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CCDB > lower limb lessons from class > Flashcards

lower limb lessons from class Flashcards

1
Q

popliteal fossa

A

common fib - lateral
tib - verticle
vein
artery (deepest - hard to palpate)

and a bursa in this area

from lateral to medial -

art, vein, tibial nerve

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2
Q

what unlocks knee joint?

A

popliteal

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3
Q

similar bursa - in arm

Baker’s Cyst?

A

cutital bursa (elbow)

if baker’s cyst gets infected - big problem - can infect joint

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4
Q

sural nerve - cutaneous, acoompanies what vein?

A

small saphenous - from tibial nerve

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5
Q

genicular arteries? 4 - to genuflect

A

all around knee - kneeling - praying

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6
Q

genicular arteries? 4 - “to genuflect”

A

all around knee - kneeling - praying

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7
Q

popteal pulse, disease common in

A

smokers
124 degree to take pulse

pop muscle runs lateral to medially - obliquely

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8
Q

sciatic nerve divides into?

A

common peroneal - divides super and deep

tibial - runs vertial -

all divides above knee

common peroneal wraps around neck of fib

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9
Q

sural nerve - cutaneous branch of tibial nerve - communicates w? provides some foot - runs down back of leg

A

fib nerve

small saphenous vein

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10
Q

blocking popliteal nerve?

A

if near knee - blocks sural too - for foot surgery -

or achilles tendon
corrective foot surgery
foot debridgement

typially blocks “terminal branches of sciatic nerve”

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11
Q

genicular anastamosis

A

around the joint
and a variety of other arteries work togther

anterior tibial
posterio tibial, etc

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12
Q

genicular anastamosis

A

around the knee joint
and a variety of other arteries work togther

anterior tibial
posterio tibial, etc

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13
Q

ankle joint

A

synovial hinge

A hinge joint is a common class of synovial joint that includes the ankle, elbow, and knee joints. Hinge joints are formed between two or more bones where the bones can only move along one axis to flex or extend.Jul 3, 2018

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14
Q

ankle joint?

A

synovial hinge

A hinge joint is a common class of synovial joint that includes the ankle, elbow, and knee joints. Hinge joints are formed between two or more bones where the bones can only move along one axis to flex or extend.

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15
Q

How many hinge joints are in the human body?

A

[3][4] The hinge joints of the body include the elbow, knee, interphalangeal (IP) joints of the hand and foot and the tibiotalar joint of the ankle.Apr 5, 2020

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16
Q

great saphenous vein?

A

runs all the way down medially leg to big toe

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17
Q

foot nerve

A

sural, deep, cutaneous peroneal and then saphenous

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18
Q

what surrounds a stocking on the leg?

A

deep fascia - two intermuscular septa in leg - and three in thigh

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19
Q

tibia separates which compartments of leg?

A

anterior and lateral

and then the septa separate the other two compartments

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20
Q

lateral compartment of leg?

2 muscles - have word “fibula in them”

A

tiny - everts foot -

posterior compartment is huge - with superficial and deep posterior compartments

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21
Q

muscle to big toe?

A

surprisingly in leg - runs from lateral side

flexor hallosus (big toe) longus

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22
Q

anterior compartment of leg

A

dorsiflexors of ankle - deep fibular n - “deep peroneal n”
invert foot at subtala joint

anterior tibial artery

tibial anterior
extensor hallucis (big toe)
extensor digitorum (most toes)
fibularis tertisu - 5th toe

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23
Q

on top of foot - interesting m - digitorum brevis

A

extends from big toe - to all of toes - nothing like this similar in hand

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24
Q

posterior compartment of leg

A

tibialis anterior
deep fibular nerve

extensor hallucis longus
extensor digitorum longus

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25
Q

anterior compartment pathologies?

foot drop

A

if m paralyzed, toe lifting is impossible

foot drop

can’t dorsiflex foot

if deep peroneal n damaged, if sciatic n damages - foot drop

steppage gait - need to raise foot very high - put toes down first

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26
Q

chroinc and exertional comparment syndrome CECS

A

repetitive exertion - deep fasica doesn’t allow m to expand - m gets compressed - burning - subsides w/in 15 min or rest - skiers, long distance runnerse, etc

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27
Q

other things that acn look like Cecs?

