Unit 5: Distal Lower limb Flashcards
1
Q
What muscle is shown in the image?
A
Tibialis anterior
Tendon to the big toe
2
Q
What muscle is shown in the image?
A
Extensor digitorum longus
Tendon to the second to fifth digit
3
Q
What muscle is shown in the image?
A
Extensor hallucis longus
4
Q
What muscle is shown in the image?
A
Fibularis tertius
Tendon to fifth digit
5
Q
What muscle is shown in the image?
A
Flexor hallucis longus
6
Q
What muscle is shown in the image?
A
Tibialis posterior muscle
7
Q
What muscle is shown in the image?
A
Flexor digitorum longus
8
Q
What muscle is shown in the image?
A
Gastrocnemius
9
Q
What muscle is shown in the image?
A
Soleus muscle
10
Q
What muscle is shown in the image?
A
Plantaris muscle
11
Q
What muscles make up the anterior leg?
A
Tibiaiis anterior
Extendor digitorum longus
Extendor hallucis longus
Fibularis tertius
12
Q
What muscles make up the lateral leg?
A
Fibularis longus
Fibularis brevis
13
Q
What muscle is shown in the image?
A
Fibularis longus
14
Q
What muscle is shown in the image?
A
Fibularis brevis
15
Q
What muscles make up the deep posterior compartment of the leg?
A
From medial to lateral
Tibialis posterior
Flexor digitorum longus
Flexor digitorum hallucis
16
Q
What muscles make up the superficial posterior compartment of the leg?
A
Soleus muscle
Plantaris muscle
Gastrocnemius muscle
17
Q
What is the popliteal fossa?
A
A diamond shaped depression on the posterior surface of the knee.
Covered in a large amount of fat proportional to the anterior surface in order to protect the structures within the fossa
18
Q
What are the different boundaries of the popliteal fossa?
A
superomedial - semimembranous
Superolateral -biceps femoris
inferior - gastrocnemius
Floor is the surface of the femur
Roof if the skin and fascia
19
Q
What can be found within the popliteal fossa?
A
Popliteal artery
Popliteal vein - drained into by the small sapehnous
Tibial nerve
Common fibular nerve
Both nerves are branches from the sciatic nerve
These sructures run from medial to lateral and get more superficial
20
Q
What is the common function and innervation of the muscles within the anterior compartment of the leg?
A
Dorsiflexion of the foot
Deep fibular nerve - branch of the common fibula nerve
21
Q
Describe the general location of the anterior muscles of the leg
A
All are lateral to the anterior tibial crest found on the middle anterior tibia
Insert between the medial and lateral malleolous (ankle bumps)
22
Q
What is the order of the anterior compartment of the leg muscles from medial to lateral?
A
Tibialis anterior
Extensor hallucis longus
Extensor digitorum longus
Fibularis tertius
23
Q
What function is unique within the anterior compartment of the leg to the fibularis tertius?
A
Aids eversion
24
Q
Where are the muscles of the lateral leg found?
A
Posterior to the lateral malleolus and anterior to the calcaneous.
25
What is the common function and innervation of the muscles of the lateral leg?
Mainly eversion and assist plantar flexion
Lateral superficial fibular nerve - a branch of the common fibular nerve
26
Which of the lateral leg muscles is most superficial?
Fibularis longus
27
What is the function of the calcaneous tendon in relation to the muscles of the leg?
Serves as a common point of attachment for all superficial posterior muscles in the leg.
28
What is the common function of the superficial posterior leg muscles?
Plantar flexion
29
What is the common function of all deep posterior leg muscles?
Assist plantar flexion
30
Where are the tendons of the posterior deep leg muscles found?
Between the calcaneous and the medial malleonous.
31
What is the common innervation of the superficial and deep posterior muscles of the leg?
Tibial nerve
32
What is the general function of the layout of the bones within the foot?
Creates a longitudinal arch, helps carry weight evenly over the balls of the feet. This helps with balance and supporting body weight
33
What is the function of the talus bone?
Most superior of the tarsal bones
Transfers weight from the tibia to the rest of the foot.
Reinforced by the medial and lateral malleolus
Allows plantar and dorsiflexion movements (hinged synovial joints)
34
What joint in the foot is responsible for eversion and inversion?
The subtalar joint
Talus joins with the navicular anteriorly and the calcaneus posteriorly.
