Exam 4 Book Lower Limb Flashcards
(123 cards)
0
Q
What are the major regions of the lower limb?
A
- Gluteal region
- Femoral region
- Knee region
- Leg region
- Ankle (or talocrural) region
- Foot region
1
Q
What is the lower limb specialized for?
A
locomotion, support body weight, maintain balance
2
Q
What bone articulates with the femur?
A
The tibia
3
Q
What bone does not articulate with the femur?
A
The fibula, it does not bear weight
4
Q
What is the talus?
A
The keystone of a longitudinal arch formed by the tarsal and metatarsal bone of each foot
5
Q
How are the femurs different between men and women?
A
Femurs in females are slightly more oblique than those of males, reflecting the greater width of their pelves
6
Q
What bones make up the hip bone?
A
Ilium
Ischium
Pubis
7
Q
At puberty the bones of the hip are separated by what?
A
a triradiate cartilage
8
Q
What is the longest and heaviest bone of the body?
A
the femur
9
Q
Describe the shaft of the femur.
A
Most of the shaft is smoothly rounded, except for a prominent double-edged ridge on its posterior aspect, the linea aspera
10
Q
What is the only portion of the femur that is not covered by articular cartilage?
A
the fovea of the femur
11
Q
What is the intertrochanteric line?
A
The roughened ridge running from the greater to the lesser trochanter
12
Q
What is the intertrochanteric crest?
A
Smooth ridge of the femur, joins the trochanters posteriorly
13
Q
What is the angle of inclination?
A
Angle between the axis of the femoral head and neck and the axis of the shaft of the femur. Typically 115-140, less in females
14
Q
What does the angle of inclination allow for?
A
It allows for greater mobility of the femur at the hip joint
15
Q
What is the torsion angle?
A
Angle between the axis of femoral neck and head and the transverse axis of the femoral condyles, 7 degrees for males and 12 degrees for females
16
Q
What is the patella?
A
The knee cap, a large sesamoid bone
17
Q
What is the nutrient foramen?
A
Located on the posterior part of the proximal 1/3 of the tibia
18
Q
What is the nutrient canal?
A
Runs inferiorly in the tibia before it opens into the medullary (marrow) cavity
19
Q
What are gluteal folds?
A
The inferior border of the buttocks and the superior boundary of the thigh
20
Q
What is the difference between the greater and lesser sciatic foramen?
A
Greater: passage for structures in and out of the pelvis
Lesser: passage for structures in and out of the perineum
21
Q
What is the gluteal bursae?
A
A flattened membranous sac containing a capillary layer of synovial fluid, separate the gluteus maximus from adjacent structures
22
Q
The skin of the gluteal region is richly innervated by the superficial gluteal nerves…
A
superior, middle and inferior clunial nerves
23
Q
What are the deep gluteal nerves?
A
sciatic posterior cutaneous nerve of the thigh superior gluteal nerve inferior gluteal nerve nerve to the quadratus femoris pudenal nerve nerve to the obturator internus
24
In the thigh the sciatic nerve branches into what to branches?
```
tibial nerve (anterior portion)
common fibular nerve (posterior portion)
```
25
What is the lymph flow from the deep tissues of the gluteal region?
Gluteal vessels --> gluteal lymph nodes --> internal, external and common iliac lymph nodes --> lumbar (caval) lymph nodes
26
What is the lymph flow from the superficial tissues of the gluteal region?
Superficial inguinal lymph nodes --> send efferent lymphatic vessels to the external iliac nodes
27
What is the lunate surface of the acetabulum?
the rim of the acetabulum, has a semilunar articular part covered with articular cartilage
28
What deepens the acetabulum?
The fibrocartilaginous acetabular labrum
29
How much of the head of the femur fits in the acetabulum?
More than half of the head
30
How much of the femur does its joint capsule cover?
Approximately the proximal 2/3 of the neck of the femur posteriorly
31
What ligaments reinforce the hip joint?
iliofemoral ligament: anteriorly/ superiorly, prevents hyperextension
pubofemoral ligament: inferiorly/ anteriorly, prevents excessive abduction
ischiofemoral ligament: posteriorly (weak)
32
What arteries supply the hip joint?
