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Lower Limb II Flashcards

1
Q

Which muscle attaches to the adductor tubercle?

A
  • adductor magnus
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2
Q

What is the adductor hiatus and which structures pass through it?

A
  • femoral artery
  • femoral vein
  • saphenous nerve
  • gap between adductor magnus and femur
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3
Q

Label this image

A
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4
Q

Label this with

  • Medial and Lateral Condyle
  • Intercondylar eminence
  • Medial and lateral Intercondylar Tubercle
  • Articular facet for the head of the fibula
  • Tibial tuberosity
  • Soleal line
  • Interosseous border
  • Medial malleolus
  • Fibular notch
  • Groove for tibialis posterior and flexor digitorum longus tendons

Fibula :

  • Apex, Head and Neck
  • Interosseous border
  • Lateral malleolus
  • Malleolar fossa of lateral malleolus
  • Articular facet of lateral malleolus
A
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5
Q

Which structures attach to the Intercondylar eminence?

A
  • The anterior and posterior cruciate ligaments and the menisci attach to the intercondylar area
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6
Q

Where do the patellar tendons insert?

A
  • tibial tuberosity
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7
Q

What attaches on the soleal line?

A
  • soleus muscle
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8
Q

What attaches to the linea aspera?

A
  • adductor magnus
  • vastus lateralis
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9
Q

Label this image

A
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10
Q

Where is the tibia most commonly fractured?

A
  • narrowest point
  • inferior 2/3
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11
Q

In which direction does the patella most commonly dislocate?

What factors help prevent dislocation?

A
  • outwardly
  • anterior projection on the lateral femoral condyle, lateral to the patellar groove preventing lateral dislocation of the patella
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12
Q

What type of joint is the knee joint?

A
  • synovial hinge joint
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13
Q

What movements occur at the knee joint?

A
  • flexion
  • extension
  • lateral rotation
  • medial rotation
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14
Q

What muscles flex the knee?

A
  • hamstrings, gracilis, sartorius and popliteus.
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15
Q

Which muscles extend the knee?

A
  • quadriceps femoris
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16
Q

Which muscle laterally rotates the knee?

A
  • biceps femoris
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17
Q

Which muscles medially rotate the knee?

A
  • semimembranosus, semitendinosus, gracilis, sartorius and popliteus.
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18
Q

Where does the iliotibial tract continue from?

A
  • thickening of the fasciae latae
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19
Q

What actions does the iliotibial tract produce?

A
  • helps to extend, abduct, and rotate your hip
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20
Q

what is the importance of the iliotibial tract in the knee joint?

A
  • provides lateral stabilisation to the knee joint
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21
Q

Why is the patellar tendon also called the patellar ligament?

A
  • The patellar tendon is also called the patellar ligament because it connects the patella to the tibia
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22
Q

Where does the great saphenous vein run and where does it drain?

A
  • from the medial part of the dorsal venous arch of the foot all the way up to drain into the femoral vein at the saphenous opening
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23
Q

What does the short saphenous vein drain and where does it drain into?

A
  • Drains the lateral side of the foot and it drains into the popliteal vein
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24
Q

What is the crural fascia?

