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MRCS Anatomy > Lower Limb > Flashcards

Lower Limb Flashcards

1
Q

What makes up the roof of the femoral triangle?

A

Fascia lata

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2
Q

What forms the floor of the femoral triangle?

A

Pectineus
Iliopsoas
Adductor longus muscles

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3
Q

What forms the superior border of the femoral triangle?

A

Inguinal ligament

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4
Q

Where does the inguinal ligament run?

A

From the anterior superior iliac spine to the pubic tubercle

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5
Q

What forms the lateral border of the femoral triangle?

A

Medial border of the sartorius

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6
Q

What forms the medial border of the femoral triangle?

A

Medial border of the adductor longus muscle

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7
Q

What is the role of the inguinal ligament in the femoral canal?

A

Acts as a flexor retinaculum - supports the contents of the femoral triangle during hip flexion

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8
Q

List the contents, from lateral to medial, of the femoral triangle:

A

Femoral nerve
Femoral Artery
Femoral Vein
Femoral canal - deep lymph nodes

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9
Q

What contains the femoral nerve artery and vein?

A

The femoral sheath (a fascial compartment)

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10
Q

What ligament does the femoral artery cross;

A

The inguinal ligament

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11
Q

Where does the femoral artery cross the inguinal ligament?

A

Midpoint between pubic symphysis and anterior superior iliac spine

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12
Q

What vessel lies close to the femoral triangle?

A

The great saphenous vein

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13
Q

Where does the great saphenous vein empty?

A

into the femoral vein within the femoral triangle

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14
Q

Where is the femoral canal located?

A

Anterior thigh, within the femoral triangle.

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15
Q

What comprises the medial border of the femoral canal?

A

The lacunar ligament

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16
Q

What forms the lateral border of the femoral canal?

A

The femoral vein

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17
Q

What forms the anterior border of the femoral canal?

A

The inguinal ligament

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18
Q

What forms the posterior border of the femoral canal?

A

Pectineal ligament
Superior ramus of pubic bone
Pectinus muscle

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19
Q

What is the opening of the femorla canal called

A

The femoral ring

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20
Q

What is contained in the femoral canal?

A

Lymphatic vessels - these drain the deep inguinal lymph nodes
Deep lymph node - lacunar node
Empty space
Loose connective tissue

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21
Q

What is the role of the empty space within the femoral canal?

A

To allow venous dilation of the femoral vein in increased venous return or increasing abdominal pressures.

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22
Q

Where is a femoral hernia located

A

Inferolateral to the pubic tubercle

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23
Q

What is another name for the adductor canal?

A

Hunter;s canal
or
Subsartorial canal

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24
Q

Where is the adductor canal?

A

Thigh - from the apex of the femoral triangle to the adductor hiatus of the adductor magnus

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25
Q

What is the role of the adductor canal?

A

It serves as a passageway between the anterior thigh and posterior leg

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26
Q

What forms the anteromedial border of the adductor canal?

A

Sartorius

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27
Q

What forms the lateral border of the adductor canal?

A

Vastus medialis

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28
Q

What forms the posterior border of the adductor canal?

A

Adductor longus
Adductgor magnus

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29
Q

What is the adductor hiatus?

A

End point of the adductor canal
A gap between the adductor and the hamstring attachments of the adductor magnus muscle

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30
Q

List the contents of the adductor canal:

A

Femoral artery
Femoral vein
Nerve to the vastus medialis
Saphenous nerve

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31
Q

What is the largest cutaneous branch of the femoral nerve:

A

The saphenous nerve

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32
Q

What does the femoral artery and vein become when they exit the adductor canal?

A

Popliteal artery and vein

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33
Q

When might the adductor canal be useful in surgery?

A

Can be used to provide anaesthetic block t the saphenous nerve - this allows for proceedures involving the distal thigh, femur, knee and lower leg to be numb.

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34
Q

What structures are used to locate the anatomical location of the saphenous nerve?

A

The femoral artery and sartorius muscle

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35
Q

What forms the superomedial border of the popliteal fossa?

A

Semimembranosus

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36
Q

What forms the superolateral border of the popliteal fossa?

A

Biceps femoris

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37
Q

What forms the inferomedial border of the popliteal fossa?

A

Medial head of the gastrocnemius

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38
Q

What forms the inferolateral border of the popliteal fossa?

