Module 15 Flashcards

1
Q

Which of the following landmarks is located on the distal end of the tibia?
Medial condyle
Medial Malleolus
Tibial Tuberosity
Lateral Malleolus

A

Medial Malleolus

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2
Q

Which of the following tarsal bones are considered bones of the hind foot? Select all that apply.
Calcaneus
Navicular
Cuboid
Cuneiforms
Talus

A

Calcaneus
Talus

Explanation:
Both the calcaneus (heel bone)and talus are tarsal bones that form the hindfoot. The navicular, cuboid and cuneiforms form the midfoot, and the metatarsals and phalanges form the forefoot.

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3
Q

The sustentaculum tali is an important bony landmark of which of the following tarsal bones?
Talus
Navicular
Cuboid
Calcaneus

A

Calcaneus

Explanation:
The sustentaculum tali is a horizontal shelf that aris from the anteromedial aspect of the calcaneus. It articulates with the talus.

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4
Q

Which of the following articulation forms the talocrural (upper ankle) joint?
Head of the fibula and lateral tibial condyle
Distal end of the fibular notch of tibia & interosseous membrane
Distal end of the tibia & fibula (malleolar mortise) and trochlea of the talus
Inferior aspect of talus & superior aspect of calcaneus

A

Distal end of the tibia & fibula (malleolar mortise) and trochlea of the talus

Explanation:
The distal end of the tibia and fibula forming the malleolar mortise will articulate with the trochlea of the talus forming the talocrural (upper ankle) joint. The inferior aspect of the talus & superior aspect of the calcaneus articulate to form the subtalar joint (forms part of the lower ankle joint). The head of the fibula articulates with the lateral tibial condyle to form the superior tibiofibular joint and the distal end of the fibula articulates with the fibular notch of the tibia and the IM to form the inferior tibiofibular joint.

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5
Q

True of False: The movements of flexion and extension occur at the upper ankle joint while the motions of inversion and eversion occur at the lower ankle joint.

A

True

Explanation:
This statement is true: the talocrural (upper ankle) joint allows for the motions of flexion and extension and the subtalar and transverse tarsal joints (lower ankle joint) allows for the motions of inversion and eversion.

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6
Q

Which of the following ligaments forms part of the lateral ligament of the ankle joint? Select all that apply.
Anterior talofibular
Anterior tibiotalar
Posterior talofibular
Posterior tibiotalor
Calcaneofibular

A

Anterior Talofibular
Posterior Talofibular
Calcaneofibular

Explanation:
The lateral ligament of the ankle joint includes: the anterior and posterior talofibular ligaments and the calcaneofibular ligament (note they all include fibular in the name- recall that fibula is the laterally located long bone of the leg); the anterior and posterior tibiotalar ligaments form part of the medial ligaments of the ankle joint (note that all of the ligaments that make up the medial ligament of the ankle joint will have tibia in the name- recall that the tibia is the medially located long bone of the leg).

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7
Q

True or False: The medial ligament of the ankle limits inversion of the ankle joint.

A

False

Explanation:
This statement is false: the medial ligament will limit eversion of the ankle joint. It is the lateral ligament that limits inversion of the ankle joint.

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8
Q

True or False: The metatarsophalangeal and interphalangeal joints are joints of the toes.

A

True

Explanation:
This statement is true: similar to the digits of the hand and toes of the foot have two important joints: metatarsophalangeal and interphalangeal joints.

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9
Q

Which of the following bones forms part of the lateral longitudinal arch of the foot? Select all that apply.
Calcaneus
Cuboid
Talus
Navicular
Lateral Metatarsal bones

A

Calcaneus
Cuboid
Lateral Metatarsal bones

Explanation:
The foot contains two longitudinal arches: medial and lateral. The lateral longitudinal arch is formed by the calcaneus, cuboid and the 2 lateral metatarsal bones. The medial arch is formed by the calcaneus, talus, navicular, cuneiforms and the 3 medial metatarsal bones.

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10
Q

Which of the following bones forms part of the transverse arch of the foot? Select all that apply.
Cuboid
Talus
Calcaneus
Cuneiforms
Bases of the metatarsal bones

A

Cuboid
Cuneiforms
Bases of the metatarsal bones

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11
Q

The passive supports of the arches of the foots are formed by the tendons of several muscles that insert onto the bones of the foot.

A

False

Explanation:
This statement is false: there are four layers of connective tissue that form the passive supports of the arches of the foot and they are as follows: palmar aponeurosis, long and short plantar ligaments, and the calcaneonavicular ligament. Muscle tendons form the dynamic supports of the arches of the foot.

