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Anatomy BMSc > Lower Limb > Flashcards

Lower Limb Flashcards

1
Q

branches of lumbar plexus

A 
iliohypogastric 
ilioinguinal
genitofemoral 
lateral cutaneous nerve of thigh 
obturator 
femoral
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2
Q

nerve roots of iliohypogastric nerve

A

L1

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3
Q

nerve roots of ilioinguinal nerve

A

L1

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4
Q

nerve roots of genitofemoral nerve

A

L1,2

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5
Q

nerve roots of lateral cutaneous nerve of thigh

A

L2,3

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6
Q

nerve roots of obturator nerve

A

L2,3,4

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7
Q

nerve roots of femoral nerve

A

L2,3,4

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8
Q

nerve roots of lumbosacral trunk

A

L4,5

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9
Q

branches of sacral plexus that receive contribution from lumbosacral trunk

A

sciatic nerve
superior and inferior gluteal nerves
nerve to quadrates femoris
nerve to obturator internus

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10
Q

nerve roots of sciatic nerve

A

L4-S3

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11
Q

nerve roots of superior gluteal nerve

A

L4-S1

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12
Q

nerve roots of inferior gluteal nerve

A

L5-S2

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13
Q

how to remember nerve roots of gluteal nerves

A

both contain roots from lumbosacral trunk
3 words so 3 nerve roots
inferior starts 1 lower than superior

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14
Q

nerve rots of nerve to quadratus femoris

A

L4-S1

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15
Q

nerve roots of nerve to obturator internus

A

L5-S2

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16
Q

innervation of gemelli

A 
inferior = nerve to quad femoris 
superior = nerve to OI
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17
Q

how do sciatic and gluteal nerves and vessels leave the pelvis

A

via the greater sciatic foramen

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18
Q

how do femoral nerves and vessels leave the pelvis

A

via the subinguinal space

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19
Q

how do obturator nerve and vessels exit the pelvis

A

obturator canal

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20
Q

what does femoral nerve supply

A

anterior thigh

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21
Q

what does obturator nerve supply

A

medial thigh

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22
Q

what does sciatic nerve supply

A

posterior thigh, and entire leg

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23
Q

superficial veins of lower limb

A 
great saphenous 
short saphenous 
accessory saphenous 
superficial circumflex iliac
superficial epigastric
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24
Q

what are the two groups of superficial inguinal lymph nodes

A

horizontal and vertical

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25
Q

which structures drain to horizontal superficial inguinal lymph nodes

A 
medial = anterior abdominal wall and lower anal canal 
lateral = posterior abdominal wall
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26
Q

which structures drain to vertical superficial inguinal lymph nodes

A

superficial lower limb

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27
Q

cutaneous supply of lateral cutaneous nerve of thigh

A

lateral thigh

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28
Q

cutaneous supply of femoral brach of genitofemoral nerve

A

upper anterior thigh (midline of thigh)

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29
Q

cuteness supply of obturator nerve

A

medial thigh (adductor compartment)

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30
Q

cutaneous supply of ilioinguinal nerve

A

upper medial thigh

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31
Q

supply of lateral cutaneous branch of T12

A

upper lateral thigh

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32
Q

supply of anterior cutaneous branches of femoral nerve

A

anterior thigh down to knees

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33
Q

what is the name of fascia over the thigh

A

fasciae latae

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34
Q

what is the name of the thickening of the lateral fasciae latae

A

iliotibial tract

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35
Q

where does the IT tract run to and from

A

iliac tubercle to anterolateral tibial tubercle

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36
Q

what is the function of the IT tract

A

supports femur over tibia when standing

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37
Q

what is the name of the fascia over the leg

A

crural fascia

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38
Q

what makes up the roof of the femoral triangle

A

fasciae latae
cribriform fascia
subcutaneous tissue
skin

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39
Q

what is the saphenous opening

A

opening in the cribriform fascia to allow great saphenous vein to grain into the femoral vein

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40
Q

where is the saphenous hiatus located

A

inferior to the medial aspect of the inguinal ligament

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41
Q

what are the boundaries of the femoral triangle

A 
roof = fascia, SC tissue and skin
base (superior) = inguinal ligament 
lateral = sartorius
medial = adductor longus 
floor = Iliopsoas and pectineus
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42
Q

what are the contents of the femoral triangle

A 
lateral to medial 
femoral nerve 
femoral artery 
femoral vein
lymphatics
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43
Q

what is the femoral sheath

A

fascia surrounding vascular structures in the femoral triangle

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44
Q

which structures are contained in the femoral sheath

A

femoral artery, vein and lymphatics

NOT femoral nerve

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45
Q

what is the femoral sheath made of

A

transversalis and Iliopsoas fascia and adventitia of femoral vessels

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46
Q

wha t is the femoral canal

A

potential space medially in the femoral sheath

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47
Q

what is contained in the femoral canal

A

fat and lymphatics

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48
Q

actions of anterior thigh muscles

A

hip flexors

knee extensors

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49
Q

actions of medial thigh muscles

A

hip adductors

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50
Q

actions of posterior thigh muscles

A

hip extension

knee flexion

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51
Q

what is the name of the small indentation on the head f the femur

A

fovea

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52
Q

what connects the greater and lesser trochanter anteriorly

A

intertrochanteric line

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53
Q

what connects the greater and lesser trochanter posteriorly

A

intertrochanteric crest

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54
Q

what is the name of the pair of ridges on the posterior surface of the shaft of femur

A

linea aspera

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55
Q

what is the name of the ridges as the lines aspera diverges towards the condyles

A

supracondylar lines

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56
Q

where is the adductor tubercle

A

inferior, medial femur

superior to medial epicondyle

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57
Q

what are the hip flexors of the anterior thigh

A

iliacus
psoas
pectineus
sartorius

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58
Q

what are the knee extensors of the anterior thigh

A

quadriceps

  • rectus femoris
  • vastus medialis
  • vastus lateralis
  • vastus intermedius
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59
Q

origin and insertion of iliacus

A

iliac crest, fossa, ala of sacrum, anterior sacroiliac ligament
TO
psoas tendon, lesser trochanter

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60
Q

innervation of iliacus

A

femoral nerve L2,3

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61
Q

action of iliacus

A

flexes hip

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62
Q

origin and insertion of psoas major

A

T12-L5, IV discs, lumbar transverse processes
TO
lesser trochanter

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63
Q

innervation of psoas major

A

anterior rami L1-3

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64
Q

action of psoas major

A

flexes hip

also has action on the trunk

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65
Q

origin and insertion of pectineus

A

superior ramus of pubis
TO
Pectineal line of femur

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66
Q

innervation of pectineus

A 
femoral nerve (L2,3)
occasionally branches from obturator (same nerve roots)
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67
Q

action of pectineus

A

adduct and flex hip

assists with medial rotation

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68
Q

origin and insertion of sartorius

A

ASIS
TO
superior part of medial surface of tibia

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69
Q

innervation of sartorius

A

femoral nerve (L2,3)

