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Flashcards in Gross Anatomy Exam 3 Deck (136)
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1
Q

6 regions of the lower limb

A
Gluteal
Femoral (thigh)
Knee
Leg
Ankle
Foot
2
Q

Os Coxae

A

ilium, ischium, pubis, acetabulum

3
Q

Ilium

A

ala, iliac crest, iliac tubercle, ASIS, AIIS, PSIS, PIIS, Iliac fossa, body, posterior andterior and inferior gluteal lines, auricular surface, iliac tuberosity

4
Q

Ischium

A

body, ramus, ischial tuberosity, ischial spine, lesser sciatic notch, greater sciatic notch

5
Q

Pubis

A

body, superior rams, inferior ramus, symphaseal surface, pubic crest, pubic tubercle, pectin pubis

6
Q

Obturator Foramen

A

large oval opening in hip bone
surrounded by ischial and pubic rami
closed by obturator membrane creating the obturator canal

7
Q

Acetabulum

A

large cup shaped cavity on lateral aspect of hip bone
articulates with femoral head and forms hip joint
Acetabular notch, acetabular fossa, lunate surface

8
Q

Femur

A

head with fovea, neck, greater trochanter, lesser trochanter, intertrochanteric line, intertrochanteric crest, quadrate tubercle, trochanteric fossa, shaft, line aspera - medial and lateral lips, gluteal tuberosity, pectineal line, medial and lateral supracondylar lines, medial and lateral femoral condyles, intercondylar fossa, patellar surface, adductor tubercle

9
Q

Patella

A

Base, apex and articular surface

10
Q

Tibia

A

shin bone, on antero lateral side of leg, articulates with femoral condyle superiorly, and talus inferiorly, fibular laterally, transmits body weight to foot
medial and lateral condyles, superior articular surface, intercondylar eminence, intercndylar tubercles, ant and post intercondylar areas, anterolateral tibial tubercle (Gerdy’s tubercle), tibial tuberosity, fibular articular facet, ant border of tibia, medial surface, medial malleoulus, interosseous border, fibular notch, soleal line, groove for tibialis post tendon, inferior articular surface

11
Q

Fibula

A

no function of weight bearing, articulates with tibia and talus
head, neck, shaft, ant interosseus and post borders, medial post and lateral surfaces, lateral malleolus

12
Q

Tarsals

A

Talus, calcaneus, Navicular, cuboid, cuneiforms

13
Q

Talus

A

no muscular or tendinous attachment, only bone that articulate with leg, divides body weight between calcaneus and forefoot
trochlea body, posterior process, head, neck

14
Q

Calcaneus

A

largest, strongest bone in foot
transmits majority of body weight from talus to ground
superior surface, anterior surface, fibular trochlea, sustentaculum tali, calcaneal tuberosity

15
Q

Navicular

A

flattened, boat shaped bone
b/w talus and 2 cuniforms
navicular tuberosity

16
Q

Cuboid

A

most lateral bone in distal row of tarsals
b/w calcaneus post and 4th and 5th metatarsals anteriorly
tuberosity of cuboid, groove fro tendon of fibularis longus

17
Q

Cuneiforms

A

each articulates with navicular posteriorly and base appropriate metatarsals anteriorly
medial (1st) largest
Intermediate (2nd) smallest
lateral (3rd) articulate with cuboid

18
Q

Metatarsals

A

make up forefoot, 5 numbered from medial to lateral, 1st is the shortest and 2nd is the longest
base, shaft, head

19
Q

Phalanges

A

base shaft and head

20
Q

Sacroiliac Joint

A
weight bearing compound joint b/w sacrum and iliac
syndesmosis posteriorly b/w tubercles and synovial anteriorly b/w auricular surfaces
Ligmaments
Anterior scroiliac
Interosseous sacroiliac
posterior sacroiliac
sacrotuberous
sacrospinous
21
Q

Pubic Symphysis

A

fibrocartilage disk at union of pubic bones in anterior median plane, thicker in females
Ligaments
superior pubic ligament
inferior pubis ligament

22
Q

Greater Sciatic Foramen

A
piriformis muscle
superior gluteal n.a.v.
inferior gluteal n.a.v.
internal pudendal a.v.
pudendal n.
posterior femoral cutaneous n.
sciatic n.
nerve to obturator internus and quadratus femoris
23
Q

Lesser Sciatic Foramen

A

obturator internus tendon
nerve to obturator internus
internal pudendal a.v.
pudendal n.

