Lower Extremity

Front 1

Nerves to hip and posterior thigh

Back 1

Lumbosacral plexus (L4-S3)

Tibial nerve (anterior branches of L4-S3) and common fibular (peroneal) nerve (posterior branches of L4-S2)

Front 2

Sciatic nerve (where does it exit and location)

Back 2

Exits greater sciatic foramen by passing UNDER piriformis muscle--emerges on its inferior border to pass into posterior thigh

Located midway b/w ischial tuberosity and greater trochanter of femur

Front 3

IM injection in buttocks

Back 3

Superior lateral quadrant--avoid sciatic nerve

Front 4

What does the sciatic nerve innervate?

Back 4

Motor innervation to flexors of leg (hamstrings) and all muscles in leg and foot

Front 5

Superior gluteal nerve (L4-S1)

Back 5

Travels through greater sciatic foramen SUPERIOR to piriformis muscles

Front 6

What does the superior gluteal nerve innervate?

Back 6

Gluteus medius and minimus and tensor fascia lata

Front 7

Inferior gluteal nerve (L5-S2)

Back 7

Travels through greater sciatic foramen INFERIOR to piriformis muscle

Front 8

What does it innervate?

Back 8

Sole innervation to gluteus maximus

Front 9

Pudendal nerve (S2-S4)

Back 9

Travels through greater sciatic foramen, loops around lesser sciatic foramen to enter perineum via pudendal canal

Front 10

What does it innervate?

Back 10

Motor innervation to perineum (external anal and urethral sphincters)

"S2, 3, and 4 keep the poop/pee off the floor"

Sensory innervation to external genitalia

Front 11

Pelvic splanchnic nerves (S2-S4)

Back 11

Travel to inferior hypogastric plexus

Front 12

What do they do?

Back 12

Involved in autonomic regulation of bladder and bowel function, and sexual response

Front 13

Hamstring muscles

Back 13

Posterior thigh

Extend the thigh and flex the leg at the knee

Front 14

Three hamstring muscles

Back 14

1. Semitendinosus

2. Semimembranosus

3. Biceps femoris

Front 15

Origin and insertion

Back 15

Origin: ischial tuberosity

Insertion: semitendinosus and semimembranosus--tibia, biceps femoris--fibula

Front 16

Short head of biceps femoris

Back 16

Not actually a hamstring, innervated by common fibular nerve

Front 17

Part of adductor magnus

Back 17

Hamstring, innervated by tibial nerve

Front 18

Injury to sciatic nerve

Back 18

Weak/absent extension of thigh and/or flexion of leg

Loss of innervation to leg and foot (foot drop)

Front 19

Hip abductors

Back 19

Gluteus medius and minimus

Important stabilizers of pelvis when walking

Insert into greater trochanter

Front 20

Superior gluteal nerve damage

Back 20

Hip abductor muscles are weakened (positive Trendelenburg)

Pelvis drops on opposite side of nerve injury

Front 21

Gluteus maximus

Back 21

Extends thigh

Injury to inferior gluteal nerve: weak or absent thigh extension

Front 22

Injury to obturator nerve

Back 22

Weak/absent thigh adduction and medial rotation

Front 23

Tensor of fascia lata

Back 23

Flexes thigh and fixes femur on tibia with standing

Innervated by superior gluteal nerve (L5, S1)

Front 24

Iliopsoas muscle

Back 24

Chief hip flexor

Innervated by L1 and L2 roots and femoral nerve (L2, L3)

Front 25

Piriformis muscle

Back 25

Lateral hip rotator

Innervated by S1 and S2

Insertion/distal attachment: greater trochanter of femur

Front 26

Blood supply to hip

Back 26

Medial and lateral circumflex femoral artery (branches of profunda femoris artery)

Front 27

Medial circumflex artery

Back 27

Supplies most of the blood via retinacular branches

Disrupted by fracture of femoral head

Front 28

Small branch of obturator artery

Back 28

Small source of blood to head of femur

Front 29

3 ligaments that reinforce head of femur into acetabulum

Back 29

1. Iliofemoral (prevents hyperextension)

2. Pubofemoral (prevents overabduction)

3. Ischiofemoral (prevents hyperextension)

Front 30

Small ligament of head of femur

Back 30

Weak and provides little support

Front 31

Origination of superficial veins and where do they empty?