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70
Q

action of sartorius

A

flex, abduct and laterally rotate hip
flex knee
(sit cross legged)

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71
Q

what are the 4 parts of quadriceps

A

rectus femoris
vastus lateralis
vastus medialis
vastus intermedius

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72
Q

origin of rectus femoris

A

anterior inferior iliac spine and ilium above acetabulum

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73
Q

origin of vastus laterals

A

greater trochanter and lateral linea aspera

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74
Q

origin of vastus medialis

A

intertrochanteric line and medial linea aspera

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75
Q

origin of vastus intermedius

A

anterior and lateral shaft of femur

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76
Q

why are the lower fibres of vastus medialis horizontally orientated

A

to prevent lateral dislocation of patella

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77
Q

why is lateral dislocation of the patella more common

A

the knees are more medially positioned than the hips, so when the quads contract, they tend to pull the patella laterally

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78
Q

what is the common insertion of quads

A

quadriceps tendon, which envelopes the patella and continues as the patellar ligament which attaches to the tibial tuberosity

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79
Q

what type of bone is the patella

A

sesamoid

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80
Q

what is the action of quads

A

extends the knee

rectus femoris is also a hip flexor

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81
Q

innervation of quads

A

femoral nerve L2,3,4

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82
Q

describe the course of the femoral nerve to the upper limb

A

passes deep to inguinal ligament
medial to ASIS
on tendon of Iliopsoas

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83
Q

muscular branches of femoral nerve supply…

A

anterior thigh muscles

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84
Q

articular branches of femoral nerve supply…

A

hip and knee joint

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85
Q

cutaneous branches of femoral nerve supply…

A

anteromedial thigh

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86
Q

what is the saphenous nerve

A

terminal cutaneous branch o femoral nerve

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87
Q

which two muscles does the saphenous nerve pass between to reach the anteromedial knee, leg and foot

A

sartorius and vastus muscles

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88
Q

medial compartment of thigh muscles

A 
gracilis 
adductor longus 
adductor bevis 
adductor Magnus 
obturator externus
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89
Q

what is the order of the adductor muscles

A

from superficial to deep
adductor longus
adductor brevis
adductor Magnus

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90
Q

which medial thigh muscle is NOT and adductor

A

obturator externus

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91
Q

attachments of gracilis

A

bony and inferior ramus of pubis
TO
superior medial surface of tibia

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92
Q

innervation of gracilis

A

obturator nerve (L2,3)

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93
Q

action of gracilis

A

adducts hip

flexes knee

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94
Q

attachment of adductor longus

A

body of pubis
TO
middle 1/3 of linea aspera

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95
Q

innervation of adductor longus

A

obturator nerve (L2,3,4)

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96
Q

action of adductor longus

A

adducts thigh

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97
Q

attachments of adductor brevis

A

body and inferior ramus of pubis
TO
Pectineal line and proximal linea aspera

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98
Q

innervation of adductor brevis

A

obturator nerve (L2,3,4)

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99
Q

action of adductor longus

A

adducts thigh

may assist in flexion

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100
Q

attachments of adductor Magnus

A

ischiopubic ramus and ischial tuberosity
TO
linea aspera, medial supracondylar line, adductor tubercle

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101
Q

what is the adductor hiatus

A

gap between attachment of adductor Magnus at supracondylar line and adductor tubercle

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102
Q

innervation of adductor Magnus

A

adductor part = obturator nerve (L2,3,4)

hamstring part = tibial division of sciatic nerve (L4)

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103
Q

action of adductor Magnus

A

adducts thigh
adductor part also flexes
hamstring part also extends

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104
Q

attachments of obturator externus

A

margins of obturator foramen and obturator membrane (anterior surface)
TO
trochanteric fossa

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105
Q

obturator externus run anterior/posterior to neck of femur

A

posterior

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106
Q

where is the trochanteric fossa

A

‘hole’ on the medial side of greater trochanter

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107
Q

innervation of obturator externus

A

obturator nerve (L3,4)

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108
Q

action obturator externus

A

laterally rotates thigh

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109
Q

nerve roots of obturator

A

L2-4

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110
Q

what are the first divisions of obturator nerve

A

anterior and posterior branches

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111
Q

what are the anterior and posterior branches of obturator nerve named in relation to

A

adductor brevis

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112
Q

where do muscular branches of obturator supply

A

medial thigh

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113
Q

what do anterior branches of obturator nerve innervate

A

cutaneous innervation to middle part of medial thigh

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114
Q

where does the adductor canal run

A

from the apex of the femoral triangle to the adductor hiatus

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115
Q

which structures make up the apex of the femoral triangle

A

sartorius and adductor longus

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116
Q

which muscle does the adductor canal run deep to

A

sartorius (distal half)

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117
Q

what are the boundaries of the adductor canal

A 
roof = sartorius 
floor = vastus medialis and adductor longus
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118
Q

what are the contents of the adductor canal

A

saphenous nerve

femoral artery/vein

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119
Q

where does saphenous nerve innervate

A

anteromedial knee
leg
foot

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120
Q

where do the femoral vessels pass after the adductor canal

A

through the adductor hiatus to reach the popliteal fossa

transitions to popliteal artery

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121
Q

the femoral artery is a continuation of which artery

A

external iliac

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122
Q

course of femoral artery

A 
deep to inguinal ligament 
femoral triangle 
adductor canal 
adductor hiatus 
popliteal fossa
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123
Q

which areas does the femoral artery supply

A

anterior and anteromedial thigh

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124
Q

profunda femoris is a branch of which artery

A

femoral artery

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125
Q

which branches does profunda femoris give off deep to adductor longus

A

3-4 perforating branches which pierce adductor Magnus

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126
Q

after piercing adductor Magnus where do the perforating branches of profunda femoris supply

A

wrap around shaft to supply structures of lateral thigh

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127
Q

which branches does the profunda femoris gives off close to the femoral neck

A

medial and lateral circumflex femoral

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128
Q

what is the cruciate anastomosis

A

anastomosis between medial and lateral circumflex femoral arteries, inferior gluteal and 1st perforating branch of profunda femoris

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129
Q

what is the importance of the cruciate anastomosis

A

alternative route for blood to enter the lower limb if there is a blockage in external iliac

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130
Q

where does the obturator artery arise from

A

internal iliac artery

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131
Q

course of obturator artery

A

through obturator foramen to medial compartment where it splits into anterior and posterior branches

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132
Q

where do the anterior and poster divisions of the obturator artery supply

A 
anterior = muscles of medial compartment 
posterior = muscles attached to ischial tuberosity
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133
Q

what is the angle of inclination of the femur

A

angle between shaft and neck

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134
Q

what is the normal range of angle o inclination

A

120-135 degrees

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135
Q

what is the angle of ante version of femur

A

angle between transverse axis of femoral condyles and axis of femoral head and neck (anteromedial to posterolateral)