24
Q

Hip Joint

A

designed for stability over wide range of movement, synovial joint
connects pelvic girdle and lower limb, ball and socket b/w head of femur and acetabulum
femoral head covered with articular cartilage and acetabulum
acetabulum labrum
permits flex/ext, MR/LR, ABD/ADD and circumduction

25
Q

Ligaments of Hip Joint

A
transverse acetabular ligament
orbicular zone
ischiofemoral ligament
iliofemoral ligament
pubofemoral ligament
ligamentum capitis femoris
26
Q

superior gluteal artery

A
from internal iliac artery
anastamoses with inferior gluteal and medial femoral circumflex arteries
participates in trochanteric anastamosis
superficial branch
deep branch
27
Q

inferior gluteal artery

A

from internal iliac artery
anastamoses with superior gluteal artery
participates in cruciate anastamosis

28
Q

Internal pudendal artery

A

from internal iliac artery
passes thru gluteal region between sacrotuberous ad sacrospinous ligaments
does not supply anything in gluteal region

29
Q

Profunda Femoris artery

A

from femoral artery
medial femoral circuflex artery
lateral femoral circumflex artery - ascending, transverse and descending branch
perforating arteries - usually 4 of them the 1st participates in anastamoses with inferior gluteal artery and cruciate anastamosis

30
Q

Gluteal Veins

A

tributaries of internal iliac vein
accompany corresponding arteries
communicate with tributaries of femoral vein, provide alternative route for blood from lower limbic femoral vein is occluded or ligated

31
Q

Cruciate Anastamosis

A

important for keeping lower limb viable
stenosis, damage or blockage of the external iliac or femoral arteries could cause series issues
provides connection between internal iliac arteries and femoral arteries - via profunda femurs artery
Involves the following arteries
inferior gluteal artery
medial femoral circumflex artery
lateral femoral circumflex artery ascending and transverse
1st perforating artery of profunda femoris

32
Q

Superior Gluteal nerve

A

from VPR L4-S1

supplies gluteus medis, minims and tensor fascia lata

33
Q

Inferior Gluteal nerve

A

from VPR L5-S2

supplies gluteal maximus muscle

34
Q

Sciatic Nerve

A

from VPR L4-S3

does not supply anything in the gluteal region

35
Q

Nerve to Obturator Femoris

A

from VPR L4-S1

supplies quadratus femurs and inferior gamellus muscles

36
Q

Nerve to Obturator Internus

A

from VPR L5-S2

supplies obturatr interns and superior gemellus muscles

37
Q

Pudendal Nerve

A

from VPR S2-4

does not supply anything in gluteal region

38
Q

Clunial Nerve

A

superior from DPR of L1-3, supplies superior buttock
middle from DPR S1-3, supply skin over sacrum and adjacent buttock
inferior from posterior cutaneous nerve of thigh

39
Q

Lumbosacral Plexus

A

consists of VPR from L1-L4 with inconsistent contributions from T12
formed within psoas major muscle
each receives postsynaptic sympathetics via tray rami communicantes`

40
Q

Iliohyopgastric and ilioinguinal nerves

A

VPR of L1

innervate the abdominal wall muscle and L1 derma tom anteriorly

41
Q

Lateral Femoral Cutaneous Nerve

A

VPR of L2-3
enters thigh deep to inguinal ligament and medial in ASIS
sensory to anterolateral skin of thigh

42
Q

Femoral Nerve

A

Posterior divisions of VPR of L2-4
passes deep to inguinal ligament and then to anterior thigh
innervates the hip flexors and knee extensors, sensory to anterior and medial thigh and anteromedial leg and foot

43
Q

Genitofemoral Nerve

A

VPR of L1-L2
genital branch passes through deep inguinal ring
sensory to anterolateral skin of scrotum/labia majora, motor to the cremaster muscle
femoral branch passes along external iliac artery, sensory innervation over femoral triangle

44
Q

Obturator Nerve

A

anterior divisions VPR or L2-4

motor to medial thigh muscles and sensory to medial thigh above knee

45
Q

Lumbosacral Trunk

A

VPR L4-5

participates with S1-S4 in forming the sacral plexus

46
Q

Sacral Plexus of Nerves

A

composed of VPR of S1-S4 and lumbosacral trunk
all branches except those to pelvic diaphragm leave pelvis via greater sciatic foramen above or below pelvis
all branches receive tray rami commincans from sympathetic trunk

