Musculoskeletal Anatomy of Lower Extremity Powerpoint Side Info Flashcards
5/22/19
Most likely place for a hip fracture of an elderly patient
The anatomical neck of the femur
Skier’s fracture mechanism
Fracture of the fibula due to extensive weight being placed on it from confined mobility of boot while twisting and turning and managing skis, individuals can typically still walk down mountain despite pain because THE FIBULA IS NOT WEIGHT BEARING
The part of the talus that interacts with the tibia and fibula
The dome of the talus
Going on the balls of your feet means placing weight on the…
…head of the metatarsals
Trochanter
Large prominence on side of bone serving as attachment site
Tuberocity
Medium prominence on side of bone serving as attachment site
Tubercle
Small, rounded prominence serving as attachment site
Apophysis
Small projections off bones that are subject to attachment site of muscles that when a force from a strong muscle pulls the attachment away we can see some diseases result
Osgood-Schlatter disease
Inflammation of the tibial tubercle that often occurs in childhood when the child’s quad muscles grow fast causing the pulling away of the patellar ligament, leading to calcium deposit and buildup resulting in appearance of “tumor” like mass
Plantar faciitis
Occurs due to overuse injury of foot where plantar fascia attaches to the calcaneus
Dorsiflexion vs plantarflexion
Dorsiflexion moves toes toward the sky
Plantarflexion moves toes toward the ground
Great saphenous vein
Long superficial vein returning blood on medial side from foot, leg and thigh and emptying into the femoral vein at the level of the femoral triangle
Important thing to remember when using the great saphenous vein in a CABG
It has valves, so must be oriented a specific way
NAVL
The femoral nerve, artery, vein, and lymphatics (in the order medial to lateral) that travel together in the femoral triangle
Borders of the femoral triangle
The inguinal ligament, adductor longus, and sartorius
Saphenous branch of femoral nerve
Goes below knee, must be identified in ACL surgery and avoided cut to protect sensation in pockets on the leg
Femoral shealth
Keeps the femoral artery and vein running side by side
Femoral nerve origin
L2-4, innervates anterior thigh muscles such as quads, sartorius, and pectineus
Muscle perforating arteries penetrate to supply, why is this important?
Penetrate adductor magnus, prevents lack of blood flow when sitting
Blood supply to vastus lateralis
Descending limb of lateral circumflex femoral artery
Elderly patient fracture at anatomical neck of femur pathophys
Anatomical neck supplied by medial circumflex femoral artery, with decreased low Ca2+ levels osteoperosis develops leaving that region likely to fracture
Gluteus medius walking mechanism
As an abductor of the femur at the hip, raises hip girdle on contralateral side
Trendelenberg gait
A result of paralysis or pareisis of the gluteus medius on the contralateral side causes swinging of leg around
Sciatic nerve origin and components
Arises from L4-S3, tibial nerve which wraps around to innervate posterior leg, and common fibular nerve to innervate the anterior leg
Sciatica caused by piriformis and why this is a conundrum for practicioners
Piriformis can pinch causing symptoms very similar to a herniated disk - make it difficult to diagnose clinically, up to 10% of individuals have part of sciatic nerve pierce piriformis muscle
Innervation of biceps femoris long head vs short head
Long head is tibial portion and short head is common fibular portion of sciatic nerve
If suspected ACL tear, way to determine via aspiration?
Aspirate fluid from the knee cavity, middle genicular artery runs alongside ACL and tears with it so blood will be found, 1 of 5 genicular arteries
Name the 6 deep external rotators of the hip
- Gemelli superior and inferior
- Obturator externus/internus
- Quadratus femoris
- Piriformis
Pathway of common fibular nerve below biceps femoris
Wraps anteriolaterally to innervate lateral and anterior, becoming the musculocutaneous and anterior tibial nerve
Pathway of tibial nerve below biceps femoris
Travels down the posterior leg medial-inferiorally until dividing into the medial and lateral plantar nerves
Divisions of the popliteal artery
Posterior and anterior tibial arteries
Adductor hiatus
Break in adductor magnus muscle to allow for passage of femoral artery and vein, changing names to popliteal
Anterior tibial artery pathway
Upon division from the popliteal artery, travels anteriorally through a space above the interosseous membrane btwn the tibia and fibula
Muscles of the anterior compartment of the tibia
Extensor hallusus longus, extensor digitorum longus, tibialis anterior
Muscles of the deep posterior compartment of the tibia
Flexor hallucis longus, flexor digitorum longus, tibialis posterior
Plantaris tendon
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What muscle in the deep posterior compartment supports the arch of the foot?
Tibialis posterior
Fibularis tertius
duh
Dorsal pedal artery
Branch/continuation of anterior tibial artery in foot
Medial plantar artery
Continuation of posterior tibial artery in foot
Fibular artery
Branch off the posterior tibial artery in foot, descends in deep compartment to underside of foot
Posterior tibial nerve
Name change of the tibial nerve entering the leg, innervates posterior leg
Common fibular nerve pathway
Follows alongside the posterior tibial artery, branches into superficial peroneal nerve, with one branch going directly into the lateral compartment and the other branch the deep peroneal nerve enters the anterior compartment
Alternative name for superficial peroneal and deep peroneal nerve
Superficial peroneal - musculocutaneous nerve
Deep peroneal - anterior tibial nerve
Pes Anserine
Attachment site of 3 different muscles, sartorius, semitendinosus, and gracilis
The gastrocnemius is ____articulate
Bi
Anterior compartment syndrome
Swelling of the anterior compartment, treated with fasciotomy of the deep fascia to allow for release of pressure over time
Freshman nerve
Tendon of the plantaris muscle that strongly resembles a nerve
In deep posterior compartment, the tendons have to…
…cross over each other - very inefficient kanye
IT tract friction syndrome
Often seen in female runners due to repetitive wear and tear