A

tibial and fib stress fracture
shin splints
popliteal artery aneurysm

findings
weak toe extension
pain on toe flexion
diminished sensation in first web

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28
Q

other things that acn look like Cecs?

A

tibial and fib stress fracture
shin splints
popliteal artery aneurysm

findings
weak toe extension
pain on toe flexion
diminished sensation in first web

deep fib nerve supplies web space and anterior compartment

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29
Q

anterior tibial artery?

A

in foot near big toe - can take a pulse here

n? deep cutaneous branch of peroneal N

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30
Q

common fibular nerve injury?

anterior and later compartment can’t work

A

foot drop - steppage gait

loss of eversion of foot and dorsiflexion of the ankle causes foot-drop

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31
Q

lateral compartment - 2 muscles

A

evert goot, innervated by superficial fib n,
fib artery

fibularis longus,
fibularis brevis

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32
Q

superficial fib nerve supplies what part of top of foot?

A

almost ALL - except sural lateral, web -deep, medial - saphenous

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33
Q

shin splits? tibia

A

inflammation of bone - bone can get remodeled, fractures, athletes - can be in front or behind

caused from excessive pulling of muscles where attached to bone.

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34
Q

posterior compartment - two groups

A

plantar flexion of ankle -
tibial n,
TIP TOES -

two arteries
posterior tibial artery and fibular artery

can invert foot

posterior tibial arter y - divides fro other artery at bottom of popliteal

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35
Q

soleus - easy to get a thrombus here - and die

A

so let’s keep an eye on that one

The soleus connects the bottom of the knee to the heel. A strain, which is strained stretch or tear to to a muscle or tendon, to the soleus is caused by strenuous exercise and improper body alignment. Pain is felt on the side of the calf after activity.

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36
Q

gastrocnemius m?

A

two joint muscle - helps walking - in posterior - pulls heel up

must be near achilles tendon?

superficial - soleus below

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37
Q

plantaris m

A

VERY long tendon - back of knee - all way down to calcaneal tendon -

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38
Q

popliteus

A

unlocks knee joint, runs behind knee from lateral to media

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39
Q

flexor digitorum longun

A

down medially leg, wraps under foot - and then to toes

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40
Q

tibialis posterior

A

deepest muscle - down leg

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41
Q

talus?

A

only bone that has no attachment to m

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42
Q

achilles tendon

A

running on hills, repetitive stress - avasular tendon

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43
Q

Great saphenous vein?

A

Great Toe - with saphenous n

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44
Q

flexor retinaculum

A

site for palplation of posterio tibial artery

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45
Q

lateral malleolus? fibula?

A

medial malleolus - both on tibia?

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46
Q

Number of tarsal bones?

A

7 tiger cubs need MILC

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47
Q

valgus, varus?

varus (Inward)

A

Whenever the distal part is more lateral, it is called valgus. Whenever the distal part is more medial, it is called varus.

forefoot varus more common - varus - medial border is raised - excessive pronation

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48
Q

congential clubfoot?

A

insufficient amniotic fluid - envionmental causes

plastarflexion equinus and INVERTED (varus)

hindfood, forfoot is inverted -

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49
Q

tendon of tibialis anterior?

A

sends tendons out to all metatarslas?