- medial circumflex femoral artery
- lateral circumflex femoral artery
- artery to the head of the femur
33
What is the nerve supply for the hip joint?
- femoral nerve: anteriorly
- obturator nerve: inferiorly
- superior gluteal nerve: superiorly
- nerve to quadratus femoris: posteriorly
34
What is the deep fascia of the thigh?
Fascia lata
35
What is the saphenous opening?
A gap or hiatus in the fascia lata inferior to the medial part of the inguinal ligament
36
What is the cribriform fascia?
A localized membranous layer of subcutaneous tissue over the saphenous opening, enclosing it
37
What is the deep fascia of the leg (crural fascia)?
Continuous with the fascia lata and attaches to the anterior and medial borders off the tibia, continuous with its periosteum. Thickest where it forms the extensor retinacula
38
What makes up the great saphenous vein?
Formed by the union of the dorsal digital vein of the great toe and the dorsal venous arch of the foot. Empties in to the femoral vein
39
What makes up the small saphenous vein?
Formed by the union of the dorsal digital vein of the 5th digit with the dorsal venous arch. Empties into the popliteal vein in the popliteal fossa.
40
What kind of veins penetrate the deep fascia of the lower limb?
Perforating veins
41
What are the valves in the veins of the lower limbs called?
Musculovenous pumps
42
Where do the lymph end up that accompany the great and small saphenous veins?
Great saphenous vein: ends in the superficial inguinal lymph nodes and pass to the external iliac lymph nodes
Small saphenous vein: ends in the popliteal lymph nodes
43
What muscles are in the anterior compartment of the thigh?
-pectineus
-iliopsoas
-sartorius
-quadriceps femoris:
~rectus femoris
~vastus lateralis
~vastus medialis
~vastus intermedius
44
What are the medial thigh muscles?
The adductor group
- adductor longus
- adductor brevis
- adductor magnus
- gracilis
- obturator externus
45
What is the adductor hiatus?
Opening between the adductor part of the adductor magnus and the tendon of the hamstring part. Transmits the femoral artery and vein from the anterior compartment of the thigh to the popliteal fossa posterior to the knee
46
What are the boundaries of the femoral triangle?
Superiorly: inguinal ligament
Medially: adductor longus
Laterally: sarotius (where the apex is formed)
47
What is the floor of the femoral triangle?
Laterally: iliopsoas
Medially: pectineus
48
What is the roof of the femoral triangle?
Fasica lata
Cribriform fascia
Subcutaneous tissue
Skin
49
What is the retro-inguinal space?
Passageway deep to the inguinal ligament, connects the trunk and abdominopelvic cavity to the lower limb
50
What are the contents of the femoral triangle?
Lateral to Medial
- Nerve (femoral)
- Artery (Femoral)
- Vein (femoral)
- Empty space (femoral canal)
- Lymph nodes (deep inguinal lymph nodes)
51
What is the adductor canal?
Extends from the apex of the femoral triangle to the adductor hiatus in the tendon of the adductor magnus. Passageway for the femoral artery and vein, saphenous nerve, and nerve to the vastus medialis
52
What is the femoral sheath?
Funnel shaped, fascial tube passes deep to the inguinal ligament and encloses proximal parts of the femoral vessels and creates the femoral canal medial to them
Does not enclose the femoral nerve
53
What are the boundaries of the popliteal fossa?
- Superolaterally: biceps femoris
- Superomedially: semimembranosus
- Inferiorly: Gastrocnemius
54
What is the floor of the popliteal fossa?
popliteal surface of the femur, posterior capsule of the knee joint and the popliteus fascia covering the popliteus muscle
55
What are the contents of the popliteal fossa?
- Termination of the small saphenous vein
- Popliteal artery and vein
- Tibial and common fibular nerves
- Posterior lymph nodes and lymphatic vessels
- Fat
56
What is the deepest part of the popliteal fossa?
The popliteal artery
57
What is the superior extensor retinaculum?
A strong, broad band of deep fascia passing from the fibula to the tibia
58
What is the inferior extensor retinaculum?
A Y-shaped band of deep fascia, attaches laterally to the anterosuperior surface of the calcaneus and medially to the medial malleolus and medial cuneiform
59
What are the muscles of the anterior compartment of the leg?
