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Back & Limbs
Johns Hopkins School of Medicine - Back & Limbs
109
Anatomy
Graduate
03/31/2008

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Cards

Term
Name the 3 types of joints, their soft tissue components, the amount of movement possible at each joint, and some examples.
Definition
Fibrous - fibrous connective tissue - no or almost no movement - skull sutures, distal tib-fib

Cartilaginous - hyaline cartilage - slightly movable - pubic symphysis, intervertebral bodies, manubrium-first rib

Synovial - several components - highly mobile - most limb joints, intervertebral articular processes
Term
What are the components of a synovial joint?
Definition
Constant: bone, hyaline cartilage, synovial membrane, synovial cavity, synovial fluid, fibrous capsule

Optional: labrum, disk, meniscus (all fibrocartilage & within synovial cavity so not easily repaired because no blood vessels in cavity); fat pad, intracapsular tendon, bursae
Term
Define axis of rotation
Definition
The point or line which remains stationary during joint movement. The action of a muscle on a joint will be determined by its position relative to the axis of rotation.
Term
What type of joint is the sacroiliac joint? Name the ligaments of the sacroiliac joint.
Definition
Synovial. Ventral and dorsal sacroiliac, sacrotuberous, sacrospinous, iliolumbar
Term
What is a moment?
Definition
The product of applied force and the perpendicular distance from the force vector to the axis of rotation.
Term
Describe the biomechanics of the sacroiliac joint.
Definition
A moment arm is created b/c the sacroiliac joint not aligned with the center of body weight. Therefore need to create opposite moment arm --> sacrotuberous & sacrospinous ligaments. The force from body weight greater than that from ligaments, so to make F1 * D1 = F2 * D2, the distance between the axis of rotation and the ligaments must be larger than that of body weight.
Term
Describe the biomechanics of the hip joint in single leg support. How does this differ for males and females?
Definition
For single leg support, must use abductors. Body weight (F1) through sacrum at a distance D1 from axis of rotation in femoral head. Abductors supply F2. D2 is distance from edge of iliac crest to axis of rotation in femoral head. The joint reaction force (F3) pushes up at femoral head. Because D1 > D2, F2 must be greater than F1. In other words the gluteal abductors must contract at 2.5 * body weight.

Females have greater D1 but same D2 and F1, so they must have an even greater F2 and F3.
Term
Describe the cartilaginous components and ligaments of the hip joint.
Definition
Within synovial cavity:
1) lunate surface of acetabulum with articular cartilage
2) labrum

Within fibrous capsule:
1) transverse acetabular ligament - bridge notch
2) ligamentum teres (w/ artery to head of femur)

Capsule:
1) capsule proper - longitudinal and circular fibers
2) blended with outer surface of capsule - iliofemoral, ischiofemoral, and pubofemoral ligaments (iliofemoral is strongest ligament in body)
tightening of ligs during hip extension --> prevent hip dislocation in extension but allow for freer movement during flexion.
Term
Blood supply to femoral head
Definition
medial & lateral femoral circumflex aa (from profunda femoris a)

artery to the head of the femur via ligamentum teres (from obturator a)

If ligament absent, fracture of femoral neck leads to total loss of blood supply to head.
Term
Which mm are responsible for flexion at hip joint?
Definition
flexion: psoas major, iliacus; assisted by rectus femoris, sartorius, and pectineus
Term
Which mm are responsible for extension at the hip?
Definition
extension: gluteus maximus, hamstring muscles
Term
Which mm are responsible for abduction at the hip?
Definition
abduction: gluteus medius and minimus, tensor fasciae latae
Term
Which mm are responsible for adduction at the hip?
Definition
adduction: pectineus, gracilis, adductor longus, brevis and magnus
Term
Which mm are responsible for medial rotation at the hip?
Definition
medial rotation (weak): tensor fasciae latae, ant. fibers of gluteus minimis and medius
Term
Which mm are responsible for lateral rotation at the hip?
Definition
lateral rotation (powerful): obturators, gemelli, quadratus femoris, piriformis, gluteus maximus, and sartorius
Term
Describe the general form and orientation of the knee joint.
Definition
Due to the lateral position of hip joint (i.e. bipedality), the knee joint is angled relative to the long axis of femoral shaft, more so in females. (Femur angled medially b/c body's COG must be balanced directly over foot, but hip joint must be out to side b/c babies.)
Term
What are the 2 functions of the patella?
Definition
1) Straightens out line of action of quadriceps across knee. Patella presses against lateral lip of patellar groove of distal femur, thus that lip is higher. (Lip needs to be higher to prevent dislocation. If patella does dislocate, then dislocates laterally.)