47
Q

Superior Gluteal Nerve

A

posterior divisions VPR L4-S1
enters gluteal region via greater sciatic foramen
sensory to hip and motor to gluteus medius, minimus and tensor fascia lata

48
Q

Inferior Gluteal Nerve

A

posterior divisions VPR L5-S2
enters the gluteal region via the greater sciatic foramen
sensory to hip and motor to gluteus maximus muscle

49
Q

Posterior Femoral Cutaneous Nerve

A

anterior and posterior divisions of VPR S1-3

sensory to skin of upper thigh, lateral perineum, inferior buttock, posterior thigh and popliteal fossa

50
Q

Sciatic nerve

A

anterior and posterior divisions of VPR L4-S3
located midway b/ ischial tuberosity and greater trochanter in gluteal region
composed of two division: tibial (anterior div) and common fibular (posterior div)
sensory to hip, knee, ankle and all foot joints, posterior and anteriolateral leg, skin of foot
motor to hamstrings, hamstring portions of adductor magnus and all leg and foot muscles

51
Q

Pudendal Nerve

A

anterior divisions of VPR S2-4
exits pelvis via greater sciatic foramen below piriformis muscle b/w sacrotuberour and sacrospinous ligaments
enters perineum via lesser sciatic forament
sensory to perineal skin, penis and clitoris
motor to perineal muscles, pelivc diaphragm and external anal sphincter

52
Q

Nerve to Quadriceps Femoris

A

anterior divisions of VPR L4-S1
enters gluteal region via greater sciatic nerve
sensory to hip and motor to quadratus femoris and inferior gemellus

53
Q

Nerve to Obturator Internus

A

posterior divisions of VPR L5-S2
exits pelvis via greater sciatic foramen and enter pelvis via lesser sciatic foramen
sensory to hip and motor to superior gemellus and obturator internus muscles

54
Q

Fascia Lata

A

continuous superiorly with: anteriorly with the inguinal ligament pubic arch body of pubis and pubic tubercle, posteriorly and lateral with iliac crest, and posterior medial with sacrum coccyx sacrotuberous ligament and ischial tuberosity ischopubic ramu
conituous inferiorly with: exposed parts of bone around knee, popliteal fascia, deep fascia of leg inferior to the knee
Thickens laterally to form Iliotibial band:
-shared aponeurosis of tensor fascia lat a and glutes maximus
-from iliac tubercle to anterolateral tubercle of tibia (gerdy’s tubercle)

55
Q

3 compartments of Fascia Lata

A

Anterior, Medial and Posterior

Septa of compartments: Lateral is the strongest, Medial and an unnamed

56
Q

Saphenous Opening

A

gap or hiatus inferior to medial part of inguinal ligament
has smooth medial margin
superior, lateral and inferior margins form a sharp crescentic edge - falciform margin, joined at the medial margin by cruciform fascia
-localied membranous tissue that closes saphenous opneing
pierced by numerous openings for lymphatic vessels and great saphenous vein

57
Q

Posterior Thigh

A

have common origin
cross hip and knee joints
share common insertion
supplied by perforating branches of profunda femurs artery

58
Q

Inferior Gluteal Artery

A

from the internal iliac artery

supplies the superior part of hamstrings

59
Q

Perforating Arteries

A

from the profunda femoris artery

supply hamstring muscles

60
Q

Perforating Veins

A

accompany arteries of same name
drain to profunda femoris vein
communicate superiorly with inferior gluteal vein and inferiorly with popliteal vein

61
Q

Sciatic Nerve

A

from VPR L4-S3
descends in posterior thigh deep to biceps femoris muscle
composed of 2 divisions

62
Q

Tibial Division of Sciatic Nerve

A

L4-S3

supplies the true hamstrings

63
Q

Common Fibular Division of Sciatic Nerve

A

L4-S2

supplies short head of biceps femoris muscle

64
Q

Posterio Cunteous Nerve of the Thigh

A

from VPR S1-3

supplies skin over posterior thigh and popliteal fossa

65
Q

Anterior Thigh Muscles

A

generally innervated by femoral nerve
contains flexors of hip and extensors of knee
includes pectinous, iliopsoas, sartorius, and quadriceps femoris
supplied by femoral and profunda femoris arteries

