Test 3 content Flashcards
Plantar fasciitis is
A common cause of heel pain, especially for joggers; results from inflammation of the plantar aponeurosis at its point of attachment for the calcaneus with pain radiating towards the toes
Plantar aponeurosis
Located just beneath the skin of the sole of the foot and overlaying the superficial layer of intrinsic muscles; a broad flat tendon that stretches form the heel to the toes
PAD
Palmar interossei
ADDuct the fingers
DAB
Dorsal interossei
ABduct the fingers
What is the patella
Triangle shaped sesamoid bone in the tendon of the quadriceps (spec. Rectus femoris)
Base
The flat superior edge of patella
Apex
The more pointed inferior edge of patella
Posterior view of patella includes (3)
Vertical ridge
Medial articular facet
Lateral articular facet
(Facets articulate w/ patellar surface of femur and medial and lateral consumes of the femur depending on where in the range it is)
The knee includes which 2 joints ?
Tibiofemoral
Patellofemoral
Knee consists of 3 articulations :
Lateral condyle of the tibia articulates with the lateral femoral condyle
Medial condyle of the tibia articulates with the medial femoral condyle
Patella articulates with the femur
What type of joint is the tibiofemoral joint?
Synovial
Modified hinge (allows for some rotation)
Biaxial
What are the available movements of the knee (tibiofemoral joint)
Flexion Extension Internal rotation (limited) External rotation (limited) Note: Rotation occurs only when knee is flexed
What type of joint is the patellofemoral joint
Synovial
Plane
Medial and lateral facets of the patella articulate with
The patellar surface of the femur
The patella moves _____ during flexion and ____ & ______ during extension
inferiority during flexion
Superiorly and laterally during extension
The lateral femoral condyle does what to prevent the patella from tracking too far laterally
The lateral femoral condyle projects farther anteriorly than the medial femoral condyle to prevent lateral tracking of the patella
Most patella dislocate in what direction?
Laterally
Valgus presentation
(Go out)
Lateral deviation of the distal bones of a joint
Aka knock knee
Varus presentation
(Return)
Medial deviation of the distal bone of a joint
Aka bow-leg
(LCL) lateral collateral ligament
Attaches what to what and restricts what action?
Attaches the lateral epicondyle of the femur to the fibular head
Checks/restricts varus deviation
(MCL) medial collateral ligament attaches what to what and restricts what action?
MCL) medial collateral ligament attaches the medial epicondyle of the femur to the medial epicondyle of the tibia
Checks/restricts valgus deviation
ACL anterior cruciate ligament attaches what to what?
When is it slack and when is it taut?
What movements does it check/restrict?
Attaches the anterior intercondylar area of the tibia to the posterior and medial side of the lateral femoral condyle
Slack when the knee is flexes and taut when the knee is in full extension
Checks anterior translation of the tibia on the femur (or posterior translation of the femur on the tibia) and knee extension
Posterior cruciate ligament (PCL) attaches what to what?
Is slack and taut when?
Checks what movement?
PCL Attaches the posterior intercondylar area of the tibia to the anterior and lateral side of the medial femoral condyle
Is slack when the knee is in extension and taut when the knee is in full flexion
Check the posterior translation of the tibia on the femur and knee flexion
Cruciate ligaments are named for…
Where they attach on the tibia
Eg, the anterior cruciate ligament attaches anteriorly on the tibia
What is the shape, make up, and purpose of the menisci of the knee?
To what are they attached?
C-shaped plates
Made of fibrocartilage attached to the articular surfaces of the tibia
Centre is thinner than outer edge
They are slightly mobile and aid in spreading synovial fluid during knee movement
Function as shock absorbers And to deepen articulation of tibia and femur
The medial meniscus Is attached to the medial collateral ligament
And the 2 meniscii are connected anteriorly by the transverse ligament of the knee
Screw home mechanism of the knee involves
the screw home mech of the knee is when the knee is fully extended, the tibia rotates laterally, locking the knee into a more stable position to flex the knee. The popliteus medically rotates the tibia to “unlock” the knee and allow it to flex
Popletieus is referred to as
The key to the knee because it “unlocks” the screw home mechanism
Popliteus has what attachment sites and does what actions
Attaches superiorly to the lateral condyle of the femur
Attaches inferiority to the posterior proximal surface of the tibia
Actions: flexion of the knee (weak) and medial rotation of the knee (key)
The tibia, fibula, interosseous membrane, and inter muscular septa divide the leg into what compartments (4)
Anterior compartment
Lateral compartment
Superficial posterior compartment
Deep posterior compartment
Muscles in the same compartment share what 3 aspects?