35
Give an overview of the layout of the bones within the foot
Calcaneous - heel bone
Talus -link to tibia
Navicular - anterior to the talus (plane joint -need to check)
Anterior to the navicular and the medial, intermediate and lateral cuniform which joint to their own metatarsal
The cuboid is a sqaure shaped bone that is the last of the tarsal on the lateral side and joins up to the fourth and fifth metatarsal
36
What is the extensor retinaculum in the foot?
A layer of connective tissue on the anterior surface of the foot, holds down tednons on the foor against the tibia, this allows efficient action from muscle contraction.
37
What is different between the muscles in the hand and the foot?
The foot has muscles on the dorsum surface the hand does not
38
What muscles are found on the dorsal surface of the foot?
Extensor digitorum brevis
Extensor hallucis brevis
Aid the anterior leg muscles in the extension of the digits
39
What are the different muscles found on the plantar surface of the foot?
Flexor digitorum brevis
Abductor hallucis
Abductor digit minimi
All are covered plantar aponeurosis a tough fibrous connective tissue.
40
What is the function of the abductor hallucis and the abductor digit mini?
Widen the surface area of the foot providing greater balance and stability to walk around.
41
What is the function of the tibialis anterior?
Dorsiflexion of the foot
Foot inversion
42
What is the origin and the insertion of the tibialis anterior?
Lateral tibia and medial fibula
Inferior aspect of the medial cuneiform
43
What is the function of the extensor hallucis longus?
Hallux extension
Dorsiflexion of the foot
44
What is the origin and the insertion of the extensor hallucis longus?
Origin - medial fibula
Insertion - base of distal phalynx 1
45
What is the origin and the insertion of the extensor digitorum longus?
Lateral tibia and medial fibula
Bases of distal and middle phalanges 2 to 5
46
What is the origin and the insertion of the fibularis tertius?
Origin is the medial fibula
Insertion is the medial aspect of the metatarsal 5
47
What is the origin and insertion of the fibularis longus?
Orign is the lateral fibula
Insertion is the inferolateral aspect of the medial cuneidorm and base of metatarsal one
hence does plantar flexion and eversion
48
What is the origin and insertion of the fibularis brevis?
Origin is the lateral fibula
Insertion is the base of the metatarsal 5
hence aids plantar flexion
49
Explain the innervation of the leg.
The sciatic nerve becomes the popliteal nerve.
Then splits into the tibial nerve which supplies the posterior compartment of the leg.
The second branch is the common fibular nerve, this splits into the deep fibular nerve which supplies the anterior compartment of the leg and the superficial fibula nerve which inervates the lateral compartment of the leg.
50
Give an overview of the popliteus muscle.
Found near the popliteal surface on the posterior compartment of the knee.
Originates from the medial aspect of the tibia and inserts onto the lateral epicondyl of the femur
Medially rotates the knee, unlocks the knee at the beginning of knee flexion.
51
What muscle is shown in the image?
Popliteus muscle
52
What ligament make up the medial side of the ankle joint?
Posterior tibiotalar ligament
Tibiocalcaneal ligament
Tibionavicular ligament
53
What ligaments make up the lateral side of the ankle joint?
Anterior talofibular ligament
Posterior talofibular ligament
Calceofibular ligament
54
What is the clinical importance of the differences between the medial and lateral ligaments in the ankle?
Medial ligaments are larger and stronger
This means they are harder to tear
Hence a person is more likley to tear their lateral ligaments hence roll over their anke by inversion
55
What does a human footprint look like?
From and infant to adulthood the arch makes a greater influence on the footprint
With the medial border raised from the floor hence becoming less seen in the footprint as we age.
56
Draw a diagram of the platnar surface of the foor showing the start and end of the metatarsals, the heel pad, weight distribution in the foot and the different foor arches.
57
Breifly describe the medial longitudinal arch.
The talus is the highest point in the arch
Starts at the calcaneous and ends at the first metatarsal.
Is supported by the tibialis posterior tendon, flexor digitorum longus tendon and flexor hallucis longus tendon.
The bottom of the arch is made by the plantar aponeurosis, flexor digitorum brevis and abductor hallucis.
58
Describe the brief structure of the lateral longitudinal arch.
Starts at the calcaneous ends at the fifth metatarsal.
Highest point is the cuboid bone
Is less pronounced than the medial longitudinal arch
Is Supported by the fibularis longus tendon and muscle
The floor is made up of the abductor digiti minimi, flexor digitorum brevis and plantar aponeurosis
59
Briefly describe the structure of the transverse arch
Arches across the width of the foot
Between the metatarsals and the cuboid/cuneiforms
Supported by the fibularis longus tendon.
60
What are the clinical terms for when the arch in your foot is to big or too small?
