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MSCT-LM > W4 lower leg > Flashcards

W4 lower leg Flashcards

(55 cards)

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1
Q

• Regions of the lower limb

A 
o	Gluteal region
o	Anterior thigh
o	Posterior thigh
o	Leg
o	Foot
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2
Q

• Gluteal region

A

o Posterolateral and between iliac crest and gluteal fold of lower buttocks
o Bones are two pelvic bones each formed by ilium, ischium, and pubis
o These bones fuse during childhood

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3
Q

• Anterior thigh

A

o Between inguinal ligament and knee joint

o Bone of the thigh is femur

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4
Q

• Posterior thigh

A

o Between gluteal fold and knee

o Bone of the thigh is femur

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5
Q

• Leg

A

o Between knee and ankle joint

o Bones are tibia and fibula

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6
Q

• Foot

A

o Distal to ankle joint

o Bones are tarsals, metatarsals and phalanges

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7
Q

• Hip movements

A 
o	Flexion
o	Extension
o	Abduction 
o	Adduction
o	Medial and lateral rotation
o	Circumduction (combination of other four motions)
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8
Q

• Abduction of hip

A

o Can be abduction of femur on fixed pelvis
o Abduction of pelvis on fixed femur
o In both, angle between pelvis and femur decreases
o When taking a step, the high of the leg that is grounded abducts

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9
Q

• Knee joint

A

o Hinge joint
o Flexion
o Extension

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10
Q

• Ankle joint

A 
o	Hinge joint
o	Dorsiflexion (toes toward shin)
o	Plantarflexion (toes away from shin)
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11
Q

• Hip joint

A

o Synovial joint
o Head of femur and acetabulum on lateral pelvic bone
o Multi-axial
o Stability and weight bearing

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12
Q

• Acetabular labrum

A

o Fibrocartilaginous collar on the rim of acetabulum
o Prevents head of femur from moving inferiorly and deepening acetabulum
o Common site of injury: pain on weightbearing, flexion, internal rotation

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13
Q

• Ligament of the head of the femur

A

o Connective tissue that attaches the head of the femur to the acetabular fossa
o Obturator artery runs with this ligament and supplies femoral head
o Synovial membrane attaches to the margins of the articular surfaces of femur and acetabulum

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14
Q

• Fibrous capsule or membrane

A

o Surrounds synovial head
o Holds femoral neck in acetabulum
o Three ligaments
 Iliofemoral – anterior to the hip joint
 Pubofemoral ligament – anteroinferior to hip joint
 Ischiofemoral ligament – posteroinferiorly to the hip joint

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15
Q

• Knee joint

A

o Primarily hinge joint
o Biggest synovial joint in the body
 Articulation between femur and tibia is weight bearing
 Articulation between patella and femur pulls quadriceps femoris muscle over the knee to tibia without tendon wear

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16
Q

• Lateral and medial meniscus

A

o Fibrocartilaginous
o Cushion knee and accommodate changes in shape of articular surfaces during movement
o Femoral condyles are flat during flexion, round during extension

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17
Q

• Synovial membrane of the knee

A

o Attaches to the margins of the articular surfaces and menisci
o forms two pouches (suprapatellar bursa and subpopliteal recess

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18
Q

• Fibrous capsule or membrane

A

o Encloses articular cavity

o Partly formed and reinforced by muscle tendons

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19
Q

• Patellar ligament

A

o Continuation of quadriceps femoris tendon

o Connects the patella to the tibia

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20
Q

• Collateral ligaments

A

o Medial or tibial (MCL or TCL) and lateral or fibular (LCL or FCL)
o Stabilize the hinge like motion of knee
o Medial meniscus attaches to MCL

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21
Q

• ACL

A

o Anterior cruciate ligament
o Crosses with PCL in intercondylar region of knee
o Connect tibia and femur and restrict movement
o Keeps tibia from moving anteriorly on the fixed femur
o Extends from lateral femoral condyle to the anterior tibia

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22
Q

• PCL

A

o Posterior cruciate ligament
o Crosses with ACL in intercondylar region of knee
o Connect tibia and femur and restrict movement
o Keeps tibia from moving posteriorly on fixed femur
o Extends from medial femoral condyle to posterior tibia

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23
Q

• Unhappy triad

Study These Flashcards
A

o ACL, MCL, and medial meniscus tear
o Caused by lateral force applied to planted leg
o Audible snap and immediate pain and swelling

