Anatomy Flashcards- Lower Extremity

Front 1

What are the boundaries of the popiteal fossa?

Back 1

The boundaries are the edges of the semimembranosus and biceps femoris muscles superiorly, and the heads of gastrocnemius inferiorly. The floor is formed by the popliteal surface of the femur as well as the knee joint capsule, superficially the “roof” of this space is covered with deep fascia.

Front 2

What passes through the popiteal fossa?

Back 2

popliteal artery, popliteal vein, tibial nerve, and the common fibular nerve

Front 3

Is the ankle is more stable in dorsiflexion or plantarflexion? Why?

Back 3

Dorsiflexion, the superior articular surface on the talus is wider anteriorly than it is posteriorly.

Front 4

Which is stronger, medial or lateral collateral ligaments?

Back 4

Medial

Front 5

What do high ankle sprains effect?

Back 5

Tibiofibular ligament and interosseous membrane

Front 6

What is a Pott's fracture?

Back 6

fracture of the distal fibula (albeit proximal to the lateral collateral as well as the anterior and posterior tibiofibular ligaments) and a medial collateral tear

Front 7

What 2 joints do inversion and eversion occur at?

Back 7

subtalar joint and transverse tarsal joint

Front 8

What supports the medial longitudinal arch?
lateral longitudinal arch?
transverse arch?

Back 8

plantar calcaneonavicular ligament (spring ligament)
long plantar ligament and short plantar ligament
tendon of the fibularis longus tendon

plantar aponeurosis supports all

Front 9

What is impinged by tarsal tunnel syndrome?

Back 9

tibial nerve is impinged by flexor retinaculum

Front 10

Where do superfical structures on the posterior side of the leg drain?
Anterior side of the leg?
Gluteal region and anterior abdominal wall?

Back 10

Superficial structures on the posterior side of the leg drain toward popliteal lymph nodes in the popliteal fossa. Superficial structures on the anterior side of the lower extremity drain toward the inferior group of superficial inguinal lymph nodes. The gluteal region and anterior area of the abdominal wall will drain toward the superolateral group of superficial inguinal lymph nodes. Superficial inguinal lymph nodes will drain to deep inguinal lymph nodes and then proximally along lymphatic channels adjacent and medial to the femoral and external iliac veins.

Front 11

What is a femoral hernia?

Back 11

30. Loops of bowel may occasionally travel through the femoral canal, an opening in the femoral sheath medial to the femoral vein (a space occupied by lymphatic structures). This loop of bowel may become strangulated and the resulting ischemic necrosis can be life threatening.

Front 12

What is Osgood-Schlatter’s disease?

Back 12

displacement of the epiphysis of the tibial tuberosity during growth

Front 13

How do the medial and lateral malleoli constrain the the trochlea of the talus?

Back 13

only medial and lateral directions

Front 14

What main nerves exit through the greater sciatic foramen?

What exits through the obdurator canal?

What exits through the superficial inguinal ring?

Back 14

sciatic nerve and posterior femoral cutaneous nerve

obturator nerve

ilio-inguinal nerve

Front 15

What does the sciatic nerve divide into? What does the common fibular nerve divide into?

Back 15

The sciatic nerve will divide into a tibial and a common fibular nerve. The common fibular divides into superficial and deep fibular nerves

Front 16

The superior and middle cluneal nerves are from dorsal or ventral rami? Inferior cluneal nerves are from dorsal or ventral rami?

Back 16

dorsal, ventral

Front 17

What do the anterior, lateral and posterior compartments of the LEG receive innervation from?

Back 17

deep fibular, superficial fibular and tibial nerves

Front 18

What do the anterior, medial and posterior compartments of the THIGH receive innervation from?

Back 18

femoral, obdurator, and sciatic nerves

Front 19

What do dorsal and ventral divisions comprise?

Back 19

Ventral rami

Front 20

Origin/insertion/action/innervation of gluteus maximus?

Back 20

origin- posterior to the posterior gluteal line
insertion- gluteal tuberosity and iliotibial tract
action-extensor of the flexed hip as well as a lateral rotator and abductor at the hip
innervation- inferior gluteal nerve

Front 21

origin/insertion/action/innervation of tensor fascia lata?

Back 21

origin- the anterior portion of the iliac crest
insertion- the iliotibial tract
action-stabilize knee, abducts?
innervation- superior gluteal nerve

Front 22

origin/insertion/action/innervation gluteus medius?

Back 22

origin-posterior and anterior gluteal lines
insertion-greater trochanter
action- abductors at the hip
innervation- superior gluteal nerve

Front 23

origin/insertion/action/innervation gluteus minimus?