Pes Cavus - too big,
Pes Planus - flat foot
61
What is shown in these x-rays?
Left intertrochanteric line is faded
Right likely a fracture of the femur neck (note different angle to the image on the left)
Also fracture line on the pubic ramus
62
What ligament is shown in the image?
Anterior talufibular ligament
63
What ligament is shown in the image?
Calcaneofibular ligament
64
What ligament is shown in the image?
Posterior talufibula ligament
65
What ligament is shown in the image?
Posterior tibiotalar ligament
66
What ligament is shown in the image?
Tibionavicular ligament
67
What ligament is shown in the image?
Anterior tibiotalar ligament
68
What ligament is shown in the image?
Tibiocalcaneal ligament
69
What is shown in the X-ray?
A fractured femur neck
70
What is shown in the x-ray?
Osteoarthritis note the narrowed joint space and the osteosclerosis around the hip joint,
Right hip is worse than the left hip
71
What is shown in the x-ray?
Osteosarcoma or bone cancer
72
What is shown in the x-ray?
Osteosarcoma or bone cancer
Bone is remodelling and have perioisteal bony eruption
73
What is shown in the x-ray?
Translucent lateral condyle of the femor
Suggests it could be metastasis
74
What is shown in the x-ray?
Knee osteoarthritis
Loss of joint space
Osteophytes
Subchondral bone cytst
Subchondral sclerosis
75
What is shown in the x-ray?
Patella fracture
Note not fully round, looks as if the bottom part has dropped down
76
What is shown in the x-ray?
Pin in a foot of a child
Note the calcareous growth plate
77
What is shown in the x-ray?
Gun shot wound, led in the soft tissue of the foot
78
What is the function of the arches of the foot?
Shock absorpton
Then release the pressure to propel the person forward, like a spring.
79
How are each compartment in the leg seperated?
By fascia
80
What is compartment syndrome?
When swelling or bleeding increases the volume of the muscle beyond the ability of the fasica to stretch
Pressure in the compartment rises and occludes blood vessels, this reduction in blood flow can cause muscle and nerve damaged, potentially eventually death.
81
Where is compartmet syndrome most common?
The anterior compartment of the leg
Also occurs in the hands, buttocks, and thighs.
82
What are the symptoms of compartment syndrome?
Pain,w rose when muscles are stretched
Muscles feel tight anf swollen
When nerves are involved and permament damage has occured: tingling and burning sensations, numbness and muscle weekness.
83
Give an overview of acute compartment syndrome?
Acute - serious injury causing bleeding and swelling causes pressure to increase rapidly.
Also too tight casts, overuse of anabolic steroids and sudden return of blood flow after surgery.
Requires emergency treatment , fasioctomy to cut fasic and relieve pressure
84
How is compartment syndrome diagnosed?
Physical exam
x-ray and imaging to rule out other causes
Compartment pressure measure tests
85
What is chronic compartment syndrome?
From prolonged muscle exertion (sports)
most common in sports with repetitive movements such as wimming or running
More likley in people with less flexible fascia.
Pain comes with exercies and decreases during rest, however during progression of the condition pain intensifies and takes longer to recover.
Pain often causes person to stop before permanenet damage can occur, hence less damage than acute.
86
How can chronic compartment syndrome be prevented?
Doing low impact exercise
Alternating different types of exercise
Building endurance slowly not abruptly.
Working out on a softer surface
wearing proper shoes.
87
What is the inferior extensor retinaculum and where does it attach?
A thickened Y shaped band of fascia located anterior to the ankle joint.
Originates from the lateral cutaneous, inserts onto the medial malleolus and medial surface of the plantar aponeurosis.
Holds the extensor tendons in place, prevents them from bowstrining when contraction takes place.
88
What is the tarsal tunnel and what does it contain?
A theoretical structure on the medial surface of the foot with a bony floor and a connective tissue roof (flexor retinaculum).
Acts as a passageway between the posterior leg and the foot.
Contains the Tibialis posterior tendon, felxor digitorum longus tendon, posterior tibial artery and vein, tibial nerve and the flexor hallucis longus tendon
Tom Dick And A Very Nervous Harry.
89
What are the plantar interossei?
What is their function?
Small muscles located on the metacarpals of digits5,4,3.
Aids flexion at the metatarsophangeal joint and adduction the digits.
90
Why is the ankle joint known as a motor joint?
Phrase taken from woodwork
Talus is secured with joint to tibia and fibula, secure and strong joint.
91
How is weight transfered in the foot?
From the heal pad up the medial side of the plantar surface to the heads of the metatarsals to the phalangeas
