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

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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4
Q

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

A

Soleal line

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5
Q

Name all the tarsal bones.

A
Talus 
Calcaneus 
Cuboid 
Navicular 
Cuneiforms (1, 2 + 3)
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6
Q

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

A
Transverse tarsal joint (between calcaneus + talus and navicular + cuboid)
Tarsometatarsal joint (between the most distal tarsal bones + metatarsals)
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7
Q

How many phalanges does each of the digits have?

A

Big toe: 2

All other toes: 3

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8
Q

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

A

On plantar 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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9
Q

Which tarsal bones have tuberosities?

A

Navicular + Cuboid

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10
Q

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

A

Medial + lateral longitudinal arches

Transverse arches

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11
Q

Which bones make up the forefoot, midfoot and hindfoot?

A

Hindfoot: calcaneus + tallus
Midfoot: cuboid, navicular + cuneiforms
Forefoot: metatarsals + phalanges

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12
Q

Which muscles of the anterior compartment of the thigh act across the knee?

A

Tensor fasciae latae
Sartorius
Quadriceps

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13
Q

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

A

Gracilis

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14
Q

Describe the arrangement of the three hamstrings.

A

Biceps femoris lies more laterally (its short head comes off linea aspera) + inserts into fibula
Semitendinosus + semimembranosus are more medial + insert into the tibia

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15
Q

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

A

Dorsiflexion of the ankle (extensors, toes pointing up)

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16
Q

Which nerve supplies the anterior compartment of the leg?

A

Deep peroneal nerve

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17
Q

Which artery supplies the anterior compartment of the leg?

A

Anterior tibial artery

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18
Q

Which muscles are found in the anterior compartment of the leg?

A

Tibialis Anterior
Extensor Digitorum Longus
Extensor Hallucis Longus

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19
Q

Describe the structure and attachment of tibialis anterior.

A

Lateral surface of the head of the tibia + 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

Contribute to dorsiflexion

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23
Q

Which nerve supplies the lateral compartment of the leg?

A

Superficial peroneal nerve

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24
Q

Which artery supplies the lateral compartment of the leg?

A

Peroneal artery

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25
Q

Describe the structure and attachments of the two muscles the lateral compartment of the leg.

A

Both attach to the shaft of the fibula + run along the lateral side of the leg, behind the lateral malleolus, then:
Brevis: attaches to base of 5th metatarsal
Longus: attaches to 1st metatarsal + medial cuneiform

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26
Q

Which muscles are in the posterior compartment of the leg?

A
Superficial:
Gastrocnemius
Soleus
Plantaris
Deep:
Flexor digitorum longus 
Flexor hallucis longus 
Tibialis posterior
Popliteus
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27
Q

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

A

Plantarflexion of the ankle

Flexion of the digits

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28
Q

Which nerve innervates the muscles in the posterior compartment?

A

Tibial nerve

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29
Q

Which artery supplies the posterior compartment of the leg?

A

Posterior tibial artery

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30
Q

What are the proximal attachments of gastrocnemius?

A

It attaches to the medial + lateral condyles of the femur

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31
Q

Which of the superficial posterior compartment muscles does not cross the knee?

A

Soleus

32
Q

Describe the distal attachment of gastrocnemius and soleus.

A

Gastrocnemius + soleus fibres come together to form 1 tendon – Achilles tendon (calcaneal tendon)

33
Q

What is the collective term given to the gastrocnemius and soleus?

A

Triceps surae

34
Q

Describe the attachments of popliteus and explain the importance of this muscle.

A

Popliteus goes from lateral femoral condyle to the posterior surface of the tibia
Important in unlocking the knee when it needs to be flexed

35
Q

Describe the positions of the long tendons (tibias posterior, FDL and FHL) relative to the medial malleolus.

A

They pass behind the medial malleolus

36
Q

Describe the arrangement of muscles in the sole of the foot.

A

4 layers of muscles

intrinsic muscles

37
Q

Describe the arrangement of muscles in the dorsum of the foot.

A

2 muscles:
Extensor digitorum brevis
Extensor hallucis brevis

38
Q

Which nerve supplies extensor digitorum brevis?

A

Common peroneal nerve

39
Q

Which nerves supply the majority of intrinsic foot muscles?

A

The tibial nerve via the medial + lateral plantar nerves

40
Q

Which muscles are found in layer 1 of the sole?

A

Abductor hallucis
Abductor digiti minimi
Flexor digitorum brevis

41
Q

Which muscles are found in layer 2 of the sole?

A

Lumbricals (1-4)

Quadratus plantae

42
Q

Which muscles are found in layer 3 of the sole?

A

Flexor hallucis brevis
Flexor digiti minimi brevis
Adductor hallucis

43
Q

Which muscles are found in layer 4 of the sole?

A
Palmar interossei (1-3)
Dorsal interossei (1-4)
44
Q

Which tendon are the lumbricals and quadratus plantae attached to?