2) Increase moment arm of quadriceps about knee.
Term
What type of cartilage is in the knee?
Definition
1) articular cartilage on plateaus of condyles
2) menisci (semilunar cartilage) - increase joint congruence, cushion joint
medial meniscus attached to medial collateral ligament (thus more commonly injured)
lateral meniscus not attached to lateral collateral ligament
Term
Name the ligaments of the knee.
Definition
1) patellar - transmits force of quadriceps to tibia, provides stability in flexion
2) lateral (fibular) collateral - prevent side-to-side motion, and provide stability in extension
3) medial (tibial) collateral - prevent side-to-side motion, and provide stability in extension
4) anterior cruciate - anterior relative to tibia; loose in flexion, tight in extension --> prevents hyperextension, anterior displacement of tibia on femur
5) posterior cruciate - loose in extension, tight in flexion --> provides stability in flexion and prevents posterior displacement of tibia on femur
6) olbique and arcuate popliteal - relatively weak, provide stability in extension
Term
Describe the collateral circulation of the knee.
Definition
possibility of kinking off popliteal a. when bend knee --> collateral circulation

genicular branches of popliteal a., recurrent branches of tibial a.
Term
Which mm responsible for flexion of leg?
Definition
biceps femoris, semitendinosus, semimembranosus, gastrocnemius; assisted by sartorius, gracilis, and popliteus
Term
Which mm responsible for extension of leg?
Definition
quadriceps femoris; assisted by tensor fascia lata thru iliotibial tract
Term
Which mm responsible for rotation (flexed knee)?
Definition
medial: semimembranosus, semitendinosus, gracilis
lateral: biceps femoris
Term
Describe the knee locking/unlocking mechanism.
Definition
Knee locking mechanism in full extension "conjunct rotation"

femur spins medially (about 20 deg) on stationary tibia, due to two factors:
1) medial condyle is longer and flatter, so slides further posteriorly
2) lateral condyle has attachment of anterior cruciate ligament on its inner surface, which tightens in extension, limiting further motion

Popliteus unlocks the knee from full extension by rotating the femur laterally, when other knee rotators are ineffective. Explains why lateral collateral ligament is not attached to lateral meniscus (popliteus passes between the two).
Term
What type of joints are the superior tibiofibular and inferior tibiofibular?
Definition
sup = synovial
inf = fibrous
Term
What are the bones of the foot?
Definition
7 tarsals (talus, calcaneus, cuboid, navicular, 3 cuneiforms)
5 metatarsals
14 phalanges
2 sesamoids
Term
Describe the foot arches.
Definition
2 longitudinal:
medial = higher, functions in shock absorption and spring
lateral = lower, transfers weight and thrust to ground

1 transverse:
at tarsometatarsal junction, transversely across foot

When standing the arches are usually maintained passively (w/o mm) by the plantar aponeurosis, ligaments in foot and arragnement of foot bones (talus as keystone of arch). Ordinarily, mm assist in supporting the arches during locomtion, but they can also assist when standing if the arches are weak or low.
Term
What are the most important ligaments in maintaining foot arches? What are the most important mm?
Definition
Ligaments
1) long plantar ligament & short plantar ligament - calcaneus to cuboid
2) plantar calcaneonavicular (spring) ligaments

Muscles
1) peroneus longus (transverse arch)
2) flexor hallucis longus (medial long arch)
3) flexor digitorum longus (lateral long arch)
Term
Describe the talocrural joint. Bones? Ligaments? Movements? Most common injury?
Definition
Bones: tibia, fibula and talus. Medial and lateral malleoli.

Ligaments:
medially = deltoid (strong)
laterally = anterior and posterior talofibular, calcaneofibular

Movements:
mainly hinge-like w/ some plantarflexion, dorsiflexion, eversion, inversion

Most common injury is through over-inversion of joint, tearing the lateral ligaments (lat malleolus may also be fractured). Deltoid stronger so less commonly injured.
Term
Name the joints within the foot.
Definition
1) intertarsal joints
2) tarsometatarsal joints
3) metatarsophalangeal joints
4) interphalangeal joints
Term
Describe the intertarsal joints. Type? Movement? Ligaments? Two most important?
Definition
All synovial and most planar. dorsal, plantar and interosseous ligaments are associated with each joint.

