Musculoskeletal Anatomy of Lower Extremity Powerpoint Side Info

Question 1

Most likely place for a hip fracture of an elderly patient

Answer 1

The anatomical neck of the femur

Question 2

Skier’s fracture mechanism

Answer 2

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

Question 3

The part of the talus that interacts with the tibia and fibula

Answer 3

The dome of the talus

Question 4

Going on the balls of your feet means placing weight on the…

Answer 4

…head of the metatarsals

Question 5

Trochanter

Answer 5

Large prominence on side of bone serving as attachment site

Question 6

Tuberocity

Answer 6

Medium prominence on side of bone serving as attachment site

Question 7

Tubercle

Answer 7

Small, rounded prominence serving as attachment site

Question 8

Apophysis

Answer 8

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

Question 9

Osgood-Schlatter disease

Answer 9

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

Question 10

Plantar faciitis

Answer 10

Occurs due to overuse injury of foot where plantar fascia attaches to the calcaneus

Question 11

Dorsiflexion vs plantarflexion

Answer 11

Dorsiflexion moves toes toward the sky

Plantarflexion moves toes toward the ground

Question 12

Great saphenous vein

Answer 12

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

Question 13

Important thing to remember when using the great saphenous vein in a CABG

Answer 13

It has valves, so must be oriented a specific way

Question 14

NAVL

Answer 14

The femoral nerve, artery, vein, and lymphatics (in the order medial to lateral) that travel together in the femoral triangle

Question 15

Borders of the femoral triangle

Answer 15

The inguinal ligament, adductor longus, and sartorius

Question 16

Saphenous branch of femoral nerve

Answer 16

Goes below knee, must be identified in ACL surgery and avoided cut to protect sensation in pockets on the leg

Question 17

Femoral shealth

Answer 17

Keeps the femoral artery and vein running side by side

Question 18

Femoral nerve origin

Answer 18

L2-4, innervates anterior thigh muscles such as quads, sartorius, and pectineus

Question 19

Muscle perforating arteries penetrate to supply, why is this important?

Answer 19

Penetrate adductor magnus, prevents lack of blood flow when sitting

Question 20

Blood supply to vastus lateralis

Answer 20

Descending limb of lateral circumflex femoral artery

Question 21

Elderly patient fracture at anatomical neck of femur pathophys

Answer 21

Anatomical neck supplied by medial circumflex femoral artery, with decreased low Ca2+ levels osteoperosis develops leaving that region likely to fracture

Question 22

Gluteus medius walking mechanism

Answer 22

As an abductor of the femur at the hip, raises hip girdle on contralateral side

Question 23

Trendelenberg gait

Answer 23

A result of paralysis or pareisis of the gluteus medius on the contralateral side causes swinging of leg around

Question 24

Sciatic nerve origin and components

Answer 24

Arises from L4-S3, tibial nerve which wraps around to innervate posterior leg, and common fibular nerve to innervate the anterior leg

Question 25

Sciatica caused by piriformis and why this is a conundrum for practicioners

Answer 25

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

Question 26

Innervation of biceps femoris long head vs short head

Answer 26

Long head is tibial portion and short head is common fibular portion of sciatic nerve

Question 27

If suspected ACL tear, way to determine via aspiration?

Answer 27

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

Question 28

Name the 6 deep external rotators of the hip

Answer 28

• Gemelli superior and inferior
• Obturator externus/internus
• Quadratus femoris
• Piriformis

Question 29

Pathway of common fibular nerve below biceps femoris

Answer 29

Wraps anteriolaterally to innervate lateral and anterior, becoming the musculocutaneous and anterior tibial nerve

Question 30

Pathway of tibial nerve below biceps femoris

Answer 30

Travels down the posterior leg medial-inferiorally until dividing into the medial and lateral plantar nerves

Question 31

Divisions of the popliteal artery

Answer 31

Posterior and anterior tibial arteries

Question 32

Adductor hiatus

Answer 32

Break in adductor magnus muscle to allow for passage of femoral artery and vein, changing names to popliteal

Question 33

Anterior tibial artery pathway

Answer 33

Upon division from the popliteal artery, travels anteriorally through a space above the interosseous membrane btwn the tibia and fibula

Question 34

Muscles of the anterior compartment of the tibia

Answer 34

Extensor hallusus longus, extensor digitorum longus, tibialis anterior

Question 35

Muscles of the deep posterior compartment of the tibia

Answer 35

Flexor hallucis longus, flexor digitorum longus, tibialis posterior

Question 36

Plantaris tendon

Answer 36

uh

Question 37

What muscle in the deep posterior compartment supports the arch of the foot?

Answer 37

Tibialis posterior

Question 38

Fibularis tertius

Answer 38

duh

Question 39

Dorsal pedal artery

Answer 39

Branch/continuation of anterior tibial artery in foot

Question 40

Medial plantar artery

Answer 40

Continuation of posterior tibial artery in foot

Question 41

Fibular artery

Answer 41

Branch off the posterior tibial artery in foot, descends in deep compartment to underside of foot

Question 42

Posterior tibial nerve

Answer 42

Name change of the tibial nerve entering the leg, innervates posterior leg

Question 43

Common fibular nerve pathway

Answer 43

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

Question 44

Alternative name for superficial peroneal and deep peroneal nerve

Answer 44

Superficial peroneal - musculocutaneous nerve

Deep peroneal - anterior tibial nerve

Question 45

Pes Anserine

Answer 45

Attachment site of 3 different muscles, sartorius, semitendinosus, and gracilis

Question 46

The gastrocnemius is ____articulate

Answer 46

Bi

Question 47

Anterior compartment syndrome

Answer 47

Swelling of the anterior compartment, treated with fasciotomy of the deep fascia to allow for release of pressure over time

Question 48

Freshman nerve

Answer 48

Tendon of the plantaris muscle that strongly resembles a nerve

Question 49

In deep posterior compartment, the tendons have to…

Answer 49

…cross over each other - very inefficient kanye

Question 50

IT tract friction syndrome

Answer 50

Often seen in female runners due to repetitive wear and tear