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Musculoskeletal System > Session 4 - Lower Limb Part 1 > Flashcards

Session 4 - Lower Limb Part 1 Flashcards

1
Q

What is the linea aspera?

A

Roughened ridge of bone on the posterior surface of the femoral shaft

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2
Q

What is the pectineal line?

A

Medial border of the linea aspera proximally

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3
Q

Where is the gluteal tuberosity?

A

Lateral border of linea aspera proximally

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4
Q

Where are the medial and lateral supracondylar lines?

A

Medial and lateral borders of linea aspera distally

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5
Q

Where is the trochlear groove?

A

Anterior surface of distal femur, where it articulates with patella

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6
Q

What are medial and lateral epicondyles?

A

Bony elevations above non-articular areas of condyles

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7
Q

Where is the patella located?

A

Anterior aspect of knee joint, within trochlear groove of femur

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8
Q

What is the superior aspect of the patella attached to?

A

Quadriceps tendon

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9
Q

What is the inferior aspect of the patellar attached to?

A

Patellar ligament

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10
Q

What is the tibial plateau?

A

Flat surface of condyles

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11
Q

What is the proximal tibiofibular joint made of?

A

Head of fibula articulating with proximal tibia

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12
Q

What is the intercondylar eminence?

A

Centre of intercondylar area between the tibial condyles

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13
Q

What is the function of the tibia?

A

Weight bearing

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14
Q

What is the function of the fibula?

A

Attachment for muscles

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15
Q

What are 3 main articulations of the fibula?

A

Proximal tibiofibular joint
Distal tibiofibular joint
Ankle joint

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16
Q

Where is the proximal tibiofibular joint?

A

Where the fibula articulates with the lateral condyle of tibia

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17
Q

Where is the distal tibiofibular joint?

A

Where fibula articulates with the fibular notch of tibia

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18
Q

Where is the ankle joint?

A

Where the fibular articulates with talus bone of foot

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19
Q

Where is the common peroneal or fibular nerve located on the fibula?

A

Winds around posterior and lateral surface of the neck of the fibula

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20
Q

What are the 3 surfaces of the fibular shaft?

A

Anterior lateral and posterior

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21
Q

What type of joint is the knee joint?

A

Hinge type synovial joint

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22
Q

What are the 2 articulations of the knee joint?

A

Tibiofemoral

Patellofemoral

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23
Q

Which joint is the weight bearing joint of the knee?

A

Tibiofemoral joint

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24
Q

What are the 4 factors contributing to the stability of the knee joint?

A

Tibial articular surface deepened by menisci
Joint capsule
Ligaments
Musculature

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25
Q

What are the 2 functions of the medial and lateral menisci?

A

Deepen articular surface of tibia to increase stability

Act as shock absorber by increasing surface area to further dissipate forces

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26
Q

What connects the 2 menisci?

A

Transverse ligament of the knee

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27
Q

What stabilizes the posterior horn of lateral meniscus by attaching to the medial femoral condyle?

A

Posterior meniscofemoral ligament

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28
Q

What are the 3 major types of ligaments in the knee joint?

A

Intracapsular
Extracapsular
Ligaments that strengthen the capsule

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29
Q

What are the 2 intracapsular ligaments?

A

Anterior cruciate ligament

Posterior cruciate ligament

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30
Q

What does the cruciate ligaments connect?

A

Femur and tibia

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31
Q

How are the anterior and posterior cruciate ligaments oriented?

A

PAMs APpLes

Posterior passes anterior inserts medially
Anterior passes posterior inserts laterally

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32
Q

What does the anterior cruciate ligament do?

A

Attached towards lateral side, so resists anterior translation and medial rotation of tibia

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33
Q

What does the PCL do?

A

Stabilizes weight bearing flexed knee and prevents femur from sliding off anterior edge of tibia, prevents posterior dislocation

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34
Q

Which ligament strengthens the joint capsule?