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12
Q

Which of the following muscle tendons form the dynamic supports of the arches of the foot? Select all that apply.
Tibialis anterior
Tibialis posterior
Fibularis longus
Flexor hallicus longus
Extensor hallicus longus

A

Tibialis anterior
Tibialis posterior
Fibularis longus
Flexor hallicus longus

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13
Q

Which of the following muscles is contained in the anterior compartment of the leg? Select all that apply.
Tibialis anterior
Fibularis longus
Extensor digitorum longus
Extensor hallucis longus
Fibularis tertius
Tibialis posterior

A

Tibialis Anterior
Extensor digitorum longus
Extensor hallucis longus
Fibularis tertius

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14
Q

True or False: The muscles of the anterior compartment of the leg are innervated by the superficial fibular nerve.

A

False

Explanation:
This statement is false: the muscles of the anterior compartment of the leg are innervated by the deep fibular nerve. The superficial fibular nerve will innervate the muscles of the lateral compartment.

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15
Q

Which of the following muscles originates from the lateral condyle of the tibia? Select all that apply.
Tibialis anterior
Extensor hallucis longus
Extensor digitorum longus
Fibularis tertius

A

Tibialis anterior
Extensor digitorum longus

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16
Q

True or False: All of the muscles of the anterior compartment of the leg can produce dorsiflexion at the upper ankle joint.

A

True

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17
Q

True or False: Both the fibularis longus and the fibularis brevis originate from the fibula.

A

True

18
Q

True or False: Fibularis longus and brevis produce inversion at the lower ankle joint.

A

False

Explanation:
This statement is false: the muscles of the lateral compartment produce eversion at the lower ankle joint.

19
Q

Which of the following nerves innervates the muscles of the lateral compartment of the leg?
Deep fibular
Superficial fibular
Tibial

A

Superficial fibular

Explanation:
The superficial fibular nerve provides motor innervation to the muscles of the lateral compartment of the leg. Reminder: the deep fibular nerve innervates the anterior compartment and the tibial nerve innervates the posterior compartment of the leg.

20
Q

Which muscles are contained in the superficial layer of the posterior compartment of the leg? Select all that apply.
Gastrocnemius
Tibialis posterior
Plantaris
Flexor digitorum longus
Soleus

A

Gastrocnemius
Plantaris
Soleus

21
Q

Which muscles of the posterior compartment originate from the femur? Select all that apply.
Gastrocnemius
Plantaris
Popliteus
Tibialis posterior
Flexor digitorum longus
Flexor hallucis longus

A

Gastrocnemius
Plantaris
Popliteus

22
Q

Which muscle tendons pass through the tarsal tunnel? Select all that apply.
Plantaris
Tibialis posterior
Flexor digitorum longus
Flexor hallucis longus
Popliteus

A

Tibialis posterior
Flexor digitorum longus
Flexor hallucis longus

23
Q

True or False: All of the muscles of the superficial layer of the posterior compartment of the leg can produce plantar flexion of the ankle EXCEPT for the popliteus.

A

True

Explanation:
Popliteus only crosses the knee joint and weakly flexes the knee joint (unlocks the knee from full extension).

24
Q

Which of the following nerves innervates the muscles of the posterior compartment of the leg.
Tibial
Deep fibular
Superficial fibular

A

Tibial

25
Q

Your patient is a runner and have been experiencing edema and pain in the distal 2/3rd of the tibia. You suspect your patient to have?

A

Shin Splints

Reason: Caused by repetitive micro-trauma of tibialis anterior resulting in edema and pain in distal 2/3rd of tibia.

26
Q

Your patient sustained a fracture of the proximal fibula resulting in an injury to the common fibular nerve. What clinical deficits do you anticipate seeing in your patient?

