deck_4687210 Flashcards
(213 cards)
1
Q
The _________ of the femur projects superolaterally, while the _________ projects medially.
A
greater trochanter - projects superolaterally;
lesser trochanter - projects medially
2
Q
The ___ of the femur is most commonly fractured in patient s with osteoporosis.
A
neck
3
Q
The ______ is a rough line that is on the posterior of the shaft of the femur. It is a site of muscle attachment. It is made up of the lateral lip and the medial lip.
A
linea aspera
4
Q
Proximally, the lateral lip of the linea aspera expands into -_______. The medial lip of the linea aspera becomes ______?
A
lateral lip –> gluteal tuberosity; medial lip –> pectineal line
5
Q
Distally, the lateral lip of linea aspera diverges into: _____ and the medial lip diverges into: _______
A
lateral lip –> lateral supracondylar lines;
medial lip –> medial supracondylar lines
6
Q
What are the structures called that articulate with the tibial plateau of the tibia? What are they separated by?
A
- Medial and lateral condyles- These are separated by the intercondylar fossa
7
Q
The ________ is for the insertion of adductor magnus. What does it rest upon?
A
adductor tubercle- rests upon medial epicondyle
8
Q
______ is where the patellar ligament of the quadriceps tendon inserts
(part of the knee)
A
tibial tuberosity
9
Q
What is the largest sesamoid bone in the body?
A
patella
10
Q
Iliacus is innervated by?
A
femoral nerve
11
Q
Psoas major is innervated by?
A
lumbar plexus
12
Q
Origin of iliacus
A
iliac fossa
13
Q
Origin of psoas major
A
T12-L5 vertebrae
14
Q
Insertion of iliopsoas
A
lesser trochanter of the femur
(remember iliopsoas technically arises in posterior compartment, but is discussed w/ anterior compartment due to femoral innervation of iliacus)
15
Q
Fxn of iliopsoas
A
Flex thigh at hip joint
Most powerful flexor of the hip
Has femoral innervation
16
Q
Psoas sign
A
indicates that patient has irritation to their iliopsoas. Hyperextension of patient’s thigh results in pain.
17
Q
What are the 4 parts of quadriceps femoris?
A
- Rectus femoris
- Vastus lateralis
- Vastus medialis
- Vastus intermedius
18
Q
What are the muscles in the anterior compartment?
A
- sartorius
- quadriceps femoris
* patella is contained in the quadriceps femoris tendon - iliopsoas (technically posterior but often listed as part of anterior)
19
Q
- Flex, abduct, laterally rotate thigh at hip joint
- Flex leg at knee joint
- Origin: ASIS
- Insertion: Medial aspect of tibia inferior to condyle
- Innervation: Femoral nerve
A
Sartorius
20
Q
- Flex thigh at hip joint
- Extend leg at knee joint
- Origin: AIIS
- Insertion: Tibial tuberosity via patellar ligament
A
function of rectus femoris
21
Q
Function of vastus lateralis, vastus intermedius, vastus medialis
A
Extend leg at knee joint
22
Q
The tendon of quadriceps femoris contains this bone _______
A
patella
23
Q
After the patella, the tendon of the quadriceps femoris continues as this:
A
patellar ligament
24
Q
What are the 5 muscles in the medial compartment?
A
- pectineus
- gracilis
- adductor longus
- adductor brevis
- adductor magnus
25
1. Fxn: Flex, adduct thigh at hip joint
2. Origin: Pectineal line of Pubis
3. Insertion: Pectineal line of femur
4. Innervation: femoral nerve
Pectineus: fxn, origin, insertion, innervation
26
1. Fxn: Adduct thigh at hip joint, flex leg at knee joint, medial rotation of hip
2. Origin: body of pubis, ischiopubic ramus
3. Insertion: pes anserinus on anteromedial tibia [ medial aspect of tibia inferior to condyle ]
4. Innervation: obturator nerve
Gracilis: fxn, origin, insertion, innervation
27
1. Fxn: Adduct thigh at hip joint
2. Origin: body of pubis
3. Insertion: linea aspera
4. Innervation: obturator nerve
adductor longus
28
adductor magnus (2 portion): fxn, origin, insertion, innervation
2 portions of adductor magnus: (1) hamstring portion; (2) adductor portion.