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50
Q

arches of foot? 3

transverse -

medial

lateral

A

medial (inner) _ high point is calcaneous HIGHEST

calcaneus, talus, navicular, etc

Ligaments: Spring ligament (plantar calcaneo navicular lig) and
plantar fascia

Tendons tibilis posterior, tibialis anterior, fibularis longus

LATERAL (outer) - high point is cuboid

Lig: long plantar, plantar fascia, plantar calcaneocurboid

Tendons - extensors of 5 digit

absorbs shocks, distributes weight

place for neurovascular things to be

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51
Q

Spring lig - plantar calcaneo navicular lig

A

supports talus -

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52
Q

long plantar lig - - more superficial than short plantar (plantar calcaneo cuboid lig)

A

running across transversely -

Tendonius longus

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53
Q

pes cavus, pex planus

A

high arch (inversion - burns, residual clubfoot, compartment syndrome)

, flat food

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54
Q

pes cavus, pex planus

A

high arch (inversion - burns, residual clubfoot, compartment syndrome)

excessive supination

flat food

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55
Q

pes cavus (cave), pex planus

A

high arch (inversion - burns, residual clubfoot, compartment syndrome)

excessive supination

flat food

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56
Q

retinaculum of foot 4 in foot

A

vs in hand (wrist)

deep fascia - protect

flexor - from heel to medial malleolus

fibular - superior and inferior (from heel to fib)

superior extensor
inferior extensor - two bands like a y running medially

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57
Q

retinaculum of foot 4 in foot

A

vs in hand (wrist)

deep fascia - protect - contain fluid - synovial sheaths

flexor - from heel to medial malleolus

fibular - superior and inferior (from heel to fib)

superior extensor
inferior extensor - two bands like a y running medially

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58
Q

deep fascia - sole of foot

A

plantar aponeurosis - from calcaneum - widens w/ 5 slips = to each digit

superficial to nerves, blood vessels and M

supports arches

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59
Q

adductor policus in hand - what nerve?

A

ulnar - HY

60
Q

medial planter and lateral plantar nerve

A

median - ulnar correspond

61
Q

long thoracic… c?

A

c 5, 6, 7

62
Q

weakened muscles in carpal tunnel?

A

The muscles supplied by the recurrent branch of the median nerve (opponens pollicis, flexor pollicis brevis, and abductor pollicis brevis) are most commonly weakened in patients with carpal tunnel syndrome.

63
Q

The adductor pollicis

A

is innervated by the deep branch of the ulnar nerve. It functions to flex and adduct the thumb, and injury would lead to a decreased ability to grip.

64
Q

Finger muscles?

A

Dorsal interossei muscles are innervated by a branch of the ulnar nerve and function to abduct the digits. The opponens digiti minimi muscle is innervated by the deep branch of the ulnar nerve and brings the fifth digit in opposition with the thumb. The patient in this vignette has normal muscle strength, making both dorsal interossei and opponens digiti minimi muscles less likely to be injured. The third and fourth lumbricals are innervated by the deep branch of the ulnar nerve and function to flex the fourth and fifth metacarpophalangeal joints while extending the interphalangeal joints of the fourth and fifth digits in the same motion.

65
Q

Osgood Schlatter Disease?

A

OSD is a musculoskeletal disorder characterized by the gradual onset of knee pain after repetitive activities, typically sports that involve running or jumping. The condition occurs most commonly in growing children: boys between the ages of 12-15 and girls between the ages of 8-12. Overall, the condition presents more frequently in boys.

66
Q

baker’s cyst? population?

A

Baker cysts typically form due to degenerative disease such as osteoarthritis or joint injury, and are much more commonly seen in older adult patients with years of chronic disease to their joints.

67
Q

foot drop?

A

NOT THE DEEP OR SUPERFICIAL _

The common fibular (peroneal) nerve is the most frequently damaged nerve in the lower limb. Patients experience foot drop, which results from a loss of dorsiflexion at the ankle, as well as loss of eversion. Thus, they may present with an inability to dorsiflex or evert. Patients also have symptoms of pain and paresthesia in the lateral leg and dorsum of the foot. Those with foot drop may also exhibit a steppage gait, as described in the vignette.

