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Anatomy > Lower Extremity > Flashcards

Lower Extremity Flashcards

1
Q

Label a superficial N. diagram for the LE

A

see notes

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2
Q

Describe the nerve supply to the LE in regards to compartments

A

ant/ext. compartment = femoral N.
med./adductor compartment = obturator N.
post/flex. compartment = sciatic N.

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3
Q

Sartorius

A

O: ASIS
I: medial tibial condyle
A: hacky sack position (hip flexion, abd,lat. rot., knee flex & med. rot.
N: femoral N (L2-L3) –> branch = nerve to sartorius

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4
Q

Rectus Femoris

A

O: AIIS
I: base of patella and tibial tuberosity (through patellar lig.)
A: hip flexion, knee ext.
N: femoral N. (L2-L4) –> branch = nerve to rec. fem

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5
Q

Vastus Lateralis

A

O: intertrochanteric line, inf. border of greater trochanter, glut tuberosity, lateral lip of linea aspera
I: lateral margin of patella and tibial tuberosity (through patellar log.)
A: ext. of knee
N: femoral N. (L2-L4) - branch = nerve to vastus lateralis

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6
Q

Vastus Medialis

A

O: intertrochanteric line, medial lip of linea aspera, medial supracondylar line
I: medial border of patella and tibial tuberosity (through patellar lig.)
A: ext. of knee, prevents lateral dislocation of patella at last 30° of knee ext.
N: femoral N. (L2-L4 - branch = nerve to vastus medialis

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7
Q

Vastus Intermedius

A

O: anterior and lat. surfaces of upper femur, linea aspera, lateral supracondylar line
I: base of patella and tibial tuberosity (through patellar lig.) - deepest fibres attach to capsule
A: ext. of knee
N: femoral N. (L2-L4) - branch = nerve to vastus intermedius

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8
Q

Iliacus

A

O: upper iliac fossa, Ala of sacrum, AIIS
I: lesser trochanter of femur (w Psoas Major)
A: hip flexion, also some lat. rot of hip b/c ant. attachment of illiim
N: femoral N. (L2-L3)

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9
Q

Psoas Major

A

O: TVP of all lumbar, VB of TXII-LV, and intervertebral discs
I: lesser trochanter of femur
A: *hip flexion, reverse fx = (hip stabilized) - pulls lumbar region ant. so increase in lumbar lordosis
N: L1-L4

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10
Q

Adductor Longus

A

O: body of pubis inf. to pubic crest
I: linea aspera
A: adduction of hip, some hip flexion
N: obturator (L2-L4)

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11
Q

Adductor Brevis

A

O: body and inf. ramus of pubis
I: pectineal line and linea aspera
A: adduction of hip, flexion of hip
N: obturator (L2-L4)

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12
Q

Gracilis

A

O: body and inf. ramus of pubis
I: medial tibial condyle
A: adduction of hip, flexion and med. rot of knee (leg)
N: obturator (L2-L3)

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13
Q

Adductor Magnus

A

Adductor Portion
O: ischiopubic ramus
I: glut tuberosity, linea aspera, and medial supracondylar line
A: add/flex of hip

Hamstring Portion:
O: ischial tuberosity
I: adductor tubercle
A: extension of hip
N: sciatic (L4)

N: obturator (L2-L4), and sciatic (L4) - dual innervation

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14
Q

Describe the femoral sheath

A

a fascial envelope with 3 longitudinal compartments

1) lateral - femoral A.
2) intermediate - femoral V.
3) medial - aka femoral canal - lymph nodes

*entrance to femoral canal is known as the femoral ring - loops of intestine can pass through here and lead to femoral hernia

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15
Q

What is the femoral triangle?

A

-a transitional area (major blood vessels and Nn. leave one area to get to the next
Floor = illiopsoas, pectineus, add. longus
Med border - add. longus/gracilis
Lat. border - sartorius
Sup. border - inguinal lig.