Back 23

origin- anterior and inferior gluteal lines
insertion- greater trochanter
action-hip abductor
innervation-superior gluteal nerve

Front 24

Origin/insertion/action/innervation piriformis?

Back 24

origin-sacrum
insertion- greater trochanter
action-laterally rotate extended hip and abduct flexed hip
innervation- S1 and S2 ventral rami

Front 25

origin/insertion/action/innervation of obturator internus muscle?

Back 25

origin-pubis
insertion- greater trochanter
action-laterally rotate extended hip and abduct flexed hip
innervation- nerve to obturator internus

Front 26

origin/insertion/action/innervation of superior gemellus?

Back 26

origin-ischium
insertion- greater trochanter
action-laterally rotate extended hip and abduct flexed hip
innervation- nerve to obturator internus

Front 27

origin/insertion/action/innervation of quadratus femoris?

Back 27

origin-ischium
insertion- greater trochanter
action-laterally rotator
innervation- nerve to quadratus femoris

Front 28

origin/insertion/action/innervation of inferior gemellus?

Back 28

origin-ischium
insertion- greater trochanter
action-laterally rotate extended hip and abduct flexed hip
innervation- nerve to quadratus femoris

Front 29

What muscle do you want to puncture with ventrogluteal injection, what muscle/nerves/arteries do you want to avoid?

Back 29

gluteus medius

gluteus maximus, sciatic nerve, superior gluteal neurovascular bundle

Front 30

origin/insertion/action/innervation of iliacus?

Back 30

origin-iliac fossa
insertion- lesser trochanter
action-hip flexor
innervation- L2-4

Front 31

origin/insertion/action/innervation of psoas major ?

Back 31

origin-lumbar transverse processes and intervertebral discs
insertion- lesser trochanter
action-hip flexor
innervation-femoral nerve, L1-3

Front 32

origin/insertion/action/innervation of sartorius muscle?

Back 32

origin- anterior superior iliac spine
insertion- inferomedial to the tibial tuberosity
action- flexor at both the hip and the knee and is a lateral rotator at the hip
Innervation- femoral nerve

Front 33

origin/insertion/action/innervation of rectus femoris, the vastus lateralis, vastus medis, and vastus intermedius?

Back 33

rectus femoris origin- anterior inferior iliac spine (enables thigh flexion at hip joint)
other origins- femoral shaft
insertion- insert into the superior aspect of the tibial tuberosity or directly into the patella
actions- knee extensors, hip flexion (rectus femoris only)
innervation-femoral nerve

Front 34

What innervates and supplies blood to the anterior and lateral compartments of leg

Back 34

deep fibular nerve and anterior tibial artery

superficial fibular nerve, fibular artery branches

Front 35

origin/insertion/action/innervation for fibularis longus?

Back 35

origin-head of fibula
insertion-runs through a groove on the distal cuboid and then across the 3rd and 2nd cuneiforms to reach the 1st cuneiform and 1st metatarsal
action-evert the foot as well as plantar flex it
innervation-superficial fibular nerve

Front 36

origin/insertion/action/innervation for fibularis brevis?

Back 36

origin-head of fibula
insertion- lateral tubercle of the base of the fifth metatarsal
action-evert the foot as well as plantar flex it
innervation-superficial fibular nerve

Front 37

What is the mirror image of fibularis longus muscle? What does it do and how does it run?

Back 37

Tibialis anterior is also a dorsiflexor but because of its particular diagonal path it produces inversion of the sole of the foot. In this sense it is a "mirror image" of the fibularis longus.

Front 38

What innervates extensor digitorum longus, tibialis anterior, and extensor hallucis longus?

Back 38

deep fibular nerve

Front 39

What is the action of Fibularis tertius muscle?

Back 39

dorsiflexion and eversion

Front 40

The adductor canal lies deep to the ________ muscle, anterior to _________ and __________ muscles, and is medial to the _________ muscle

Back 40

sartorius muscle, adductor longus and adductor magnus muscles, vastus medialis muscle

Front 41

What does the adductor canal contain?

Back 41

nerve to vastus medialis, the saphenous nerve [both branches of the femoral n.], femoral artery and vein

Front 42

If the saphenous nerve does not go through the adductor hiatus, where does it travel instead? What does it innervate?

Back 42

travels between sartorius and gracilis to supply cutaneous innervation to the medial side of the leg

Front 43

What innervates the medial compartment of the thigh? What is the exception to the rule?

