Lecture 13 review Flashcards by Morgan Evans

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List the 6 regions of the lower extremities (that exist for descriptive purposes)

1) Gluteal region (buttocks and hip) – transition zone
2) Hip joint
3) Femoral region (thigh)
4) Knee region (joint)
5) Leg or crural region
6) Ankle or talocrural region (joint)
7) Foot region

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1) Are the 3 bones that make up the hip bones still separated at puberty? Explain
2) When does cartilage disappear and begin to fuse?
3) When does fusion finish?

1) At puberty still separated by triradiate cartilage
2) Cartilage disappears and begin to fuse ~ 15-17 y/o
3) Fusion complete by age 20-25 y/o

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List the 3 bones of the hip bones and some features of each

1) Ilium: body, ala, iliac crest
2) Ischium: body, ramus
3) Pubis: body, superior & inferior rami, symphysis

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What are the two parts of the hip joint?

Femoral head and acetabulum

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What bones make up the LE?

1) Hip bones – 3 bones, acetabulum
2) Femur
3) Patella (sesamoid)
4) Tibia
5) Fibula
6) Tarsus (7 bones)
7) Metatarsus (5)
8) Phalanges (14)

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1) What is the main part of the femur called?
2) What are the features of the proximal femur?
3) What are the features of the distal femur?
4) What rests on top of the distal femur?

1) Shaft
2) Head w articular cartilage, neck, and trochanters
3) Femoral epicondyles & condyles (articular cartilage)
4) Patella

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Explain the angle of inclination

1) When we’re born, the angle of inclination is abt 135 degrees
2) Reaches about 125 degrees in adulthood
3) As elderly people age, that angle decreases even more, can cause neck of femur to snap off

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Explain the torsion angle of the femur

At the axis of the femoral head and neck there’s about a 12 degree angle. If the angle is larger the toes will point inward; sometimes kids start with outward pointing toes.

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What does the angle of inclination + torsion angle allow for?

Rotatory movements of the femoral head within the obliquely placed acetabulum to convert into flexion and extension, abduction and adduction and rotational movement of the thigh.

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What are the 4 surface landmarks of the distal femur?

1) Epicondyles (“above” the condyles)
2) Adductor tubercle (adductor m.)
3) Condyles (articular surface)
4) Patella (big sesamoid bone)

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What are 3 tibial articulations?

1) Femur condyles superiorly
2) Talus inferiorly
3) Fibula at proximal and distal ends.

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Where does the distal end of the tibia rest? What does this form?

Medial malleolus; medial and posterior mortise of ankle joint

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Surface anatomy:
1) What is at the base of 5th MT?
2) What is just distal to f. brevis insertion?
3) What are the features of the big toe (hallux)?

1) Fibularis brevis insertion
2) Fibularis tertius
3) 2 phalanges and 2 sesamoids planter surface of MT-P joint

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Surface anatomy:
1) Where do bunions typically occur?
2) Where are Taylors bunions?
3) How many tarsal bones are there and what do they provide?

1) Medial MTP joint
2) Lateral 5th MTP joint
3) 7; provide flexibility and shock absorption during weight bearing

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Surface anatomy:
1) What bone is weight bearing (and the only tarsal bone to articulate with the leg)?
2) What envelops the calcaneus? What does this continue as?
3) What does the navicular bone refer to?

1) Talus
2) Achilles tendon; continues as plantar aponeurosis
3) Tarsus and carpus (scaphoid)

1) What is the transition between the glutes and thigh called?
2) What is the Fascia Lata? What does it do?

1) Gluteal fold
2) Deep fascia of the thigh; investing like a stocking, compression, support.

What are the fascial components of the leg? Which is continuous from the Fascia Lata? Which is divided into 3 compartments?

1) Crural fascia (deep investing): continuous from Fascia Lata, septa divide into 3 compartments
2) Transverse intermuscular septum

1) What makes up the superficial fascia/ SQ of the thigh?
2) What forms the thigh’s deep or investing fascia (continuous from Fascia Lata)?

1) Fatty tissue and superficial veins
2) Fascia lata and 3 intermuscular septa

What are the 3 compartments formed by the deep/ investing fascia (continuous from Fascia Lata) of the thigh?

