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Questions and Answers
Where can the pulsations of the posterior tibial artery typically be felt?
Where can the pulsations of the posterior tibial artery typically be felt?
Which artery is sometimes absent and replaced by a large perforating branch of the fibular artery?
Which artery is sometimes absent and replaced by a large perforating branch of the fibular artery?
What type of injuries are associated with meniscal tears in young adults?
What type of injuries are associated with meniscal tears in young adults?
Which artery may be larger than normal and can sometimes replace the posterior tibial artery in the lower leg?
Which artery may be larger than normal and can sometimes replace the posterior tibial artery in the lower leg?
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What is the anatomical location of the flexor hallucis longus in relation to the great saphenous vein?
What is the anatomical location of the flexor hallucis longus in relation to the great saphenous vein?
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What is the condition characterized by pain that disappears with rest but recurs upon walking?
What is the condition characterized by pain that disappears with rest but recurs upon walking?
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From which segments of the spinal cord does sympathetic innervation of the arteries to the leg derive?
From which segments of the spinal cord does sympathetic innervation of the arteries to the leg derive?
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What procedure may be used to enhance blood flow in patients with occlusive arterial disease in the lower limb?
What procedure may be used to enhance blood flow in patients with occlusive arterial disease in the lower limb?
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Which nerve provides sympathetic fibers to the femoral artery?
Which nerve provides sympathetic fibers to the femoral artery?
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What kind of muscle innervation do most skeletal muscles receive?
What kind of muscle innervation do most skeletal muscles receive?
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During the patellar tendon reflex, which muscle contracts?
During the patellar tendon reflex, which muscle contracts?
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Where do preganglionic sympathetic fibers synapse for lower limb innervation?
Where do preganglionic sympathetic fibers synapse for lower limb innervation?
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What is the role of the Achilles tendon reflex in the context of muscle function?
What is the role of the Achilles tendon reflex in the context of muscle function?
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Which of the following muscles is NOT paralyzed due to common fibular nerve injury?
Which of the following muscles is NOT paralyzed due to common fibular nerve injury?
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Which area of sensation remains unaffected by common fibular nerve injury?
Which area of sensation remains unaffected by common fibular nerve injury?
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What type of clinical presentation is often seen in patients with common fibular nerve injuries?
What type of clinical presentation is often seen in patients with common fibular nerve injuries?
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Which two nerves supply the muscles that are paralyzed in a common fibular nerve injury?
Which two nerves supply the muscles that are paralyzed in a common fibular nerve injury?
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What is a common cause of injury to the common fibular nerve?
What is a common cause of injury to the common fibular nerve?
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Which action is primarily affected by a common fibular nerve injury?
Which action is primarily affected by a common fibular nerve injury?
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Which nerve is primarily responsible for sensation along the lateral side of the foot?
Which nerve is primarily responsible for sensation along the lateral side of the foot?
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What is the primary role of the adductor canal?
What is the primary role of the adductor canal?
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Which ligament is most commonly damaged during hyperextension combined with rotation?
Which ligament is most commonly damaged during hyperextension combined with rotation?
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What does a positive anterior drawer test indicate?
What does a positive anterior drawer test indicate?
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Where is the ligamentum patellae attached?
Where is the ligamentum patellae attached?
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What is a common characteristic of meniscal cysts?
What is a common characteristic of meniscal cysts?
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What distinguishes the posterior cruciate ligament (PCL) from the ACL?
What distinguishes the posterior cruciate ligament (PCL) from the ACL?
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What typically causes damage to the PCL?
What typically causes damage to the PCL?
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How can the medial and lateral collateral ligaments be identified?
How can the medial and lateral collateral ligaments be identified?
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What type of joint is classified as a synovial ball and socket joint?
What type of joint is classified as a synovial ball and socket joint?
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Which ligament is known to prevent excessive abduction and extension in the hip joint?
Which ligament is known to prevent excessive abduction and extension in the hip joint?
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What structure is described as the strongest ligament that prevents overextension during standing?
What structure is described as the strongest ligament that prevents overextension during standing?
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Which layer of the foot contains the flexor digitorum longus tendon?
Which layer of the foot contains the flexor digitorum longus tendon?
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What is the primary composition of the medial collateral ligament in the knee?
What is the primary composition of the medial collateral ligament in the knee?
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Which muscle is an abductor of the hallux?
Which muscle is an abductor of the hallux?
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Which part of the body is the tibial plateau associated with?
Which part of the body is the tibial plateau associated with?
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What is the primary function of the plantar aponeurosis?
What is the primary function of the plantar aponeurosis?
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What type of cartilage is predominantly found in the knee joint?
What type of cartilage is predominantly found in the knee joint?
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Which ligament connects the femoral head to the acetabulum?
Which ligament connects the femoral head to the acetabulum?