- Tibialis anterior
- Extensor digitorum longus
- Extensor hallucis longus
- Fibularis tertius
60
What are the muscles of the medial compartment of the leg?
- Fibularis longus
| - Fibularis brevis
61
What nerve supplies the muscles of the lateral compartment of the leg?
the superficial fibular nerve
62
What type of joint is the knee?
A modified hinge joint
63
The stability of the knee joint depends on...
- strength and actions of surrounding muscles and their tendons
- ligaments connecting the femur and tibia
64
Which muscles are most important in stabilizing the knee?
The quadriceps femoris, particularly the inferior fibers of the vastus medialis and lateralis
65
What ligaments strengthen the knee joint?
- Patellar ligament
- Fibular collateral ligament
- Tibial collateral ligament
- Oblique popliteal ligament
- Arcuate popliteal ligaments
66
What do the collateral ligaments do?
Taut when fully extended. As flexion proceeds they become increasingly slack, permitting rotation at the knee.
67
What is the anterior cruciate ligament (ACL)?
weaker, arises from the anterior intercondylar area of the tibia and extends to attach to the posterior part of the medial side of the lateral condyle of the femur.
-limits posterior rolling of the femur on the tibia during flexion, prevents hyperextension, most common sports injury
68
What is the posterior cruciate ligament (PCL)?
Stronger, arises from the posterior intercondylar area of the tibia tp the anterior part of the lateral surface of the medial condyle of the femur
-prevents anterior rolling on the tibia, helps prevent hyperflexion of the knee joint, main stabilizer of the femur
69
What are the menisci of the knee joint?
Crescentic plates of fibrocartilage on the articular surface of the tibia that deepen the surface and play a role in shock absorption.
70
What are coronary ligaments?
Ligaments of the knee, are capsular fibers that attach the margins of the menisci to the tibial condyles
71
What is the transverse ligament of the knee?
a slender fibrous band, joins the anterior edges of the menisci, allowing them to move together during knee movement
72
What bursae allow the skin to move freely over the knee joint during movements?
- subcutaneous prepatellar
| - infrapatellar
73
What type of joint is the tibiofibular joints?
plane synovial
74
What increases the Q angle?
Genu valgum
75
What decreases the Q angle?
Genu varum
76
What compartment of the leg is the largest?
Posterior
77
What is the transverse intermuscular septum?
It divides the posterior leg compartment into: superficial and deep subcompartments and muscle groups
78
What vessels supply the posterior leg?
Tibial nerve
| Posterior tibial/ fibular vessels (run in the deep part, just deep, anterior, to the transverse intermuscular septum)
79
What are the superficial muscles of the posterior leg?
- gastrocnemius
- soleus
- plantaris
80
What muscles share the calcaneal tendon in the posterior leg?
- gastrocnemius
| - soleus
81
What tendon do the gastrocnemius and soleus share?
the calcaneal tendon
82
What makes up the 3 headed triceps surae?
- 2 heads of the gastrocnemius
| - soleus
83
What do the 2 heads of the gastrocnemius and soleus form?
Triceps surae
84
What does the triceps surae do?
Elevates the heel and thus depresses the forefoot, generating as much as 93% of the plantarflexion force
85
What is the orientation of the calcaneal tendon?
Spirals a quarter turn (90 degrees) during its descent, so that the gastrocnemius fibers attach laterally and the soleal fibers attach medially
86
What does the calcaneal tendon do?
Has elastic ability to absorb energy (shock) and recoil, releasing the energy as part of the propulsive force it exerts
87
Do the soleus and the gastrocnemius act alone?
Yes "You stroll with the soleus but win the long jump with the gastrocnemius"
88
How can you test the triceps surae?
The foot is plantarflexed against resistance (standing on the toes and the resistance is gravity), if normal the calcaneal tendon and triceps surae can been seen and palpated
89
What is located between the skin and the calcaneal tendon and allows the skin to move over the taut tendon?
a subcutaneous calcaneal bursa
90
What allows the calcaneal tendon glide over the bone? (between the tendon and the calcaneal tuberosity)
a deep bursa of the calcaneal tendon
91
What is the most superficial muscles of the posterior leg?
the gastrocnemius
92
What forms the proximal and most prominent part of the calf?
