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83 Cards in this Set

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Largest bone in the leg:
Tibia
What is the tibia for?
Weight bearing
Tibia articulates with what 3 bones:
1. Femur (prox) / Patella
2. Fibula (prox/dist)
3. Talus
What exact part of the tibia articulates w/ the femur?
Medial/Lateral Epicondyles
What is between the Epicondyles?
What is this important for?
Intercondylar Eminence
-Attachment of ACL/PCL
What important landmark is on the anterior surface of tibia?
Tibial tuberosity - insertion of patellar ligament/quadriceps
What disease is associated w/ the Tibial Tuberosity?
Osgood-Schlatter's - inflammation in growing boys
Where is the Soleal border?
On posterior tibia where soleus muscle originates.
What is the function of the Fibula?
NOT weight-bearing; an attachment point for muscles.
What type of joint is the ankle joint?
Mortis
What characterizes a mortis joint, and what does it allow?
3-sided; allows inversion and eversion - but also injury.
What is the most common site of ankle sprains?
Lateral malleolus of the Fibula
What is attached to the lateral malleolus?
Tripartite ligament
What ligament is attached to the medial malleolus?
Deltoid
So the ankle ligaments are:
Lateral = Tripartite

Medial = Deltoid
What ankle injury would u see in a:
-Basketball player
-Motercycle biker
Bball: INVERSION - injury to the lateral malleolus (common)