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16
Q

Fill in diagram of femoral N. path and it’s branches

A

see notes

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17
Q

Complete a LE Artery diagram

A

see notes

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18
Q

Biceps Femoris

A

O: ischial tuberosity (long head), linea aspera & lat. supracondylar line (short head)
I: head of fibula
A: *knee flexion, lat. rot and hip ext.
Reverse Fx: post. pelvic tilt, decr. lumbar lordosis
N: tibial N (long head), common fibular (short head) divisions of sciatic (L5-S2)

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19
Q

Semi-tendinosus

A

O: ischial tuberosity
I: medial surface of tibia
A: knee flexion and med. rot.; hip ext and post. tilt of pelvis
N: tibial division of Sciatic (L5-S2)

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20
Q

What is polio gait caused by?

A

Lost quads, no heel strike (no knee ext.)

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21
Q

Semi-membranosus

A

O: ischial tuberosity
I: medial condylar groove
A: knee flexion and med. rot.; hip ext and post. tilt of pelvis
N: tibial division of Sciatic (L5-S2)

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22
Q

Draw the acronym for lumbar plexus

A 
S ubcostal -             T12
I liohypogastric -       L1
I lioinguinal -             L1
G enitofemoral -        L1-L2
L at. cut. N of thigh - L1-L2
O turator                  L2-L3-L4
F emoral                  L2-L3-L4
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23
Q

Name the borders of the popliteal fossa and the contents

A

Sup - hamstrings
Lat - biceps femoris
Med - semi-tendonosus
Inf. - gastroc (lat & med heads)

Contents:

  • popliteal A&V (continuation of femoral A&V
  • tibial and common fib divisions of sciatic N.
  • lymph nodes
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24
Q

What type of joint is the knee joint?

A

-hinge joint

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25
Q

Describe the orientation of the PCL

A

PAIN

Post. cruciate lig
Anterior in direction
INternal condyle (medial condyle) of femur

Origin = post. intercondylar area
Insertion = medial condyle of femur
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26
Q

Describe the orientation of the ACL and it’s attachments

A

APEX

Ant. cruciate lig
Posteriorly in direction
EXternal (lateral) condyle of femur

Origin = ant. intercondylar area
Insertion = lat. condyle of femur
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27
Q

What is the purpose of the ACL and PCL?

A
  • ant and post. stability

- they are stronger/more stable with medial rotation (med rot. makes ligs shorter = holds everything tighter)

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28
Q

The collateral ligaments in the knee are most stretched in what position?

A

Lateral rotation

Tip: think “co-lateral” lig are stretched in lateral rot.

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29
Q

List the ligaments of the knee joint and their function

A
  • ACL, PCL (ant. post. stability)
  • MCL, LCL (med. and lat. stability)
  • oblique popliteal lig. (prevents hyperext. of knee w. arcuate lig.) - is a continuation of semimembranosus tendon
  • arcuate lig. -
  • meniscofemoral lig. (from lat. meniscus to med. femoral condyle - sometimes called humphrey lig.
30
Q

What is the purpose of menisci in the knee joint?

A
  • shock absorber

- deepen tibial plates

31
Q

What is the purpose of the horns (ant. and post) of the menisci in the knee joint?

A

-acts as a pivot point, the horns are where the menisci attach to the bone - allows menisci to slide

32
Q

Which menisci is more mobile?

A

lateral b/c it is attached to politeus M. (muscle has more mvm’t than the MCL which is attachement point of medial meniscus

33
Q

Does the knee joint roll then glide when going from extension to flexion or glide to roll?

A

rolls for first 20° knee flexion, then replaced with gliding - gliding has more friction - so with arthritis - safest mvm’t range is 15-20° flex maximum. (at 90° movm’t is purely gliding)

34
Q

Tibialis Anterior

A

O: lateral tibial condyle, lateral surface of tibia, interosseous membrane
I: *medial cuneiform, base of 1st MT
A: DF of ankle, inversion of foot
N: Deep Fibular N. (L4,L5)

35
Q

Extensor Hallucis Longus (EHL)

A

O: shaft of fibula, interosseous membrane
I: 1st DIP
A: ext of 1st MTP, PIP and DIP, ankle DF
N: Deep Fibular N. (L5-S1)

36
Q

Extensor Digitorum Longus (EDL)

