Basic Anatomy of the Lower Limb Flashcards

1
Q

Where do the lower limbs extend from?

A

The pelvis

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2
Q

What are the functions of the lower limbs?

A

Support body weight, locomotion, maintain balance

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3
Q

What are the six regions of the lower limbs?

A

Gluteal, femoral (thigh), knee, leg, ankle, foot

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4
Q

Where do nerves enter/exit the pelvis and perineum in the gluteal region?

A

Via the greater (for pelvis) and lesser (for perineum) sciatic foramen

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5
Q

What forms the greater and lesser sciatic foramen?

A

The sacrotuberous and sacrospinous ligaments

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6
Q

What makes up the superficial muscle groups of the gluteal region?

A

Gluteus maximus, gluteus medius, gluteus minimus, tensor fascia latae; extensors, abductors and medial rotators of thighs

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7
Q

What are the superficial muscle groups of the gluteal region innervated by?

A

Gluteus maximus = inferior gluteal

All others = superior gluteal

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8
Q

What is Trendelenburg’s gait?

A

Abnormal gait caused by weakness of abductor muscles of lower limbs, gluteus medius and gluteus maximus; caused by lesions of superior gluteal nerve

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9
Q

What makes up the deep muscle groups of the gluteal region?

A

Piriformis, obturator internus, gemelli, quadratus femoris; lateral rotators of thigh and hip stabilisers

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10
Q

What are the deep muscles of the gluteal region innervated by?

A

Nerves from the sacral plexus

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11
Q

What nerves are present in the gluteal region?

A
Sciatic nerves (L4-S3)
Pudendal nerves (S2-S4)
Posterior cutaneous nerve of the thigh (S1-S3)
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12
Q

Where does the sciatic nerve supply?

A

Posterior thigh, all leg and foot muscles and most of the skin via tibial and common fibular branches (largest nerve in body)

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13
Q

Where does the pudendal nerve supply?

A

Principal nerve of the perineum

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14
Q

Where does the posterior cutaneous nerve of the thigh supply?

A

Skin over posterior thigh, popliteal fossa, lateral perineum and upper medial thigh

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15
Q

Where does the sciatic nerve usually exit the spinal column?

A

Inferior to the piriformis

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16
Q

What is normally the most lateral structure exiting the greater sciatic foramen?

A

The sciatic nerve

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17
Q

What is the name of the artery that supplies the sciatic nerve?

A

Artery to the sciatic nerve

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18
Q

Does the sciatic nerve supply anything in the gluteal region?

A

No-passes down posterior to thigh

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19
Q

Where does the sciatic nerve separate, and what does it separate into?

A

Separates in distal thigh to tibial nerve (larger, medial) and the common fibular (smaller, lateral)

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20
Q

What are the boundaries of the femoral triangle?

A
Superior = inguinal ligament
Medially = adductor longus
Laterally = sartorius
Floor = iliopsoas and pectineus
Roof = deep fascia (fascia lata)
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21
Q

What are the contents of the femoral triangle?

A

Femoral nerve, femoral artery, femoral vein, lymphatics

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22
Q

What is compartment syndrome?

A

Fascia creates enclosed space, increased pressure causes swelling of tissue or increase in fluid, may be acute or chronic

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23
Q

What does compartment syndrome affect and how can it be relieved?

A

Can affect functions of muscles and nerves in that compartment; fasciotomy relives pressure in an emergency

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24
Q

What are the muscle compartments of the thigh?

A

Anterior, medial and posterior

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25
Q

What are the muscle compartments of the leg?

A

Anterior, posterior and lateral

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26
Q

What make up the anterior compartment of the thigh?

A

Flexors of thigh = pectineus, iliopsoas, sartorius

Extensors of leg = quadriceps femoris

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27
Q

What nerves supply the anterior compartment of the thigh?

A

The femoral nerve (L2-L4), also the psoas major

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28
Q

What make up the medial compartment of the thigh?

A

Adductors of thigh = adductor longus, adductor brevis, adductor magnus, gracilis, obturator externus

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29
Q

What nerves innervate the medial compartment of the thigh?

A

All innervated by the obturator nerve (L2-L4)

Hamstring part of adductor magnus innervated by tibial nerve

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30
Q

What make up the posterior compartment of the thigh?

A

Extensors of thigh and flexors of leg = semitendinosus, semimembranosus, biceps femoris

31
Q

What nerves supply the posterior compartment of the thigh?

A

All innervated by the tibial division of sciatic nerve (L5, S1, S2)
Short head of biceps femoris innervated by common fibular division of the sciatic

32
Q

What make up the anterior compartment of the leg?

A

Dorsiflexors of ankle and extensors of toes = tibialis anterior, extensor digitorium longus, extensor hallucis longus, fibularis tertius

33
Q

What nerve supplies the anterior compartment of the leg?

A

The deep fibular nerve (L4, L5)

34
Q

What make up the lateral compartment of the leg?

A

Evert foot and weakly plantarflex ankle = fibularis longus, fibularis brevis

35
Q

What nerve innervates the lateral compartment of the leg?

A

Superficial fibular nerve (L5, S1, S2)

36
Q

What make up the superficial group of the posterior compartment of the leg?

A

Plantarflexors of ankle = gastrocnemius, soleus, plantaris

37
Q

What make up the deep group of the posterior compartment of the leg?

A

Flexors of toes, plantarflexors of ankle = popliteus, flexor hallucis longus, flexor digitorium longus, tibialis poterior

38
Q

What nerve innervates both the superficial and the deep groups of the posterior compartment of the leg?