General function
Nerve supply
Blood supply
Tibialis anterior has what attachments and preforms what actions?
Proximal attachment: anterior, lateral, superior half of the tibia, interosseous membrane
Distal attachment: base of the 1st MT, 1st medial cuneiform (plantar surface)
Actions: Doris flexion and inversion
Eccentric contraction: when your heel strikes the ground and rest of foot slaps on the ground (food drop
Extensor hallucis longus attachments and actions
Superior attachment: anterior middle fibula and interosseous membrane
Distal attachment: base of the distal phalanx of the 1st toe (dorsal surface)
Action: extension of the MTP, IP of 1st toe
Assists with Dorisiflexion, inversion
What muscles are found in the anterior compartment from medial to lateral?
T- tibialis
E - extensor hallucis longus
E - extensor digitorum longus
Tom
Harry
Dick
Patrick - peroneus tertius
What muscles are in the superficial posterior compartment
G - gastrocnemius
P - plantaris
S- soleus
Extensor digitorum longus attachments and actions
Proximal attachment: proximal 3/4 of the anterior fibula, interosseous membrane
Distal attachment: middle and distal phalanges of lateral 4 toes (dorsal surface)
Action: dorsiflexion, eversipn, extension of the MTPs, PIPs, and DIPs 2nd-5th digits
Peroneus tertius attachments and actions
Proximal attachment: anterior distal fibula
Distal attachment: base of the 5th MT (dorsal surface)
Action: dorsiflexion (weak) and eversion (weak)
What is the purpose of the inferior and superior extensor retinaculum?
Prevents the tendons from bowing as the muscles contract
What is the purpose of the tendon sheath?
Where there is the possibility of friction betw the tendons and the retinacula a tendon sheath surrounds the tendon
Includes CT outer layer for structure and a synovial layer for lubrication as the tendons move
Peroneus longus attachments and actions
Superior attachment: lateral proximal 2/3 of fibula
Inferior attachment: base of the 1st MT, 1st medial cuneiform (plantar surface)
**passes through the tunnel formed by the extensions of the long plantar ligament
Action: plantar flexion and eversion
***forms a stirrup with tibialis anterior at the base of the 1st MT. This sling supports transverse arch.
Another aka for peroneus longus and brevis
Fibularis longus and brevis
Peroneus brevis attachments and actions
Superior attachment: lateral distal 2/3 of the fibula
Inferior attachment: tuberosity of the 5th MT
Actions: plantar flexion and eversion
Gastrocnemius attachments and actions
Superior attachment: 2 heads attach to the medial and lateral femoral condyles
Inferior attachment: calcaneus (via Achilles’ tendon)
Actions: plantar flexion and knee flexion (weak)
Soleus Attachments and actions
Superior attachment: proximal posterior fibula, soleal line (tibia), middle 1/3 of medial border of the tibia
Interior attachment: calcaneus (via Achilles’ tendon)
Action: plantar flexion
Gastrocnemius and soleus together are known as
Triceps surae
Plantaris attachments and actions
Superior attachment: distal lateral supracondylar ridge of the femur
Inferior/distal attachment: calcaneus
Action: plantar flexion and knee flexion (weak)
Tibialis posterior attachments and actions
Superior attachment: posterior tibia, interosseous membrane, fibula
Interior attachment: navicular tuberosity and surrounding bones (cuneiform, cuboid, based off 2-4th MTs)
Action: plantar flexion and inversion
Flexor hallucis longus attachments and actions
Superior attachment: lower 2/3 of posterior fibula, interosseous membrane
Inferior attachment: plantar surface of 1st distal phalanx
Actions: 1 MTP, 1 IP flexion
Plantar flexion (crossing over ankle)
Flexor digitorum longus attachments and actions
Superior attachment: posterior middle tibia
Inferior attachment: plantar surface of distal phalanges of lateral 4 toes
Action: PIP/DIP, MTP flexion of 2-5 digits
Plantar flexion
Where do the posterior compartment muscle tendons pass at the ankle?
They pass behind the medial malleolus.
Note the flexor retinaculum - this forms a tunnel called the tarsal tunnel which is clinically relevant.
Possible causes for tarsal tunnel syndrome include prolonged eversion/probation, chronic tendinitis
Stages of rheumatoid arthritis
- Synovitis
- Pannus
- Fibrous ankylosis
- Bony ankylosis
Gradual breakdown of cartilage and fusion of bones
