Politeal region and Posterior leg

Question 1

What are the boundaries of the popliteal fossa?

Answer 1

biceps femoris

semitendinosus and semimembranosus

gastrocnemius

skin/fascia

Question 2

What are the contents of the popliteal fossa?

Answer 2

popliteal artery and vein

common fibular and tibial nerves

fat and lymph nodes

small saphenous vein

Question 3

What is the popliteal artery a continuation of? Where does the name change occur?

Answer 3

It’s a continuation of the femoral artery

name changes at the adductor hiatus

Question 4

What type of fracture will put the pepliteal artery (and tibial nerve) at risk?

Answer 4

dstal femur fractures

Question 5

The popliteal artery gives rise to what branches that supply the knee?

Answer 5

the genicular arteries:

superior medial

superior lateral

inferior medial

inferior lateral

Question 6

Where does the small saphenous vein begin?

What does it empty into?

Answer 6

starts on the lateral side of the dorsal venous network of the foot

passes behind the lateral malleolus up the back of the leg

empties into the pepliteal vein

Question 7

What nerve accompanies the small saphenous vein?

Answer 7

the sural vein

Question 8

How can the common fibular nerve be injured?

Answer 8

from fracture of the neck of the fibula or from pressure from a cast

this is because the common fibular nerve winds around the head of the fibula in the subcutaneous tissue

Question 9

Under cover from the fibularis longus, the common fibular nerve divides into what?

Answer 9

the superficial and deep fibular nerves

Question 10

THe sural nerve is a combination of what two branches?

Answer 10

the medial sural cutaneous nerve (from the tibial nerve) and the lateral sural cutaneous nerve (from the common fibular nerve) via the sural communicating branch

Question 11

What cutaneous nerve supplies the back of the pepliteal region?

Answer 11

the posterior cutaneous nerve of the thigh

Question 12

What forms the compartments of the leg?

Answer 12

the anterior and posterior crurual intermuscular septa (as extensions of the deep crurual fascia) and the tibia

Question 13

What are the three compartments of the leg called?

Answer 13

anterior

lateral

posterior (deep and superficial)

Question 14

What divides the anterior and posterior compartments of the leg?

Answer 14

the itnerosseous membrane between the tibia and the fibula

Question 15

What divides the posterior compartment into deep and superficial areas?

Answer 15

the transvers intermuscular septum

Question 16

What are the three eg muscles in the superficial posterior group?

Answer 16

gastrocnemius

plantaris

soleus

Question 17

Where does the gastrocnemius originate? Insert?

Answer 17

the lateral head inserts on the lateral condule of the femur while the medial head is on the pepliteal surface of the femor, superior to the medial condyle

it inserts on the powerior surface of the calcanius via the calcaneal tendon

Question 18

What does the gastrocnemius do?

Answer 18

it flexes the knee joint and plantarflexes the foot joint at the ankle

Question 19

what innervates the gastrocnemius?

Answer 19

tibial nerve

Question 20

Where does the plantaris originate and insert?

Answer 20

orginates on the inferior end of the lateral supracondylar line of the femor, as well as the oblique popliteal ligament

it inserts on the posterior surface of the calcaneus - but probably not thorugh the calcaneal tendone

Question 21

What is the plantaris analogous to in the forearm?

Answer 21

palmarus longus

Question 22

What does the plantaris do?

Answer 22

is plantarflexes the foot at the anke joint and weakly flexes the knee joint (used to tendon grafts since it’s so redundant)

Question 23

Wht nerve innervates the plantaris?

Answer 23

tibial nerve

Question 24

What is the plantaris tenodn often mistaken for?

Answer 24

the tibial nerve

Question 25

Where is the soleus located?

Answer 25

deep to the gastrocnemius

Question 26

What does the soleus do?

Answer 26

it's a slow platnarflexor of the ankle joint - an antigravity muscle that contracts alternately with the extensor muscles of the leg to maintain balance

Question 27

What nerve innervates the soleus?

Answer 27

tibial nerve

Question 28

What are the 4 muscles of the posterior deep grooup?

Answer 28

popliteus flexor digitorum longus tibialis posterior flexor hallucis longus

Question 29

What nerve innervates the posterior deep group of muscles?

Answer 29

the tibial nerve

Question 30

Where does the popliteus originate and insert?

Answer 30

originates just above the soleus muscle and crosses thorugh the knee between the lateral meniscus and fibular collateral ligament to insert on the femur

Question 31

What is the interesting function of the popliteus?

Answer 31

It flexes the knee joint and unlocks the knee by lateral rotation of the femur on the tibia

Question 32

What is the strongest plantarflexor? Is it also the fastest?

Answer 32

the soleus is the strongest, but it's slow - the gastrocnemius is the fast one

Question 33

Does the soleus act on the knee joint?

