MSK - Lower Limb 2

Question 1

what bones compose the leg?

Answer 1

tibia - bigger one

and

fibula - skinny one, lateral

Question 2

label what u can of the anterior leg

Answer 2

Question 3

label posterior part of leg bones

Answer 3

Question 4

How is the tibia and fibula held together?

Answer 4

through interosseous membrane

• joins the interosseous border of the tibia with the interosseous borderof the fibula
• also splits the leg into an anterior and posterior compartment

Question 5

label this pic first

the interosseous membarne isnt exactly complete, it has some openings, these are..?

Answer 5

opening for anterior tibial vessels

opening for perforating branch of fibular artery

Question 6

What type of joint at the superior end of the fibula and tibia? (knee) -

Answer 6

plane synovial joint which allows for some sliding in dorsiflexion

Question 7

what are the 4 ligaments that hold the tibia and fibula together (superiorly and inferiorly)

i swear its easy

Answer 7

superior - ant and post ligament of head of fibula

inferior - ant and post tibiofibular ligament

Question 8

label a cross section of the leg - muscular compartments

Answer 8

anterior, posterior and lateral (small and is formed by intermuscular septum)

Question 9

What are the 3 parts that the foot? - what are each part made of !!!

label

Answer 9

Question 10

What are the divisions of the phalanges?

Answer 10

proximal, middle and distal (hallux only has proximal and distal)

Question 11

What is the body of the ankle contained by?

Answer 11

medial and lateral malleolus

Question 12

How many tarsal bones are there?
and what are they?

Answer 12

7
calcaneus, talus, navicular, cuboid, medial cuneiform, middle cuneiform, lateral cuneiform

Question 13

What is the sustentaculum tali?

Answer 13

groove which runs on the anteromedial portion of the calcaneus
- attaches to tuberosity on 5th toe

Question 14

What is the Achilles tendon?

Answer 14

calf muscle attachment which will pull up when on tippy toes

Question 15

What are the 5 ankle and foot joints?

Answer 15

1. tibiotalar
2. subtalar
3. transverse tarsal
4. metatarsophalangeal
5. interphalangeal

Question 16

What is the tibiotalar joint and what does it do?

Answer 16

actual ankle joint which does hinge dorsiflexion

Question 17

What is the subtalar joint and what does it do?

Answer 17

reinforced by talocalcaneal ligaments which do eversion and inversion

Question 18

What are the 2 types of transverse tarsal joint?

Answer 18

1. calcaneocuboid
2. talocalcaneonavicular

Question 19

What is the role of the metatarsophalangeal joint?

Answer 19

flexion, extension, abduction and adduction (then happen together to do circumflexion)

Question 20

Where does abduction and adduction happen from?

Answer 20

the midline is considered to be the 2nd toe

Question 21

What is the level of movement in the tallus joint?

Answer 21

• hinge joint => main movement is plantarflexion and dorsiflexion
• the articular surface is narrower posteriorly = joint more unstable when plantar flexed
• plantarflexed position allows for ‘wiggle room’ which allows for eversion/inversion or abduction/adduction

Question 22

What are the 4 parts of the medial ligament of the ankle joint?

Answer 22

• tibiocalcaneal part
• tibionavicular part
• anterior tibiotalar part
• posterior tibiotalar part

Question 23

What are the lateral ligaments in the ankle?

Answer 23

1. anterior talofibular ligament - clinically important because mostly involved in ankle sprains
2. calcaneofibular ligament
3. posterior talofibular ligament

An ankle sprain refers to partial or complete tears in the ligaments of the ankle joint. It usually occurs via excessive inversion to a plantarflexed and weight-bearing foot.

Question 24

label the ligaments on the plantar side of the foot

Answer 24

long plantar ligament, short plantar ligament, plantar calcanonavicular ligament, deltoid ligament

Question 25

What does the natural arch of the foot allow for?

Answer 25

weight distribution acting as a lever

Question 26

What are the divisions of the arch of the foot?

Answer 26

medial longitudinal arch, lateral longitudinal, transverse arch

Question 27

How are some people flat-footed? clin rel

Answer 27

calcaneaonavicular joint disruption = collapse of medial arch = flat footed

Question 28

What are the ligaments across the toes?

Answer 28

collateral ligaments, plantar ligaments

Question 29

label these

Answer 29

Question 30

What are the compartments of the leg?

Answer 30

anterior, posterior, and lateral - anterior and posterior separated by the interosseous membrane - lateral formed by the anterior and posterior intermuscular septa

Question 31

What are the components of the superficial compartment of the leg?