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The structure responsible for the suspension from above in the context of foot anatomy refers to which tendon?
The structure responsible for the suspension from above in the context of foot anatomy refers to which tendon?
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Which of the following structures is NOT part of the intrinsic muscles of the foot?
Which of the following structures is NOT part of the intrinsic muscles of the foot?
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Which part of the hip joint stabilizes against hyperextension?
Which part of the hip joint stabilizes against hyperextension?
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Study Notes
Intermittent Claudication
- Pain in the legs caused by lack of oxygen during exercise, relieved by rest, and recurring when exercise resumes.
Sympathetic Innervation of Arteries to the Leg
- The lower three thoracic and upper two or three lumbar segments of the spinal cord are responsible for supplying the arteries to the leg.
- Preganglionic fibers travel through white rami to the lower thoracic and upper lumbar ganglia.
- Postganglionic fibers reach blood vessels through branches of the lumbar and sacral plexuses.
- The femoral artery receives sympathetic fibers from the femoral and obturator nerves.
- More distal arteries receive postganglionic fibers from the common fibular and tibial nerves.
Lumbar Sympathectomy
- Treatment option for occlusive arterial disease of the lower limb.
- Removal of the upper three lumbar ganglia and the intervening parts of the sympathetic trunk.
- Aims to increase blood flow through collateral circulation.
Patellar Tendon Reflex (Knee Jerk)
- Extension of the knee joint upon tapping the patellar tendon.
- Lumbar segments L2, L3, L4 are involved.
- Quadriceps contraction can be felt during the test.
Achilles Tendon Reflex (Ankle Jerk)
- S1, S2 segments are involved.
Common Fibular Nerve Injury
- The common fibular nerve is vulnerable as it winds around the neck of the fibula.
- Can be injured in fractures of the neck of the fibula or by pressure from casts or splints.
- Motor: Paralysis of the anterior and lateral leg compartment muscles, leading to footdrop.
- Sensory: Loss of sensation on the anterior and lateral leg, dorsum of the foot, and toes.
Anatomy of the Foot
- Plantar ligaments: Long & short plantar ligaments, Deep transverse ligament.
- Plantar Aponeurosis: Medial part of the plantar aponeurosis.
- 2nd Layer: Flexor digitorum longus tendon, Flexor hallucis longus tendon, Flexor hallucis brevis, Adductor hallucis.
- 3rd Layer: aBductor digiti minimi.
- 1st layer: Quadratus plantae, Lumbricals.
- Lateral half of FDL & FDB: Peroneus longus
Hip Joint
- Type: Synovial ball and socket.
- Composition: Femoral head, acetabulum, hyaline cartilage.
- Ligaments: Iliofemoral, pubofemoral, ischiofemoral.
Knee Joint
- Type: Hinge joint.
- Composition: Femoral condyle, patella, tibial plateau, hyaline cartilage.
- Ligaments: Medial Collateral, Lateral Collateral, anterior cruciate (ACL), posterior cruciate (PCL).
Adductor Canal
- Located in the middle third of the thigh, distal to the apex of the femoral triangle.
- Contains the femoral vessels and the saphenous nerve.
Knee Region
- Patella and Ligamentum Patellae: Easily palpated in front of the knee, traced to the tibial tuberosity.
- Femoral Condyle and Tibial Condyles: Recognized on the sides of the knee, joint line identifiable between them.
- Medial and Lateral Collateral Ligaments: Can be palpated on the sides of the joint line, followed above and below to their bony attachments.
Lateral McMurray's Test
- Used for diagnosing meniscal tears, particularly in young adults.
- Steps: Leg flexed, foot internally rotated.
Meniscal Injuries
- Tears or ruptures often occur during hyperextension movements, especially with rotation.
- Degenerative lesions common in middle age.
- Symptoms: Joint line tenderness, especially on the lateral side.
- Causes: Hyperextension, rotation.
Anterior Cruciate Ligament (ACL)
- Damaged more often than the PCL.
- Anterior drawer test and Lachman test are diagnostic.
Posterior Cruciate Ligament (PCL)
- Thicker and stronger than the ACL.
- Damaged by dashboard injuries.
- Posterior drawer test is diagnostic.
Posterior Tibial Artery
- Lies between the tendons of flexor digitorum longus and flexor hallucis longus.
- Pulsations can be palpated midway between the medial malleolus and the heel.
Dorsalis Pedis Artery
- May be absent in some individuals, replaced by a large perforating branch of the fibular artery.
Fibular Artery
- Can be larger than normal and replace the posterior tibial artery in the lower part of the leg.
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Description
Explore the complex relationship between intermittent claudication, sympathetic innervation of leg arteries, and the patellar tendon reflex. This quiz examines the physiological mechanisms and treatment options for occlusive arterial disease. Test your knowledge on how the nervous system affects blood flow and reflex actions in the lower limbs.
