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ESA 2 > The Lower Limb > Flashcards

The Lower Limb Flashcards

0
Q

Give the muscles that make up the medial compartment of the thigh

A 
Adductor magnus
Adductor longus
Adductor brevis
Obturator externus
Gracialis
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1
Q

State the muscles that make up the anterior compartment of the thigh

A

Ilipsoas - psoas major and iliacus
Quadriceps femoris - vastus medialis, intermedius and lateralis, and rectus femoris
Satorius
Pectineus

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2
Q

What is the most superficial and medial muscle in the medial compartment of the thigh?

A

Gracialis

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3
Q

What is the smallest, most superior muscle of the medial compartment of the thigh?

A

Obturator externus

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4
Q

What is the largest muscle of the medial compartment and where is it located in relation to the other muscles?

A

Adductor magnus

Posterior

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5
Q

What is the longest muscle in the body that is located in the thigh?

A

Sartorius

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6
Q

What nerve innervates the majority of the anterior compartment of the thigh, and what is the exception?

A

Femoral nerve

Psoas major - anterior rami of L1-L3

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7
Q

Function of the psoas major

A

Flex the lower limb at the hip and assists in lateral rotation

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8
Q

Innervation of psoas major

A

Anterior rami of L1-L3

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9
Q

Function of iliacus

A

Flex the lower limb at the hip and assists in lateral rotation

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10
Q

Innervation of iliacus

A

Femoral nerve

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11
Q

What muscles make up the ilipsoas?

A

Psoas major

Iliacus

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12
Q

What muscles make up the quadriceps femoris

A

Vastus medialis
Vastus intermedius
Vastus lateralis
Rectus femoris

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13
Q

Function of the vastus muscles

A

Extend the knee

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14
Q

Innervation of the vastus muscles

A

Femoral nerve

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15
Q

Innervation of the rectus femoris

A

Femoral nerve

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16
Q

Function of the sartorius

A

Flexes, abducts and laterally rotates at the hip joint

Flexes at the knee

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17
Q

Innervation of sartorius

A

Femoral nerve

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18
Q

Function of pectineus

A

Adduction and flexion at the hip joint

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19
Q

Innervation of pectineus

A

Femoral nerve

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20
Q

How and why would you test the quadriceps femoris?

A

Do for suspected femoral nerve damage.
Patient lies supine with the knee slightly flexed. Ask the patient to extend the leg and resist the movement. Should be able to clearly see the contraction.

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21
Q

Which nerve and artery supplies the majority of the medial compartment of the thigh?
What is the exception?

A

Obturator nerve
Obturator artery
Hamstring part of adductor magnus innervated by the tibial nerve

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22
Q

Function of the two parts of the adductor magnus.

A

Adductor part - adducts and flexes the thigh

Hamstring part - adducts and extends the thigh

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23
Q

Innervation of the two parts of adductor magnus

A

Adductor - obturator nerve

Hamstring - tibial nerve

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24
Q

Function of adductor longus

A

Adducts and medially rotates the thigh

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25
Q

Innervation of adductor longus

A

Obturator nerve

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26
Q

Function of adductor brevis

A

Adduction of the thigh

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27
Q

Innervation of adductor brevis

A

Obturator nerve

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28
Q

Function of obturator externus

A

Lateral rotation of the thigh

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29
Q

Innervation of obturator externus

A

Obturator nerve

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30
Q

Function of gracialis

A

Adduction of the thigh at the hip and flexion of the leg at the knee

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31
Q

Innervation of gracialis

A

Obturator nerve

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33
Q

Describe injury to the adductor muscles and the treatment you would recommend.

A

‘Groin strain’
Proximal part of the muscles affected, tearing near their bony attachments
RICE protocol - rest, ice, compression, elevate

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34
Q

Describe the main function of the fibula.

A

An attachment for muscles

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35
Q

What if the lateral surface of the fibula that extends inferiorly called?

A

Lateral malleolus

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36
Q

Describe how the lateral malleolus is prone to fracture

A

Forced external rotation of the ankle so force is exerted on it by the talus, causing a spiral fracture.
Or eversion causing a transverse fracture.