Subtalar joint (talocalcaeal) - inf concave surface of talus with superior, convex surface of calcaneus

transverse tarsal joint (includes talocalcaneonavicular and calcaneocubiod joints) - head of talus and anterior portion of calcaneus with navicular and cuboid

Inversion and eversion take place at subtalar and transverse tarsal joints.
Term
Compare type & movement of tarsometatarsal joints, metatarsophalangeal joints, and interphalangeal joints.
Definition
Tarsometatarsal joints: synovial, planar.

Metatarsophalangeal joints: synovial and multiaxial; extension/flexion, adduction/abduction

Interphalangeal: synovial, hinge; flexion/extension only

All joints in foot are synovial!
Term
Which mm are responsible for dorsiflexion & inversion? Which nerves innervate these mm?
Definition
dorsiflexion = mm of the anterior compartment of the leg
inversion = pass medial to subtalar axis

tibialis anterior
extensor hallucis longus

deep fibular n.
Term
Which mm are responsible for plantarflexion & inversion? Which nerves innervate these mm?
Definition
plantarflexion = Lateral and posterior compartments of the leg
inversion = mm passing medial to subtalar axis (mm. of posterior compartment w/ insertions on foot)

flexor hallucis longus
flexor digitorum longus
tibialis posterior
tibial n.
Term
Which mm are responsible for plantarflexion & eversion? Which nerves innervate these mm?
Definition
plantarflexion = Lateral and posterior compartments of the leg
eversion = mm passing lateral to subtalar axis (mm. of lateral compartment)

peroneus longus
peroneus brevis
superficial fibular n.
Term
Which mm are responsible for dorsiflexion & eversion? Which nerves innervate these mm?
Definition
dorsiflexion = mm of the anterior compartment of the leg
eversion = pass lateral to subtalar axis

extensor digitorum longus
peroneus tertius

deep fibular n.
Term
Which mm are responsible for plantarflexion? Which nerves innervate these mm?
Definition
Gastrocnemius (P)
soleus (P)
plantaris (P)
flexor hallucis longus (PI)
flexor digitorum longus (PI)
tibialis posterior (PI)

tibial n.
Term
What are the muscles acting on the toes (dorsal)? Which nerves innervate these mm?
Definition
Extrinsic:
extensor hallucis longus
extensor digitorum longus

Intrinsic:
extensor digitorum brevis
extensor hallcuis brevis

deep fibular n.
Term
What are the muscles acting on the toes (plantar)? Which nerves innervate these mm?
Definition
flexors, abductors, adductors

Extrinsic:
1) flexor hallucis longus
2) flexor digitorum longus

Intrinsic (4 layers):
1) abductor hallucis
abductor digiti minimi
flexor digitorum brevis

2) quadratus plantae
lumbricals (to toes 2-5)

3) flexor hallucis brevis
adductor hallucis
flexor digiti minimi brevis

4) plantar interossei (3 - adductors)
dorsal interossei (4 - abductors)

Nerves to intrinsics all lateral plantar n. (branch of tibial) except:
LAFF (lumbrical 1, abductor hallucis, flexor hallucis brevis, flexor digitorum brevis) which are supplied by medial plantar nerve (branch of tibial n.)
Term
What are the nerves of the leg and foot?
Definition
tibial --> medial and lateral plantar
common fibular --> deep and superficial fibular
other cutaneous branches: medial and lateral sural (from tibial and common fibular, respectively), saphenous (from femoral)
Term
What are the arteries of the leg and foot?
Definition
popliteal --> anterior and posterior tibial
anterior tibial --> dorsalis pedis, arcuate
posterior tibial --> fibular, medial and lateral plantar
Term
Anterior compartment of leg (mm, nerves, blood)
Definition
muscles: tibialis anterior, extensor digitorum longus, peroneus tertius, extensor hallucis longus

nerve: deep fibular n.

vascular: anterior tibial a.
Term
Lateral compartment of leg (mm, nerve, blood)
Definition
muscles:
fibularis longus
fibularis brevis

nerve:
superficial fibular n.

