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Anatomy for resit cause your stupid > MSK Lower Limb > Flashcards

MSK Lower Limb Flashcards

1
Q

What are the superficial veins of the lower limb?

A

Great saphenous vein

Small saphenous vein

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2
Q

What does the great saphenous vein empty into?

A

Femoral vein

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3
Q

Where does the great saphenous ascend?

A

Anterior to the medial malleolus of the tibia

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4
Q

What does the small saphenous vein empty into?

A

Popliteal vein

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5
Q

Where does the small saphenous vein ascend?

A

Posterior to the lateral malleolus

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6
Q

What vein are varicose veins more common in?

A

Great saphenous vein

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7
Q

What is a common clinical problem of deep veins of the lower limb?

A

DVT

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8
Q

What does the superficial inguinal nodes of the lower limb drain?

A

Skin of buttocks
Thigh
Anterior calf
Dorsum of foot

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9
Q

What does the popliteal lymph nodes drain?

A

Skin of plantar side of foot

Posterior calf

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10
Q

What do the deep inguinal lymph nodes drain?

A

Superficial inguinal nodes

Popliteal nodes

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11
Q

Vessels accompanying the great saphenous vein are drained by what nodes?

A

Superficial inguinal nodes

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12
Q

Vessels accompanying the small saphenous vein are drained by what nodes?

A

Popliteal lymph nodes

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13
Q

What kind of joint is the hip joint?

A

Ball and socket synovial joint

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14
Q

What type of cartilage is the acetabular labrum?

A

Fibrocartilage

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15
Q

Function of the acetabular labrum

A

Provides an articulating surface for the head of the femur

Increases depth of the acetabulum

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16
Q

What are the 3 main ligaments of the hip joint?

A

Iliofemoral
Pubofemoral
Ischiofemoral

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17
Q

Function of the iliofemoral ligament

A

Prevents hyperextension of the hip

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18
Q

Function of the pubofemoral ligament

A

Prevents hyperabduction of the hip

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19
Q

Function of ischiofemoral ligament

A

Reinforce posterior aspect of joint capsule

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20
Q

What travels out of the great sciatic foramen?

A

Sciatic nerve
Superior gluteal vessels
Pudendal nerve
Piriformis tendon

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21
Q

What travels out of the lesser sciatic foramen?

A

Pudendal nerve
Internal pudendal artery
Internal pudendal vein
Obturator internus tendon

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22
Q

What are the muscles that flex the hip?

A

Iliacus
Psoas major
Pectinus

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23
Q

Innervation of the illiacus

A

Femoral nerve

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24
Q

Innervation of the pectinus

A

Femoral nerve

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25
Q

Innervation of the psoas major

A

L1-L3 anterior rami

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26
Q

What is the iliopsoas muscle?

A

Iliacus and psoas major muscle sharing a common tendinous attachment of the femur

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27
Q

What is the chief flexor of the thigh?

A

Quadriceps muscle

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28
Q

What is the main extensor of the hip?

A

Gluteus maximus

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29
Q

Muscles that extend the hip

A 
Gluteus maximus 
Long head of biceps femoris
Semimembranous
Semitendinosus 
Posterior part of adductor magnus
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30
Q

Hamstring muscles

A

Biceps femoris long and short heads
Semitendinosus
Semimembranous

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31
Q

Innervation of the Semitendinosus

A

Tibial branch of sciatic nerve

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32
Q

Innervation of the semimembraneous

A

Tibial branch of sciatic nerve

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33
Q

Innervation of short head of biceps femoris

A

Common fibular nerve

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34
Q

Innervation of long head of biceps femoris

A

Tibial branch of sciatic nerve

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35
Q

Actions of the hamstring muscles

A

Extend hip
Flexion of knee
Medial rotation of knee

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36
Q

Innervation of pectinus

A

Femoral nerve

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37
Q

Muscles the adduct the hip

A 
Pectineus
Adductor longus
Adductor brevis 
Gracilis 
Obturator externus 
Adductor magnus
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38
Q

Innervation of adductor longus

A

Obturator nerve

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39
Q

Innervation of adductor brevis

A

Obturator nerve

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40
Q

Innervation of adductor magnus

A

Obturator nerve

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41
Q

Innervation of gracilis

A

Obturator nerve

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42
Q

What is found in the adductor magnus?