Back 31

Dorsal venous arch of foot, empty into great saphenous vein (medial side of foot) and small saphenous vein (lateral side of foot)

Front 32

Great saphenous vein path

Back 32

Ascends anterior to medial malleolus, up medial leg, posteromedial knee, and anteromedial thigh through saphenous hiatus into fasica lata and empties into femoral vein

Front 33

What does the great saphenous vein drain?

Back 33

Dorsum of foot, anterior leg, and anterior, medial, and lateral thigh

Front 34

Small (lessor) saphenous vein path

Back 34

Ascends posterior to lateral malleolus, up middle of posterior leg (deep to crural fascia), empties into popliteal vein

Front 35

Perforating veins and valves

Back 35

Convey blood from superficial to deep veins

Valves prevent backflow from deep to superficial veins (varicose veins=failure of valves)

Front 36

Termination of lymph drainage

Back 36

Superficial inguinal lymph node (drain from superficial lower abdominal wall, external genitalia, perineum, buttocks, and lower limb)

Front 37

Lymph drainage from superficial inguinal node

Back 37

External iliac nodes (some into deep inguinal node)

Front 38

Deep inguinal nodes

Back 38

3 total, located in femoral canal, medial to femoral nerve

Front 39

Saphenous nerve

Back 39

Branch of femoral nerve

Accompanies greater saphenous vein

Cutaneous innervation to anterior and medial side of leg and medial foot

Front 40

Sural nerve

Back 40

Formed from tibial and common fibular nerves

Accompanies small saphenous vein and provides cutaneous innervation to posterior and lateral leg and lateral foot

Front 41

Superficial fibular nerve

Back 41

Branch of common fibular nerve

Cutaneous innervation to inferior third of anterior leg and dorsum of foot

Front 42

Deep fascia of thigh

Back 42

Fascia lata

Front 43

Deep fascia of leg

Back 43

Crural fascia

Front 44

3 specializations of fascia lata

Back 44

1. Iliotibial tract (lateral thigh, iliac crest to lateral condyle of tibia)

2. Lateral intermuscular septum (separates quad from hamstrings)

3. Medial intermuscular septum (separates quad from adductors)

Front 45

3 specializations of crural fascia

Back 45

1. Posterior intermuscular septum (separates posterior muscles from lateral muscles)

2. Transverse intermuscular septum (separates deep posterior muscles from superficial posterior muscles)

3. Anterior intermuscular septum (separates anterior muscles from lateral muscles)

Front 46

Boundaries of femoral triangle

Back 46

Superior: inguinal ligament

Lateral: sartorius muscle

Medial: adductor longus muscle

Front 47

Contents of femoral triangle

Back 47

(Lateral to medial)

1. Femoral nerve

2. Femoral artery

3. Femoral vein

4. Deep inguinal lymph node

"NAVL"

Front 48

Femoral sheath

Back 48

Encloses contents of femoral triangle (except femoral nerve)

Front 49

3 compartments of femoral sheath

Back 49

1. Lateral: femoral artery

2. Middle: femoral vein

3. Medial: "femoral canal," fat, deep inguinal node (node of Cloquet)

Front 50

Opening at superior end of femoral canal

Back 50

Femoral ring

Front 51

Femoral hernia

Back 51

Small intestine protrudes through femoral ring into femoral canal

Lump in superior thigh

Front 52

Differentiation between femoral hernia and inguinal hernia

Back 52

Femoral hernia: swelling is inferior to inguinal ligament (more common in women)

Inguinal hernia: swelling is superior to inguinal ligament

Front 53

Femoral triangle (clinical significance)

Back 53

Catheterization--femoral artery for coronary angiography, percutaneous coronary transluminal angioplasty, and stent placement

Cath of femoral vein--Swan-Ganz catheter (measurement of central venous pressure, pulmonary artery wedge pressure, and cardiac output)

Front 54

Risks of catheterization

Back 54

Damage to femoral artery and vein, injury to femoral nerve, formation of arteriovenous fistula

Front 55

Risks compared to subclavian or internal jugular catheterization

Back 55

No pneumothorax

No thromboembolism (stroke)

Front 56

Adductor canal boundaries

Back 56

Lateral: vastus medialis

Posterior: adductor longus

Medial: sartorius

Roof: sartorius as well

Front 57

Function of adductor canal

Back 57

Passage for femoral vessels and saphenous nerve in middle third of thigh

Front 58

End of adductor canal

Back 58

Adductor hiatus (opening to adductor magnus muscle--permits femoral vessels to travel to posterior knee--popliteal)