A

O: lateral tibial condyle, ant. surface of fibula, interosseous membrane
I: mid and distal phalanges of lateral 4 toes
A: ext of MTP, PIP and DIP of lateral 4 toes, ankle DF
N: Deep fibular N. (L5,S1)

37
Q

Fibularis Tertrius

A

O: surface of fibula (distal, ant.), interosseous membrane
I: base of 5th MT
A: ankle DF, eversion
N: Deep fibular N. (L5,S1)

*considered anterior compartment b/c of innervation

38
Q

Fibularis Longus

A 
Lateral Compartment
O: head of fibula
I: medial cuneiform, base of 1st MT (passes underneath foot (plantar aspect) to medial cuneiform)
A: *eversion, PF
N: superficial fibular (L5-S2)
39
Q

Fibularis Brevis

A 
Lateral Compartment
O: surface of fibula (distal, lateral)
I: base of 5th MT
A: PF and eversion of foot
N: superficial fibular (L5-S2)
40
Q

What holds the tendons of the lateral compartment in place (prevents them from bowing?)

A

Fibular retinaculum

-stretches from calcaneus to lateral malleolus

41
Q

Complete a diagram of the LE innervation

A

see notes

42
Q

What is a steppage gait?

A

gait pattern when fibular nerve is damaged (ant. compartment)
-this causes foot drop from lack of active DF, so steppage gait increase in hip flexion to kick knee out to allow passive DF of foot via momentum

43
Q

Gastrocnemius

A

O: lateral and medial femoral condyles
I: post. calcaneus
A: PF, assist knee flexion
N: tibial N. (S1-2)

44
Q

Soleus

A

O: fibular head, *soleal line, post. surface tibia
I: post. calcaneus
A: *PF, stability of leg on foot
N: tibial N. (S1-2)

45
Q

The soleus M. and gastroc M. together are called what?

A

Triceps Surae

46
Q

Plantaris

A 
O: lateral condyle of femur
I: post. surface of calcaneus
A: PF, assist flexion of knee
N: tibial N. (S1-2)
*some ppl don't have this M. - not that useful
47
Q

Popliteus

A

O: lateral femoral condyle, lateral meniscus
I: post. surface of tibia
A: knee flex, med rot. of leg (lat. rot. of thigh), pulls lat. meniscus posteriorly in knee flexion to prevent entrapment between femur and tibia
N: tibial N. (L4-S1)

48
Q

Flexor Hallucis Longus

A

O: post. fibula
I: base of 1st DP (passes behind medial malleolus
A: *big toe flexion (all joints), PF of ankle, supports medial longitudinal arch
N: tibial N (S2-S3)

49
Q

Flexor Digitorum Longus

A

O: post. surface of tibia
I: DP of lateral 4 toes (passes behind medial malleoulus)
A: *flexion of lateral 4 toes (all joints), PF ankle, support of longitudinal arches of foot
N: tibial (S2-S3)

50
Q

Tibialis Posterior

A

O: post. surface fibula, interosseus membrane
I: navicular tuberosity, cuboid, cuneiforms, bases of 2nd-4th MT’s
A: PF, inversion, maintain medial longitudinal arch*
N: tibial N. (L4,L5)

51
Q

Which structures go through the tarsal tunnel?

A

Tom Dick And Not Harry

Tib post
eDl
post. tibial A.
tibial N.
fHl
52
Q

There are 3 joints between the tibia and fibula. What are they, what type of joint are they, and what ligaments are involved with each?

A

superior tibio fibular - synovial planar; ant. ligament of fibular head
middle Tibiofibular joint - syndesmosis joint; interosseous lig.
inferior tibiofibular joint - syndesmosis joint; ant and post. tibiofibular ligaments

53
Q

Abductor Hallucis

A

O: plantar aponeurosis, inf. surface of calacaneus
I: med. surface of PP of 1st toe
A: abduction and flexion of 1st toe
N: medial plantar (S1-S3)

54
Q

Flexor Digitorum Brevis

A

O: inf. surface of calcaneus
I: med. and lat. surfaces of base of middle phalanges of lateral 4 toes
A: flexion of lateral 4 toes
N: medial plantar (S1-S3)

