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ACE Unit 1 > TBL 8 - Gluteal Region, Posterior Thigh, Popliteal Fossa, Posterior Leg, Ankle and Foot > Flashcards

TBL 8 - Gluteal Region, Posterior Thigh, Popliteal Fossa, Posterior Leg, Ankle and Foot Flashcards

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1
Q

Describe the sacral hiatus and whats inside

A

inverted U that opens into the sacral canal (part of vertebral canal). Sacral cornea project inferiorly at the corners of the hiatus. The sacral nerve roots of the caudal equina are inside

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2
Q

How is caudal epidural anesthesia performed and which spinal nerves are typically affected?

A

It is injected through the sacral hiatus into the fat of the sacral canal around the proximal portions of the sacral nerves. It affects the S2-Co1 nerves

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3
Q

What holds the sacrum and hip bones together

A

The anterior and posterior sacroiliac ligaments

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4
Q

What creates the greater and lesser sciatic foramina

A

The sacrotuberous ligament connected to the ischial tuberosity and sacrospinous ligament connected to the ischial spine

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5
Q

Gluteus maximus

A

superoposterior ilium and posterior sacrum to the iliotibial tract
Extensor of thigh from flexed position

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6
Q

What does the inferior gluteal nerve innervate

A

the gluteus maximus

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7
Q

Gluteus Medius and minimus

A

Just deep to the maximus, external surface of ilium to the greater trochanter of the femur
Abduct and medially rotate the thigh

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8
Q

What does the superior gluteal nerve innervate

A

The gluteus medius and minimus

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9
Q

What are the main lesions that cause a positive Trendelenburg test?

A

Lesions to the superior gluteal nerve as the Trendelenburg suggest a problem in the gluteus medius

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10
Q

Where is the safe area for intragluteal injections?

A

Superolateral quadrant of buttocks or superior to line from PSIS to the superior border of the greater trochanter

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11
Q

Tensor Fasciae Lata

A

ASIS to iliotibial tract. Helps flex thigh

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12
Q

Paralysis of which muscle activates hypertrophy of the tensor fascia lata?

A

Iliopsoas. The tensor fasciae lata tries to compensate for the iliopsoas

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13
Q

Piriformis

A

Anterior surface of the sacrum to the greater trochanter of the femur occupying the greater sciatic foramen

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14
Q

Quadratus femoris

A

Ischial tuberosity to the intertrochanteric surface of femur

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15
Q

What muscles laterally rotate the thigh

A

Piriformis and quadratus femoris

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16
Q

What muscles attach to the ischial tuberosity

A

Quadratus femoris, semitendinosus, semimembranosus, long head of the biceps femoris, and the hamstring portion of the adductor magnus

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17
Q

Short head of biceps femoris and distal for both heads

A

Attaches to the linea aspera to the common distal attachment of head of fibula

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18
Q

Distal attachment for semitendinosus and semimembranosus

A

superior tibia

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19
Q

What does the tibial division of the sciatic nerve innervate?

A

The semitendinosus and semimembranosus, and long head of the biceps femoris

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20
Q

What does the common fibular division of the sciatic nerve innervate

A

Short head of biceps femoris

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21
Q

Pes Anserinus

A

On the superomedial tibia - semitendinosus, sartorial, and gracilis and they are separated from tibia by the anserine bursa, bursitis of which causes medial knee pain

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22
Q

Why are both heads of the biceps femoris not always paralyzed after nerve injury in the posterior thigh?

A

Different nerves. Long head = tibial division of sciatic. Short head = common fibular division

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23
Q

Why does complete section of the sciatic nerve, although uncommon, cause loss of ipsilateral lower limb function?

A

Its divisions innervate most, if not all of the lower limb. Happens if hypertrophy occurs in the piriformis or some trauma to the gluteal region

24
Q

What supplies the hamstring muscles

A

Deep artery of the thigh

25
Q

What supplies the gluteal region

A

The gluteal arteries

26
Q

Describe the course of the tibial nerve, popliteal artery/vein, and common fibular nerve through the popliteal fossa

A

Tibial nerve and popliteal artery/vein through the center and common fibular around the lateral border

27
Q

Name the borders of the popliteal fossa

A

Superomedial - Semimembranosus
Superolateral - biceps femoris
Inferomedial - medial head of gastrocnemius
Inferolateral - gastrocnemius

28
Q

Popliteus muscle

A

Lateral condyle of femur to superoposteriar tibia, separates the LCL and lateral meniscus and forms floor of popliteal fossa

29
Q

What muscles unlocks knee and how?