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136
Q

what is the angle of anteversion also known as

A

angle of torsion

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137
Q

what is the normal range of ante version of femoral head

A

15-20 degrees

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138
Q

what is the function of the angle of torsion of femoral head

A

affects how the muscles attach

changes the axis of movement at the hip joint

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139
Q

where is the trochanteric fossa

A

medial side of greater trochanter

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140
Q

where is the gluteal tuberosity

A

superior aspect of linea aspera

inferior to lesser trochanter

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141
Q

where is the Pectineal line

A

inferior to lesser trochanter, posterior surface of femur

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142
Q

where is the adductor tubercle

A

superior to medial condyle

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143
Q

lateral rotators of the hip

A 
gluteus maximus 
piriformis 
obturator internus 
gemelli 
quadrates femoris
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144
Q

medial rotators and abductors of hip

A

gluteus medius

gluteus minimus

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145
Q

what is the main action of gluteus Maximus

A

extension of hip

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146
Q

attachments of tensor fasciae latae

A

anterior iliac crest and ASIS
TO
iliotibial tract

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147
Q

action of tensor fasciae latae

A

tenses fascia lata and iliotibial tract

supports femur on tibia when standing

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148
Q

innervation of tensor fasciae latae

A

superior gluteal nerve

L4, L5, S1

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149
Q

in which muscular plane is superior gluteal nerve found

A

between gluteus minibus and medius

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150
Q

attachments of gluteus Maximus

A

sacrum, sacrotuberous ligament, ilium behind posterior gluteal line
TO
iliotibial tract (superficial 3/4) and gluteal tuberosity (deeper 1/4)

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151
Q

action of gluteus Maximus

A

extension of hip

assists in lateral rotation

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152
Q

innervation og gluteus maximus

A

inferior gluteal nerve

L5, S1, S2

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153
Q

attachments of Piriformis

A

anterior sacrum and sacrotuberous ligament
TO
superior border of greater trochanter

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154
Q

action of piriformis

A

lateral rotation of hip

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155
Q

innervation of piriformis

A

anterior rami S1, S2

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156
Q

attachments of obturator internus

A

pelvic surface of obturator membrane and surrounding bones
TO
trochanteric fossa (via tendon)

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157
Q

where does tendon of obturator internus pass to reach trochanteric fossa

A

lesser sciatic foramen

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158
Q

where does piriformis pass to reach trochanteric fossa

A

greater sciatic fossa

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159
Q

action of obturator internus

A

laterally rotates hip

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160
Q

innervation of obturator internus

A

nerve to obturator internus

L5, S1

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161
Q

attachments of superior gemellus

A

ischial spine
TO
trochanter fossa

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162
Q

action of superior gemellus

A

laterally rotate hip

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163
Q

innervation of superior gemellus

A

nerve to obturator internus

L5, S1

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164
Q

attachments of inferior gemellus

A

ischial tuberosity
TO
trochanteric fossa

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165
Q

action of inferior gemellus

A

laterally rotate hip

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166
Q

innervation of inferior gemellus

A

nerve to quadratus femoris

L5, S1

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167
Q

attachments of quadrates femoris

A

ischial tuberosity
TO
quadrate tubercle on intertrochanteric crest of femur

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168
Q

action of quadratus femoris

A

laterally rotates hip

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169
Q

innervation of quadratus femoris

A

nerve to quadratus femoris

L5, S1

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170
Q

attachments of obturator externus

A

outer surface of obturator membrane
TO
trochanter fossa

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171
Q

action of obturator externus

A

laterally rotates hip

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172
Q

innervation of obturator externus

A

obturator nerve

L3, L4

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173
Q

lateral rotators from cranial to caudal

A 
piriformis 
superior gemellus 
obturator externus 
inferior gemellus 
quadratus femoris
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174
Q

attachments of gluteus medius

A

ilium between posterior and anterior gluteal lines
TO
lateral surface of greater trochanter

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175
Q

action of gluteus medius

A

abducts and medially rotates hip

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176
Q

innervation of gluteus medius

A

superior gluteal nerve

L4, L5, S1

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177
Q

attachments of gluteus minimus

A

ilium between anterior and inferior gluteal lines
TO
anterior surface of greater trochanter

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178
Q

action of gluteus minimus

A

abducts and medially rotates hip

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179
Q

innervation of gluteus minimus

A

superior gluteal nerve

L4, L5, S1

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180
Q

roots of sciatic nerve

A

L4, L5, S1, S2, S3

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181
Q

branches of sciatic nerve

A

tibial

common peroneal

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182
Q

describe route of superior gluteal nerve

A

exits pelvis above piriformis

moves between.gluteus medius and minimus

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183
Q

what do branches of superior gluteal artery supply

A

superficial: gluteus maximus
deep: gluteus minimus, gluteus maximus and tensor fasciae latae

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184
Q

roots of posterior cutaneous nerve of thigh

A

S1, S2, S3

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185
Q

which areas does posterior cutaneous nerve of thigh supply

A

posterior thigh

inferior half of buttock via inferior clunial nerves

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186
Q

what are the roots of the clunial nerves

A

superior: posterior rami L1, L2, L3
middle: posterior rami S1, S2, S3
inferior: anterior rami S1, S2, S3

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187
Q

where do the superior clunial nerves supply

A

skin of superior half of buttocks

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188
Q

where do the middle clunial nerve supply

A

skin on medial side of buttocks

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189
Q

what type of cartilage covers the articular surface of hip joint

A

hyaline cartilage

except at fovea

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190
Q

what shape is the acetabulum

A

horse-shoe shaped

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191
Q

what structure connects the inferior ends of the acetabulum

A

transverse acetabular ligament

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192
Q

what attaches to the fovea on head of femur

A

ligament of head of femur

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193
Q

what is carried in the ligament of head of femur

A

artery to head of femur

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194
Q

where does the capsule of hip joint attach

A

margins of acetabulum

whole neck of femur (intertrochanteric line and above crest)

195
Q

which ligaments attach hip bones to femur

A

iliofemoral
ischiofemoral
pubofemoral

196
Q

attachments of iliofemoral

A

AIIS to intertrochanteric line

197
Q

what are the divisions of iliofemoral ligament

A

upper (more posterior, attaches to superior aspect of intertrochanteric line)
lower (more anterior, attaches to inferior intertrochanteric line)

198
Q

which movements does the iliofemoral ligament limit

A

extension
lateral rotation
abduction (lower)
adduction (upper)

