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MSK > Clinical Anatomy of the Lower Limb > Flashcards

Clinical Anatomy of the Lower Limb Flashcards

1
Q

what are the bony components of the lower limb?

A 
pelvis
hip joint (ball and socket)
femur
knee joint
tibia/fibula
ankle joint
foot 
- hindfoot
- midfoot
- forefoot
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2
Q

why are there bumps on bones?

A

for muscle attachment

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3
Q

what stabilised the hip joint?

A

large surface between femoral head and acetabulum

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4
Q

what are the compartments of the knee?

A

medial
lateral
patellofemoral

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5
Q

what is the ankle mortus?

A

contains the talus

composed of the lateral malleolus (fibular head), distal end of tibia and medial malleolus (tibial head)

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6
Q

what makes up the hindfoot?

A

calcaenous

talus

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7
Q

what makes up the midfoot?

A

navicular
cuneiforms
cuboid

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8
Q

what are the bones of the forefoot?

A

metatarsals

phalanges

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9
Q

acetabulum pedis?

A

spring ligament

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10
Q

sacral foramen?

A

holes in fused sacrum that allow exit of sacral nerves

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11
Q

what is the labrum?

A

rim of fibrocartilage surrounding the acetabulum which stabilises the hip joint by deepening the acetabulum and encapsulating the femoral head

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12
Q

what is the blood supply to the femoral head?

A

medial femoral circumflex artery
small amount from obturator artery
small amount from lateral femoral circumflex artery
medial and lateral come back around head

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13
Q

what is the upper femoral epiphysis and what happens there?

A

upper femoral epiphysis = small area of bone in the femoral head surrounded by cartilage and separate from the femoral neck bone
spreads out via ossification of the surrounding cartilage until it meets the femoral neck bone at around 6-9 years

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14
Q

where does the iliacus originate and insert?

A 
origin = iliac crest/inner aspect of ilium
insertion = lesser trochanter of femur
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15
Q

where does the psoas major originate and insert?

A 
origin = transverse processes of L1-L5
insertion = lesser trochanter
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16
Q

give a possible problem with psoas major?

A

psoas abscess

common in IV drug users

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17
Q

what are the secondary hip flexors?

A

rectus femoris

sartorius

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18
Q

where does the rectus femoris originate and insert?

A 
origin = AIIS
insertion = tibia via patella tendon
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19
Q

where does the sartorius originate and insert?

A 
origin = ASIS
insertion = tibia
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20
Q

what else does the sartorius do?

A

externally rotates the hip

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21
Q

what is a common problem in secondary hip flexors?

A

avulsion fractures in children after kicking a football

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22
Q

what are the 5 hip adductors?

A 
adductor brevis
adductor longus
adductor magnus
pectineus
gracilis
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23
Q

what is the common origin and insertion of the hip adductors?

A

inferior pubic rami

insertion = linea aspera, pectineal line, tibia

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24
Q

name 3 clinical issues with hip adductors?

A

adductor tendinopathy
osteitis pubis
spasticity in NM conditions

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25
Q

what are the 2 hip abductors?

A

gluteus minimus/gluteus medius

tensor fascia lata

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26
Q

where does the gluteus minumus/medius originate and insert?

A 
originate = iliac wing
insertion = greater trochanter of femur
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27
Q

clinical issue with gluteus maximus/medius?

A

weakness

- trendelenberg gait

28
Q

where does the tensor fascia lata originate and insert?

A 
origin = iliac crest
insertion = lateral tibia via iliotibial tract
29
Q

what is the main hip extensor?

A

gluteus maximus

30
Q

where does the gluteus maximus originate and insert?

A 
origin = posterior aspect of ilium/sacrum
insertion = iliotibial tract
31
Q

what are the hip extensors/knee flexors?

A

hamstrings:
biceps femoris
semimembranous
semitendinous

32
Q

where does the biceps femoris originate and insert?

A 
origin = long head - ischial tuberosity, short head - lineu aspera
insertion = fibula head
33
Q

where does the semimembranous originate and insert?

A 
origin = ischial tuberosity
insertion = posterior tibia
34
Q

where does the semitendinous originate and insert?

