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2 - MSK > Lower Leg Anatomy > Flashcards

Lower Leg Anatomy Flashcards

1
Q

State the bones of the knee joint and the movement

A

Formed by articulations between femur, tibia and patella
Modified hinge - rotation in flexion
Popliteus muscle ‘unscrews’ femur to begin flexion
Extension, and some lateral and medial rotation

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2
Q

What type of cartilage lines the knee joint

A

Hyaline cartilage

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3
Q

What are menisci

A

C-shaped fibrocartilagenous rings on medial and lateral surfaces of tibia
Load transmission, shock absorbency, instability, nutrition
Absorb tension - fills the gap inbetween bone surfaces
Deepens the articular surface making the joint more stable
Medial meniscus is fixed to tibial collateral ligament, so damage to ligament may damage meniscus

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4
Q

Describe the patella ligament

A

A continuation of the quadriceps femoris tendon and inserts into tibial tuberosity

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5
Q

Describe the role of the collateral ligaments in the knee

A

Medial and lateral collateral ligaments stabilize the knee and prevent medial or lateral rotation
Medial collateral ligament is a wide flat ligament that attaches to medial epicondyle of tibia
Lateral collateral ligament is thinner and rounder and attaches to lateral epicondyle of fibula

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6
Q

Describe the role of the cruciate ligaments in the knee

A

ACL - attaches from the anterior intercyondyle region on the tibia and goes to the posterior femur
Prevents the tibia moving anteriorly
PCL - comes from the posterior inter condylar region of the tibia to the anterior femur
Prevents the tibia dislocating posteriorly, prevents femoral forward slide

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7
Q

What is the role of bursa

A

Sac filled with synovial fluid

Acts to reduce ware and tear and improve mobility

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8
Q

Describe the bursa around the knee joint

A

Suprapatella bursa: an extension of the knee synovial cavity, its located between the quadriceps femoris and the femur
Prepatella bursa: found between the patella and the skin
Infrapatella bursa: has deep and superficial parts
Deep lies between the tibia and the patella ligament
Superficial lies between the patella ligament and the skin
Semimembranosus bursa: between the knee, the semimembranosus muscle and the head of gastrocnemius

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9
Q

State the anterior leg muscles and their innervation and major function

A 
Tibialis anterior, extensor hallucis longus, extensor digitorum longus, fibularis tertius 
Deep peroneal (fibular) nerve
All dorsiflex foot
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10
Q

Tibialis anterior - AFI

A

Strongest dorsiflexor of foot
Test by standing on heels
Attachments - originates from lateral surface of tibia and attaches to medial cuneiform at base of metatarsal I Actions - dorsiflexion and inversion of foot
Innervation - deep peroneal nerve

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11
Q

Extensor digitorum longus - AFI

A

Attachments - originates from lateral condyle of tibia and medial surface of fibula
Converge into a tendon which travels to dorsal surface of foot, splits into 4 and inserts into a toe
Actions - extension of lateral four toes and dorsiflexion of foot
Innervation - deep peroneal nerve

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12
Q

Extensor hallucis longus - AFI

A

Attachments - originates from medial surface of fibular shaft and attaches to base of distal phalanx of great toe
Action - extension of the great toe and dorsiflexion of the foot
Innervation - deep peroneal nerve

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13
Q

Fibularis tertius - AFI

A

Attachment - originates with extensor digitorum longus from medial surface of fibula
At dorsal surface of foot, it diverges and attaches to metatarsal V
Actions - eversion and dorsiflexion of foot
Innervation - deep peroneal nerve

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14
Q

What is the arrangement of the anterior muscles of the leg

A

Medial to lateral - tibialis anterior, extensor hallucis longus, extensor digitorum longus
THUD

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15
Q

State the lateral leg muscles and their innervation and major function

A

Fibularis longus, fibularis brevis
Superficial peroneal nerve
All evert foot

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16
Q

Fibularis longus - AFI

A

Attachments - originates form superior and lateral surface of fibula and lateral tibial condyle
Attaches to bones on medial side - medial cuneiform and base of metatarsal I
Actions - eversion and plantarflexion of foot
Supports lateral and transverse arches of foot
Innervation - superficial peroneal nerve

17
Q

Fibularis brevis - AFI

A

Attachments - originates from inferolateral surface of fibular shaft
Attaches to tubercle on metatarsal V
Actions - eversion of the foot
Innervation - superficial peroneal nerve

18
Q

State the superficial posterior leg muscles and their innervation and major function

A

Gastrocnemius, plantaris, soleus
Tibial nerve
All plantarflex foot

19
Q

Gastrocnemius - AFI

A

Attachments - lateral head originates from lateral femoral condyle
Medial head originates from medial femoral condyle
Inserts into calcaneal tendon
Actions - plantarflexes at ankle joint and flexion at knee
Innervation - tibial nerve