Front 59

Femoral artery

Back 59

Supplies most of thigh

Front 60

Deep femoral artery (profunda femoris)

Back 60

Major branch of femoral artery

Supplies hip joint, proximal and posterior thigh (hamstrings), neck of femur

Front 61

Medial circumflex artery

Back 61

Branch of deep femoral artery

Supplies hip joint via ascending and descending branches

Front 62

Lateral circumflex artery

Back 62

Branch of deep femoral artery

Supplies lateral hip, thigh, and knee

Front 63

Obturator artery

Back 63

Supplies medial thigh, hip, small amount to head of femur

Front 64

Obturator nerves

Back 64

L2, L3, L4

Supply adductor muscles

Between adductor longus and brevis

Front 65

Injury to obturator nerve

Back 65

Inability to flex and adduct thigh

Front 66

Femoral nerve

Back 66

L2, L3, L4

Supplies quad, sartorius, rectus femoris, iliopsoas, and pectineus

Superficial to psoas major

Front 67

Injury to femoral nerve

Back 67

Inability to extend leg and flex thigh

Front 68

Lumbosacral plexus

Back 68

Nerve supply to hip and posterior thigh (L4-S4)

Front 69

Sciatic nerve

Back 69

Major branch of lumbosacral plexus

L4-S3

Tibial nerve (anterior, L4-S3) + common fibular--peroneal (posterior, L4-S2)

Front 70

Primary stabilizers of knee

Back 70

ACL and PCL, MCL and LCL, medial and lateral meniscus, medial and lateral rentinacula

Front 71

Secondary stabilizers of knee

Back 71

IT band (tensor fascia lata), quad, hamstrings, and popliteus muscles

Front 72

Function of popliteus muscle

Back 72

Locks knee in full extension and unlocks knee to initiate flexion

Front 73

3 articulations of knee joint

Back 73

2 tibiofemoral, 1 patellofemoral

Front 74

5 extracapsular ligaments

Back 74

1. Patellar ligament (distal quad tendon to tibial tuberosity)

2. Fibular (lateral) collateral ligament (lateral epicondyle of femur to lateral surface of fibular head)

3. Tibial (medial) collateral ligament (medial epicondyle of femur to superior medial tibia)

4. Oblique popliteal ligament

5. Arcuate popliteal ligament (strengthens posterior fibrous capsule)

Front 75

2 intra-articular ligaments (external to synovial cavity)

Back 75

1. Anterior cruciate ligament

2. Posterior cruciate ligament

Front 76

ACL location and function

Back 76

Connects anterior intercondylar tibia with lateral condyle of femur

Prevents anterior displacement of tibia on femur

Prevents posterior displacement of femur on tibia

Front 77

PCL location and function

Back 77

Connects posterior intercondylar tibia with medial condyle of femur

Prevents posterior displacement of tibia on femur

Prevents anterior displacement of femur on tibia

Front 78

Medial meniscus

Back 78

C shaped

Attached to tibial (medial) collateral ligament

Front 79

Lateral meniscus

Back 79

Circular, more freely moveable

Front 80

Two area of menisci injury

Back 80

1. White zone (avascular): central 2/3

2. Red zone (vascular): outer 1/3

Front 81

Terrible or unhappy triad

Back 81

Injury to ACL, MCL, and medial meniscus

Trauma to lateral knee (twisting) while in flexion, foot planted

Front 82

ACL injury

Back 82

Trauma to anterior knee (often seen in skiing)

Front 83

S/Sx of ACL rupture

Back 83

Rapid swelling due to simultaneous rupture of tibial intracondylar artery (located on anterior surface of ACL)

Front 84

Tx

Back 84

Surgically replaced with allograft (Achilles=preferred)

OR

Autograft (preferred=middle third of patellar tendon, but quadrupled semitendinosus-gracilis tendon=fewer risks for patellar fx and post-op anterior knee pain)

Front 85

PCL injury

Back 85

Landing on tibial tuberosity with knee flexed (basketball or head-on collision)

Front 86

Medial meniscus injury

Back 86

Twisting of leg (football and volleyball)

Front 87

3 superficial bursa of knee

Back 87

1. Prepatellar

2. 2 infrapatellar (subcutaneous and deep)