1. Hamstring portion:
- Fxn: adduct and weakly EXTENDS thigh at hip jt.
- Origin: ischial tuberosity
- Insertion: adductor tubercle
- Innervation: sciatic nerve
2. Adductor portion
- Fxn: adducts and weakly FLEXES thigh at hip jt
- Origin: ischiopubic ramus
- Insertion: linea aspera
- Innervation: Obturator nerve
29
When the femoral vessels emerge from the adductor hiatus, what are they known as?
popliteal vessels
30
What is the space between the adductor magnus and the femur?
adductor hiatus
31
Where does the quadriceps tendon insert and how?
Tibial tuberosity via patellar ligament
32
This group of three muscles in the anterior compartment extends the leg at the knee joint. This group originates on the femur and inserts on the tibial tuberosity as the patellar ligament.
Vastus intermedius
Vastus lateralis
Vastus medialis
33
This muscle originates on AIIS and inserts w/rest of quadriceps muscles. Acts on both the hip and the knee joints.
Rectus femoris
34
The iliopsoas is innervated by _______.
femoral nerve
Iliopsoas- strongest hip flexor
Considered part of the anterior compartment b/c it is innervated by femoral nerve
35
This muscle is innervated by the femoral nerve, but it is located in the medial compartment of the thigh.
Responsible for flexing and adducting the thigh.
pectineus
36
The femoral sheath surrounds only: _____, _____, and _____
femoral artery, vein, and canal
37
NAVEL is used to remember...
structures in femoral triangle from LATERAL to MEDIAL
38
largest connection between deep and superficial venous system occurs at...
saphenous opening
39
How are the deep and superficial venous systems connected?
perforating veins
40
What does the femoral nerve innervate?
1. Sartorius
2. Quadriceps femoris
3. Pectineus
4. Iliopsoas
41
What does the obturator nerve innervate?
1. Gracilis
2. Adductor longus
3. Adductor brevis
4. Adductor magnus (adductor portion)
42
All of the following can be found in the femoral canal EXCEPT:
a. femoral nerve
b. loop of ileum
c. extraperitoneal fat
d. deep inguinal node
a. femoral nerve
b/c femoral nerve lies lateral to femoral artery (and therefore lateral to femoral canal) NAVEL.
- Femoral canal does contain lymphatics
- Could contain loop of ileum or extraperitoneal fat --> femoral hernia
43
As the great saphenous vein travels superiorly, it passes _______ to medial malleolus and _____ to medial femoral epicondyle.
anterior to medial malleolus
| posterior to medial femoral epicondyle
44
The neck of the femur is most directly supplied by:
a. perforating arteries
b. lateral circumflex femoral artery
c. superficial femoral artery
b. lateral circumflex femoral artery
| branch of deep femoral artery --> also gives off perforating arteries --> these supply posterior thigh
45
What does the superficial femoral artery supply?
- Superficial femoral artery = femoral artery distal to the deep femoral artery
- Gives off muscular branches and 1 branch to the knee
46
Anterior compartment muscles do this function:
- Flex hip
| - Extend leg at knee joint
47
Medial compartment muscles do this:
-Adduct hip
48
Posterior compartment muscles do this:
- Extend hip
| - Flex leg at knee joint
49
This, which is on the posterior femur, is the site of attachment for several thigh muscles, including the adductor magnus and the biceps femoris.
linea aspera
50
This, which is on the anterior femur, is the attachment for the anterior part of the hip joint capsule
intertrochanteric line
51
This is the site of attachment for the ligament of the head of the femur.
fovea capitis
52
This is the large prominence that serves as a site of attachment for multiple muscles. it projects superolaterally.
greater trochanter
53
this is the site of attachment of the quadratus ffemorus muscle
Quadrate tubercle
54
this is one of the insertion sites for the gluteus maximus muscle
gluteal tuberosity
55
this is the part of the pelvis that articulates with the femur. is made up of the ilium (superiorly), ischium (posteriorly), and pubis (anteriorly).
os coxa
56
Where do the ilium, ischium, and pubis meet? Also known as the socket of the hip joint.
acetabulum
57
What are the most important landmarks of gluteal region?