A

Oblique popliteal ligament posteriorly

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35
Q

What are the 2 extracapsular ligaments?

A

Collateral ligaments and patellar ligament

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36
Q

What is the function of the collateral ligaments?

A

Stabilize hinge motions of knee, prevents excessive medial or lateral angulation of tibia on femur

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37
Q

Where does medial collateral ligament attach to?

A

Medial epicondyle of femur and medial condyle of tibia

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38
Q

What is the function of medial collateral ligament?

A

Resist lateral angulation of tibia on femur

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39
Q

Where does the lateral collateral ligament attach to?

A

Lateral epicondyle of femur and depression on lateral surface of fibular head

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40
Q

What is the function of the lateral collateral ligament?

A

Resist medial angulation of tibia

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41
Q

What is a bursa?

A

A small sac lined by synovial membrane, contains a thin layer of synovial fluid

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42
Q

What is the function of a bursa?

A

Provides a cushion between bones and soft tissues allowing free movement

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43
Q

What are the 6 bursae of the knee joint?

A 
Suprapatellar 
Prepatellar 
Superficial infrapatellar
Deep infrapatellar
Semimembranosus
Subsartorial or pes anserinus
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44
Q

What are the 4 movements that the knee joint permits?

A

Extension
Flexion
Lateral rotation
Medial rotation

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45
Q

What are the 4 muscles that produces knee extension?

A

Quadriceps femoris - rectus femoris, vastus medialis, vastus lateralis, vastus intermedius

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46
Q

What are the 3 muscles that produces knee flexion?

A

Biceps femoris
Semimembranosus
Semitendinosus

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47
Q

What muscle produces lateral rotation?

A

Biceps femoris

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48
Q

What are the 5 muscles that produces knee medial rotation?

A 
Semimembranosus 
Semitendinosus
Gracilis
Sartorius
Popliteus
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49
Q

How does the knee lock?

A

Medial rotation of femoral condyles on the tibial plateau and cruciate ligaments tighten

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50
Q

How does the knee unlock?

A

Popliteus contracts, rotates femur laterally by 5 degrees on tibial plateau so flexion of knee can occur

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51
Q

Which nerve is the anterior thigh innervates by?

A

Femoral nerve

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52
Q

Which branches and which artery supplies the anterior thigh?

A

Lateral and medial femoral circumflex arteries

Profunda femoris

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53
Q

What are the 4 muscles on the anterior thigh?

A

Pectineus
Sartorius
Quadriceps femoris
Iliopsoas

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54
Q

What are the 2 muscles of the iliopsoas?

A

Papas major

Iliacus

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55
Q

What is the action of the iliopsoas?

A

Flex lower limb at hip joint

Assist in lateral rotation of femur at hip joint

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56
Q

What is psoas major innervated by?

A

Anterior rami of L1-3

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57
Q

What is the iliacus innervated by?

A

Femoral nerve

58
Q

What are the 4 muscles of quadriceps femoris?

A

Rectus femoris
Vastus medialis
Vastus lateralis
Vastus intermedius

59
Q

What is the function of the quadriceps femoris?

A

Main extensor of knee

60
Q

What is the action of vastus lateralis?

A

Extends knee joint and stabilize patella

61
Q

What is the function of vastus intermedius?

A

Extends knee joint and stabilize patella

62
Q

What is the function of vastus medialis?

A

Extends knee joint and stabilize patella

63
Q

What is the action of vastus medialis obliquus?

A

Resist lateral displacement of patella

64
Q

What is the function of rectus femoris?

A

Flex thigh at hip joint

Extends leg at knee joint

65
Q

What is the action of sartorius?

A

Flexes, abduct and externally rotate thigh

Flexes and internally rotate tibia at knee joint

66
Q

What is the function of pectineus?

A

Adduct and flex thigh at hip joint

67
Q

What is the function of medial thigh muscles?

A

Hip adductors

68
Q

What are the 5 medial muscles?

