CH 7M TGB Leg & Foot

<sub>The knee is formed by the articulation of the distal _____ and the proximal ____

A. Ulna and Tibia
B. Femur and Tibia
C. Femur and Fibula
D. Femur and Patella</sub>

<sub>The ______ joint, the largest synovial joint in the body, is a modified hinge joint.

A. Tibiofemoral
B. Tibiofibular
C. Iliofemural
D. Carpophalangeal</sub>

<sub>1. The Tibula and Fibula are the bones of the leg. The ____ ("shinbone") runs superficially from the knee to the ankle. The _____ is lateral to it and virtually deep to the surrounding muscles.
2. The ______ bears only 10% of the body's weight as its the thinnest bone in the body in proportion to its length.
3. The thickest layering of cartilage in the body can be found on the posterior surface of the ______. It is located on the anterior surface of the _____ and is the largest sesamoid.
4. When the knee is flexed, the patella is sinks into the space between the proximal ______ and the femoral ______.</sub>

<sub>1. The _____ _____ is a superficial knob located distal to the patella on the shaft of the tibia. Roughly half an inch in diameter and serves as an attachment site for the ____ ligament.
2. The ____ of the Tibia runs superficially along the anterior leg from the ____ tuberosity to the medial _____.</sub>

The head of the _____ is on lateral side of leg and is attachement site for biceps femoris, a portion of soleus muscle and the fibular collateral ligament.

A. Head of the Tibia
B. Head of the Patella
C. Head of the Fibula
D. Head of the Femur

<sub>Medial and lateral rotation of the knee can occur when the knee is in a ____ position.

A. Lateral Flexed
B. Extended
C. Rotated
D. Flexed</sub>

<sub>1. The bony landmark located distal to the patella is the ____ ____.
2. The connective tissue structure connecting the patella to the tibial tuberosity is the ____ ____
3. The ____ of the tibial plateaus is the only portion that can be accessed.
4. To locate the lateral epicondyle of the femur, palpate deep to the ____ ____</sub>

The head of the fibula is the attachment side for two muscles and one ligament. The Two muscles are ___ ___ and ____. The ligament is the ___ ___.

A. External Oblique and Gracilis / Tibular Collateral Ligament
B. Biceps Femoris and Gracilis / Fibular Collateral Ligament
C. Biceps Femoris and Soleus / Fibular Collateral Ligament
D. Sarorius Magus and Illiocicis / Fibular Collateral Ligament

The Sartorius tendon, Gracilis tendon, and Semitendinosus tendong form the ___ ____ tendon.

A. Common Central
B. Pes Peserinus
C. Pes Anterioris
D. Pes Anserinus

The landmark___ ____ is located proximal to the medial epicondyle of the femur, and the tendon of the ___ ____ muscle attaches to it.

A. Femoral Condyle and Adductor Magnus
B. Adductor Tubercle and Adductor Magnus
C. Adductor Tubercle and Adductor Brevis
D. Adductor Tubercle and Biceps Femoris

<sub>1. The bone at the heel of the foot is the ______ while the bone that articulates with the tibia and fibula is the ______
2. The tarsals are the most accessible along the _____ surface of the foot.
3. As you palpate both malleoli of the ankle the ____ ____ extends further distally.
4. To shorten the surrounding tissue of the medial malleolar groove, you have your partner ____ the foot.
5. The proximal end of the first metatarsal articulates to the _____ ____</sub>

<sub>The head of the talus can be located between which two bony landmarks?

A. Medial Condyle and Lateral Condyle
B. Medial Facet and Lateral Facet
C. Medial Malleolus and Navicular Tubercle
D. Medial Malleolus and Lateral Malleolus</sub>

<sub>1. To best locate the _____ of the talus, you would passively invert and planter flex the foot.
2. The dorsal and medial surfaces of the first _______ are easily accessible.
3. Spelled out, the acronyms "pip" and "dip" spell out ___ ____ and ___ ___
4. The tuberosity of the 5th metatarsal is the attachment side for the ___ ___ muscle.
5. To located the medial cuneiform, follow the ___ ___ tendon along the dorsal surface of the ankle.</sub>

<sub>1. Locate the Navicular and Tuberosity of the 5th Metatarsal. The ____ is situated further distally on the foot.
2. The direction from the medial malleolus to locate the sustenaculum is ______ and you would move your thumb about ___ inch.
3. Between the ______ of the 5th Metatarsal to the Lateral ______ are the two bony landmarks you can draw a line to locate the cuboid.</sub>

<sub>Distal to the lateral plateau is a swelling of bone called the ____ _____ which is an attachment site for the ____ tract.