199
Q

attachments of pubofemoral ligament

A

iliopubic eminence to lower part of intertrochanteric line

200
Q

which movements does the pubofemoral ligament limit

A

extension
lateral rotation
abduction

201
Q

attachments of ischiofemoral ligament

A

posterior acetabulum to greater trochanter

202
Q

which movements does ischiofemoral ligament limit

A

medial rotation
adduction
extension

203
Q

which movement of the hip is not limited by a ligament and why

A

flexion

trunk will limit movements

204
Q

artery to head of femur is a branch of…

A

obturator artery

205
Q

which arteries provide the main blood supply of hip joint

A

medial and lateral circumflex femoral arteries

branch of profanda femoris

206
Q

what are the hamstrings muscles

A

semitendinosus
semimembranosus
biceps femoris

207
Q

what are the characteristics of a true hamstring

A

attachment to ischial tuberosity
acts upon the hip and knee
innervation by tibial division of sciatic nerve

208
Q

which posterior thigh muscle is NOT a true hamstring

A

short head of biceps femoris

209
Q

attachments of semitendinosus

A

ischial tuberosity
TO
medial surface of superior tibia

210
Q

which muscles are closely associated with the distal attachment of semitendinosus

A

sartorius and gracilis

211
Q

innervation of semitendinosus

A

tibial division of sciatic nerve

L5, S1,2

212
Q

action of semitendinosus

A

flexion of knee

extension of hip

213
Q

attachments of semimembranosus

A

ischial tuberosity
TO
posterior surface of medial condyle of tibia

214
Q

innervation of semimembranosus

A

tibial division of sciatic nerve

L5, S1,2

215
Q

attachments of biceps femoris

A

long head: ischial tuberosity
short head: linea aspera and lateral supracondylar line of femur
TO
head of fibula

216
Q

innervation of biceps femoris

A

long head: tibial division of sciatic nerve (L5, S1,2)

short head: common fibular division of sciatic nerve (L5, S1,2)

217
Q

what role do the hamstrings play during the gait cycle

A

eccentric activity during swing phase to control speed of swinging leg

218
Q

when is maximal rotation of the knee possible

A

when knee is flexed

219
Q

which muscles cause lateral rotation of the knee

A 
biceps femoris 
(attached to lateral aspect of knee joint)
220
Q

which muscles cause medial rotation of the knee

A

semimembranosus/semitendinosus
gracilis and sartorius
(medial attachment to tibia)

221
Q

roots of sciatic nerve

A

L4,5, S1,2,3

222
Q

which muscle is the sciatic nerve deep to in the posterior thigh

A

long head of biceps

223
Q

which branch of the sciatic nerve is located most medially in the popliteal fossa

224
Q

what makes up the roof of the popliteal fossa

A

deep fascia of leg

225
Q

which structures pierce the roof of popliteal fossa

A

short saphenous vein

sural nerve

226
Q

describe the course of the short saphenous vein

A

runs up midline of calf
pierces roof of popliteal fossa
drains to popliteal vein

227
Q

what does the rural nerve innervation

A

skin of posterolateral leg

228
Q

what are the superior boundaries of the popliteal fossa

A

diverging tendons of hamstrings

medially: semiten/semimem
laterally: biceps fem

229
Q

what are the inferior boundaries of the popliteal fossa

A

medial and lateral head of gastrocnemius

230
Q

what makes up the floor of the popliteal fossa

A

popliteal surface of femur
capsule of knee joint
popliteus muscle

231
Q

which ligament is present in the posterior surface of knee joint capsule

A

oblique popliteal ligament

232
Q

what forms the oblique popliteal ligament

A

expansion from semimembranosus tendon

233
Q

which vessels pierce the knee joint capsule posteriorly

A

middle genicular vessels

234
Q

what do the middle genicular vessels supply

A

cruciate ligaments

235
Q

what are the contents of the popliteal fossa (medial/deep to lateral/superficial)

A

popliteal artery
popliteal vein
terminal branches of sciatic nerve (tibial then common fibular)

236
Q

when does the femoral artery become the popliteal artery

A

when it passes through the adductor hiatus

237
Q

when does the popliteal artery end

A

inferior border of popliteus

238
Q

what are the branches of the popliteal artery in the popliteal fossa

A 
lateral superior genicular artery 
medial superior genicular artery 
middle genicular artery 
lateral inferior genicular artery 
medial inferior genicular artery
239
Q

what are the terminal branches of the popliteal artery

A

anterior and posterior tibial artery

240
Q

which external structures support the knee joint anteriorly

A

quadriceps tendon
patella
patellar ligament

241
Q

which external structures support the knee joint laterally

A

tendon of biceps femoris

242
Q

which external structures support the knee joint medially

A

sartorius
gracilis
semitendinosus
semimembranosus

243
Q

what type of joint I the knee joint

A

modified hinge joint

244
Q

why is the knee joint described as a modified hinge joint

A

as well as flexion/extension medial and lateral rotation are possible

245
Q

which bones articulate at the knee joint and what are these articulations called

A 
femur 
patella 
tibia 
femoropatellar 
femorotibial x2
246
Q

which muscle often contains a small sesamoid bone in its proximal tendon

A

gastrocnemius

247
Q

what are the femoral articular surface of the knee joint

A

femoral condyles

patellar surface

248
Q

describe the femoral condyles

A

medial and lateral rounded condyles

located on anteroinferior aspect of femur

249
Q

what separates the medial and lateral femoral condyles

A

intercondylar fossa/notch

250
Q

describe the patellar surface of the femur

A

superior to the condyles

greater ridge on border of lateral surface to prevent lateral displacement of patella

251
Q

describe the articular surface of the patella

A

has a medial and lateral facet that articulates with the medial and lateral aspects of patellar surface of femur
lateral facet is larger

252
Q

describe the tibial articular surface of knee joint

A

medial and lateral condyles

much flatter than femoral condyles

253
Q

what separates the tibial condyles

A

intercondylar eminence

254
Q

describe the capsule attachments of the knee joint

A

anteriorly fuses with the quadriceps tendon superiorly and patellar ligament inferiorly
posteriorly it follows the margins of the femoral condyles and posterior margin of intercondylar fossa and along the border of the tibial condyles, gains enclosing the intercondylar eminence

255
Q

why is there an opening in the posterolateral aspect of the knee joint capsule

A

to allow passage of popliteus muscle

256
Q

describe the attachment of the synovial membrane of the knee joint to the femur

A

follows articular margins

257
Q

describe the attachment of the synovial membrane of the knee joint to the tibia

A

follows the margins of the condyles almost completely, leaving the intercondylar eminence outside the synovial cavity

258
Q

what are the alar folds

A

medial and lateral folds cover the inner surface of fat pads on either side of the patellar ligament

259
Q

which bursae of the knee communicate with the joint cavity

A

suprapatellar
gastrocnemius
semimembranosus
popliteus

260
Q

describe the suprapatellar bursa

A

travels superiorly deep to quadriceps tendon

reduces friction of movement of quad tendon

261
Q

what is articularis genu and what is its function

A

small muscle made from fibres of vastus intermedium

holds suprapatellar bursa in place and prevents it falling downwards

262
Q

where is the subcutaneous prepatellar bursa

A

between the skin and lower part of the patella

263
Q

where is the subcutaneous infra patellar bursa

A

between the skin and patellar ligament

264
Q

where is the deep infra patellar bursa

A

between patellar ligament and upper tibia

265
Q

what is the anserine bursa

A

bursa on the medial aspect the knee joint separating the tendons of gracilis, Sartorius and semitendinosus from the medial collateral ligament