A 
Gracilis 
Obturator externus 
Adductor brevis
Adductor longus
Adductor magnus
69
Q

Which artery supplies the medial thigh?

A

Obturator artery

70
Q

What are the 2 parts of the adductor magnus?

A

Adductor and hamstring

71
Q

What is the actions of the adductor component of the adductor magnus?

A

Adduct thigh

Flex thigh

72
Q

What are the actions of the hamstring component of the thigh?

A

Adduct thigh

Extend thigh

73
Q

What is the adductor component of the thigh innervated by?

A

Obturator nerve

74
Q

What is the hamstring component of the adductor magnus innervated by?

A

Tibial component of sciatic nerve

75
Q

What is the action of adductor longus?

A

Adduct thigh

76
Q

What is the adductor longus innervated by?

A

Obturator nerve

77
Q

What is the action of adductor brevis?

A

Adduct thigh

78
Q

What is the adductor brevis innervated by?

A

Obturator nerve

79
Q

What is the action of the gracilis?

A

Adduct thigh at hip

Flex leg at knee

80
Q

What is the action of obturator externus?

A

Adduct and lateral rotation of thigh

81
Q

What are the 3 borders of the femoral triangle?

A

Inguinal ligament
Medial border of sartorius
Medial border of adductor longus

82
Q

What are the 4 contents of the femoral triangle?

A

Femoral nerve
Femoral artery
Femoral vein
Femoral canal

83
Q

What is the femoral canal?

A

Structure containing deep lymph nodes and vessels

84
Q

What is the femoral sheath?

A

Fascial compartment containing artery, vein and canal

85
Q

How to remember contents of femoral triangle form lateral to medial?

A 
NAVEL 
Nerve
Artery
Vein
Empty space
Lymph
86
Q

How do you mark the femoral artery on the surface?

A

MIPA

Mid inguinal point is the artery / midway between anterior superior iliac spine and symphysis pubis

87
Q

What is the 4 borders of the femoral canal?

A

Lacunar ligament
Femoral vein
Inguinal ligament
Pectineal ligament

88
Q

What is the femoral ring?

A

Opening to femoral canal

89
Q

What is the femoral septum?

A

Connective tissue layer closing the ring pierced by lymphatic vessels exiting the femoral canal

90
Q

What is the adductor canal?

A

Passageway for structures passing between anterior thigh and posterior leg

91
Q

What is the adductor canal bordered by?

A

Sartorius
Vastus medialis
Adductor longus
Adductor magnus

92
Q

What are the first cutaneous branches to arise from femoral nerve?

A

Anterior cutaneous branches

93
Q

What is the terminal cutaneous branch of the femoral nerve?

A

Saphenous nerve

94
Q

What does the anterior cutaneous branch of femoral nerve supply?

A

Anteromedial thigh

95
Q

What does the saphenous nerve supply?

A

Medial side of leg and foot

96
Q

What is the main artery of the lower limb?

A

Femoral artery

97
Q

What is the artery in the femoral triangle?

A

Profunda femoris artery

98
Q

What are the 3 branches of the profunda femoris artery?

A

Lateral femoral circumflex
Medial femoral circumflex
Perforating branches

99
Q

What is the artery after the common femoral artery gives off profunda femoris branch?

A

Superficial femoral artery

100
Q

What does the superficial femoral artery become after going through adductor canal?

A

Popliteal artery

101
Q

Which artery supplies the medial thigh?

A

Obturator

102
Q

What artery is the gluteal region supplied by?

A

Superior and inferior gluteal arteries

103
Q

What are the 5 deep veins involved in the thigh and gluteal region?

A 
Femoral vein 
Profunda femoris vein 
External iliac vein
Gluteal vein 
Obturator vein
104
Q

What are the 2 major superficial veins?

A

Great saphenous

Small saphenous

105
Q

What are the 2 types of superficial lymphatic vessels?

A

Medial vessels

Lateral vessels

106
Q

What does the medial vessels drain into?