- ischial spine
- ischial tuberosity
- PSIS
58
What are the three lines called that define where the gluteal muscles arise?
3 gluteal lines:
Posterior
Anterior
Inferior
59
Gluteus maximus arises _______ (anterior/posterior) to the posterior line and also on the sacrotuberous ligament.
posterior
60
Gluteus medius arises _______ (ant/post/between) the anterior and posterior gluteal lines
between
61
Gluteus minimus arises between the ____ and ____ gluteal lines.
Anterior and Inferior
62
The joint between the femoral head in the acetabulum reprsents the: ______
hip joint
63
The ligaments of the ____ are designed to prevent hyperextension of the femur on the pelvis.
hip joint. While standing, you can be in slight extension on the hip joints without using hip flexor muscles to prevent yourself from falling backward. The ligaments tighten with extension.
64
The anterior ligament of the hip joint is called the _______.
iliofemoral ligament, also called the Y ligament.
| It is the strongest ligament of the hip joint!
65
Hip dislocations tend to be posterior because the _____ ligaments are weakest.
posterior
66
The ring of fibrocartilage in the acetabulum is called the...
acetabular labrum. The labrum deepens the fossa.
67
The ligament that extends from the pelvis into the fovea of the head of the femur is called the...
ligament of the head of the femur (ligamentum teres). It carries a small blood vessel (artery of the head of the femur).
68
Normal angle of the neck of the femur relative to the shaft
120-135degrees.
69
coxa vara is if the angle is _____
smaller than 120
70
cox valga is if the angle is ___
greater than 135
71
Shenton's line is a way to test for:
alignment of the hip structures. This line should appear like a smooth arch.
72
If the neck of the femur is fractured, the stronger muscles take over, resulting in an _____-rotated and ____-displaced leg.
externally rotated, superiorly displaced
73
Cartilage is ______ (shows greater transparency) on x-rays, so you can see the joint space. In the case of osteoarthritis, you cannot see the joint space.
radiolucent
74
The tensor fasciae latae muscle and the gluteus maximus muscle both insert into ______ on the lateral thigh
iliotibial band. The 2 muscles exert opposing forces on the IT band.
75
This muscle extends and externally rotates the thigh, and is especially active in extension against gravity (getting up from a chair, climbing stairs).
It originates POSTERIOR to the posterior gluteal line and from the sacrotuberous ligament.
Gluteus maximus
76
_____ (superficial or deep) to the Gluteus maximus, there are muscles that are mainly abductors and external rotators of the thigh.
Deep
77
Fan shaped muscle that originates from the ilium and inserts on the greater trochanter.
Specifically originates between the POSTERIOR and ANTERIOR gluteal lines
It functions as an abductor of the thigh and may participate in rotation (depending on if hip is flexed or extended, and if the anterior or posterior fibers are activated).
-It is a quite weak rotator.
Gluteus medius (it is deep to gluteus maximus)
78
This muscle is deep to gluteus medius, and superior gluteal vessels and nerve travel between these two muscles (gluteus medius and ______).
It is mostly an abductor; quite a weak rotator.
Originates between anterior and inferior gluteal lines
gluteus minimus
79
_______ is inferior to gluteus medius.
Origin: Anterior part of sacrum
Insertion: Greater trochanter of the femur
Innervation: Sacral plexus
Function: Laterally rotates the thigh at the hip joint
Piriformis muscle
80
These muscles are also inferior to gluteus medius. They surround the obturator internus muscle tendon.
Origin: Lesser sciatic notch
Insertion: trochanteric fossa
Innervation: Sacral plexus
Function: Laterally rotates thigh at hip joint
Superior and inferior gemelli
81
This muscle is even further inferior than the gemelli muscles.
Origin: Ischial tuberosity
Insertion: quadrate tubercle
Innervation: Sacral plexus
Function: Laterally rotates thigh at hip joint
Quadratus femoris
82
The large bursa between the gluteus maximus muscle and the greater trochanter is called ________. It can become inflamed and painful.