A) foot drop secondary to muscle weakness of the muscles of the lateral and anterior compartments of the leg
check

B) pain radiating into the web space between the first and second toes

C) complaints of pain radiating along the lateral side of leg and the dorsum of the ankle

D) complaints of pain with evesion and dorsiflexion of the foot, and possible muscle wasting on the intrinsic muscles (plantar layers) of the foot

A

foot drop secondary to muscle weakness of the muscles of the lateral and anterior compartments of the leg

Reason:

Recall that the common fibular nerve gives rise to the superficial (supplies the muscles of the lateral compartment - evertors) and the deep (supplies the muscles of the anterior compartment - dorsiflexors) fibular nerves. Since these nerves supply the muscles that are responsible for producing eversion and dorsiflexion of the ankle, the patient will present with foot drop (plantar flexed and inverted ankle). In addition, there is likely to be sensory loss along the lateral aspect of the leg and the dorsum of the foot (why would that be the case?). Pain radiating into the web space between the first and second toes is a clinical sign associated with compression of the deep fibular nerve; pain radiating along the lateral side of the leg and dorsum of the ankle is a clinical sign associated with an injury to the superficial fibular nerve and pain with eversion and dorsiflexion of the foot and possible muscle wasting of the intrinsics of the foot are clinical signs associated with injury to the tibial nerve in the tarsal tunnel

27
Q

Due to overuse of the ANTERIOR compartment muscles would result in edema, typical complains of the dorsal foot. What type of nerve entrapment is this?

A

Deep fibular nerve

28
Q

Which neurovascular structures travel through the tarsal tunnel? Select all that apply.
Posterior tibial artery
Posterior tibial vein
Tibial nerve
Superficial fibular nerve
Deep fibular nerve
Anterior tibial artery

A

Posterior tibial artery
Posterior tibial vein
Tibial nerve

Explanation:
The neurovascular structures that travel through the tarsal tunnel include the: posterior tibial artery and vein and the tibial nerve.

29
Q

Which of the following nerves provides the motor innervation to the lateral compartment of the leg?
Superficial fibular
Deep fibular
Tibial

A

Superficial fibular

30
Q

True or False: The deep fibular nerve will cross the ankle and then divide into the lateral and medial branches of the deep fibular nerve.

A

True

31
Q

Which nerve gives rise to the medial and lateral plantar nerves of the foot?
Superficial fibular
Deep fibular
Tibial

A

Tibial

32
Q

Which nerves supply the skin of the leg region? Select all that apply.
Saphenous
Medial and lateral plantar
Superficial fibular
Sural nerves

A

Saphenous
Superficial fibular
Sural nerves

33
Q

Which of the following sensory nerves are branches of the tibial nerve that supply the skin overlying the sole of the foot? Select all that apply.
Medial Plantar
Lateral plantar
Superficial fibular
Median branch of deep fibular
Medial Calcaneal

A

Medial Plantar
Lateral plantar
Medial Calcaneal

34
Q

Which artery is a branch of the anterior tibial artery?
Medial Plantar
Lateral plantar
Dorsalis Pedis
Fibular Artery

A

Dorsalis Pedis

Explanation
The tibial artery wil divide in the popliteal fossa into the anterior and posterior tibial arteries. The anterior tibial artery will give rise to the dorsalis pedis artery. The posterior tibial artery gives rise to the fibular, plantar and calcaneal arteries.

35
Q

Which of the following arteries provides the blood supply to the muscles of the posterior compartment of the leg?
Posterior tibial
Anterior tibial
Fibular

A

Posterior Tibial

Explanation:
The posterior tibial artery provides the blood supply to the muscles of the posterior compartment of the leg an (via its plantar and calcaneal branches) the intrinsic muscles (plantar layers) of the foot. The anterior tibial artery provides the blood supply to the anterior compartment of the leg (and contribution to lateral compartment), and the fibular artery (branch of posterior tibial artery) will supply muscles of the lateral compartment of the leg.

36
Q

Deep Fibular Nerve entrapment

A
37
Q

Superficial fibula nerve entrapment

A
38
Q

Tibial nerve entrapment

A
39
Q

Your patient sustained a fracture of the proximal fibula resulting in an injury to the common fibular nerve. What clinical deficits do you anticipate seeing in your patient?
Foot drop secondary to muscle weakness of te muscles of the lateral and anterior compartments of the leg
Pain radiating into the web space between the first and second toes
Complaints of pain radiating along the lateral side of the leg and the dorsum of the ankle
Complaints of pain with eversion and dorsiflexion of the foot, and possible muscle wasting on the intrinsic muscles (plantar layers) of the foot

A

Foot drop secondary to muscle weakness of te muscles of the lateral and anterior compartments of the leg

40
Q

Your patient is complaining of burning pain in the area of the heel and muscle wasting of the intrinsic muscles of the foot. You suspect your patient to have what type of nerve entrapment?

A

Tibial nerve (tarsal tunnel syndrome)

41
Q

Your patient has had a history of chronic ankle sprains and has complained about a pain along the LATERAL side of the leg. What do you suspect your patient to have?

A

Superficial fibular nerve