A
  • continuation of the fasciae latae
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25
What is the crural fascia pierced by?
* the short saphenous vein
26
Label this image
27
What are the compartments of the leg?
* anterior * posterior * lateral
28
What types of muscles are contained in the anterior compartment of the leg?
* dorsiflexors of the ankle/extensors of the toes
29
What types of muscles are contained in the posterior compartment of the leg?
* posterior flexors * flexors of the toes
30
What is the action of the muscles in the lateral compartment of the leg?
* evertors of the foot
31
Label this image
32
What are the 4 muscles in the anterior compartment of the leg?
* tibialis anterior * extensor digitorum longus * extensor hallucis longus * peroneus tertis
33
What nerve are the muscles in the anterior compartment supplied by?
* deep peroneal nerve
34
What 2 compartments does the peroneus tertius span?
* partly in the lateral * partly in the anterior
35
Label this image
1) gastrocnemius 2) soleus 3) tendo calcaneus
36
What 2 muscles converge onto the achilles tendon?
* gastrocnemius * soleus
37
What are the gastrocnemius and the soleus referred to as collectively?
* triceps surae
38
What is the nerve supply to the deep layer of the posterior compartment?
* tibial nerve
39
Label this image
40
Where do the deep tendons of the deep layer of the posterior compartment pass?
* under the medial malleolus
41
Where do the tendons of the lateral compartment pass?
* under the lateral malleolus
42
What is the nerve supply to the lateral compartment?
* superficial peroneal nerve
43
What is the muscle that is not supplied by the superficial peroneal nerve in the lateral compartment?
* peroneus tertius
44
Label this image
45
Name all the muscles in the posterior compartment of the leg
* superficial : gastrocnemius + soleus * deep : plantaris, popliteus, tibialis posterior, flexor digitorum longus, flexor hallucis longus
46
What does the common peroneal nerve divide into?
* deep and superficial branches
47
What are the superior and inferior boundaries of the popliteal fossa?
* superior : hamstrings * inferior : gastrocnemius
48
What 4 structures does the popliteal fossa contain?
* the tibial nerve * common peroneal * popliteal artery * popliteal vein
49
What does the sciatic nerve bifurcate into at the popliteal fossa?
* tibial nerve and common peroneal
50
Where does the common peroneal nerve wind around?
* head of the fibula
51
What does the adductor hiatus contain?
* popliteal vein and artery
52
Label this image
53
Where do the tibial nerve and popliteal artery go?
* pass down through the popliteal fossa, they pierce an opening in the soleus muscle * continue between the superficial and deep layers of the muscles
54
What does the posterior tibial artery divide into?
* lateral peroneal branch
55
What are the 5 structures that pass from the posterior compartment into the plantar region of the foot?
* Tibialis posterior * Flexor digitorum longus * Artery * Nerve * Flexor hallucis longus
56
Label this image
57
What nerve supplies the lateral compartment?
* superficial peroneal nerve
58
What nerve supplies the anterior compartment?
* deep peroneal nerve
59
Which nerve when damaged leads to foot drop?
* deep peroneal nerve
60
Where do the anterior peroneal artery and vein run?
* on the interosseous membrane
61
When does the anterior tibial artery change its name and what name is this?
* when anterior tibial artery passes onto the dorsum of the foot it is called the dorsalis pedis
62
Label this image
63
What is a bursa?
* sac of synovial fluid associated with a joint
64
What are the function of bursae?
* prevent friction when soft tissue (e.g tendon) rubs against bone
65
How many bursae are associated with the knee?
* 12
66
Label this image
67
Label this image
68
Where does the lateral collateral ligament of the knee pass?
* between the distal femur and the head of the fibula and on the medial side the medial collateral ligament
69
What acts as a shock absorber for the tibial condyles?
* medial and lateral meniscus which act as a shock absorber
70
What is the medial collateral ligament attached to?
* medial meniscus
71
What is the function of the medial and lateral collateral ligaments?
* prevent the joint from opening out at either side
72
What is the function of the cruciate ligament?
* prevent the femur sliding backwards and forwards on the tibia
73
Where does the tendon of the popliteus pass?
* between the lateral collateral ligament and the lateral condyle of the femur
74
What does the meniscofemoral ligament do?
* anchors the lateral meniscus
75
What movement of the tibia does the anterior cruciate ligament resist?
* prevents the tibia moving forward
76
How do you test for a torn ACL?
* flex the knee and try to draw the tibia forward
77
Which movement of the tibia does the posterior cruciate ligament resist?
* resist excessive posterior translation of the tibia
78
What is the role of the menisci in the knee joint?
* reduce friction during movement
79
Why are tears of the medial meniscus more common than tears of the lateral meniscus?
* medial meniscus is more commonly injured because it is firmly attached to the medial collateral ligament and joint capsule