A 
origin = ischial tuberosity
insertion = medial tibia
35
Q

give a clinical issue with hamstrings

A

avulsion

tears

36
Q

what clinical issue can occur with bursae?

A

trochanteric bursitis

- causes lateral hip pain

37
Q

what do the collateral ligaments do?

A

resist varus/valgus stresses at the knee

38
Q

clinical issue with collaterals?

A

tear

39
Q

what are the cruciate ligaments and what do they do?

A

ACL - resists anterior movement of tibia

PCL - resists posterior movement of tibia

40
Q

clinical issue with cruciates?

A

tears

41
Q

what are the main functions of the meniscus?

A

load transfer/shock absorbers
increase conformity of tibia and knuckles of femoral head
stabilised knee during movement
lubricates the knee

42
Q

direction of the ACL?

A

direction of hands in pockets

43
Q

clinical issue with menisci?

A

tears

44
Q

2 types of tear in menisci?

A

bucket handle - parallel along the meniscus

radial - across meniscus

45
Q

what are the knee extensor muscles?

A

quadriceps

  • rectus femoris
  • vastus intermedius
  • vastus medialis
  • vastus lateralis
46
Q

where do each of the knee extensors originate?

A

rectus femoris = AIIS
vastus intermedius = anterolateral proximal femur
vastus medialis = medial edge linea aspera and greater trochanter
vastus lateralis = medial edge linea aspera and lesser trochanter
insert at the patellar tendon

47
Q

describe the extensor mechanism

A

quadriceps muscle > quadriceps tendon > patella > patella tendon > tibial tuberosity

48
Q

what 4 factors may predispose to patellar instability/dysfunction?

A

genu valgum (Q angle)
femoral head anteversion
weak quadriceps (vastus medialis)
ligamentous laxity

49
Q

what separates the compartments of the leg?

A

thick, fascial compartments

all muscles in a compartment have the same nerve supply

50
Q

what are the anterior muscles of the leg and what nerve supplies them?

A 
tibialis anterior
extensor hallicus longus
extensor digitorum longus
peroneus tertius
nerve = deep peroneal nerve
51
Q

what are the lateral muscles of the leg and what nerve supplies them?

A

fibularis longus/brevis

nerve = superficial peroneal nerve

52
Q

what are the deep muscles of the posterior leg?

A 
tibialis posterior
flexor hallivus longus
flexor digitorum longus
popliteus
nerve = tibial nerve
53
Q

what are the superficial posterior leg muscles and what nerve supplies them?

A

gastrocnemius
soleus
plantaris
nerve = medial sural cutaneous nerve

54
Q

which nerve is likely to be damaged by a fibula neck fracture?

A

common peroneal(fibular) nerve

55
Q

what are the 3 ankle plantar flexor muscles?

A

gastrocnemius (medial and lateral heads)
soleus
plantaris

56
Q

where do the ankle plantar flexors originate and insert?

A

gastroc = femoral condyles
soleus = broad area on posterior tibia/fibula
plantaris = lateral femoral condyle
common insertion = calcaenous via achilles tendon

57
Q

clinical issue with ankle plantar flexion?

A

achilles tendinopathy

58
Q

what muscle dorsiflexes the ankle?

A

tbialis anterior

59
Q

where does the tibialis anterior originate and insert?

A 
origin = lateral surface of proximal tibia
insertion = medial cuneiform and base of 1st metatarsal
60
Q

what are the 2 main ankle ligaments?

A 
deltoid ligament (medial)
lateral ligement complex (lateral)
61
Q

how many ligaments are in the the lateral ligament complex?

A

3

62
Q

what is the main supporter of the medial arch?

A 
tibialis posterior tendon
calcaneonavicular ligament (spring ligament)
63
Q

where does the tibialis posterior tendon originate and insert?

A 
origin = posterior proximal tibia/fibula
insertion = navicular/plantar surface of medial cuneiform
64
Q

describe a common clinical issue in the medial arch

A

dysfunction of tibialis dysfunction
common in 6th decade
gives pain on medial aspect and causes flattening of foot

65
Q

where does the plantar fascia originate and insert?

A 
origin = tuberosity of calcaneus
insertion = heads of metatarsals
66
Q

clinical issue with plantar fascia?

A

plantar fascitis

MSK (66 decks)

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