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37
Q

Describe the main function of the tibia

A

Weight bearing

Articulates at the knee and ankle joints

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38
Q

Describe the intercondylar eminence

A

Two tubercles and a roughened area which are the main sites for attachments of the menisci and ligaments of the knee joint.

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39
Q

Where does the patellar ligament attach on the tibia?

A

Tibial tuberosity

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40
Q

What marks the posterior surface of the tibial shaft?

A

Scleal line

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41
Q

What is attached to the lateral border of the tibial shaft?

A

Interosseus membrane

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42
Q

What part of the distal tibia articulates with the tarsal bones to form the ankle joint?

A

Medial malleolus

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43
Q

What does the head of the femur articulate with at the hip?

A

Acetabulum of the pelvis

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44
Q

What is the importance of the head of the femur being thin?

A

Allows for increased range of movement at the hip joint

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45
Q

Describe the difference between the greater and lesser trochanters (aside from size)

A

Greater - originates from anterior shaft. Site of attachment for abductor and lateral rotator muscles of the leg.

Lesser - projects from posteromedial side. Psoas major and iliacus attach here.

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46
Q

What is the intertrochantic line in the femur?

A

A ridge of bone connecting the two trochanters where the iliofemoral ligament attaches.

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47
Q

Describe the intertrochantic crest of the femur.

A

A ridge of bone which connects the two trochanters. Has a quadrate tubercle where the quadratus femoris attaches.

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48
Q

Describe the difference between intracapsular and extracapsular fractures of the proximal femur.

A

Intracapsular - Common in the elderly, can damage the femoral circumflex artery causing avascular necrosis of the femoral head. Leg is shortened with toes pointed inward.

Extracapsular - more common in the young. Blood supply remains intact. Leg shortened and laterally rotated.

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49
Q

The femoral shaft has linea aspera, which is rough ridges of bone. Describe what this changes into proximally, distally, and on the lateral border.

A

Proximally - pectineal line
Lateral border - Gluteal tuberosity
Distally - widens to form the floor of the popliteal fossa.

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50
Q

Describe a fracture of the femoral shaft.

A

Relatively uncommon as it requires a lot of force.
Tend to be spiral fractures with leg shortening
May cause femoral nerve palsy (weakness of the quadriceps primarily) and must ensure that the blood supply hasn’t been damaged.

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51
Q

What type of joint is the knee?

A

Hinge synovial joint

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52
Q

What type of joint is the hip?

A

Ball and socket synovial joint

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53
Q

Where is the primary attachment for extensor muscles of the thigh?

A

Posterior ilium

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54
Q

Where is the primary attachment for flexor muscles of the thigh?

A

Anterior ilium

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55
Q

Where can the tensor of fascia lata be found?

A

Deep within the lateral fascia

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56
Q

Describe the changes from the aorta into the thigh.

A 
Aorta
Common iliac
(Internal iliac --> obturator)
External iliac
Femoral artery
(Popliteal artery) and
Deep artery of the thigh
- Perforating arteries
- Lateral/medial humeral circumflex
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57
Q

Describe the passage of the great saphenous vein to the femoral vein.

A

From the foot, passes anterior to the medial malleolus, up the medial surface of the thigh, then posterior to the medial condyle of the femur to the saphenofemoral junction where it becomes the femoral vein.

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58
Q

Describe the passage of the small saphenous vein.

A

Passes up the posterior calf and inserts into the popliteal vein.

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59
Q

Give the borders of the femoral triangle.

A

Superior - inguinal ligament
Lateral - medial border of sartorius
Medial - medial border of adductor longus

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60
Q

Give the contents of the femoral triangle from lateral to medial.

A

Femoral nerve
Femoral artery
Femoral vein
Some lymph

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61
Q

Where can the femoral artery be palpated?

A

At the mid-inguinal point.

Midway between the pubic symphysis and anterior superior iliac spine (ASIS)

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62
Q

Describe the femoral sheath and it’s contents.

A

Fascia coming together. Contains femoral artery and vein, and some lymph vessels and nodes.
Has a hole for the great saphenous vein

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63
Q

Describe the lacuna ligament.

A

Passes round the medial side of the femoral canal.

Is moon-shaped.

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64
Q

Describe the femoral canal.