The gastrocnemius
93
Can the gastrocnemius exert its full power on both the knee and the ankle joints at the same time?
No
94
What is the tendinous arch of soleus?
a continuous prozimal attachment of the soleus in the shape of an inverted U to the posterior aspects of the fibula and tibia
95
What passes through the tendinous arch of soleus?
the popliteal artery and tibial nerve (exit the popliteal fossa by passing through this arch)
96
How can you palpate the soleus?
On either side of the gastrocnemius when the individual is standing on tiptoes
97
What muscle in the posterior leg is an antigravity muscle?
soleus
98
What is the plantairs muscle?
on the posterior leg, small muscle with a short belly, long tendon and high density of muscle spindles, absent in 5%-10% of people, minor motor role, can be removed for grafting
99
What muscles make up the deep muscles of the posterior compartment of the leg?
- popliteus
- flexor digitorum longus
- flexor hallucis longus
- tibialis posterior
100
What is the difference of the popliteus from the other deep muscles of the posterior compartment of the leg?
the popliteus acts to unlock the fully extended knee joint, whereas the other muscles act on the ankle and foot joints
101
What is the deepest muscle in the posterior compartment of the leg?
tibialis posterior
102
What muscles does the tibialis posterior lie between?
- flexor digitorum longus
| - flexor hallucis longus
103
What is the largest branch of the sciatic nerve?
The tibial nerve (L4, L5 and S1-S3)
104
What innervates all the muscles of the posterior compartment of the leg?
tibial nerve
105
What makes up the sural nerve?
- the medial sural cutaneous nerve (branch of the tibial nerve)
- sural communicating branch of the common fibular nerve
106
What does the sural nerve supply?
the skin of the lateral/posterior parts of the inferior 1/3 of the leg and the lateral side of the foot
107
What artery supplies the blood to the posterior compartment of the lef and the foot?
the posterior tibial artery (branch of the popliteal artery)
108
What are the branches of the posterior tibial artery?
- medial plantar artery
| - lateral plantar artery
109
What are the branches of the fibular artery?
- muscular branches (to the muscles in the posterior/lateral compartments of the leg)
- nutrient artery of the fibula
- perforating branches
110
What is the nutrient artery of the tibia?
Arises from the origin of the anterior or posterior tibial artery
111
What type of joint is the ankle joint (talocrural articulation)?
synovial hinge joint, articulation of the lateral/ medial malleoli (of the tibia and fibula) with the trochlea of the talus
112
When is the grip of the malleolus on the talus the strongest?
dorsiflexion
| -forces the wider anterior part of the trochlea posterior, spreading the tibia and fibula slightly apart
113
When is the ankle joint relatively unstable?
during plantarflexion, the trochlea is narrower posteriorly and lies loosely within the malleoli grip
114
What makes the ankle joint strong?
Strong collateral ligaments
115
What are the lateral ligaments of the ankle?
- anterior talofibular ligament
- posterior talofibular ligament
- calcaneofibular ligament
116
What is the anterior talofibular ligament of the ankle joint?
flat, weak band that extends anteromedially from the lateral malleolus to the neck of the talus
117
What is the posterior talofibular ligament of the ankle joint?
thick, fairly strong band that runs horizontally medially and slightly posteriorly from the malleolar fossa of the fibula to the lateral tubercle of the talus
118
What is the calcaneofibular ligament of the ankle joint?
round cord that passes postero-inferiorly from the tip of the lateral malleolus to the lateral surface of the calcaneus
119
What is the medial ligament of the ankle?
deltoid ligament- attaches proximally to the medial malleolus and fans out from it to attach distally to the talus, calcaneus and navicular via 4 parts
-stabilizes the ankle joint during eversion of the foot and prevents partial dislocation (subluxation) of the ankle joint
120
What are the 4 parts of the deltoid ligament of the medial ligament of the ankle?
1. tibionavicular part
2. tibiocalcaneal part
3. anterior tibiotalar part
4. posterior tibiotalar part
121
What muscles of the leg produce dorsiflexion?
the ones in the anterior compartment
-limited by passive resistance of the triceps surae to stretching and by tension in the medial and lateral ligaments
122
What muscles produce plantarflexion of the ankle?
the muscles in the posterior and lateral compartments of the leg