Biker: EVERSION - injury to the medial malleolus (rare)
What are the 5 important arteries to know in the leg?
1. Popliteal
2. Anterior Tibial
3. Posterior Tibial
4. Fibular/Peroneal
5. Genicular
Where is the Popliteal Artery?
In the popliteal fossa - the continuation of the Femoral artery after passing through adductor hiatus.
Where is the Ant Tibial Artery? What is it a branch from?
What does it supply?
How does it become Anterior?
-In Anterior Compartment
-Branch of Popliteal
-Supplies Anterior Compartment
-Pierces interosseous membrane
Posterior tibial Artery:
-Found where
-Supplies what
-Where it goes
Found: in posterior compartment
Supplies: posterior compartment
Goes: around medial malleolus
Peroneal/Fibular Artery:
-Found where
-Supplies what
-Where it goes
Found: In Post. compartment lateral to Post Tib Artery
Supplies: LATERAL compartment
Goes: to small anastamosis w/ artery in feet
Where/what are Genicular Arteries?
Anastomases around the knee joint.
4 sites for palpating pulses in the lower extremity:
-Femoral artery - inguinal
-Popliteal artery
-Dorsalis pedis - top foot
-Posterior tibial - behind medial malleolus
Where is the Femoral artery palpated?
Near the inguinal canal, in the femoral triangle
Where is dorsalis pedis pulpated?
On the top of the foot, between 1st and 2nd Metatarsals
Where is Posterior tibial palpated?
Behind the medial malleolus
What are the important deep veins in the leg?
Same as the arteries:
1. Popliteal
2. Anterior tibial
3. Posterior Tibial
4. Peroneal (fibular) artery
5. Genicular arteries
What disease is associated with leg arteries?
Vascular Artery Disease - cholesterol build up narrows the openings.
What disease is associated with leg deep veins?
DVT - deep venous thrombosis - can throw a clot to the lungs and result in pulmonary embolism.
What patients are at increased risk for DVT?
Those w/ incompetent valves - results in stasis.
What are the superficial veins in the leg?
-Great saphenous
-Small Saphenous
-Dorsal Venous Arch
Where does the Great Saphenous Vein run?
-Medial side of leg, anterior to medial malleolus.
-Drains into femoral vein at Saphenous Opening
What supplies blood to the Greater Saphenous Vein?
Dorsal Venous Arch
Where is the Dorsal Venous Arch?
On the foot - it drains into both Great and Small Saphenous Veins
Where is the Small Saphenous Vein? Where does it empty?
Lateral side of leg; runs posterior to gastrocnemius from dorsal venous arch, empties into deep veins in popliteal fossa.
Important Motor Nerves of Leg:
(4)
1. Tibial nerve
2. Common peroneal nerve
3. Superficial peroneal nerve
4. Deep peroneal nerve
Where is the Tibial nerve?
What does it supply?
-Medial leg
-Supplies Posterior compartment
What does the Tibial nerve terminate as?
2 Branches:
-Medial plantar nerve
-Lateral plantar nerve
Where is the Common Peroneal Nerve located?
Wraps around the outside of fibula from Popliteal fossa
What will result from injury to Common Peroneal nerve?
Foot drop - because the Superficial and Deep Peroneal nn are nonfunctional.
What genetic disease is associated with the Common Peroneal nerve?
Charcot-Marie Tooth Disease
What does Charcot-Marie Tooth Disease cause?
Atrophy of the lateral and anterior leg muscle compartments.
What muscles recieve their innervation from the Superficial Peroneal nerve?
-Lateral Compartment muscles
-Dorsal foot
What muscles are innervated by the Deep Peroneal Nerve?
Anterior Compartment muscles
What Cutaneous nerves in the leg are important? (5)
1. Saphenous Nerve
2. Sural Nerve
3. Deep Peroneal Nerve
4. Superficial Peroneal Nerve
5. Tibial Nerve
Saphenous Nerve:
-Branch of what?
-Supplies what?
-Branch of Femoral n.
-Supplies medial portion of lower leg
Sural Nerves:
-Branches of what?
-Supplies what?
-Tibial br. (medial sural nerve)
-Common Peroneal br. (lateral sural nerve)
-Supplies Lat/Post lower leg and Dorsum of Foot
Deep Peroneal Nerve:
Supplies what?
Supplies 25c size spot on dorsal surface of 1st/2nd toes.
Superficial Peroneal Nerve:
-Supplies sensory to what?
-Anterior leg
-Lateral leg
-Dorsum of foot (except 25c spot)
Tibial Nerve:
-Supplies sensory to what?
PLANTUM (bottom) of foot.
Diabetic complications:
LOSS OF BOTH MOTOR AND SENSORY FUNCTIONS primarily related to the Common Peroneal nerve.
Where would you find superficial lymph nodes primarily in the leg?
Inguinal region
What is Compartment Syndrome?
Condition caused by Crush injury
-Tremedous swelling/pressure
-Compresses arteries/nerves
What are the primary symptoms of Compartment sydrome?
-Muscle Necrosis
-Loss of pulses
-Pallor distal to the injury
Anterior Leg Compartment Muscles (3):
-Tibialis anterior
-Extensor hallucis longus
-Extensor digitorum longus
Anterior Compartment:
-nerve
-artery
-action
Nerve: Deep Peroneal
Artery: Anterior Tibial
Action: Dorsiflexion
Lateral Leg Compartment Muscles:
-Peroneus longus
-Peroneus brevis
Lateral Leg Compartment
-Nerve
-Artery
-Action
Nerve: Superficial Peroneal n.
Artery: Peroneal artery (major) and Posterior Tibial (minor)
Action: Eversion/Dorsiflexion
Superficial Posterior Compartment of Leg Muscles:
Action?
-Gastrocnemius
-Soleus
-Plantaris
Antigravity - keep you standing
What is the action of Gastroc?
-Antigravity
-Slight leg flexion
What is the action of Soleus?
-Antigravity
-Plantarflexion
What is the action of Plantaris?
It has none.
Posterior Leg Compartment
-Nerve
-Artery
(both superfic. and deep)
Nerve: Tibial nerve
Artery: Posterior Tibial Artery
What muscles are in the DEEP Posterior leg compartment?
-Flexor hallucis longus
-Tibialis posterior
-Flexor Digitorum longus
-Popliteus
What is the action of the Deep posterior compartment muscles?
-Plantarflexion
-Inversion of the foot
What does Popliteus specifically do?
Helps unlock the knee medially
What is the Thompson Test?
Used for determining if the Achilles tendon is detached from calcaneus or not.
How do you do the Thompson Test?
-Have the patient lie on stomach
-Squeeze gastrocnemius
-Foot should flex
If the foot does flex what is most likely the cause of pain?
Plantaris muscle or tendon is torn
Where are most ankle sprains?
Lateral malleolus - Tripartite Ligament
What is the Weight Distribution in the foot?
50% = metatarsals
50% = calcaneus
Diabetic Complications result in
Both motor and sensory function loss
If a patient can't feel anything in the medial lower leg what nerve is cut?
Saphenous / femoral
If a patient lacks feeling in the posterior leg, what nerve?
Sural nerve (medial from tibial, lateral from peroneal)
If a patient lacks feeling in a 25c spot between toes 1 and 2 on the dorsum of foot, what nerve?
Deep Peroneal Nerve
If a patient lacks feeling on the Anterior/lateral leg, what nerve is probly cut?
Superficial Peroneal
If a patient lacks feeling on the BOTTOM of the foot, what nerve is probly cut?
Tibial
What bones are weight bearing in the lower limb?
Tibia/Femur
What bone bears no weight?
Fibula
What is the most common site of Gout?
1st MTP joint
What is Osgood-Schlatter disease?
Patellar inflammation in young growing males
What free-floating bone can be found within the lateral head of the gastrocnemius muscle?
The Fabella
Where does the Popliteus muscle insert?
Within the knee joint