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Knee and Leg Flashcards

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1
Q

Gastrocnemius Proximal?

A
  1. Medial Head: Popliteal surface of Femur

2. Lateral Head: Lateral Condyle of Femur

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2
Q

Gastrocnemius Distal?

A

Calcaneus (achilles or calcaneal tendon)

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3
Q

Gastrocnemius Action?

A
  1. Plantar Flexes Ankle
  2. Flexes Knee
  3. Raises heel when walking
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4
Q

Gastrocnemius Nerve?

A

Tibial

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5
Q

Soleus Proximal?

A
  1. Soleal Line of Tibia
  2. Posterior Head of Fibula
  3. Tendinous arch
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6
Q

Soleus Distal?

A

Calcaneus (achilles tendon)

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7
Q

Soleus Action?

A

Plantar Flexes Ankle

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8
Q

Soleus Nerve?

A

Tibial

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9
Q

Plantaris Proximal?

A
  1. Supracondylar line of Femur

2. Oblique popliteal ligament

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10
Q

Plantaris Distal?

A

Calcaneus (achilles tendon)

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11
Q

Plantaris Action?

A
  1. Weakly Plantar Flexes Ankle

2. Weakly Flexes Knee

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12
Q

Plantaris Nerve?

A

Tibial

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13
Q

Popliteus Proximal?

A
  1. Lateral Femoral Epicondyle

2. Lateral Meniscus (joint capsule)

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14
Q

Popliteus Distal?

A

Superior to Soleal Line on posterior surface of Tibia

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15
Q

Popliteus Action?

A
  1. Tibia fixed: Laterally rotates Femur on Tibia 5 degrees and unlocks (flexes) knee
  2. Femur fixed: Medially rotates Tibia on Femur and unlocks (flexes) knee
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16
Q

Popliteus Nerve?

A

Tibial

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17
Q

Tibialis Posterior Proximal?

A
  1. Posterior Tibia inferior to Soleal line

2. Interosseus Membrane

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18
Q

Tibialis Posterior Distal?

A
  1. Navicular Tuberosity
  2. Plantar surface of Cuneiforms, Cuboid, and sustentaculum tali of calcaneus
  3. Bases of 2nd-4th Metatarsals
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19
Q

Tibialis Posterior Action?

A
  1. Inversion of foot
  2. Plantar Flexes Ankle
  3. Maintains arch of foot
  4. Functionally: Resists Hyperpronation
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20
Q

Tibialis Posterior Nerve?

A

Tibial

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21
Q

Flexor Digitorum Longus Proximal?

A

Posterior Surface of Tibia inferior to Soleal Line

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22
Q

Flexor Digitorum Longus Distal?

A

Plantar Surface of the bases of 2nd-5th Distal Phalanges

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23
Q

Flexor Digitorum Longus Action?

A
  1. Primarily Flexes 2nd-5th Toes
  2. Plantar Flexes Ankle
  3. supports longitudinal arch of foot
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24
Q

Flexor Digitorum Longus Nerve?