Front 88

4 bursa that communicate with synovial joint cavity

Back 88

1. Suprapatellar (largest, infxn can spread directly into joint cavity)

2. Anserine

3. Popliteus

4. Gastrocnemius

Front 89

Prepatellar bursitis

Back 89

Housemaid's knee

Front 90

Infrapatellar bursitis

Back 90

Clergyman's knee

Front 91

Knee extensors

Back 91

Quad (rectus femoris, vastus lateralis, medialis, intermedius)

5th: articularis genu (deep to vastus intermedius)

Front 92

Articularis genu function

Back 92

Pulls suprapatellar bursa to prevent pinching between patella and femur during extension

Front 93

Quadriceps tendon

Back 93

Encloses patella

Continues as patellar ligament, inserts into tibial tuberosity

Front 94

Patella function

Back 94

Additional leverage for quadriceps muscles

Front 95

Patellar reflex

Back 95

Tests L4 (and L3 and L5 somewhat)

Front 96

Knee flexors

Back 96

Hamstrings (biceps femoris, semimembranosus, semitendinosus)

Also extend thigh

Front 97

Innervation to hamstrings

Back 97

Tibial division of sciatic nerve

Front 98

Hamstring strain

Back 98

Tear of tendon at proximal attachment to ischial tuberosity

Occurs in quick start sports (jumping, sprinting, hurdling)

Front 99

Pes anserinus (Goose foot)

Back 99

3 tendons on medial surface of tibia

Sartorius, gracilis, semitendinosus

Flex leg at knee

Front 100

Plantaris muscle

Back 100

Weakly assists gastrocnemius in plantar flexing ankle and knee

Organ of proprioception for gastrocnemius

Source for tendon grafts for hand

Front 101

Popliteus muscle

Back 101

Weak flexor of knee

Rotates femur five degrees laterally on tibia to unlock knee (from extended position)

Front 102

Popliteal fossa boarders

Back 102

Superior: hamstring

Medial: semitendinosus, semimembranosus

Lateral: biceps femoris

Inferior: 2 heads of gastrocnemius

Front 103

Contents of popliteal fossa

Back 103

Small saphenous vein, popliteal arteries and veins, tibial, and common fibular (peroneal) nerves

Deepest: popliteal artery (passes through adductor hiatus)

Most superficial: tibial nerve

Front 104

Bifurcations of popliteal artery

Back 104

Anterior and posterior tibial arteries

Front 105

Popliteal vein

Back 105

Superficial to the artery

Small saphenous vein drains into it

Becomes femoral vein after it passes through adductor haitus

Front 106

End of sciatic nerve

Back 106

Superior angle of popliteal fossa

Separates into tibial and common fibular nerves

Front 107

Tibial nerve innervates

Back 107

Posterior leg, plantar foot

Front 108

Common fibular nerve

Back 108

Very superficial and susceptible to injury (most injured in lower extremity)

Must avoid tight casting in this area

Impingement: foot drop and "steppage" gait

Divides into superficial (lateral) and deep branches (anterior)

Front 109

Anterior compartment of leg

Back 109

Tibialis anterior, extensor hallucis longus, extensor digitorum longus, fibularis tertius

Front 110

Blood supply to anterior compartment

Back 110

Anterior tibial artery

Front 111

Function of anterior compartment muscles

Back 111

Dorsiflex and invert foot at ankle

Front 112

Anterior compartment syndrome

Back 112

Increase in pressure in anterior compartment (compresses deep fibular nerve and anterior tibilar artery--loss of sensation between second and great toes)

Front 113

Paralysis of muscles in anterior compartment

Back 113

Foot drop (inability to dorsiflex)

Front 114

Muscles of lateral compartment

Back 114

Fibularis (peroneus) longus and fibularis (peroneus) brevis

Brevis is deep to longus

Front 115

Blood supply to lateral compartment

Back 115

Fibular artery (branch of posterior tibial artery)

Front 116

Muscle innvervation in lateral compartment

Back 116

Superficial fibular nerve

Front 117

Action of muscles in lateral compartment

Back 117

Evert foot and assist in plantar flexion

Front 118

Separation of superficial and deep posterior compartments

Back 118

Transverse intermuscular septum

Front 119

Muscles of superficial posterior compartment

Back 119

Gastrocnemius, plantaris, and soleus

Front 120

Insertion and action of superficial posterior compartment muscles

Back 120

Calcaneus via calcaneal (Achilles tendon)

Plantar flex foot

Front 121

Blood supply to gastrocnemius and soleus

Back 121

Posterior tibial artery

Front 122

Muscles of deep posterior compartment

Back 122

Popliteus, flexor hallucis longus, flexor digitorum longus, and tibialis posterior