A. Tibial Tubercle and Iliotibial Tract
B. Tibial Tubercle and Tibial Tract
C. Tibial Tubercle and Femurial Tract
D. Femural Tubercle and Iliotibial Tract</sub>

The ____ and ____ plateaus of the Tibia ar located on the proximal end

A. Distal and Proximal
B. Medial and Lateral
C. Proximal and Lateral
D. Medial and Proximal

<sub>What are the three tendons of the thigh that converge at the medial knee which attaches the proximal, medial shaft of the tibia?

A. Satorius, Gracilis, and Semitendinosus
B. Satorius, Pes Anserinus, Gracilis
C. Satorius, Tibialis, Semitendinosus
D. Satorius, Gracilis, Tibialis</sub>

<sub>1. The edges of the ____ ____ play an important role in the tracking of the patella when the knee is flexed and extended.
2. The ___ ___ is the flat area medial to the tibial tuberosity.
3. The ____ epicondyle of the Femur is a bald, knobby area located on the surface of the knee, deep to the iliotract and anterior to biceps femoris tendon.
4. The ____ epicondyle of the Femur is deep to tendon of the Sartorius, distal to vastus medialis and serves as attachment site for tibial collateral ligament
5. The _____ tubercle is located proximal to the medial epicondyle, between the belly of vastus medialis and the hamstring tendons.</sub>

<sub>1. The foot contains ___ bones. The hind foot is the union of the _____ and the _____.
2. The ____ articulates with the tibis and fibula to form the talocrural or ankle joint.
3. The large, chunky _____ is the bone at the heal of the foot.
4. The forefoot is formed by long, superficial phalanges and _____ which consists of a proximal base, a shaft and a distal head.
5. The first toe is formed by two sizable _____, the remaining toes have three each. They are palpable on all sides. The first toe or big toe is also known as the ____.</sub>

The lateral and medial ____ are the large conspicuous knobs on either side of the ankle, the broader medial is located at distal end & slender lateral protrudes from distal fibula.

_{A. Cuboid
B. Talus
C. Trochlea
D. Malleolus}

<sub>1. The large, solid ____ forms the heel of the foot. It is situated beneath the talus and projects two inches posteriorly from the _____.
2. The ____ of the calcaneus is a rounded region along the posterior surface. The ____ tendon attaches to superior aspect of the tuberosity.
3. The ____ ___ is located on the medial side of the calcaneus, roughly one inch distal to the medial malleolus. Shaped like a plank, supports the talus on the calcaneus.
4. The ___ ____ is located on the lateral side of the foot, roughly an inch distal to the lateral malleolus, small, superficial prominence to stabilize the peroneal muscles.</sub>

<sub>1. The Talus has three accessible landmarks, the ____, the ____ and the medial ____.
2. The ___ of the Talus is the round, anterior portion that articulates with the navicular.
3. The ____ of the Talus is the large, superior prominence of the body of the talus, wedged between the distal ends of fibula and tibia.
4. Finally the small medial _____ of the talus is posterior to the medial malleolus & serves as attachment site doe deltoid ligament.</sub>

The Medial, Middle and Lateral _____ lie in a row between the navicular, talus and metatarsals.

A. Cuboids
B. Cuneiforms
C. Naviculars
D. Plantaris

The ____ is a bean-shaped bone sandwhiched between the medial and middle cuneiforms and the talus. The dorsal and medial surfaces are superficial and palpable.

_{A. Cuboid
B. Navicular
C. Malleolus
D. Calcaneus}

The cube-shaped _____ is surrounded on three of its four sides by the fourth and fifth metatarsals, the lateral cuneiform and the calcaeus. Only partially accessible.

A. Hyoid
B. Cuboid
C. Navicular
D. Styloid

What are the four major muscle groups of the Leg and Foot?

_{A. Gastrocnemius and soleus, peroneus longus and brevis, extensors and flexors
B. Gastrocnemius and soleus, peroneus capitis and gracilis, externsors and flexors
C. Gastrocnemius and capitis, peroneus longus and brevis, externsors and flexors
D. Gastorcnemius and capitis, peroneus longus and brevis, tensors and flexors.}

<sub>1. large muscle mass of the posterior leg is composed of the _____ and the ____ muscles.
2. The superficial _____ has two head and crosses two joints- knee and ankle. Emerging between the hamstring tendons, the short head extend halfway down the leg before blending into the ______ tendon.
3. Compared to the thin gastrocnemius, the thick _____ is deep yet is medial and lateral fibers bulge from the sides of the leg and extend further distal that the gastrocnemius heads.
4. The common action to contract these muscles is to stand on his ____.</sub>

Which muscle is known as the "second heart" because of the important role its strong contractions play in returning blood from the leg to the heart?

