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Anatomy > Lower Limb Part 1 > Flashcards

Lower Limb Part 1 Flashcards

1
Q

what is an innominate bone

A

this is the coxal bone or the hip bone. that is a flattened irregularly shaped bone

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2
Q

what is the pelvis

A

2 hip bones and sacrum

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3
Q

what is the coxal bone made up of

A

ilium
ischium
pubis
- these complete fusion around the age of 20-25 years old

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4
Q

read chapers 3

A

pages 327-337, 350-355, 357-362

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5
Q

what is the angle of inclination

A

angle between the femoral neck to the femoral shaft

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6
Q

what does the angle of inclination allow

A

allows for greater mobility places the head and neck more perpendicular to the acetabulum

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7
Q

what is the angle of a child, normal adult, and in older populations

A

child = 135 degrees
normal adult= 126 degrees
older population= 120 degrees

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8
Q

why might the angle of inclination change

A

due to pathological process that weaken the neck of the femur

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9
Q

what is the coxa vara

A

the angle of inclination is decreased

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10
Q

what is the coxa valga

A

the angle of inclination is increase

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11
Q

what type of fascia is seen in the thigh

A

superficial

deep

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12
Q

what type of fascia is the deep fascia of the thigh

A

this invest the lower limb like ann elastic stocking

- contains the fascia lata ( iliotibial tract)

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13
Q

what type of fascia is the deep fascia of the leg

A
  • the crural fascia

- extensor retinacula

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14
Q

what is the iliotibial tract

A

lateral thickening of deep fascai

– this is tendinous reinforcements form the TFL and gluteus maximus

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15
Q

where does the iliotibial tract start and end

A

from iliac tubercle to anterolateral tubercle of tibia

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16
Q

what is intermuscular septum

A

this is the fascia separating the muscles into compartments

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17
Q

what are the muscle compartments of the thigh

A

anterior
medial
posterior

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18
Q

what are the muscle compartments of the leg

A

anterior
lateral
posterior

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19
Q

where can the saphenous opening be found

A

inferiro to inguinal ligament whcih is a hole in the fascia lata

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20
Q

what is the fascia that surounds the opening of the fascia lata

A

the cribiform fascia

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21
Q

what is the cribiform fascia

A

subcutaneous tissue spreads over saphenous opening and closing it

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22
Q

What is the gluteal region ( buttocks)

A

transitional area between trunk and limbs

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23
Q

what are some gluteal region ligaments

A

sacrotuberous

sacrospinous

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24
Q

what is the sacrotuberous ligament of the gluteal region

A

goes from sacrum dorsal surface to ischial tuberosity

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25
Q

what is the sacrospinous ligament of the gluteal region

A

goes from margins of sacrum to ischial spine

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26
Q

what do the gluteal region ligaments create

A

they create the greater and lesser sciatic foramen

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27
Q

what is the greater sciatic foramen

A

helps with passage for strucutes in and out of the pelvis

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28
Q

what are the greater sciatic boundries

A

greater sciatic notch, sacrotuberous lig, and sacrospinus Lig

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29
Q

what takes up most of the greater sciatic forament space

A

the piriformis

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30
Q

what come out/ in above the pirifomris

A

superior gluteal vessel, Superior gluteal n

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31
Q

what come out/in below the piriformis

A

inferior gluteal vessels, internal pudendal vessels, inferior gluteal n., pudendal n , sciatic n, posteriro femoral cutaneous n., nerve to quadratus femoris, terve to obturator internus

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32
Q

what are some structures that pass from the perineum through the greater sciatic forament

A

internal pudendal a, nerve to obturator internus, pudendal n

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33
Q

what is the lesser sciatic foramen

A

passage for structures in and out of perineum

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34
Q

what are the boundries of the lesser sciatic formane

A

ischial tuberosity, sacrospinous lig, sacrotuberous lig

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35
Q

what is the path of nerve to obturator internus

A

travels through the greater sciatic forament inferior to the piriformis , but then loops back aroudn to reenter the pelivis through the lesser sciatic foramen

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36
Q

what is the path of the internal pudendal artery

A

it exits the pelvic cavity through the greater sciatic foramen to enter the gluteal region. it then curves aroudn the sacrospinous ligament to enter the perineum throgh the lesser sciatic foramen

