Lachmans TEST REVIEW (PERSONAL Lower Limb)

Question 1

Where does the sciatic nerve pass in relation to anatomical landmarks at the gluteal fold?

Answer 1

Midway between the greater trochanter and the ischial tuberosity.

Question 2

How does the sciatic nerve enter the gluteal region?

Answer 2

It passes through the greater sciatic foramen, inferior to the piriformis.

Question 3

What is the function and origin of the lateral sural cutaneous nerve?

Answer 3

Branch of the common fibular nerve and provides sensory innervation over the lateral calf.

Question 4

What are the sensory and motor functions of the superficial fibular nerve?

Answer 4

Motor innervation to the muscles of the lateral compartment of the leg (fibularis longus and brevis)

Sensory innervation to the skin of the lower leg and the dorsum of the foot

Question 5

What are the functions of the deep fibular nerve?

Answer 5

Dorsiflexion of the foot and extension of the toes

“Motor innervation to muscles in the anterior compartment of the leg and dorsum of the foot

Sensory cutaneous innervation to the inferior tibiofibular joint”

Question 6

Deep Fibular nerve is a branch of ?

Answer 6

Common fibular nerve (L4/L5—S2).

Question 7

How do the superior and inferior gluteal nerves exit the pelvis?

Answer 7

Both exit through the greater sciatic foramen.

The superior gluteal nerve exits superior to the piriformis;

The inferior gluteal nerve exits inferior to it.

Question 8

What muscles and structures are innervated and vascularized by the superior gluteal nerve?

Answer 8

Gluteus medius and minimus

Superior gluteal vessels have superficial branches between gluteus maximus and medius.

Question 9

What does the inferior gluteal nerve innervate and what is its blood supply?

Answer 9

Innervates gluteus maximus and receives blood supply from both inferior and superior gluteal vessels.

Question 10

Name the main external (lateral) rotators of the hip.

Answer 10

Piriformis, obturator internus & externus, superior & inferior gemelli, quadratus femoris, and gluteus maximus.

Question 11

Which muscles contribute to shortening of the limb in hip fractures?

Answer 11

Gluteal muscles, hamstrings, adductors, iliopsoas, and other thigh flexors.

Question 12

What is the normal angle of inclination of the femur and how does it change in hip fractures?

Answer 12

Normally 125°; reduced in hip fractures → coxa vara.

Question 13

What happens to the angle of inclination in a valgus position due to fracture?

Answer 13

Increases due to abduction of the thigh; no limb shortening is seen

Question 14

Coxa Valga Vs Coxa Vara?

Answer 14

Coxa valga is characterized by an increased angle

Coxa vara is characterized by a decreased angle.

Valga- Knock
Vara- Bow Knee

Question 15

What are the three main sources of blood supply to the femur?

Answer 15

Nutrient arteries (from perforating branches of deep femoral a.)

Periosteal vessels

Medial femoral circumflex artery (posterior branches to femoral head)

Question 16

What artery runs through the ligament of the head of femur and is it significant?

Answer 16

Acetabular branch of obturator a (foveal artery); typically not significant for head supply.

Question 17

Why is the femoral head at risk for necrosis in subcapital fractures?

Answer 17

Branches of the medial femoral circumflex a. are torn, and the foveal artery is often insufficient.

Question 18

What is Hilton’s Law regarding joint innervation?

Answer 18

A joint receives innervation from the same nerves that supply the muscles acting on it.

Question 19

Which nerves supply sensory innervation to the hip joint?

Answer 19

Femoral, obturator, and sciatic nerves.

Question 20

What are the Capsular ligaments of the knee?

Answer 20

Patellar (anterior), oblique popliteal, arcuate popliteal (posterior)

Question 21

What are the Extracapsular ligaments of the knee?

Answer 21

Tibial (MCL) and fibular (LCL) collateral ligaments

Question 22

What are the Intracapsular ligaments of the knee?

Answer 22

ACL and PCL

Question 23

Where are the menisci and cruciate ligaments located relative to the synovial cavity?

Answer 23

Outside the synovial cavity, but inside the fibrous capsule.

Question 24

What movements are possible at the knee joint besides hinging?

Answer 24

Rolling, gliding, and rotation.

Question 25

What position is the knee most stable in and why?

Answer 25

Full extension; femur and tibia are most congruent, and ACL, PCL, MCL, LCL are taut (“locked”).

Question 26

During knee extension what ligaments are "locked"

Answer 26

ACL, PCL, MCL, LCL

Question 27

How is the knee “unlocked”?

Answer 27

Slight flexion and lateral rotation of the femur on the tibia, initiated by the popliteus muscle.

Question 28

What causes injury to the tibial (medial) collateral ligament (MCL)?

Answer 28

Adduction of the femur with the knee partially flexed, stressing the medial side.

Question 29

Which muscles insert at the pes anserinus crossing the MCL?

Answer 29

Sartorius, gracilis, and semitendinosus.

Question 30

Where does the anterior cruciate ligament (ACL) attach?

Answer 30

From lateral wall of intercondylar notch (femur) to anterior intercondylar area of tibia.

Question 31

What are the functions of the cruciate ligaments?

Answer 31

ACL: Limits anterior tibial translation PCL: Limits posterior tibial translation

Question 32

What does increased anterior mobility during testing indicate?

Answer 32

ACL tear.

Question 33

What contributes to knee stability besides ligaments? `

Answer 33

Iliotibial (IT) band.

Question 34

Describe the medial meniscus.

Answer 34

C-shaped, wedge-shaped (thicker at the periphery), less mobile (anchored to MCL), more commonly injured.

Question 35

Why is the lateral meniscus less prone to injury?