Front 123

Blood supply to flexor hallucis longus, flexor digitorum longus, and tibialis posterior

Back 123

Posterior tibial artery

Front 124

Midcalf muscle positions

Back 124

Flexor digitorum: medial

Tibialis posterior: middle

Flexor hallucis longus: lateral

Front 125

Tendon order at medial malleolus

Back 125

Anterior to posterior

"Tom, Dick, ANd, Harry"

Tibialis posterior, flexor Digitorum, posterior tibial Artery, tibial Nerve, Hallucis longus

Front 126

Action of tibialis posterior

Back 126

Foot inversion

Contributes to plantar flexion

Front 127

Action of flexor hallucis longus

Back 127

Flexes distal phalanx of great toe

Contributes to plantar flexion

Front 128

Action of flexor digitorum longus

Back 128

Flexes distal phalanges of lateral four toes

Contributes to plantar flexion

Front 129

Bifurcations of popliteal artery

Back 129

Anterior and posterior tibial arteries

Front 130

Anterior tibial artery supplies

Back 130

Anterior compartment of leg

Becomes dorsalis pedis artery at dorsum of foot

Front 131

Posterior tibial artery supplies

Back 131

Posterior compartment of leg, travels behind medial malleolus to ankle and sole of foot

Gives off branch: fibular artery--supplies lateral compartment of leg

Front 132

Anterior compartment innervated by

Back 132

Deep fibular nerve

Front 133

End of deep fibular nerve

Back 133

Cutaneous innervation to dorsum of foot between second and great toe

Front 134

Lateral compartment innervated by

Back 134

Superficial fibular nerve

Front 135

Common fibular nerve turns into

Back 135

Deep and superficial fibular nerves

Front 136

Innervation to superficial and deep posterior compartments

Back 136

Tibial nerve

Front 137

Saphenous nerve innervation

Back 137

Cutaneous to medial leg and foot up to metatarsals

Front 138

Superficial fibular nerve innervation

Back 138

Cutaneous to distal 1/3 of anterior leg, dorsum of foot (except between great and second toe), and toes

Front 139

Deep fibular nerve innervates

Back 139

Web space between great and second toe

Front 140

Sural nerve innervation

Back 140

Lower posterior leg, lateral foot

Front 141

Terminal branches of tibial nerve

Back 141

Medial and lateral plantar nerves

Innervate skin of plantar surface

Front 142

L4 dermatome

Back 142

Anterior knee, anteromedial leg, medial malleolus, medial side of foot, great toe

Patellar reflex

Front 143

L5 dermatome

Back 143

Lateral to anterior leg, dorsum of foot, web space between second and great toe, middle three toes, middle plantar surface including heel

Front 144

S1 dermatome

Back 144

Posterolateral leg to lateral lower leg, lateral malleolus, lateral foot, little toe

Calcaneal reflex

Front 145

Mortise of ankle

Back 145

Between tibia and fibula, trochlea of talus fits into

Front 146

"Mortise view"

Back 146

AP view with foot in 15-20 degrees of internal rotation

Front 147

Talus held between

Back 147

Medial and lateral maleoli

Strongest grip during dorsiflexion

Front 148

90% of ankle injuries

Back 148

Forced inversion while in plantar flexion

Front 149

3 lateral ligaments

Back 149

1. Anterior talofibular (weak, prevents inversion of ankle in plantar flexion)

2. Posterior talofibular (strong, prevents inversion in dorsiflexion)

3. Calcaneofibular (prevents inversion in dorsiflexion)

Front 150

Most commonly injured ankle ligament

Back 150

Anterior talofibular ligament

Front 151

Grade 1 sprain

Back 151

Stretching of anterior talofibular and calcaneofibular ligaments

Front 152

Grade 2 sprain

Back 152

Partial tear of anterior talofibular and stretching of calcenofibular

Front 153

Grade 3 sprain

Back 153

Complete tear of anterior talofibular and calcaneofibular and partial tear of posterior talofibular

