MSK 8 - Lower Limbs 4 Flashcards

1
Q

What is the popliteal fossa?

A

The popliteal fossa is a fat–filled diamond- shaped space located posterior to the knee joint. It is comparable to the ante-cubital fossa found in the upper limb

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2
Q

What is 1?

A

Biceps femoris

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3
Q

What is 2?

A

Semimembranosus

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4
Q

What is 3?

A

Semitendonosus

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5
Q

What is 4?

A

Tibial nerve

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6
Q

What is 5?

A

Popliteal artery

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7
Q

What is 6?

A

Common peroneal (fibular) nerve

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8
Q

What word is interchangable with fibular?

A

Peroneal

(not perineal)

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9
Q

What structures are found in the popliteal fossa?

A
  1. Biceps femoris
  2. Semimembranosus
  3. Semitendinosus
  4. Tibial nerve
  5. Popliteal artery
  6. Common peroneal nerve
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10
Q

What is the relationship between the popliteal vein and popliteal artery?

A

Popliteal artery is deep to vein

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11
Q

What muscles form the following boundaries of the popliteal fossa:

  • superior
  • inferior
A
  • Superior boundary
    • Medial - semimembranosus and semitendonosus tendons
    • Lateral - bicep femoris
  • Inferior
    • Gastrocnemius
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12
Q

What are the contents of the popliteal fossa?

A
  1. Fat
  2. Posterior cutaneous nerve of thigh
  3. Tibial and common fibular nerves
  4. Popliteal artery and vein and their branches and tributaries
  5. Termination of small saphenous vein
  6. Popliteal lymph nodes and vessels
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13
Q
A
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14
Q

What is the popliteal artery a contuation of?

A

Femoral artery as it emerges from adductor hiatus

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15
Q

What compartment of the lower leg is the largest?

A

Posterior compartment

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16
Q

How can the muscles in the posterior compartment of the lower leg be divided?

A

Into superficial and deep group

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17
Q

How many heads does the gastrocnemius have?

A

2 heads

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18
Q

What nerve innervates the gastrocnemius muscle?

A

Tibial nerve (S1, S2)

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19
Q

What are the nerve roots of the tibial nerve?

A

S1, S2

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20
Q

What is the action of the gastrocnemius?

A

Dorsiflexion of ankle

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21
Q

What is the action of the plantasis?

A

Weakly assist gastrocnemius in plantarflexion of ankle, function is mainly proprioceptive

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22
Q

What is unsual about the plantaris?

A

Very long tendon

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23
Q

What are the superficial muscles of the posterior compartment of lower leg?

A
  1. Gastrocnemius
  2. Plantaris
  3. Soleus
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24
Q

What is A?

A

Medial head of gastrocnemius

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25
Q

What is B?

A

Lateral head of gastrocnemius

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26
Q

What is C?

A

Aponeurosis of gastrocnemius

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27
Q

What is D?

A

Soleus

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28
Q

What is E?

A

Plantaris

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29
Q

What is F?

A

Achiles tendon

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30
Q

What is the strong terminal attachment of the gastrocnemius called?

A

Achilles tendon

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31
Q

Where does the gastrocnemius insert?

A

As the achilles tendon onto the posterior aspect of calcaneous bone

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32
Q

What is 1?

A

Popliteus

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33
Q

What is 2?

A

Flexor halluces longus

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34
Q

What is 3?

A

Tibialis posterior

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35
Q

What is 4?

A

Flexor digitorum longus

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36
Q

What are the 4 muscles of the deep compartment of posteror compartment of lower leg?

A
  1. Popliteus
  2. Flexor halluces longus
  3. Tibialis posterior
  4. Flexor digitorum longus
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37
Q

How do the deep posterior muscles of the lower legs get to the sole olf the foot?

A

These muscles must pass to the sole of the foot, but do not travel around the calcaneus, where they would be compressed.

Rather they pass medially to enter through the ‘door to the foot’, posterior to the medial malleolus, covered by the flexor retinaculum

38
Q

What is the action of the deep posterior muscles of the lower leg?

A

Flexion of toes and/or ankle

39
Q

What nerve and vessel accompany the deep posterior muscles of the lower leg to the ‘door of the foot’?

A
  • Tibial nerve
  • Posterior tibial artery
40
Q

Which nerve innervates all the muscles of the posterior compartment of the leg?

A

Tibial nerve (S1, S2)

41
Q

Which branch of the popliteal artery supplies the posterior compartment of the leg?

A

Posterior tibial artery

42
Q

What is A?

A

Tibial nerve

43
Q

What is B?

A

Posterior tibial artery

44
Q

What is C?

A

Common fibular nerve

45
Q

What is D?

A

Anterior tibial artery

46
Q

What is a rule of thumb about the course of the main motor nerves and sensory nerves of the lower legs?

A
  • Generally
    • Motor nerves follow arterial supply
    • With some sensory nerves following venous supply
47
Q

What are the functions of the foot?

A

The foot functions to support the body weight and plays an important role in locomotion.

48
Q

What is 1?

A

Body of talus

49
Q

What is 2?

A

Calcaneus

50
Q

What is 3?

A

Navicular

51
Q

What is 4?

A

Cuboid

52
Q

What is 5?

A

Medial, intermediate and lateral cuneiform

53
Q

What is 6?