vascular: branches of fibular a. from posterior compartment
Term
Posterior compartment of leg (mm, nerve, blood)
Definition
muscles:
superficial group - gastrocnemius, plantaris, soleus
deep group - popliteus, flexor digitorum longus, tibialis posterior, flexor hallucis longus

nerve: tibial n.

blood: posterior tibial artery, fibular artery
Term
What are the 7 structures passing anterior to the ankle (medial to lateral)?
Definition
great saphenous vein
saphenous n.
tendon of the tibialis anterior m.
tendon of the extensor hallucis longus m.
dorsalis pedis a. and its venae comitantes, deep fibular n.
tendon of the extensor digitorum longus
tendon of the peroneus tertius
Term
What are the structures passing posterior to the medial malleolus - medial to lateral?
Definition
tom dick (and) blood nervous harry

tendon of the tibialis posterior
tendong of the flexor digitorum longus
psterior tibial artery
tibial n
tendon of the flexor hallucis longus
Term
What are the structures passing posterior to the lateral malleolus - anterior to posterior?
Definition
tendon of peroneus brevis m.
tendon of peroneus longus m.
sural n.
small saphenous v.
Term
A single gait cycle for one lower limb is defined as ________. In slow walking approximately _________% is stance and __________% swing. Thus over the combined gait cycles of both limbs, the total period of double support is about _____%, single support ______%. In faster walking the period of double support is reduced.
Definition
A single gait cycle for one lower limb is defined as from heel strike to heel strike of that limb. In slow walking approximately 62.5% is stance and 37.5% swing. Thus over the combined gait cycles of both limbs, the total period of double support is about 25%, single support 75%. In faster walking the period of double support is reduced.
Term
During stance, how is weight transferred? What special anatomical adaptations make this possible?
Definition
During stance phase, wt is transferred from heel to lateral side of the foot, across the ball of the foot to the first metatarsal head and finally to the hallux.

foot arches; sesamoid bones around flexor hallucis longus tendo, allowing it to contract even as full body wt is supported on the first metatarsal head at toe-off; sustentaculum tali creates pulley for tendon of flexor hallucis longus
Term
Why is walking very energy efficient?
Definition
60-70% of input energy is recovered. The ballistic model of human gait - the lower limb acts like an inverted pendulum, taking advantage of gravity. Downward velocity is proportional to the accel due to gravity and the total length of the lower limb. Theoretical max speed of level walking is set by lower limb length.
Term
Describe the mechanisms to minimize vertical displacement of body center of gravity during gait.
Definition
1) pelvic rotation raises lowest point by lengthening the step, effectively increasing the length of the leg.
2) pelvic tilt (down on swing side and raised until heel strike, also need knee flexion of swing leg) lowers highest point
3) knee flexion of stance leg lowers highest point
4) plantarfleion of foot raises the lowest point and smoothes transition
Term
What are the 3 major functions of mm during gait?
Definition
1) provide fwd and upward thrust just before toe-off
2) prevent lateral collapse over unsupported side during single-limb support
3) smooth transitions and prevent buckling in plane of progression
Term
Describe the mm. that act during each phase of gait.
Definition
heel strike:
hamstrings decel limb, then stabilize knee (w/ quads)
dorsiflexors prevent foot slap (decel descent of foot)
gluteus maximus acts w/ hamstrings to decel limb and prevent lurching forward of trunk

flat foot:
abductors prevent excess pelvic tilt
plantarflexors begin to act, providing fwd and upward accel

toe off:
plantarflexors contract until just prior to toe off

swing:
dorsiflexors lift foot to clear group
Term
High "steppage gait" with foot slap and foot drop is an injury of which nerve?