A

Lateral head of the gastrocnemius and plantaris

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39
Q

What forms the floor of the popliteal fossa?

A

Posterior surface of the knee joint capsule
Popliteal muscle
Posterior femur

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40
Q

What two layers form the roof of the popliteal fossa?

A

The popliteal fascia
Skin

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41
Q

List the contents of the popliteal fossa from medial to laterl:

A

Popliteal artery
Popliteal vein
Tibial nerve
Common fibular nerve (aka common peroneal nerve) - alongside the biceps femoris tendon

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42
Q

What structures are the most superficial contents of the popliteal fossa?

A

The tibial and common femoral (peroneal) nerves

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43
Q

What are the tibial and common fibular (peroneal) nerves branches of?

A

The sciatic nerve

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44
Q

What muscle does the common fibular (common peroneal) nerve follow?

A

Biceps femoris

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45
Q

What vessel pierces the popliteal fascia and passes between the gastrocnemius two heads?

A

The small saphenous vein

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46
Q

What vessel does the small saphenous vein drain into?

A

The popliteal vein

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47
Q

What is the deepest structure of the popliteal fossa?

A

The popliteal artery.

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48
Q

Give two differentials for swelling in the popliteal fossa:

A

Baker’s cyst
Anuerysm of the popliteal artery

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49
Q

What is a Baker’s cyst:

A

Inflammation and swelling of the semimembranosus bursa

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50
Q

What vessel is at risk of compression in a popliteal anuerysm?

A

Tibial nerve

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51
Q

What clinical signs are suggestive of tibial nerve compression?

A

Absent / weakened plantar flexion
Parasthesia of the foot and posterolateral leg

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52
Q

List the contents of the tarsal tunnel from anterior to posterior:

A

Tibialis posterior tendon
Flexor digitorum longus tendon
Posterior tibial artery and vein
Tibial nerve
Flexor hallicus longus tendon

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53
Q

What is tarsal tunnel syndrome:

A

Entrapement and compression of the tibial nerve as it passes through the tarsal tunnel

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54
Q

What are some clinical signs of tarsal tunnel syndrome?

A

Altered sensation on sole of foot
Weakness / wasting of intrinsic foot muscles

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55
Q

What acts as the floor of the tarsal tunnel?

A

Medial aspect of the tibia, talus and calcaneus

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56
Q

What converts the tarsal tunnel into a tunnel?

A

The flexor retinaculum

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57
Q

Where is the flexor retinaculum of the tarsal tunnel located?

A

Spans obliquely between the medial malleolus and the medial tubercle of the calcaneus

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58
Q

What forms the roof of the tarsal tunnel?

A

The flexor retinaculum

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59
Q

Where does the ligamentum teres attach?

A

The fovea of the femoral head

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60
Q

What is the angulation of the femoral neck.

A

135 degrees

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61
Q

What muscles attach to the greater trochanter?

A

Piriformis
Gluteus minimus
Gluteus medius

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62
Q

What muscles attach to the lesser trochanter?

A

Iliopsoas

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63
Q

Where is the intertrochanteris line?

A

Ridge of bone running inferomedial, on anterior surface, betweent he two trochanters.

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64
Q

What attaches at the intertrochanteric line?

A

Iliofemoral ligament
Anterior attachement for the hip joint capsule

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65
Q

Where does the quadratus femoris attach?

A

The quadrate tubercle - a rounded tubercle on the intertrochanteric crest (posterior femur)

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66
Q

Define intracapsular hip fractures:

A

Occuring within the hip capsule
Can damage medial femoral circumflex artery leading to avascular necrosis

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67
Q

Define extracapsular hip fractures:

A

Blood supply remains in tact.

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68
Q

What is the name of the roughened patch of bone on the posterior femoral surface?

A

Linea aspera

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69
Q

Where does the gluteus maximus attach?

A

The gluteal tuberosity of the femur

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70
Q

Where does the adductor magnus attach?

A

The adductor tubercle of the distal femur

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71
Q

Where are the medial and lateral condyles of the femur?

A

The posterior aspext of the femur

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72
Q

Where are the medial and lateral epicondyles located?

A

The sides of the distal end of the femur

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73
Q

What attaches to the epicondyles?

A

Medial and lateral collateral ligaments

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74
Q

Where does the ACL attach?