Back 43

obturator nerve. Femoral innervates pectineus muscle.

Front 44

What is origin/insertion/action/innervation of pectineus?

Back 44

origin-pectineal line of the pubis
insertion- pectineal line on the femur
action- adducts and flexes the thigh
innervation- femoral (surprise?)

Front 45

origin/insertion/action/innervation of adductor longus?

Back 45

origin- inferior to pubic tubercle
insertion- linea aspera
action- pure adductor
innervation- obturator nerve

Front 46

origin/insertion/action/innervation of adductor brevis?

Back 46

origin- anterior pubis
insertion- linea aspera
action- pure adductor
innervation- obturator nerve

Front 47

origin/insertion/action/innervation of obturator externus?

Back 47

origin- external surface of obturator membrane
insertion- near greater trochanter
action- pure adductor
innervation- obturator nerve

Front 48

origin/insertion/action/innervation of gracilis?

Back 48

origin-anterior surface of pubic body
insertion- medial side of the proximal tibial shaft
action-adducts hip and flexes knee
innervation-obturator nerve

Front 49

origin/insertion/action/innervation of adductor magnus?

Back 49

origin-ischiopubic ramus/ischiopubic ramus
insertion- distal, proximal to the adductor hiatus
action-pure adductor
innervation-obturator nerve (adductor part), tibial part of sciatic nerve (hamstring part)

Front 50

origin/insertion/action/innervation of semimembranosus?

Back 50

origin-ischial tuberosity
insertion-medial proximal tibia
action-extensors of the hip joint, medial rotator
innervation- sciatic nerve

Front 51

origin/insertion/action/innervation of semitendinosus?

Back 51

origin-ischial tuberosity
insertion-medial proximal tibia
action-extensors of the hip joint, medial rotator
innervation- sciatic nerve

Front 52

origin/insertion/action/innervation of biceps femoris?

Back 52

origin-ischial tuberosity (long head), linea aspera (short head)
insertion-fibular head
action-extensors of the hip joint, lateral rotator
innervation- long head of the biceps femoris is innervated by the tibial nerve and the short head is innervated by the common fibular nerve

Front 53

How does Lombard's Paradox influence getting up from a chair?

Back 53

The quadriceps is the extensor for the knee, but the rectus femoris crosses the hip joint where it is a flexor. So this creates the paradox that both muscle groups must be active and yet "fight" each other. The rectus femoris "wins" at the knee because it is further anterior to the transverse axis of rotation at the knee (thanks patella!) than the hamstrings are posterior to the axis. The situation is reversed at the hip joint where the hamstrings "win" the competition of who can be further away from the transverse axis at the hip joint.

Front 54

What are muscles in the posterior leg compartment innervated by?

Back 54

Tibial nerve

Front 55

What is the innervation of gastrocnemius, soleus, and the plantaris muscles?
What are the actions of these muscles?
What is the common insertion of the soleus and gastrocnemius?

Back 55

Gastrocnemius, soleus, and plantaris – All muscles in the posterior compartment are innervated by the tibial nerve.
gastrocnemius and plantaris- knee flexors and plantarflexors
soleus - plantarflexor. tendo calcaneous.

Front 56

What is the action of tibialis posterior?

Back 56

inverter for the foot, but it passes posterior to the transverse axis of the ankle so the tibialis posterior is a plantarflexor

Front 57

What is the action of the popliteus muscle?

Back 57

weak knee flexor and unlocks knee

Front 58

What is to anterior compartment syndrome? How do you treat it?

Back 58

Compression of anterior leg compartment which causes ischemic necrosis by compressing anterior tibial artery. Treatment is a fasciotomy. The deep fibular nerve would also be compressed.

Front 59

What happens to muscle length during isometric, concentric, and eccentric contraction?

Back 59

no change, shorten, lengthen

Front 60

What are three methods of deducing muscle function? What do the three methods measure?

Back 60

electromyography (muscle activity), instrumented tendon buckles (magnitude of force production), sonomicrometry (muscle length changes)

Front 61

Where is the center of balance at the hips? What muscles prevent hyperextension (okay, that gave away the first answer)?

Back 61

Behind the hip joints.
1. passive- iliofemoral ligament (much stronger than pubiofemoral or ischialfemoral ligaments) 2. active- small amount of iliopsoas muscle (not always active).

Front 62

Where is the center of balance at the knee level? What structures resist hyperextension?

Back 62

Anterior to the knee.
ACL

Front 63

Where is the center of gravity at ankle joint? What action does this encourage? What muscles act to limit this action? Which of these two muscles is more efficient? Why?