Trochanteric bursa
83
The ______ ________ is the origin for 3 of the 4 hamstring muscles.
Ischial tuberosity
84
The obturator internus, gemelli, quadratus femoris, piriformis, gluteus maximus m. are all involved in:
a. internal rotation
b. external rotation
External rotation
85
Gluteus medius and maximus....
- Abducts and medially rotates the thigh at the hip joint
| - Stabilizes the pelvis when standing on 1 leg
86
Gluteus maximus and TFL are involved in _____ by tensing the iliotibial tract. The abductor muscles (gluteus medius and minimus) are also involved in ______.
Balance (simultaneous activation of several muscle groups).
87
This is a method of testing strength of the gluteus medius/minimus muscles and the stability of the hip joint. Involves examining level of pelvis when lifting 1 foot off the ground. Example: when lifting the L leg, if the R gluteus medius muscle is weak, the pelvis will drop on the left. Usually it will contract to prevent the left side of the pelvis from dropping.
Trendelenburg test
+ Test: when the pelvis drops on the side that the leg is lifted from the floor. Why? If the hip itself is unstable or if the gluteal muscles are weak on that side.
+ for: Femoral head dislocation, gluteus medius and gluteus minimus rupture or weakness, superior gluteal nerve damage.
Tells us that the gluteus m.m. on the SUPPORTED side are not working.
88
Posterior thigh muscles are called....
hamstrings
89
What side of the posterior thigh are semimembranousus and semitendonosus on?
- Lateral or
- Medial
Medial side of the posterior thigh
90
Biceps femoris (long and short heads) is on which side of the thigh?
Lateral side
91
Except for ___ ____ of the biceps femoris, all of the hamstring muscles originate from where?
except for short head of biceps femoris, all hamstring muscles originate at the ischial tuberosity.
The short head originates on linea aspera.
92
Short head of biceps femoris is supplied by which nerve, while the other three hamstring muscles are supplied by the TIBIAL nerve?
common fibular nerve portion of the sciatic nerve
93
The iliotibial band inserts on the lateral tibial plateau at __________. The distal end of the iliotibial band passes over the ___ ____ ____ where it can be irritated by knee flexion (IT band syndrome).
Gerty's tubercle
| lateral femoral condyle
94
The biceps femoris inserts on the ____ ______
fibular head
95
The semimembranosus muscle inserts on the _____ ____ ____.
medial tibial plateau
96
The _____, _____ , and ______ (three other long tendons) insert on the anteromedial tibia. This insertion is fan shaped and reminded someone of the foot of a goose. Insertion site: pes anserine
semitendonosus muscle
gracilis muscle
sartorius
97
Superior gluteal nerve artery and vein travel superior to _______ (muscle). They travel through the suprapiriform foramen.
piriformis muscle
98
The inferior gluteal vessels, pudendal nerve, internal pudendal artery and vein, sciatic nerve, and posterior femoral cutaneous nerve all exit _____ (sup/inf) to piriformis.
Inferior
99
Most of the time, the sciatic nerve passes ____ (sup/inf) to piriformis.
inferior. But there can be a lot of variations in the fibular portion - it can travel inferior, superior, or through the piriformis muscle.
100
Must avoid which 2 nerves when giving an intramuscular injection
Sciatic nerve
| Superior gluteal nerve
101
Where does the blood supply of the posterior thigh arise from?
Perforating branches of the deep femoral artery, which penetrates insertion of adductor magnus
102
Posterior aspect of the hip joint has an anastomosis between some of the perforating branches of ______ and branches of the medial and lateral femoral circumflex vessels and the _____ ______ vessels. What is this anastomosis called?
Cruciate anastomosis
Anastomosis between: perforating branches of deep femoral artery, branches of medial and lateral femoral circumflex vessels, and the inferior gluteal vessels.
103
Hip joint is primary supplied by what?
Medial and lateral circumflex arteries (branches of deep femoral artery). MEDIAL circumflex is considered the major source.
104
The femoral head receives blood supply from which 2 sources:
1. Medial and lateral circumflex arteries (branches of deep femoral artery)
2. Artery of the head of the femur
105
Head of the femur in a child is entirely dependent on blood flow through the...
artery of the head. This is because the epiphyseal plates haven't yet closed.
