Lecture 6 Flashcards
Where are the 2x most common places for compartment syndrome to occur?
Forearm
Leg
What is the structural boundaries and components of the leg?
Knee to ankle
2x bones: Fibula and Tibia
3x compartments: Anterior, Lateral and Posterior
3x fascia: Interosseus membrane + Anterior and Posterior Intermuscular Septae
What are the 3x structures which divide the leg into its 3x compartments?
Interosseous Membrane
Anterior + Posterior Intermuscular Septae
What are the structural boundaries of the anterior compartment of the leg?
Bound Anteriorly: by Skin + Deep Fascia Medially: by Lateral surface of Tibia Posteriorly: by interosseous membrane Laterally: Anterior intermuscular septum
What are the main features of the anterior compartment of the leg?
Dorsiflexor (extensor) compartment Bound Anteriorly: by Skin + Deep Fascia Medially: by Lateral surface of Tibia Posteriorly: by interosseous membrane Laterally: Anterior intermuscular septum --Due to being bound by 3x fairly rigid structures (2x bones and interosseous membrane) is Most vulnerable to compartment syndrome Contains: 4x muscles: Tibialis Anterior, Ext. Digitorum Long. , Ext. Hallucis Long. & Peroneus Tertius Deep Peroneal Nerve Anterior Tibial Artery
Where in the leg is most vulnerable to compartment syndrome and why?
Anterior Compartment of the Leg
-as it is bound by 3x fairly rigid structures( 2x bones and Interosseous membrane)
What are the 6x contents of the Anterior Compartment of the leg?
4x muscles: Tibialis Anterior Ext. Digitorum Long. Ext. Hallucis Long. Peroneus Tertius 1x Deep Peroneal Nerve 1. Anterior Tibial Artery
What other compartment does the anterior compartment of the leg belong to?
Dorsiflexor/Extensor compartment
What is the function of the interosseus membrane in the Leg?
Thick and rigid/tight and unyeilding membranous sheet
Landmark
a) Divides Anterior and Posterior compartment
b) then splits Laterally dividing Anterior and Lateral compartments (from anterior 1/2 of the leg)
What is the physical properties of the interosseus membrane?
Thick and Rigid membranous Sheet
Tight and Unyielding material
For what 2x reasons is the interosseus membrane in the leg a landmark?
a) Divides Anterior and Posterior Compartment
b) Splits Laterally and divides Anterior and Lateral Compartments (from anterior 1/2 of leg)
What is the relationship between the Deep Fascia and the Tibia?
Deep fascia is quite ADHERENT to the tibia
Which compartments in the Leg have the least space?
Lateral (smallest) and Anterior
What happens when there is a tibial/fibular fracture?
NOT Uncommon to fractur BOTH tibia and fibula when there’s moderate-severe trauma to the leg
Upon fracture/breaking = fluid, blood and material leaks out of the bone marrow
-cancellous bone is making cells and contains fluid
-alot of blood out of the middle
Increases Volume -> Increases Pressure in Anterior Compartment
-as extra fluid is forced into the compartment with nowhere to go
Is it common or uncommon to break both the Tibia and Fibula in one injury?
Common/NOT Uncommon
when there’s Moderate-severe Trauma to the leg
What leaks out of bone marrow when there is a Tibular/fibular fracture/break?
Upon break= Fluid, blood and material leaks out of bone marrow
-as cancellous bone is making cells and contains fluid
-alot of Blood out of the middle
RESULT:
increase in volume –> increase in pressure
- as extra fluid is forced into the anterior compartment with nowhere to go
Why is there an increase in volume when the bone marrow is broken with a tibial and/or fibular fracture?
Cancellous bone is making cells and contains fluid
alot of blood out of the middle
Increase in volume –> Increase in pressure
-as there is extra fluid is forced into the anterior compartment with no where to go
What are some essential facts about the tibia?
Large/main bone
“shin”
Medial side of leg
Weight bearing bone
What is the main weight bearing bone in the leg?
Tibia
What bone is the leg is the most Medial?
Tibia
What bone in the leg is most Lateral?
Fibula
What are some essential facts about the fibula?
Thin
Lateral side of the leg
important with muscles but not weight bearing bone
Ideal place for bone grafting - you’re able to take some/middle of bone out with only minor lasting effect
Where is the ideal location in the body to utilise for bone grafting?
Fibula
you can take some/middle of bone out with only a minor lasting effect
Where is the ideal location in the body to utilise for vessel grafting?
Great Saphenous vein