Front 154

How to assess anterior talofibular ligament

Back 154

Anterior drawer test

Front 155

Assess calcaneofibular ligament

Back 155

Talar tilt (inversion stress) test

Front 156

Deltoid ligament

Back 156

Very strong layers of ligaments, medial ligament

Front 157

Eversion sprain

Back 157

Deltoid ligament, not very common

Front 158

What prevents motion between distal tibia and fibula

Back 158

Anterior inferior tibiofibular and posterior inferior tibiofibular ligaments

Front 159

Lauge-Hanse fracture

Back 159

Supination-external

Danis Weber type B

40-75% of malleolar fractures, spiral oblique fracture of lateral malleolus

Tibial plafond level

Front 160

Tibial plafond

Back 160

Tibial-talar articular surface

Front 161

7 tarsal bones

Back 161

Calceneous, talus, navicular, cuboid, medial, intermediate, and lateral cuneiforms

Front 162

Calcaneous

Back 162

Heel

Front 163

Talus

Back 163

Conveys weight of body from tibia to calcaneous

Front 164

Navicular

Back 164

Medial, articulates with cuneiforms

Front 165

Cuboid

Back 165

Lateral, articulates with 4th and 5th metatarsals

Front 166

Subtalar joint

Back 166

B/w talus and calcaneous

Permits foot to be placed on slanted surfaces

Front 167

Transverse tarsal joint

Back 167

Talonavicular joint medially and calcaneocuboid joint laterally

Permits foot eversion and inversion

Front 168

Medial arch in foot

Back 168

From calcenous across talus, navicular, and cuneiforms, to metatarsals

Front 169

"Spring ligament"

Back 169

Plantar calcaneonavicular ligament (supports head of talus)

Supports longitudinal arch

Front 170

Plantar aponeurosis

Back 170

Connects ends of longitudinal arch, provides some support

Inflammation=plant fasciatis

Front 171

Transverse arch

Back 171

Formed by distal row of tarsal bones and base of metatarsals

Front 172

What is located between the heads of the metatarsal bones and the calcaneal tuberosity?

Back 172

All intrinsic plantar muscles, plantar aponeurosis, spring ligament, and plantar nerves, arteries, and veins

Front 173

Two pulse points on foot

Back 173

Dorsalis pedis and posterior tibial arteries

Front 174

Dorsalis pedis is continuation of

Back 174

Anterior tibial artery

Palpated on dorsum of foot between tendons of extensor hallucis longus and extensor digitorum longus

Major source of blood to toes and supplies plantar surface of foot via deep plantar artery

Front 175

Posterior tibial artery is palpated

Back 175

Posterior to medial malleolus (between medial malleolus and calcneal tendon)

Divides into medial and lateral plantar arteries which supply sole of foot

Front 176

Two phases of gait cycle

Back 176

Stance and swing

Front 177

Stance phase

Back 177

Begins with heel strike and ends with push off

60% of cycle

Front 178

Swing phase

Back 178

Beings with push off and ends with heel strike

40% of cycle

Front 179

Muscles active during stance phase

Back 179

Heel strike: dorsiflexors (tibialis anterior primarily)

Weight bearing: knee extensors (quads)

Push off: plantar flexors (triceps surae--gastrocnemius and soleus)

Front 180

Muscles active during swing phase

Back 180

Leg shortening: hip (iliopsoas), knee flexors (hamstrings), and foot dorsiflexors

Midswing: knee extensors and foot dorsiflexors

Hip abductors are active in both phases

Front 181

Angle of inclination

Back 181

Angle between long axis of shaft and axis of femoral neck and head

About 145 degrees in child, decreases with age (adult average=126 degrees)

Front 182

Function of angle of inclination

Back 182

Allows greater mobility of femur at hip joint

Increases leverage of abductors and rotators of thigh

Permits all joints inferior to hip to flex posteriorly (permits upright posture and bipedal walking)

Front 183

Coxa vera

Back 183

Shortened angle of inclination--less than 120 degrees

Happens via trauma, neoplasia, and rickets

Front 184

Area of tibia most susceptible to fracture

Back 184

Junction of middle and distal third (thinnest)

Poorest blood supply

Front 185

Common area used for bone grafts

Back 185

Middle 1/3 of fibula (nutrient artery)

Front 186

"Tibial step-off"

Back 186

Amount of tibia that protrudes anterior to femur (observed from medial side)

Normal=1cm at 90 degrees of flexion

0 cm step-off=PCL tear

Front 187

ACL graft source

Back 187

Central 1/3 of patellar ligament/tendon

Hamstring tendons

Front 188

Grade 3 (complete) tear of MCL

Back 188

Gap (between condyles of femur and tibia) greater than 1cm with 30 degrees of flexion

Front 189

Grade 1 tear

Back 189

Pain without gap

Front 190

Meniscal tear on MRI

Back 190

"White line" on T2 weight MRI