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Knee and leg1. Posterior tibial arterya. Divides superior to the flexor retinaculumb. Divides into the medial and lateral plantar arteries – true, distal to the flexor retinaculumc. Branches from 2 plantar arteries in the footd. Lateral plantar branch supplies the big toee. Divides inferior to the flexor retinaculum <= true2. Regarding the knee jointa. middle geniculate artery supplies the cruciate ligament <= synovial membrane and peripheries of the menisci (pg 643)b. Bursa beneath medial head gastrocnemius usually communicate with joint <= 4 bursa normally communicate: suprapatella, popliteus, anserine and gastrocnemius (pg 645)c. Rotation takes place below the menisci <= trued. Coronary ligament attaches menisci to the articular margins of tibia and femur <= to the joint capsule and articular margins of the tibiae. All of the above <=3. Popliteal fossaa. The floor is provided by biceps femoris – politeal surface of femur and politeus. Bicep femoris is the superolateral border, the superomedial is semimem and semitend b. The sural communicating nerve pierces the roof - ?c. Popliteal lymph nodes lie next to the popliteal artery <= pg587 “surround the vessels”d. The recurrent genicular nerve pierces the roofe. Superior and inferior geniculate nerves supply the medial ligament4. The stability of the weight bearing flexed knee is maintined bya. Anterior cruciate ligamentb. Ilio-tibial tractc. Posterior cruciate ligmanet <=d. Popliteus and posterior cruciate ligamente. Arcuate popliteal ligament and anterior cruciate ligament5. The short saphenous veina. Lies anterior to the lateral malleolus - posteriorb. Is accompanied by the saphenous nerve – sural nerve distalyc. Drains into the great saphenous vein – communicates with, but drains into the popliteald. Drains to the lateral margin of the foot <= drains the lateral margin via lateral dorsal venous arche. Lies deep to the deep fascia of the calf - superficial6. Which is not true of the tendo achillesa. It inserts into the middle third of the posterior surface of the calcaneousb. It is invested in a synovial sheathc. It is formed from the soleus and gastrocnemius <= true (+ plantaris)d. A bursa lies between the tendon and the upper third of calcaneouse. A bursa lies between it and the deep fascia near its insertion7. The anterior tibial arterya. Pierces the interosseous membrane – runs through a gapb. Supplies the lateral compartment of the leg – posterior via perforating branchesc. Lies lateral to the deep peroneal nerve - mediald. Lies lateral to tibialis anterior <= between TA and EDLe. Gives the nutrient artery to the tibia – from PT 8. The suprapatellar bursaa. Does not communicate with the knee jointb. Lies in front of the vastus intermedius musclec. Extends 5cm or more above the patella <= this is true?d. Lies deep to the patella retinacula – superior to?e. None of the above9. Regarding the extensor compartment of the lower leg, all of the following statements are true, excepta. The tibialis anterior muscle is supplied by the deep peroneal and recurrent genicular nerves (L4)b. Extensor digitorum longus and peroneus tertius muscle lie lateral to the tibialis anterial artery throughoutc. The deep peroneal nerve arises within the peroneus longus muscled. The extensor digitorum longus dorsiflexes the lateral toese. The extensor hallucis longus arises from the middle two-fourths of the tibia and adjacent interosseous membrane10. Regarding lower leg structuresa. The anterior tibial artery lies lateral to tibialis anterior <=b. The deep peroneal nerve originates in the popliteal fossac. Peroneus longus is supplied by the deep peroneal nerved. Extensor digistorum longus lies medial to tibialis anteriore. The tibia receives a nutrient vessel from the anterior tibial – PT 11. Tibialis anterior inserts intoa. Navicularb. Medial cuneiform and base of first metatarsal <=c. Lateral cuneiform and base of 5th metatarsald. Middle three metatarsalse. Medial cuneiform and base of 1st phalanx12. Tibialis posterior inserts intoa. The base of the first metatarsalb. The navicular <=c. Base of 2nd and third metatarsals <= and 4th and sustentaculum tali of calcaneusd. The cuboid <=e. None of the above13. Factors that stabilise the patella include all excepta. Forward prominence of the lateral condyleb. Forward prominence of the medial condyle <=c. Medial patellar retinacular fibresd. Vastus medialis fibres that insert into the lowest part of the patellae. The tone in vastus medialis14. Popliteus musclea. Is a weak flexor of the knee <=b. Is intracapsular – between the fibrous layer and synovial membrane nb the mensci are the only intrasynovial structures15. Regarding the menisci of the knee jointa. Posterior cruciate is medial <=b. Medial meniscus is avascular – poor medial supplyc. Fold of synovium lies posterior to anterior cruciate – anterior tod. Anterior horn of medial meniscus is attached to medial tibial condyle – anterior intercondylar area, but is generally attached more than the lateral meniscus16. Which ligament