A

Medial aspect of the lateral condyle

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75
Q

Where does the PCL attach?

A

Lateral aspect of the medial condyle

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76
Q

What is the ost common site for a femoral fracture?

A

The neck

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77
Q

Forceful contraction of which ligament can lead to an avulsion femur fracture?

A

Iliopsoas

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78
Q

What is the strongest ligament of the hip joint?

A

The iliofemoral ligament

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79
Q

Where is the quadrate tubercle located?

A

The intertrochanteric crest (a ridge of bone connecting the two trochanters)

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80
Q

Where is the proximal tibia is the main point of attachment for ligaments and menisci of the knee?

A

The intercondylar eminence

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81
Q

Where does the patellar ligament attach?

A

The tibial tuberosity

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82
Q

What binds the tibia and fibula together

A

The interosseus membrane

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83
Q

Where in the distal tibia does it bind to the fibula?

A

The fibular notch - lateral.

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84
Q

What tendon passes on a groove on the posterior tibia

A

The tibialis posterior

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85
Q

Where in the tibia most commonly is fractured?

A

The shaft

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86
Q

Fractures of the proximal tibia are called ________

A

Tibial plateau fractures

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87
Q

What classification system is used in tibial fractures?

A

The Schatzker classification

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88
Q

What movement can lead to a fractured medial malleolus?

A

Twisting inwards / over inversion of the tibia / ankle
Rarely occurs in isolation and the lateral malleolus is also fractured usually

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89
Q

What tendon passes posterior to the medial malleolus?

A

Tibialis posterior

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90
Q

What are the 3 main articulatios of the fibula?

A

Proximal tibiofibular joint
Distal tibiofibular joint
Ankle joint

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91
Q

Where on the fibula can the common fibular nerve be located?

A

Posterior and lateral surfaces of the proximal fibular neck

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92
Q

Where on the fibula is most prone to fractures?

A

The lateral malleolus

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93
Q

What does the common fibular nerve branch into?

A

The superficial and deep fibular nerves

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94
Q

Where is the patella located?

A

Within the patellofemoral groove of the femur

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95
Q

What type of bone is the patella

A

A sesamoid bone

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96
Q

What are the two main functions of the patella?

A

Extension of the leg - enhances leverage of quadriceps tendon
Protection

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97
Q

What direction do most patella fractures pccur?

A

Lateral

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98
Q

Whayt is a common mechanism of injury for a patellar dislocation?

A

Sudden or forceful twisting of the knee

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99
Q

Sudden contraction of what ligament may lead to a patellar fracture?

A

Quadriceps

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100
Q

The base of the patella connects to the __________ tendon

A

Quadraceps

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101
Q

The apex of the patella connects to the __________ tendon

A

Patellar

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102
Q

Where does the fascia lata begin proximally?

A

Around the iliac crest and inguinal ligament

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103
Q

Where does the fascia lata end?

A

The bony prominences of the tibia

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104
Q

What does the intermuscular septa originate from and create?

A

The fascia lata (at its deepest aspect)
The anteior, medial and lateral thigh compartments

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105
Q

Where is the saphenous opening

A

The fascia lata, inferior to the ingional ligament

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106
Q

What is the role of the saphenous opening?

A

Sevrves as entry point for efferent lymph and great saphenous vein to drain into the superficial inguinal lymph nodes and femoral vein respectivelt

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107
Q

What is the tensor fascia lata?

A

A gluteal muscle

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108
Q

What functions does the tensor fascia lata perform?

A

Hip flexion
Hip internal rotation
Hip abduction

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109
Q

What innervates the tensor fascia lata?

A

The superior gluteal nerve

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110
Q

What is the iliotibial tract?

A

A longitudinal thickening of the fascia lata

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111
Q

Where is the iliotibial tract located?

A

Lateral thigh
Extends from iliac tubercle to the lateral tibial condyle

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112
Q

What are the 3 main function of the iliotibial tract?

A

Movement (extends, abduct and lateral rotation of hip)
Compartmentalistion
Muscular sheath around tensor fascia lata

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113
Q

Where does the tensor fascia lata attach posteriorly?

A

The saccrum and coccyx

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114
Q

Where does the fascia lata connect laterally?

A

Iliac crest

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115
Q

Where does the tensor fascia lata attach anteriorly?

