Exam 2: Lower Extremity Handout Part 1
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Which bone is a common source of bone for grafting?
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
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
Does the missing piece of bone from the fibula regenerate?
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
What causes paralysis of tibialis anterior?
injury of common peroneal nerve or deep peroneal nerve
What occurs when the tibialis anterior is paralyzed?
What does foot drop mean?
foot falls into plantar flexion when it is raised off ground
What are shin splints?
- painful condition of anterior compartment of the leg
- anterior tibial mm swell
What causes shin splints?
- vigorous and/or lengthy exercise
- sudden overuse of anterior tibial mm.
- not warming up adequately or cooling down sufficiently
What type of person is likely to develop pain in anterior part of legs after long walks?
What happens when anterior tibial mm. swell from sudden overuse?
reduce blood flow to muscles
When shin splints occur what might happen if use of the mm. is continued?
What affect does pressure have on the swollen mm.?
painful and tender to pressure
Is inflammation, strain, or rupture of tendo calcaneus common?
What is another name for tendo calcaneus?
calcaneal (Achilles) tendon
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
Does injury to tendo calcaneus occur more commonly in young or older people?
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
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
Which muscles make up the triceps surae muscle?
gastrocnemius and soleus
What is the ankle reflex (ankle jerk)?
twitch of triceps surae muscle
How is the ankle reflex tested?
striking tendo calcaneus with reflex hammer
Where is the reflex center for the ankle reflex?
in S1 and S2 segments of spinal cord
What is "tennis leg"?
- painful calf injury
- partial tearing of medial belly of gastrocnemius at or near musculotendinous junction
What causes tennis leg?
overstretching muscle by concomitant full extension of knee and dorsiflextion of ankle joint
The gastrocnemius is one of a few muscles with only one source of:
What provides blood supply to the gastrocnemius?
The sural arteries supplying the gastrocnemius are branches from which artery?
Do the sural arteries anastomosis with other arteries?
no, except by capillaries
What happens if one branch of the sural arteries is blocked?
part supplied by it dies
Which arteries supply the soleus muscle?
- sural arteries
- branches from peroneal artery
Inflammation and swelling of tendo calcaneus/cancaneal bursa=
Calcaneal bursitis is fairly common in who?
long distance runners
What causes calcaneal bursitis?
excessive friction on bursa as tendo calcaneus contiuously slides over it
When standing, the venous return of the leg depends largely on what?
muscular activity, esp. of triceps surae muscle
What improves the efficiency of the "calf pump"?
tight stocking of deep fascia covering the mm
What happens to blood when calf muscles contract?
blood is pumped superiorly in deep vein
What normally prevents blood from flowing into the superficial veins?
valves in perforating veins
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
What are distended perforating and superficial veins called?
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