The knee, leg, ankle and foot Flashcards

1
Q

What is the small protrusion in the middle of the tibial plateau called?

A

Intercondylar eminence

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2
Q

What inserts into the tibial tuberosity?

A

Patellar tendon (through which the quadriceps act)

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3
Q

Which bone in the leg does not bear any weight?

A

Fibula

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4
Q

What protrusions in the ankle do the distal ends of the tibia and fibula form?

A

Tibia – medial malleolus

Fibula – lateral malleolus

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5
Q

What is the name of the ridge running obliquely down the posterior surface of the tibia?

A

Soleal line

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6
Q

Name all the tarsal bones.

A
Tallus 
Calcaneus 
Cuboid 
Navicular 
Cuneiforms (1, 2 and 3)
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7
Q

What are the two main joints in the foot and where do they lie?

A
Transverse tarsal joint (between calcaneus + tallus and navicular + cuboid)
Tarsometatarsal joint (between the most distal tarsal bones and the metatarsals)
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8
Q

How many phalanges does each of the digits have?

A

Big toe – 2

All other toes - 3

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9
Q

Where are sesamoid bones found in the foot and which tendon do these bones lie in?

A

On the dorsal surface of the foot, beneath the metatarsophalangeal joint of the big toe
It lies in the tendon of flexor hallucis brevis

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10
Q

Which tarsal bones have tuberosities?

A

Navicular and Cuboid

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11
Q

What are the three arches that are formed when the bones of the foot fit together?

A

Medial and lateral longitudinal arches

Transverse arches

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12
Q

Which bones make up the forefoot, midfoot and hindfoot?

A

Hindfoot – calcaneus and tallus
Midfoot – cuboid, navicular and cuneiforms
Forefoot – metatarsals and phalanges

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13
Q

Which muscles of the anterior compartment of the thigh do not act across the knee?

A

Iliopsoas and Pectineus

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14
Q

Which muscle in the medial compartment of the thigh acts across the knee?

A

Gracilis

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15
Q

Describe the arrangement of the three hamstrings.

A

Biceps femoris lies more laterally (its short head comes from the lateral lip of the linea aspera) and inserts into fibula
Semitendinosus and semimembranosus are more medial and insert into the tibia

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16
Q

What movement is the anterior compartment of the leg responsible for?

A

Dorsiflexion of the ankle

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17
Q

Which nerve supplies this compartment?

A

Deep peroneal nerve

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18
Q

Which artery supplies this compartment?

A

Anterior tibial artery

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19
Q

Describe the structure and attachment of tibialis anterior.

A

Lateral surface of the head of the tibia and travels medially
Goes in front of the medial malleolus
Attaches to the medial cuneiform + 1st metatarsal

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20
Q

What are the names of the two extensor retinacula in the foot?

A

Superior extensor retinaculum

Inferior extensor retinaculum

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21
Q

Which muscles are in the lateral compartment of the leg?

A

Peroneus longus

Peroneus brevis

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22
Q

What movement is the lateral compartment responsible for?

A

Eversion of the foot

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23
Q

Which artery and nerve supply the lateral compartment of the leg?

A

Superficial peroneal nerve

Peroneal artery

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24
Q

Describe the structure and attachments of the two muscles in this compartment.

A

Both the muscles attach to the shaft of the fibula and run along the lateral side of the leg, behind the lateral malleolus and then:
Brevis – attaches to the base of the 5th metatarsal
Longus – attaches to 1st metatarsal and medial cuneiform (same as tibialis anterior but on the plantar surface)