A

Adductor hiatus

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43
Q

What passes through the adductor hiatus?

A

Femoral artery

Femoral vein

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44
Q

Actions of adductor longus and brevis

A

Adduction of hip
Flexion of hip
Internal rotation of hip

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45
Q

Actions of gracillis

A

Hip adduction

Assists in knee flexion

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46
Q

Muscles that abduct the hip

A

Gluteus medius
Gluteus minimus
Tensor fasciae latae (TFL)
Piriformis

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47
Q

What does an injury to the hip abductors cause?

A

Trendelenberg gait

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48
Q

What do the hip abductors contribute to?

A

Normal walking gait

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49
Q

What is the obturator internus tendon accompanied by?

A

Twin gemeli

Quadratus femoris

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50
Q

Where do lateral/external rotators of the hip cross the joint?

A

On the posterior side

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51
Q

Where do medial/internal rotators of the hip cross the joint?

A

On the anterior side

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52
Q

Muscles that internally rotate the hip

A 
Gluteus medius (anterior part)
Gluteus minimus (anterior part)
Tensor fasciae latae
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53
Q

Innervation of the quadriceps femoris

A

Femoral nerve

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54
Q

How many heads does the quadriceps femoris have?

A

4

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55
Q

What are the 4 heads of the quadriceps femoris?

A

Rectus femoris
Vastus medialis
Vastus intermedius
Vastus lateralis

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56
Q

Function of rectus femoris

A

Stabilises joint

Helps iliopsoas flex hip joint

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57
Q

What do the 4 heads of the quadriceps unite to form and where?

A

Quadriceps tendon

Proximal to the platella

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58
Q

What does the quadriceps tendon continue as and where?

A

Platellar ligament

Distal to the platella

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59
Q

What does the platellar tendon attach to?

A

The tibial tuberosity

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60
Q

Actions of quadriceps muscles

A

Knee extensors

Hip flexors

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61
Q

Actions of the sartorius

A

Flexion of hip
Abduction of hip
Lateral rotation of hip
Flexion of knee

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62
Q

Where does the sartorius cross the joint?

A

Crosses hip joint anteriorly

Crosses knee joint posteriorly

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63
Q

Nerve roots of obturator nerve

A

L2-L4

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64
Q

How does the obturator nerve enter the medial thigh?

A

Via obturator canal

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65
Q

Where is the obturator canal found?

A

Obturator membrane in the obturator foramen

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66
Q

What does the obturator nerve innervate?

A

Medial compartment of thigh

Cutaneous sensations to skin of medial thigh

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67
Q

What is the main artery of the thigh?

A

Femoral artery

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68
Q

What is the femoral artery a continuation of?

A

External iliac artery

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69
Q

What level does the femoral artery arise?

A

L5

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70
Q

Where does the femoral artery enter the thigh?

A

Midway between the anterior superior iliac spine and the pubic symphysis

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71
Q

What is a branch of the femoral artery and where does it go?

A

Profunda Femoris artery

Passes posteriorly towards the hamstrings

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72
Q

What is the femoral vein a continuation of?

A

The popliteal vein

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73
Q

The femoral vein passes under _____ to continue as _____

A

The inguinal ligament

External iliac vein

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74
Q

What drains into the femoral vein in the femoral triangle?

A

Profunda femoris vein

Great saphenous vein

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75
Q

What is cannulation of the femoral vein used for?

A

Right cardiac angiography

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76
Q

Nerve roots of the femoral nerve

A

L2-L4

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77
Q

What is the largest branch of the lumbar plexus?

A

Femoral nerve

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78
Q

Course of the femoral nerve

A

passes deep to inguinal ligament

enters femoral triangle lateral to the femoral veins

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79
Q

What does the femoral nerve supply?

A

Sartorius
Pectinus
Iliacus
Quadriceps muscles

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80
Q

Why is the femoral triangle exposed?

