Block 3: Knee and Leg TBL Flashcards

1
Q

What type of joint is the knee?

A

synovial joint with hinge

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2
Q

F(x) of the knee joint

A

hinge joint that allows for flexion and extension

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3
Q

What are the articulations of the knee joint?

A

b/w femur & tibia (weight bearing)

b/w patella and femur

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4
Q

Briefly describe the anatomy of the knee joint

A
  • Synovial hinge joint
  • 2 articulations
  • 2 fibrocartilaginous mensici on either side
  • Supporting Ligaments
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5
Q

Describe the fibrocartilaginous menisci of the knee joint

location, f(x)

A

location: one medial, one lateral

f(x): accomodate for change in shape of the articular surfaces during joint movement

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6
Q

What are the supporting ligaments of the knee joint?

A
  • 2 collateral ligaments
  • 2 cruciate ligament s
  • Patellar Ligament
  • Transverse Ligament of the Knee
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7
Q

Describe the collateral ligaments of the knee

location
f(x)
name

A

location: on either side of the knee joint
f(x): stabilize the hinge joint on the knee
names: fibular collateral tibial collateral

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8
Q

Describe the cruciate ligaments of the knee

location
f(x)
names

A

location: connecting the tibia and the femur
f(x): (anterior): prevent anterior displacement of tibia; (posterior): restricts posterior displacement

anterior and posterior cruciate ligaments

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9
Q

Describe the patellar ligament

A

most anterior ligament; inferior extension of the quadriceps ligament

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10
Q

F(x) of the transverse ligament of the knee

A

connecting the 2 menisci

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11
Q

Describe the vascular supply of the knee

A

genicular anastamoses around the knee (supplied by genicular branches of femoral and popliteal arteries)

These branches form an anastamotic network around the joint

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12
Q

What is the innervation of the knee joint?

A

obturator
femoral
tibial
commonf ibular nerves

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13
Q

What is the f(x) of the posterior compartment of the leg

A

flexors

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14
Q

Contents of the superficial group of the posterior leg compartment

A

gastrocnemius, soleus, plantaris

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15
Q

Describe the gastrocnemius muscle

A

2 heads (lateral and medial) that come together to form the calf

In the lower leg, the fibers join the soleus to become the calcaneal tendon

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16
Q

Contents of the deep group of the posterior leg

A

popliteus, flexor hallucis longus, flexor digitorum longus, tibialis posterior

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17
Q

Arteries of the posterior compartment of the leg

A

popliteal artery, anterior tibial artery, posterior tibial artery

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18
Q

Nerves of the posterior compartment of the leg

A

tibial nerve

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19
Q

Tibial Nerve is a branch of

A

sciatic nerve

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20
Q

What does the tibial nerve innervate?

A

deep muscles in the posterior compartment of the leg, superficial muscles in the posterior compartment of the leg

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21
Q

Describe the course of the tibial nerve

A
  1. descends into the posterior compartment from the popliteal fossa
  2. passes under tendinous arch b/w fibular and tibial heads of soleus muscle
  3. leaves posterior compartment of the leg at the ankle by passing through the tarsal behind the media lmalleolus
  4. enters the foot to supply most intrinsic muscles and skin
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22
Q

Gastrocnemius

Innervation, F(x), Significant Notes

A

Innervation: tibial nerve
f(x): plantarflexes the foot, flexes the knee
note: medial and lateral heads join w/ soleus to form calceneal tendon

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23
Q

Plantaris

Innervation, F(x), notes

A

Innervation: tibial nerve
f(x): plantarflexes foot, flexes knee
note: small muscle belly and thin, long tendon

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24
Q

Soleus

Innervation, F(x), notes

A

Innervation: tibial nerve
f(x); plantarflex the foot
notes: on the inferior end, it narrows to join the calcaneal tendon

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25
Q

Popliteus

Innervation, f(x),

A

innervation: tibial nerve

f(x): stabilizes the knee joint by resisting lateral rotation of the tibia on the femur; unlocks the knee joint

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26
Q

Flexor Hallucis Longus

Innervation, f(x), notes

A

innervation: tibial nerve
f(x): flexes the great toe
note: very active during toe off phase of walking

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27
Q

Flexor Digitorum Longus

Innervation, f(x), notes

A

innervation: tibial nerve

f(x): flexes lateral 4 toes involved w/ gripping the ground during walking

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28
Q

Tibialis Posterior

Innervation, f(x)

A

innervation: tibial nerve

f(x): inversion & plantarflexion of the foot

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29
Q

What is the nerve of the posterior compartment

A

tibial nerve

30
Q

What does the tibial nerve give rise to?