A

Inguinal ligament
Superior pubic rami

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116
Q

Where does the tensor fascia lata attach medially?

A

Inferior ischiopubic rami
Ischial tuberosity
Sacrotuberous ligament

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117
Q

What inserts into the iliotibial tract?

A

Tendon from the gluteus maximus
Tensor fascia lata tendon

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118
Q

What is the continuation f=of the fascia lata?

A

The crural fascia

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119
Q

What muscles are collectively known as the superficial abductors and extenders?

A

Gluteus maximus
Gluteus medius
Gluteus minimus
Tensor fascia lata

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120
Q

What group of muscles (aka deep lateral rotators) are responsible for lateral femur rotation

A

Quadratus femoris
Piriformis
Gemellus superior and inferior
Obturator internus

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121
Q

What vessels are branches of the internal iliac artery?

A

Superior and inferior gluteal arteries

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122
Q

What innervates the gluteus maximus?

A

The inferior gluteal nerve

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123
Q

What does the superior gluteal nerve innervate?

A

Gluteus medius
Gluteus minimis
Tensor fascia lata

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124
Q

What clinical sign is suggestive of superior gluteal nerve injury?

A

Trendelenburg Sign

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125
Q

What muscle is used to locate the sciatic nerve and lies immediately inferior to the superior gluteal nerve?

A

Piriformis

126
Q

What muscle travels through the greater sciatic foramen>

A

Piriformis

127
Q

What muscle tendon runs between the superior and inferior gemelli?

A

The obturator internus tendon

128
Q

What does the nerve to the obturator internus innervate?

A

The obturator internus
The superior gemelli

129
Q

What muscles are responsible for medial rotation of the hip?

A

Gluteus medius, minimus and tensor fascia lata.

130
Q

Where are the deep gluteal muscles located?

A

Underneath the gluteus minimus

131
Q

What deep gluteal muscle is the most superior?

A

The piriformis

132
Q

What nerve innervates the piriformis?

A

The nerve to the piriformis

133
Q

What muscle forms the lateral walls of the pelvic cavity?

A

Obturator internus

134
Q

What deep muscle travels through the lesser sciatic foramen?

A

Obturator internus

135
Q

What does the nerve to the quadratus femoris innervate?

A

The quadratus femoris
The inferior gemelli

136
Q

What is the most inferior deep gluteal muscle?

A

The quadratus femoris

137
Q

What nerve root does the femoral nerve originate from?

A

L2 - L4

138
Q

What nerve innervated the anterior thigh compartment?

A

Femoral

139
Q

What is the arterial supply to the anterior thigh compartment?

A

The femoral artery

140
Q

List the muscles of the anterior compartment of the thigh?

A
  • Iliopsoas –> psoas major and iliacus
  • Quadriceps: Rectus femoris Vastus medialis Vastus intermedius, Vastus lateralis
  • Sartorius
  • Pectineus
141
Q

Which muscle of the quadriceps is the only muscle to cross both the hip and knee joint, and what is its movement role?

A

Rectus femoris
Extends knee and flexes hip

142
Q

What anteior thigh muscle does NOT perform knee extension

A

The iliopsoas

143
Q

What is the movement of the iliopsoas

A

Flexion of the thigh at the hip joint

144
Q

What is the longest muscle in the body?

A

The sartorius

145
Q

What movemetns does the sartorius perform?

A

Hip flexion
Hip abduction
Hip lateral rotation
Knee flexion

146
Q

What are the attachements of the sartorius?

A

Anterior superior iliac spine
Superior medial tibial surface

147
Q

What muscle is tested when suspicious of femoral nerve palsy?

A

Quadriceps femoris

148
Q

What innervates the major psoas muscle?

A

Anterior rami of L1-L3

149
Q

What muscle is supplied by both the femoral nerve and the nerve to the obturator externus

A

The pectineus muscle

150
Q

What muscle lies directly on top of the iliac fossa?

A

The iliacus

151
Q

What is the collective term for the miscles of the medial thigh compartment?

A

The hip adductorsq

152
Q

List the miscles of the medial thigh compartment:

A

Gracillis
Obturator externus
Adductor Brevis
Adductor longus
Adductor magnus

153
Q

What are the two parts of the adductor magnus

A

An adductor component and hamstring

154
Q

What are the movements of the two parts of the adductor magnus?

