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A&P1 B6 > Third slide deck- the Leg > Flashcards

Third slide deck- the Leg Flashcards

1
Q

Observable features of leg..

A

slide 2

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2
Q

Observable features of leg..

A

Gastrocnemius
Soleus
Great saphenous vein
Calcaneal tendon

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3
Q

Both the ___ and ___ muscles insert on the calcaneus via the calcaneal (Achilles) tendon

A

Gastrocnemius

Soleus

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4
Q

The ___ ___is the large bony projection on the medial side of the ankle

A

medial malleolus

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5
Q

The greater saphenous vein is the ____ of the two saphenous veins

A

Medial

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6
Q

The greater sephenous vein travels anterior to the medial malleolus, and ascends on the medial leg and thigh to terminate in the ___

A

femoral vein

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7
Q

The ___ ___ is the large bony projection on the lateral side of the ankle

A

lateral malleolus

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8
Q

The ___ ___ vein is the lateral of the two saphenous veins

A

lesser saphenous

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9
Q

The lesser saphenous travels posterior to the lateral malleolus, and ascends on the posterior leg to terminate in the ___ ___

A

Popliteal vein

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10
Q

More observable pictures of the leg…

A

slide 6

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11
Q 
which compartment is responsible for:
Dorsiflexion at the ankle
Inversion of the foot (supination is a combination of inversion, plantarflexion and adduction.) 
Extension of the toes
Innervation: deep fibular nerve
A

Anterior compartment

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12
Q

Which compartment is responsible for:
Weak plantarflexion
Eversion of the foot (pronation is a combination of eversion, dorsiflexion and abduction)
Innervation: superficial fibular nerve

A

Lateral compartment

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13
Q

Which compartment is responsible for:
Plantarflexion of the ankle
Flexion of the toes
Innervation: tibial nerve

A

Posterior Compartment

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14
Q

Compartments of the leg as seen from above:

A

slide 8

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15
Q

Compartments of the leg cross section:

A

slide 9

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16
Q

Anterior compartment consists of muscles that dorsiflex the foot:

A
  • Tibialis anterior
  • Extensor hallucis longus
  • Extensor digitorum longus
  • Fibularis (peroneus) tertius
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17
Q

Innervation of the anterior compartment muscles of the leg:

A

Innervation: deep fibular (peroneal) nerve

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18
Q

review some ant. compartment muscles of the leg:

A

slide 11

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19
Q

Tendons of the muscles of the anterior compartment are held firmly to the ankle by thickenings of deep fascia: the superior extensor retinaculum (AKA __ ___of the ankle) and inferior extensor retinaculum (AKA ___ ___ of the ankle)

A

Transverse ligament

Cruciate ligament

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20
Q

Origin: tibia, and interosseous membrane
Insertion: first cuneiform and first metatarsal

A

Tibialis Anterior

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21
Q

Action: dorsiflexes foot at the ankle and inverts foot
Innervation: deep fibular (peroneal) nerve

A

Tibalis Anterior

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22
Q

Origin: fibula, and interosseous membrane
Insertion: distal phalanx of great toe (dorsal surface)

A

Extensor Hallucis Longus

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23
Q

Action: extends great toe and dorsiflexes foot at ankle
Innervation: deep fibular (peroneal) nerve

A

Extensor Hallucis Longus

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24
Q

Origin: tibia, fibula, and interosseous membrane
Insertion: toes 2 – 5 (dorsal surface of middle and distal phalanges)

A

Extensor Digitorum Longus

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25
Q

Action: extend toes 2 - 5 and dorsiflexes foot at ankle
Innervation: deep fibular (peroneal) nerve

A

Extensor Digitorum Longus

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26
Q

Origin: fibula, and interosseous membrane
Insertion: base of fifth metatarsal

A

Fibularis (Peroneus) Tertius

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27
Q

Action: dorsiflexes and everts the foot (in conjunction with extensor digitorum longus)
Innervation: deep fibular (peroneal) nerve

A

Fibularis (Peroneus_ Tertius

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28
Q

Lateral compartment consists of muscles that ___ __ and evert the foot

A

Plantar flex

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29
Q

Lateral compartment consists of muscles that plantar flex and evert the foot

A

Fibularis (peroneus) longus

Fibularis (peroneus) brevis

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30
Q

Fibularis (peroneus) longus
Fibularis (peroneus) brevis

Innervation: ??