_{A. Gastrocnemius
B. Soleus
C. Peroneus Longus
D. Peroneus Brevis}

The large _____ and _____ form the "calf muscles" of the posterior leg.

_{A. Gastrocnemius and Soleus
B. Peroneus longus and brevis
C. Extensors and Flexors
D. None of the these make up the leg}

<sub>1. The Peroneal muscles (Peroneus Longus & Brevis) are slender muscles located along the lateral side of the _____ of the leg, between the extensor ____ ____ and the ____ muscle.
2. They lie between the extensor ___ ____ and the ____ muscle. A portion of peroneus ___ lies deep to the peroneus ____, yet both are accessible.
3. Their distal tendons are _____ and palpable behind the lateral _____ and along the side of the heel.
4. The two bony landmarks that can help you isolate the peroneal bellies are the Head of the _____ and the lateral _____.
5. The action you can ask your partner to perform to fell the peroneals tighten is ____ the foot.</sub>

<sub>1. The ______ had a short muscle belly but the "Longest" tendon in the body.
2. Its belly lies at an ____ angle along the popliteal space of the posterior knee between the gastrocnemius heads.
3. The tendon extends down the length leg and attaches to the _____.
4. Although the belly of the _____ is situated in a small, cramped area, it can be easily accessed.
5. From evolution standpoint, it is said to be what remains of the large ___ flexor which in reptiles is an important muscle of propulsion.</sub>

What are the two muscles that form the "Triceps Surae"?

_{A. Gastrocnemis and Soleus
B. Popliteus and Soleus
C. Medial Malleolus and Soleus
D. Lateral Malleolus and Soleus}

<sub>1. Although the gastrocnemis & soleus are located on posterior leg, they are palpate by anterior surface by sliding _____ off the shaft of the ____. The ____ head of the Gastrocnemis extends further distally when palpated.
2. The muscle belly of the ______ can be accessed between the gastrocnemius heads in the popliteal space.</sub>

<sub>1. As the name suggests the ______ is located in the popliteal space. Has a small, short belly with diagonal fibers.
2. Lying beneath the upper fibers of the ______ and _____ it is the deepest muscle of the posterior knee and popliteal space.
3. Although the muscle is a weak flexor of the knee, it is vital in "____" the joint from an extended knee position.
4. To access the tendionous attachment you need to push the overlying edge of the Gastrocnemius and the _____ to the side on the posterior leg.</sub>

Which muscle is known as "the key which unlocks the knee"?

_{A. Gastrocnemius
B. Soleus
C. Popliteus
D. Plantaris}

<sub>Shortening or Lengthening
1. Passive dorsiflexion of the ankle would ____ the soleus.
2. Passive lateral rotation of the knee would _____ the popliteus.
3. Passive inversion of the foot would _____ the peroneus longus.
4. Passive flexion of the knee would _______ the gastrocnemis.</sub>

Gastrocnemius of Posterior Leg

_{Action: ___ the knee and ____ flex the ankle
Origin: _____ of the femur, posterior surfaces.
Instertion: ______ via calcaneal tendon.}

Soleus of Posterior Leg

_{Action: ___ flex the ankle
Origin: ____ line, posterior surface of ____ and proximal, posterior surface of ____
Insertion: _____ via calcaneal tendon}

Plantaris of the Posterior Leg

_{Action: Weak ___ flexion of ankle, Weak ___ of the knee
Origin: Lateral ____ of the femur
Insertion: _____ via calcaneal tendon}

Popliteus of the Posterior Leg

_{Action: Mediall ____ the flexed knee and ____ the knee
Origin: Lateral ______ of the femur
Insertion: _____, posterior aspect of Tibia}

_{Peroneus Longus and Brevis Actions are the same: ____ the foot and assist to ____ flex the ankle
Peroneus Longus
Origin: ____ two-thirds of lateral fibula
Insertion: Base of the ___ metatarsal and the medial ______
Peroneus Brevis
Origin: ____ two-thirds of lateral fibula
Insertion: _____ of 5th metatarsal}

Extensor Tibialis Anterior
_{Action: ____ the Foot and _____ the ankle
Origin: Proximal lateral surface of ___ and interosseous membrane
Insertion: _____ cuneiform and base of ___ metatarsal}