68
Q

plantar faccitis

A

pain on soul of foot- standing a long time - no insole on shoes

69
Q

Dorsum of foot

A

dorsalis pedis artery - continuation of anterior tibila artery

70
Q

Dorsum of foot - plantar arch

A

dorsalis pedis artery - continuation of anterior tibila artery

palpate where tarsal bones are

71
Q

venous drainage

A

drains into both saphenous veins

each artery has two veins - helps in counter current exchange mechanism

as veins come in- they cool the blood - the artery gives its warmth which takes blood into center of body

72
Q

nerves on soul of foot?

A

looks like mostly tibial except when saphenous - which comes from femoral

73
Q

saphenous nerve comes from what N?

A

femoral

74
Q

foot muscles - many come from leg - are there “foot only” muscles?

A

but in the foot, there are also four layers of Foot Only muscles

75
Q

1st layer - 2 abductors, 1 flexor - 3 layer?

A

reversed - 1 adductor - 2 flexors -

2nd and fourth layer simliarly opposite -

2nd - two tendons, 2 muscles - flexor digitorum longus - attached to lumbricals

4th layer -

“preaxial” border - means toward big toe - vs. post axial border -

76
Q

hand lumbricals are attached to?

A

The lumbricals are four, small, worm-like muscles on each hand. These muscles are unusual in that they do not attach to bone. Instead, they attach proximally to the tendons of flexor digitorum profundus and distally to the extensor expansions.

77
Q

flexor hallusus longus goes to what?

A

The great toe - Where does it start from?

78
Q

Pott’s fracture?

A

A Pott’s fracture is a fracture affecting one or both of the malleoli.

79
Q

Lumbar plexus - I (twice) Got Lunch on Friday

A 
Iliohypo
iliioinguinal
Genital femoral
Lateral femoral
obturator
femoral
80
Q

Sacral Plexus - L4 - S4

A

1 superior
2. inferior
3 sciatic NOT S4 (ends lower 1/3 of thigh and divides)

  • (common peroneal - deep - superficial)
  • tibial - sural / medial/lateral plantar

4 Posterior femoral cutaneous S1 - S3
5 Pudendal S2 -4

81
Q
  • slit wrist - what muscles may be affected on wrist - if ulnar area damages?
A

adductor pollicis muscle has an oblique and transverse head, both of which are innervated by the deep branch of the ulnar nerve, allowing the muscle to participate in thumb adduction and thumb MCP flexion. An injury to the ulnar nerve would result in a deficit of both of these actions.

The abductor pollicis brevis muscle is a thenar (thumb) muscle innervated by the recurrent branch of the median nerve and functions in abduction and opposition of the thumb. The first and second lumbricals and opponens pollicis are also innervated by the median nerve. Although the median nerve is commonly damaged when the wrists are slashed in a suicide attempt, it runs deep in the carpal tunnel and is protected from superficial injury, as seen in this patient. Injury to the median nerve would also present with sensory loss over the first 3½ digits, making these answer choices less likely. The extensor pollicis brevis, located on the dorsal part of the forearm, is innervated by the posterior interosseous nerve (a continuation of the deep branch of the radial nerve). This patient has superficial lacerations on the medial ventral side—not the radial side—of her left wrist and sensory loss over the fifth digit, making extensor pollicis brevis injury less likely.

82
Q

carpal tunnel syndrome,

A

which occurs in individuals whose work involves repetitive hand motions. The muscles supplied by the recurrent branch of the median nerve (opponens pollicis, flexor pollicis brevis, and abductor pollicis brevis) are most commonly weakened in patients with carpal tunnel syndrome.

83
Q

nerve that supplies quads?

A

femoral n - also supplies iliacus

Femoral b supplies a LOT of anterior lower limb

84
Q

femoral n?

A

deep to fascia iliaca

artery and vein - superficial

85
Q

femoral n?