Answer 31

- gastrocnemius (lateral and medial head) - become archilles (calcaneous) tendon - soleus - plantaris - popliteal - popliteus

Question 32

Where does the gastrocnemius and soleus join?

Answer 32

at the calcaneal tendon / archilles

Question 33

What does the plantaris do?

Answer 33

not much - but does have a long tendon which can be harvested for repair elsewhere

Question 34

What does the popliteus allow for?

Answer 34

knee flexion and locks the knee joint for lateral rotation

Question 35

What are the borders of the popliteal fossa?

Answer 35

- Superomedial border = semimembranous - Superolateral border = biceps femoris - Inferomedial border = medial head of gastrocnemius - Inferolateral border = lateral head of gastrocnemius and plantaris

Question 36

What are the components of the deep compartment of leg?

Answer 36

- tibialis posterior (forms medial arch of foot as it inserts into medial side of foot) - flexor digitorum longus - flexor halllucis longus

Question 37

What is the tarsal tunnel? clin rel

Answer 37

narrow space in medial ankle where tibialis posterior, flexor digitorum longus, flexor hallucis longus and its nerves and lymphatic run

Question 38

What is the calcaneal bursa?

Answer 38

reduces friction when the calcaneal tendon moves up and down

Question 39

What are the components of the lateral leg?

Answer 39

- fibularis longus - fibularis brevis (attaches to tuberosity on 5th metatarsal) - fibular retinaculum (helps with plantarflexion)

Question 40

What is the main job of the lateral compartment of the foot?

Answer 40

evertion of foot

Question 41

label the tendon and ligaments holding it in place

Answer 41

Question 42

What is in the anterior compartment of the leg?

Answer 42

- tibialis anterior - extensor hallucis longus - extensor digitorum longus - fibularis tertius (help with eversion and insert into 5th metatarsal)

Question 43

How does the fibularis longus tendon travel?

Answer 43

underneath the foot to the 1st metatarsal

Question 44

What is the plantar aponeurosis for?

Answer 44

allow the ligament to come and join before spreading

Question 45

How does the femoral artery go through the popliteal fossa?

Answer 45

femoral artery => through adductor hiatus => turns into popliteal artery

Question 46

What are the contents of the popliteal fossa?

Answer 46

- popliteal artery - popliteal vein - gives small saphenous vein branch - sciatic nerve starts at the top and splits into common fibular nerve and tibial nerve

Question 47

What do the genicular arteries do?

Answer 47

pass around the knee

Question 48

What is the artery travel in posterior leg?

Answer 48

popliteal => anterior tibial (piercing through interosseous membrane) = through the anterior compartment => supply the muscle => becomes dorsalis pedis

Question 49

Nerve innervation to anterior compartment of leg Nerve innervation to lateral compartment of leg

Answer 49

common fibular nerve => superifical and deep fibular (L5-S2) superficial fibular nerve

Question 50

Nerve innervation to posterior compartment of leg

Answer 50

tibial nerve, medial plantar nerve (further down) and lateral plantar nerve

Question 51

what does the sural nerve do in the posterior leg?

Answer 51

penetrate deep fascia

Question 52

How does the saphenous vein travel?

Answer 52

up the dorsal side of the foot and then wraop around the medial part of thigh and peirce the deep fascia

Question 53

What is the order of the contents through the tarsal tunnel?

Answer 53

Tom, dick, and very nervous harry 1.tibialis posterior 2.Digitiorium liongus 3.Artery, vein, nerve 4.Harry

Question 54

How does pain in the tarsal tunnel ascend?

Answer 54

through the calf

Question 55

What are the 5 compartments of the foot?

Answer 55

- Medial compartment of sole - Central compartment of sole - Lateral compartment of sole - Interosseous compartment of foot - Dorsal compartment of foot

Question 56

What is in layer 1 of foot?

Answer 56

flexor digitorium brvis, abductor hallucis, abductor digiti minimi

Question 57

What is in layer 2 of foot?

Answer 57

lumbrical 1-4, flexor hallucis, flexor digitorum longus tendon, flexor hallucis tendon, quadratus plantae

Question 58

What is in layer 3 of foot?

Answer 58

adductor hallucis, flexor digiti minimi, flexor hallucis brevis

Question 59

What is in layer 4 of foot?

Answer 59

- plantar interossei (1, 2,3 ) - dorsal interossi (1, 2, ) - fibularis longus tendon

Question 60

Where do all muscles on the dorsal side of the foot come from?

Answer 60

calcaneus

Question 61

What bones is the hindfoot made of?

Answer 61

tarsal and calcaneus