A

Tendon of flexor digitorum longus

45
Q

What are the boundaries of the popliteal fossa?

A
Superior lateral: biceps femoris
Superior medial: semimembranosus 
Inferior: medial + lateral heads of gastrocnemius
Floor: femur 
Roof: skin + fascia
46
Q

What are the contents of the popliteal fossa?

A

Popliteal artery + vein
Common peroneal nerve + tibial nerve
Short saphenous vein
Popliteal lymph nodes

47
Q

Where does the short saphenous vein drain?

A

Into the popliteal vein

48
Q

What does the sural nerve come off?

A

It is formed from a branch of the tibial nerve + a smaller branch of the common peroneal nerve

49
Q

What type of joint is the knee?

A

Synovial hinge joint

50
Q

What part of the femur does the patella articulate with?

A

Intercondylar region of the femur

51
Q

What are the two articulations between the femur and the tibia?

A

Medial + lateral femorotibial articulations

52
Q

Describe the attachments of the posterior and anterior cruciate ligaments

A

Anterior: Anteriorly attached to intercondylar tibia, the goes back + attaches to femur
Posterior: Posteriorly attached to tibia + comes anterior to femur

53
Q

What is the main difference between the medial and lateral menisci?

A

Medial collateral ligament is attached to the medial meniscus
Lateral meniscus is separate to the lateral collateral ligament

54
Q

Name the bursae that are found around the knee.

A
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
Q

What is the main difference between the proximal tibiofibular joint and the distal tibiofibular joint?

A

Proximal tibiofibular: synovial joint, capsular ligaments limit movement
Distal tibiofibular: fibrous joint
Both move slightly during dorsiflexion + plantarflexion

56
Q

Which ligaments are most commonly damaged in the ankle?

A

Lateral ligaments:
Anterior talofibular
Posterior talofibular
Calcaneofibular

57
Q

Name a broad ligament on the medial side of the ankle that is rarely damaged.

A

Deltoid Ligament

Tibiocalcaneal ligament

58
Q

What larger joint are the talo-calcaneonavicular and calcaneocuboid joints a part of?

A

Transverse tarsal joint (aka mid-tarsal joint)

59
Q

What are the three arches of the foot?

A

Lateral longitudinal arch
Medial longitudinal arch
Transverse metatarsal arch

60
Q

What structures help maintain the arches of the foot?

A

Ligaments + long tendons

61
Q

Which vessel do the circumflex femoral arteries come from?

A

Profunda femoris

62
Q

What is the popliteal trifurcation?

A

Division of the popliteal artery into the:
Anterior tibial artery (anterior compartment)
Posterior tibial artery (posterior compartment)
Peroneal artery (lateral compartment)

63
Q

What are the two main arteries of the foot and which parts of the foot do they supply?

A
Dorsalis pedis (continuation of anterior tibial artery): dorsal part of the foot + digits 
Posterior tibial artery: sole of foot (via the medial + lateral plantar arteries)
64
Q

What does the anterior tibial artery have to go through to access the anterior compartment?

A

Interosseous membrane

65
Q

What is the arch shaped artery on the dorsum of the foot?

A

Arcuate artery

66
Q

Which small arteries supply the digits?

A

Dorsal + plantar digital arteries

67
Q

What are the main superficial veins draining the foot and leg?

A

Long saphenous vein (from medial end of dorsal venous arch, anterior to medial malleolus + along the medial side of the leg)
Short saphenous vein (from lateral end of dorsal venous arch, posterior to lateral malleolus)

68
Q

Where does the great saphenous vein drain?

A

It passes along the medial side of the leg + thigh, pierces through saphenous opening + drains into the femoral vein

69
Q

Where does the short saphenous vein drain?

A

Into the popliteal vein

70
Q
State the motor nerve supply for:
Hip Flexors 
Hip Extensors 
Knee Extensors 
Knee Flexors 
Ankle Dorsiflexors 
Ankle Plantarflexors
A
Hip Flexors: L2,3
Hip Extensors: L4,5
Knee Extensors: L3,4
Knee Flexors: L5-S1
Ankle Dorsiflexors: L4,5
Ankle Plantarflexors: S12
71
Q

What is a good way of remembering some of the sensory segmental supply?

A

L3 to the knee
L4 to the floor
L5 to the great toe
S1 to the lateral + sole of the foot

72
Q

What does the tibial nerve divide into as it passes behind the medial malleolus?

A

Medial + lateral plantar nerves

73
Q

The tibial nerve supplies all intrinsic foot muscles except one. Name this muscle.

A

Extensor digitorum brevis

74
Q

What is the sural nerve made up of?

A

A branch of the tibial nerve + a smaller branch of the common peroneal nerve
Can be used in nerve repair

75
Q

Which tendon runs between the sesamoid bones of the foot?

A

Flexor hallucis longus tendon

76
Q

What does the common perineal nerve supply?

A

Deep peroneal nerve: Anterior compartment

Superficial peroneal nerve: Lateral compartment