266
Q

describe the popliteus bursa

A

surrounds the popliteus tendon as it reaches beyond the opening on the joint capsule

267
Q

what are the extracapsular ligament associated with the knee joint

A

oblique popliteal
arcuate popliteal
medial and lateral collateral

268
Q

describe the oblique popliteal ligament

A

expansion on the semimembranosus tendon on the posterior surface of the capsule

269
Q

describe the arcuate popliteal ligament

A

thickening of the capsule over the opening for popliteus

strengthens posterolateral capsule

270
Q

how do the medial and lateral collateral ligaments of the knee differ in appearance

A

the MCL is a strong, flat thickening of the capsule

the LCL is cord-like and narrow

271
Q

attachments of the MCL of knee

A

medial epicondyle of femur
TO
medial condyle and superior medial surface of tibia (close/deep to attachments of sartorius/gracilis/semitendinosus)

272
Q

the medial collateral ligament attaches to which other structure of the knee joint

A

deep fibres attach to the medial meniscus

273
Q

attachments of the LCL of knee

A

lateral epicondyle of femur
TO
lateral head of fibula

274
Q

which structures are associated with the LCL of the knee

A

popliteus tendon runs deep

biceps femoris tendon splits around it

275
Q

which collateral ligament is most likely to be injured

A

medial collateral ligament

from force directed on lateral side of knee

276
Q

damage to the MCL is often associated with damage to which other structure

A

medial meniscus

277
Q

which ligaments are found within the capsule of the knee joint

A

cruciates

intracapsular but extrasynovial

278
Q

attachments of ACL

A

anterior intercondylar area of tibia
TO
medial side of lateral condyle of femur

279
Q

which movements does the ACL limit

A

prevents backward translation of femur on tibia, hyperextension and medial rotation on planted foot

280
Q

what are the two bands of the ACL and how does their function differ

A

anteromedial band limits flexion

posterior lateral band limits extension

281
Q

attachments of the PCL

A

posterior intercondylar area of tibia
TO
lateral side of medial condyle of femur

282
Q

which movements does the PCL limit

A

prevents forward movement of femur on tibia

283
Q

what are the divisions of the PCL and how do their actions differ

A

anterolateral band limits flexion

posteromedial band limits extension

284
Q

what is the most important function of the PCL

A

supporting body weight over a bent knee eg when climb stairs
stops the body weight from pushing the femur over the anterior edge of tibial plateau

285
Q

how do the cruciate ligaments work together to limit medial rotation

A

they wind around each other

286
Q

what are the menisci made of

A

fibrocartilage

287
Q

what is the function of the menisci

A

deepen tibial articular surface and increase congruency

shock absorption

288
Q

describe the medial meniscus

A

C-shaped
firmly attached to tibia
firm attachment from medial collateral ligament

289
Q

describe the lateral meniscus

A

circular
not tightly attached to tibia (freely moveable)
attachment to popliteus

290
Q

why does the lateral meniscus have an attachment to popliteus

A

contraction of popliteus pulls the lateral meniscus into a better position to accommodate the femur when the knee is flexed

291
Q

which ligaments are associated with the menisci

A

transverse ligament of knee stretches between anterior aspects of menisci
posterior meniscofemoral ligament arises from lateral meniscus and blends with pCL

292
Q

which meniscus is more injury prone and why

A

medial
firmly attached to tibia
attached to MCL so are often injured together

293
Q

branches of which arteries supply the knee

A

femoral

popliteal

294
Q

what is the name of the complex anastomosis supplying the knee

A

periarticular genicular anastomosis

295
Q

what are the branches of the periarticular genicular anastomosis

A

5 genicular branches from popliteal a.
descending genicular artery from femoral a.
descending branch from lateral circumflex femoral a.
recurrent branches from anterior and posterior tibial a.

296
Q

why does the knee have such an extensive blood supply

A

because when the knee is fully flexed the popliteal artery is compressed meaning that collateral blood supply is needed to supply the leg/foot

297
Q

what are the compartments of the leg

A

anterior
lateral
posterior

298
Q

the anterior septum divides which two compartments

A

anterior and lateral

299
Q

the interosseous membrane divides which two compartments

A

anterior and posterior

300
Q

the posterior septum divides with two compartments

A

posterior and lateral

301
Q

which direction do fibres of the interosseous membrane pass

A

inferolaterally

from the tibia, downwards and outwards to the fibula

302
Q

what are the functions of the interosseous membrane of the leg

A

provides a surface for muscle attachment

helps resist the downward pull of muscles attached to the fibula

303
Q

what is the purpose of the space in the superior part of the interosseous membrane

A

passage of anterior interosseous vessels and deep peroneal nerve

304
Q

what type of joint is the superior tibiofibular joint

A

plane synovial joint

305
Q

articular surface of the superior tibiofibular joint

A

head of fibula and facet on lateral tibial condyle

306
Q

which ligaments support the superior tibiofibular joint

A

anterior and posterior ligaments of head of fibula

307
Q

movements at the superior tibiofibular joint

A

very little movement

fibula pushes slightly upwards during dorsiflexion of ankle

308
Q

how many muscles are in the anterior compartment of the leg

309
Q

what is the main function of the anterior compartment of the leg

A

extensors of ankle joint and digits

310
Q

innervation of anterior compartment

A

deep peroneal nerve (L4,5)

311
Q

attachments of tibialis anterior

A

lateral condyle of tibia, superior 1/2 of lateral tibial surface and interosseous membrane
TO
medial and inferior surface of medial cuneiform and base of 1st MT
crosses dorsal surface of foot

312
Q

action of tibialis anterior

A

dorsiflexion of ankle

inversion

313
Q

innervation of tibialis anterior

A

deep peroneal nerve (L4,5)

314
Q

attachments of extensor digitorum longus

A

lateral condyle of tibia, superior 3/4 of medial surface of fibula, interosseous membrane
TO
middle and distal phalanges of lateral 4 digits

315
Q

action of extensor digitorum longus

A

extends lateral 4 digits

dorsiflexion of ankle

316
Q

innervation of extensor digitorum longus

A

deep peroneal nerve (L4,5)

317
Q

attachments of peroneus tertius

A

inferior /3 anterior fibula and interosseous membrane
TO
dorsal of 5th MT

318
Q

action of peroneus tertius

A

dorsiflexion of ankle
assists in eversion
small muscle - minimal contribution

319
Q

innervation of peroneus tertius

A

deep peroneal nerve

L4,5

320
Q

attachments of extensor hallucis longus

A

middle anterior surface of fibula, interosseous membrane
TO
dorsal aspect of distal phalanx of hallux

