- Ends in the vicinity of the neck of the fibula by dividing into its two terminal branches: the deep fibular and superficial fibular nerves.
Course of deep fibular nerve
- Descends through much of its course in the leg anterior to the interosseous membrane.
- Extends from the leg into the foot by passing in front of the ankle joint.
Course of the superior fibular nerve
- Begins deep to the lateral leg muscles
- Passes between the two lateral leg muscles as it descends through the leg
- Descends within the subcutaneous tissues on the lateral side of the distal half of the leg.
What is the function of the superior fibular nerve?
The superficial fibular nerve provides sensory innervation to the skin on the distal half of the anterolateral side of the leg.
What are the two chief supinators of the foot?
Tibialis anterior
Tibialis posterior
_________ is the spinal nerve which provides most of the nerve fibers that control extension of the big toe.
L5
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 __________.
Superior and inferior extensor retinacula
Foot drop
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.
How can person compensate for loss of foot dorsiflexion?
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.
Chief pronators of the foot
Fibularis longus and brevis
How does unlocking of the knee joint occur? What is the purpose of this?
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.
_________ muscle is responsible for the unlocking rotation movement.
Popliteus
The tendons of insertion of soleus, plantaris, and gastrocnemius pass directly behind the ankle joint and fuse with each other to form the __________.
Achilles tendon
Where does the Achilles tendon insert?
onto the tuberosity of the calcaneus
The Achilles tendon reflex test assesses spinal cord reflex activity in the _____ and ______ spinal cord segment levels.
S1; S2
____ and____ arethe spinal nerves which provide most of the nerve fibers that control plantarflexion of the foot.
S1; S2
Gastrocnemius and soleus help defin which actions of the walking gait? During which phase?
Ankle Rocker and Forefoot rocker
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.
In the lower part of the __________, the popliteal artery divides into its two terminal branches: the anterior and posterior tibial arteries.
popliteal fossa
Course of Anterior Tibial arteries
- 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.
- Lies through most of its descent in the leg anterior to the interosseous membrane.
- 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
Upon passing deep to the inferior extensor retinaculum, the anterior tibial artery ends in front of the ankle joint as the origin of the ________.
dorsalis pedis
Where can pulsations of the dorsal pedis be palpated?
On the dorsum of the foot immediately lateral to the insertion tendon of extensor hallucis longus
Course of the posterior tibial artery
- Descends through the deep posterior muscle compartment of the leg
- Descends behind and then extends underneath the medial malleolus in company with the tibial nerve to enter into the sole of the foot.
- Ends deep to the flexor retinaculum upon division into its two terminal branches: the medial and lateral plantar arteries.
Where can the pulsations of the posterior tibial artery be palpated?
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).
Peripheral atherosclerotic occlusive disease
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.
Occlussions of the external iliac artery diminish blood supply to which part of the body?
. 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.
Occlusions in the femoral artery immediately proximal to the origin of the deep artery diminish blood supply where is the body?
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.
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?
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.
What are the largest superficial veins of the lower limb?
Great saphenous vein
Small saphenous vein
Course of the great saphenous vein
- 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.
- 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.
- 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.
The _______________ is the prominent, curved vein in the superficial fascia of the dorsum of the foot.
dorsal venous arch of the foot
Which tissues of the lower limb are drained by the tributaries of the great saphenous vein?
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.
Coronary artery bypass surgery
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
Why is the great saphenous vein commonly used for a coronary artery bypass surgery?
- 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.
Course of the small saphenous vein
- Begins as the lateral extension of the dorsal venous arch of the foot
- Curves upward into the leg by passing behind the lateral malleolus
- Ascends the posterolateral aspect of the leg and then commonly ends by uniting with the popliteal vein.
Which tissues are drained by the tributaries of the small saphenous vein?
The tributaries of the small saphenous vein drain the superficial tissues of the lateral side of the foot and posterolateral side of the leg.
The valves of superficial veins are oriented to ensure net blood flow away from ___________tissues.
cutaneous
The perforating veins arise from __________ veins, extend into deeper regions of the limb, and end by anastomosis with __________-veins.
superficial; deep
The valves of perforating veins oriented to ensure net blood flow in what direction?
From supericial veins to deep veins
The valves of deep veins are oritented to ensure net blood flow in what direction?
Toward the heart
What is the most common cause of sciatia?
The most common cause of sciatica is herniation of an intervertebral disc in the lumbar region of the spine.