A

Within the femoral sheath, contains just the lymph nodes. Allows slight distention of the femoral vein.

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65
Q

Describe herniation of the intestine into the femoral canal.

A

The femoral ring is a weak point.

The lacuna ligament may then constrict the blood supply, causing avascular necrosis.

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66
Q

Why is there minimal rotation of the tibia and fibula when the leg is extended?

A

The collateral ligaments are tighter

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67
Q

What bone of the foot articulates with the leg?

A

Talus

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68
Q

Describe the importance of the suprapatellar bursa.

A

Prevents rubbing on the patellar groove. Connects round and through the knee which means that an infection can easily pass deep into the joint.

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69
Q

What are osteophytes?

A

Bone spurs.

Commonly form at joints due to arthritis.

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70
Q

Describe how you could test for rupture of the calcaneus (achilles) tendon.

A

Grip the gastronemius and squeeze.

Foot won’t flex if the tendon has ruptured.

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71
Q

If a patient came in with a fractured fibula, what would you look for to see if they had damaged their fibular nerve?

A

Foot drop

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72
Q

What is the pelvic outlet?

A

The lowermost ring of bones in the pelvis

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73
Q

What is the acetabulum?

A

The socket part of the hip joint.

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74
Q

What two ligaments pass across the pelvis to form the sciatic frame?

A

Sacrospinous ligament

Sacrotuberous ligament.

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75
Q

What is the function of the intercondylar notch in the femur?

A

Stops the tibial tuberosities catching in flexion, and makes room for the cruciate ligaments.

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76
Q

Describe an upper tibial fracture

A

Also known as a bumper fracture. Causes huge swelling and pain.
Check for popliteal artery, tibial and common perineal nerve damage.
Can lead to osteoarthritis at the knee and compartment syndrome.

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77
Q

Describe a fracture of the tibial and fibular shafts.

A

Pain and swelling
Neurovascular injury
May be an open fracture so check for infection
Can lead to compartment syndrome

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78
Q

Describe a Pott’s fracture

A

Bimalleolar ankle fracture
Commonly a tackle injury
Can lead to arthritis

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79
Q

Describe an intertrochantic fracture

A

Limb shorter and externally rotated
Can’t weight bear
Swelling
No ischaemia

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80
Q

Describe a femoral shaft fracture

A

Occurs most commonly in young aducts
Can cause serious blood loss, shock, pain and swelling.
High risk for a fat embolus due to yellow marrow.

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81
Q

Describe how you would conduct a Trendelenburg test.

A

Ask the patient to stand unassisted on each leg in turn.
If positive, the pelvis will drop on the side of the unsupported leg.
Look for the level of the iliac crest on both sides.

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82
Q

State which nerve the Trendelenburg tests, and why.

A

Superior gluteal nerve
Gluteus minimus and medius normally contract when the contralateral leg is raised, preventing the unsupported pelvis from dropping on that side.tf

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83
Q

State the muscles that make up the superficial abductors and extenders in the gluteal region

A

Gluteus maximus
Gluteus medius
Gluteus minimus

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84
Q

Function of the gluteus maximus

A

Main extensor of the thigh, assists with lateral rotation.

Only used when force is required.

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85
Q

Innervation of the gluteus maximus

A

Inferior gluteal nerve

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86
Q

Function of gluteus medius

A

Abducts and medially rotates the lower limb.

Secures the pelvis during locomotion, preventing pelvic drop of the opposite limb.

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87
Q

Innervation of gluteus medius

A

Superior gluteal nerve

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88
Q

Function of gluteus minimus

A

Abducts and medially rotates the lower limb.

Secures the pelvis during locomotion, preventing pelvic drop of the opposite limb.

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89
Q

Innervation of gluteus minimus

A

Superior gluteal nerve

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90
Q

Function of the piriformis

A

Key landmark in the gluteal region

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91
Q

Innervation of piriformis

A

Nerve to piriformis

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92
Q

Function of obturator internus

A

Lateral rotation and abduction

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93
Q

What muscle forms the lateral wall of the pelvic cavity?

