Module 4: The lower limb Flashcards

1
Q

Muscles of gluteal region

A

Gluteal muscles (max, med, min)
Lateral (external) rotator muscles

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2
Q

Lateral rotator muscles

A

Lateral rotation of femur at hip joint, deep to gluteal muscles

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3
Q

Lateral rotator muscles

A

Piriformis
Obturator internus
Superior and inferior gemelli
Quadratus femoris
Obturator externus

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4
Q

Piriformis

A

Attaches to the pelvic surface of the lateral part of the sacrum and leaves the pelvic cavity through the greater sciatic foramen to attach femur

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5
Q

Obturator internus

A

Originates on obturator membrane of pelvis and its tendon exits the pelvis through the lesser sciatic foramen to insert on femur

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6
Q

Superior and inferior gemelli

A

Run above and below obturator internus

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7
Q

Quadratus femoris

A

Runs from ischial tuberosity

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8
Q

Obturator externus

A

Runs from outer surface of obturator membrane to femur

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9
Q

Gemellus pain syndrome

A

Strained gemelli muscles when trying to aid in flexion at the hip joint

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10
Q

Symptoms of gemellus pain syndrome

A

Compressed posterior femoral cutaneous muscle
Reduced range of motion at hip, numbness in skin of posterior thigh

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11
Q

Blood supply to gluteal region

A

Branches of internal iliac artery: superior and inferior gluteal arteries

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12
Q

Venous supply to gluteal region

A

Superior and inferior gluteal veins, drain into internal iliac vein

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13
Q

Internal iliac artery stenosis

A

Narrowing of the internal iliac arteries reduces blood supply to the structures supplied by branches of the internal iliac artery

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14
Q

Symptoms of internal iliac artery stenosis

A

Cramping of muscles in lower back, hip, buttock or thigh, further induced by exercise

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15
Q

Innervation of gluteal region

A

Sacral plexus
- superior and inferior gluteal nerve
- posterior femoral cutaneous nerve
- sciatic nerve
- pudendal nerve

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16
Q

Superior gluteal nerve

A

Supplies motor innervation to gluteus medius, gluteus minimus and tensor fasciae latae

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17
Q

Inferior gluteal nerve

A

Supplies motor innervation to gluteus maximus

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18
Q

Posterior femoral cutaneous nerve

A

Supplies sensory innervation to skin posterior thigh

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19
Q

Sciatic nerve

A

Largest nerve in body, supplies muscles that make up the posterior thigh
L4, L5, S1-S3

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20
Q

Pudendal nerve

A

Motor innervation to anal sphincters and the urethral sphincter
Sensory innervation to the perineum, the penis, the scrotum, labia majora and clitoris

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21
Q

Pathway of sciatic nerve through the gluteal region

A

After forming from the sacral plexus, the sciatic nerve leaves the pelvis via the greater sciatic foramen and emerges below the piriformis muscle

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22
Q

Pathway of sciatic nerve through posterior thigh

A

Passes superficial to the lateral rotator muscles, where it enters the posterior thigh deep to hamstring muscles

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23
Q

Piriformis syndrome

A

Caused by compression of the sciatic nerve by the piriformis muscle

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24
Q

Symptoms of piriformis muscle

A

Pain, tingling, numbness at affected site, pain can radiate to lower back where the spinal nerves converge to from the sciatic nerve, down the thigh, along the same path as sciatic nerve

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25
Q

The hip joint

A

Ball and socket synovial joint

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26
Q

Acetabular labrum

A

Rim of fibrocartilage that deepens the acetabulum, allowing more than half the femoral head to fit

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27
Q

Ligamentum teres

A

Secondary stabilizer of hip joint supplementing work of capsular ligament

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28
Q

Fibrous capsule

A

Thick and strong group of ligaments that help hold head of femur in acetebulum

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29
Q

Traumatic posterior hip sublaxation

A

Sublaxation (partial dislocation) occurs when the head of the femur is forced partially out of the acetabulum

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30
Q

What can result from posterior hip sublaxation?