A

Due to quadrupedal to bipedal stance

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81
Q

Medial border of femoral triangle

A

Adductor longus

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82
Q

Lateral border of the femoral triangle

A

Sartorius

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83
Q

Superior border of the femoral triangle

A

Inguinal ligament

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84
Q

What forms the base of the femoral triangle?

A

Pectinus
Illiopsoas
Adductor longus

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85
Q

Contents of the femoral triangle

A 
Femoral nerve
Femoral artery 
Femoral vein 
Femoral canal 
Deep inguinal lymph nodes 
Assosiated lymphatic vessels
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86
Q

What is the femoral sheath?

A

A funnel shaped fascial tube which surrounds the proximal parts of the femoral vessels (NOT the nerve) and creates the femoral canal medial to them, which contains lymphatic vessels

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87
Q

3 compartments of the femoral sheath

A

Lateral
Intermediate
Medial

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88
Q

What does the lateral compartment of the femoral sheath contain?

A

Femoral artery

Femoral branch of genitofemoral nerve

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89
Q

What does the intermediate compartment of the femoral sheath contain?

A

Femoral vein

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90
Q

What is the medial compartment of the femoral sheath?

A

Femoral canal

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91
Q

What does the femoral canal contain?

A

fat
loose connective tissue
efferent lymph vessels
a lymph node not embedded in lymphatic tissue (of cloquet)

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92
Q

Which gender gets femoral hernias more?

A

F > M

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93
Q

Pathology of femoral hernias

A

Femoral ring week area

Abdominal contents push into femoral canal within the femoral sheath

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94
Q

Other names for the adductor canal

A

Hunters canal

Subartorial canal

95
Q

Where do neurovascular structures in the adductor canal come from?

A

Leaving the femoral triangle distally and burrowing into the muscles and continues posteriorly until it reaches the adductor hiatus of the adductor magnus tendon

96
Q

Where does the adductor canal emerge after going through the adductor hiatus of the adductor magnus tendon?

A

Popliteal fossa

97
Q

At the adductor hiatus, what does the anterior femoral artery turn into?

A

Popliteal artery

98
Q

Contents of the adductor canal

A

Femoral artery
Femoral vein
Saphenous nerve
Femoral nerve

99
Q

Nerve roots of the lumbar plexus

A

T12-L4

100
Q

What are two major nerves of the lumbar plexus?

A

Femoral nerve

Obturator nerve

101
Q

Through the greater sciatic foramen, structures enter and leave the what?

A

Pelvis

102
Q

Through the lesser sciatic foramen, structures enter and leave the what?

A

Perineum

103
Q

Superficial gluteal muscles

A

Gluteus maximus
Gluteus medius
Gluteus minimus
Tensor fasciae latae

104
Q

Innervation of gluteus maximus

A

Inferior gluteal nerve

105
Q

Innervation of gluteus medius and minimus

A

Superior gluteal nerve

106
Q

Innervation of tensor fasciae latae

A

Superior gluteal nerve

107
Q

Where is the lumbar plexus found?

A

Emerges through psoas major on posterior abdominal wall

108
Q

Action of the gluteus maximus

A

Extension of hip

External rotation of hip

109
Q

Actions of the gluteus medius and minimus

A

Flexion of hip

Medial rotators of the hip

110
Q

Actions of the tensor fasciae latae

A

Flexion of hip

Medial rotator of hip

111
Q

What are the deep gluteal muscles?

A

Piriformis
Obturator internus
Superior and inferior gemelli
Quadratus femoris

112
Q

Actions of the deep gluteal muscles

A

Stabilise hip joint

Lateral rotation

113
Q

What two muscles are attached to the iliotibial tract?

A

Gluteus maximus

Tensor fasciae latae

114
Q

What is the iliotibial tract?

A

Long fibrous reinforcement of the TFL

115
Q

Actions of the iliotibial tract

A

Extension of hip
Abduction of hip
Lateral rotation of hip
Lateral knee stabilisation

116
Q

Where is the sacral plexus found?