321
Q

action of extensor hallucis longus

A

extends hallux

dorsiflexes ankle

322
Q

how many parts of the extensor retinaculum are there on the dorsal of the foot

A

2

superior and inferior

323
Q

attachments of superior extensor retinaculum

A

anterior border of tibia
TO
lower end end of fibula

324
Q

attachments of inferior extensor retinaculum

A

Y-shaped
stem: calcaneus (laterally)
upper limb: medial malleolus
lower limb: passes round medial border of foot to blend with dense fascia over abductor hallucis

325
Q

how many muscles in the lateral compartment of leg

326
Q

what is the function of the lateral compartment of leg

A

eversion of foot

can assist in plantar flexion as pass posterior to ankle joint

327
Q

innervation of lateral compartment

A

superficial peroneal nerve

328
Q

attachments of peroneus longus

A

head of fibula and upper 2/3 of lateral fibula
TO
base of 1st MT and medial cuneiform

329
Q

action of peroneus longus

A

eversion of foot

330
Q

describe the course of the tendon of peroneus longus on the planter surface of foot

A

crosses from lateral side of foot to medial side to reach 1st MT/medial cuneiform
crosses cuboid bone creating a deep groove on its surface

331
Q

innervation of peroneus longus

A

superficial peroneal nerve

L5, S1,2

332
Q

attachments of peroneus brevis

A

inferior 2/3 of lateral fibula
TO
tuberosity on lateral side of base of 5th MT

333
Q

innervation of peroneus brevis

A

superficial peroneal nerve

L5, S1,2

334
Q

which bony features are associated with the muscles of the lateral compartment of leg
(4)

A

groove at distal end of fibula on posterior medial aspect to allow passage of tendons
peroneal trochlea of calcaneus separates the two tendons (brevis is superior)
tuberosity on 5th MT for brevis
groove on inferior surface of cuboid for longus

335
Q

what is the common origin of muscles of the dorsum of foot

A

superior surface of calcaneus and inferior extensor retinaculum (lateral side)

336
Q

what are the muscles of the dorsum of the foot

A

extensor hallucis brevis and extensor digitorum brevis

337
Q

insertion of extensor hallucinations brevis

A

base of proximal phalanx of hallux

338
Q

insertion of extensor digitorum brevis

A

long extensor tendons of toes 2-4

339
Q

innervation of dorsal foot tendons

A

deep peroneal nerve

L5, S1

340
Q

branches of common peroneal nerve

A

superficial and deep peroneal nerve

341
Q

where does the common peroneal nerve divide into its branches

A

after it wraps around the neck of fibula

342
Q

what does the superficial peroneal nerve innervate

A

lateral compartment then continues on as cutaneous innervation

343
Q

which areas does the superficial peroneal nerve supply cutaneous innervation

A

distal anterior surface of leg and most of dorsal of foot

344
Q

describe course of deep peroneal nerve

A

passes through EDL and travels with anterior tibial artery on anterior surface of interosseous membrane
crosses ankle joint to supply muscles of dorsum of foot

345
Q

what does deep peroneal nerve supply

A

anterior compartment of leg
dorsum of foot
cutaneous innervation to 1st web space

346
Q

which nerves provide cutaneous innervation in the leg

A

saphenous: anterior/medial leg
sural: lateral leg, lateral border of foot
superficial peroneal: most of dorsum/lower anterolateral leg
deep peroneal: 1st web space

347
Q

describe course of anterior tibial artery

A

passes through interosseous membrane and descends along with deep peroneal nerve
crosses anterior to ankle joint to become dorsals pedis

348
Q

where does fibular artery arise from

A

posterior tibial artery

349
Q

where does fibular artery supply

A

lateral compartment

350
Q

branches of dorsals pedis

A

lateral tarsal artery
deep plantar artery
arcuate artery

351
Q

how does deep plantar artery reach planter surface of foot

A

dives down between 1st and 2nd MTs

352
Q

which arteries are connected by the arcuate artery

A

lateral tarsal and dorsalis pedis

353
Q

which venous structure gives rise to great saphenous vein

A

dorsal venous arch

354
Q

what are the bones of the foot

A 
talus 
calcaneus 
navicular 
cuboid 
cuneiforms
355
Q

which bones make up the hind foot

A

calcaneus

talus

356
Q

which bones make up the mid foot

A

navicular
cuboid
cuneiforms (medial, intermediate, lateral)

357
Q

what bones make up the fore foot

A

metatarsals

phalanges

358
Q

what is the thick, central portion of the deep fascia of the plantar surface of the foot

A

plantar aponeurosis

359
Q

where is the deep fascia of the plantar surface o the foot thickest

A

centrally (plantar aponeuorsis)

weaker medially and laterally

360
Q

what are the attachments of the plantar aponeurosis

A

tubercle of calcaneus
TO
fibrous digital sheaths
splits into 5 bands to attach to each digit

361
Q

what is the function of the vertical inter muscular septa arising from the plantar aponeurosis

A

splits muscles into medial, central and lateral compartments

362
Q

which muscles are found in the lateral compartment of the foot

A

muscles of the little toe
abductor digiti minimi
flexor digiti minimi brevis

363
Q

which muscles are found in the medial compartment of the foot

A

muscles of the great toe
abductor hallucis
flexor hallucis brevis

364
Q

which muscles are founding the central compartment of the foot

A

flexor digitorum brevis
quadratus plantae
lumbricals
adductor hallucis

365
Q

where is the first layer of plantar foot muscles found

A

between plantar aponeurosis and long flexor tendons

366
Q

muscles of first layer of plantar foot muscles

A

abductor hallucis
flexor digitorum brevis
abductor digiti minimi

367
Q

attachments of abductor hallucis

A

medial tubercle of calcaneus and flexor retinaculum
TO
medial base of proximal phalanx

368
Q

attachments of flexor digitorum brevis

A

medial tubercle of calcaneus
TO
middle phalanges of lateral 4 digits

369
Q

attachments of abductor digiti minimi

A

medial and lateral tubercle of calcaneus
TO
lateral base of proximal phalanx of little toe

370
Q

how so the tendons of flexor digitorum brevis attach to the middle phalanges

A

tendon splits into two to attach to either side of the middle phalanx to allow the leg tendon to pass through and reach the distal phalanx

371
Q

which muscles are found in layer 2 of the foot and what do they have in common

A

lumbricals and quadratus plantae

attach to the flexor digitorum longus tendons

372
Q

attachments of the lumbricals

A

medial side of tendons of FDL
TO
medial side of dorsal tendon expansion

373
Q

action of lumbricals

A

flex MTPJ

extend IPJs

374
Q

attachments of quadratus plantae

A

medial and lateral surfaces of calcaneus
TO
lateral side of FDL tendon

375
Q

what is quadratus plantae also known as

A

flexor accessorius

376
Q

what is the action of quadratus plantae

A

prevents contraction of FDL from pulling toes medially as it crosses over the plantar surface of the foot
contracts and pulls the lateral side of the tendon to straighten it out