80
Which ligaments act to limit extension of the knee?
* ACL
81
Which ligament acts to prevent excessive abduction and adduction of the knee?
* PCL
82
Where does the popliteus tendon pass ?
* under the lateral collateral ligament
83
How can the knee joint remain in extension without using the muscles?
* The femur medially rotates as the joint settles into full extension, this tightens the ligaments so the joint can remain in extension without using the muscles
84
How does locking the knee work?
* mechanical process brought about by the differences in the shape of the medial and lateral condyles of the femur
85
How does unlocking the knee occur?
* popliteus muscle unlocks the knee and rotates it laterally to flex the knee
86
What is the third arrow pointing to?
* popliteus muscle
87
What is the difference between “housemaids’ knee” and “Clergyman’s knee”?
* housemaid = prepatellar bursitis * clergyman = infrapatellar bursitis
88
Label the bursae
89
with the knee flexed and relaxed, it is possible to test knee reflex or ‘jerk’ test. Which ligament is struck and what nerve segments does it test?
* patellar ligament * L2, L3, and L4
90
What is haemarthrosis?
* bleeding into a joint cavity
91
What kind of a joint is between the tibia and the fibula?
* fibrous joint
92
What is found at the ends of the tibia and fibula interosseous membrane?
* tibiofibular ligaments
93
What kind of a joint is the ankle joint?
* synovial hinge joint
94
What is the ankle joint formed from and what kind of a joint does it make?
* formed between the medial and lateral malleoli and the trochlea of the talus which forms a mortise joint
95
What aer the medial and lateral ligaments that reinforce the ankle joint?
* medial : deltoid ligament * lateral : anterior and posterior
96
What is the medial ankle ligament made up of?
* anterior and posterior tibiotalar, tibionavicular and tibiocalcaneal
97
What is the lateral ankle ligament made of?
* anterior and posterior talofibular and calcaneofibular ligaments
98
Label this image
99
What is the main complication in fractures in the neck of the Talus?
* limp, arthritis, and chronic pain
100
What is hallux valgus?
* big toe deviates from the normal position and angles inward toward the second toe
101
What is shown in this diagram?
* malleolar mortise
102
Label these 3 ligaments
103
Label the anterior tibiofibular and posterior tibiofibular ligament
104
Which of the preceding ankle ligaments are commonly affected by inversion injuries?
* lateral (anterior talofibular)
105
How does Pott's fracture occur?
* Occurs after forcible foot eversion often causing tearing of the medial malleolus. * The talus then moves laterally, shearing off the lateral malleolus or breaking the fibula superior to the inferior tibiofibular joint.
106
At what joint do eversion and inversion of the foot occur?
* subtalar joint
107
What movements can the transverse tarsal joint do?
* inversion * eversion * rotation
108
What bones is the transverse tarsal joint formed from?
* between the talus and the navicular, the calcaneus and the cuboid
109
What movement occurs at the tarsometatarsal joint?
* gliding/sliding
110
What movement occurs at the metatarsophalangeal joints?
* flexion/extension abduction and adduction
111
What movement occurs at the interphalangeal joints?
* flexion/ extension
112
What joint is shown here?
* subtalar
113
What joint is shown here?
* transverse tarsal
114
What joint is shown here?
* Talocalcaneonavicular
115
What joint is shown here?
* Calcaneocuboid
116
What joint is shown here?
* Tarsometatarsal
117
What joint is shown here?
* Metatarsophalangeal
118
What joint is shown here?
* Interphalangeal
119
How are the bones in the foot arranged?
* longitudinal and transverse arches
120
In the erect position what parts of the foot make contact with the ground?
* heel, lateral margin of the foot, ball of the foot and the pads of the toes
121
What ligaments are important in maintaining the arch of the foot?
* spring ligaments
122
Label this image
123
What does peroneus brevis attach to?
* base of the 5th metatarsal
124
Where does peroneus longus attach to?
* crosses from lateral to medial and attaches to the base of the first metatarsal and medial cuneiform
125
Where do the tendons of tibialis anterior and posterior converge onto?
* base of the first metatarsal and the cuneiform
126
Label this image
127
What arches are involved in ‘flat feet’ (pes Planus)?
* loss of the medial longitudinal arch of the foot
128
What is Plantar Fasciitis (fasciosis)?
* inflammation of the plantar fascia
129
Where does the plantar fascia originate from?
* originates from the medial tubercle of the calcaneus
130
Label these 2 structures
131
What arches are shown here?
132
133
What are the structures in the popliteal fossa from medial to lateral?
* Popliteal artery * Popliteal vein * Tibial nerve.
134
What is the roof of the popliteal fossa formed by?
* fascia lata
135
What is the floor of the popliteal fossa formed by?
* popliteal surface of the femur, capsule of the knee joint and the popliteus muscle and its fascia
136
What are the proximal attachments of the gastrocnemius?
* medial condyle of femur and area just above condyle. * lateral condyle of femur and area just above condyle.