How about "pelvic slump"?
Definition
steppage gait = common peroneal nerve injury

pelvic slump = superior gluteal n. injury
Term
How do intrinsic foot mm help in gait?
Definition
all fire at once at toe-off, converting foot into rigid lever
Term
What do you expect to see in a patient with a painful hip? Why?
Definition
If have painful hip, reduce joint reaction force by leaning over that hip.
Term
Why is running more energy efficient than would be predicted?
Definition
Elastic energy is stored in large tendons and ligaments (e.g. quadriceps, achilles) during running.
Term
psoas major
Definition
o: T12-L5 vertebrae
i: lesser trochanter
n: L1, L2 (ant rami)
m: flexes thigh at hip
Term
illiacus
Definition
o: iliac cres, iliac fossa, sacrum, sacro-iliac ligaments
i: lesser trochanter and femur distal to it
n: femoral n.
m: flexes thigh at hip
Term
tensor fasciae latae
Definition
o: ant sup iliac spine
i: iliotibial tract that attaches to lat condyle of tibia
n: sup gluteal
m: abducts, medially rotates and flexes thigh; helps to keep knee extended; steadies trunk of thigh
Term
sartorius
Definition
o: ant sup iliac spine
i: sup part of medial surface of tibia
n: femoral n.
m: flexes, abducts, and laterally rotates thigh at hip; flexes leg at knee joint
Term
rectus femoris
Definition
o: ant inf iliac spine
i: base of patella and by patellar lig to tibial tuberosity
n: femoral n
m: extends leg at knee & steadies hip joint and helps iliopsoas flex thigh
Term
vastus lateralis
Definition
o: greater trochanter and lateral lip of linea aspera of femur
i: base of patella and by patellar lig to tibial tuberosity
n: femoral n
m: extends leg at knee
Term
vastus medialis
Definition
o: intertrochanteric line and medial lip of linea aspera of femur
i: base of patella and by patellar lig to tibial tuberosity
n: femoral n
m: extends leg at knee
Term
vastus intermedius
Definition
o: anterior and lateral surfaces of body of femur
i: base of patella and by patellar lig to tibial tuberosity
n: femoral n
m: extends leg at knee
Term
pectineus
Definition
o: superior pubic ramus
i: pectineal line of femur, just inferior to lesser trochanter
n: femoral n., may receive branch from obturator
m: adducts and flexes thigh; assists with medial rotation of thigh
Term
adductor longus
Definition
o: body of pubis inferior to pubic crest
i: middle third of linea aspera
n: obturator n.
m: adducts thigh
Term
adductor brevis
Definition
o: body of pubis and inferior pubic ramus
i: pectineal line and prox part of linea aspera
n: obturator n.
m: adducts thigh and, to some extent, flexes it
Term
adductor magnus
Definition
o: inferior pubic ramus, ramus of ischium, and ischial tuberosity
i: gluteal tuberosity, linea aspera, medial supracondylar line, and adductor tubercle
n: adductor part- obturator n.; hamstring part - tibial division of sciatic n.
m: adducts thigh; adduction part also flexes thigh; hamstring part also extends thigh
Term
gracilis
Definition
o: body of pubis and inf pubic ramus
i: sup part of medial surface of tibia
n: obturator n.
m: adducts thigh, flexes leg, and helps rotate it medially
Term
obturator externus
Definition
o: obturator foramen and obturator membrane
i: trachanteric fossa of femur
n: obturator n.
m: laterally rotates thigh, steadies head of femur in acetabulum
Term
gluteus maximus
Definition
o: posterior of iliac crest, dorsal surface of sacrum and coccyx, sacrotuberous ligament
i: iliotibial tract that inserts into lateral condyle of tibia; some fibers to gluteal tuberosity
n: inferior gluteal n.
m: extends thigh and assists in lateral rotation; steadies thigh and assists in raising trunk from flexed position
Term
gluteus medius
Definition
o: external surface of ilium (along crest); gluteal fascia
i: greater trochanter (lat surface)
n: superior gluteal n.
m: abducts and medially rotates thigh; keeps pelvis level when opposite leg is off ground and advances pelvis during swing phase of gait
Term
gluteus minimus
Definition
o: external surface of ilium (middle of wing)
i: greater trochanter (ant surface)
n: superior gluteal n.
m: abducts and medially rotates thigh; keeps pelvis level when opposite leg is off ground and advances pelvis during swing phase of gait
Term
tensor fasciae latae
Definition
o: ant sup iliac spine & iliac crest