A

superficial fibular (peroneal) nerve

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31
Q

Lateral compartment muscle review:

A

slide 18

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32
Q

Origin: fibula
Insertion: first metatarsal and first cuneiform (medial, plantar foot)

A

Fibularis (Peroneus) Longus

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33
Q

Action: everts foot and plantar flexes foot at ankle (also helps to support the transverse arch of the foot)
Innervation: superficial fibular (peroneal) nerve

A

Fibularis (Peroneus) Longus

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34
Q

___ ___ inserts on the base of the 1st metatarsal and the medial cuneiform

A

Fibularis Longus

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35
Q

Tendon of fibularis longus crosses the ___ of the foot

A

Sole

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36
Q

Origin: fibula
Insertion: base of fifth metatarsal (lateral, plantar foot)

A

Fibularis (Peroneus) Brevis

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37
Q

Action: Everts foot and plantar flexes foot at ankle
Innervation: superficial fibular (peroneal) nerve

A

Fibularis (Peroneus) Brevis

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38
Q

Fibularis brevis inserts on the tuberosity of the ___ metatarsal

A

5th

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39
Q

Recall that tibialis anterior inserts dorsally at the base of the first metatarsal and first cuneiform bones, and ___ the foot.

A

Dorsiflexes

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40
Q

Fibularis longus inserts on the plantar aspect of the base of the first metatarsal and first cuneiform bones, and ___ __ the foot

A

Plantar flexes

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41
Q

Tibialis anterior and fibularis longus are therefore ____ muscles at the base of the first metatarsal and first cuneiform.

A

antagonistic

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42
Q

Posterior compartment consists of muscles in superficial and deep groups
The superficial muscles share a common tendon of insertion, the ___ ___ tendon

A

calcaneal (Achilles) tendon

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43
Q

Posterior compartment consists of muscles in superficial and deep groups
The deep muscles are deeper and (do/do not)? share a common tendon (either among themselves or with the superficial group)

A

Do not

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44
Q

Superficial posterior compartment pictures:

A

slide 25

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45
Q

Origin: lateral and medial femoral condyles
Insertion: the two heads unite into a broad aponeurosis which eventually unites with the deep tendon of the soleus to form the calcaneal (Achilles) tendon, inserting on the posterior calcaneal surface

A

Gastrocnemius

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46
Q

Action: plantar flexes foot at ankle, and flexes leg at knee
Innervation: tibial nerve

A

Gastrocnemius

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47
Q

Origin: tibia and fibula
Insertion: unites with the gastrocnemius aponeurosis to form the calcaneal (Achilles) tendon, inserting on the posterior calcaneal surface

A

Soleus

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48
Q

Action: plantar flexes foot at the ankle
Innervation: tibial nerve

A

Soleus

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49
Q

__ __ is a term sometimes applied to the combination of the gastrocnemius and soleus muscles, since both insert into the calcaneus, and together form the major part of the muscle of the posterior portion of the leg (the calf, L. sura).

A

Triceps surae

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50
Q

Origin: femur
Insertion: calcaneus

A

Plantaris

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51
Q

Action: plantar flexes foot at ankle, and flexes leg at knee
Innervation: tibial nerve

A

Plantaris

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52
Q

Deep posterior compartment leg

A

Pic page 30

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53
Q

Origin: femur
Insertion: tibia (just superior to the popliteal line)

A

Popliteus

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54
Q

Action: rotates knee medially and flexes the leg on the thigh
Innervation: tibial nerve

A

Popliteus

55
Q

Origin: tibia, fibula, and interosseous membrane
Insertion: plantar tarsals and metatarsals of foot (second, third, and fourth metatarsals; navicular; cuneiforms; cuboid)

A

Tibialis Posterior

56
Q

Action: plantar flexes foot at ankle, and inverts foot
Innervation: tibial nerve

A

Tibialis Posterior

57
Q

Origin: tibia
Insertion: distal phalanges of toes 2 – 5

A

Flexor Digitorum Longus

58
Q

Action: flexes toes 2 – 5, and plantar flexes foot
Innervation: tibial nerve

A

Flexor Digitorum Longus

59
Q

Origin: fibula
Insertion: plantar surface of the distal phalanx of the great toe

A

Flexor Hallucis Longus

60
Q

Action: flexes great toe, and plantar flexes foot at ankle (weakly)
Innervation: tibial nerve