A

Metatarsals 1-5

54
Q

What is the deep fascia of the foot known as?

A

Plantar fascia

55
Q

What are the functions of the investing fascia?

A
  • Supporting arches of foot
  • Acting as spring when pushing off in normal walking gait
56
Q

How does plantar fascitis often present?

A

Plantar fasciitis is a common presenting condition, often felt as heel pain and is generally brought on by overuse (running) or increase in weight and/ or age.

57
Q

What is treatment of plantar fascitis?

A

Treatment of this involves resting, strengthening exercises or invasive interventions such as steroid injection or as a last resort surgery.

58
Q

What movements of the ankle are achieved at the mortise joint of the ankle?

A

Flexion and extension

59
Q

What joints does movement of the ankle occur at?

A
  • Mortise joint
    • Flexion and extension
  • Subtalar joints (those below talus) - talonavicular and talocalcaneal
    • Exersion and inversion
60
Q

What movements occur at the subtalar joint?

A

Inversion and eversion

61
Q

What is 1?

A

Talonavicular joint

62
Q

What is 2?

A

Talocalcaneal joint

63
Q

What are the subtalar joints?

A
  • Talonavicular joint
  • Talocalcaneal joint
64
Q

What movements occur at:

  • talonavicular joint
  • talocalcaneal joint
A
  • Talonavicular joint
    • Inversion and eversion
  • Talocalcaneal joint
    • Helps with process allowing for some lateral sliding movement
65
Q

What kind of joint is the talonavicular joint?

A

Ball and socket synovial joint

66
Q

What kind of joint is the talocalcaneal joint?

A

Plane type synovial joint

67
Q

What are the 2 arches of the foot?

A
  • Longitudinal arch
  • Transverse arch
68
Q

What are the fucntions of the arches of the foot?

A
  • Distribute body weight on the main fat pads of food
  • Act as shock absorber
69
Q

Body weight tends to force what bones apart?

A

In the view of the foot below, see how the body weight acting vertically downwards on the talus will tend to force the navicular and calcaneus bones apart.

This force is resisted by many of the muscle tendons which cross these joints but also by some important ligaments. This is the plantar calcaneo-navicular or ‘spring’ ligament. It also helps to maintain the medial longitudinal arch and contributes to the subtalar joints.

70
Q

What ligament helps resist the force of body weight seperating the navicular and calcaneus bones apart?

A

Plantar calcaneo-navicular or spring ligament (also called)

71
Q

What are the functions of the plantar calcaneo-navicular ligament?

A
  1. Resist body weight seperating navicular and calcaneus bones apart
  2. Maintain medial longitudinal arch
  3. Contribute to subtalar joints
72
Q

What is the plantar calcaneo-navicular ligament also called?

A

Spring ligament

73
Q

What is the integrity of the foot arches maintained by?

A
  • Passive factors
    • Shape of united bones
    • Plantar spring ligament
    • Long plantar ligament
    • Short plantar ligament
  • Dynamic factors
    • Intrinsic muscles of foot
    • Long flexor tendons
    • Tendon of tibialis anterior and fibularis longus
74
Q

What are some conditions of the arches in the foot?

A

High arches (pes cavus)

Flat feet (pes planus)

75
Q

What are the 4 layers of the muscles in the foot?

A
  1. Immeditely deep to plantar fascia
  2. Flexors and neurovascular bundle
  3. Deep intrinsic muscles
  4. Interossei muscles
76
Q

What is A?

A

Abductor digiti minimi

77
Q

What is B?

A

Flexor digitorum brevis

78
Q

What is C?

A

Abductor hallucis

79
Q

What is D?

A

Flexor hallicus longus

80
Q

What is E?

A

Flexor digitorum accessoris

81
Q

What is F?

A

Lumbricals 1-4

82
Q

What is G?

A

Lateral plantar nerve and artery

83
Q

What is H?

A

Medial plantar nerve and artery

84
Q

What muscles are immediately deep to the plantar fascia?

A
  1. Abductor digiti minimi
  2. Abductor hallucis
  3. Flexor digitorum brevis
85
Q

What are the muscles in the 2nd layer of the plantar foot?

A
  1. Flexor hallicus longus
  2. Flexor digitorum accessoris
  3. Lumbricals 1-4
86
Q

What is found in the neurovascular bundle in the 2nd layer of the plantar foot?

A
  1. Medial plantar nerve and artery
  2. Lateral plantar nerve and artery
87
Q

What is the action of the first layer of plantar foot muscles?

A

Flexion of toes, initirating the first part of gait cycle (ground phase)

88
Q

What are the terminal branches of the tibial artery and nerve?

A
  • Tibial artery
    • Medial plantar artery
    • Lateral plantar artery
  • Tibial nerve
    • Medial plantar nerve
    • Lateral plantar nerve
89
Q

What does layer 3 (deep instrinsic muscles) of the foot contain?

A

The adductors and short flexors of toes

90
Q

What does layer 4 of the foot muscles contain?

A
  • Interossei
    • Subdivided into plantar interossei which adduct
    • and dorsal interossei which abduct digits
91
Q

What can the interossei of the foot be subdivided into?

A

Plantar and dorsal interossei

92
Q

What is the action of:

  • plantar interossei
  • dorsal interossei
A
  • Plantar interossei
    • Adduction of digits
  • Dorsal interossei
    • Abduction of digits