1) Anterior: knee extend, hip flex
2) Medial: hip adductor
3) Posterior: hamstrings

What are the 3 compartments formed by the Crural fascia (deep investing) of the leg?

1) Anterior: dorsiflexor compartment
2) Lateral: foot evertor compartment
3) Posterior: plantar flexor compartment

1) What does the transverse intermuscular septum divide into two parts?
2) What are these two parts?

1) Posterior fascia compartment of lower leg into superficial and deep parts
2)
Superficial = calf muscles (cross knee and ankle)
Deep = foot plantar flexors (cross ankle)

What type of veins have one-way valves and go superficial to deep (except foot – deep to superficial)?

Perforating veins

The great saphenous vein ascends anteromedially. While it does this, where is it in relation to?:
1) The medial malleolus
2) Medial condyle
3) Saphenous opening in fascia lata

1) Anterior to medial malleolus
2) Posterior to medial condyle (about hands breath posterior to medial margin of patella)
3) Traverses it into the femoral vein

1) Where does the small saphenous vein run? 2) What does it empty into/ continue as?

1) Dorsolateral foot to posterior leg 2) Popliteal vein

Where does the small saphenous vein ascend?

-Posterior to lateral malleolus -Inclines to midline to penetrate the deep fasci & ascends between heads of the gastrocnemius mm.

Describe deep lymphatics of the LE; what do they accompany? To where?

Deep veins; to popliteal nodes > deep inguinal nodes > iliac nodes

1) What is the major artery to lower extremity? 2) What supplies the posterior and lateral aspects of the thigh with blood? 3) What is usually a branch of internal iliac artery that supplies the medial compartment of the thigh?

1) Femoral artery 2) Profunda femoris artery 3) Obturator artery

What 2 things does the popliteal artery branch into? Describe the courses of each

Anterior and posterior tibial arteries (distal to popliteal fossa (leg)) 1) Anterior tibial a.: to anterior compartment of leg to ankle to become Dorsal Pedis a. 2) Posterior tibial a.: to posterior compartment of leg to become medial and lateral plantar aa.

1) Where does the femoral artery go through? 2) What arteries does it branch into?*

1) Adductor canal and hiatus 2) Profunda femoral artery and circumflex arteries

What dermatome is the anterior thigh compartment? What innervates it?

L2-4; femoral nerve

1) What are the two motor functions of the femoral nerve? 2) What are the two sensory functions of the femoral nerve? What branches are these performed as?

1) Flexors of the hip + extensors of the knee 2) Anterior cutaneous n. for thigh and Saphenous n. for medial calf and foot

1) What is the motor function of the obturator nerve? What's the exception? 2) What is the sensory function of the obturator nerve?

1) Adductors of the thigh (L2-4) -*Except hamstring part of adductor magnus m. innervated by tibial nerve 2) Medial thigh sensation

Where does the sciatic nerve come from? (dermatome and plexus) 1) What are its two major branches? 2) What does one of those branch into?

L4-S3; sacral plexus: 1) Tibial nerve (posterior thigh and leg) 2) Common fibular nerve: into superficial and deep fibular (peroneal) nerves (anterior and lateral leg)

What motor and sensory functions is the sciatic nerve responsible for? Why?

1) Branches provide ALL motor below knee 2) Most sensory below knee -Saphenous nerve is from the femoral n. on medial aspect of leg and foot

1) What are the two motor functions of the tibial nerve? (branch of sciatic nerve) 2) What two branches does this nerve use to provide sensory innervation? What two areas are supplied?

1) Hamstrings: semi-T & semi-M (flex knee & extend hip) and hamstring pt of adductor m. 2) Medial sural n. and sural n.; calf region and heel of foot

1) Where does the plantar nerves supply motor innervation to? 2) What two places does the plantar nerves supply with sensory innervation?

1) Intrinsic muscle of foot 2) Plantar surface + other nerves

1) What is the common fibular nerve a branch of? What spinal level does it come from? 2) What 2 parts of the leg does it supply?

1) Sciatic nerve; L4-S2 2) Anterior and lateral compartment

1) What is the motor function of the common fibular nerve? 2) What does the common fibular nerve branch into to provide sensory innervation? Where to?

1) Dorsiflexion and Eversion of the foot 2) Lateral sural n.; lateral leg & foot, dorsum of foot