Answer 33

no - diesn't cross it, so only works at the ankle joint

Question 34

In the proximal leg, what is the order (from medial to lateral) of the deep compartment?

Answer 34

1. flexor digitorum longus 2. tibialis posterior 3. flexor hallucis longus Dick, Tim, Harry

Question 35

Where does the flexor digitorum longus insert?

Answer 35

it splits into 4 tendons that insert on the base of the distal phalanges of the lateral four toes

Question 36

WHere does the tibialise poserior insert?

Answer 36

it inserts into the tarsal bones and base of metatarsals, running along the interosseous membrane

Question 37

Where does the flexor hallucis longus insert?

Answer 37

on the distal phalanx of the great toe

Question 38

What does the flexor digitorum lungus do? WHat does the tibialis posterior do? WHat does the flexor hallucis longus do?

Answer 38

FDL: plantarflexes the ankle joint and flexes lateral 4 digits the tibialis posterior plantarflexes the ankle joint and inverts the foot. the FHL flexes the great toe

Question 39

Down at the ankle, the deep leg muscles cross under what structure? In what order now?

Answer 39

under the flexor retinaculum the tibialis posterior crosses under the flexor digtorum longus, so the order is... Tim's Dick And Now Harry's tibialis posterior flexor digitorum longus tibial artery tibial nerve flexor hallucis longus

Question 40

How does the tibial nerve enter the posterior compartment of the leg? WHat does it run between?

Answer 40

it enters the posterior compartment between the heads of the gastrocnemius it runs between the deep and superficial muscle groups, deep to the transverse crurual intermuscular septum

Question 41

The tibial nerve will divide into what two branches in the sole of the foot?

Answer 41

the medial and lateral plantar nerves

Question 42

What is the plantar reflex testing. What is normal? WHat is abnormal?

Answer 42

the plantar reflex (of L4-S2) is a deep tendon reflex you stroke the lateral aspect of the sole of the foot from heel to great toe normal is curling the toe slightly abnormal is a Babinski's sign - slight flaying and extension of the great toe

Question 43

How is the calcaneal tendon reflex tested? What's normal?

Answer 43

You strike the achilles tendon with a reflex hammer normal response is plantarflexion of the ankle joint

Question 44

In regards to the calcaneal tendon reflex, the following would suggest what? absent delayed reduced

Answer 44

absent = sciatic nerve pathology delayed = hypothyroidism reduced = peripheral neuropathy

Question 45

THe tibial nerve is hard to injure because of it's deep location in the popliteal foss and posterioa compartment, but how can it be? WHat would happen?

Answer 45

deep lacerations posterior dislocation of the knee joint you'd lose the function of the posterior compartment of the leg and the intrinsic muscles of the sole of the foot

Question 46

popliteal artery divides into what?

Answer 46

the posterior and anterior tibial artery

Question 47

What does the posterior tibial artery divide into?

Answer 47

the fibular artery (peroneal artery) and the medial/lateral plantar arterial branches to the foot

Question 48

What holds the deep flexor muscle tendons in place in the ankle?

Answer 48

the flexor retinaculum

Question 49

Where does the flexor retinaculum span from?

Answer 49

from the medial malleolus to the calcaneus

Question 50

What is the most severe, acute muscualr problem of the leg?

Answer 50

calcaneal tendon rupture can occur in those who have a hx of tendinitis of the tendon - or just as an acute injury

Question 51

What happens in tennis leg?

Answer 51

is a muscle strain of the medial head of the gastrocnemius occures in middle aged men who try to play tennis - full extension fo the knee with dorsiflexion of the ankle at the same time

Question 52

What is a baker's cyst? Where do they occur?

Answer 52

It's a popliteal cyst it occurs when any sort of inflammation affects the knee joint and causes effusion of synovial fluid

Question 53

Popliteal aneurysms are often asymptomatic, but what's the main concern with them?

Answer 53

that clots in the aneurysm will interfere with blood flow to the lower extremity - amputation may be the result so surgical repair is often called for even though the aneurysm is unlikely to rupture

Question 54

Which leg bone bears the weight of the body (and it bigger)?

Answer 54

the tibia

Question 55

Which leg bone articulates with the femur

Answer 55

the tibia (fibula does not participate)

Question 56

What lies between the lateral condyle and medial condyle of the tibia?

Answer 56

the tibial plateau

Question 57

THe interosseous membrane between the fibula and tibia is what type of joint?

Answer 57

syndesmosis

Question 58

the knee joint involves a hinge joint between the ___ and \_\_\_ and a plane/gliding joint between the ___ and the \_\_\_\_

Answer 58

hunge between the femur and tibia plane between the femur and the patella

Question 59

Which bone of the foot do the two leg bones articulate with in a hinge joint?

Answer 59

the talus