66
Q

Medial Thigh Muscles

A

comprises the adductor group
includes adductor longs, brevis and magnus and gracillis muscles
all supplied by obturator nerve, except hamstring part of adductor magnus muscle
supplied by obturator artery (anterior or posterior)

67
Q

Adductor Hiatus

A

opening b/w distal attachments of two adductor magnus parts
located just lateral and superior to adductor tubercle
Transmits femoral artery and vein to/from adductor canal to/from popliteal fossa
Does not contain saphenous nerve

68
Q

Femoral Artery

A

direct continuation of external iliac artery distal to inguinal ligament and primary a of lower limb
this is one of 4 places to take a pulse
passes thru the femoral triangle lateral to femoral v.
branches into descending genicular artery before adductor hiatus
trerminates as it traverses adductor hiatus to become the politeal artery

69
Q

Superficial Circumflex iliac artery

A

from the femoral artery just past inguinal l.

parallels inguinal l. towards ASIS

70
Q

Superficial Epigastric Artery

A

from femoral artery

runs subcutaneously towards umbilicus

71
Q

Superficial and Deep External Pudendal Arteries

A

from femoral artery

runs to skin of scrotum and labia majora

72
Q

Profunda Femoris Artery

A

from lateral or posterior side of femoral artery
chief artery of thigh
gives rise to;
medial femoral circumflex artery- supplies blood to the head and neck of femur is involved in cruciate anastamosis
lateral femoral circumflex artery - mainly supplies the lateral thigh muscles
divides into ascending (cruciate anastamosis), transverse (cruciate anastamosis), descending (genicular anastamosis)
gives of 3 perforating arteries and the 4 terminates it
1st perforating is involved in cruciate anastamosis
traverses the adductor canal and branches off to

73
Q

Descending Genicular Artery

A

beaches off the femoral artery just before femoral artery passes thru adductor hiatus
participates in genicular anastamosis

74
Q

Obturator Artery

A

from the internal iliac artery
20% branch from inferior epigastric, accessory or replacement obturator arteries
Divides into the anterior branch of obturator artery and posterior branch of obturator artery
Also forms the ace tabular branch which supplies the head of femur thru the ligament to the head of the femur

75
Q

Great Saphenous Vein

A

from medial spect of dorsal venous arch
ascends anteriorly to medial malleolus
passes posteriorly at medial femoral condyle, found in subcutaneous tissue of medial thigh
traverses saphenous opening, drains into femoral vein

76
Q

Accessory Saphenous Vein

A

joining of medial and posterior thigh tributaries

when present is main communication b/w saphenous veins

77
Q

Femoral Vein

A

direct continuation of popliteal vein as it traverses adductor hiatus
ascends thru adductor canal
enters femoral sheath lateral to femoral canal
becomes external iliac vein posterior to inguinal ligament

78
Q

Lymphatics

A

pass the superficial inguinal nodes then to external iliac nodes

79
Q

Femoral Nerve

A

from posterior divisions VPR L2-4
located in the femoral triangle
Femoral cauda equina- collective name for numerous branches of femoral nerve found in femoral triangle
supplies anterior compartment muscles

80
Q

Saphenous Nerve

A

comes from the femoral nerve
runs in the adductor canal but does not pass thru the adductor hiatus
does not supply anything in the thigh but it does in the leg

81
Q

Anterior Cutaneous branch

A

Gives rise to the medial cutaneous branch and the intermediate cutaneous branch

82
Q

Obturator Nerve

A

from anterior division of VPR L2-4
exits the obturator canal, divides into the anterior and posterior branches that are separated by adductor brevis muscle
Ant. branch supplies longs, brevis and gracilic
Post. branch supplies brevis, and adductor part of adductor magnus and obturator externus
Sensory to skin of medial thigh just above knee

83
Q

Lateral Femoral Cutaneous Nerve

A

From VPR L2-3

supplies skin on anterior and lateral thigh

84
Q

Genitofemoral Nerve

A

From VPR L1-2

Femoral branch supplies the skin over lateral femoral triangle

85
Q

Ilioinguinal Nerve

A

From VPR L1

supplies the skin of upper medial thigh

86
Q

Femoral Triangle

A

located inferior to inguinal ligament
N.A.V.L.
boundaries: base - inguinal l.
medial border - lateral border of adductor longs
lateral border - sartorius m.
Floor - pectinous m and iliopsoas m
Roof - fascia lata, cribriform fascia, subcutaneous tissue, skin
contains: femoral n., femoral a., femoral v. and deep inguinal lymph nodes and vessels