A

Anterior to piriformis

117
Q

Nerve roots of the sacral plexus

A

Union of ventral rami of spinal nerves L4-S4

118
Q

Two main branches of the sacral plexus

A

Sciatic nerve

Pudendal nerve

119
Q

Branches of the sacral plexus

A 
Nerves to piriformis (S1+S2)
Posterior femoral cutaneous branch 
Nerve to quadratus femoris (L4-S1)
Nerve to obturator internus (L5-S2)
Pudendal nerve
120
Q

The lumbosacral trunk is made up from the union of….

A

L4 and L5

121
Q

Nerve roots of supply to piriformis

A

S1+S2

122
Q

Nerve roots of supply to quadratus femoris

A

L4-S1

123
Q

Nerve roots of supply to obturator internus

A

L5-S2

124
Q

Nerve roots to superior gluteal nerve

A

L4-S1

125
Q

What does the superior gluteal nerve supply?

A

Gluteus medius
Gluteus minimus
Tensor fasciae latae

126
Q

Nerve roots of the inferior gluteal nerve

A

L5-S2

127
Q

What is the largest nerve in the body?

A

Sciatic nerve

128
Q

What is the sciatic nerve a continuation of?

A

Main part of sacral plexus

129
Q

Terminal branches of sciatic nerve

A

Tibial nerves

Common fibular nerve

130
Q

Nerve roots of sciatic nerve

A

L4-S3

131
Q

What type of joint is the knee joint?

A

Synovial hinge

132
Q

What are the articular surfaces of the knee joint?

A

Medial and lateral condyles of the femur
Tibia
Posterior surface of the patella

133
Q

What bone is NOT involved in the knee joint?

A

Fibula

134
Q

What is noted about the right and left patella?

A

They are different

135
Q

Stability of the knee joint depends on what?

A

Strength and action of surrounding muscles, their tendons and ligaments connecting the femur and the tibia

136
Q

What is the most important muscle to stabilise the knee joint?

A

Quadriceps femoris

137
Q

What are ligaments of the knee?

A

Thickenings of the joint capsule

138
Q

What are the collateral ligaments of the knee?

A

Lateral collateral ligament

Medial collateral ligament

139
Q

What does the tendon of the popliteus do in the knee joint?

A

Passes deep to the lateral collateral ligament, separating it from the lateral meniscus

140
Q

What is the relationship between the medial collateral ligament and the medial meniscus?

A

At its midpoint, the medial collateral ligament is firmly attached to the medial meniscus - making the meniscus vulnerable in ligament injuries

141
Q

What does the anterior cruciate ligament prevent?

A

Anterior dislocation of the tibia onto the femur

142
Q

What does the posterior cruciate ligament prevent?

A

Posterior dislocation of the tibia onto the femur

143
Q

What are the menisci of the knee?

A

C shaped plates of fibrocartilage on the articular surface of the tibia

144
Q

What kind of cartilage is on the knee menisci?

A

Fibrocartilage

145
Q

What are the two menisci of the knee?

A

Lateral

Medial

146
Q

Which of the two menisci is bigger?

A

Medial menisci

147
Q

Function of menisci of the knee

A

Deepen the surface

Play a role in shock absorption

148
Q

What does the medial meniscus firmly adhere to?

A

Deep surface of the tibial and medial collateral ligament

149
Q

Pathology of the “unhappy triad”

A

Impacts from knee generally come from lateral direction
Puts load on MCL, which is attached to medial meniscus
This tears the medial meniscus
This puts a load on the ACL, which then tears
Therefore 3 injuries

150
Q

What are involved in the unhappy triad?

A

Medial collateral ligament
Medial meniscus
Anterior cruciate ligament

151
Q

What flexes the knee?

A

Hamstrings
Gracilis
Sartorius
Popliteus

152
Q

What extends the knee?

A

Quadriceps femoris

153
Q

What is housemaid’s knee?

A

Prepatellar bursitits

154
Q

What is prepatellar bursitis caused by?

A

Friction between skin and patella

155
Q

What knee bursa articulates with joint cavity?

A

Suprapatellar bursae

156
Q

Where can bone marrow be taken from?

A

Sternum

Iliac crest

157
Q

What is the tibialis anterior innervated by?

A

Deep fibular nerve

158
Q

What is the extensor digitorum longus innervated by?