A

Fibrous capsule and ligamentum teres can be torn or disrupted

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31
Q

Compartments of thigh

A
  1. Anterior
  2. Medial
  3. Posterior
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32
Q

Medial compartment

A

Adductors
Originate from pubis and insert into linea alba of femur

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33
Q

Muscles of medial compartment

A

Pectineus
Adductor brevis
Adductor longus
Gracilis
Adductor magnus

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34
Q

Adductor magnus insertion

A

Length of linea aspera

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35
Q

Adductor magnus action

A

Adducts thigh, extends and medially rotates the thigh at the hip joint

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36
Q

Hamstring part of adductor magnus

A

Inserts on adductor tubercle on femur to form the adductor hiatus

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37
Q

Adductor hiatus

A

Allows passage of vessels btwn the anterior and posterior thigh

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38
Q

Adductor magnus strain

A

Tearing of a muscle when muscle has been forced to stretch or contract beyond its limits

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39
Q

Symptoms of adductor magnus strain

A

Limited movement of hip, affecting one’ gait, pain with adduction, extension and medial rotation of thigh, can result in trigger points

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40
Q

Localization of pain in adductor magnus strain

A

Deep aching pain radiates to pelvis area, near origin of adductor magnus
Pain at front or back of thigh along body of the muscle
Pain may radiate to knee, near insertion of adductor magnus

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41
Q

Posterior compartment muscles

A

Semitendinosus
Semimembranosus
Biceps femoris

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42
Q

Posterior compartment muscles origin and insertion

A

Ischial tuberosity and posterolateral and posteromedial aspects of knee

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43
Q

Action of posterior compartment muscles

A

Extend hip and flex knee

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44
Q

The femoral triangle

A

Area in upper anterior thigh that contains major neurovascular structures

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45
Q

Borders of femoral triangle

A

Superior: Inguinal ligament
Lateral: sartorius
Medial: adductor longus
Floor: lliopsoas and pectineus
Roof: fascia lata

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46
Q

Femoral artery- branches to hip

A

Deep femoral artery (profunda femoris) and the circumflex arteries w multiple branches around neck of femur

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47
Q

Femoral artery- branches to thigh

A

Profunda femoris artery and superficial femoral artery

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48
Q

Femoral vein

A

Drains thigh and rest of lower limb
Longest tributary is great sapheneous vein

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49
Q

Great sapheneous vein

A

Drains superficial tissues of most of lower limb and empties into femoral vein in upper thigh

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50
Q

Pathway of femoral artery and vein through adductor hiatus

A

Descend through femoral triangle to its apex where they pass into adductor (Hunter’s) canal deep to sartorius and superficial to adductor magnus

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51
Q

Pathways of femoral artery and vein to popliteus

A

From canal they pass through adductor hiatus to posterior knee where they change their name to politeal artery and vein

52
Q

Avascular necrosis of femoral head

A

Occurs when blood supply to femoral head is disrupted; caused by trauma to joint or bone

53
Q

Symptoms of avascular necrosis of femoral head

A

Necrosis of bone tissue, affected joint pain during weight bearing activities ion later stages, persisting pain when laying down

54
Q

Nerve supply of hip and thigh

A

Femoral nerve
Obturator nerve
Lateral cutaneous nerve
Sciatic nerve

55
Q

Femoral nerve

A

Innervates quadriceps muscles and skin of anterior thigh, runs along femoral artery and vein in femoral triangle

56
Q

Obturator nerve

A

Innervates muscles and skin of medial compartment of thigh

57
Q

Lateral cutaneous nerve

A

Innervates skin on lateral aspect of thigh above knee

58
Q

Obturator nerve entrapment

A

Occurs due to inflammation of adductor muscles bc the obturator nerve travels in btwn adductor longus and adductor brevis

59
Q

Consequences of obturator nerve entrapment

A

Pain that follows course of the nerve along medial thigh and can radiate into groin or knee