Extensor Digitorum Longus

_{Action: Extend the ___ through ____ toes (metatarsophalangeal and interphalangeal joints)
Origin: Proximal ____ shaft of fibular and interosseous membrane
Insertion: Middle and distal ______ or second through fifth toes.}

Extensor Hallucis Longus

_{Action: ____ the first toe (metatarsophalangeal & interphalangeal joint), ____ the ankle and ____ the foot.
Origin: Middle, anterior surface of _____ and interrosseous membrane
Insertion: Distal ______ of first toe}

Flexor Tibialis Posterior

_{Action: _____ the foot and ____ flex the ankle (talocrural joint)
Origin: _____ posterior shaft of tibia
Insertion: Navicular, _____ cuboid and bases of second through fourth metatarsals}

Flexor Digitorum Longus

_{Action: Flex the ____ through ___ toes (metatarsophalangeal and interphalangeal joints)
Origin: ____ posterior surface of tibia}

Flexor Hallucis Longus
_{Action: ____ the first toe, Weak ____ flexion of ankle and ____ the foot
Origin: Middle half of _____ leg
Insertion: Distal ____ of first toe}

What are the three muscles of the Flexor Group?

A. Tibialis Posterior, Digitorum Longus and Hallucis Longus
B. Tibialis Anterior, Digitorum Longus and Hallucis Longus
C. Tibialis Lateral, Digitorum Longus and Hallucis Longus
D. Tibialis Medial, Digitorum Longus and Hallucis Longus

What are the three muscles of the Extensor Group?

A. Tibialis Anterior, Digitorum Longus and Hallucis Longus
B. Tibialis Medial, Digitorum Longus and Hallucis Longus
C. Tibialis Lateral, Digitorum Longus and Hallucis Longus
D. Tibialis Posterior, Digitorum Longus and Hallucis Longus

<sub>The Extensors of the Ankle and Toes (Tibialis Anterior, Extensor Digitoum Longus, Extensor Hallucis Longus)
1.These _____ muscles are located on the anterior aspect of the leg between shaft of tibia and peroneal muscles.
2. The tendons of all three muscles cross beneath the extensor _____ at the ankle.
3. The ___ ___ is large, superficial and the most clearly isolated of the group lying directly lateral to the tibial shaft.
4. The Extensor ____ ___ is partially superficial and its four tendons are clearly palpable on the dorsal surface of the foot.
5. The muscle belly of the Extensor ___ ___ lies deep to the other two muscles and can be accessed only indirectly.</sub>

<sub>The Flexors of the Ankle and Toe (Tibialis Posterior, Flexor Digitoum Longus, Flexor Hallucis Longus)
1. These three slender muscles, buries deep to the gastrocnemius & soleus on the posterior leg, are primarily responsible for ____ the foot and ____ the toes.
2. All three are virtually inaccessible, except at the small region on the ____ side of the leg, gap between the tibial shaft and edge of ____ tendon
3. The tendons of these three muscles curve around the medial ____ and pass deep to the flexor _____
4. The ____ artery and nerve are situated between the tendons at the medial ankle.</sub>

Complete the following for the mnemonic device "Tom, Dick AN Harry" for the Flexors
<sub>1. T _____ _____
2. _____ D ______ _____
3. _____ A _______
4. _____ N _______
5. ______ H ______ ______</sub>

1. The action of the toes is to ____ them to feel contraction of all the flexor bellies
2. The first layer of muscles on the foot's plantar surface is deep to the connective tissue structure ____ ____
3. To isolate the extensor ____ ____, the structures of the plantar surface of the heel and 2nd through 5th toes are helpful
4. Beside abducting the first toe, another action is ____ the first toe to contract the abductor hallucis.

What three points of contact from a Triangle with the three arches of the foot.

_{A. Talus, Head of 1st Metatarsal and Head of 4th Metatarsal
B. Calcanus, Head of 1st Metatarsal and Head of 4th Metatarsal
C. Calcanus, Head of 1st Metatarsal and Head of 5th Metatarsal
D. Plantaris, Head of 1st Metatarsal and Head of 5th Metatarsal}

<sub>Shortening and Lengthening Extensors, Flexors and Muscles of Foot
1. Passive flexion of the fifth toes would ______ the abductor digiti minimi
2. Passive eversion of the foot would ______ the tibialis posterior.
3. Passive dorsiflexion of the ankle would _____ the extensor digitorum longus.
4. Passive eversion of the foot would _____ the tibialis anterior.</sub>

The action Dorsiflexion of the Ankle occurs at the _____ joint

A. Metacarpophalangeal
B. Tibiofemoral
C. Distal Interphalangeal
D. Talocrural

What is the two Antagonists to the Tibialis Anterior and Extensors Hallicus Longus and Digitorum Longus during the action of Dorsiflexion of the ankle?

