Week 4 - Lower Limb Flashcards
Angular Knee Deformaties
Genu Valgum (Knock-knee).
Genu Varum (Bow-legged).
Anterior Cruciate Ligament
ACL
Taut in EXTENSION.
Prevents posterior displacement of femur.
Lachman Test.
O = medial wall of lateral femoral condyle.
I = Intercondyloid eminence of tibia.
Posterior Cruciate Ligament
PCL
Taut in FLEXION.
Prevents anterior displacement of femur.
O = medial Femoral Condyle.
I = posterior aspect of TIBIAL Plateau.
Menisci
Medial:
C-shaped.
Attached to MCL.
Fixed.
Lateral:
Oval-shaped.
Attached to Popliteus tendon.
Mobile.
Connected anteriorly by transverse ligament.
Terrible Triad
Tibial Collateral Ligament,
Medial Meniscus.
Anterior Cruciate Ligament.
Popliteus
Key to the Knee.
O: Lateral femoral epicondyle.
I: Post proximal tibia.
Action: Laterally rotates femur on tibia.
Artery: Popliteal
Nerve: Tibial
Quadriceps Femoris
Muscles? Nerve? Action?
Rectus Femoris
Vastus (Medialis, Intermedius, Lateralis).
Action: Extend knee (L3-L4)
Nerve: femoral nerve (L2-L4).
Q-Angle
Quadriceps line of pull & patellar tendon intersection.
~15 degrees.
angle > in females.
Strengthen Vastus Medialis to counteract Lateralis.
Iliotibial Band
O: Iliac Crest.
I: Lateral tibial tract.
Thickening of fascia latae.
Action: Lateral stabilization of hip/knee. Pulls knee into hyper extension.
Nerve: Superior & inferior gluteal.
Artery: Superior gluteal.
Hamstrings
Semitendinosus.
Semimembranosus.
Biceps femoris.
Flex knee.
Sciatic Nerve (except for SH BF = CFN)
Pes Anserinus
Attachment site
Goose Foot
3 conjoined tendons from each thigh compartment.
1. Sartious
2. Gracilis
3. Semitendinosus
Anteromedial tibia. Superficial to MCL.
Knee Bursae
- Suprapatellar
- Subcutaneous prepatellar
- Deep infrapatellar
- Subcutaneous infrapatellar
Sural nerve
S1,S2
Cutaneous nerve formed by sciatic nerve in popliteal fossa. Lateral leg innveration. Runs alongside small saphenous vein.
Runs deep until Calcaneal (Achilles) tendon (base of gastronemious).
Sole of the foot Innervation.
Medial and Lateral plantar (Branch of tibial nerve)
Malleolus
(Ankle bone)
Lateral Malleolus from fibula.
Medial malleolus from tibia.
Osteology of Foot
7 Tarsals.
- Proximal: talus + calcaneus
- Intermediate: Navicular
- Distal: Cuboid + M/I/L cuneiforms
5 MetaTarsals.
14 Phalanges.
Anterior Compartment lower leg
Muscles/Blood supply/Nerve
Tibialis Anterior.
Extensor Hallucis Longus.
Extensor Digitorum Longus.
Fibularis Tertius.
Dorsiflex Ankle (L4-L5).
Deep fibular Nerve (Lesion results in footdrop).
Anterior Tibial Artery.
Dorsalis Pedis Artery
Continuation of Anterior Tibia artery. Name changes once artery crosses the ankle joint.
Lateral Compartment
Muscles
Fibularis Longus.
Fibularis Brevis.
Evert Ankle (L5-S1).
Superficial Fibular nerve.
Fibular Artery.
Retinacula
Superior & Inferior Extensor retinaculum.
Superior & Inferior Fibular Retinaculum.
Superficial Posterior Compartment
3 Muscles
Gastrocnemius.
Soleus.
Plantaris.
Action: Plantar Flexors (S1,S2).
Posterior Tibial Artery.
Tibial Nerve.
Gastrocnemius crosses the knee, therefore also a knee flexor.
Soleus is solely flexor.
Deep Posterior Compartment
4 Muscles
Tibialis Posterior.
Flexor Digitorum Longus.
Flexor Hallucis Longus.
Popliteus.
Tibial Nerve.
Posterior Tibial Artery.
Action: Plantar Flexors (S1,S2).
Tarsal Tunnel
Tom Dick ANd Harry
Tibialis Posterior.
flexor Digitorum longus.
posterior tibial Artery.
tibial Nerve.
flexor Hallucis Longus.
Anterior to Posterior. Tendon order only applies here.
Subtalar Joint
Talocalcaneonavicular joint.
Ball and socket joint.
Site of Inversion and Eversion of foot.
Fibular Collateral Ligament
3 ligaments
3 ligaments:
Anterior Talofibular.
Posterior Talofibular.
Calcaneofibular.
Deltoid Ligament
4 ligaments
- Anterior Tibiotalar
- Posterior Tibiotalar
- Tibiocalcaneal
- Tibionavicular
Hallux Valgus & Varus
Valgus: Lateral metatarsal deviation.
Varus: Medial deivation - big toe towards midline.
Myotomes of Lower Limb
L2 -Hip flexion
L3 - Knee Extension
L4 - Ankle Dorsiflex
L5 - Big toe Extension
S1 - Ankle Plantarflex
Mytomes of Upper Limb
C5 - Shoulder Abduction
C6 - Elbow Flexion
C7 - Elbow Extension
C8 - Finger Flexion
T1 - Finger Abduction
4 Strategies for correcting COM
- Ankle
- Hip
- Step
- Combined
To maintain balance, COM must be withing BOS.
Sensory component of balance
- Somatosensory - skin receptors
- Proprioceptive - muscle spindles
- Visual - eyes
- Vestibular - inner ear
Need to:
Predict
Detect
Execute
Posture
Relative position of various body parts in relation to others, environment, and gravity.
Static: When the body is still
Dynamic: Balance during movement