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1
Q

What is the origin of the super gluteal neurovascular bundle?

A

L4-S1 (All gluteal region nerves arise from lumbrosacral plexus)
Emerges superior to piriformis muscle (all others emerge inferior to piriformis muscle)

2
Q

What is the function of the superior gluteal neurovasculat bundle?

A

Motor to gluteus minimus and medius muscles

Trendenlenburg sign

3
Q

Where would you find the superior gluteal neurovascular bundle?

A

Between gluteus minimus and gluteus medius muscles

4
Q

A lesion of the superior gluteal neurovascular bundle would produce:

A

Weakness of Abducting the thigh at the hip
Would cause Trendelenberg sign – sagging of muscles of unaffected side of butt/pelvis
Muscles unable to provide necessary stability while walking

5
Q

What are the landmarks of the deep branch of the femoral artery?

A

Branches around the lower trochanter and heads deeper/posteriorly
Runs down thigh (closer to femur than femoral artery)
Runs between pectineus and adductor longus muscles
The artery does not leave the thigh region

6
Q

What branches of the deep femoral artery supply the hip?

A

Medial and lateral femoral circumflex

7
Q

What region of the thigh is supplied by the deep branches of the femoral artery (perforating)?

A

Medial and posterior thigh

8
Q

What are the landmarks for the adductor brevis muscle?

A

Runs from the sides of the pubic symphysis to the area of femur just below lesser trochanter
Found under the adductor longus muscles

9
Q

What other muscles share the same function as adductor brevis?

A
Stabilize pelvis when standing and  femur when sitting with knee bent
Adductor longus (on top of brevis)
Adductor magnus (below brevis, very large)
10
Q

A lesion to the adductor muscles would result in:

A

Obturator nerve innervates adductors
“Waddling gait”
—Wide gait that is aligned with the shoulders instead of the normal alignment with the pelvis

11
Q

What are the landmarks of the sartorius muscle?

A

Runs from the ASIS in the pelvis to the Pes Anserine on the medial part of the tibia; in anterior compartment
Longest muscle in human body and is an outermost long, thin muscle
Upper part forms lateral border of the femoral triangle

12
Q

What are the primary functions of the sartorius muscle?

A

Flex knee

Weakly flexes, abducts and laterally rotates hip

13
Q

What is the nervous innervation to sartorius muscle?

A

Anterior/Superficial branch of femoral nerve

Sensory and motor to Sartorius

14
Q

Would a strong vargas or valgus force compromise the integrity of the MCL?

A

Valgus Force

Abducting force of limb against a stationary thigh (knocking knee in with fore coming from a lateral direction)

15
Q

What are the landmarks of the MCL?

A

From medial epicondyle of the femur to the medial condyle of the tibia (medial side of the knee)

16
Q

What are the potential consequences of an MCL injury?

A

MCL is directly connected to medial meniscus, so a medial meniscus tear is common

17
Q

Tendon of the Obturator Internus Muscle

Landmarks?

A

From anterior ischium/rim of pubis to greater trochanter region

18
Q

Tendon of the Obturator Internus Muscle

Primary action?

A

Primary action:
Lateral rotation of femur with hip flexion
Steady femoral head in acetabulum

19
Q

Tendon of the Obturator Internus Muscle

What other muscles do the same action?

A

Primary action:
Lateral rotation of femur with hip flexion
Steady femoral head in acetabulum

Three other muscles with same action:
Superior gamellus muscle
Inferior gamillus muscle
Quadratus femorus

20
Q

What are the landmarks of the deep branch of the common fibular nerve?

A

Passes deep to the extensor digitorum longus

Winds around fibula

21
Q

A lesion of the common fibular nerve would result in:

A

Foot drop
Loss of sensation to dorsum of foot
Walk with slapping of foot on the ground and difficulty “heel walking”
Typically occurs with trauma to the neck of the fibula, as it winds around it

22
Q

What artery accompanies the common fibular nerve?

A

Anterior tibial artery

23
Q

What are the landmarks of the tendon of the flexor hallicus longus?

A

Muscle runs down lateral leg, and tendon can be seen curving around medial portion of ankle to run down to end of hallux (big toe)
“Tom, Dick, and HARRY”

24
Q

What artery lies immediately deep to the flexor hallicus longus and what does it supply?

A

Peroneal (fibular) artery (peroneal branch of posterior tibial artery)
Blood supply to lateral compartment of the leg

25
Q

Name two other muscles in the deep portion of the posterior compartment of the leg besides flexor hallicus longus and what nerve supplies them?

A

Innervation:
Tibial Nerve

Flexor digitorum longus
Tibialis posterior

26
Q

What are the landmarks of tibialis anterior muscle?

A

Origin: lateral condyle and proximal half of lateral surface of tibia
Passes anterior to medial malleolus and inserts onto the inferior surface of the 1st cuneiform bone and 1st metatarsal

27
Q

Primary action of tibialis anterior on the foot and what muscle is a synergist?

A

Inversion of ankle and supination of foot

Tibialis posterior

28
Q

Primary action of tibialis anterior muscle on ankle and what muscles are synergists?

A

Dorsiflexion at ankle

Extensor hallucus longus
Extensor digitorum longus

29
Q

What are the landmarks of the IT band?

A

Formed by tendinous insertion of gluteus maximus and tensor fascia lata onto lateral tibial condyle

30
Q

What is the function of the IT band?

A

tabilizes lateral aspect of knee by keeping the femur from moving on the tibia when the knee is flexed

31
Q

What muscle lies at the IT band’s superior extent and what is its action?