A

Adductor: Adduction and flexion of thigh
Hamstring: Adduction and extension of thigh

155
Q

What are the nerve supplies to the adductor magnus?

A

Adductor: obturator nerve
Hamstring: Tibial component of sciatic nerve

156
Q

What are the nerve roots for the obturator nerve?

A

L2-L4

157
Q

What are the nerve roots for the sciatic nerve?

A

L2-S3

158
Q

What nerve is the main innervator of the medial compartment of the thigh?

A

The obturator nerve

159
Q

What is the main arterial supply to the medial compartment of the thigh?

A

The obturator artery

160
Q

What muscle separates the antior and posterior branches of the obturator nerve?

A

The adductor brevis

161
Q

What is the smallest muscle of the medial thigh compartment?

A

The obturator externus

162
Q

What is the most superficial muscle of the medial thigh compartment?

A

The gracilis

163
Q

What movements does the obturator externus contribute to?

A

Adduction of hip
lateral rotation of the thigh

164
Q

What movemetns does the gracilis muscle contribute to?

A

Adduction of the thigh at the hip
Flexion of the leg at the knee

165
Q

Stain of the adductor muscles is known as what?

A

Groin strain

166
Q

What is the collective name for muscles of the posterior thigh compartment?

A

Hamstrings

167
Q

What nerve innervates the posterior thigh compartment?

A

The sciatic nerve

168
Q

List the muscles of the posterior thigh compartment:

A

Biceps femoris
Semitendinosis
Semimembranosus

169
Q

What innervates the biceps femoris?

A

Long head: tibial part of the sciatic nerve
Short head: common fibular branch of the sciatic nerve

170
Q

List the movements aided by the biceps femoris:

A

Knee flexion
Thigh extension
Lateral rotation of the knee and hip

171
Q

What bone in the lower leg does the biceps femoris insert onto?

A

The fibula

172
Q

What muscles of the posterior thigh contribute to medial rotation of the thigh at the hip and knee joints?

A

Semimembranosus
Semitendinosus

173
Q

Where do all muscles of the posterior thigh originate from?

A

The ischail tuberosity of the pelvis

174
Q

What is the collection action of the hamstring muscles?

A

Knee flexion

175
Q

What is the mechanism of action of the anterior compartment of the (lower) leg?

A

Dosiflexion and inversion of the foot

176
Q

What nerve supplies the anterior compartment of the lower leg?

A

Deep fibular nerve

177
Q

What are the nerve roots for the deep fibular (peroneal) nerve?

A

L4 - S1

178
Q

What is the arterial supply to the anterior compartment of the lower limb?

A

Anterior tibial artery

179
Q

List the muscles of the anterior lower limb?

A

Tibialis anterior
Extensor digitorum longus
Extensor hallicus longus
Fibularis tertius

180
Q

What is the main movement of the extensor digitorum longus?

A

Extension of the lateral four toes
Dorsiflexion of the foot

181
Q

What is the main movement of the extensor hallicus longus?

A

Extension of the great toe
Dorsilflexion of the foot

182
Q

What is the main movements of the fibularis tertius?

A

Eversion and dorsiflexion of the foot

183
Q

What clinical sign is suggestive of damage to either the common or deep fibular nerve / anterior muscles of the lower limb?

A

Foot drop - loss of dorsiflexion

184
Q

What muscle both produces dorsiflexion and inversion of the foot?

A

Tibialis anterior

185
Q

Where in the foot does the anterior tibiliar attach?

A

Base of the 1st metatarsal

186
Q

List the muscles of the lateral lower limb compartment:

A

Fibularis longus
Fibularis Brevis

187
Q

What is the main function of the lateral lower leg compartment?

A

Eversion of the foot

188
Q

What is the nerve that innervates the lateral lower leg?

A

THe superficial fibular nerve

189
Q

Which muscle is larger and more superficial in the lateral leg compartment?

A

Fibularis longus

190
Q

Where does the fibularis longus insert in the foot?

A

Medial cuneiform and base of metatarsal 1

191
Q

What is the movements associated with the fibularis longus?

A

Eversion and plantar flexion of the foot
(Note: also supports lateral and transverse foot arch)

192
Q

What muscle passes posteriorly to the lateral malleolus?