377
Q

where is layer 2 found in the foot

A

deep to long flexor tendons

378
Q

which muscles are found in layer 3 of the foot

A

flexor hallucis brevis
adductor hallucis
flexor digiti minimi brevis

379
Q

attachments of flexor hallucis brevis

A

cuboid and lateral cuneiform
TO
both sides of base of proximal phalanx of hallux

380
Q

how is the tendon of flexor hallucis brevis adapted to aid in the function of flexor hallucis longus

A

contains sesamoid bones in its split tendon at the level of the 1st metatarsal head
creates a tunnel for FHL tendon to pass through, even when body weight is applied to the 1st MT during gait

381
Q

attachments of adductor hallucis

A

transverse head: plantar ligament of MTP joint
oblique head: base MT 2-4
TO
lateral side of base of proximal phalanx of hallux

382
Q

attachments of flexor digiti minimi brevis

A

base of 5th MT
TO
base of proximal phalanx of 5th digit

383
Q

which muscles are found in the 4th layer of the foot

A

interossei

384
Q

how many plantar interossei are there

385
Q

which toe is the axial digit of the foot (which toe does adduction/abduction occur around)

386
Q

attachments of the plantar interossei

A

medial side of metatarsals 3-5
TO
medial side of proximal phalanx of digits 3-5

387
Q

why are there not plantar interossei for digits 1-2

A

plantar interossei ADduct the toes
as 2nd digit is the axial digit it cannot be adducted, only abducted
1st digit has as separate muscle (adductor hallucis) to adduct it

388
Q

how many dorsal interossei are there

A

4 dorsal interossei

389
Q

attachments of dorsal interossei

A

bipennate attachments to adjacent sides of metatarsals 1-5
1st dorsal interosseous: medial side of proximal phalanx of 2nd digit
2nd-4th dorsal interossei: lateral side of proximal phalanx of 2nd-4th digits

390
Q

why does the 2nd digit have a dorsal interossei attaching to both sides

A

as it is the axial digit, it cannot be adducted, so has an abductor attached to both sides

391
Q

why do the 1st and 5th digits (big and little toes) not have a dorsal interossei attached to them

A

they have named abductors (abductor hallucis and abductor digiti minimi)

392
Q

which tendons are visible in the 4th layer of the foot

A 
peroneus longus (attaching to base of 1st MT and medial cuneiform)
tibialis posterior (plantar surfaces of medial tarsal bones)
393
Q

which nerves supply the muscles of the foot

A

medial and lateral plantar nerves

terminal branches of tibial nerve

394
Q

how do the terminal branches of the tibial nerve enter the foot

A

pass deep to flexor retinaculum

enter foot deep to abductor hallucis

395
Q

where is the medial plantar nerve found

A

between abductor hallucis and flexor digitorum brevis

396
Q

where is the lateral plantar nerve found

A

between layers 1 and 2

397
Q

what are the branches of the lateral plantar nerve

A

deep and superficial

deep branch runs between layers 3 and 4

398
Q

which muscles are innervated by medial plantar nerve

A

abductor hallucis
flexor digitorum brevis
1st lumbrical
flexor hallucis brevis

399
Q

which muscles are innervated by lateral plantar nerve

A 
abductor digiti minimi 
quadratus plantae 2nd-4th lumbricals
adductor hallucis 
flexor digiti minimi brevis 
interossei
400
Q

which muscles are innervated by the deep branch of lateral plantar

A

adductor hallucis

401
Q

which muscles are innervated by superficial plantar nerve

A

flexor digiti minimi brevis

402
Q

what is the cutaneous innervation of the plantar surface of foot

A

medial plantar: skin over medial 3 1/2 toes
lateral plantar: skin over lateral 1 1/2 toes
calcanea branches: skin over heel

403
Q

branches of which artery supply the plantar surface of the foot

A

posterior tibial artery

404
Q

what are the branches of the posterior tibial artery in the foot

A

medial and lateral plantar artery

405
Q

what is supplied by the medial plantar artery

A

muscles of hallux and overlying skin

406
Q

which branch occasionally arises from the medial plantar artery

A

superficial plantar arch

creates a loop over 1st MT

407
Q

the lateral plantar artery gives off which branches in the more distal foot

A

deep plantar arch

runs across lateral 4 MTs

408
Q

how is the arterial supply of the plantar surface of foot connected to the dorsum of the foot

A

deep plantar arch (branch of lateral plantar artery)

connects to deep plantar branch of dorsalis pedis

409
Q

what’s the function of the arches of the foot

A

distribute weight
shock absorbers
spring boards

410
Q

which structures support the transverse arch

A

tendon of tibialis posterior
tendon of peroneus longus
adductor hallucis muscle
deep transverse metatarsal ligament

411
Q

which tendons support the tarsal part of the transverse arch

A

tendon of tibialis posterior

tendon of peroneus longus

412
Q

which muscle supports the metatarsal transverse arch

A

adductor hallucis

413
Q

which bones make up the lateral longitudinal arch

A

calcaneus
cuboid
metatarsals 4 and 5

414
Q

is the medial or lateral longitudinal arch more pronounced

A

medial is more arched

lateral arch rests on ground when standing

415
Q

which bones make up the medial longitudinal arch

A 
calcaneus
talus 
navicular 
3 cuneiforms 
metatarsals 1-3
416
Q

what two types of support help to maintain the longitudinal arches

A

dynamic (muscles)

passive (ligaments)

417
Q

structures that provide dynamic support of the longitudinal arch

A

intrinsic muscles of the foot
flexor hallucis longus
flexor digitorum longus

418
Q

structures that provide passive support of the longitudinal arch

A 
plantar calcaneonavicular (spring) ligament 
short plantar ligament (calcaneocuboid)
long plantar ligament 
plantar aponeurosis
419
Q

how is weight distributed through the foot

A

weight is distributed equally between calcaneus and heads of metatarsals

420
Q

which joints make up the mid tarsal joint

A

talonavicular and calcaneocuboid joints

421
Q

which bones make up the subtalar joint

A

slightly concave posterior calcanea surface

convex posterior articular facet of calcaneus

422
Q

which ligaments support the subtalar joint

A

medial, lateral, interosseous and posterior talocalcaneal ligaments

423
Q

which is the strongest ligament of the subtalar joint

A

interosseous ligament

424
Q

what is the classification of the different parts of the mid tarsal joint

A

talocalcaneal part of talocalcaneonaviclar joint = plane synovial
talonavicular part of talocalcaneonavicular joint = ball and socket
calcaneocuboid joint = plane synovial

425
Q

which ligaments support the mid tarsal joint

A 
bifurcate ligament 
dorsal calcaneocuboid ligament 
long plantar ligament 
short plantar ligament 
spring ligament
426
Q

attachments of bifurcate ligament of mid tarsal joint

A

calcaneus
TO
navicular and cuboid

427
Q

attachments of dorsal calcaneocuboid ligament

A

calcaneus
TO
cuboid

428
Q

attachments of long plantar ligament

A

calcaneus (posteriorly)
TO
cuboid (deep fibres)
metatarsals (superficial fibres)