i: iliotibial tract that attaches to lateral condyle of tibia
n: superior gluteal n.
m: abducts and medially rotates thigh; keeps pelvis level when opposite leg is off ground and advances pelvis during swing phase of gait; contributes to stability of extended knee
Term
piriformis
Definition
o: anterior surface of sacrum and sacrotuberous ligament
i: greater trochanter
n: anterior rami of S1-S2
m: laterally rotate extended thigh and abduct flexed thigh; steady femoral head in acetabulum
Term
obturator internus
Definition
o: pelvic surface of obturator membrane and surrounding bones
i: greater trochanter (medial surface)
n: nerve to obturator internus (L5, S1) and nerve to quadratus femoris (L5, S1)
m: laterally rotate extended thigh and abduct flexed thigh; steady femoral head in acetabulum
Term
superior gemellus
Definition
o: ischial spine
i: greater trochanter (medial surface)
n: nerve to obturator internus (L5, S1) and nerve to quadratus femoris (L5, S1)
m: laterally rotate extended thigh and abduct flexed thigh; steady femoral head in acetabulum
Term
inferior gemellus
Definition
o: ischial tuberosity
i: greater trochanter (medial surface)
n: nerve to obturator internus (L5, S1) and nerve to quadratus femoris (L5, S1)
m: laterally rotate extended thigh and abduct flexed thigh; steady femoral head in acetabulum
Term
quadratus femoris
Definition
o: ischial tuberosity
i: quadrate tubercle on intertrochanteric crest of femur
n: nerve to obturator internus (L5, S1) and nerve to quadratus femoris (L5, S1)
m: laterally rotate thigh; steady femoral head in acetabulum
Term
semitendinosus
Definition
o: ischial tuberosity
i: medial surface of superior part of tibia
n: tibial division of sciatic
m: extend thigh; flex leg and rotate it edially; when thigh and leg are flexed can extend trunk
Term
semimembranosus
Definition
o: ischial tuberosity
i: posterior part of medial condyle of tibia
n: tibial division of sciatic n.
m: extend thigh; flex leg and rotate it medially; when thigh and leg are flexed, can extend trunk
Term
biceps femoris
Definition
o: long head - ischial tuberosity
short head - linea aspera and lateral supracondylar line of femur
i: lateral side of head of fibula; tendon is split a this site by fibular collateral ligament of knee
n: long head - tibial division of sciatic n.
short head - common fibular division of sciatic n.
m: flexes leg and rotates it laterally; extends thigh (e.g. when initiating a walking gait)
Term
tibialis anterior
Definition
o: lateral condyle and superior half of lateral surface of tibia
i: medial cuneiform and base of 1st metatarsal
n: deep fibular
m: dorsiflexion and inversion
Term
extensor hallucis longus
Definition
o: anterior surface of fibula and interosseous membrane
i: base of distal phalanx of hallux
n: deep fibular
m: extends great toe and dorsiflexes ankle
Term
extensor digitorum longus
Definition
o: lateral condyle of tibia and anterior surface of interosseous membrane
i: middle and distal phalanges of lateral 4 digits
n: deep fibular
m: extends lateral four digits and dorsiflexes ankle
Term
fibularis tertius
Definition
o: inferior third of anterior surface of fibula & interosseus membrane
i: base of 5th metatarsal
n: deep fibular
m: dorsiflexes ankle and aids in eversion
Term
fibularis longus
Definition
o: head and superior two thirds of lateral surface of fibula
i: base of first metatasal and medial cuneiform
n: superficial fibular
m: evert foot and weakly plantarflex ankle
Term
fibularis brevis
Definition
o: inferior two thirds of lateral surface of fibula
i: tuberosity on lateral side of base of fifth metatarsal
n: superficial fibular n.
m: evert foot and weakly plantarflex ankle
Term
gastrocnemius
Definition
o: lateral head - lateral condyle of femur; medial head - popliteal surface of femur, superior to medial medial condyle
i: calcaneal tendon to calcaneal tuberosity
n: tibial n.
m: plantarflexes ankle when knee is extended; raises heel during walking, and flexes leg at knee joint
Term
soleus
Definition
o: head of fibula, superior fourth of posterior surface of fibula, soleal line and medial border of tibia
i: calcaneal tendon to calcaneal tuberosity
n: tibial n.
m: plantarflexes ankle and steadies leg on foot
Term
plantaris
Definition
o: lateral supracondylar line of femur and oblique popliteal ligament