A

Deep fibular nerve

159
Q

What is the fibularis tertius innervated by?

A

Deep fibular nerve

160
Q

What is the extensor hallicus longus innervated by?

A

Deep fibular nerve

161
Q

Action of anterior compartment of leg

A

Dorsiflex ankle

Inversion

162
Q

Action of fibularis teritus

A

Dorsiflexion

Eversion

163
Q

What artery supplies the anterior leg?

A

Anterior tibial artery

164
Q

What does the common fibular nerve split into?

A

Deep fibular nerve

Superficial fibular nerve

165
Q

What are the two divisions of the sciatic nerve?

A

Common fibular nerve

Tibial nerve

166
Q

Where does the tibial artery run?

A

Midway between malleoli

167
Q

What innervates fibularis longus?

A

Superficial fibular nerve

168
Q

What innervates fibularis brevis?

A

Superficial fibular nerve

169
Q

Which of the fibularis longus and fibularis brevis is more superior?

A

Fibularis longus

170
Q

Action of fibularis longus and brevis

A

Eversion

WEAKLY plantar flex foot

171
Q

What causes injury to common fibular nerve?

A

Habitual or prolonged kneeling / squatting / leg crossing

172
Q

What muscles are affected in injury to the common fibular nerve?

A

Dorsiflexion muscles

173
Q

What is the presentation of injury to the common fibular nerve?

A

Foot drop

174
Q

What is the dorsalis pedis pulse found lateral to?

A

Tendon of the extensor hallicus longus

175
Q

What type of joint is the ankle joint?

A

Synovial hinge

176
Q

What is the malleolar mortise formed from?

A

Transverse part of the posterior tibial ligament and lower end of the tibia and fibia

177
Q

What does the malleolar mortise socket articulate with?

A

Pulley shaped trochlea of the talus bone

178
Q

Articular surfaces of the ankle

A

Distal end of tibia and fibia
Superior part of talus bone
Malleoli grip tallus tightly during movements

179
Q

When is the malleolar grip strongest?

A

During dorsiflexion

180
Q

When is the ankle joint unstable?

A

Plantar flexion

181
Q

Ligaments of the ankle joint

A 
Medial/deltoid ligament (4x)
Lateral ligament (3x)
182
Q

What does the medial/deltoid ligament resit?

A

Over eversion of foot

183
Q

What does the lateral ligament resist?

A

Over inversion of foot

184
Q

3 distinct ligaments of the lateral ligament of the ankle

A

Anterior talo fibular
Posterior talo fibular
Calcaneofibular

185
Q

What are ankle sprains due to?

A

Torn fibres of ankle ligament

186
Q

What causes the most common ankle sprain?

A

Inversion of subtalar joint

187
Q

What is footballers ankle?

A

Repeated strain on the anterior capsule

188
Q

What muscles dorsiflex the ankle?

A

Tibialis anterior
Extensor hallicus longus
Extensor digitorum longus
Fibularis tertius

189
Q

What muscles plantarflex the ankle?

A 
Tibialis posterior
Gastrocnemius 
Soleus 
Plantaris 
Fibularis longus and brevis (weakly)
Flexor hallicus longus 
Flexor digitorum longus
190
Q

What kind of joint is the proximal tibio-fibular joint?

A

Synovial plane

191
Q

What kind of joint is the distal tibio-fibular joint?

A

Fibrous joint (syndesmosis)

192
Q

Upper medial border of popliteal fossa

A

Semimembraneous

193
Q

Upper lateral border of popliteal fossa

A

Biceps femoris muscle

194
Q

Inferior border of popliteal fossa

A

Lateral and medial heads of gastrocnemius muscle

195
Q

Contents of popliteal fossa

A 
Fat
Popliteal artery 
Popliteal vein 
Tibial nerve
Common fibular nerve
Popliteal lymph nodes and lymphatic vessels
196
Q

What is the order of contents in the popliteal fossa?

A

Medial -> lateral

Popliteal artery, Popliteal vein, tibial nerve, common fibular nerve (down biceps femoris)

197
Q

What is the popliteal artery a continuation of and where?