60
Q

Sensory changes caused by obturator nerve entrapment

A

Numbness ad paresthesia (pins and needles) of medial thigh

61
Q

Motor changes caused by obturator nerve entrapment

A

Adductor weakness, limited ROM at hip joint, pain that worsens with activity

62
Q

Ligaments of the knee

A

Patellar ligaments
Collateral ligaments
Cruciate ligaments

63
Q

Patellar ligament

A

Continuation of quadriceps tendon and helps keep patella in proper position

64
Q

Collateral ligaments

A

Medial and lateral
Stabilize hinge motion of the knee, prevent excessive lateral and medial movement

65
Q

Medial collateral ligament (MCL)

A

Joins distal femur to proximal tibia

66
Q

Lateral collateral ligament (LCL)

A

Joins distal femur to head of fibula

67
Q

Cruciate ligaments

A

Deep ligaments of the knee that prevent the femur and tibia from sliding forwards and backwards

68
Q

Anterior cruciate ligament (ACL)

A

Prevents anterior dislocation of tibia on fixed femur
Extends from lateral femoral condyle to intercondylar surface of tibia

69
Q

Posterior cruciate ligament (LCL)

A

Prevents posterior dislocation of tibia on fixed femur
Extends from medial femoral condyle to the posterior lateral intercondylar surface of tibia

70
Q

Menisci of knee

A

C-shaped fibrocartilaginous pads on condyles of tibia that function to deepen the articular surface of the tibia to increase stability
Medial meniscus: cresent shaped
Lateral meniscus: circular

71
Q

Causes of medial meniscus tear

A

Jumping, suddenly changing direction, rotation of knee joint, getting up quickly

72
Q

Symptoms of medial meniscus tear

A

Localized pain of affected knee, swelling, stiffness, pain with weight bearing movements

73
Q

Action of posterior compartment of leg

A

Plantarflexion of foot and ankle

74
Q

Popliteus

A

O: lateral femur
I: posterior surface of itbia

75
Q

Gastrocnemius

A

O: medial/lateral sides of femur
I: calcaneus
A: Flex leg and foot

76
Q

Plantaris

A

O: posterolateral femur
I: calcaneus

77
Q

Border of popliteal fossa (diamond)

A

Superior medial: semimembranosus
Superior lateral: biceps femoris
Inferior medial: medial head of gastrocnemius
Inferior lateral: lateral head of gastrocnemius

78
Q

Medial gastrocnemius strain cause

A

Stretching/contracting muscle beyond its limits

79
Q

Symptoms of medial gastrocnemius strain

A

Calf pain, tenderness localized to medial head of gastrocnemius at knee, pain and weakness when flexing leg at knee joint

80
Q

Popliteal artery

A

Continuation of femoral artery within popliteal fossa

81
Q

What does the popliteal artery bifurcate into?

A

Anterior and posterior tibial arteries

82
Q

Posterior tibial artery

A

Supplies posterior compartment of leg

83
Q

Anterior tibial artery

A

Supplies anterior compartment of leg

84
Q

Fibular (peroneal) artery

A

Branches off posterior tibial artery
Supplies lateral compartment of leg

85
Q

Great saphenous vein

A

Drains superficial tissue of most of lower limb

86
Q

Small saphenous vein

A

Drains blood from lower leg into popliteal vein

87
Q

Posterior tibial vein

A

Drains fibular vein and posterior compartment of leg
Drains into popliteal vein

88
Q

Anterior tibial vein

A

Drains anterior compartment of leg
Drains into popliteal vein

89
Q

Fibular vein

A

Drains lateral compartment of leg
Drains into posterior tibial vein

90
Q

Deep vein thrombosis

A

Formation of blood clot in deep vein

91
Q

Symptoms of deep vein thrombosis

A

Pain that starts in calf, feeling like a cramp or soreness due to blockage and pooling of blood near clot, red or discoloured skin and feel warm and swollen

92
Q

What does the sciatic nerve bifurcate into?