A

Obturator internus

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94
Q

Innervation of obturator internus

A

Nerve to obturator internus

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95
Q

Function of the superior and inferior gemelli

A

Lateral rotation and abduction

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96
Q

What separates the superior and inferior gemelli

A

Obturator internus tendon

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97
Q

State the deep muscles of the gluteal region

A

Piriformis
Obturator internus
Superior and inferior gemelli
Quadratus femoris

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98
Q

Innervation of the superior and inferior gemelli

A

Superior - nerve to obturator internus

Inferior - nerve to quadratus femoris

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99
Q

Function of quadratus femoris

A

Lateral rotation

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100
Q

Innervation of quadratus femoris

A

Nerve to quadratus femoris

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101
Q

Describe how the piriformis is an important landmark of the gluteal region.

A

Divides into anterior/superior parts.
Division determines the name of the vessels/nerves that supply the area.
Can be used to locate the sciatic nerve which enters the gluteal region directly inferior to the piriformis and is visible as a flat band.

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102
Q

What is the ligamentum teres?

A

Ligament which passes into the head of the femur from the acetabulum with the obturator artery.

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103
Q

Where is the acetabulum weakest?

A

At the bottom: acetabular notch

104
Q

What ligaments strengthen the hip joint?

A 
Acetabular transverse ligament
Iliofemoral ligament
Pubofemoral ligament
Ischiofemoral ligament
Ligamentum teres
105
Q

What part of the femoral neck is largely extracapsular?

A

Lateral

106
Q

What cartilage is present in the acetabulum before the three bones fuse?

A

Tri-radate cartilage

107
Q

What are the adductors at the hip?

A 
Adductor magnus
Adductor longus
Adductor brevis
Gracialis
Obturator interni
108
Q

What are the muscles which extend at the hip?

A

Semitendinosus
Semimembranosus
Long head of biceps femoris
Gluteus maximus

109
Q

What muscles abduct at the hip?

A

Gluteus medius
Gluteus minimus
Tensor fascia lata

110
Q

What are the lateral rotators at the hip (superior to inferior)

A 
Piriformis
Superior gemellus
Obturator internus
Inferior gemellus
Quadratus femoris
111
Q

What is the piriformis an important landmark for?

A

Sciatic nerve, which usually runs beneath it

112
Q

What are the anterior, inferior, superior and posterior nerves that supply the hip?

A

Anterior - Femoral
Inferior - obturator
Superior - superior gluteal nerve
Posterior - nerve to quadratus femoris

113
Q

What arteries are involved in blood supply to the hip?

A

Deep femoral artery which gives rise to the medial/lateral circumflex femoral arteries that supply the head of the femur.
Obturator artery which supplies the head of the femur through the ligamentum teres, but is unable to support the joint alone.

114
Q

Describe hip dysplasia.

A

Abnormal growth of the hip changing the angle of the femoral neck or it’s relationship with the acetabulum.
Relatively common and is seen in a spectrum.
Can increase the risk of dislocation at birth or sometime later.
Problems with the acetabulum, head of the femur or the support capsule.

115
Q

Describe a slipped upper femoral epiphysis

A

Fracture through the growth plate which is very problematic if left.
The head is still articulating but the rest has moved.
Check for in a teen with hip pain, can’t always be seen on an x-ray

116
Q

Describe hip dislocation

A

The hip will be shortened and medially rotated.
Very uncommon as huge force is involved (unless congenital)
Can cause damage to the sciatic nerve.
The capsule and acetabulum will be disrupted.

117
Q

Describe a femoral neck fracture

A

Common in the elderly
Must be fixed quickly as it has a high mortality
Is an intracapsular fracture
Shortened and laterally rotated.
Blood supply may be disrupted, leading to avascular necrosis.
If healthy can be fixed with reduction but if beginning to necrotise will need to be replaced.

118
Q

Describe a trochanteric fracture

A

Extracapsular so there is decreased risk of necrosis.

Can treat with a dynamic hip screw.

119
Q

Give the important bursae in the hip.

A

Ilipsoas bursa - below the muscle
Trochanteric bursa - over the greater trochanter
Gluteus medius bursa
Ischiogluteal bursa - on ischeal tuberosity

120
Q

Which bursa of the hip is most likely to become inflamed during horse riding or riding a bike?

A

Ischiogluteal bursa

121
Q

What is subchondral sclerosis?