forms part of the knee capsulea. Lateral collateralb. Medial collateral <= intrinsic capsular ligament pg 636c. Anterior cruciated. Posterior cruciatee. Popliteus tendon17. With regard to peroneus longus musclea. The tendon lies below peroneus brevis in the lateral compartment of the leg – superficial tob. It is supplied by the superficial peroneal nerve (L5, S1) <= L5 S1 and S2c. Arises from the lower 2/3 s of the peroneal surface of fibula - upperd. The action is to invert the foot - everte. It has a broad tendon in comparison to the narrower tendon of peroneus brevis - ?18. Tibialis anteriora. Everts the footb. Is supplied by the superficial peroneal nervec. Arises from the lower 2/3s of the tibia and interosseous membraned. Lies medial to the anterior tibial artery <=e. Lies lateral to peroneus tertius19. Of muscles and tendons crossing the kneea. Popliteus medially rotates the femur to unlock the knee from extension - laterallyb. Soleus crosses the posterolateral aspect of the joint – doesn’t cross the kneec. Semitendinosis tendon passes anterior to the medial condyle - postd. Gluteus maximus crosses the knee joint by way of the iliotibial tract <=e. Biceps femoris inserts into the anterolateral aspect of the tibia - anteropost20. Regarding innervation of flexion/extension of the kneea. All muscles of the quadriceps femoris are supplied by L3/4 <= via femoral nerveb. Vastus medialis are intermedius are supplied by the same branch of the femoral nervec. Flexion of the knee by hamstrings is supplied solely by tibial component of sciatic nerve – short head of biceps is the common fibular divisiond. Flexor innervation of the knee can be tested by knee jerk L3e. Traumatic fracture dislocation of hip affects knee extension greater than flexion21. Tibialis anteriora. Is supplied by the superficial peroneal nerveb. Has a synovial sheath that continues below superior extensor retinaculum <=c. Dorsiflexes and everts the foot – and invertsd. Inserts into the lateral cuneiform – medial and base of 1st MTe. Originates from the tibia and fibula – tibia and IO membrane22. With regard to the stability of the knee jointa. The posterior cruciate ligament prevents the femur from slipping posteriorly on the tibiab. The lateral collateral ligament is more prone to damage than the medialc. The medial meniscus is more prone to damage than the lateral <=d. The integrity of the anterior cruciate ligament is most important when walking down stairse. The fit of the articular surfaces of the tibia and femur is the most important factor in providing stability to the knee23. The ligament important in producing the screw home position in full extension of the knee is thea. Anterior cruciate ligament <=b. Posterior cruciate ligamentc. Arcuate popliteal ligamentd. Patellar retinaculae. All of the above24. The cruciate ligaments would be anaesthetized by injury toa. Femoral nerveb. Common peroneal nervec. Tibial nerve <= not detailed in Moores?d. Obturator nervee. None of the above25. The cruciate anastomsosisa. Is supplied by the inferior branch of the medial circumflex femoral arteryb. Is supplied by the descending branch of the first perforating arteryc. Begins at the level of the greater trochanterd. Is supplied by the transverse branch of the lateral circumflex femoral artery <= ?e. Gives blood supply to the head of the femur26. In the popliteal fossaa. The sural nerve branches from the common peroneal nerve – tibial -> medial sural + communicating sural from CFN -> suralb. The roof is formed by biceps femoris - superolatc. The popliteal vein lies between the popliteal artery and tibial nerve <= true, nerve sup, artery deepd. The inferomedial border is soleus – heads of gastroce. The politeal artery runs vertically – inferolaterally to inferior border of popliteus to divide27. Politeusa. Arises from the tibia above the condylesb. Slopes upwards and mediallyc. Inserts into the lateral meniscus <=d. In innervated by a branch of the common peroneal nerve - deepe. Acts to “lock” the knee in full extension28. With regards to the knee jointa. The medial collateral ligament extends 8cm below the joint marginb. The medial collateral ligament is extra-articularc. The tenson of politeus is intra-articular – ‘intracapsular’, it is outside the synoviumd. The lateral meniscus is more C-shapede. All of the above <=29. Tibialis anteriora. Dorsiflexes and everts the footb. Arises from the upper 2/3s of the fibulac. Inserts into the medial cuneiform <= and base of 1st MTd. Shares its site of insertion with peroneus tertius – dorsum base of 5th (is an ant com m)e. Is supplied by L5,S1 – L4,530. In the lateral compartment of the lega. The muscles are supplied by the deep peroneal nerveb. The peroneus longus muscles arise only from the fibula <=c. The peroneal muscle tendons are bound at the lateral malleolus by the inferior peroneal retinaculumd. The peroneal muscles share a common synovial sheath at the lateral malleoluse. The blood supply is from the anterior tibial artery - post ................
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