- So the child cannot get blood flow from the neck of the femur, through the medial/lateral circumflex arteries. If the artery of the head of the femur isn't enough or is damaged --> avascular necrosis.
- In older people, if the neck of the femur fractures, the artery of the head is also insufficient.
106
Ligament of the head of the femur enters at the...
fovea capitis
107
Which is not a site of attachment of the gluteus maximus muscle?
a. iliac crest
b. gluteal tuberosity
c. sacrotuberous ligament
d. iliotibial band
iliac crest
108
anterior thigh dermatome distribution
L2/L3
109
lateral to the knee, lateral leg
L5
110
middle of the posterior thigh
S1/S2
111
around the anus
S3/S4/S5
112
Anterior compartment muscles do this:
knee extensors and hip flexors
Innervated by: femoral nerve
A-KEHFF
(King Edward Has Fun Flipping Anteriorly)
113
Medial compartment muscles do this:
Hip adductors
| HAM (hip adductors - Medial)
114
Posterior compartment muscles do this:
Knee flexors and hip extensors:
| KFHE (King Frederick Has Elephants - Posteriorly)
115
1. Fxn: adduct thigh at hip joint
2. Origin: body of pubis + inferior ramus of pubis
3. Insertion: linea aspera
4. Innervation: obturator nerve
adductor brevis
116
Where does the superior gluteal vein, artery, and nerve travel?
Superior to piriformis
| Sandwiched btw. gluteus medius and gluteus minimus
117
This place is where the saphenous vein gives rise to the femoral vein.
Saphenous hiatus.
118
Gluteus medius is located _____ to piriformis.
posterior
119
The medial collateral ligament of the knee is connected to which other structure?
medial meniscus
120
This artery supplies blood to the head and neck of the femur, and does not have an anastomosis with distal vessels.
median circumflex artery
121
This artery arises from the profunda femoris. It has a descending branch that is sent down to the knee.
lateral femoral circumflex artery
122
Gluteus maximus is innervated by _____.
inferior gluteal nerve.
123
Gluteus minimus is innervated by _____
superior gluteal nerve
124
If there is a fracture of the greater trochanter, which will still have normal function:
a. gluteus maximus
b. gluteus minimus
gluteus maximus. Insertion points: gluteal tuberosity and iliotibial tract.
125
The apex of the femoral triangle occurs at the junction of:
adductor longus and sartorius (called butcher's block injury if you get a cut here). very dangerous!!!
126
This is a diamond shaped area in the posterior thigh. Its borders:
- Bordered medially by: semimembranosus and semitendonosus
- Bordered laterally by: biceps femoris
- Bordered in the posterior leg by: 2 heads of the gastrocnemius.
It contains: popliteal artery and vein(s), tibial and common fibular nerves, fat and lymph nodes.
popliteal fossa
127
3 bones of the knee
Femur
Tibia
Patella
*Note: Fibula is NOT part of the knee joint, doesn't bear any weight!
128
Difference between radius/ulna and fibula/tibia combination
No motion between fibula and tibia.
| Fibula doesn't bear any weight.
129
What are the 2 fibrocartilage menisci?
- Lateral meniscus
| - medial meniscus
130
This is a synovial joint between the femur and tibia; includes articular between the patella (kneecap) and femur, all enclosed within a single joint capsule. Basically a hinge joint.
Knee joint
131
There are two fibrocartilagenous ______ within the joint, interposed between condylar articular surfaces of femur and tibia.
-Purpose: cushion the joint, provide great surface area of articulation
menisci - there is a lateral meniscus and a medial meniscus.
132
Upon extension of the knee, there is ____ area of contact between femoral articular surface and menisci. Collateral ligaments are ____ (looser/tighter) than when the knee is flexed.
Greater area of contact
| Tighter ligaments
133
The medial meniscus is attached to the _____ collateral ligament.
Medial meniscus is attached to the tibial collateral ligament
134
The lateral meniscus is separated from the fibular collateral ligament by the: intervening _____ of the _____ muscle. So, the lateral meniscus is more mobile than the medial meniscus, b/c the lateral meniscus is unattached to the capsule of the joint.