i: calcaneal tendon to calcaneal tuberosity
n: tibial n.
m: weakly assist gastrocnemius in plantarflexing ankle and flexing knee
Term
popliteus
Definition
o: lateral condyle of femur & lateral meniscus
i: posterior surface of tibia, superior to soleal line
n: tibial n.
m: unlocks fully extended knee (laterally rotates femur on planted tibia) & weakly flexes knee
Term
flexor hallucis longus
Definition
o: inf 2/3rds of posterior surface of fibula & inferior part of interosseous membrane
i: base of distal phalanx of hallux
n: tibial n.
m: flexes great toe at all joints and plantarflexes ankle; supports medial longitudinal arch of foot
Term
flexor digitorum longus
Definition
o: posterior surface of tibia inferior to soleal line
i: bases of distal phalanges of lateral four digits
n: tibial n.
m: flexes lateral 4 digits and plantarflexes ankle; supports longitudinal arches of foot
Term
tibialis posterior
Definition
o: interosseous membrane, posterior surface of tibia inferior to soleal line and posterior surface of fibula
i: tuberosity of navicular, cuneiform, and cuboid and bases of metatarsals 2-4
n: tibial n.
m: plantarflexes ankle and inverts foot
Term
abductor hallucis
Definition
1st layer intrinsic foot
o: calcaneal tuberosity, flexor retinaculum, and plantar aponeurosis
i: medial side of base of proximal phalanx of 1st digit
n: medial plantar n.
m: abducts and flexes 1st toe
Term
flexor digitorum brevis
Definition
1st layer intrinsic foot
o: calcaneal tuberosity & plantar aponeurosis
i: middle phalanges of lateral four digits
n: medial plantar n.
m: flexes lateral four digits
Term
abductor digit minimi
Definition
1st layer intrinsic foot
o: calcaneal tuberosity & plantar aponeurosis
i: lateral side of base of proximal phalanx of 5th digit
n: lateral plantar n.
m: abducts and flexes 5th digit
Term
quadratus plantae
Definition
2nd layer intrinsics of foot
o: calcaneus
i: posterolateral margin of tendon of flexor digitorum longus
n: lateral plantar n.
m: assists flexor digitorum longus in flexing lateral 4 digits
Term
lumbricals
Definition
2nd layer intrinsics of foot
o: tendons of flexor digitorum longus
i: medial aspect of extensor expansion over lateral four digits
n: #1- medial plantar n.; #2-4 - lateral plantar n.
m: flex proximal phalanges and extend middle and distal phalanges of lateral 4 digits
Term
flexor hallucis brevis
Definition
3rd layer intrinsics of foot
o: cuboid & lateral cuneiforms
i: base of prox phalanx of 1st digit
n: medial plantar n.
m: flexes proximal phalanx of 1st digit
Term
adductor hallucis
Definition
3rd layer intrinsics of foot
o: oblique head - bases of metatarsals 2-4; transverse head - plantar ligaments of metarsophalangeal joints
i: lateral side of base of proximal phalanx of 1st digit
n: deep branch o lateral plantar n.
m: adducts first digit; assists in maintaining transverse arch of foot
Term
flexor digiti minimi
Definition
3rd layer intrinsics of foot
o: base of 5th metatarsal
i: base of proximal phalanx of 5th digit
n: superficial branch of lateral plantar n.
m: flexes proximal phalanx of 5th digit, thereby assisting with its flexion
Term
plantar interossei
Definition
4th layer intrinsics of foot
3 mm
o: bases and medial sides of metatarsals
i: medial sides of bases of proximal phalanges of digits 3-5
n: lateral plantar n.
m: adducts digits 3-5 and flex metatarsophalangeal joints
Term
dorsal interossei
Definition
4th layer intrinsics of foot
4 mm
o: adjacent sides of metatarsals 1-5
i: first attaches to medial side of proximal phalanx of second digit; second-fourth attaches to lateral sides of digits 2-4
n: lateral plantar n.
m: abduct digits 2-4 and flex metatarsophalangeal joints
Term
What is in the femoral sheath?
Definition
lat --> med = femoral artery, femoral vein, lymphatic

femoral nerve lies outside of sheath
Term
Which muscles form the femoral triangle?
Definition
medial = adductor longus
lateral = sartorius
floor = adductor brevis, pectineus, illiopsoas
Term
In the anterior thigh, the femoral artery runs on top which mm? How about profunda femoris?
Definition
Femoral artery - runs over pectineus, adductor longus
profunda femoris - runs btwn adductor magnus & pectineus, adductor longus, adductor brevis
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