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Joints of the Lower Limb Morse Anatomy Block II Unit II

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How many arches are there on the foot? What are they?
3, Transverse, Lateral, and medial (longitudinal)
What is the "keystone" of the arch of the foot?
The talus bone.
Where does extensor Hallicus tendon attach?
Base of the distal phalanx of the great toe.
What nerve supplies most of the skin on the dorsum of the foot?
Superficial fibular nerve.
What compartment is the superficial fibular nerve found in?
Lateral compartment
What nerve innervates fibularis longus and brevis (lateral compartment)?
Superficial fibular nerve
What nerve runs with the anterior tibial artery?
The deep tibial nerve.
What does the anterior tibial artery become on the dorsum of the foot?
The dorsalis pedis artery or the dorsal artery of the foot.
What muscle do you feel just lateral to to feel a pulse on the foot?
Extensor Hallicus longus
What are the 3 arteries for taking a pulse on the leg?
Femoral, popliteal, and dorsal artery of the foot
What are the attachements of extensor digitorom BREVIS?
Toes 1,2,3,4 NOT 5 (little toe) and it originates from the calcaneous.
What nerve supplies extensor digitorum brevis?
Deep fibular nerve.
What muscle will you damage if you drop something on top your foot?
Extensor digitorum brevis.
What two veins originate from the venous arch on the foot?
Long saphenous medially and short saphenous laterally.
What structure separates the long and short saphenous vein?
The long saphenous vein passes anterior to the medial malleoulus while the short saphenous passes posterior to the medial malleolus.
What arteries does the arch of arteries on the foot give rise to?
Dorsal metatarsal, dorsal phalange arteries.
What sort of curvature does the arch of arteries on the foot have?
Medial to lateral curvature.
Where is the deep or communicating artery of the foot found?
Originating from the arch of arteries on the foot and going between 1+2 metarsals going to the plantar surface of the foot.
What nerves run on/supply the dorsum of the foot?
Superficial and deep fibular nerves.
What is the most superficial layer of the plantar foot? (besides skin)
Plantar aponeurosis.
Where does the plantar aponeurosis run to/from?
From calcaneous and splits to slip into each toe.
What are the compartments of the foot? Why is this significant?
Medial, lateral, and intermediate. INfection can travel up the medial compartment but it will not go into the lateral or intermediate compartment.
What are the 3 muscles in the first layer of the foot? (Give them from lateral to medial).
ABductor digiti minimi (lateral longitudinal arch)
Flexor digitorum brevis
ABductor Hallicus (medial longitudinal arch)
What are the attachments of flexor digitorum brevis?
Attached to calcaneous with a tendonous slit to toes 2,3,4,5
What are the attachments of ABductor Hallicus?
Calcaneous and metatarsals.
What are the attachments of ABductor digiti minimi?
Calcaneous and metatarsals.
What muscles are in the second layer of the foot?
Quadratus plantae, and 4 lumbricals.
What side of the ankle does Flexor hallicus longus cross?
On the medial side of the ankle.
What are the actions of flexor digitorum longus?
Plantar flex, inferts the foot, flexes the toes.
What are the attachements of quadratus plantae?
Originates from the calcaneous and inserts onto the tendon of Flexor digitorum longus.
What is the action of quadratus plantae?
It redirects teh force of Flexor digitorum longus so you can flex the toes without inverting the foot.
What are the attachements of the lumbricals of the foot?
Originate from flexor digitorum longus and attach to the distal phalanges.
What are the actions of the lumbricals of the foot?
THey extend the interphalangeal joints and help you to "grip the floor" by keeping the extension in the interphalangelal joints.
What nerve's terminal branches are in the second layer of the foot? What are the name of them?
Tibial nerve, medial and lateral plantar nerves.
What type of nerves are the medial and lateral plantar nerves?
Sensory and motor.
What artery splits with the tibial nerve in the 2nd layer of the foot? What are the names of these vessels?
Posterior tibial artery. The names of these vessels are lateral and medial plantar arteries (major arteries of the plantar foot.
What skin does the medial plantar nerve innervate?
Skin of the medial 3 1/2 toes.
What skin does the lateral plantar nerve innervate?
Skin of the lateral 1 1/2 toes.
What muscles are found in the 3rd layer of the foot?
Flexor Hallicus Brevis, Flexor Digiti minimi brevis, and adductor halicus.
What are the 2 heads of adductor halicus?
Oblique and transverse head.
Where does the oblique head of adductor halicus originate from?
From the tarsals.
Where does the transverse head of adductor halicus originate from?
From the heads of the metatarsals.
What toe serves as a reference for AB/ADduction?
Toe #2
What muscles are found in the 4th layer of the foot?
Interossei muscles
How many interossei are there?
3 plantar interossei (Toes 2,3,4).
What are the two heads of flexor hallucis brevis?
Medial and lateral heads
What does the medial plantar nerve supply?