A

Increased bone density or thickening below the cartilage of a joint, usually due to osteoarthritis.

122
Q

Give the stages of rheumatoid arthritis.

A

Healthy
Synovitis
Pannus - abnormal layer of fibrovascular or granulation tissue
Fibrous ankylosis - fibrous connective tissue process causing decreased range of movement
Bony ankylosis - osseus tissue fuses two bones together, reducing mobility.

123
Q

What are the upper margins of the popliteal fossa?

A

Medially - semitendinosus and semimembranosus

Laterally - biceps femoris

124
Q

What are the lower margins of the popliteal fossa?

A

Medially - medial head of gastrocnemius

Laterally - lateral head of gastrocnemius and plantaris muscle

125
Q

What is the floor of the popliteal fossa?

A 
Capsule of the knee joint
Adjacent surfaces of the femur and tibia
Popliteus muscle (inferiorly)
126
Q

What is the roof of the popliteal fossa?

A 
Deep fascia (with the small saphenous vein)
- continuous with the fascia lata of the thigh and deep fascia of the leg
127
Q

What are the contents of the popliteal fossa, medially to laterally?

A

Popliteal artery - under semimembranosus
Popliteal vein - superior to the artery
Tibial nerve
Common fibular nerve

128
Q

What is the function of the biceps femoris?

A

Flexes the leg at the knee.
Long head also laterally rotates and extends the hip.
With the knee partly flexed, can laterally rotate the leg at the knee.

129
Q

What is the innervation of the biceps femoris?

A

Long head - tibial nerve

Short head - common fibular nerve

130
Q

What is the function of semitendinosus?

A

Flexes the leg at the knee and extends the thigh at the hip

Medially rotates the thigh at the hip and the leg at the knee.

131
Q

What is the innervation of semitendinosus?

A

Tibial nerve

132
Q

What is the function of semimembranosus?

A

Flexes the leg at the knee and extends the thigh at the hip.

Medially rotates the thigh at the hip and the leg at the knee.

133
Q

Innervation of semimembranosus

A

Tibial nerve

134
Q

What are the bony surfaces of the knee joint?

A

Condyles of the femur
Condyles of the tibia
Patellar surface of femur
Articular surface of the patellar

135
Q

What attaches to the epicondyles of the femur?

A 
Lateral collateral ligaments
Adductor magnus (medially)
136
Q

What is the top, flattened part of the tibial surface known as?

A

Tibial plateau

137
Q

Describe the difference between the medial and lateral surface of the tibial plateau.

A

Medial is slightly concave

Lateral is slightly convex

138
Q

What is the function of menisci in the knee?

A

Deepen the tibial element of the knee
Act as shock absorbers
Have a role in synovial fluid movement

139
Q

What are menisci made from?

A

Fibrocartilage

140
Q

What attaches the menisci to the joint capsule?

A

Coronary ligament

141
Q

What connects the medial meniscus anteriorly to the knee?

A

Transverse ligament

142
Q

What muscles help to stabilise the knee joint.

A

Inferior fibres of vastus medialis/lateralis

Iliotibial tract

143
Q

Describe the passage of the posterior cruciate ligament through the knee.

A

Passes anteriorly and inserts medially

144
Q

Describe the function of the posterior cruciate ligament

A

Limits posterior movement of the tibia
Limits hyperflexion
Main stabiliser in a weight bearing flexed knee

145
Q

How do you test the function of the posterior cruciate ligament?

A

Posterior drawer test.

146
Q

Describe the passage of the anterior cruciate ligament through the knee.

A

Passes posteriorly and inserts laterally.

147
Q

What is the function of the anterior cruciate ligament?

A

Limits anterior movement of the tibia against the femur

Limits hyperextension

148
Q

How do you test the function of the anterior cruciate ligament?

A

Anterior drawer test.

149
Q

Describe the association of the lateral collateral ligament with the knee

A

Inserts into the fibular head

Sits largely outside the joint capsule

150
Q

Describe the association of the medial collateral ligament with the knee.

A

Part of the fibroid capsule

Attached to the medial meniscus

151
Q

What reinforces the lateral collateral ligament in the knee?