87
Q

Retro Inguinal space

A

is deep to the inguinal ligament
divided into 2 compartments by iliopectineal arch
thickening of iliopsoas fascia
from inguinal l. to iliopubic eminence
two compartments are lacuna musculorum and lacuna vasculorum

88
Q

Lacuna Musculorum

A

lateral compartment
outside femoral sheath
lateral to fermoral artery
contains the iliopsoas muscle and femoral nerve

89
Q

Lacuna Vasculorum

A
medial compartment
encloses femoral sheath
contains femoral a. and several branches
femoral v. and tributaries
deep inguinal lymph nodes and lymph vessels
weak area and site of femoral hernia
90
Q

Femoral Sheath

A

funnel shaped fascial tube
lines lacuna vasculorum
formed by transversals fascia and iliopsoas fascia in abdomen
terminates inferiorly by blending with adventitia of femoral vessels
encloses proximal parts of femoral vessels and creates femoral canal medial to them
allows femoral a. and v. to glide deep to inguinal l.
Divided into 3 compartments; lateral, intermediate and medial

91
Q

Lateral Compartment of Femoral Sheath

A

for the femoral artery

92
Q

Intermediate Compartment of Femoral Sheath

A

for the femoral vein

93
Q

Medial Compartment of Femoral Sheath

A

constitutes femoral canal where lymphatics pass and site of herniation

94
Q

Femoral Canal

A

b/w medial edge of femoral sheath and femoral vein
extends to level of saphenous opening
allows femoral vein to expand in temporary stasis and times of increase venous return from lower limb
contains loose CT and lymphatics
base of canal is femoral ring

95
Q

Femoral ring

A

small opening at proximal end of femoral canal
closed extra peritoneal fat and parietal peritoneum
pierced by lymphatics b/w inguinal and external iliac nodes

96
Q

Adductor Canal

A

also know as sub sartorial canal or Hunters Canal
narrow passageway in middle of thigh
extends from apex of femoral triangle to adductor hiatus
Passage for: femoral a. and v., saphenous n. and N. to vastus medialis
Boundaries: Anteriorly and laterally - vastus medialis, Posteriorly - adductor longus and magnus, Medially - sartorius muscle
Anteromedial intermuscular septum - b/w adductors longus and magnus and vastus medialis miscles, adductor hiatus is located inferior to this structure

97
Q

Knee Joint

A

function commonly impaired with hyperextension
stability depends on: strength and actions of surrounding mm. and tt., the most important is quadriceps femurs (vastus medialis and lateralis)
ligaments connect femur and tibia
fibula has no articulation with femur
permits flex/ext, slight medial and lateral rotation (with flexed knee)
Features: hinge type synovial joint
Consists of 3 articulations- 2 femorotibial and 1 femoropatellar
joint capsule has an opening posterior and lateral to tibial condyle allowing polite us tendon to exit capsule
anteriorly, muscles and tendons replace capsule

98
Q

Suprapatellar Bursa

A

may extend halfway up anterior femur
synovial membrane of capsule is continuous with synovial lining of bursa
muscle slips from vastus intermedius form articulates genu muscle, retract bursa during extension

99
Q

Bursae around knee

A

Subcutaneous Prepatellar and infrapatellar - located at convex surface of joint allow skin to move freely during movement of knee
Suprapatellar - infection of this one may spread to knee cavity
Popliteus
Anserine
Gastrocnemius

100
Q

Ligaments of the Knee

Extracapsular

A
patellar l.
fibular collateral ligament
tibial collateral ligament
oblique popliteal ligament
arcuate popliteal ligament
101
Q

Ligaments of the Knee

Intracapsular

A
Cruciate ligaments-
Anterior cruciate ligament
Posterior Cruciate ligament
Menisci-
medial and lateral menisci
coronary ligmanet
transverse ligament of knee
102
Q

Patellar Ligament

A

from apex and adjoining margins of patellar to tibial tuberosity
anterior ligament of knee joint
receives medial and laterall patellar retinaculua, helps to form the knee joint capsule and helps keep the patella alignment