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37
Q

what are the m. of the gluteal region

A

gluteus max, med, min

plus the lateral rotators

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38
Q

what does the gluteal region do for the tfl

A

tightens the fascia lata allowing the thigh mm. to increase the power

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39
Q

what are some different ways the sciatic n wraps around the pirirforms

A 
normal= it comes below the m. toghether 
1= the tibial n is below the m and the common fibular n is going through the m. 
2= the tibial n is going belwo and the common fiibular is going above the m.
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40
Q

where do the nerves of the lower limb come from

A

lumbar and sacral plexus

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41
Q

what is the spinal ns of the lumbar plexus

A

Ventral rami of L1-L4

and help from the subcostal n (T12)

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42
Q

what are the spinal ns of the scaral plexus

A

ventral rami of L4-L5
ventral rami of S1-4

( 2 main ns. are the sciatic and pudendal nn)

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43
Q

what is the lumbosacral trunk

A

descending part fo L4 unites with anterior ramus of L5 then joins sacral plexus
– this is not part of lumbar plexus

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44
Q

what is the cocygeal plexus

A

S5 and Co which form the coccygeal nerve

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45
Q

what are the nerves of the gluteal region and posterior thigh

A 
1= gluteal nerves= cutaneous nerves 
- superior cluneal n.
-middle cluneal n.
-inferior cluneal n. 
2=deep nerves
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46
Q

What is the spinal n. of the superior cluneal n.

A

dorsal rami of L1-L3

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47
Q

What does the the superior cluneal n. supply

A

superior 2/3 of the the buttock

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48
Q

what is the spinal n. of the middle cluneal n.

A

dorsal rami of S1-S3

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49
Q

What does the the middle cluneal n. supply

A

skin over sacrum and adjacent buttock

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50
Q

what is the spinal n. of the inferior cluneal n.

A

derived rom posterior femoral cutaneous n ( S2-S3)

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51
Q

What does the the inferior cluneal n. supply

A

larger, innervates inferior half of buttock

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52
Q

what are deep nerves of the gluteal/ posterior thigh regioin

A

all are branches of scaral plexus
all leave pelivs via greater sciatic formane
EXCEPT superior gluteal n . they emerge inferior to pirifomris m.

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53
Q

what is the spinal n. of the superior gluteal n.

A

L4-S1

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54
Q

what are the branches of the superior glureal n.

A
  • superior branch

- inferior branches

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55
Q

what does the superior branch of the superior gluteal n. supply

A

gluteus medisu

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56
Q

what does the inferior branch of the superior gluteal n. supply

A

gluteus medius
minimus
tensor fasciae latae

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57
Q

what are the spinal ns. of the inferior glutteal n

A

L5-S2

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58
Q

what do the branches of the inferior gluteal n innverate

A

glutues max

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59
Q

what are the spinal ns. of the sciatic n.

A

L4-S3

largest nerve in humans

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60
Q

what does the sciatic n supply

A

no muscles in gluteal region

supplies muscles in posterior compartment of thigh

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61
Q

what are the branches of the sciatic n.

A

tibial n.
common fibular n

( they separate about half way down the thigh)

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62
Q

what are the spinal ns of the posterior cutaneous ne of the thigh

A

S1-S3

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63
Q

what does the posterior cutaneous ne of the thigh supply

A

skin of buttock, perineum, posterior thigh, upper meidal thigh

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64
Q

what are the spinal ns of the nerve to the quadratus femoris m.

A

L4-S1

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65
Q

what does the nerve to the quadratus femoris m. supply

A

articular br. → to hip joint

muscular br. → quadratus femoris and inferior gemellus m.

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66
Q

what are the spinal nn. of the nerve to the obturator internus

A

L5-S2

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67
Q

what does the nerve to the obturator internus supply

A

obturator internus and superior gemellus

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68
Q

what are the spinal nn. of the pudendal n.

A

S2-S4

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69
Q

what does the pudendal n. supply

A

structures in the perineum

genitalia, sphincter urethra, anal sphincter

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70
Q

what are the arteries of the gluteal and posterior thigh region

A

all are branches of internal iliac artery

  • superior gluteal a
  • inferior gluteal a
  • internal pudendal a.
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71
Q

what is the superior gluteal a path

A

leaves pelvis thorugh greater sciatic foramen- superiorr to teh piriformis

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72
Q

what are the branches of the superior glureal a.

A

superficial branch

deep branch

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73
Q

what does the superficial branch of the superior gluteal a supply

A

gluteus maximus

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74
Q

what does the deep branch of the superior gluteal a supply

A

gluteaus medius
gluteaus minimus
TFL

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75
Q

what is the path of the inferior gluteal artery

A

leaves pelvis through greater sciatic formaen inferior to the pirifomris m

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76
Q

what does the infereior gluteal a supply

A

to gluteus max, obturator internus, quadratus fem, superior part of hamstring mm.