By the intervening tendon of the popliteus tendon
135
Knee joint is reinforced on either side by _____ ligaments (one on either side of the joint)
collateral ligaments - tibial collateral ligament and fibular collateral ligament.
136
Two very strong ligaments interconnect adjacent ends of the femur and tibia and maintain their opposed positions during movement. These are called: ____ ligaments.
- They prevent anterior and posterior displacement of the tibia relative to the femur. These ligaments are not inside the synovial cavity, but are inside the joint capsule.
- During full extension, they remain taut and are maximally tight.
cruciate ligaments (anterior and posterior)
137
The patella articulates with the femur, but not the: ____
tibia
138
When the knee joint is fully extended, the ___ rotates slightly medially on the tibia to _____ the knee.
femur rotates medially to LOCK the knee. Creating a more stable position due to shape of femoral articular surface.s
139
Before flexion begins, this muscle (_____) must contract to unlock the knee by rotating the femur ____ on the tibia.
Popliteus must contract --> unlocks the knee --> rotates the femur LATERALLY
140
There is _____________ between tibia and fibula.
interosseus membrane
141
Is the fibula lateral or medial?
Lateral
142
The leg is divided by the: (1) _____, (2)_____, (3)_____, and (4) two fibrous septa into ANTERIOR, LATERAL, and POSTERIOR compartments.
tibia
fibula
interosseus membrane
143
The muscles of each compartment are innervated by:
a) different nerves
b) same nerve
different nerves
144
How is the posterior compartment of the leg subdivided?
It is subdivided by the transverse intermuscular septum into superficial and deep portions.
145
What is the function of the muscles in the anterior compartment of the knee/lower leg? Innervation?
They dorsiflex and invert the foot and extend the toes.
| Innervated by: deep fibular nerve
146
Where is the only cutaneous innervation of the deep fibular nerve?
web space between the big and second toes.
147
What are the muscles in the anterior compartment of the knee/lower leg?
Tibialis anterior
Extensor digitorum longus
Extensor hallucis longus
148
What is the function of the muscles in the lateral compartment of the leg?
Evert the foot
149
Innervation of muscles in the lateral compartment of the leg. What does it cutaneously innervate?
Superficial fibular nerve.
| - Cutaneous innervation: lateral side and dorsum of the foot.
150
What are the muscles of the lateral compartment of the foot?
Fibularis (peroneus) longus
| Fibularis (peroneus) brevis
151
The fibularis longus tendon passes ____, then ______ to the fibularis brevis tendon to pass across the plantar foot to insert on medial cuneiform b one and base of first metatarsal.
laterally, then inferiorly
152
What are the muscles in the superficial posterior compartment of the leg? (3)
1. Gastronemius (leads to Calcaneal/Achilles tendon)
2. Plantaris
3. Soleus
153
Where do the medial and lateral heads of the gastrocnemius originate from, and where do they insert?
Origin: medial and lateral femoral condyles.
Insertion: on calcaneus
154
Fxn of muscles in the superficial group of the deep compartment of the leg
Plantarflex the foot
Flex the knee
(NOT soleus)
155
What are the muscles in the deep posterior compartment of the leg? (4)
1. Popliteus
2. Tibialis posterior
3. Flexor digitorum longus
4. Flexor hallucis longus
156
Where does the flexor digitorum longus originate?
Tibia
157
Where does the tibialis posterior originate?
Tibia and Fibula and interosseus membrane between them
158
Where does the flexor hallucis longus originate?
Fibula and interosseus membrane
159
What is the function of the muscles in the deep group (posterior compartmenet of the leg) except for popliteus?
Plantarflex the foot
Invert the foot
Flex the toes
160
What is the innervation of all the muscles of the posterior compartment and the plantar foot?
Tibial nerve or its branches
161
The tibial nerve and common fibular (peroneal) nerves are both components of this nerve: ____ _____. They pass through the ____ _____.
sciatic nerve.
| The tibial nerve and common fibular nerve pass through the popliteal fossa.