A

Inferior group of superficial inguinal lymph nodes in femoral triangle

107
Q

What does the lateral vessels drain into?

A

Popliteal lymph nodes in popliteal fossa then deep inguinal nodes or join medial group

108
Q

What are the 3 main groups of deep lymphatic vessels?

A

Anterior tibial
Posterior tibial
Peroneal

109
Q

What do deep lymphatic vessels drain into?

A

Popliteal lymph nodes

110
Q

How do femoral shaft fractures occur?

A

Usually high velocity trauma

111
Q

What is a symptom of femoral shaft fracture?

A

Swollen and tense thigh

112
Q

What is a risk of femoral shaft fracture?

A

Blood lose in closed femoral shaft fractures can be very high and may develop hyovolaemic shock

113
Q

How do you treat femoral shaft fracture?

A

Surgical fixation

114
Q

What are tibial plateau fractures?

A

Fracture of articulating surface of the tibia within knee joint

115
Q

How to diagnose patellar fractures using physical examination?

A

Palpable defect in patella

Cannot do straight leg raise

116
Q

How to treat displaced patellar fractures?

A

Reduction and surgical fixation

117
Q

How to treat undisplaced patellar fractures?

A

Protect for it to heal

118
Q

What is patella dislocation?

A

Patella completely displaced out of its normal alignment

119
Q

How to treat patella dislocation?

A

Extend knee then manually reducing patella

Immobilize while healing takes place then physiotherapy

120
Q

How do meniscal injuries occur?

A

Sudden twisting motion of weight bearing knee in high degree of flexion

121
Q

How to treat acute traumatic meniscal tears?

A

Surgically through meniscectomy or meniscal repair

122
Q

What is the unhappy triad?

A

Injury to the anterior cruciate ligament, medial collateral ligament and medial meniscus

123
Q

How is the unhappy triad caused?

A

Strong force applied to lateral aspect of knee

124
Q

How to dislocate the knee?

A

3/4 ligaments rupture

125
Q

What is a knee effusion?

A

Accumulation of fluid inside knee joint

126
Q

What are the 2 types of knee effusions?

A

Acute and delayed

127
Q

What are 2 types of acute knee effusions?

A

Haemarthrosis - blood in joint

Lipo-haemarthrosis - blood and fat in the joint

128
Q

What is knee bursitis?

A

Inflammation of bursa

129
Q

What are the 4 most commonly inflamed bursa of the knee?

A

Prepatellar bursa
Infrapatellar bursa
Pes anserinus bursa
Suprapatellar bursa

130
Q

What is pre-patellar bursa?

A

Superficial bursa with thin synovial lining located between skin and patella

131
Q

What is Housemaid’s Knee?

A

Pre-patellar bursa becomes inflamed

132
Q

What is infrapatellar bursa?

A

One bursa superficially between patella tendon and skin

Another bursa between patella tendon and tibia bone

133
Q

What is cleryman’s knee?

A

Infrapatellar bursitis

134
Q

What is popliteal cyst or Baker’s cyst?

A

Swelling in popliteal fossa or semimembranosus bursitis

135
Q

What is Osgood-Schlatter’s Disease?

A

Inflammation of apophysis of patellar ligament into tibial tuberosity

136
Q

What are the 3 symptoms of osteoarthritis of the knee?

A

Knee pain
Stiffness
Swelling

137
Q

What is crepitus?

A

Grating sound and cracking sensation on movement of joint

138
Q

What is septic arthritis?

A

Invasion of joint space by micro organisms usually bacteria

139
Q

What is reactive arthritis?

A

Sterile inflammatory process that result from extra articular infection

140
Q

What are the 3 symptoms of septic arthritis?

A

Fever
Pain
Reduced range of motion

141
Q

What to do if septic arthritis is suspected?

A

Aspiration of joint immediately

Aspirate sent for urgent microscopy, culture and sensitivities

Musculoskeletal System (9 decks)

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