A

The fibularis longus

193
Q

What movements are performed by the fibularis brevis?

A

Eversion of the foot

194
Q

Where does the fibularis brevis insert in the foot?

A

Tubercle of the 5th metatarsal

195
Q

What is foot eversion?

A

Turning the sole of the foot outwards

196
Q

List the muscles of the superficial, posterior compartment of the lower leg from most superficial to least:

A

Gastrocnemius
Soleus
Plantaris

197
Q

What nerve innervates the superficial posterior muscles of the lower leg?

A

The tibial nerve

198
Q

Where do the 3 muscles of the superficial posterior leg insert in the foot?

A

The calcaneus

199
Q

List the muscles of the deep posterior leg compartment:

A

Popliteus
Flexor digitorum longus
Flexus hallicus longus
Tibialis posterior

200
Q

Which muscle of the deep posterior leg compartment only acts on the knee?

A

The popliteus

201
Q

What nerve innervates the deep compartment of the posterior leg?

A

The tibial nerve

202
Q

What muscles form the calcaneal tendon?

A

The soleus, the gastrocnemius (and the plantaris which can be absent in 10% of people)

203
Q

What muscles are associated with both plantarflexion of the foot (at the ankle joint) and flexion at the knee joint?

A

Gastrocnemius
Plantaris

204
Q

What is the movement associated with the soleus?

A

Plantarflexion of the foot (at the ankle joint)

205
Q

Which muscle of the posterior leg compartment has two heads?

A

The gastrocnemius

206
Q

What is the movement associated with the flexor digitorum longus?

A

Flexion of the lateral 4 toes.

207
Q

What movements are associated with the flexor hallicus longus?

A

Flexion of the great toe.

208
Q

What is the movement of the tibialis posterior?

A

Inversion and plantarflexion of the foot.
(NOTE: also contributes to the medial arch of the foot)

209
Q

How many tarsal bones are there?

A

7

210
Q

HOw many metatarsals are there?

A

5

211
Q

What bones make up the hindfoot?

A

Talus and calcaneus

212
Q

What bones make up the midfoot?

A

Navicular, cuboid and cuneiforms

213
Q

What bones make up the forefoot?

A

The metatarsals and the phalanges

214
Q

What tarsal is repsonsible for transmitted the entire weight of the body to the foot?

A

the Talus

215
Q

Name the three articulations of the Talus:

A

Superiorly: ankle joint - tibia and fibula
Inferiorly: subtalar joint - calcaneus
Anteriorly: talonavicular joint - navicular

216
Q

Which bone is more commonly known as the heel bone

A

The calcaneus

217
Q

How many muscles attach onto the talus?

A

None

218
Q

Which tarsal is at high risk of avascular necrosis and why?

A

Talus
Has no muscles inserting onto it - relies solely of vascular supply of fascial structures

219
Q

What is the largest tarsal bone?

A

Calcaneus

220
Q

What are the two articulations of the calcaneus?

A

superiorly: talus
Anteriorly - cuboid

221
Q

What tendon attaches onto the calcaneus and where does it attach?

A

Calcaneal tuberosity - achilles tendon

222
Q

What tendon attaches to the navicular and on what surface?

A

The tibialis posterior
Plantar surface

223
Q

List all the articulations of the navicular?

A

Posteriorly - talus
Laterally - cuboid
Anteriorly - three cuneiform bones

224
Q

Which tarsal bone lies most lateral in the distal tarsal group?

A

Cuboid

225
Q

What tendon attaches to the plantar surface of the cuboid

A

fibularis longus

226
Q

List the attachements to the medial cuneiform:

A

Tibialis anterior
(Partial) Tibialis posterior
Fibularis longus

227
Q

List the attachements to the lateral cuneifrom

A

Flexor Hallicus brevis

228
Q

Where does a fracture most commonly occur in the talus?

A

Neck region

229
Q

Describe the mechanism most commonly associated with talar fractures:

A

High energy injury
Foot is dorsiflexed - neck of talus pushes against tibia
Blood supply can be disturbed causing avascular necrosis

230
Q

What area of the talus can be fractured by jumping from height:

A

Talar body fracture

231
Q

IF a patient has a calcaneus fracture, what other area of the body should you be assessing for damage?

