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brau2308
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Which bone is a common source of bone for grafting?
fibula
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When a long piece of the fibula has been removed for grafting, how does this affect movement?
- walking, running, and jumping can be normal
- does not affect leg/foot function
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Why would free vascularized fibulae be used to restore skeletal integrity to upper and lower extremities?
- congenital bone defects
- replace segments of bone following trauma or excision of malignant tumor
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Does the missing piece of bone from the fibula regenerate?
no
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Why does the missing piece of fibula not regenerate
periosteum and nutrient artery are generally removed w/ piece of bone so graft will remain alive when transplanted
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What causes paralysis of tibialis anterior?
injury of common peroneal nerve or deep peroneal nerve
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What occurs when the tibialis anterior is paralyzed?
foot drops
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What does foot drop mean?
foot falls into plantar flexion when it is raised off ground
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What are shin splints?
- painful condition of anterior compartment of the leg
- anterior tibial mm swell
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What causes shin splints?
- vigorous and/or lengthy exercise
- sudden overuse of anterior tibial mm.
- not warming up adequately or cooling down sufficiently
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What type of person is likely to develop pain in anterior part of legs after long walks?
sedentary people
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What happens when anterior tibial mm. swell from sudden overuse?
reduce blood flow to muscles
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When shin splints occur what might happen if use of the mm. is continued?
cramps
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What affect does pressure have on the swollen mm.?
painful and tender to pressure
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Is inflammation, strain, or rupture of tendo calcaneus common?
yes
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What is another name for tendo calcaneus?
calcaneal (Achilles) tendon
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How do injuries to the tendo calcaneus occur?
- durring running
- games requiring quick starts
- person stumbles or is startled causing them to jump or suddenly run
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Does injury to tendo calcaneus occur more commonly in young or older people?
young
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What is the result of complete rupture of the tendo calcaneus?
- abrupt pain in posterior aspect of leg
- unable to use extremity
- lump or increase in prominence of calf occurs
- foot dorsiflexes to greater extent than normal
- unable to plantarflex foot against resistance
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With a complete rupture of the tendo calcaneus, why does a lump or increase in prominence of the calf occur?
shortening of triceps surae muscle
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Which muscles make up the triceps surae muscle?
gastrocnemius and soleus
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What is the ankle reflex (ankle jerk)?
twitch of triceps surae muscle
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How is the ankle reflex tested?
striking tendo calcaneus with reflex hammer
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Where is the reflex center for the ankle reflex?
in S1 and S2 segments of spinal cord
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What is "tennis leg"?
- painful calf injury
- partial tearing of medial belly of gastrocnemius at or near musculotendinous junction
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What causes tennis leg?
overstretching muscle by concomitant full extension of knee and dorsiflextion of ankle joint
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The gastrocnemius is one of a few muscles with only one source of:
blood supply
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What provides blood supply to the gastrocnemius?
sural arteries
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The sural arteries supplying the gastrocnemius are branches from which artery?
popliteal
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Do the sural arteries anastomosis with other arteries?
no, except by capillaries
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What happens if one branch of the sural arteries is blocked?
part supplied by it dies
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Which arteries supply the soleus muscle?
- sural arteries
- branches from peroneal artery
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Inflammation and swelling of tendo calcaneus/cancaneal bursa=
calcaneal bursitis
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Calcaneal bursitis is fairly common in who?
long distance runners
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What causes calcaneal bursitis?
excessive friction on bursa as tendo calcaneus contiuously slides over it
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When standing, the venous return of the leg depends largely on what?
muscular activity, esp. of triceps surae muscle
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What improves the efficiency of the "calf pump"?
tight stocking of deep fascia covering the mm
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What happens to blood when calf muscles contract?
blood is pumped superiorly in deep vein
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What normally prevents blood from flowing into the superficial veins?
valves in perforating veins
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What happens if the valves in perforating veins become incompetent?
blood is forced into superficial veins during contraction of triceps surae musces and by hydrostatic pressure when straining or standing
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What are distended perforating and superficial veins called?
varicose veins
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