A

Tibial

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25
Flexor Hallucis Longus Proximal?
1. Posterior, Inferior 2/3 Fibula | 2. Interosseus Membrane
26
Flexor Hallucis Longus Distal?
Plantar Surface of base of Distal Phalanx of Hallux
27
Flexor Hallucis Longus Action?
1. Flexes Hallux 2. Weakly Plantar Flexes Ankle 3. Supports medial longitudinal arch of foot
28
Flexor Hallucis Longus Nerve?
Tibial
29
Peroneus (Fibularis) Longus Proximal?
1. Head of Fibula | 2. Superior lateral surface of Fibula
30
Peroneus (Fibularis) Longus Distal?
1. Base of lateral side of 1st Metatarsal | 2. Medial Cuneiform
31
Peroneus (Fibularis) Longus Action?
1. Everts and Horizontally Abducts Foot 2. Weakly Plantar Flexes Foot 3. Maintains arch of foot
32
Peroneus (Fibularis) Longus Nerve?
Superficial Fibular
33
Peroneus (Fibularis) Brevis Proximal?
Inferior lateral surface of Fibula
34
Peroneus (Fibularis) Brevis Distal?
Tuberosity on Lateral Aspect of Base of 5th Metatarsal
35
Peroneus (Fibularis) Brevis Action?
1. Everts and Horizontally Abducts Foot | 2. Weakly Plantar Flexes Foot
36
Peroneus (Fibularis) Brevis Nerve?
Superficial Fibular
37
Tibialis Anterior Proximal?
1. Lateral Tibial Condyle and Anterolateral Surface of Tibia | 2. Interosseous Membrane
38
Tibialis Anterior Distal?
1. Medial and Plantar Surface of Base of 1st Metatarsal | 2. Medial and Plantar Surface of 1st Cuneiform
39
Tibialis Anterior Action?
1. Dorsiflexes Foot | 2. Helps Invert and Horizontally Adduct Foot
40
Tibialis Anterior Nerve?
Deep Fibular (Peroneal)
41
Extensor Hallucis Longus Proximal?
1. Middle and Anterior surface of Fibula | 2. Interosseus Membrane
42
Extensor Hallucis Longus Distal?
Dorsal surface of base of Distal Phalanx of Hallux
43
Extensor Hallucis Longus Action?
1. Extends Distal Phalanx of Big Toe 2. Weakly Dorsiflexes Foot 3. Weakly Inverts and Adducts Foot
44
Extensor Hallucis Longus Nerve?
Deep Fibular (Peroneal)
45
Extensor Digitorum Longus Proximal?
1. Lateral Condyle of Tibia 2. Superior medial surface of Fibula 3. Interosseus Membrane
46
Extensor Digitorum Longus Distal?
Dorsal Surface of the Bases of the Middle and Distal Phalanxes of the 2nd-5th digits
47
Extensor Digitorum Longus Action?
1. Extends Lateral 4 Toes | 2. Weakly Dorsiflexes and Everts Foot
48
Extensor Digitorum Longus Nerve?
Deep Fibular (Peroneal)
49
Peroneus (Fibularis) Tertius Proximal?
1. Distal 1/3 of Anterior Fibula | 2. Interosseous membrane
50
Peroneus (Fibularis) Tertius Distal?
Dorsal Surface of the Base of the 5th Metatarsal
51
Peroneus Tertius Action?
Weakly Dorsiflexes and Everts Foot
52
Peroneus Tertius Nerve?
Deep Fibular (Peroneal)
53
Superior Tibiofibular joint?
- Connects Lateral Condyle of Tibia to Head of Fibula - Move together with inferior tibiofibular joint to dorsiflex - Plane type synovial joint enclosed in joint capsule - enhanced by posterior and anterior ligaments of fibular head
54
Inferior Tibiofibular joint?
- Connects Lateral Malleolus of Fibula and lateral surface of distal Tibia - Syndesmosis joint- slides and glides, no fluid between bones, minimal movement - enhanced by interosseous membrane and reinforced by anterior and posterior tibiofibular ligaments
55
Knee joint? Actions?
- largest and most superficial joint - hinge, synovial joint - Flexes (hamstrings) and extends (quads) with some medial and lateral rotation
56
Knee Joint articulations?
1. Lateral Femorotibial: between lateral condyles of femur and Tibia 2. Medial Femorotibial: between medial condyles of femur and tibia 3. Femoropatellar: posterior patella and inferior and distal femur
57
Knee Joint capsule?
- external fibrous layer with internal lining of synovial membrane - anterior: quads tendon, patella, patellar ligament - intercondylar area: intrapatellar synovial fold and fat pad
58
Knee bursa function?
- sac lined synovial membrane which secretes fluid - cushion and reduces friction - 12 surround knee
59
Popliteus bursa?
- between popliteus muscle and lateral tibial condyle - communicates with knee joint along with supra patellar bursa - allow fluid circulation but could transmit inflammation (bursitis)
60
Housemaid's knee?