103
Q

fibular collateral ligmanet

A

strong and cord-like
lateral collateral ligament of the knee
taut with extension
from lateral epicondyle and femur to lateral surface of fibular head
tendon of popliteus passes deep to FCL separating ligament from meniscus
splits tendon of biceps femurs into two parts

104
Q

Tibial Collateral Ligament

A

strong and flat, weaker than FCL
medial collateral ligament of the knee
taut with extension
from medial epicondyle of femur to medial surface of tibia
deep fibbers are firmly attached to medial meniscus, more often damaged

105
Q

Oblique popliteal ligmanet

A

recurrent expansion of semimembranosus tendon
from medial tibial condyle passing superolaterally to lateral femoral condyle
reinforces joint capsule posteriorly

106
Q

Arcuate popliteal ligament

A

from posterior aspect of fibular head passing superomedially over tendon of popliteus, spreads over posterior surface of knee joint
strengthens joint capsule posteriorlaterally

107
Q

Cruciate Ligaments

A

cross each other obliquely within joint capsule, outside synovial cavity
during medial rotation of tibia on femur, wind around each other, limit MR to about 10 degrees
during LR it can go 60 degree especially when knee flexed it can go 90.
in every position 1 cruciate lig. is tense

108
Q

Anterior Cruciate ligament

A

weaker b/c poor blood supply
from anterior intercondylar area
extends posteriorly superiorly and laterally
attaches to posterior part of medial side of lateral femoral condyle
prevents posterior displacement of femur on tibia
prevents anterior displacement of tibia on femur when knee flexed
resists hyperextension

109
Q

Posterior Cruciate Ligament

A

stronger
from posterior intercondylar area
extends anteriorly, superiorly and medially
attaches to anterior part f lateral side of medial femoral condyle
prevents anterior displacement of femur on tibia
prevents posterior displacement of tibia on femur when knee is flexed
resists hyperextension of knee joint
main stabilizing factor of femur when weight bearing on the flexed knee (walking down hill)

110
Q

Menisci

A

crescentic plates of firbrocartilage
deepen tibial plateau, act as shock absorber
thicker at external margins
unattached at interior of joint
firmly attached at ends to intercondylar area of tibia

111
Q

Medial Meniscus

A

c shaped
adheres to deep surface of TCL
less mobile on tibial plateau, more prone to injury

112
Q

Lateral Meniscus

A

neraly circular
smaller and more freely moveable
tendon to popliteus passes b/w it and FCL
posterior meniscofemoral ligament joins the lateral menaces to PCL and medial femoral condyle

113
Q

Coronary Ligament

A

portions of joint capsule

extends b/w margins of menisci and periphery of tibial condyles

114
Q

Transverse ligament of knee

A

joins anterior edges of menisci
crosses anterior intercondylar area
tethers menisci to each other

115
Q

Popliteal Fossa

A

diamond shaped depression posterior to knee joint
Boundaries: superolateral-biceps femoris m
superomedial - semimembranosus and tendinosis
inferolateral - gastroc lateral head
inferomedial - gastroc medial head
posteriorly (roof) - skin of popliteal fascia
floor- medial and lateral supracondylar lines, soleal line of tibia and popliteus muscle
Contains; termination of small saphenous vein, popliteal a. and v., tibial and common fibular n., posterior cutaneous n. of thigh, lymphatics

116
Q

Fascia of Popliteal Fossa

A

superficial fascia contains the small saphenous vein and 3 cuteness nerves
posterior cutaneous n of the thigh and medial and lateral sural cutaneous nerves
Deep fascia is continuous sup. with fascia lat a and inf. with crural fascia
forms protective layer covering structures passing from thigh to leg
forms a loose, but effective retinaculum for hamstring muscles
often pierced by small saphenous v.

