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Lower Limbs > The knee, leg, ankle and foot > Flashcards

The knee, leg, ankle and foot Flashcards

1
Q

What is the small protrusion in the middle of the tibial plateau called?

A

Intercondylar eminence

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2
Q

What inserts into the tibial tuberosity?

A

Patellar tendon (through which the quadriceps act)

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3
Q

Which bone in the leg does not bear any weight?

A

Fibula

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4
Q

What protrusions in the ankle do the distal ends of the tibia and fibula form?

A

Tibia – medial malleolus

Fibula – lateral malleolus

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5
Q

What is the name of the ridge running obliquely down the posterior surface of the tibia?

A

Soleal line

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6
Q

Name all the tarsal bones.

A 
Tallus 
Calcaneus 
Cuboid 
Navicular 
Cuneiforms (1, 2 and 3)
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7
Q

What are the two main joints in the foot and where do they lie?

A 
Transverse tarsal joint (between calcaneus + tallus and navicular + cuboid)
Tarsometatarsal joint (between the most distal tarsal bones and the metatarsals)
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8
Q

How many phalanges does each of the digits have?

A

Big toe – 2

All other toes - 3

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9
Q

Where are sesamoid bones found in the foot and which tendon do these bones lie in?

A

On the dorsal surface of the foot, beneath the metatarsophalangeal joint of the big toe
It lies in the tendon of flexor hallucis brevis

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10
Q

Which tarsal bones have tuberosities?

A

Navicular and Cuboid

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11
Q

What are the three arches that are formed when the bones of the foot fit together?

A

Medial and lateral longitudinal arches

Transverse arches

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12
Q

Which bones make up the forefoot, midfoot and hindfoot?

A

Hindfoot – calcaneus and tallus
Midfoot – cuboid, navicular and cuneiforms
Forefoot – metatarsals and phalanges

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13
Q

Which muscles of the anterior compartment of the thigh do not act across the knee?

A

Iliopsoas and Pectineus

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14
Q

Which muscle in the medial compartment of the thigh acts across the knee?

A

Gracilis

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15
Q

Describe the arrangement of the three hamstrings.

A

Biceps femoris lies more laterally (its short head comes from the lateral lip of the linea aspera) and inserts into fibula
Semitendinosus and semimembranosus are more medial and insert into the tibia

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16
Q

What movement is the anterior compartment of the leg responsible for?

A

Dorsiflexion of the ankle

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17
Q

Which nerve supplies the anterior compartment of the leg?

A

Deep peroneal nerve

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18
Q

Which artery supplies the anterior compartment of the leg?

A

Anterior tibial artery

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19
Q

Which muscles are found in the anterior compartment of the leg?

A

Tibialis Anterior
Extensor Digitorum Longus
Extensor Hallucis Longus

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20
Q

Describe the structure and attachment of tibialis anterior.

A

Lateral surface of the head of the tibia and travels medially
Goes in front of the medial malleolus
Attaches to the medial cuneiform + 1st metatarsal

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21
Q

What are the names of the two extensor retinacula in the foot?

A

Superior extensor retinaculum

Inferior extensor retinaculum

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22
Q

Which muscles are in the lateral compartment of the leg?

A

Peroneus longus

Peroneus brevis

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23
Q

What movement is the lateral compartment responsible for?

A

Eversion of the foot

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24
Q

Which nerve supplies the lateral compartment of the leg?

A

Superficial peroneal nerve

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25
Q

Which artery supplies the lateral compartment of the leg?

A

Peroneal artery

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26
Q

Describe the structure and attachments of the two muscles in the lateral compartment of the leg.

A

Both the muscles attach to the shaft of the fibula and run along the lateral side of the leg, behind the lateral malleolus and then:
Brevis – attaches to the base of the 5th metatarsal
Longus – attaches to 1st metatarsal and medial cuneiform (same as tibialis anterior but on the plantar surface)

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27
Q

Which muscles are in the posterior compartment of the leg?

A 
Superficial:
Gastrocnemius
Soleus
Plantaris
Deep:
Flexor digitorum longus 
Flexor hallucis longus 
Tibialis posterior
Popliteus
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28
Q

What movement is the posterior compartment of the leg responsible for?

A

Plantarflexion of the ankle

Flexion of the digits

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29
Q

Which nerve innervates the muscles in the posterior compartment?

A

Tibial nerve

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30
Q

Which artery supplies the posterior compartment?

A

Posterior tibial artery

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31
Q

What are the proximal attachments of gastrocnemius?

A

It attaches to the medial and lateral condyles of the femur

32
Q

Which of the superficial posterior compartment muscles does not cross the knee?

A

Soleus

33
Q

Describe the distal attachment of gastrocnemius and soleus.

A

Gastrocnemius and soleus fibres come together to form one tendon – Achilles tendon (calcaneal tendon)

34
Q

What is the collective term given to the gastrocnemius and soleus?

A

Triceps surae

35
Q

Describe the attachments of popliteus and explain the importance of this muscle.

A

Popliteus goes from the lateral condyle of the femur to the posterior surface of the tibia (near the soleal line)
It is important in unlocking the knee when it needs to be flexed

36
Q

Describe the positions of the long tendons relative to the medial malleolus.

A

They pass behind the medial malleolus

37
Q

Describe the arrangement of muscles in the sole of the foot.

A

There are 4 layers of muscles

38
Q

Describe the arrangement of muscles in the dorsum of the foot.

A

There are 2 muscles

39
Q

Which nerve supplies extensor digitorum brevis?

A

Deep peroneal nerve

40
Q

Which nerves supply the majority of intrinsic foot muscles?

A

The tibial nerve via the medial and lateral plantar nerves

41
Q

Which muscles are found in layer 1 of the sole?