A

Common peroneal nerve
Tibial nerve

93
Q

Common peroneal nerve

A

Innervates muscles of lateral and anterior compartments of leg

94
Q

Tibial nerve

A

Descends posteriorly through popliteal fossa and innervates muscles of posterior leg

95
Q

Superficial fibular nerve

A

Innervates muscles of lateral compartment of leg

96
Q

Deep fibular nerve

A

Innervates muscles of anterior compartment of leg

97
Q

Contents of popliteal fossa

A

Popliteal artery and vein
Tibial nerve
Common peroneal nerve

98
Q

Common peroneal nerve dysfunction

A

Damage to peroneal nerve leading to loss of movement or sensation in foot and and leg

99
Q

Common peroneal dysfunction symptoms

A

Foot drop, muscle atrophy

100
Q

Arches of the foot

A

Medial longitudinal arch
Lateral longitudinal arch
Transverse arch

101
Q

Stress fracture

A

Small crack in bone or severe bruising of bone due to overuse

102
Q

Symptoms of stress fracture

A

Pain that worsens with weight bearing activities and diminishes during rest, swelling on top of foot or side of ankle, difficulty walking

103
Q

Ankle joint

A

Synovial hinge joint permitting dorsiflexion and plantarflexion of foot

104
Q

Ligaments of ankle joint

A

Deltoid ligament
Spring ligament
Plantar fascia

105
Q

Deltoid ligament

A

Stabilize ankle during plantar flexion, external rotation and pronation of foot to prevent overstretching of muscles
Runs btwn tibia and talus

106
Q

Spring ligament

A

Runs btwn navicular and calcaneus bone
Helps stabilize medial longitudinal arch and talus

107
Q

Plantar fascia

A

Longest ligament
Supports medial longitudinal arch

108
Q

Deltoid ligament strain

A

Caused by sudden lateral rotation of ankle

109
Q

Symptoms of deltoid ligament strain

A

Pain of medial ankle, swelling, bruising, difficulty walking and bearing weight

110
Q

Intrinsic muscles of the foot

A

Stabilize arches of foot, control movement of digits

111
Q

Where do extrinsic muscles of foot arise from?

A

Arise from anterior, posterior and lateral compartments of leg

112
Q

What action are the extrinsic muscles of the foot responsible for?

A

Eversion, inversion, plantar flexion and dorsiflexion

113
Q

Tibialis posterior muscle

A

Imp extrinsic muscle of foot
Attacthes to navicular

114
Q

Symptoms of posterior tibial tendonitis

A

Pain, swelling, warm and red localized to area around inside of foot and ankle

115
Q

Arterial supply of foot

A
  1. Dorsalis pedis artery
  2. Posterior tibial artery
116
Q

Dorsalis pedis artery

A

Branches from anterior tibial artery and supplies dorsum of foot

117
Q

Posterior tibial artery

A

Supplies plantar surface of foot

118
Q

Dorsal venous arch

A

Drains dorsal surface of foot, drains to small saphenous vein laterally and great saphenous vein medially

119
Q

Varicose veins

A

Twisted, enlarged veins caused by damaged or weak valves in veins, can cause backflow and pooling of blood in vein

120
Q

Symptoms of varicose veins

A

Aching pain and discomfort due to pooling of blood

121
Q

Tibial nerve

A

Supplies muscles of posterior compartment of leg and intrinsic muscles of plantar surface of foot

122
Q

Deep fibular nerve

A

Supplies muscles of anterior compartment of leg and part of skin of dorsum of foot

123
Q

Superficial fibular nerve

A

Supplies muscles of lateral compartment of leg and skin of lower anterior leg and most of skin on dorsum of foot

124
Q

Tibial nerve dysfunction

A

Damage to tibial nerve that causes loss of movement or sensation of foot

125
Q

Symptoms of tibial nerve dysfunction

A

Burning, numbness or tingling of skin of sole of foot, pain of sole of foot and toes, weakness in muscles that plantarflex foot

126
Q

What else does the sciatic nerve innervate?

A

Hamstring portion of adductor magnus