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77
Q

what is the internal pudendal a path

A

leaves pelvis through greater sciatic foramen and descends posteriro to the ischial spine then reenters the pelivs vis lesser sciatic foramen and enters perineum with pudendal nerve

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78
Q

what does the pudendal a supply

A

muscles in perineal region and external gentialia

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79
Q

what are the veins of the lower limb form the internal iliac v

A

gluteal veins

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80
Q

what are some superficial vv of the lower limb

A
  • small saphenous

- great saphenous

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81
Q

where does the small saphenous v begin

A

on lateral foot

82
Q

what creates the small saphenous v

A

union of dorsl venous arch and dorsal vein of little toe

83
Q

what is the path of the small saphenous v

A

passes posterior to lateral malleolus and ascends along the lateral side of the calcaneal tendon to popliteal fossa

84
Q

what does the small saphenous v run with

A

the sural n.

85
Q

where does the small saphenous v end

A

by unitin with popliteal v.

86
Q

what creates the great saphenous v

A

dorsal veins of great toe joins dorsal venous arch

87
Q

what is the great saphenous v path

A

ascends medially pssing anterior to medial malleolus with spahenous nerve to knee then pass 10cm posterior to medial border of patella then pass through saphenous opening enters femoral v.

88
Q

how does the deep veins travel

A

they accompany the major aa.

89
Q

what are the deep veins

A

anterior tibial v
fibular vein
posterior tibial v

90
Q

where do all the deep veins drian into

A

popliteal v

91
Q

what creates the posterior tibial v

A

plantar arch unites with the medial and lateral plantar vv

92
Q

what are perforating veins

A

drain blood from superficial veins to deep veins- valves allow only this one way flow
and they perforate fascia of muscles

93
Q

what are some cutaneous ns. of the lower limb

A
  • subcostal n
  • ilioinginal n
  • genitofemoral n
  • iliohypogastric n
  • lateral cutaneous n. of thigh
  • anterior cutaneous br of femoral n
  • posterior cutaneous n of thigh
  • cutaneous br. of obturator n.
94
Q

what is the spinal n of subcostal n

A

T12

95
Q

what does the subcostal n supply

A

skin of hip inferior to anterior iliac crest and anterior to greater trochanter

96
Q

what is the spinal n of ilioinguinal n

A

L1

97
Q

what does the ilioinguinal n supply

A

skin of superomedial area of thigh, over medial femoral triangle

98
Q

what is the spinal n of iliohypogastric n

A

L1

99
Q

what does the iliohypogastric n supply

A

superolateral quadrant of buttock

100
Q

what are the branches of the genitofemoral n

A

femoral br.

genital br

101
Q

what is the spinal n of the femoral br.

A

L1-L2

102
Q

what does the femoral br. supply

A

supply skin over lateral femoral triangle

103
Q

what is the spinal n of the genital br.

A

L1-L2

104
Q

what doe the genital br. supply

A

supply external genitalia

105
Q

what is the spinal n of the lateral cutaneous n. of thigh

A

L2,L3

106
Q

what does the lateral cutaneous n. of thigh supply

A

direct br. of lumbar plexus to skin on anterior and lateral aspects of thigh

107
Q

what is the spinal n of the anterior cutaneous br. of the femoral n

A

L2-L4

108
Q

what does the anterior cutaneous br. of the femoral n supply

A

supply skin on anterior and medial sided of thigh

109
Q

what is the spinal n of the posterior cutaneous n. of the thigh

A

S1-S3

110
Q

what does the posterior cutaneous n. of the thigh supply

A

branch of sacral plexus, supplies the skin on posterior aspect of the thigh and posterior to knee

111
Q

what is the spinal n of the cutaneous br. of obturator n

A

L2-L4

112
Q

what does the cutaneous br. of obturator n supply

A

skin of middle part of medial thigh

113
Q

what are the popliteal fossa nerves

A
  • tibial n
  • comon fibular n
  • sural n.
114
Q

what happens to the sciatic n in the superior popliteal fossa

A

the sciatic n

115
Q

what does the tibial n supply

A

in fossa br. to soleus, gastroc, plantaris , popliteus

116
Q

what is the branch of the tibial n

A

medial sural cutaenous n

117
Q

where does the common fibular n divide

A

around the neck of the fibula

118
Q

what are the branches of the common fibular n

A

superficial fibular n
deep fibular n
lateral sural cutaneous n

119
Q

what forms the sural n

A

medial sural n ( of tibial n ) and the lateral sural cutaenous n (from common fibular n )