Flexor Digitorum Brevis
ABductor Hallicus
Flexor Hallicus Brevis
Lumbrical 1
What neve supplies everything the medial plantar nerve does not?
The lateral plantar nerve.
What artery meets up with the dorsal artery of the foot?
Lateral plantar artery or the deep arch of the foot.
Where does tibialis anterior tendon attach?
Base of metatarsal 1 and the medial cuniform.
What does tibialis anterior do?
Inverts the foot and also dorsiflexes.
What does tibialis posterior do?
Inverts the foot (attaches to tarsal bones)
Where does fibularis brevis attach?
To the base of metatarsal 5
Describe the course of fibularis longus.
Parallels FB in entrance to the foot then goes deep to the plantar ligament. It then attaches to the 1st metatarsal.
Where is the plantar calcaneor ligament? What does it connect?
It is under the articulation of the talus/navicular bone and it connects the calcaneous and navicular bone on the planter surface.
At what bones are inversion and eversion taking place? What is this joint called?
At the talus/calcaneous bones, it is called the subtalor joint.
What is another name for plantar calcaneor ligament? What is its function?
Also known as the the spring ligament, it adds springiness to the dorsum of the foot. It is essential at holding the bones of the foot in postion.
WHere does dorsal/plantar flextion take place?
In the ankle joint (talus, tibia, fibula)
What is the deltoid ligament AKA? Where is it? What is its function?
It is also known as the medial collateral ligment of the ankle joint. It is onthe medial aspect of the ankle joint and it is used in restricting eversion. It is VERY strong.
What ligament is on the opposite side of the foot from the deltoid ligament? What does this ligament do?
It is the lateral collateral ligament. It is weak and it restricts inversion.
Which injury is more likely, an inversion or eversion injury?
Inversion, more likely to tear the lateral collateral ligament.
What is it called when you fracture the distal fibula during powerful eversion?
Potts fracture.
What is a sprain vs. a strain?
Sprain = ligament
Strain = muscle or tendon.
What muscles support the knee joint?
Vastus medialis and lateralis tendons contribute to the joint capsule to form retinacula which support the joint.
What are the the muscles that contribute to the pes ansirunus?
Semitendonosous, gracilus, and sartorius.
Which tendon reinforce the knee joint capsule?
Semimembranosous, oblique popliteal ligament.
What is the origin/insertion of popliteus?
Origin from lateral condyle, insertion above the soleal line.
Which ligament of the knee is independent of the joint capsule?
The lateral or fibular collateral ligament.
With what is the medial collateral ligament fused?
With the joint capsule.
Which ligament does the popliteus muscle run undr?
The lateral fibular collateral ligament.
What are the intracapsular ligaments?
Posterior and anterior cruciate ligaments.
What do the anterior and posterior cruciate ligaments do?
They hold the femur/tibia together.
What are the plates of articular cartilage that rest on the superior aspect of the tibia called?
Menisci
Which ligament of the knee is most often injured?
The medial collateral ligament.
What ligament completes teh capsule of the knee anteriorly?
Ligamentum patella.
Which part of the menisci are avascular? Which are vascular?
The medial poriton of the menisci is avascualr and the lateral portion is vascular.
What is it called when cartilage comes off of menisci and goes in the joint capsule? What pathology will this produce?
It is called joint "mice". The knee locks because of the pain.
When is the knee most vulnerable?
When it is partially flexed and the foot is on the ground.
What is the anterior drawer test? What does it do?
You see if you can displace the tibia anteriorly. It tests the integrity of the ACL.
If you rotate the tibia medially and there is pain what structure has the patient most likely damaged?
You have most likely damaged the medial meniscus.
What sort of injury causes the unhappy triad? What 3 things are injured?
A hit from the lateral side with your foot on the floor. The damage is to the medial cruciate ligament, medial meniscus, and the ACL.
What bone does popliteus move when the leg is weight bearing? How about non weight bearing?
Wieght bearing = femur rotates medially
Non Weight bearing = Tibia rotates medially
Where is the iliofemoral ligament? What does it connect?
It connects the ilium to the intertrochanteric line.
What does the iliofemoral ligament do?
Resists hyperextension of the hip (strongest ligament in the body)
What is the iliofemoral ligament AKA?
"Y" ligament.
What does the pubofemoral ligmament connect? What does it do?
The pubofemoral ligament connects the pubus to the proximal end of the femur. It resists ABduction of the hip.
Where is the ischiofemoral ligament? What does it do?
It is on the posterior aspect of the hip and it resists flexion of the hip joint.
WHat goes between the ligaments of the hip?
Diverticula of synovial membrane (i.e. psoas bursa)
What is the labrum of the acetabulum made out of? What does it do?
It is made out of fibrocartilage and it increases the depth of the socket of the hip.
What is the pit in the head of the femur called?
The fovea.
What is in the fovea?
A fold of synovial membrane and a small BV.
What artery supplies most of the blood to the head of the femur?
The medial femoral circuflex.
Where does a broken hip usually take place?
Usually takes places in the neck region of the femur.

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