A

Tibial nerve (S1, S2)

39
Q

What kind of joint is the hip joint?

A

Ball and socket = ball is head of femur, socket is acetabulum of hip
Synovial joint = within strong joint capsules, external and internal fibrous layers

40
Q

What directions can the hip joint move in?

A

Multi-axial = flexion-extension, abduction-adduction, medial-lateral rotation, circumduction

41
Q

What part of the hip joint forms the ligaments?

A

The thick part of the fibrous layer of the joint capsule

42
Q

Where do the ligaments of the hip joint begin, and what is there function?

A

Spiral from pelvis to femur; strengthen the joint capsule

43
Q

What are the ligaments of the hip joint?

A

Iliofemoral, pubofemoral, ischiofemoral

44
Q

What is the name of the ligament that goes from the hip to the head of the femur?

A

The ligamentum teres

45
Q

What vessels supply the hip joint?

A

Medial and lateral circumflex femoral arteries = usually from deep femoral artery, give off retinacular arteries

46
Q

What vessel supplies the head of the femur?

A

A branch of the obturator, travels in ligament to head of femur

47
Q

What kind of joint is the knee joint?

A

Hinge joint = 3 articulations (2 are femerotibial, one is femeropatellar)
Synovial joint = external fibrous layer ( not as strong as hip joint) and internal fibrous layer (extensions as bursae)

48
Q

What is the main movement of the knee joint?

A

Flexion-extension ( some medial-lateral rotation can occur when knee is flexed)

49
Q

What are the three types of ligament found in the knee?

A

Extracapsular, Intra-articular, Menisci

50
Q

What are some examples of extra-capsular (outside capsule) ligaments of the knee?

A

Patellar ligament, lateral (fibular) collateral ligament, medial (tibial) collateral ligament

51
Q

What are some examples of intra-articular (within joint) ligaments of the knee?

A

Anterior cruciate ligament (ACL), posterior cruciate ligament (PCL)

52
Q

What are some features of the menisci of the knee?

A

Crescent shaped, fibrocartilage, medial and lateral

53
Q

What gives an indicator of knee joint integrity?

A

Anterior/posterior drawer signs = if positive then the ACL/PCL is torn

54
Q

Where is the popliteal fossa located?

A

Posterior to the knee

55
Q

What are the boundaries of the popliteal fossa?

A
Superolaterally = biceps femoris
Superomedially = semimembranosus
Inferiorly = gastrocnemius
Roof = popliteal fascia
56
Q

What are the contents of the popliteal fossa?

A

Lots of fat, terminal small saphenous vein, popliteal vessels, tibial and common fibular nerves

57
Q

What is the other name for the calcaneal tendon?

A

The achilles tendon

58
Q

What are some features of the calcaneal tendon?

A

Thickest and strongest in body , about 15cm long, tendons to gastrocnemius and soleus together, attaches to calcaneal tuberosity of the calcaneus

59
Q

What is the “ankle jerk” reflex?

A

Test of S1 and S2 nerve roots, normal result is plantarflexion

60
Q

What are some features of the superficial lymphatics?

A

Follow saphenous vein, drain into superficial inguinal lymph nodes then external iliac lymph nodes

61
Q

What are some features of the deep lymphatics?

A

Follow deep veins, popliteal lymph nodes to deep inguinal lymph nodes then external iliac lymph nodes

62
Q

Where does the lymphatics flow to once it has reached the external iliac lymph nodes?

A

The common iliac lymph nodes (lumbar lymphatics)

63
Q

Where does the femoral nerve (L2-4) supply?

A

Quadriceps femoris, sartorius, iliacus, pectineus

64
Q

Where does the obturator nerve (L2-4) supply?

A

All of the medial compartment of thigh, all adductors (except hamstring part of magnus), gracilis

65
Q

Where does the common fibular part of the sciatic nerve (L4-S2) supply?

A

Short head of biceps femoris

66
Q

Where does the superior fibular branch of the common fibular nerve supply?

A

Muscles of the lateral compartment of leg (fibularis longus and brevis)

67
Q

What compartments does the tibial part of the sciatic nerve (L4-S3) supply?

A

Muscles of posterior compartment of thigh, muscles of posterior compartment of leg, muscles of sole of foot

68
Q

What muscles of the posterior compartment of the thigh does the tibial part of the sciatic nerve supply?

A

True hamstrings = long head of biceps femoris, semimembranosus, semitendinosus

69
Q

What muscles of the posterior compartment of the leg does the tibial part of the sciatic nerve supply?

A

Gastrocnemius, soleus, plantaris, popliteus, tibialis posterior

70
Q

What muscles of the sole of the foot does the tibial part of the sciatic nerve supply?

A

Flexors of digits (digitorium and hallucis longus), all intrinsic muscles of sole of foot (via medial and lateral plantar branches)

71
Q

Where does the deep fibular branch of the common fibular nerve supply?

A

Muscles of anterior compartment of leg = tibialis anterior, extensor digitorium longus, extensor hallucis longus, fibularis tertus
Muscles of dorsum of foot = extensor digitorium brevis (EDB), extensor hallucis brevis (EHB)

72
Q

What plexus of nerves supplies all other lower limb associated muscles (e.g gluteal/lateral rotators)

A

Branches of the lumbosacral plexus

73
Q

What muscles make up the quadriceps?

A

Rectus femoris, vastus lateralis, vastus medialis, vastus intermedius ( under rectus femoris)

74
Q

Why is the short head of the biceps femoris not a true hamstring?

A

It doesn’t attach to the ischial tuberosity