Lower limb 3 (distal neurovasculature, ankle and foot) Flashcards
Does the great (long) saphenous vein travel or posterioir to the medial malleolus?
Anterior
Are the saphenous veins superficial or deep?
The saphenous veins form the superficial venous drainage route of the lower limb
Which veins are deep to the saphenous veins?
The external iliac, internal iliac and femoral veins are all deep.
Where do the superficial saphenous veins drains into?
Long/great saphenous vein - drains into femoral vein
Small saphenous vein - drains into popliteal vein
Does the great saphenous vein pass along the medial or lateral aspect of the lower limb?
Medial aspect
What can happen if saphenous veins are enlarged? and what causes this?
Varicose veins - swollen or enlarged saphenous veins. Can be caused by old age, pregnancy, long periods of standing.
Where does the small saphenous vein travel?
The small (short) saphenous vein passes from the lateral foot, up the posterior leg to the popliteal fossa. At the middle is accompanied by the sural nerve.
What is the sensory consequence of damage to the sural nerve?
Sensation loss to calf and lateral foot.
Where are the deep veins located?
Within the muscular compartments.
Where is the deep venous plexus located?
In between the gastocnemius and soleus.
What does the sciatic nerve split into above the popliteal fossa?
Medially as tibial nerve and laterally as common fibular nerve.
Why is the common fibular nerve most vulnerable to damage?
It is most superficial and passes around the fibula neck. Therefore, a superficial laceration e.g. during a car accident can damage the nerve.
What can happen if the superficial fibular nerve is damaged?
Superficial fibular nerve
Innervates the muscles of the lateral leg compartment and skin over most of the dorsal foot; Damage may lead to loss of active foot eversion and an inability to resist foot inversion
What can happen if the deep fibular nerve is damaged?
Deep fibular nerve
Innervates the anterior leg compartment muscle, muscles of the dorsal foot and the skin between digits 1 and; 2; Proximal damage to this nerve leads to foot-drop.
What is the dorsalis pedis artery a continuation of?
The continuation of the anterior tibial artery on the dorsal foot; located between the tendons of extensor hallucis longus and extensor digitorum longus.Travels toward the 1st web space where a branch travels deep onto the plantar foot to join the arterial arch on sole
What is the posterior tibial artery a continuation of?
The posterior tibial artery (a continuation of the popliteal artery) passes down the posterior compartment of the leg.
Passes posterior to the medial malleolus within the tarsal tunnel to continue as the plantar arteries on sole (plantar surface) of foot
What passes within the tarsal tunnel? Tarsal tunnel is on the medial side of the foot.
Tom Dick And Very Nervous Harry
T - Tibialis posterior
D – Flexor Digitorum
A – Posterior Tibial Artery
V - Vein
N – Tibial Nerve
H – Flexor Hallucis longusWhat is the role of the flexor retinaculum?
Covers the tarsal tunnel, prevents tendons lifting away and bowstringing.
Describe the ankle joint,
The ankle joint is a synovial hinge joint between the talus, tibia and fibula. It periods movement in one plane - plantarflexion and dorsiflexion
Which position is the ankle most stable in? Dorsi/plantar
Most stable during dorsiflexion
What is the name of 4 medial collateral ligaments of the ankle? and function.
The medial collateral (Deltoid) ligament consists of four distinct bands of ligamentous fibres
The medial collateral ligaments resist excess foot eversion
The ligaments, or their bony attachments, can be damaged by excess foot eversion - avulsion fracture
Name the lateral collateral ligaments of the ankle.
Lateral collateral ligament consists of three distinct bands of ligamentous fibres
Most important - Anterior Talofibular ligament (ATFL)
Most commonly injured ligament; mechanism via excess inversion and plantarflexion
What is the test you can perform to examine the ATFL
The ankle drawer test can be used to examine for an anterior talofibular ligament (ATFL) tear
What are the ottawa foot rules?
- Bone tenderness at the base of 5th metatarsal
- Bone tenderness at navicular
- Unable to walk 4 steps in ED or weight-bear immediately