A

Femoral artery as it emerges from the adductor hiatus

198
Q

Weak or loss of popliteal pulse indicates what?

A

Femoral artery obstruction

199
Q

Innervation of posterior leg

A

Tibial nerve

200
Q

How many heads does the gastrocnemius have?

A

2

201
Q

Actions of gastrocnemius

A

Plantarflexion

Flexion of knee

202
Q

What is the gastrocnemius essential for?

A

Walking gait

203
Q

Action of plantaris

A

Plantar flexion

204
Q

Nerve roots of tibial nerve

A

L4-S3

205
Q

What is the arterial supply to the posterior compartment of the leg?

A

Posterior tibial artery

206
Q

Where is the posterior tibial artery palpated?

A

Between the posterior surface of the medial malleolus and medial border of the calcaneal tendon

207
Q

Order of deep posterior leg muscles coming posterior to the medial malleolus to enter the sole of the foot

A 
Anterior to posterior 
TOM DICK AND VERY NERVOUS HARRY
Tibialis posterior 
Flexor digitorum longus 
Posterior tibial artery 
Tibial vein 
Tibial nerve 
Flexor hallicus longus
208
Q

Function of the foot

A

Supports body weight

Plays an important role in locomotion

209
Q

Bones of the foot

A

Tarsals
metatarsals
Phalanges

210
Q

What type of joint is the transverse talar joint?

A

Synovial plane

211
Q

What is the subtalar joint?

A

Talo-calcaneal joint

212
Q

What type of joint is the subtalar joint?

A

Synovial plane

213
Q

What type of joint is between the talus and navicular bones?

A

Ball and socket joint

214
Q

Movements at the subtalar joint

A

Inversion

Eversion

215
Q

What are essential for movement for walking on uneven ground or balancing on one leg?

A

Articulated ball and socket joint between talus and navicular bones allowing pivot
Joints between talus and calcaneous allowing side to side movements
Some movement at the transverse talar joint

216
Q

Innervation of flexor digitorum brevis

A

Medial plantar nerve

217
Q

Innervation of abductor digiti minimi

A

Lateral plantar nerve

218
Q

Innervation of adductor hallicus

A

Medial plantar nerve

219
Q

Innervation of quadratus plantae

A

Lateral plantar nerve

220
Q

Innervation of the foot lumbricals

A

Most medial = median plantar nerve

Most lateral 3 = lateral plantar nerve

221
Q

Two terminal branches of the tibial nerve

A

Medial plantar nerve

Lateral plantar nerve

222
Q

Branches of the posterior tibial artery

A

Medial plantar artery

Lateral plantar artery

223
Q

Function of arches of the feet

A

Distribute body weight

Act as shock absorbers

224
Q

What is the influence of body weight on the feet?

A

Acts vertically
On the talus
Forces apart navicular and calcaneus bones

225
Q

What is the force of body weight of the feet resisted by?

A

Muscle tendons that cross the joints

Plantar calcaneonavicular ligament / spring ligament

226
Q

Function of calcaneonavicular ligament / spring ligament

A

Resist force of weight on the bones
Maintain medial longitudinal arch
Contributes to subtalar joints

227
Q

3 arches of the feet

A

Medial longitudinal arch
Lateral longitudinal arch
Anterior transverse arch

228
Q

What passive factors help to maintain the integrity of the arches?

A

Shape of united bones
Plantar aponeurosis
Long plantar ligament
Short plantar ligament

229
Q

What dynamic factors help to maintain the integrity of the arches?

A

Intrinsic muscles of the foot
Long flexor tendons
Tendon of tibialis anterior and fibularis longus

230
Q

Who is flat feet common in?

A

Older people

231
Q

What are acquired flat feet (fallen arches) likely due to?

A

Dysfunction of dynamic or passive factors

232
Q

Where can you find the sciatic nerve (surface anatomy)?

A

Midway between the greater trochanter and ischial tuberosity

233
Q

Where is a safe IM injection site?

A

Upper lateral quadrant

234
Q

Where can the common fibular nerve be damaged?

A

Neck of the fibula

Anatomy for resit cause your stupid (9 decks)

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