A

deep to fascia iliaca

artery and vein - superficial

The fascia iliaca is located anterior to the iliacus muscle (on its surface) within the pelvis. It is bound superolaterally by the iliac crest and merges medially with the fascia overlying the psoas muscle.

86
Q

What is femoral sheath? Where is it? Is this the fasica iliaca?

A

The femoral sheath (crural sheath) is formed by a prolongation downward, behind the inguinal ligament, of the abdominal fascia, the transverse fascia being continued down in front of the femoral vessels and the iliac fascia behind them. The femoral sheath is contained within the femoral triangle.

The fascia iliaca is located anterior to the iliacus muscle (on its surface) within the pelvis. It is bound superolaterally by the iliac crest and merges medially with the fascia overlying the psoas muscle.

87
Q

L5 problem

A

may not be able to walk - trendelberg problem

88
Q

dermatome skin over tibia?

A

L4

89
Q

over fibula

A

L5

90
Q

epideral?

A

need to NOT penetrate into dural sheath

91
Q

Gait abnormalities?

A

Hemiplegic Gait

foot drop - knee extension - seen with upper neuron lesion

have to swing leg - because e

DIPLEGIC - hips and knees are flexed - narrow base, both lakes drag - toes scrape - (scissors gait) - lesion in brain

involve both sides

92
Q

Steppage gait

A

EQUINE GAIT - foot drop - can have one nerve injured for example- L5

nueropathic gait -

if bilateral - Charcot marie Tooth disease and other peripheral neruopathies

shoes worn out anteriorly and ?

93
Q

Waddling Gait -

A

turns trunk to one side and leift foot - muscular disease - weakness on side where pelvis is higher -

94
Q

Parkinson’s gate -

A

basal ganglia - hypokinesia - rigidity - person doesn’t move - small/shuffling steps marche a a petit pas - difficulty to start walking

may have acceleration - short steps - fesinations - hard to turn around is difficult also

95
Q

Choreiform Gait

A

basal ganglia disorder - increased movement - huntington’s disease - jerky movements increased jerkiness when walking

96
Q

Ataxic Gait - cerebellar

A

alcohol drinkers - broad based gait - lurch to either side,

midline cerebellar disease - may not be able to balance if close eyes -

97
Q

Sensory Gait

ROMBERG test -

A

wide based - may fall if close eyes - give the the ROMBERG test

Sensory ataxia a

98
Q

lumbricals - of hands 4

A

lateral - media, medial - ulnar nerve

flex metacarpals

99
Q

position of “function”

A

hand flexed - fingers extended

100
Q

if ulnar damaged

A

all hand claws because interossi for all fingers controlled by ulnar-

101
Q

palmar interossi missing what muscle?

A

none on the 3rd finger - ADDUCTS PAD, ADduct

102
Q

DAB - Abduct

A

dorsal interossei

103
Q

adductor pollicis - what nerve?

A

ulnar

104
Q

upper lesion C5 - C6

Erb’s palsy - waiter’s tip

A

birthing, grabbing on to a branch

axillary, suprascp, and musculo nerves affected - they run in C5 - C6

can’t abduct arm,

105
Q

radial nerve - if damage in axilla - what will work -

A

NOTHING - wrist drop, can’t extend elbow, etc

However, if damage distal to axilla (midshaft) - still have wrist drop - but can extend elbow

106
Q

carpal tunnel

A

can be hereditary, hypothyroidism, rheumatoid arthritis.

107
Q

median nerve - laboror’s nerve

Ulnar n?

A

musician’s n

Fracture of hook of hamate, wrist damage, medial epycondyle

“card” test - can’t hold paper between fingers

108
Q

thumb adduction?

A

hyper pollicus

109
Q

knocked knee

A

valgum deformity GUM

110
Q

elbow fractures - how to treat? what causes?