55
Q

Abductor Digiti Minimi

A

O: med. and lat. tubercles of calcaneal tuberosity
I: lat. surface of base of proximal phalanx of 5th toe
A: flexion and abduction of 5th toe
N: lateral plantar (S2-S3)

56
Q

Quadratus Plantae

A

O: med. and lat. plantar surface of calcaneus
I: lateral border of FDL tendon
A: flexion of lateral 4 toes (assists)
N: lateral plantar (S2-S3)

57
Q

Lumbricals of foot

A

O: tendons of FDL
I: medial side of dorsal digital expansion of lateral 4 toes
A: flexion of MTP’s and extension of PIP’s and DIP’s of lateral 4 toes

*note - no bony attachment - soft tissue to soft tissue
N: medial plantar (first lumbrical), lateral plantar (lateral 3 lumbricals)

58
Q

Flexor Hallucis Brevis

A

O: plantar surface of cuboid
I: med. and lat (two heads) surfaces of base of proximal phalanx of 1st toe
A: flexion of MTP of 1st toe
N: medial plantar (S2-S3)

59
Q

Adductor Hallucis

A

O: bases of 2nd - 4th MT’s (oblique and transverse head); fibularis longus tendon (oblique head)
I: lat. surface of base of proximal phalanx of 1st toe
A: adduction of 1st toe, maintenance of transverse arch of foot
N: deep branch of lateral plantar nerve (S2-S3)

60
Q

Flexor Digiti Minimi Brevis

A

O: base of 5th MT and fibularis longus tendon
I: base of PP of 5th toe
A: flexion of MTP of 5th toe
N: superficial branch of lateral plantar N. (S2-S3)

61
Q

Plantar Interossei

A

O: medial surfaces of 3rd-5th MT’s
I: medial surfaces of dorsal digital expansion of corresponding toe
A: adduction of 3rd-5th toes
N: lateral plantar N. (S2-S3)

*PAD - plantar does ADduction

62
Q

Dorsal Interossei

A

O: adjacent surfaces of 1st-5th MT’s
I: medial PP of 2nd toe; lateral PP of 2nd-4th toes; dorsal digital expansion
A: abduction of 2nd-4th toes
N: lateral plantar N. (S2-S3)

  • DAB - dorsal does ABduction
  • 2nd toe is the axis of reference for abduction/adduction - so 2nd toe does abduction in 2 directions (no adduction)
63
Q

Extensor Digitorum Brevis

A

O: lateral calcaneal surface, inf. band of extensor retinaculum
I: lateral tendons of EDL for 2nd-4th toes, dorsal digital expansion of those toes
A: extension of MTP’s and IP’s of 2-4th toes
N: deep fibular nerve (L5-S1)

64
Q

Extensor Hallucis Brevis

A

O: lateral calcaneal surface, inf. band of extensor retinaculum
I: base of proximal phalanx of 1st toe
A: extension of MTP of 1st toe
N: deep fibular nerve (L5-S1)

65
Q

Describe the innervation of the foot

A

-See notes diagram

66
Q

Label the arterial diagram of the foot

A

-See notes diagram

67
Q

What is the technical name for the ankle joint? What type of joint is it? What are the supporting ligaments?

A

Talocrural joint - hinge joint
Medial lig - post. tibio-talar, tibio-navicular, ant. tibio-talar
Lateral lig - post. talo-fibular, calcaneo-fibular, ant. talo-fibular

68
Q

What are the ligaments of the transverse tarsal joint?

A

long plantar lig, short plantar lig, plantar calcanei-navicular (spring), plantar cuboido-navicular (not imp.)

69
Q

What are the ligaments supporting the subtalar joint?

A

-med, lat, post, interosseous talo-calcaneal lig’s

70
Q

Which ligaments maintain the horizontal arches and therefore, are the most important supportive ligaments of the foot?

A

-plantar metatarsal, plantar tarso-metatarsal, plantar plate, deep transverse metatarsal

71
Q

Name the 3 arches of the foot

A
  • medial longitudinal arch
  • lateral longitudinal arch
  • transverse
72
Q

What two muscles are the most important in maintaining the medial longitudinal arch?

A
  • fibularis longus

- tibialis posterior

Anatomy (10 decks)

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