Back 63

Far anterior to ankle.
Dorsiflexion.
gastrocnemius and soleus muscles
soleus, more slow twitch fibers (type II)

Front 64

What are the 5 determinants of gait?

Back 64

Hip flexion + extension

Knee flexion

Pelvic adduction

Pelvic rotation

Physiological genu valgus

Front 65

Which 2 of the gait determinants reduce vertical rise of COM at midstance?

Back 65

knee flexion and pelvic adduction (hip drop)

Front 66

What increases stride length and what decreases stride length?

Back 66

Pelvic rotation and Physiological genu valgus

Front 67

What are the 4 stages of the foot in the gait cycle?

Back 67

heel strike, inversion, eversion, and toe-off

Front 68

What is a sign of Trendelenburg gait? What muscle weakness causes Trendelenburg gait? What do those muscles do?

Back 68

Trendelenburg gait sign- falling toward unsupported and lateral movement
less gluteals
abduct thigh and prevent hip drop (pelvic adduction)

Front 69

When does gluteus maximus effect gait? What does it do? How can you compensate?

Back 69

Active only immediately after heel strike.
Helps prevent forward trunk motion.
Can adjust by leaning back before each heel strike.

Front 70

When are the vasti muscles active? What do they do? What happens in case of impairment? How do you compensate?

Back 70

Active after foot hits ground.

Vasti prevent excessive knee flexion early in gait. If there is some impairment, knees extend through gravity.

If we lean forward a little bit, moving center of mass, tendency will be to hyperextend and accommodate the problem.
One can also push forward on thigh to prevent flexion.

Front 71

What do they hamstring do during gait? What muscles are they similar to? When are they active? How do you compensate?

Back 71

Hamstring muscles prevent jacknifing, similar to gluteus maximus. They are active right before/after heel strike and at toe-off. To compensate, do the same thing as with gluteus maximus, lean back.

Front 72

When are iliopsoas active? what do they do? What compensates for their weakness?

Back 72

Iliopsoas are active in late stance phase and prevent extension and begin hip flexion. The abductor are active and help slightly flex hip. If these muscles are impaired, the other hip flexors can help: lesser gluteals and tensor fascia latae.

Front 73

When is rectus femoris important? What does it do? How do you compensate?

Back 73

Before toe-off
Rectus femoris prevents further extension of hip. If this muscle is weak, you rely on iliopsoas.

Front 74

When does sartoris work? What happens if it is weak?

Back 74

If sartorius is impaired in late stance and early swing, not much happens.

Front 75

When are triceps surae important? What do they do? How do you compensate?

Back 75

These muscles are active in second half of support phase. Important in plantar flexing, they propel forward. They are engines of walk gait. This is majority of energy consumption. Without them, cannot plantar flex easily.
You could lean back and short steps use hip flexors. Better alternative, rotate feet laterally and use fibularis longus and brevis to have an everting motion and propel forward.

Front 76

When are anterior tibial muscles active? What is their action during gait? What happens when they are impaired?

Back 76

Anterior tibial muscles are active after heel strike and during all of swing phase.

They are dorsal flexors and control speed of plantar flexion. They also keep toes off ground in swing.

Consequently, impairment leads to high stepping to keep toes off ground and can’t control plantar flexion, which leads to foot slapping.

Front 77

When are peroneus muscles active in gait? What do they they do? What muscles take over if they are impaired. Is their action important?

Back 77

Peroneus longus and brevis active in late stance and they evert foot. They help roll support of foot to lateral side to medial side. Triceps surae take over. The everting motion is not important.

Front 78

When do quadratus plantae and flexor digitorum brevis act in gait? What is the characterisitic problem from impairment?

Back 78

Quadratus plantae and flexor digitorum brevis act when your foot is plantar flexing, no characteristic problem.

Front 79

ACL limits (anterior or posterior) motion of the femur on the tibia

ACL limits (anterior or posterior) motion of the tibia on the femur

Back 79

posterior, anterior

Front 80

PCL limits (anterior or posterior) motion of the femur on the tibia

PCL limits (anterior or posterior) motion of the tibia on the femur

Back 80

anterior, posterior

Front 81

What is a Doppler test used for?

Back 81

It detects narrowing of leg arteries

Front 82

What signs are indicative of spinal stenosis?

Back 82

psuedoclaudication (not claudication)
pain is not relieved by standing still, only by sitting down

typically bilateral

commonly asymptomatic, comon in imaging

Front 83

What is a radiculopathy?