A

n elbow dislocation occurs when the bones of the forearm (the radius and ulna) move out of place compared with the bone of the upper arm (the humerus). The elbow joint, formed where these 3 bones meet, becomes dislocated, or out of joint.

111
Q

most common elbow dislocation?

A

The two general types of elbow dislocation are:
Simple elbow dislocation: The radius and ulna articulate with the humerus at the elbow. …
Complex elbow dislocation: This injury is a simple dislocation combined with a fracture of the humerus, radius, ulna or a combination of all three bones.

112
Q

muscle attached to olecronon process?

A

tricep

113
Q

if triceps damage to radial nerve at medial groove, still possible?

A

yes

114
Q

colles fracture

A

distal fracture goes dorsally

115
Q

smith’s

A

distral fractures goes ventrally

116
Q

HY - medial four digits of hand - front of digits - no hair - flexion

thumb non hairy skin - when moves medially - flexion - when move laterally - EXTENSION

A

abduction and adduction

thumb moving away from axis - adduction

abduction - toward axis

which muscle causes this? adductor policies

ulnar nerve

117
Q

Salter harris fracture?

A

in a growth plate - in children

TYPE 2 most common -

TYPE 5 - direct impact, most serious - can’t grow more.

118
Q

foot drop? and fixing via steppage gait

raise knee higher OR use brace

A

deep fib - extensors can’t dorsiflex

knee flexors to solve problem, raise knee higher

hamstrings flex knee up higher

Tibialis anterior isn’t working

119
Q

to hold a key- need to Adduct thumb

A

adductor pollicus - which nerve? ulnar

120
Q

adduct shoulder?q

A

lat, bunch of mucles

121
Q

palmar interossi?

A

abducts fingers

122
Q

7 movements of thumb + circumduction +

A

add, abd, flex, exten, opposition, reopoosion

123
Q

if can’t extend elbow - what nerve?

A

radial

124
Q

if only inability to extend wrist

A

distal problem

if can’t extend elbow- problem in axilla

125
Q

2 muscles that flex the wrist

A

flexor carpi ulnar and radialis

and what else can they do? ABDUCT wrist

126
Q

radioulnar joint in elbow

A

pronates, supinates -

127
Q

2 muscles that cause supination?

A

supinator and biceps brachii

128
Q

which division is musculocutanerous from?

A

anterior

3 posterior from radial

musculo - 2 divisions - upper and middle-

129
Q

what nerve flexes hip?

A

ilapsoas - L1 - L2, lumbar spinal nerve, and femoral

130
Q

what extends knee?

A

quadriceps, gluteus max, tensor fascia

131
Q

sartorius?

A

flexes knee -

132
Q

epimere

A

dorsal rami

133
Q

hypomere?

A

ventral rami

134
Q

lateral plate mesoderm? splanchno and somatic

A

BBC

Bones, Blood, CT

limb muscles from somites

135
Q

secondary ossif - when appear? except one?

A

end of long bone - lower end of femur - 9th month - viable - if don’t see this 2day ossif - maybe not 9 months old

136
Q

which of follwoing bones ossify my membranous

A

maxilla

137
Q

which develop the muscle of body wall

A

hypoaxial division

138
Q

AER - fgf8 - proximo distal growth

A

proximal first

139
Q

antero prosterio

A

zone of polarizing activity - anterio, postrio pole -

140
Q

antero prosterio

SSH - ulnar, little finger

Less SSH - thumb develops

A

zone of polarizing activity - anterio, postrio pole - caudal first - POST axial border - little finger, SSH!

141
Q

hindlimb TBS4

A

forelimb is not 4

142
Q

forelimb TBX5

A

forelimb is not 4

143
Q

dorsal ectoberm -

A

wnt7a

144
Q

preaxial

A

radius, thumb

leg: big toe, tibia

145
Q

post axial develop first or last

A

first - SSH develops

if excess SSH - absense of radius -

CCDB (13 decks)

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