A

Flexor Hallucis Longus

61
Q

___ artery divides into the anterior and posterior tibial arteries at the inferior border of popliteus

A

Popliteal

62
Q

Gives off the fibular artery (perforating branches to the lateral compartment)
Will supply most of the foot as plantar arteries (after dividing into medial and lateral plantar arteries)
Has paired deep veins (venae comitantes)

A

Posterior Tibial

63
Q

Runs anterior to the interosseus membrane and supplies anterior compartment
Has paired deep veins (venae comitantes)

A

Anterior tibial artery

64
Q

Arterial distribution

veinous drainage

A

charted on slide 36-40

65
Q

Sciatic…

and nerves of the leg

A

slide 41/42/43

66
Q

The __ __ __ winds around the fibular neck before dividing into the deep fibular (deep peroneal) and superficial fibular (superficial peroneal) nerves.

It is likely to be injured simultaneously with injury at or near the head of the fibula.

A

Common fibular nerve

67
Q

Superficial fibular to the two lateral compartment muscles

Deep fibular to the four anterior compartment muscles

COMMON FIBULAR components to short head of biceps, anterior and lateral compartments of the leg, dorsum of the foot

A

Slide 44 all together

68
Q

Because of the superficial position of the ___ __ __ as it winds around the fibular neck, it is the nerve most injured in the lower limb
It may be severed during fracture of the fibular neck, or severely stretched when the knee joint is injured or dislocated

A

Common fibular nerve

69
Q

Severance of the common fibular nerve results in paralysis of all muscles in the anterior and lateral compartments of the leg (dorsiflexors of the ankle and evertors of the foot), causing __ __ The condition makes it impossible to make the heel strike the ground first—the foot drops and the toes drag on the floor when walking

A

Foot drop

70
Q

The patient compensates by adopting a high stepping (“steppage”) gait, raising the foot as high as necessary to keep the toes from hitting the ground.

A distinctive clop is produced as the foot comes down (or, rather, is slung down)

There will also be a variable loss of sensation on the ____ aspect of the leg and the ___ of the foot due to loss of cutaneous sensation provided by the fibular nerve

A

Anterolateral - leg

Dorsum - foot

71
Q

Deep fibular nerve AKA deep peroneal nerve

Travels in the front of the ankle and enters the top of the foot by passing under the __ __

A

Extensor retinaculum

72
Q

Deep fibular nerve:
Continues on to supply
the extensor hallucis brevis muscle

extensor digitorum brevis muscle(s)

cutaneous sensation to an area between the

A

1st and 2nd Toes

73
Q

Deep fibular neuritis is an entrapment neuropathy
Symptoms include pain, 1st / 2nd toe numbness and tingling, and weakness of big toe dorsiflexion
Deep fibular nerve may be injured after direct ankle trauma, or by tightly fitting lace up shoes

A

Deep peroneal neuritis

74
Q

Common fibular nerve cutaneous innervation

A

slide 52/53

75
Q

The ankle joint is a __-__ ___ joint between the distal ends of the tibia and fibula, and the superior part of the talus

A

hinge type synovial

76
Q

A __ __ is formed by the distal ends of the tibia and fibula, into which the trochlea of the talus fits

A

malleolar mortise

77
Q

The joint capsule is thin anteriorly and posteriorly, but is supported on each side by strong ___ __

A

collateral ligaments

78
Q

movements of ankle

A

slide 56

79
Q

movement:

Tibialis anterior, Extensor digitorum longus, and extensor hallucis longus

A

Dorsiflexion

80
Q

Movement:
all muscles of the posterior compartment which cross the joint, and muscles of the lateral compartment (their action is weaker)

A

Plantarflexion

81
Q 
Movement:
Tibialis anterior (supination is an outward roll of the foot during normal motion, and is an inversion-type movement)
A

Inversion

82
Q

Movement:
lateral compartment, and fibularis tertius (pronation is an inward roll of the foot during normal motion; it is an eversion-type movement, and may be associated with flat foot and/or knock knees (genu valgum))

A

Eversion

83
Q

Hinge-type synovial joint
Tibia/ talus & fibula/ talus
The tibia transfers weight to the joint, the ___ ___

A

Fibula stabilizes

84
Q

A mortise is formed by the distal ends of the tibia and fibula, into which the trochlea of the talus fits

Superior surface of the talus is wider anteriorly than posteriorly (plantarflexion is less stable). The ankle joint is most stable when it is fully ____

A

dorsiflexed

85
Q

Ankle articular capsule:

Fibrous capsule is rather ___, but is supported and stabilized on each side by strong collateral ligaments

A

thin

86
Q

Ankle, medial ligment AKA..