117
Q

Popliteal artery

A

continuation of femoral artery
one of four places to take a pulse
terminates by dividing into anterior and posterior tibial arteries at inferior border of politeus muscle
gives rise to medial and lateral superior and inferior genicular arteries and the middle genicular artery that all take part in genicular anastamosis

118
Q

Genicular anastamosis

A

medial and lateral superior and inferior genicular arteries
middle genicular artery
descending genicular artery
descending branch of lateral femoral circumflex artery
anterior tibial recurrent artery
fibular circumflex artery
posterior tibiabl circumflex artery

119
Q

Popliteal Vein

A

begins at inferior border of popliteus muscle
continuation of posterior tibial vein
receives small saphenous vein
becomes femoral vein as it traverses adductor hiatus

120
Q

Lymphatics

A

superficial and deep popliteal nodes drain into deep inguinal nodes
ultimately end up in external ilac nodes

121
Q

Tibiofibular joints

A

2 joints; superior tibiofibular joint and inferior tibiofibular joint (tibiofibular syndesmosis)
also held together by interosseous membrane
fibbers of all 3 run inferiorly from tibia to fibula
resists downward pull placed on fibula by 8 muscles
allows slight upward movement of fibular
movement at superior joint impossible without movement on inferior
anterior tibial vessels pass through hiatus at superior end of interosseus membrane

122
Q

Superior Tibiofibular Joint

A

plane type synovial joint, permits slight upward movement during dorsiflexion
between flat facet of fibular head and similar articular facet on lateral tibial condyle
joint is crosses posteriorly by popliteal tendon
20% of time the popliteus bursa communicates with this joint capsule
Ligaments are an anterior and posterior ligaments of the fibular head

123
Q

Inferior Tibiofibular Joint

A

Tibiofibular Syndesmosis
compound fibrous joint
integrity of joint is essential for stability of ankle
keeps lateral malleolus firmly against lateral surface of talus
features; b/w triangular area on medial surface of fibula with facet on end of tibia
fibrous union of tibia and fibula by, interosseous membrane, interosseous tibiofibular l., ant. tf l., post tf l.
permits slight movement to accommodate wide portion of trochlea during dorsiflexion

124
Q

Crural Fascia

A

attaches to anterior and medial borders of tibia, continuous with periosteum
thick proximally and thinner distally
forms the anterior, posterior inter muscular septa dividing the leg into 4 compartments; anterior, lateral posterior deep and posterior superficial
forms retinacula that prevents bowstringing during ankle movements

125
Q

Superior Extensor retinaculum

A

found anteriorly

passes from fibula to tibia proximal to malleoli

126
Q

Inferior Extensor Retinaculum

A

found anteriorly
Y-shaped band
attaches laterally to calcaneus, medially to medial malleolus and inferiorly to plantar aponeurosis
great saphenous vein and superficial fibular n. pass superficial to extensor retinacula

127
Q

Superior Fibular Retinaculum

A

found laterally

from lateral malleolus to calcaneus

128
Q

Inferior Fibular Retinaculum

A

found laterally
from fibular trochlea to calcaneus
both cover tendons of fibularis longs and brevis
small saphenous v. and sural n. pass superficial

129
Q

Flexor retinaculum

A

found medially
formed by distal part of transverse inter muscular septum
covers deep posterior compartment flexor tendons

130
Q

Anterior Tibial Artery

A

from the popliteal artery
passes from posterior to anterior via gap in interosseous membrane
runs with deep fibular nerve
Forms the Anterior tibial recurrent artery that participates in genicular anastamosis
Also forms the Perforating branches which supply the lateral compartment of the leg
descends between TA and EDL, then TA and EHL
Supplies the anterior compartment of leg
Forms the Medial and Lateral melleolar branches supplying the ankle
Terminates as dorsalis pedis artery b/w malleoli

131
Q

Anterior Tibial Vein

A

drains into posterior tibial vein

132
Q

Deep Fibular Nerve

A
terminal branch of common fibular nerve
also known as deep peroneal nerve
Runs with anterior tibial artery
supplies anterior compartment muscles
Terminates as the lateral and medial branches of deep fibular nerve
133
Q

Saphenous Nerve

A

from the femoral Nerve
runs with great saphenous vein
supplies skin of anteromedial and posteromedial leg

134
Q

Superficial Fibular Nerve

A

terminal branch of common fibular nerve
only nerve in lateral compartment
terminates as medial dorsal cutaneous nerve and intermediate dorsal cutaneous nerve

135
Q

Lateral Sural Cutaneous Nerve

A

from common fibular nerve

supplies skin of upper lateral leg

136
Q

Muscles of Posterior Comparment

A

divided into the superficial and deep compartments by the transverse intermuscular septum
Gastrocnemeus and soleus make up the triceps surae
Insert on the calcaneal tendon (achillies tendon)
most powerful and thickest tendon in body