A

Abductor hallucis
Abductor digiti minimi
Flexor digitorum brevis

42
Q

Which muscles are found in layer 2 of the sole?

A

Lumbricals

Quadratus plantae

43
Q

Which muscles are found in layer 3 of the sole?

A

Flexor hallucis brevis
Flexor digiti minimi brevis
Adductor hallucis

44
Q

Which muscles are found in layer 4 of the sole?

A

Palmar interossei

Dorsal interossei

45
Q

Which tendon are the lumbricals and quadratus plantae attached to?

A

Tendon of flexor digitorum longus

46
Q

What are the two muscles on the dorsal surface of the foot?

A

Extensor hallucis brevis

Extensor digitorum brevis

47
Q

What are the boundaries of the popliteal fossa?

A 
Superior lateral – biceps femoris
Superior medial – semimembranosus 
Inferior – medial and lateral heads of gastrocnemius
Floor – femur 
Roof – skin and fascia
48
Q

What are the contents of the popliteal fossa?

A

Popliteal artery and vein
Common peroneal nerve and tibial nerve
Short saphenous vein
Popliteal lymph nodes

49
Q

Where does the short saphenous vein drain?

A

Into the popliteal vein

50
Q

What does the sural nerve come off?

A

It is formed from a branch of the tibial nerve (medial cutaneous sural nerve) and a smaller branch of the common peroneal nerve (sural communicating branch)

51
Q

What type of joint is the knee?

A

Synovial hinge joint

52
Q

What part of the femur does the patella articulate with?

A

Intercondylar region of the femur

53
Q

What are the two articulations between the femur and the tibia?

A

Medial and lateral femorotibial articulations

54
Q

Which sides of the intercondylar fossa do the cruciate ligaments attach to?

A

Anterior cruciate – lateral

Posterior cruciate – medial

55
Q

What is the main difference between the medial and lateral menisci?

A

The medial collateral ligament is attached to the medial meniscus
The lateral meniscus is separate to the lateral collateral ligament

56
Q

Name the bursae that are found around the knee.

A 
Suprapatellar bursa 
Subcutaneous pre-patellar bursa
Subtendinous pre-patellar bursa 
Subcutaneous infrapatellar bursa 
Deep infrapatellar bursa 
Popliteal bursa 
Gastrocnemius bursa 
Semimembranosus bursa
Anserine bursa
57
Q

What is the main difference between the proximal tibiofibular joint and the distal tibiofibular joint?

A

Proximal tibiofibular – synovial joint
Distal tibiofibular – fibrous joint
NOTE: they both move slightly during dorsiflexion and plantarflexion of the foot

58
Q

Which ligaments are most commonly damaged in the ankle?

A

Lateral ligaments:
Anterior talofibular
Posterior talofibular
Calcaneofibular

59
Q

Name a broad ligament on the medial side of the ankle that is rarely damaged.

A 
Deltoid Ligament
Anterior tibiotalar ligament 
Posterior tibiotalar ligament 
Tibiocalcaneal ligament 
Tibionavicular ligament
60
Q

What larger joint is the talo-calcaneonavicular joint a part of?

A

Transverse tarsal joint (aka mid-tarsal joint)

61
Q

What are the three arches of the foot?

A

Lateral longitudinal arch
Medial longitudinal arch
Transverse arch

62
Q

What structures help maintain these arches?

A

Ligaments and long tendons

63
Q

Which vessel do the circumflex femoral arteries come from?

A

Profunda femoris

64
Q

What is the popliteal trifurcation?

A

Division of the popliteal artery into the:
Anterior tibial artery
Posterior tibial artery
Peroneal artery

65
Q

What are the two main arteries of the foot and which parts of the foot do they supply?

A

Dorsalis pedis – dorsal part of the foot and digits

Posterior tibial artery – sole of the foot (via the medial and lateral plantar arteries)

66
Q

What does the anterior tibial artery have to go through to access the anterior compartment?

A

Interosseous membrane

67
Q

What is the arch shaped artery on the dorsum of the foot?

A

Arcuate artery

68
Q

Which small arteries supply the digits?

A

Dorsal and plantar digital arteries

69
Q

What are the main superficial veins draining the foot and leg?

A

Long saphenous vein (from the medial end of the dorsal venous arch, going 2 cm above and lateral to the medial malleolus and along the medial side of the leg)
Short saphenous vein (from the lateral end of the dorsal venous arch, going behind the lateral malleolus)

70
Q

Where does the great saphenous vein drain?

A

It passes along the medial side of the leg and it drains into the femoral vein at the saphenofemoral junction

71
Q

Where does the short saphenous vein drain?

A

It drains into the popliteal vein

72
Q 
State the motor nerve supply for:
Hip Flexors 
Hip Extensors 
Knee Extensors 
Knee Flexors 
Ankle Dorsiflexors 
Ankle Plantarflexors
A 
Hip Flexors 
L23
Hip Extensors 
L45
Knee Extensors 
L34
Knee Flexors 
L5S1
Ankle Dorsiflexors 
L45
Ankle Plantarflexors 
S12
73
Q

What is a good way of remembering some of the sensory segmental supply?

A

L3 to the knee
L4 to the floor
L5 to the great toe
S1 to the lateral side and sole of the foot

74
Q

What does the tibial nerve divide into is it passes behind the medial malleolus?

A

Medial and lateral plantar nerves

75
Q

The tibial nerve supplies all intrinsic foot muscles except one. Name this muscle.

A

Extensor digitorum brevis

76
Q

What is the sural nerve made up of?

A

A branch of the tibial nerve (medial sural cutaneous nerve) and a smaller branch of the common peroneal nerve (sural communicating branch)
NOTE: it can be used in nerve repair

Lower Limbs (3 decks)

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