_{A. Flexor Hallucis Longus and Flexor Digitorum Longus
B. Flexor Digitorum Longus and Flexor Digitorum Brevis
C. Flexor Hallucis and Flexor Digitorum Brevis
D. Plantaris and Flexor Digitorum Longus}

What are the two Synergists of the two Antagonists Tibialis Anterior and Posterior during Eversion of the Foot.

_{A. Tibialis Anterior and Extensor Hallicis Longus
B. Extensor Digitorym Longus and Brevis
C. Flexor Digitorum Longus and Brevis
D. Peroneus Longus and Brevis}

What is the Antagonist to the Flexor Digiti Minimi (5th), Flexor Digitorum Longus and Brevis during the action Flexion of the toes?

_{A. Lumbricals
B. Flexors
C. Extensors
D. Peroneals}

The action Extension of Toes happens at three joints. The Proximal and Distal Interphalangeal are two of them, what is the third?

_{A. Metatarsalphalangeal
B. Metatarsal
C. Metacarpal
D. Metacarpophalangeal}

During extension of the toes. Extensor Digitorum Longus and Brevis as well the Lumbricals are the Synergists. What are the three Antagonists?

_{A. Flexor Digitorum Longus and Brevis and the Tibialis Posterior
B. Flexor Digitorum Longus and Brevis and the Tibialis Anterior
C. Flexor Digitorum Longus and Brevis and the Digiti Minimi (5th)
D. Flexor Digitorum Longus and Brevis and the Soleus}

The Tibalis Anterior and Posterior, the flexors Hallucis Longus and Digitorum Longus assist in Inversion of the foot. What is the Antagonist?

_{A. Extensor Digitorum Longus
B. Extensor Digitorum Brevis
C. Extensor Hallucis Longus
D. Extensor Hallucis Brevis}

Plantar Flexion of the Ankle as the Antagonists of Extensors Hallucis Longus and Digitorum Longus. What are the two Synergists?

A. Soleus and Tibialis Posterior
B. Soleus and Tibialis Anterior
C. Soleus and Talus
D. Soleus and Plantaris

What are the Four Muscles of the Foot?

_{A. Extensor Digitorum Longus and Brevis, Abductor Hallucis and Digiti Minimi
B. Extensor Digitorum Brevis, Flexor Digitorum Longus, Abductor Hallucis and Digiti Minimi
C. Extensor Digitorum Brevis, Flexor Digitorum Brevis, Abductor Hallucis and Digiti Minimi
D. Extensor Digitorum Longus and Brevis, Abductor Talus and Digiti Minimi}

<sub>Muscles of the Foot (Extensor Digitorum Brevis, Flexor Digitorum Brevis, Abductor Hallucis and Abductor Digiti Minimi)
1. The dorsal surface of the foot is home to the _____ Digitorum Brevis. Its small belly lies deep to the _____ digitorum brevis.
2. Unlike the dorsal surface of the foot, the plantar surface is made up of several layers. The first layer, located deep to the ____ _____ is formed by three muscles that lie side by side.
3. The center muscle is the ____ digitorum brevis, which extends down the center of the foot from the calcaneus to the phalanges.
4. Medial to this muscle is the thick, superficial Abductor _____; Lateral to this is the superficial Abductor _____
5. So, in summation, the muscles from medial to lateral are Abductor _____, the _____ Digitorum Brevis, and the Abductor _____</sub>

_{Extensor Digitorum Brevis - 1. Action: Extend the ____ through ___ toes / Origin: ______ (dorsal surface) / Insertion: ___ through ___ toes via the extensor digitorum longus tendons
Flexor Digitorum Brevis - 2. Action: Flex middle phalanges of ___ through ___ toes / Origin: ______ (dorsal surface) / Insertion: Middle phalanges of ___ through ___ toes
Abductor Hallucis - 3. Action: ____ the first toe, assist to ___ the first toe / Origin: _____ (plantar surface) / Insertion: Proximal phalanges of ___ toe and the ____ bone
Abductor Digiti Minimi - 4. Action: ____ the fifth toe, assist to ___ the fifth toe / Origin: ____ (plantar surface) / Insertion: Proximal phalanges of ___ toe (lateral side)}