Back 83

Pain along a nerve root.

Front 84

How will a hernia at L5-S1 present?

Back 84

S1 root impinged
numbness in lateral part of foot (distal)
loss of ankle reflex
weakness in plantar flexion (make them stand on toes)

Front 85

How will a hernia at L4-L5 present?

Back 85

pain down leg into back of leg
numbness in big toe
drop foot, weakness in extensor hallicus longus
slapping foot in gait

Front 86

How will a hernia at L3-L4 present?

Back 86

mesial leg pain
anterior thigh numbness
weakness in quadriceps

Front 87

What can cause caudal equina syndrome? What are the signs?

Back 87

Tumor and hernia

bilateral weakness/numbness
bilateral loss of reflex
loss of bladder control

Front 88

What are the signs of myelopathy?

Back 88

Bilateral Leg weakness
Usually increased tone and reflexes
Sensory level
Abnormal reflexes-Babinski
Loss of bowel and bladder function

Front 89

What are the three mucles innervated by superior gluteal nerve?

Back 89

Tensor fascia lata muscle, gluteus medius muscle, gluteus minimus muscle

Front 90

What inserts into great trochanter?

Back 90

Gluteus medius, gluteus maximus, piriformis, superior gemellus, obturator internus, inferior gemellus, quadratus inferior (sort of, just next to it)

Front 91

What muscles laterally rotate the extended hip and abduct the flexed hip?

Back 91

Piriformis, superior/inferior gemellus, obturator internus muscles

Front 92

What is innervated by nerve to obturator internus? What is innervated by nerve to quadratus femoris?

Back 92

Obturator internus and superior gemellus muscle

Quadratus femoris and inferior gemellus

Front 93

What muscles insert on linea aspera?

Back 93

adductor longus, adductor brevis, short head of biceps femoris

Front 94

How does the popliteus unlock the knee?

Back 94

it rotates the femur laterally on the tibia to "unlock" the knee.

Front 95

What does arterial vascular dysfunction present as?

Back 95

Claudication, limiting exercise and activity
Pain at rest
Gangrene

Front 96

What does venous vascular dysfunction present as?

Back 96

Pain
Swelling
Chronic ulceration
Infection
Amputation

Front 97

What does obesity, limping, and abnormal ROM indicate?

Back 97

Slipped Capital Femoral Epiphysis (SCFE)

Front 98

What is the treatment for Osteoarthritis?

Back 98

total hip replacement

Front 99

What is the treatment for Intertrochanteric hip fracture and femoral head fracture?

Back 99

Screw, if not possible, total hip replacement

Front 100

What disease presents as constant pain, especially at night? Other symptoms include weight loss

Back 100

Primary or Metastatic Neoplasm of Bone

Front 101

What are the benefits of negative pressure dressing?

Back 101

Removes transudate / exudate, reducing swelling and approximating wounds
Promotes micro-vascular regeneration and a granulation bed for skin grafting
Reduction of infectious load
Reduction of inflammatory response by removing mediators

Front 102

What are the major two factors in anterior compartment syndrome?
What are the major two reasons?

Back 102

Pressure vs volume

INCREASED CONTENTS
Hemorrhage
Vascular or cellular leakage
Decreased outflow (venous obstruction)
Fluid Infusion (IV, arthroscopy, pressure gun)

DECREASED COMPLIANCE OR VOLUME
Excessively tight bandage or cast
Burn eschar

Front 103

What are the signs of anterior compartment compression?

Back 103

Pain, Pressure, Pallor, Pulse-less, Paresthesias

Front 104

What is Phlegmasia Cerulea Dolens?

Back 104

Massive thrombosis of the venous system progressing to compartment syndrome and venous gangrene

Front 105

What layer is not included in spermatic cord?

Back 105

transversus abdominis

Front 106

What does the cremaster muscle originate from?

Back 106

IAO muscle

Front 107

What hernia follows the path of the spermatic cord?

Back 107

indirect

Front 108

Which hernia skips the deep inguinal ring?

Back 108

direct

Front 109

What is the inguinal ligament amde of?

Back 109

Thickening of external abdominal oblique aponeurosis.

Front 110

What is the medial border of the femoral canal?

Back 110

lacunar ligament

Front 111

What is the processus vaginalis made of?

Back 111

parietal peritoneum

Front 112

What is the gubernaculum in the male? Female?

Back 112

Resorbed
round ligament of uterus and ovary

Front 113

What makes up cremaster fasica

Back 113

IAO

Front 114

What makes up external spermatic fascia

Back 114

EAO