162
The tibial nerve accompanies the ____ ____ artery inferiorly
posterior tibial artery
163
The common fibular nerve travels laterally to pass subcutaneously around the neck of the fibula before branching into superficial and deep _____ nerves
fibular
164
The ____ nerve (sensory nerve) receives fibers from both tibial and fibular nerves.
sural nerve
165
This nerve passes posterior to the lateral malleolus on its way to the lateral foot.
sural
166
This nerve innervates the lateral compartment muscles of the leg.
superficial fibular nerve
167
This nerve innervates the anterior compartment muscles of the leg.
deep fibular nerve
168
The _____ artery changes its name to the popliteal artery when it passes through the adductor hiatus in the adductor magnus muscle.
femoral artery --> popliteal
169
How does the popliteal artery end (2 branches)?
1. Anterior tibial artery
| 2. Posterior tibial artery
170
The fibular artery is a branch of which artery?
posterior tibial artery
171
The anterior tibial artery passes anteriorly through an opening in the interosseus membrane between tibia and fibula bones. It enters and supplies the anterior compartment. It descends across the anterior ankle and onto the dorsum of the foot as the ___ ______ artery.
Anterior tibial artery --> dorsalis pedis artery
172
Posterior tibial artery passes ____ to interosseus membrane, -_____ to medial malleolus and into the sole of the foot.
posterior
| posterior
173
Fibular artery descends along the ____ border of the fibula, where some branches perforate the interosseus membrane to supply the lateral leg compartment.
medial border of the fibular
174
The anterior tibial artery also supplies some blood to the ____ compartment.
lateral
175
What are the 2 large superficial veins in the subctaneous tissue of the legs?
1. Great saphenous vein
| 2. short (small) saphenous vein
176
Where does the small saphenous vein begin?
Lateral venous arch of the foot
Passes POSTERIOR to lateral malleolus
Ascends in posterior leg alongside the sural nerve --> then pierces the deep fascia to drain into the popliteal vein.
177
Which lymph nodes are the first filters in the lymphatic drainage of the leg?
Popliteal lymph nodes
178
Which muscle helps pump blood back to the heart at a pressure higher than systolic pressure?
Soleus muscle
179
The body's line of gravity passes:
____ to the hip joint
____ to the knee joint
____ to the ankle joint
posterior to the hip joint
anterior to the knee joint
This allows for full passive extension of both joints w/o muscular effort.
Anterior to ankle joint. --> so we require continuous contraction of soleus muscle to plantarflex the foot to prevent falling forward.
180
What are the 6 structures that pass posterior to the medial malleolus and cross the ankle to enter the plantar foot?
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Tom, Dick, And Very Nervous Harry TDAVNH
Tibialis posterior tendon
Flexor digitorum longus tendon
Posterior tibial artery
Posterior tibial vein
Tibial nerve
Flexor hallucis longus tendon
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181
What supplies the main blood supply to the leg and foot?
popliteal artery
182
Where does the great saphenous vein originate and pass?
- Originates from DORSAL venous arch of the foot
- Passes ANTERIOR to medial malleolus
- Ascends up the medial aspect of the leg and thigh
- Drains into the FEMORAL vein at the saphenous opening in the groin.
183
The great saphenous vein is accompanied by which nerve?
Saphenous nerve - cutaneous branch of femoral nerve, innervating medial side of leg and foot
184
How are the superficial veins in the leg connected to the deep veins?
via perforating veins
185
The bones that make up the ankle and foot are composed of:
7 tarsal bones with metatarsals and phalanges analogous to the hand.
186
What are the three bones contained by the ankle? What type of joint is the ankle?
tibia
fibula
talus
- Ankle is a hinge joint because the distal ends of tibia and fibula form a mortise into which the trochlea of the talus fits.
- Creates movement in 1 plane (plantarflexion and dorsiflexion)
187
What is the ankle joint strengthened by?
Lateral and medial (deltoid) ligaments
188
The trochlea of the talus is wider _____ (ant/posteriorly). This allows the ankle joint to be more stable in _____flexion (dorsi vs. plantar).