A

Deltoid ligament

87
Q

Comprises four discrete parts, collectively called the ___ ___
Anchors the medial malleolus to the talus
Stabilizes the ankle joint during eversion, and resists extreme eversion

A

Medial Ligament

88
Q

Medial ligament:

Stabilizes the ankle joint during ___, and resists extreme ___

A

Eversion

89
Q

Three discrete ligaments, collectively called the lateral ligament

The weaker of the two collateral ligaments

A

Lateral ligament (ankle)

90
Q

Naming ligaments of the ankle joint:

Named after the bones the ligaments connect, plus a modifier (anterior, posterior) if necessary

A

slide 60

did you identify the “Spring” ligament

91
Q

more ligament pics

A

slide 61

92
Q

The most commonly injured ligament in the ankle is the ___ ___ ligament

A

anterior talofibular

93
Q

It is rare for the ___ ligament to be sprained because the fibula tends to prevent the ankle from moving far enough to stretch the ligament. When the ___ ligament is injured, the event is often associated with a fracture of the fibula

A

Deltoid (medial)

94
Q

The foot has ## bones and 55 articulations. It acts as a platform and shock absorber to support the weight of the body, and is also a powerful lever to propel the body

A

26 bones

95
Q

foot has 3 distinct regions:

A

Forefoot, comprising the toes and metatarsals

Midfoot, consisting of the cuneiforms, cuboid, and navicular bones

Hindfoot, comprising the calcaneus and talus

96
Q

what region:
most common site of foot complaints. Most problems are caused by poor shoe selection, foot deformities, or degenerative changes. Some conditions are bunions, stress fractures, fifth metarsal fractures

A

Forefoot

97
Q

complaints are relatively uncommon, but include ___ sprain, tarsal fractures, and posterior tibialis dysfunction

A

Midfoot

98
Q

Most problems (in this region?) are caused by overuse or excessive weight. Common complaints are plantar fasciitis, Achilles tendinosis, and bursitis

A

Hindfoot

99
Q

Observable features of foot

A

slide 66

100
Q

The two large bony projections on the sides of the ankle are the ___ and the ___

A

Medial malleolus

lateral malleolus

101
Q

Which extensor tendons are observable on the foot?

A

Tendon of the extensor hallucis longus

Tendons of the extensor digitorum longus muscle

102
Q

Which vessel is observable on the foot

A

Dorsal venous arch

103
Q

Right foot, dorsal view

A

slide 70

104
Q

right foot, anterolateral view

A

slide 71/72

105
Q

Tom, Dick, and Harry

A

slide 73

106
Q

Note the grooves for the tendon of flexor hallucis longus in the talus, and for the tendon of tibialis posterior in the tibia

A

slide 74

107
Q

origin of foot surface features

A

slide 75

108
Q

is a foot deformity caused by pressure from footwear, and degenerative joint disease.
Characterized by lateral deviation of the great toe (the “L” in valgus indicates lateral deviation).
In some persons, the deviation is so large that the great toe overlaps the second toe, and the first digit can not be moved away from the second digit because the sesamoids under the head of the first metatarsal are displaced and lie in the space between the heads of the first and second metatarsals.

A

Hallux valgus

109
Q

A ___ is an enlargement of bone or tissue, or a tender and inflamed subcutaneous bursa that has formed around the metatarsophalangeal joint at the base of the big toe in hallux valgus.
The term usually is used to refer to the pathological bump on the side of the great toe joint. The bump is the swollen bursal sac and/or an osseous (bony) deformity that has grown on the mesophalangeal joint (where the first metatarsal bone and hallux meet).