24
Q

• Movements of the gluteal region

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A

o Abduct, extend, and laterally rotate the femur relative to pelvic bone

25
• Deep muscles of gluteal
``` o Lateral rotators of the femur o Piriformis o Obturator internus o The gemelli o Quadratus femoris ```
26
• Superficial muscles of the gluteal
``` o Abduct (Gluteus mimimus and maximus) o Extend hip (gluteus maximus) ```
27
• Tensor fasciae latae
o stabilizes knee in extension by acting on iliotibial tract | o IL tract is a band of deep fascia that passes down lateral side of thigh to attach to proximal end of tibia
28
• Iliotibial tract
o Band of deep fascia that passes down lateral side of thigh to attach to proximal end of tibia
29
• Nerves of gluteal
o Enter from pelvis through greater sciatic foramen o Most are in between superficial and deep muscles o Superior gluteal nerve passes superior to piriformis muscle o Others pass inferior to piriformis muscle
30
• Superior gluteal nerve
o L4, L5, S1 | o Innervates gluteus miminus and medius muscles and tensor fascia latae
31
• Nerve to quadratus femoris
o L5, S1 | o Supplies gamellus inferior
32
• Nerve to obturator internus
o L5, S1 o Supplies gemellus superior o Then passes through lesser sciatic foramen to innervate obturator internus
33
• Posterior cutaneous nerve of the thigh
o Innervates the skin of the gluteal region the posterior thigh and posterior leg
34
• Inferior gluteal nerve
o L5,S1,S2 | o Supplies gluteus maximus muscle
35
• Piriformis muscle innervation
o Innervated by branches of S1,S2
36
• Pudendal nerve
o S2-S4
37
• Trendelenburg sign/gait
o Superior gluteal nerve injury (innervates hip abductors, gluteus minimus and medius o Sign: when patient stands on affected limb, pelvis drops over swing limb and abduction of pelvis on fixed femur does not occur o Gait: when pelvis tilts over the swing limb patient compensates by lurching trunk to affected side to maintain level of pelvis during gait o Contraction of gluteus minimus and medius on stance side prevents excessive pelvic tilt during swing phase on opposite side
38
• Gluteal blood supply
o Superior and inferior gluteal arteries | o Originate in iliac artery (a terminal branch of the aorta)
39
• Anterior compartment of the thigh
o Femoral nerve o Branches of femoral artery o Extension of leg o Quadriceps femoris  Rectus femoris flexes the thig at hip and extends leg  Vastus lateralis, vastus medialis, and vastus intermedius extend leg o Sartorius muscle flexes thigh and flexes leg o Psoas major and iliacus pass into upper part of anterior compartment from posterior abdominal wall and flex thigh
40
• Medial compartment
o Obturator nerve o Branches of the deep femoral artery and obturator artery o Adduction of the thigh (and medially rotate) o Gracilis o Pectineus o Adductor longus and brevis o Adductor magnus o Obturator externus lateral rotates thigh
41
• Posterior compartment
o Tibial division of sciatic nerve (common fibular division of sciatic nerve to short head of biceps femoris) o Perforating branches of deep femoral artery o Flexion of leg, extension of thigh o Can rotate hip and knee joint o Biceps femoris, semitendinosus, and semimembranosus (hamstrings) o All but biceps femoris cross both hip and knee joints
42
• Pes anserinus
o Goose’s foot | o Common insertion of tendons of sartorius, gracilis, and semitendious muscles on proximal tibia
43
• Femoral artery
o Continuation of external iliac artery o begins as external iliac artery passes under inguinal ligament to enter femoral triangle on anterior aspect of upper thigh o middle branch is deep artery of the thigh (profundal femoris)
44
• deep artery of thigh
o major blood supply to thigh o branches into  medial and lateral circumflex femoral arteries – medial compartment  perforating branches – posterior compartment
45
• obturator artery
o branch of internal iliac artery o branches anastomose with inferior gluteal and medial circumflex arteries  anterior or superficial branch  a posterior or deep branch – near head of femur
46
• valgus
o bowing of a shaft of bone | o distal part is more lateral
47
• valrus
o bowing of shaft of bone |  distal part is more medial
48
• Lachman
``` o Test for ACL o Patient is supine with knee flexed at 30 degrees o Grasp and stabilize thigh o Move proximal leg anteriorly o Positive is excessive forward motion ```
49
• Anterior drawer
o Test for ACL o Patient supine with knee flexed at 90 degrees o Sit on dorsum of foot o Place hands behind knee and move proximal leg anteriorly o Positive test is excessive forward motion of tibia o Less sensitive than Lachman’s test
50
• Posterior drawer
o Test for PCL o Patient supine with knee flexed at 90 degrees o Palms of hands push proximal leg posteriorly
51
• Valgus stress
o MCL test o Patient supine with knee extended or flexed 30 degrees o Stabilize lateral aspect of knee and push ankle laterally o Estimate medial joint space o Positive test is significant gap in medial joint space
52
• Varus stress
o LCL o Patient supine with knee extended or flexed 30 degrees o Stabilize medial aspect of knee o Push ankle medially o Estimate lateral joint space o Positive test is significant gap in lateral joint space
53
• McMurray
o Examiner passively flexes the knee with rotation of tibia or foot o Or have patient do a two-legged squat o Pain or popping on external rotation is medial meniscus o Pain or popping during internal rotation is lateral meniscus o Joint line tenderness
54
• Patellar apprehension test
o Apply lateral directed force toward medial aspect of patella o Positive is apprehension from patient that it will dislocate
55
• Patellofemoral grind
o Apply downward and inferior pressure on patella while patient contracts quadriceps on extended knee. o Pain with movement or unable to complete test shows patellofemoral pathology

MSCT-LM (14 decks)

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