Wider anteriorly
| More stable in dorsiflexion (trochlea will be more tightly wedged between the malleoli)
189
Where does inversion and eversion of the foot occur?
At more distal joints.
- One betewen talus and calcaneus (subtalar joint)
- Others between tarsal and metatarsal bones
190
How many parts are there to the deltoid ligament, and what does it support?
4 parts
| Supports medial ankle
191
What ist he ligament that is most common injured in an inversion sprain of the ankle?
Anterior talofibular ligament.
192
The shapes of the bones of the foot form both _____ and ___ arches. These arches absorb ____ (up/downward) forces.
longitudinal
transverse arches
Absorb downward forces.
193
How is the longitudinal arch of the foot supported?
1. Plantar calcaneonavicular "spring" ligament
| 2. Plantar aponeurosis
194
How is the transverse arch formed?
By bones held together by multiple ligaments. Forms a slight that supports the arches of the foot.
- Fibularis longus tendon passes across the foot from lateral --> medial, inferior to tarsal and metatarsal bones; inserts on medial cuneiform and base of 1st metatarsal
- Tendons of tibialis anterior and posterior also support.
195
Which 2 bones articulate at the knee?
a) femur and patella
b) tibia and patella
c) fibula and femur
d) patella and fibula
Femur and patella
There is a tendon between tibia and patella...but they do not directly articulate.
196
Upon knee extension, the collateral ligaments ___ (loosen or tighten) and there is ______ (more or less) contact area between the femoral condyles and menisci.
Tighten
More contact area
Knee joint is more stable when extended.
197
If someone hits the outside of your knee while your knee is planted, what ligament is most at risk?
- ACL
- PCL
- LCL
- MCL
Medial Collateral Ligament (MCL) because the knee is suddenly forced MEDIALLY.
198
Injuries of the ____ cruciate ligament result from hyperextension
anterior cruciate ligament
199
Injuries of the PCL result from:
if the knee is struck while flexed.
200
The joint capsule covers the entire knee joint (ACL, PCL, femur, tibia, patella). The synovial membrane encloses the articular surface between femur and tibia, but not the ___ or ___.
ACL or PCL
201
The PCL prevents posterior displacement of the _____ in relation to the femur.
TIBIA
202
Match the nerves with the compartments of the KNEE
1. anterior compartment....
2. lateral compartment....
3. posterior compartment ....
A. deep fibular nerve
B. tibial nerve
C. superficial fibular nerve
Anterior - deep fibular nerve
Lateral - sup fibular nerve
Posterior - tibial nerve
203
Deep posterior compartment muscles do this:
- Inversion of feet
- Plantarflexion of feet
- Flex toes.
204
Superficial posterior compartment muscles do this:
- Plantarflexion of the foot
- Knee flexion
* But soleus does not do these actions!
205
____ nerve provides sensation to lateral foot and 5th toe. This nerve is on the posterior leg.
Sural
206
The popliteal artery first bifurcates into ____ and _____ ____ arteries.
anterior and posterior tibial arteries
207
The posterior tibial artery sends off a _____ branch.
fibular
208
The anterior tibial artery passes into anterior compartment through an opening in the _____ membrane.
interosseus
209
The veins in the lower leg allow the blood to flow proximally and from ____ to ____systems.
superficial to deep
210
Small saphenous vein drains into the _____ vein in the popliteal fossa.
popliteal
211
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What is the order (anterior to posterior) of what goes posterior to medial malleolus?
Options:
- Flexor hallucis longus
- Tibialis posterior
- Flexor digitorum longus
- Tibial nerve
- Posterior tibial artery
- Posterior tibial vein
```
Ant to Post:
1. Tibialis posterior muscle
2. Flexor digitorum longus
3. Posterior tibial artery
4. Posterior tibial vein
5. Tibial nerve
6. Flexor hallucis longus
212
Branch of the femoral nerve that provides cutaneous innervation to medial leg and foot
Saphenous nerve
213
The ligaments that support the ankle joint are stronger on which side - medial or lateral - so which type of sprains are LESS likely to occur (inversion vs. eversion)
Stronger medially
| Eversion sprains less likely, b/c ankle joint allows LESS eversion to take place.