A

Tensor fascia lata

ABducts and stabilizes the hip
Assists with initiation of hip flexion

32
Q

What is the landmark of the quadriceps tendon?

A

Combined Tendon of 4 muscles superior to the patella (and encases patella)

33
Q

Name action of muscles who’s fibers terminate as the quadriceps tendon:

A

All work together to extend the knee

Rectus Femoris
Vastus Medialis
Vastus Intermedius
Vastus Lateralis

34
Q

What is the relationship of the quadriceps tendon to the patella?

A

Encases patella, then continues on to form the patellar ligament to insert on the tibia for knee extension

35
Q

What are the landmarks of the dorsalis pedis artery?

A

Runs superficially down middle of top of foot towards area between the first and second toes

36
Q

The dorsalis pedis artery is the termination of what artery?

A

Anterior tibial artery

37
Q

What is the clinical significance of the dorsalis pedis artery?

A

You can take pedal pulse from it to check for cardiovascular problems/mismatch
Runs over talus, navicular, and intermediate cuneiform bones

38
Q

What are the landmarks of the common fibular nerve?

A

Split of the sciatic nerve (other branch of sciatic n. is tibial nerve) superior to knee on lateral leg

39
Q

What are the cutaneous termini of the two major branches of the common fibular nerve?

A

Common fibular branches into superficial and deep fibular nerves

Cutaneous branches are:
Articular Cutaneous Nerve
Sural Cutaneous Nerve

40
Q

What are the landmarks of the popliteus muscle?

A

Deep to hamstrings, posteriorly

Runs diagonally across the back of the knee, laterally, from the femur to the medial tibia

41
Q

How does the popliteus unlock the knee?

A

Causes a slight rotation of the femur laterally on the tibia (in the weight bearing position), which is required in unlocking the knee

42
Q

What is the nerve supply to the popliteus muscle?

A

Tibial nerve

43
Q

What is the landmark for the tendo calcaneus?

A

Back of leg at ankle

44
Q

What two muscles contribute to the tendo calcaneus?

A

Two heads of gastrocnemius muscle (lateral and medial)
Soleus muscle
(through this tendon, the triceps surae attach to the back of the calcaneus)

45
Q

What functional deficit would occur following rupture of the Achilles tendon?

A

Sharp pain in back of ankle or lower leg that will affect ability to walk, especially uphill or up stairs and difficulty rising up on the toes

46
Q

What are the landmarks of the ACL?

A

Between (anterior) tibia and crosses anteriorly to PCL to attach to (posterior) femur

47
Q

What functional deficit would occur following rupture of ACL?

A
Functions to resist anterior movement of the tibia on the femur
Pain and swelling in the knee
Loss of range of motion
Tenderness along the joint line
Discomfort while walking
48
Q

How would you test for an injury to the ACL?

A

Lachman test: Flex knee at 20-30 degrees with pt supine, pull forward on tibia while holding femur in place – assess amt of forward motion

49
Q

What are the landmarks of the iliofemoral ligament?

A

Anteriorly connects the ilium to the femur

Strongest and most important extrascapular ligament, covering the anterior and inferior aspects of the joint

50
Q

What is the function of the iliofemoral ligament?

A

Prevents hyperextension of the hip

51
Q

How does the iliofemoral ligament facilitate standing for long periods of time?

A

It helps lock the hip joint

It prevents hyperextension of the joint, preventing movement of the femur past a vertical line, locking it into place

52
Q

What are the landmarks for the lateral ligament of the ankle?

A

Set of 3 ligaments on the lateral ankle from the lateral malleolus of the radius to the talus or calcaneus – they resist inversion (supination) of the foot

53
Q

What portion of the lateral ligament of the ankle is usually torn as a result of inversion injury?

A

Usually get a foot inversion ankle sprain because the lateral ligament is weaker than the medial deltoid
Calcaneofibular portion

54
Q

What may be the consequences of a young patient if the portion of the lateral ligament of the ankle that attaches to the fibula is torn?

A

If the calcaneofibular ligament is involved, the distal portion of the lateral malleolus is often avulsed

This injury can damage the growth plate of the fibula, in a young individual, and disrupt the course of the tendons of the fibularis muscles

55
Q

What are the landmarks of the spring ligament?

A

Located on the bottom of the foot and connects the navicular bone’s plantar surface with the calcaneus’s sustentaculum

56
Q

What is the function of the spring ligament?

A

Supports the medial longitudinal arch

57
Q

If the spring ligament is lax, what clinical symptom/consequence may result?

A
Flat feet (pes planus)
In this situation, the head of the talus moves inferiorly and the medial longitudinal arch is flattened, while the metatarsals and phalanges are noticibly deviated laterally
Pain due to excessive strain and pressure on the muscles and bones in the foot because of inappropriate weight transfer while walking
58
Q

What are the landmarks of the fibularis longus muscle?

A

Muscle in the lateral compartment of leg and tendon wraps around the lateral (malleolus) ankle and crosses bottom of foot to attach at lateral side of the base of the first metatarsal of big toe

59
Q

What is the major action of the fibularis longus muscle?

A

Eversion/Pronation and plantarflexion of the foot

60
Q

What function does the tendon of the fibularis longus serve on the plantar surface of the foot?

A

Helps steady the leg upon the foot, especially when standing on one leg where there is a tendency of the leg to move medially – fibularis longus overcomes this tendency by drawing on the lateral side of the leg