Savarese Ch 8: Lower Extremities Flashcards
External rotation of the hip does what to the femoral head?
Anterior glide
External rotation of the foot does what to the proximal fibular head?
Moves anterior
distal fibula will be pushed posterior by the talus
What is pronation of the foot?
Dorsiflexion, eversion, abduction (external rotation)
What is supination of the foot?
Plantarflexion, inversion, ADduction (internal rotation)
Femoral Nerve:
Composed of:
Motor/sensory innervation:
L2-L4
IN: quads, Iliacus, Sartorius, pectineus
Sen IN: anterior thigh, medial leg
Sciatic Nerve:
Composed of:
Course:
Branches:
L4-S3
Courses through the greater sciatic foramen. inferior to the piriformis in 85%
Peroneal and Tibial branches
Tibial Nerve:
Innervates:
Motor: most hamstrings, most plantar flexors, toe flexors
Sensory: lower leg and plantar surface of foot
Peroneal nerve innervations
Motor: short head of biceps femoris, evertors, dorsiflexors, and most extensors of toes
Sensory: lower leg and dorsum of foot
Angulation of the head of the femur
Angle between the neck and shaft of the femur
nml: 120-135
135 = coxa valga
Q angle: what is it and what is nml
2 lines: ASIS –> middle of patella and tibial tubercle –> middle of patella.
nml Q angle - 10-12 degrees
Increased Q angle
Genu valgum
Patient appears knock-kneed
Decreased Q angle
Genu varum
Patient appears bow legged
Clinical significance of a posterior fibular head
The common peroneal nerve courses posterior to the fibular head
Patello-femoral syndrome:
Caused by a strong vastus lateralis and a weak vastus medialis.
Related to a large Q angle (women = predisposed)
Which compartment is most affected in compartment syndrome?
The anterior compartment.
Severe, unrelenting pain during and after exercise - anterior tibilais muscle
What makes up O’Donahue’s triad aka Terrible triad:
ACL, MCL and medial meniscus injury
The ankle is most stable in _______. So, we see:
Dorsiflexion
80% of ankle sprains occur in plantar flexion
What somatic do we most often see in the arches?
The transverse arch (navicular, cuboid, or cuneiforms) –> seen in long distance runners
An ankle sprain will most likely injury what?
The lateral stabilizers –> anterior talofibular ligament first
Then Calcaneofibular, followed by posterior talofibular ligament. (type I, II, and III; respectively)
Which ligaments prevent excessive supination of the foot?
Lateral stabilizers
Which ligaments prevent excessive pronation of the foot?
Medial stabilizer - the deltoid ligament. (very strong - would see fracture of the medial malleolus first)