137
What is the proximal attachment of the soleus?
* 1/3 of posterior fibula
138
What is the principle action of the gastrocnemius and soleus?
* plantar flexing the foot at the ankle joint * flexing the leg at the knee joint
139
What is the action of the popliteus?
* flexing the leg upon the thigh * when the leg is flexed, it will rotate the tibia inward
140
Which artery provides the principal blood supply to the posterior compartment of the leg and what are its terminal divisions?
* popliteal artery * anterior and posterior tibial arteries
141
What is the relationship of the neurovascular bundle and the tendons of the three deep muscles to the medial malleolus?
* posterior to medial malleolus
142
What is the common action of the : flexor digitorum longus Flexor Hallucis longus Tibialis posterior
* plantar flex and invert the foot
143
What is the nerve supply and nerve roots of the : Flexor Digitorum longus Flexor Hallucis longus Tibialis posterior
* Tibial nerve (L5, S1, S2)
144
What 2 muscles does the lateral compartment contain?
* Fibularis (peroneus) longus * Fibularis (peroneus) brevis
145
What is the sensory and motor innervation for the superficial peroneal nerve?
* Motor : Innervates the muscles in the lateral compartment of the leg. * Sensory: Supplies the vast majority of the skin over the dorsum of the foot, apart from the webbing between the hallux and the second digit
146
What is the sensory and motor innervation for the deep peroneal nerve?
* motor function: Innervates the muscles in the anterior compartment of the leg, as well as some of the intrinsic muscles of the foot. * Sensory function: Supplies the triangular region of skin between the 1st and 2nd toes.
147
Label this image
148
What is the function of the retinacula?
* prevents bowstringing of tendons
149
The tendons of the peroneus (fibularis) longus and brevis pass posteriorly behind which bony structure of the Fibula?
* lateral malleolus
150
Label this image
151
Label this image
152
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153
Label this image
154
What is the common action of these muscles : Tibialis anterior Extensor digitorum longus Extensor hallucis longus Fibularis tertius
* dorsiflex and invert the foot at the ankle joint
155
What is the common innervation of these muscles : Tibialis anterior Extensor digitorum longus Extensor hallucis longus Fibularis tertius
* deep fibular nerve (L4-S1)
156
What is an important pulse to examine in arteriopathies?
* dorsalis pedis
157
Between which tendons does the dorsalis pedis lie?
* between the extensor hallucis longus tendon and the medial tendon of the extensor digitorum longus muscle
158
What nerve are these muscles supplied by? Extensor Digitorum Brevis Extensor Hallucis Brevis
* deep peroneal nerve.
159
What are the 3 muscles in the 1st layer of the foot?
* Abductor Hallucis * Flexor Digitorum Brevis * Abductor Digiti Minimi
160
What are the muscles in the 2nd layer of the foot?
* 4 lumbricals Quadratus Plantae
161
What are the 3 muscles in the 3rd layer of the foot?
* flexor hallucis brevis * flexor digiti minimi brevis * adductor Hallucis
162
What muscle and tendon is contained in the 4th layer of the foot?
* Plantar Interossei (4 dorsal and 3 Plantar) * Tendons of fibularis longus and tibialis posterior
163
What is the function of the 4 lumbricals quadratus plantae?
* assist flexor digitorum longus
164
What is the function of the muscles in the 1st layer of the foot and what is their nerve supply?
* Abductor Hallucis – abducts and flexes great toe (medial plantar nerve) * Flexor Digitorum Brevis – flexes lateral four digits (medial plantar nerve) * Abductor Digiti Minimi – abducts and flexes 5th digit – Lateral plantar nerve
165
What is the nerve supply (named nerve & “nerve roots”) of the intrinsic muscles of the foot?
* plantar nerve or the lateral plantar nerve, which are both branches of the tibial nerve * L4, L5, S1, S2, and S3
166
Label this image & what layer do these muscles belong to?
* 1st layer
167
Label this image & what layer do these muscles belong to?
168
What structure is this and what layer?
* 4th layer * interossei
169
Label this image & what layer of the foot is this?
170
Label this image
* A = lateral epicondyle * B = medial epicondyle * C = fibula * D = tibia * E = medial femoral condyle * F = lateral femoral condyle * G = intercondylar eminence * H = medial tibial plateau * I = lateral tibial plateau
171
Label this image
* J = * K = tibia * L = fibula * M = tibiofibular joint * N = medial condyle * O = shaft of femur *
172
Label this image
* A = fibula * B = tibia * C = malleolar fossa / lateral malleolus * D = medial malleolus * E = trochlea of talus * F = inferior articular surface
173
Label this image
* A = tibia * B = talus * C = navicular * D = calcaneus * E = tibiotalar joint * F = talocalcaneal joint
174
Label this image
* **A** = Distal phalanx * B = proximal phalanx * C = metatarsal I * D = medial, lateral and intermediate cuneiforms * E = navicular * F = cuboid * G = talus * H = calcaneium * I = distal phalanx * J = intermediate phalanx * K = metatarsophalangeal joint * L = sesamoid bones * M =

Clinical anatomy (10 decks)

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