Answer 35

It is not attached to the lateral collateral ligament (LCL), giving it greater mobility.

Question 36

Where does the abdominal aorta bifurcate and into what?

Answer 36

Bifurcates into the two common iliac arteries anterior to L4.

Question 37

What does the external iliac artery become after passing under the inguinal ligament?

Answer 37

Common femoral artery, which enters the femoral sheath.

Question 38

What are the branches of the common femoral artery?

Answer 38

Deep femoral (profunda femoris): supplies anterior, medial, posterior thigh Superficial femoral a.: enters adductor canal → becomes popliteal a.

Question 39

What arteries does the popliteal artery branch into?

Answer 39

Anterior tibial a. → anterior leg → dorsalis pedis a. Posterior tibial a. → posterior/lateral leg → gives off fibular (peroneal) a.

Question 40

What arteries does the popliteal artery branch into?

Answer 40

Anterior tibial a. → anterior leg → dorsalis pedis a. Posterior tibial a. → posterior/lateral leg → gives off fibular (peroneal) a.

Question 41

Which arteries supply the knee?

Answer 41

Deep femoral a. → proximal knee Superficial femoral a. → distal knee

Question 42

Describe the ureter’s anatomical course in relation to the iliac arteries.

Answer 42

Crosses anterior to the bifurcation of the common iliac a., and passes over the origin of the external iliac a.

Question 43

What forms the femoral sheath and what does it contain?

Answer 43

Formed from transversalis fascia evaginating under inguinal ligament Contains femoral a., femoral v., and lymphatics

Question 44

What are the boundaries and contents of the femoral triangle?

Answer 44

Boundaries: Inguinal lig (sup.), sartorius (lat.), adductor longus (med.) Contents: NAVEL (Nerve, Artery, Vein, Empty space, Lymphatics)

Question 45

What structures are in the adductor canal and what does it become?

Answer 45

Contents: Superficial femoral a., femoral v., saphenous n., n. to vastus medialis Becomes popliteal fossa after vessels pass through adductor hiatus

Question 46

What are the boundaries and contents of the popliteal fossa?

Answer 46

Boundaries: Biceps femoris (superolateral), semitendinosus/semimembranosus (superomedial), gastroc. heads (inferior) Contents (post → ant): Tibial n. → popliteal v. → popliteal a.

Question 47

Trace the path of the great and small saphenous veins.

Answer 47

Great saphenous v.: medial → medial malleolus → femoral triangle → drains into femoral v. Small saphenous v.: lateral → lateral malleolus → between gastrocnemius heads → drains into popliteal v.

Question 48

What muscles are in the anterior compartment of the leg?

Answer 48

Tibialis anterior Extensor hallucis longus Extensor digitorum longus Fibularis tertius (sometimes considered, lateral portion)

Question 49

What structures define the boundaries of the anterior leg compartment?

Answer 49

Tibia, fibula, and interosseous membrane (posterior boundary) Crural fascia (encircling layer) Anterior intermuscular septum (lateral boundary with lateral compartment)

Question 50

What is the origin and role of the deep fibular (peroneal) nerve?

Answer 50

Branch: Common fibular nerve (L4/L5—S2). Innervates anterior compartment muscles and some foot dorsum muscles Provides cutaneous innervation to skin between 1st and 2nd digits

Question 51

Describe the branching of the common fibular nerve.

Answer 51

Wraps around the neck of the fibula Splits into: Superficial fibular n. (lateral compartment; skin of anterolateral leg & foot dorsum) Deep fibular n. (anterior compartment & toe web space)

Question 52

What is the primary arterial supply of the anterior compartment?

Answer 52

Anterior tibial artery (branch of popliteal a.)

Question 53

Where can the dorsalis pedis pulse be palpated?

Answer 53

Lateral to the tendon of extensor hallucis longus on the dorsum of the foot

Question 54

What arteries contribute to the collateral blood supply of the anterior compartment?

Answer 54

Branches of the posterior tibial and fibular arteries These perforate the interosseous membrane to anastomose with the anterior tibial a.

Question 55

Where does the common fibular nerve originate and how does it travel?

Answer 55

One of two terminal branches of the sciatic nerve Sciatic n. divides at the upper end of the popliteal fossa Common fibular n. lies against the medial edge of the biceps femoris, crosses the lateral head of fibula, wraps around fibular neck, and divides into superficial and deep fibular nerves

Question 56

What muscles and functions are associated with the superficial fibular nerve?

Answer 56

Motor: Fibularis longus & brevis (lateral compartment) → evert the foot Sensory: Skin of anterolateral distal leg & dorsum of the foot

Question 57

What muscles are innervated by the deep fibular nerve in the anterior leg?

Answer 57

Tibialis anterior – dorsiflexes and inverts the foot Extensor hallucis longus – extends the great toe & dorsiflexes foot Extensor digitorum longus – extends digits 2–5 & dorsiflexes foot Fibularis tertius – everts foot

Question 58

What are the functions of the deep fibular nerve in the foot? (Relations to extensor retinaculum)? digits

Answer 58

Innervates: (Extensors of the Leg) Tibialis anterior, extensor digitorum longus, extensor hallucis longus, fibularis tertius, Dorsiflexion of the foot and extension of the toes

Question 59

What is the sensory role of the saphenous nerve?

Answer 59

Branch of femoral nerve Provides sensory innervation to anteromedial leg and dorsomedial surface of foot

Question 60

What area does the sural nerve supply?

Answer 60

Sensory innervation to the skin of the posterior leg

Question 61

What is the sensory role of the tibial nerve in the foot?

Answer 61

Provides sensation to the sole of the foot via its medial and lateral plantar branches