120
Q

why are the thigh mm. put into their groups

A

by there location, action, nerve supply and are separated by intermuscular septa

121
Q

where can the pectineus m found

A

in 2 different layers

    • lateral part ( lateral femorall n )
  • -meidal part ( branch from obturator n )
122
Q

what does the sartorius cover up

A

the femoral artery

123
Q

what is the controversy m of the thigh

A

the vastus medialsi is the VMO

124
Q

what is so different about the vmo

A

it is reported to have a more oblique orientation creating a better pull on patella medially
BUT many anatomists beleve they are parallel

125
Q

what are the articualr m of the knee

A

they arise from the vastus intermedius fiber
O: ant. surface fo femur above patell
I: synovial capsule of knee and wall of suprapatellar bursa
A: pulls synovial capsule superiorlyduring extension of knee so it willnot get cuaght in knee joint

126
Q

what are the medial and lateral patellar retinacula

A

portions of quadriceps tendon inserted onto upper tibia and contribute to knee joint capsule

127
Q

what is the patella

A

large triangular sesamoid bone in the tendon of the quadriceps

128
Q

what attaches patella ligament attach too

A

the tibial tuberosity

129
Q

what does the patella ligaments articulate with

A

the patellar groove of the femur

130
Q

what does the patella ligament do

A

increases leverage for muscles of lower limbs

131
Q

what is the continuation of the patellar ligament

A

of the tendon of quadricpes

132
Q

read slides

A

64

133
Q

what divides the obturator n

A

the adductor brevis

then it becomes the anterior and posterior

134
Q

what does the anterior obturator n supply

A

adductor longus, gracillis, adductor brevis

135
Q

what does the posterior obturator n supply

A

obturator externus, adductor magnus, adductor brevis, articular to knee

136
Q

what is the adductor hiatus

A

opening in the aponeruotic attachment leads inot popliteal fossa

137
Q

what is the adductor minimus

A

upper fibers of adductor magnusm

– sometimes the upper fivers are separate

138
Q

what forms the Pes Anserinus

A

the gracilis , sartorius, and semitendious

139
Q

what doe the SGT FOS

A

gracilis , sartorius, and semitendious

femoral n, obturatorn, sciatic n.

140
Q

what is the femoral triangle and adductor canal

A

triangular subfascial sace in superomedial 1/3 of the thigh

141
Q

where can the femoral triangle and adductor canal be found

A

inferior to the inguinal ligament when thigh is actively flexed at hip joint

142
Q

what are the main contians of the femoral triangle and adductor canal

A

femoral vessels and branches of femoral nerve

143
Q

what are the boundaries of the femoral triangle and adductor canal

A 
superior= inguinal ligaments form base
medially= lateral border of adductor longus 
laterally= medial border of sartoris  ( femoral pulse )
144
Q

what are the spinal n of femoral n

A

L2-L4 ( largest branch of lumbar plexus )

145
Q

what does the femoral n divid into

A

muscular and cutaneous brnaches

146
Q

what does the femoral n supply

A

the anterior thigh m, knee and hip joints and to skin o n anteromedial side of lower limb

147
Q

what does anterior division of the femorla n supply

A

cutaneous and muscular to pectineus and sartoris

148
Q

what does the posterior division of the femoral n supply

A

muscular to quadriceps and articualr to knee

149
Q

what is the saphenous n

A

cutaneous branch of femoral n.

150
Q

where does the saphenous n go

A

descend through femoral triangle and passes through the adducto canal BUT not through the adductor hiatus

151
Q

what does the saphenous n become

A

superficial between the gracilis and sartorisu

152
Q

what does the saphenous n supply

A

the skin and fascia on meidal side of the leg and foot

153
Q

where does the femoral a come from

A

continuation of external iliac artery

154
Q

what are the branches of the femoral a

A 
superifical epigastric a 
superficial circumflex iliac a
superficial external pudendal a 
deep external pudendal a 
deep femoral a -- deep artery of the thigh 
descending genicualr a 
popliteal a
155
Q

where does the descending genicualr a. arise

A

just before it passes through the adductor hiatus

156
Q

what are the branches of the descending genicular a

A
  • saphenous branch

- musculor articular br.

