MSK 3 - Lower Limbs Flashcards

1
Q

a

A

Proximal tibiofibular joint

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2
Q

b

A

Tibial tuberosity

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3
Q

c

A

Head of fibula

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4
Q

d

A

Interosseous membrane

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5
Q

e

A

Distal tibiofibular joint

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6
Q

f

A

Groove for tibialis posterior

Medial malleolus tendon

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7
Q

g

A

Lateral malleolus

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8
Q

The tibia and fibula are held together by sheet of fibrous material called the _________ membrane. This provides additional stability to the skeletal bones

A

interosseous

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9
Q

The tibia and fibula are joined at the proximal and distal aspects

The superior or proximal tibio-fibular joint is a _____ type of synovial joint

The inferior or distal tibio- fibular joint is a type of _______ joint

A

plane

fibrous

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10
Q

The musculature of the leg is built around this framework and is divided into 3 compartments

Identify these compartments on the cross section

A

1. Green = lateral compartment

  1. Blue = anterior compartment
  2. Yellow and Red = posterior superficial and deep compartment
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11
Q

What is the anterior bony prominence you can feel about 3 to 4 cm below the knee joint?

A

tibial tuberosity

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12
Q

Straighten your leg – which tendon attaches onto the superior aspect of this? (tibial tuberosity)

A

Patellar tendon

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13
Q

Feel for the malleoli at the distal aspect of the leg as it reaches the ankle

What bone makes up the medial malleolus?

What bone makes up the lateral malleolus?

A

Tibia

Fibula

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14
Q

_________ is the movement of the ankle upwards

A

Dorsiflexion

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15
Q

_________ flexion is the movement of the ankle downwards

A

Plantarflexion

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16
Q

Eversion is the movement of the ankle ________

A

outwards

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17
Q

Inversion is the movement of the ankle ________

A

inwards

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18
Q

Identify the 4 muscles in the anterior compartment of the leg:

1

A

1. Tibialis anterior

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19
Q

Identify the 4 muscles in the anterior compartment of the leg:

2.

A

Extensor Digitorum longus

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20
Q

Identify the 4 muscles in the anterior compartment of the leg:

3

A

3. Extensor Hallucis longus

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21
Q

Identify the 4 muscles in the anterior compartment of the leg:

4.

A

Fibularis Tertius – this is a small muscle found at the distal aspect of the leg

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22
Q

Muscles of anterior compartment of leg:

1. Tibialis anterior

2. Extensor Digitorum longus

3. Extensor Hallucis longus

4. Fibularis Tertius – this is a small muscle found at the distal aspect of the leg

These muscles are mainly __________ of the ankle joint and ________ of the toes.

A

dorsiflexors

extensors

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23
Q

Clinical – Fibular or Peroneal (or both?):

whats the difference?

A

Within the leg the terms ‘peroneus/peroneal’ and ‘fibularis/fibular’ are interchangeable when referring to muscles and nerves.
For the purposes of this workbook we are sticking to ‘fibularis or fibular’ for description

Importantly please don’t get peroneal mixed up with perineal…these refer to very different anatomical areas!

24
Q

Neurovascular Structures of the Anterior Leg

The neurovascular structures of the leg are continuations with structures in the thigh as they continue distal through the popliteal fossa

What are the two divisions of sciatic nerve?

A
  1. Tibial nerve
  2. Common fibular nerve
25
Q

What are the two divisions of the popliteal artery as it enters the leg?

A
  1. Anterior tibial artery
  2. Posterior tibial artery
26
Q

The common fibular nerve further divides in the leg into the ________ fibular and ____ fibular nerves

A

superficial

deep

27
Q

Which branch (of the common fibular nerve) innervates the muscles in the anterior compartment of the thigh?

A

Deep fibular nerve

28
Q

a

A

Superficial fibular nerve

29
Q

b

A

Deep fibular nerve

30
Q

c

A

Anterior tibial artery

31
Q

d

A

Dorsalis pedis artery

32
Q

The lateral compartment of the leg contains two muscles, what are they?

A
  1. Fibularis longus
  2. Fibularis brevis
33
Q

Muscles in the lateral compartment of the leg ________ the foot and weakly ________ the ankle joint.

A

eversion

plantarflex

34
Q

Which fibular nerve supplies the muscles of the lateral compartment?

A

Superficial fibular nerve

35
Q

Clinical Case

A 24-year-old man presents to the A+E department with new foot drop (inability to dorsiflex the ankle) following being tackled in a game of football.

The tackle occurred on the lateral aspect of his leg

Specifically, where has the injury occurred?

Which letter does it correspond to on the diagram?

Why has the foot drop occurred?

A

Deep fibular nerve

B

C is tibial nerve, A is superficial fibular nerve and D is the common fibular nerve

Loss of innervation of the anterior muscles of the leg

36
Q

The dorsum of the foot (anterior aspect) is similar to that found in the upper limb. what is it like?

A

It has loose skin, compared to the plantar surface, and has a number of structures passing through the area heading distally to the foot and ankle.

37
Q

The lesser saphenous vein ascends on the _________ aspect of the leg, and drains into the _______ vein

The greater saphenous vein ascends on the ______ aspect of the leg and thigh and drains into the _______ vein.

A

posterior

popliteal

medial

femoral

38
Q

a

A

Tibialis anterior

39
Q

b

A

Dorsalis pedis

40
Q

c

A

Extensor digitorum longus tendons

41
Q

Clinical – Pulses

2 pulses can be felt in and around the foot and ankle area.

what are they?

A

The dorsalis pedis is the continuation of the anterior tibial artery and is palpated between the 1st and 2nd metatarsal bones.

Feel for it on your foot, and try and trace it proximally as it heads deep into the anterior compartment of the leg

The posterior tibial pulse is palpated behind the medial malleolus it is the continuation of the posterior tibial artery.

42
Q

what type of joint is the ankle joint?

A

The ankle joint is a hinge type of synovial joint

43
Q

The ankle is a type of mortise joint - what does this mean?

A

meaning that the bones at the superior aspect of the joint provide a socket in which the talus fits into and can fit into a move.

44
Q

model the superior (articular surface of the talus is covered with what?

A

hyaline cartilage

45
Q

The articular surfaces of the ankle are:

The distal end of the ____ and ______ with the superior part of the _____ bone.

The malleoli grip the _____ tightly during the movements of the ankle joint

The malleolar grip is strongest during __________ movement of the ankle joint.

The ankle joint is unstable during _________ movement of the ankle joint.

A

tibia

fibula

talus

talus

dorsiflexion

plantarflexion

46
Q

1

A

Tibionavicular

47
Q

2

A

Tibiocalcaneal

48
Q

3

A

Posterior talofibular

49
Q

4

A

Anterior tibiofibular

50
Q

5

A

Calcaeofibular

51
Q

6

A

Anterior talofibular

52
Q

Which ligament of ankle joint is the weakest?

A

Lateral ligament – anterior talofibular

53
Q

Which ligament of the ankle joint is named the deltoid ligament?

A

Medial ligament

54
Q

During which movements of the subtalar joint are ankle sprains more common?

A

Inversion

Because of the strength of these ligaments both over inversion and eversion of the ankle joint can cause fractures to the either the medial or lateral malleoli

55
Q

Movement of the nakle joint - dorsiflexion

what muscles are involved in this movement?

A

Tibiails anterior, extensor digitorum longus, extensor hallucis longus

56
Q

Movement of the nakle joint - Plantar flexion

what muscles are involved in this movement?

A

Plantaris, soleus, fibularis longus, gastrocnemius, flexor hallucis longus, flexor digitorum longus