A

Ilio-tibial tract

152
Q

What muscles cause flexion at the knee?

A

Biceps femoris
Semimembranosus
Semitendinosus
Gastrocnemius

153
Q

What muscles cause extension at the knee?

A

Rectus femoris
Vastus medialis
Vastus intermedius
Vastus lateralis

154
Q

Why do the knees lock in extension?

A

Decrease the effort by the muscles to stand

155
Q

Describe the movement of the bones that cause locking of the knees in extension?

A

Femur rotates internally over the tibia

156
Q

What muscle helps to ‘unlock’ the knee and how does it do this?

A

Popliteus

Rotates the femur externally

157
Q

Describe the unhappy triad

A

Injury to the PCL, ACL and medial meniscus.
Caused by lateral twisting of a flexed knee, usually due to trauma.
ACL is injured because it’s taut during flexion

158
Q

Describe the cause of ACL damage

A

Hyperextension of the knee

159
Q

Describe the cause of PCL damage

A

A fall onto the tibial tuberosity with a flexed knee as the tibia is pushed back against the femur

160
Q

Why are the menisci less likely to be injured than ligaments at the knee?

A

They are very mobile.

161
Q

Describe bursitis in the knee

A

Can be suprapatellar, prepatellar (housemaid’s knee) or superficial infrapatellar (clergyman’s knee).
Tends to occur due to excessive kneeling.
Is hard to spot the difference between them because they look very similar.
Treat with NSAIDs and rest.

162
Q

Why is osteoarthritis of the knee common?

A

The knees are weight bearing

163
Q

Describe a popliteal cyst in the knee.

A

A baker’s cyst.
Abnormal fluid-filled sac of synovial membrane, usually in the semimembranosus tendon.
Generally hard and may be tender
Is a sign of chronic knee effusion.
Tends to settle without intervention.
Can connect to the synovium of the knee joint.

164
Q

Give a way in which you could investigate injuries of the knee joint.

A

Imaging - MRI best for soft tissue
Arthroplasty
Aspiration - blood indicates a fracture
Clinical examination

165
Q

At what point does the femoral artery become the popliteal artery?

A

On passage through the adductor hiatus

166
Q

What two nerves does the sciatic nerve bifurcate into and where to they run?

A

Common fibular nerve - runs laterally in the popliteal fossa along the biceps femoris.
Tibial nerve - runs through the centre of the popliteal fossa with the popliteal vein and artery

167
Q

State the contents of the popliteal fossa from lateral to medial.

A

Common fibular nerve
Tibial nerve
Popliteal vein
Popliteal artery

168
Q

What are the branches of the popliteal artery?

A

Posterior tibial artery
Anterior tibial artery
Circumflex fibular artery

169
Q

Why is a blocked popliteal artery not a disaster?

A

There is an extensive anastamoses system.

170
Q

Where does the tibial nerve provide sensory innervation?

A

Posterolateral and anterolateral leg

Sole of the foot

171
Q

Where does the common fibular nerve provide sensory innervation?

A

Lateral leg

Dorsal surface of the foot

172
Q

What are the two sets of ligaments of the ankle?

A

Medial ligament - four separate ligaments which fan out from the medial malleolus. Resists over eversion.

Lateral ligament - three distinct and separate ligaments. Resists over-eversion of the foot.
Anterior talofibular, posterior talofibular, calcaneofibular

173
Q

What muscles cause plantarflexion of the foot?

A

Gastrocnemius
Soleus
Plantaris
Posterior tibialis

174
Q

What muscles cause dorsiflexion of the foot?

A

Tibialis anterior
Extensor hallicus longus
Extensor digitorum longus

175
Q

What is most likely to be damaged in an ankle sprain and why?

A

Lateral ligament. Weaker than the medial ligament and resists inversion.
Anterior talofibular ligament most at risk of irreversible damage.

176
Q

Describe a Pott’s fracture

A

Trimalleolar (both malleoli and tibia) or bimalleolar (both malleoli) fractured due to forced eversion.

177
Q

Explain how a Pott’s fracture occurs.

A

Forced eversion pulls the medial ligaments, causing an avulsion fracture of the medial malleolus.
Talus moves laterally, breaking the lateral malleolus.
Tibia forced anteriorly, shearing the distal and posterior part against the talus.