429
Q

which tendon passes under the superficial fibres of the long plantar ligament

A

peroneus longus

430
Q

attachments of short plantar ligament

A

calcaneus
TO
cuboid

431
Q

attachments of the spring ligament

A

AKA plantar calcaneonavicular ligament
calcaneus
TO
navicular

432
Q

functions of the spring ligament

A

supports the longitudinal arch, mid tarsal joint, head of talus

433
Q

what is lisfranc’s joint

A

tarsometatarsal joints

between cuboid and cuneiforms and bases of metatarsals

434
Q

which ligaments support the tarsometatarsal joints

A

plantar, dorsal and interosseous tarsometatarsal ligaments

435
Q

what type of joints are the MTPJs

A

synovial condyloid

436
Q

what type of joints are the IPJs

A

synovial hinge

437
Q

which joints are involved in inverse/eversion of the foot

A

mid tarsal and subtalar joints

438
Q

describe how the mid tarsal and subtalar joints are involved in inversion/eversion of the foot

A

muscles of inversion/eversion attach to forefoot and mid foot
causes mid foot to rotate on hind foot
ligaments tighten and transfer force to calcaneus
causes calcaneus to rotate under talus

439
Q

where is the soleal line

A

runs from lateral to medial on posterior surface of tibia

440
Q

how many muscles are in the posterior compartment

A

7
3 superficial
4 deep

441
Q

common insertion of superficial muscles of posterior leg

A

posterior surface of calcaneus via the tendocalcaneus

NOT ACHILLES TENDON

442
Q

attachments of gastrocnemius

A

medial head: popliteal surface of femur superior to medial condyle
lateral head: lateral aspect of lateral femoral condyle
TO
tendocalcaneus

443
Q

innervation of gastrocnemius

A

tibial nerve

S1, S2

444
Q

action of gastrocnemius

A

plantarflexes ankle

flexes knee

445
Q

attachments of plantaris

A

lateral supracondylar line of femur
TO
tend-Calcaneus

446
Q

innervation of plantaris

A

tibial nerve

S1 S2

447
Q

action of plantaris

A

assists in plantar flexion (not a lot)

448
Q

attachments of soleus

A

soleal line of tibia, upper 1/3 posterior fibula, tendinous arch between bony attachments
TO
tendocalcaneus

449
Q

innervation of soleus

A

tibial nerve

S1 S2

450
Q

action of soleus

A

plantar flexion

451
Q

what are the deep posterior leg muscles

A

popliteus
flexor hallucis longus
flexor digitorum longus
tibialis posterior

452
Q

attachments of popliteus

A

lateral condyle of femur and lateral meniscus
TO
popliteal area of tibia above soleal line

453
Q

innervation of popliteus

A

tibial nerve L4 L5 S1

454
Q

action of popliteus

A

unlocks knee by laterally rotating femur on fixed tibia

455
Q

what is the importance of lateral rotation of femur on fixed tibia when locking/unlocking knee joint

A

to get to full extension, the leg must be laterally rotate slightly to loosed the ligaments sufficiently to allow full extension
after achieving full extension the ligaments tighten around the joint to maintain the position without much muscle effort (PASSIVE)
to unlock the knee, popliteus contracts to laterally rotate the femur, which causes the ligaments to loosen enough to flex the knee (ACTIVE)

456
Q

attachments of flexor digitorum longus

A

posterior surface of tibia
TO
distal phalanges of digits 2-5

457
Q

innervation of FDL

A

tibial nerve

L5, S1, S2

458
Q

action of FDL

A

flexion of digits 2-5

weak plantar flexion

459
Q

attachments of FHL

A

posterior surface of fibula
TO
distal phalanx of hallux

460
Q

innervation of FHL

A

tibial nerve

L5, S1, S2

461
Q

action of FHL

A

flexes hallux

weak plantar flexion

462
Q

attachments of tibialis posterior

A

posterior surface of tibia and fibula and interosseous membrane
TO
tuberosity of navicular, cuneiforms, cuboid, calcaneus, and bases of Mts 2-4

463
Q

innervation of tibialis posterior

464
Q

action of tibialis posteiror

A

plantarflexion

inversion

465
Q

what is the order of the origins of deep posterior leg muscles

A 
medial to lateral 
flexor digitorum longus (posterior tibia)
tibialis posterior (tibia, IO membrane, Fibula)
flexor hallucis longus (fibula)
466
Q

what is the order of the tendons of the deep posterior leg muscles at the medial malleolus

A

medial to lateral
tibialis posterior
flexor digitorum longus
flexor hallucis longus

467
Q

attachments of the flexor retinaculum

A

medial malleolus to calcaneus

468
Q

where are the posterior tibial vessels and tibial nerve found at the level fo the flexor retinaculum

A

between the tendons of FDL and FHL

tom dick and very naughty harry

469
Q

describe the course of the posterior tibial artery

A

terminal branch of popliteal artery

passes between heads of gastrocnemius and deep to soleus to run on surface of TP and FDL

470
Q

the fibular artery is a branch of which artery

A

posterior tibial

471
Q

fibular artery runs within which muscle

A

flexor hallucis longus

472
Q

branches of the fibular artery

A

perforating branches to lateral compartment

473
Q

terminal branches of posterior tibial artery

A

meidal and lateral plantar arteries

474
Q

describe course of tibial Neve

A

runs between heads of gastrocnemius, deep to soleus and along surface of TP and FDL

475
Q

terminal branches of tibial nerve

A

medial and lateral plantar nerves

476
Q

describe cutaneous innervation of the leg

A

posterior cutaneous nerve of thigh: popliteal fossa (posterior thigh)
sural nerve: posterolateral leg
saphenous nerve: posterior medial leg

477
Q

what type of joint is the inferior toibofibular joint

A

syndesmosis (fibrous joint)

478
Q

ligaments of the inferior tibiofibular joint

A

anterior and posterior tibiofibular ligaments

interosseous tibiofibular ligament that is continuous with the IO membrane

479
Q

degree of movement possible at ankle joint

A

20-30 degree dorsiflexion

30-50 degrees plantar flexion

480
Q

is plantar or dorsiflexion more stable

A

dorsiflexion as the wider anterior part of the talus is held between the malleoli CF plantarflexion when the narrower posterior part is held between them

481
Q

which ligaments stabilise the ankle joint

A

medial collateral ligament (aka deltoid)

lateral collateral ligament

482
Q

what are the parts of the medial collateral ligament

A

anterior tibiotalar ligament
tibionavicular ligament
tibiocalcaneal ligament
posterior tibiotalar ligament

483
Q

what are the parts of the lateral collateral ligament

A

anterior Talofibular
calcaneofibular
posterior Talofibular

Anatomy BMSc (9 decks)

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