A

Lumbar spine and lower limb

232
Q

What is the main mechanism of injury that causes calcaneus fractures:

A

Axial loading (eg falling from great height)

233
Q

How are the metatarsals numnbered?

A

Medial to lateral

234
Q

Describe the shape / structure of the metatarsal

A

Convex dorsally
Consist of a head neck shaft and base

235
Q

List three ways in which the metatarsal bones can be fractured:

A
  • Direct blow to foot (most common)
  • Stress fracture - common in athletes, most commonly fractures neck of 2nd and 3rd metatarsals
  • Excessive inversion of foot (avulsion of fibularis brevis - tearing off 5th metatarsal)
236
Q

Where is the common fibular nerve found on the fibula?

A

Posterior and lateral surface of the fibular neck

237
Q

how many surfaces are there on the fibula?

A

Three - anterior, lateral and posterior

238
Q

What is the lateral surface on the distal end of the fibula known as?

A

The lateral malleolus

239
Q

What movement causes fracture of the lateral malleolus of fibula?

A

Forced external rotation of ankle (spiral fracture)

Foot eversion (transverse fracture)

240
Q

What forms the tibial plateu?

A

The medial and lateral condyles of the tibia

241
Q

Where is the intercondylar eminence located?

A

Between the condyles, projecting upwards on either side - forming medial and lateral intercondylar tubercles.

242
Q

What is the main site of attachment for ligaments and menisci of knee joint?

A

Intercondylar eminence - the intercondylar tubercles

243
Q

What surface does the intercondylar tubercles articulate with?

A

Intercondylar fossa of the femur

244
Q

What shape is the tibia shaft

A

Prism

245
Q

Where is the tibial tuberosity?

A

Proximal anterior shaft of tibia

246
Q

What ligament attaches to the tibial tuberosity?

A

Patella ligament

247
Q

What landmark is noted on the posterior surface of proximal tibia?

A

Soleal line

248
Q

What is the main role of the soleal line?

A

Origin of the soleus muscle

Note: Extends inferomedially and blends with the medial border of the tibia

249
Q

What attaches to the lateral border of the tibia?

A

The interosseus membrane which binds the tibia and fibula

250
Q

The groove on the posterior distal tibia allows for what tendon to pass?

A

Tibialis posterior

251
Q

Where is the most common place for tibial fractiure?

A

The shaft

252
Q

What mechanism of injury leads to fracture of the medial malleolus?

A

Over inversion of the ankle (twisting inwards)

253
Q

Medial malleolus usually fractures in isolation. True or false

A

False
Usually the lateral malleolus will also fracture

254
Q

What classification system is used for tibial fractures (proximal fractures)

A

Schatzker classification

255
Q

What muscle originates at the greater trochanter?

A

Vasa lateralis (one of the quadriceps)

256
Q

What muscles attach to the greater trochanter?

A

Gluteus minimis, gluteus medius and piriformis.

257
Q

What movement can result in avulsion fracture of the greater trochanter?

A

Forceful contraction of the gluteus medius

258
Q

Where is the lesser trochanter of the femur located/

A

Posteromedial side of the femur - inferior to the neck-shaft junction

259
Q

What muscle attaches to the lesser trochanter?

A

The iliopsoas

260
Q

Where is the intertrochanteric line of the femur located?

A

The inferomedial direction on anterior surface of femur (between two trochanters)

261
Q

What ligament attaches to the intertrochanteric line?

A

Iliofemoral ligament

Also for anterior attachment of the capsule of the hip joint

262
Q

What is the intertrochanteric crest?

A

The ridge between the two trochanters on the posterior surface

263
Q

What name is given to the tubercle on superior half of the intertrochanteric crest?

A

The quadrate tubercle

264
Q

What attaches to the quadrate tubercle?

A

the quadratus femoris

265
Q

Where is the linea aspera located on the femur?

A

Proximal surface of the shaft

266
Q

What attaches to the gluteal tuberosity?

A

Gluteus maximus

267
Q

What forms the =gluteal tuberosity?

A

Proximal medial border of the linea aspera forms the pectineal line - the lateral border of the pectineal line becomes the gluteal tuberosity.

268
Q

What forms the popliteal fossa?

A

Widening of the distal linea aspera

269
Q

What attaches to the medial supracondylar of the femur?

A

The adductor magnus

270
Q

What tubercle is found of the medial supracondylar line of the distal femur?