178
Q

What type of joint is the distal tibiofibular joint?

A

Syndesmosis - fibrous.

179
Q

What type of joint is the proximal tibiofibular joint?

A

Plane synovial

180
Q

What type of joint is the ankle?

A

Rolling hinge synovial joint

181
Q

Describe what is meant by a mortise tenon joint in relation to the ankle.

A

Concave box arrangement of the malleoli is the mortise

Protrusion of the talus is the tenon

182
Q

Describe the arches of the foot.

A

Medial longitudinal arch - calcaneus, talus, navicular, cuneiform, 1-3 metatarsals

Lateral longitudinal arch - calcaneus, cuboid, 4-5 metatarsals

Transverse arch - strengthened by tendons of the leg muscles. Tarsals and metatarsals.

183
Q

Describe the retinacula of the ankle.

A

Extensor retinaculum anteriorly - superior/inferiorly
Inferior peroneal retinaculum
Superior peroneal retinaculum

184
Q

What would be the consequences of a lack of retinaculum in the ankle?

A

Risk of bow-stringing

185
Q

What bones articulate to form the ankle?

A

Tibia (superior and medial articulatory surfaces)
Fibula (lateral articulatory surface)
Talus (superior, inferomedial and inferolateral surfaces)

186
Q

Describe the arches of the foot.

A

Medial longitudinal arch - calcaneus, talus, navicular, cuneiform, 1-3 metatarsals

Lateral longitudinal arch - calcaneous, cuboid, 4-5 metatarsals

Transverse arch - strengthened by the tendons of the leg muscles. Tarsals and metatarsals.

187
Q

How many articular surfaces does each tarsal bone have?

A

6

188
Q

What spinal nerves are tested by dorsiflexion of the foot?

A

L4-5

189
Q

What spinal nerves are tested by plantar flexion of the foot?

A

S1-2

190
Q

Describe the deltoid ligament of the foot?

A

Strengthens the medial surface.

  • Tibionavicular ligament
  • Calcaneotibial ligament
  • Talotibial fibres (deep)

Crossed by tibialis posterior and flexor digitorum longus tendons which reinforce.

191
Q

Describe the lateral ligament of the foot.

A

Strengthens the lateral surface.

  • Anterior and posterior fibres to talus
  • Intermediate fibres to calcaneus
192
Q

Describe a Pott’s fracture.

A

Variety of bimalleolar fractures caused by excessive eversion. Tears off the medial malleolus, then the talus moves laterally and shears off the lateral malleolus.

193
Q

Function of gastrocnemius

A

Plantarflexion

Flex at knee

194
Q

Innervation of gastrocnemius

A

Tibial nerve

195
Q

Function of plantaris

A

Plantarflexion

Flexion at the knee

196
Q

Innervation of plantaris

A

Tibial nerve

197
Q

Function of soleus

A

Plantarflexion of the foot

198
Q

What muscles form the calcaneal tendon?

A

Gastrocnemius, plantaris and soleus

199
Q

Function of popliteus

A

Allows initiation of flexion by unlocking the knee

Stabalises the knee joint

200
Q

Innervation of soleus

A

Tibial nerve

201
Q

Innervation of popliteus

A

Tibial nerve

202
Q

Function of flexor hallicus longus

A

Flex great toe

Starts gait cycle

203
Q

Innervation of flexor hallicus longus

A

Tibial nerve

204
Q

Function of flexor digitorum longus

A

Flexion of four digits

Plantar flexion

205
Q

Innervation of flexor digitorum longus

A

Tibial nerve

206
Q

Function of tibialis posterior

A

Plantarflexion

Supports the arch of the foot

207
Q

Innervation of tibialis posterior

A

Tibial nerve

208
Q

What muscles pass through the flexor retinaculum in the leg?

A

Flexor hallicus longus, flexor digitorum longus, tibialis posterior

209
Q

What arteries branch from the posterior tibial artery?

A

Fibular
Plantar arch
Medial plantar

210
Q

What artery branches from the anterior tibial artery?

A

Dorsalis pedis?

211
Q

What artery branches from dorsalis pedis?