A
  1. branches that supply all the muscles in the posterior compartment of the leg
  2. sural nerve & medial calcaenal nerve (cutaneous nerves)
31
Q

Sural Nerves f(x)

A

supplies skin on the lower posterolateral surface of the leg and the lateral side of the foot, little toe

32
Q

Medial Calcaneal Nerve f(x)

A

innervates the skin on the medial surface and sole of the heel

33
Q

Crural Fascia

A

deep fascia of the leg, continuous w/ the facia lata superiorly (after the knee joint, the fascia lata is then the crura fascia)

34
Q

Small Saphenous Vein

A

arises from the lateral end of the dorsal venous arch of the foot; pierces the deep fascia in the popliteal fossa and drains into the popliteal vein

35
Q

Interosseous Membrane

A

membrane b/w the tibia and fibula

36
Q

Fasciotomy

A

cutting of the fascia; good treatment for compartment syndrome

37
Q

Compartment Syndrome

A

swelling within a fascia enclosed muscle compartment in the limb

38
Q

Achilles Tendon

aka
attaches
formed by

A

aka calcaneal tendon

attaches to the sole of the foot

formed by convergence of the medial and lateral head of the gastrocnemius w/ the soleus muscle

39
Q

Flexor Retinaculum

A

thick strip of connective tissue that spans the bony depression formed by the malleolus, medial & posterior surfaces of the calcaneus, & the interior surface of the sustenaculum tali

40
Q

Achilles Tendon Reflex Testing

Purpose
Method

A

purpose: part of lower extremities exam
method: a tap on the calcanea tendon posterior to the ankle (tendon of gastrocnemius & soleus) tests S1 and S2 spinal cord levels

41
Q

What is the main arterial supply of the leg?

A

popliteal artery

42
Q

Popliteal Artery

supplies
how does it enter the posterior compartment?
branches

A

supplies: leg and foot
enters: from the popliteal fossa behind the knee
branches: anterior and posterior tibial divisions

43
Q

Anterior Tibial artery supplies

A

anterior compartment of the leg

44
Q

Posterior tibial artery supplies

A

posterior compartment of the leg

45
Q

Branches of the posterior tibial aertery

A

circumflex artery, fibular artery

46
Q

Describe Achilles Rupture

due to
occurs in
diagnosis

A

due to sudden or direct trauma

occurs in healthy tendons, but can also occur if there are certain conditions that predispose you to it (ex: tendinopathy)

diagnosis: pt. describes as being “shot” or “kicked” behind the ankle

47
Q

What are the muscles of the anterior compartment of the leg?

A

tibialis anterior
extensor hallucis longus
extensor digitorum longus
fibularis tertius

48
Q

What is the arterial supply to the anterior compartment of the leg?

A

anterior tibial artery

49
Q

What is the innervation of the anterior compartment of the leg?

A

deep fibular nerve

50
Q

What are the muscles of the lateral compartment of the leg?

A

fibularis longus

fibularis brevis

51
Q

What is the arterial supply to the lateral compartment of the leg?

A

no major artery, supplied by branches of the fibular artery

52
Q

What is the innervation of the lateral compartment of the leg?

A

superficial fibular nerve

53
Q

Deep fibular nerve innervates

A

anterior compartment of the leg

54
Q

Fibularis Longus

anatomy
action
innervation

A

anatomy: arises in the lateral compartment but its tendons cross under the foot to attach to bones on the medial side
action: everts and plantarflexes the foot; supports arches of the foot
innervation: superficial fibular nerve

55
Q

Fibularis Brevis

anatomy
action
innervation

A

anatomy: deep to longus
action: eversion of foot
innervation: superficial fibular nerve

56
Q

Tibialis Anterior
anatomy
action
innervation

A

anatomy: most anterior & medial of the muscles in the anterior compartment; muscle fibers converge in lower 1/3 of leg to form a tendon
action: dorsiflexion of foot and ankle joint, inversion of foot, dynamic support of medial arch of foot
innervation: deep fibular nerve

57
Q

Extensor Hallucis Longus

anatomy
action
innervation

A

anatomy: lies next to and is overlapped by the tibialis anterior
action: extension of the great toe, dorsiflexion of the foot
innervation: deep fibular nerve

58
Q

Extensor Digitorum Longus
anatomy
action
innervation

A

anatomy: most posterior & lateral of the muscles in the anterior compartment of leg
action: extends the toes, dorsiflexes the foot @ anle joint
innervation: deep fibular nerve

59
Q

Fibularis Tertius
anatomy:
action
innervation

A

anatomy: normally considered part of the exensor digitorum longus
action: dorsiflexion and eversion of the foot
innervation: deep fibular nerve

60
Q

Deep Fibular Nerve Innervates

A

all muscles of the anterior compartment

continues to dorsal aspect of the foot where it innervates the extensor digitorum brevis, contributes to innervation of the first 2 dorsal interossei muscles, supplies skin b/w 2nd and great toes

61
Q

Superficial Fibular Nerve innervates

A

lateral compartment of the leg

62
Q

What are the branches of the common fibular nerve?

A

cutaneous branches
deep fibular nerve
superficial fibular nerve

63
Q

What are the cutaneous branches of the common fibular nerve

A

sural communicating nerve

lateral sural cutaneous nerve

64
Q

Sural Communicating Nerve innervates

A

skin over the lower posterolateral side of the leg

65
Q

Lower sural cutaneous nerve innervates

A

skin over the upper lateral leg

66
Q

Superficial Fibular Nerve innervates

A

fibularis longus and fibularis brevis

supplies all dorsal areas of foot and toe

67
Q

What is the arterial supply for the anterior leg

A

anterior tibial artery

68
Q

Describe the origin of the anterior tibial artery

A

from the popliteal artery in the posterior compartment, then passes into the anterior compartment of the leg

69
Q

anterior tibial artery gives rise to

A

anterior medial malleolar artery & anterior lateral malleolar artery

70
Q

What is the arterial supply of the lateral compartment of the leg?

A

no major arteries pass through the lateral compartment, so supply is from branches from the fibular artery in the posterior compartment of the leg

71
Q

Intermuscular Septa

A

fascial layers between the compartments