A

Popliteus by rotating femur 5 degrees laterally

30
Q

What arteries anastomose around the knee for collateral circulation and whats the importance

A

Branches of the popliteal, the anterior tibial, and femoral arteries. Importance is to make sure that if the vessels are occluded or the knee is flexed for too long, blood still gets to where it needs to go

31
Q

What artery supplies the fibulas longus and braves and other muscles on the lateral side of posterior leg

A

fibular artery

32
Q

What artery supplies posterior of leg

A

Posterior tibial artery

33
Q

Why can palpation of the popliteal arterial pulse be difficult and what can cause its weakening or absence?

A

Artery is deep. Weakening is a sign of femoral artery obstruction

34
Q

Where is the posterior tibial pulse palpated and why is its absence in people over 60 related to intermittent claudication?

A

Between the medial malleolus and medial border of calcaneal tendon. Sign of occlusive peripheral artery disease in people older than 60. Intermittent claudication (leg pain and cramps) is a result of ischemia of the leg muscles

35
Q

Gastrocnemius

A

Distal end of femur to calcaneal tendon to calcaneal tuberosity

36
Q

Soleus

A

Fibula and tibia to calcaneal tendon which goes to the calcaneal tuberosity

37
Q

Plantaris

A

long tendon joins the calcaneal tendon. Used for grafting without any compromise of plantarflexion

38
Q

What muscles plantar flex foot?

A

Gastrocnemius and soleus along with plantaris

39
Q

Why does rupture of the calcaneal tendon cause the most severe acute problem of the leg?

A

Cannot plantar flex against resistance so there is excessive dorsiflexion. Walking is difficult

40
Q

What does the tibial nerve innervate

A

Superficial and deep muscles of the posterior leg

41
Q

Tom, dick, harry flexors

A

Tibialis posterior, flexor digitorum longus, and flexor hallucis longus all go around the medial malleolus of the tibia.

42
Q

Ankle joint

A

superior aspect of talus with eh tibial medial malleolus and fibular lateral malleolus

43
Q

Ligaments of the ankle joint

A

Anterior talofibular, posterior talofibular, and calcaneofilbular ligaments are the lateral side. The medial side is the deltoid or strong medial ligament (much stronger than lateral)

44
Q

Why is a Pott fracture-dislocation of the ankle erroneously called a trimalleolar fracture?

A

Foot is forcibly everted, the medial ligament is torn causing the medial malleolus to be torn off, talus moves laterally shearing off the lateral malleolus or distal fibula causing the tibia to go anteriorly and shear off the distal tibia

45
Q

What joint does inversion and eversion go across?

A

The subtalar joint, part of the the talocalcaneonavicular joint

46
Q

Why are comminuted fractures of the calcaneus usually disabling?

A

Disrupts the subtalar joint where the talus articulates with the calcaneus

47
Q

Purpose of the arches of the foot.

A

Springboards to help the FHL propel the foot off the ground

48
Q

What provides support for the medial longitudinal arch

A

Plantar calcaneonavicular ligament (spring ligament) and plantar aponeurosis provides passive support along with tendons of tibias posterior and flexor digitorum longus that provide active support

49
Q

What causes acquired flatfeet and how do they differ from rigid flatfeet?

A

Acquired is from dysfunction of the tibias posterior due to trauma, degeneration with age, or nerve damage. Rigid is from bone deformity from childhood

50
Q

When is pain from this inflammatory condition, plantar fasciitis, most severe, when does it dissipate, and how is it exacerbated?

A

Severe after sitting. Dissipates from 5-10 min of activity and is exacerbated by dorsiflexion of the ankle or weight-bearing. Passive extension of the toe causes problems

51
Q

What nerve supplies the plantar surface of foot

A

The tibial branches posterior to the medial malleolus into medial and lateral plantar nerves

52
Q

What innervates the dorsum of the foot and the lateral side of ankle

A

Superficial fibular nerve

53
Q

What innervates skin between 1st and 2nd toes

A

Deep fibular nerve

54
Q

What innervates the lateral side of foot and where does it come from

A

The sural nerve formed by the branches of the tibial and common fibular nerves

55
Q

Why can injury of the sciatic nerve in the gluteal region cause loss of sensation from the foot?

A

The sciatic nerve innervates the foot

56
Q

Describe the course of the posterior tibial artery and what it becomes

A

Posterior to medial malleolus and bifurcates into the medial and lateral plantar arteries

ACE Unit 1 (8 decks)

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