- bursitis in Subcutaneous Prepatellar Bursa | - between skin and front of patella
61
Preacher's knee?
bursitis in Subcutaneous infrapatellar bursa
62
External knee ligaments (extra capsular)?
- Patellar: quads tendon to tibial tuberosity - MCL: medial epicondyle of femur to medial condyle of tibia - LCL: lateral epicondyle of femur to fibular head - Oblique popliteal (posterior) - arcuate popliteal: runs over popliteus muscle (posterior)
63
Internal knee ligaments (intra-articular)?
- ACL | - PCL
64
Anterior Cruciate Ligament (ACL)? Function?
- from anterior intercondylar area and inserts on medial side of lateral condyle of femur - poor blood supply, weaker and shorter - prevents posterior rolling and displacement of femur on fixed Tibia during flexion - prevents posterior displacement of femur on tibia.
65
Posterior Cruciate Ligament (PCL)? Function?
- from posterior intercondylar area and inserts on anterior lateral surface of medial condyle of Femur - limits anterior rolling of the femur on the tibia during extension; prevents anterior displacement of femur on the tibia
66
ACL and PCL test?
Anterior and Posterior Drawer test - patient lies supine with knees bent, physician stabilizes foot and has thumbs on either side of patellar ligament and ensures hamstring muscle is relaxed - ACL: force applied anterior - PCL: force applied posterior - positive if over 5mm of movement
67
Medial Menisci?
- C shaped - larger - attached to MCL
68
Lateral Menisci?
- Circular, attaches to joint capsule - thicker external edge - smaller and movable - posterior meniscofemoral ligament
69
Coronary Ligaments?
-fix menisci to Tibial plateau
70
Transverse Ligaments?
connect anterior edges of medial and lateral menisci so they can move together
71
Crural Fascia? Functions?
- deep fascia in leg (fascia lata in thigh) - protection - form Flexor (medial), Extensor (anterior), and Fibular (lateral) Retinaculum to hold tendons in place - Deep fascia divides muscles into compartments (Intermuscular septa of leg) - helps guide venous blood up the leg
72
Blood supply to knee?
Genicular Anastomoses: - Superior Medial - Superior Lateral - Middle - Inferior Lateral - Inferior Medial
73
Blood Supply to lower leg?
1. Anterior: Anterior Tibial Artery becomes Dorsal Artery of foot 2. Lateral: branches of Anterior Tibial and Fibular Artery 3. Posterior: Posterior Tibial Artery (divides into medial and lateral plantar) and Fibular Artery
74
Innervation of lower leg?
Anterior: Deep Fibular Nerve (2 branches into foot) Lateral: Superficial Fibular Nerve (cutaneous distally) Posterior: Tibial Nerve
75
Knee Joint Innervation?
Hilton's Law - nerve supplies to both the muscles and joint it moves - articular branches of Femoral nerve, Tibial, Common Fibular, and Obturator nerves
76
Cutaneous Nerves of the leg?
- Saphenous nerve: anterior medial - Lateral Sural: from common fibular nerve, gets lateral part of leg - Superfical Fibular: becomes dorsal digital nerves, gets dorsum of foot - Deep Fibular Nerve: space in between first two toes
77
Veins of the leg?
- Great Saphenous: anterior, union of dorsal venous arch and dorsal digital vein of great toe, drains into Femoral Vein - Small saphenous: posterior, union of dorsal venous arch and dorsal digital vein of small toe (anastomose with great saphenous), drains into Popliteal Vein - Perforating vein: drain blood from superficial to deep
78
Varicose Veins?
1. leaflets of valves do not close properly | 2. superficial veins become enlarged b/c blood cannot be pushed back into deep veins
79
Common Fibular Nerve injury?
- nerve wraps around neck of Fibula, fracture to Fibula injures it - car bumper nerve - crushed, stretched - loss of skin sensation and foot drop when severed
80
The Unhappy Triad?
- Classical (O'Donoghue): tears of ACL, MCL, and Medial Meniscus - More common acute injury: tears of ACL, MCL, and lateral meniscus with or without medial meniscus injury
81
Suprapatellar bursa?
- between quad tendon and distal femur | - communicates with knee joint
82
Functions of compartments of the leg?
1. Anterior- Dorsiflex 2. Lateral- Evert 3. Posterior- Plantar flex

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