Anatomy of the Lower Limb

Question 1

what are the 6 regions of the lower limb?

Answer 1

gluteal
femoral
knee
leg
ankle 
foot

Question 2

what is the acetabulo-femoral joint and what type of joint is it?

Answer 2

hip joint

ball and socket synovial joint

Question 3

what movements does the hip joint allow?

Answer 3

flexion/extension
abduction/adduction
medial/lateral rotation
circumduction

Question 4

what is the purpose of the spiral formation of ligaments in the hip joint?

Answer 4

brings 2 sides closer together when twisted and makes it more stable when standing

Question 5

what are the 3 ligaments in the hip?

Answer 5

iliofemoral
ischiofemoral
pubofemoral

Question 6

what is the primary blood supply to the head of the femur?

Answer 6

medial circumflex femoral artery

Question 7

genu prefix?

Answer 7

knee

Question 8

femoral triangle contents?

Answer 8

NAVY from medial to lateral
- femoral Nerve
femoral Artery
femoral Vein
lYmphatics

Question 9

what is the ligamentum teres?

Answer 9

round ligament of the femur

Question 10

how might a femoral neck fracture result in ischaemia

Answer 10

can cause damage to intracapsular retinacular arteries which surround it

Question 11

what type of joint is the knee and what does this allow?

Answer 11

modified synovial hinge joint

allows flexion/extension and slight rotation to help stabilise

Question 12

what are the 3 main joints/articulations of the knee?

Answer 12

medial and lateral tibiofemoral
patellofemoral
(additional joint on lateral side - proximal tibiofibular joint)

Question 13

what muscles help to stabilise the knee?

Answer 13

quadriceps in the anterior thigh

Question 14

what are the extracapsular ligaments?

Answer 14

ligaments outside of the knee joint capsule

• patellar ligament
• lateral collateral ligament (thin cord)
• medial collateral ligament (wide and flat)

Question 15

what are the intra-articular ligaments?

Answer 15

ligaments within the knee joint capsule
- anterior cruciate (ACL)
- posterior cruciate (PCL)
ACL and PCL cross over inside the knee

Question 16

what do the ACL and PCL do?

Answer 16

ACL - prevents anterior movement of tibia away from femur

PCL - prevents posterior movement of tibia away from femur

Question 17

what are the menisci?

Answer 17

crescent shaped fibrocartilage that sit around the condyles of the femur like an egg cup, supporting them

Question 18

what is the Q angle?

Answer 18

angle between the femur and tibia
usually non-existent as they should line up perfectly
genu varum = separation at lateral side
genu valgum = separation at medial side

Question 19

how do nerves enter/exit pelvis?

Answer 19

via greater and lesser sciatic foramen (separated by sacrospinous and sacrotuberous ligament)

Question 20

what do the greater and lesser sciatic foramen allow entry to?

Answer 20

greater = gluteal region
lesser = perineum

Question 21

where does the sciatic nerve originate and what does it innervate?

Answer 21

originates L4 - S3

supplies posterior thigh, leg, foot and most of skin (nothing in gluteal region)

Question 22

where does the pudenal nerve originate and what does it supply?

Answer 22

S2-S4
supplies perineum (pelvic floor - 2,3,4 keeps guts off the floor)

Question 23

where does the posterior cutaneous nerve of the thigh originate and what does it supply?

Answer 23

S1-S3

supplies skin over posterior thigh, popliteal fossa, lateral perineum and upper medial thigh

Question 24

what are the superficial muscles of the gluteal region and what do they do?

Answer 24

gluteus maximus
gluteus medius
gluteus minimus
tensor fascia latae
extend, abduct and medially rotate)

Question 25

how are the superficial gluteal muscles innervated?

Answer 25

inferior gluteal supplies gluteus

superior gluteal supplies the rest

Question 26

what are the deep gluteal muscles and what do they do?

Answer 26

piriformis
obturator internus
gemelli
quadratus femoris
lateral rotation of thigh and hip stabilisation

Question 27

what nerve supplies the deep gluteal muscles?

Answer 27

nerves from sacral plexus

Question 28

what is a trendelenberg gait?

Answer 28

reduced function of superior gluteal nerve causing weak hip abduction by the gluteus medius
results in dropping of hip on opposite side (camp, swinging hips walk)

Question 29

what are the 2 portions of the sciatic nerve? describe its course

Answer 29

tibial nerve (larger, medial)
common fibular (smaller, lateral)
exists inferior to piriformis
seen most laterally exiting greater sciatic foramen

Question 30

how are compartments formed?

Answer 30

invagination of deep fascia form septums between groups of muscles

Question 31

what are the 3 compartments of the thigh?

Answer 31

anterior, medial and posterior

Question 32

what are the 3 compartments of the leg?

Answer 32

anterior, lateral, posterior

Question 33

what is compartment syndrome and how is it treated?

Answer 33

increased pressure in a compartment (e.g from bleeding) can affect function of muscles, nerves and vessels
fasciotomy is performed to relieve pressure

Question 34

what two types of muscle function are seen in the anterior thigh?

Answer 34

flexors of the thigh

extensors of the leg

Question 35

name 3 muscles in the anterior thigh and what they do

Answer 35

sartorius = flexor of thigh
vastus = extensor of leg
rectus femoris = both

Question 36

what nerve innervates muscles in anterior thigh?

Answer 36

femoral nerve (apart from psoas major)

Question 37

what features form the boundaries of the femoral triangle?

Answer 37

superior = inguinal ligament
medial = medial adductor longus
lateral = medial sartorius
floor = iliopsoas and pectineus
roof = deep fascia (fascia lata)

Question 38

what is contained within the medial compartment of the thigh and how are they innervated?

Answer 38

adductors of thigh
- adductor muscles
- gracilis
- obturator
innervated by obturator nerve

Question 39

what s contained within the posterior compartment of the thigh and how are they innervated?

Answer 39

extensors of thigh and flexors of leg
- semitendinous (cord like)
- semimembranous (flat)
- biceps femoris
supplied by tibial part of sciatic nerve

Question 40

what 2 groups of muscles exist in the posterior compartment of the leg?

Answer 40

superficial - plantarflexors of ankle

deep - flexors of toes and plantarflexors of ankle

Question 41

what supplies muscles in posterior compartment of leg?

Answer 41

tibial nerve

Question 42

what is contained within anterior compartment of the leg and what innervates them?

Answer 42

dorsiflexors of ankle and extensors of toes

innervated by deep fibular nerve

Question 43

what is contained within the lateral compartment of the leg?

Answer 43

muscles which evert the foot and plantarflex ankle

innervated by superficial fibular nerve

Question 44

what is deep fibular nerve palsy and what causes it?

Answer 44

reduced/absent dorsiflexion of ankle due to loss of muscle action in anterior leg compartment

Question 45

what are the boundaries of the popliteal fossa?

Answer 45

superolaterally - biceps femoris
superomedially - semimembranous
inferiorly - gastrocnemius
roof - popliteal fascia

Question 46

what are the contents of the popliteal fossa?

Answer 46

fat
end of small saphenous vein
tibial and common fibular nerves (sciatic)
popliteal vessels (anastomoses and collaterals)

Question 47

what is the calcaneal tendon?

Answer 47

achilles tendon
strongest tendon in body
attaches to calcaneal tuberosity of calcaenous
tests S1 and S2 nerve root function via ankle jerk reflex

Question 48

what 2 tendons join to form the achilles?

Answer 48

gastronaemus

soleus