157
Q

what does the superifical epigastric a supply

A

pubis and inferior umbilical region

158
Q

what does the superficial circumflex iliac a supply

A

inguinal region and adjacent anterior thigh

159
Q

what does the superficial external pudendal a supply

A

upper medial thigh, pubic region

160
Q

what does the deep external pudendal a supply

A

pectineus m., adductor longus m, external genitalia

161
Q

what does the deep femoral a – deep artery of the thigh supply

A

hip joint, proximal and posterior thigh

162
Q

what does the descending genicualr a supply

A

skin and superficial structures of the medial aspect of the knee and upper leg

163
Q

what are the branches of the deep femoral a.

A

medial circumflex femoral a
lateral circumflex femoral a
perforating branches

164
Q

what does medial circumflex femoral a supply

A

head and neck of femur

165
Q

what is a branch of the medial circumflex femoral a

A

posterior retinacular artery

this is often torn in the femoral neck is fractured

166
Q

what does the lateral circumflex femoral a supply

A

the mm. on lateral side of thigh

167
Q

what happens to the transverse branch of the lateral circumflex femoral a

A

winds around femur

168
Q

what happens to the descending branch of the lateral circumflex femoral a

A

joins genicular anastomoses

169
Q

what does the obturator a do

A

assist deep femoral artery supply adductor m of the thigh

170
Q

where does the obturator a travel through

A

through the obturator foramen entering the thigh

171
Q

what does the obturator a divide into

A

anterior and posterior branches

172
Q

what does the posterior division of the obturator a supply

A

adductor m, knee capsule, small branch to head of femur

173
Q

what does the anterior division of the obturator a supply

A

adductor brevis, skin of_________________?

174
Q

where does the obturator n arise from

A

either internal iliac artery or from inferior epigastric artery

175
Q

where does the femoral v enter from

A

thigh medial to femoral artery

176
Q

what does the femoral v pass over

A

the pectineus

177
Q

where does the femoral v end

A

posterior to inguinal ligaments where ti becomes external iliac vein

178
Q

what happens to the femoral vein in the femoral triangle

A

it receives the deep femoral v., great saphenous v and other tributaries

179
Q

what is the femoral sheath

A

oval, funnel shaped fascial tube

180
Q

what does the femoral sheath contain

A

prosimal femoral vessels BUT NOT the femoral nerve

181
Q

what are the 3 compartments of the femoral sheath

A

lateral
intermediate
medial

182
Q

what is in the lateral compartment of the femoral sheath

A

femoral a

183
Q

what is in the intermediate compartment of the femoral sheath

A

femoral v

184
Q

what is in the medial compartment of the femoral sheath

A

a space = femoral canal

185
Q

what is the adductor canal

A

narrow fascial tunnel in thigh

–intermuscular passage for femoral vessel to popliteal fossa

186
Q

what can be found in the adductor canal

A

saphenous n. and femoral a

187
Q

what happens with the saphenous n

A

the nerve pierces deep fascia and passes down the medial side of the leg with the great saphenous v.

188
Q

what leaves the adductor canal

A

the femoral artery and v leave the canal through the adductor hiatus

189
Q

what is the popliteal fossa

A

a diamond shaped region posterior to knee

– between semiten and biceps femoris tendon

190
Q

what are the boundries of the popliteal fossa

A

superiorlatrally: by beceps femoris
superomedially: semimembranous and semitendinous
inferolaterally: latera head of gastrocnemius
inferomedially: medial head of gastrocnemius

191
Q

what are the contents of the popliteal fossa

A 
popliteal vessels ( artery , veins and lymph)
tibial nerves
common fibular nerves
small saphenous veins 
4 to 6 popliteal lymph nodes
192
Q

what is the popliteal a the continuation of

A

femoral artery

193
Q

where does the popliteal a start

A

at adductor hiatus

194
Q

where does the popliteal a end

A

at inferior border of popliteus by dividing into anterior and posterior tibial aa.

195
Q

what are the branches of the popliteal a

A
  • genicular br.

- muscualr br.

196
Q

what are the branches of the genicular a of the popliteal a

A
  • superior lateral
  • superior medial
  • middle
  • inferior lateral
  • inferior medial

= these form the genicular anastomoese aroudn the knee

197
Q

what does the muscular branches of the popliteal a supply

A

hamstrings, gastroc, soleus, plantaris
— the sural arteries form the poplitieal artery to muscles in posterior leg that anastomeose with posterior tibial, middle and lateral inferior genicular arteries

198
Q

where does the popliteal v begin

A

at distal border of popliteus m.

199
Q

what is the popliteal v a continuation of

A

posterior tibial v.

200
Q

what does the popliteal v become

A

femoral v as it enters adductor hiatus then becomes external iliac v above inguinal ligament

Anatomy (18 decks)

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