A

Arcuate artery (dorsal arch)

212
Q

Nerve roots of femoral nerve

A

L2 to L4

213
Q

Cutaneous supply by femoral nerve

A

Anterior thigh
Anteromedial knee
Medial leg
Medial foot

214
Q

Nerve roots of obturator nerve

A

L2 to L4

215
Q

Nerve roots of sciatic nerve

A

L4 to S3

216
Q

Nerve roots of gluteal nerve

A

L4 to S2

217
Q

Nerve roots of lateral cutaneous nerve of the thigh

A

L2 to L3

218
Q

Cutaneous supply by lateral cutaneous nerve of the thigh

A

Skin of the lateral thigh

219
Q

Nerve roots of the tibial nerve

A

L4 to S3

220
Q

Cutaneous supply by tibial nerve

A

Posterolateral leg
Lateral foot
Sole of foot

221
Q

Nerve roots of common fibular nerve

A

L4-S3

222
Q

Cutaneous supply by common fibular nerve

A

Upper lateral and lower posterolateral leg

223
Q

Nerve roots of deep fibular nerve

A

L4-L5

224
Q

Cutaneous supply by deep fibular nerve

A

Triangular region of skin between 1st and 2nd toes

225
Q

Nerve roots of superficial fibular nerve

A

L4-S1

226
Q

Cutaneous supply by superficial fibular nerve

A

Dorsum of foot, anterior and lateral aspect of medial 1/3 of leg

227
Q

What muscles are in the anterior compartment of the leg?

A

Tibialis anterior
Extensor digitorum longus
Extensor hallucis longus

228
Q

What muscles are in the lateral compartment of the leg?

A

Fibularis longus

Fibularis brevis

229
Q

Function of tibialis anterior

A

Dorsiflexion and inversion of the foot

230
Q

Innervation of tibialis anterior

A

Deep fibular nerve

231
Q

Function of extensor digitorum longus

A

Extension of the lateral four toes and dorsiflexion of the foot

232
Q

Innervation of extensor digitorum longus

A

Deep fibular nerve

233
Q

Function of extensor hallucis longus

A

Extension of the great toe and dorsiflexion of the foot

234
Q

Innervation of extensor hallucis longus

A

Deep fibular nerve

235
Q

Function of fibularis longus

A

Eversion and plantarflexion of the foot.

Supports the lateral and transverse arches.

236
Q

Innervation of fibularis longus

A

Superficial fibular nerve

237
Q

Function of fibularis brevis

A

Eversion of the foot

238
Q

Innervation of fibularis brevis

A

Superficial fibular nerve

239
Q

Where would you test for the L1 dermatome?

A

Over the inguinal ligament

240
Q

Where would you test for the L2 dermatome?

A

Lateral thigh

241
Q

Where would you test for the L3 dermatome?

A

Lower medial thigh

242
Q

Where would you test for the L4 dermatome?

A

Medial side of great toe OR

Medial ankle

243
Q

Where would you test for the L5 dermatome?

A

Medial side of digit II

244
Q

Where would you test for the S1 dermatome?

A

Little toe OR

Heel

245
Q

Where would you test for the S2 dermatome?

A

Back of the thigh

246
Q

Where would you test for the S3 dermatome?

A

Gluteal fold

247
Q

How could you test L2 motor function?

A

Hip flexion

248
Q

How could you test L3 motor function?

A

Knee extension

249
Q

How could you test L4 motor function?

A

Foot dorsiflexion

250
Q

How could you test L5 motor function?

A

Great toe extension

251
Q

How could you test S1 motor function?

A

Foot plantarflexion

252
Q

How could you test S2 motor function?

A

Knee flexion

253
Q

Where could you test the sensory function of the obturator nerve?

A

Medial thigh

254
Q

Where could you test the sensory function of the sciatic nerve?

A

Posterior thigh, leg and foot

255
Q

Where could you test the sensory function of the femoral nerve?

A

Anterolateral thigh, anteromedial leg, dorsum of foot

256
Q

Where could you test the sensory function of the superficial fibular nerve?

A

Anterolateral leg

257
Q

Where could you test the sensory function of the tibial nerve?

A

Posterolateral leg

ESA 2 (46 decks)

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