20
Q

Plantaris - AFI

A

Attachments - originates from lateral supracondylar line of femur
Actions - plantarflexes at ankle joint and flexion at knee
Innervation - tibial nerve

21
Q

Soleus - AFI

A

Attachments - originates from soleal line of tibia and proximal fibular area
Actions - plantarflexes the foot at ankle joint
Innervation - tibial nerve

22
Q

State the deep posterior leg muscles and their innervation and major function

A

Popliteus, tibialis posterior, flexor digitorum longus, flexor hallucis longus
Tibial nerve
All apart form popliteus plantarflex and invert foot

23
Q

Popliteus - AFI

A

Lies behind knee joint forms base of popliteal fossa
Attachments - originates from posterior surface of proximal tibia
Attaches to lateral condyle of femur and lateral meniscus of knee joint
Actions - laterally rotates the femur - unlocking the knee so flexion can occur
Innervation - tibial nerve

24
Q

Tibialis posterior - AFI

A

Attachments - originates from interosseous membrane between tibia and fibula
Travels posterior to medial malleolus and attaches to plantar surfaces of medial tarsal bones
Actions - inverts and plantarflexes foot, maintains medial arch of foot
Innervation - tibial nerve

25
Q

Flexor digitorum longus - AFI

A

Attachments - originates from medial surface of tibia and attaches to plantar surfaces of lateral 4 digits
Actions - inverts and plantarflexes foot, flexes lateral 4 toes
Innervation - tibial nerve

26
Q

Flexor hallucis longus - AFI

A

Attachments - originates from posterior surface of fibula and attaches to plantar surface of phalanx of great toe
Actions - inverts and plantarflexes foot, flexes great toe
Innervation - tibial nerve

27
Q

State the arrangement of deep posterior leg muscles near the medial malleolus

A

Tom Dick and a Very Nervous Harry
From anterior to posterior - tibialis posterior, flexor digitorum longus, tibial artery, tibial vein, tibial nerve, flexor hallucis longus

28
Q

State the 7 tarsal bones

A

Talus, calcaneus, navicular, cuboid, 3 cuneiforms

29
Q

Describe the ligaments of the ankle joint

A

Medial ligament originate from medial malleolus and resist over-eversion of foot
Include tibionavicular, tibiocalcaneal, and posterior tibiltabular
Lateral ligaments originates from lateral malleolus and resist over-inversion of foot
Anterior talofibular ligament spans between lateral malleolus and lateral aspect of talus
Posterior talofibular ligament spans between lateral malleolus and posterior aspect of talus
Calcaneofibular ligament spans between lateral malleolus and calcaneus

30
Q

Where is the subtalar joint

A

Articulation between the talus and calcaneus in the foot

31
Q

How is the subtalar joint stabilized

A

Subtalar joint enclosed by a joint capsule which is lined internally by synovial membrane and strengthened externally by a fibrous layer
Supported by posterior, medial and lateral talocalcaneal ligament
Interosseous talocalcaneal ligament binds talus and calcaneus together
Lies within sinus tarsi - small cavity between talus and calcaneus to increase stability

32
Q

Explain how the medial arch of foot is formed and how it is supported

A

Formed by calcaneus, talus, navicular, three cuneiforms and first three metatarsal bones
Supported by plantar fascia and plantar ligaments (bottom)
Flexor hallucis longus ties bottom ends together
Fibularis/peroneus longus suspends arch from above

33
Q

Explain the venous drainage system of the lower leg

A

Great saphenous vein ascends up medial side of leg and passes anterior to medial malleolus
Drains into femoral vein
Small saphenous vein ascends up posterior side of leg and passes posterior to lateral malleolus
Drains into popliteal vein

34
Q

Explain the arterial system of the lower leg

A

Popliteal artery divides into anterior and posterior tibial artery
Posterior tibial artery continues inferiorly and behind medial malleolus with tibial nerve
Passes in-between flexor digitorum longus and flexor hallucis longus
Anterior tibial artery travels in the interosseous space down into the foot

35
Q

What does the tibial nerve innervate and branch off to

A

Tibial nerve arises from popliteal fossa and gives branches to sural nerve
Descends on posterior leg and innervates posterior muscles of leg
Sural nerve runs in-between two heads of gastrocnemius

36
Q

Describe the sensory functions of the foot

A

Sural nerve provides sensation on lateral side of foot
Superficial fibular (peroneal) nerve innervates skin on dorsum of foot
Deep fibular (peroneal) nerve innervates skin between first and second toes
Saphenous nerve runs with great saphenous vein anterior to medial malleolus
Posterior tibial nerve gives sensation to sole of foot
Lateral sural cutaneous nerve innervates skin over upper lateral leg

37
Q

What ankle ligament is most commonly injured

A

In an inversion injury, the anterior talofibular ligament is most likely to be injured, followed by calcaneofibular ligament and then posterior talofibular ligament

2 - MSK (19 decks)

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