A

Bunion

110
Q

Flatfoot, AKA…

A

Pes Planus

111
Q

A condition in which the longitudinal arch or instep of the foot collapses and comes in contact with the ground
Traditional home diagnosis is by means of the “wet footprint” test

A

Flatfoot

aka Pes planus

112
Q

Flat appearance of the foot before age 3 is normal, resulting from the thick subcutaneous fat-pad (“baby fat”) in the sole, which is lost with age wherein a normal medial longitudinal arch becomes visible
Some people never develop arches, which is a normal variation in foot type
____ may or may not cause problems

A

Flatfoot

113
Q

Contraction of the flexor muscles of the foot that is not balanced by the other foot muscles, or which is abnormal due to disease, flatfoot, or improper footwear can result in ___ or hammertoe

A

Clawfoot (clawtoe)

114
Q

attaches to the middle phalanges of the toes

A

Flexor digitorum brevis

115
Q

attaches to the distal phalanges of the toes

A

Flexor digitorum longus

116
Q

contraction overpowers the other muscles, the middle phalanx is pulled downward due to the mechanical action of the muscle, resulting in clawfoot (clawtoe)

A

Flexor digitorum brevis

117
Q

contraction overpowers the other muscles, the mechanical result of its pulling action is bending the toe at the middle joint, so that the tip of the toe is bent downward while the middle of the toe is cocked upward resembling a hammer

A

Flexor digitorum longus

118
Q

AKA Claw foot, claw toe.
Claw toe is a deformity of the foot in which the toes (usually the lateral four toes) are pointed down and the arch is high, making the foot appear claw-like

A

see pic on slide 82

119
Q

The metatarsophalangeal joints are hyperextended, and the distal interphalangeal joints are flexed.
___ can be a condition from birth or develop as a consequence from other disorders, such as in diabetics whose neurological lesions lead to atrophy of muscles of the foot

A

Claw toe

120
Q

____ is a deformity of the proximal interphalangeal joint causing it to be permanently bent. The base of the toe points upward and the end of the toe points down.

A

Hammertoe

121
Q

____ can involve the second, third, or fourth toe, although it usually exists in only one of those toes (unlike clawfoot, which occurs in multiple toes simultaneously)
In the earlier stages, ___ are flexible and can often be managed with noninvasive measures. If left untreated, ____can become more rigid and will not respond to non-surgical treatment.

A

Hammertoes

122
Q

Improperly fitting shoes is a common cause of ____. Poorly-fitting shoes can hold the toes in an abnormal position and result in tightening of the muscles required to maintain that position. In particular, shoes that have high heels and are narrow at front tend to push the toes into an abnormal, bent position
Less commonly, diseases of the nerves, muscles, or joints (such as arthritis) can result in ____ deformity

A

Hammertoe

123
Q

Congenital deformity in which the foot is twisted inferiorly and medially, and the angle of the arch is increased.

A

Clubfoot

124
Q

Clubfoot AKA..

A

AKA talipes or talipes equinovarus

125
Q

Without treatment, persons appear to walk on the sides of their feet or on their ankles
Treatment consists of manipulating the arch to a normal curvature by casts or adhesive tape, usually soon after birth (Ponseti method). Corrective shoes or surgery may also be required

A

Clubfoot

126
Q

Some instances are caused by genetic factors, such as Edward’s syndrome (trisomy 18)
Other instances are due to external influences in the third trimester, such as intrauterine compression

A

Clubfoot

127
Q

Straining and inflammation of the plantar aponeurosis may result from running and high-impact aerobics.
___ __ causes pain on the plantar surface of the heel and on the medial aspect of the foot. It is most severe after sitting, and when first walking in the morning.

A

Plantar Fasciitis

128
Q 
If a calcaneal spur 
  protrudes from the
  medial calcaneal 
  tubercle, the 
  plantar fasciitis 
  may produce the 
  “\_\_\_\_ .”
A

Heel spur syndrome

129
Q

Heel spur syndrome:

A ___ develops at the end of the spur, and that may also become inflamed and tender

A

Bursa

130
Q

Cutaneous innervation of foot

A

slide 93

131
Q

Arterial supply:
Dorsalis pedis at the ankle joint -> arcuate artery & deep plantar artery
Deep plantar artery joins the lateral plantar artery to form the plantar arch

A

slide 94

132
Q

Posterior tibial divides into medial and lateral plantar arteries behind the __ __

A

medial malleolus

133
Q

foot artery:
Medial plantar artery (smaller)

Lateral plantar artery joins the deep plantar artery to form the __ __

A

Plantar arch

134
Q

foot artery:

The arch gives off plantar metatarsal arteries -> ____

A

common digital arteries

A&P1 B6 (3 decks)

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