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25
Which muscles are in the posterior compartment of the leg?
Superficial: Gastrocnemius Soleus Plantaris ``` Deep: Flexor digitorum longus Flexor hallucis longus Tibialis posterior Popliteus ```
26
What movement is the posterior compartment of the leg responsible for?
Plantarflexion of the ankle | Flexion of the digits
27
Which nerve innervates the muscles in the posterior compartment?
Tibial nerve
28
Which artery supplies the posterior compartment?
Posterior tibial artery
29
What are the proximal attachments of gastrocnemius?
It attaches to the medial and lateral condyles of the femur
30
Which of the superficial posterior compartment muscles does not cross the knee?
Soleus
31
Describe the distal attachment of gastrocnemius and soleus.
Gastrocnemius and soleus fibres come together to form one tendon – Achilles tendon (calcaneal tendon)
32
What is the collective term given to the gastrocnemius and soleus?
Triceps surae
33
Describe the attachments of popliteus and explain the importance of this muscle.
Popliteus goes from the lateral condyle of the femur to the posterior surface of the tibia (near the soleal line) It is important in unlocking the knee when it needs to be flexed
34
Describe the positions of the long tendons relative to the medial malleolus.
They pass behind the medial malleolus
35
Describe the arrangement of muscles in the sole of the foot.
There are 4 layers of muscles
36
Describe the arrangement of muscles in the dorsum of the foot.
There are 2 muscles
37
Which nerve supplies extensor digitorum brevis?
Deep peroneal nerve
38
Which nerves supply the majority of intrinsic foot muscles?
The tibial nerve via the medial and lateral plantar nerves
39
Which muscles are found in layer 1 of the sole?
Abductor hallucis Abductor digiti minimi Flexor digitorum brevis
40
Which muscles are found in layer 2 of the sole?
Lumbricals | Quadratus plantae
41
Which muscles are found in layer 3 of the sole?
Flexor hallucis brevis Flexor digiti minimi brevis Adductor hallucis
42
Which muscles are found in layer 4 of the sole?
Palmar interossei | Dorsal interossei
43
Which tendon are the lumbricals and quadratus plantae attached to?
Tendon of flexor digitorum longus
44
What are the two muscles on the dorsal surface of the foot?
Extensor hallucis brevis | Extensor digitorum brevis
45
What are the boundaries of the popliteal fossa?
``` Superior lateral – biceps femoris Superior medial – semimembranosus Inferior – medial and lateral heads of gastrocnemius Floor – femur Roof – skin and fascia ```
46
What are the contents of the popliteal fossa?
Popliteal artery and vein Common peroneal nerve and tibial nerve Short saphenous vein Popliteal lymph nodes
47
Where does the short saphenous vein drain?
Into the popliteal vein
48
What does the sural nerve come off?
It is formed from a branch of the tibial nerve (medial cutaneous sural nerve) and a smaller branch of the common peroneal nerve (sural communicating branch)
49
What type of joint is the knee?
Synovial hinge joint
50
What part of the femur does the patella articulate with?
Intercondylar region of the femur
51
What are the two articulations between the femur and the tibia?
Medial and lateral femorotibial articulations
52
Which sides of the intercondylar fossa do the cruciate ligaments attach to?
Anterior cruciate – lateral | Posterior cruciate – medial
53
What is the main difference between the medial and lateral menisci?
The medial collateral ligament is attached to the medial meniscus The lateral meniscus is separate to the lateral collateral ligament
54
Name the bursae that are found around the knee.
``` Suprapatellar bursa Subcutaneous pre-patellar bursa Subtendinous pre-patellar bursa Subcutaneous infrapatellar bursa Deep infrapatellar bursa Popliteal bursa Gastrocnemius bursa Semimembranosus bursa Anserine bursa ```
55
What is the main difference between the proximal tibiofibular joint and the distal tibiofibular joint?
Proximal tibiofibular – synovial joint Distal tibiofibular – fibrous joint NOTE: they both move slightly during dorsiflexion and plantarflexion of the foot
56
Which ligaments are most commonly damaged in the ankle?
Lateral ligaments: Anterior talofibular Posterior talofibular Calcaneofibular
57
Name a broad ligament on the medial side of the ankle that is rarely damaged.
``` Deltoid Ligament Anterior tibiotalar ligament Posterior tibiotalar ligament Tibiocalcaneal ligament Tibionavicular ligament ```
58
What larger joint is the talo-calcaneonavicular joint a part of?
Transverse tarsal joint (aka mid-tarsal joint)
59
What are the three arches of the foot?
Lateral longitudinal arch Medial longitudinal arch Transverse arch
60
What structures help maintain these arches?
Ligaments and long tendons
61
Which vessel do the circumflex femoral arteries come from?
Profunda femoris
62
What is the popliteal trifurcation?
Division of the popliteal artery into the: Anterior tibial artery Posterior tibial artery Peroneal artery
63
What are the two main arteries of the foot and which parts of the foot do they supply?
Dorsalis pedis – dorsal part of the foot and digits | Posterior tibial artery – sole of the foot (via the medial and lateral plantar arteries)
64
What does the anterior tibial artery have to go through to access the anterior compartment?
Interosseous membrane
65
What is the arch shaped artery on the dorsum of the foot?
Arcuate artery
66
Which small arteries supply the digits?
Dorsal and plantar digital arteries
67
What are the main superficial veins draining the foot and leg?
Long saphenous vein (from the medial end of the dorsal venous arch, going 2 cm above and lateral to the medial malleolus and along the medial side of the leg) Short saphenous vein (from the lateral end of the dorsal venous arch, going behind the lateral malleolus)
68
Where does the great saphenous vein drain?
It passes along the medial side of the leg and it drains into the femoral vein at the saphenofemoral junction
69
``` State the motor nerve supply for: Hip Flexors Hip Extensors Knee Extensors Knee Flexors Ankle Dorsiflexors Ankle Plantarflexors ```
``` Hip Flexors: L23 Hip Extensors: L45 Knee Extensors: L34 Knee Flexors: L5S1 Ankle Dorsiflexors: L45 Ankle Plantarflexors: S12 ```
70
What is a good way of remembering some of the sensory segmental supply?
L3 to the knee L4 to the floor L5 to the great toe S1 to the lateral side and sole of the foot
71
What does the tibial nerve divide into is it passes behind the medial malleolus?
Medial and lateral plantar nerves
72
The tibial nerve supplies all intrinsic foot muscles except one. Name this muscle.
Extensor digitorum brevis - Deep fibular nerve
73
What is the sural nerve made up of?
A branch of the tibial nerve (medial sural cutaneous nerve) and a smaller branch of the common peroneal nerve (sural communicating branch) NOTE: it can be used in nerve repair
74
Which muscles are found in this compartment?
Tibialis Anterior Extensor Digitorum Longus Extensor Hallucis Longus