A

The adductor tubercle

271
Q

Which type of femoral neck fracture can lead to avascular necrosis - intra or extra capsular?

A

intracapsular
Can lead to damage of the medial femoral circumflex artery

272
Q

What articulates with the medial and lateral condyles?

A

Posterior and inferior surfaces - tibia and menisci of the knee
Anterior surface - patella

273
Q

Where do the medial and lateral collateral ligaments originate from?

A

Medial and lateral epicondyles

274
Q

Where is the intercondylar fracture located?

A

Posterior distal femur

275
Q

Where does the ACL attach?

A

Medial aspect of the lateral condyle - within the intercondylar fossa

276
Q

Where does the posterior cruciate ligament attach in the femur?

A

Lateral aspect of the medial condyle within the intercondylar fossa

277
Q

What type of bone is the patella classified as?

A

Sesamoid

278
Q

How does the apex of the patella connect to the tibial tuberosity?

A

Patellar ligament

279
Q

What surface of patella articulates with the femur?

A

Posterior - with articulating facets

280
Q

what are the two main functions of the patella?

A

Extension of leg
Protection of anterior knee

281
Q

What direction are most patellar dislocations?

A

Lateral

282
Q

How does patellar dislocation occur?

A

High force impact or sudden twistin of the knee - eg hockey / football / rugby

283
Q

Contraction of what muscle can result in a patellar fracture?

A

Quadriceps

284
Q

What ligament attaches to the base of the patella?

A

Quadriceps

285
Q

What ligament attaches to the apex of the patella?

A

Patellar ligament

286
Q

What dermatome corresponds with the inguinal region and superior aspect of the medial thight?

A

L1

287
Q

Where would L2 dermatome correspond with?

A

Middle and lateral anterior thigh

288
Q

Which dermatome covers medial condyle of the femur and runs inferomedial across the thgih?

A

L3

289
Q

L4 dermatome covers what area?

A

Medial malleolus

290
Q

What dermatome covers the dorsal aspect of the foot until the third metatarsopharyngeal joint?

A

L5

291
Q

The lateral calcaneus is covered by the ______ dermatome

A

S1

292
Q

Which dermatome covers the popliteal fossa?

A

S2

293
Q

Which dermatome covers the horizontal gluteal crease?

A

S3

294
Q

The perianal region is supplied by the ___ and ____ dermatomes

A

S4 and S5

295
Q

Cutaneous innervation of the space between 1st and 2nd tones on the dorsal foot is by?

A

The deep fibular nerve

296
Q

The superficial fibular nerve provides cutaneous innervation to __________?

A

Dorsum of foot excluding the space between 1st -2nd toes.
Anterolateral aspect of the leg

297
Q

The medial and lateral plantar nerves are branches of what nerve?

A

Tibial nerve

298
Q

Where does the medial plantar nerve supply?

A

Medial 2/3rds of the sole (plantar surface) of the foot

299
Q

Where does the lateral plantar nerve supply?

A

The lateral 1/3rd of the plantar / sole of the foot

300
Q

The saphenous nerve is a branch of the ___________ nerve

A

Femoral

301
Q

Where does the saphenous nerve provide cutaneous innervation?

A

Medial margin of the hindfoot and midfoot
Anteromedial aspect of the leg

302
Q

What nerves form the sural nerve?

A

The tibial and common fibular nerves

303
Q

Where does the sural nerve provide cutaneous innveration?

A

Lateral margin of hindfoot and midfoot
Posterolateral aspect of the leg

304
Q

Where does the medial calcaneal nerve come from?

A

The tibial nerve

305
Q

Where does the medial calcaneal nerve provide cutaneous innervation?

A

The medial aspect of the heel

306
Q

What vessel lies directly anterior to the medial malleolus?

A

The great saphenous vein

307
Q

What vessel is found posterior to the lateral malleolus?

A

The short saphenous vein

308
Q

The popliteal artery continues into the __________ artery before dividing into the _______ and ______.

A

Tibia-peroneal trunk artery
Peroneal and posterior tibial arteries

309
Q

What vessel is the lateral plantar artery a branch of?

A

the posterior tibial artery

310
Q

The gastrocnemius gets its motor supply from the ___________ nerve.

A

Tibial nerve

311
Q
A

MRCS Anatomy (8 decks)

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