Lecture 26 (10-7-14) Flashcards Preview

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Flashcards in Lecture 26 (10-7-14) Deck (46):
1

What are the bones of the lower limb?

  • pelvic girdle
  • femur
  • petella
  • tibia
  • fibula
  • 7 tarsals
  • 5 metacaples 
  • 14 carples

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2

What kind of bone is petella?

sigmoid

3

What are the dermatomes?

kness 4-5 s1 posterior ankle and foot s2 most of posterior thighs gluteal region s3-s4

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4

 

 

What are the cutaneous nerves and where are their associated innervations?

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5

What is fascia lata?

Deep fascia of thigh

  • in the thigh
  • saphenous ring

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6

What is crural fascia?

Deep fascia in the leg

7

What is the it band?

thickening of fascia lata

8

Where do all the arteries for the lower limb come from? continuation from what are its branchs

  • Femoral artery
  • external iliac
  • deep femoral artery
  • medial and lateral deep circumflex femoral

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9

What does the femoral artery become and where does it exit?

FINISH! ~poplieteal a --> adductora hiatus--> anterior tibial (

10

What are the superfical and deep veins of lower limb?

Superficial 

  • Dorsal venous arch
  • Small saphenous v (to popliteal)
  • Great saphenous v (to femoral v)

 

Deep accompany major arteries 

  •  Anterior tibial (to popliteal)
  • Posterior Tibial (to popliteal
  • Popliteal (to femoral)
  • Femoral (to external iliac)

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11

What are some arteries used for cabag

  • radial
  • maxillary
  • great saphenous

12

Lymphatics of the leg

have superficial and deep the deep drains into the superficial . they go with veins. and works its way back to the ---

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13

fascial compartments of the thigh

  • anterior compartment
  • posterior compartment
  • intermuscular septea
  • medial compartment

 

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14

Surface features of the anterior and medial thight

~quadrocetps ~sartorius ~femoral triangle ~petella

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15

What are the parts of the thigh bone?

  1. head
  2. neck
  3. greater trochaner:
    • inf./sup. gemellus
    • obturator internus
    • piriformis
    • vastus lateralis (only origin)
    • gludeus medis
  4. interochanteric line--> (o) vastus medualis
  5. intertrochnteric crest--> (i) quadratus femoris
  6. lesser trochanter*** illipsopsas (ins)

  7. trocanteric fossa ** obturator externus
     

  8. shaft
  9. lateral epicondyle 
  10. adductor tubericle******adductor magnus (hamstring part)
  11. medial epicondyle
  12. posterior fovea capitis
  13.  pectineal line--> ins. pectines
  14. gluteal tuberosity (i) glut. max
  15. linea aspera (lat and medial lips) o: vastus medialsi
    • short head biceps femorsi (i)
    • vastes lateralis (o) 
  16. intercondylar fossa
  17. lateral condyle
    • gastrocnemus 
    • PCL
  18. med condyle-ACL
    1. gastrocnemus 
  19. lateral supracondylar line--> plantaris 

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16

how many muscles are on the lesster trochantar

ONE!!! ********* ILLIOPSOSAS!

17

where is Gurneys tuberical?

Lateral condyle to the tibia where it band attaches

18

What is in the anterior thigh muscles

FLEXORS OF HIP all innervated by femoral nerve

  • sartorius
  • Illiopsoas
  • Pectineus 

 

EXTENDORS of knee

  • Quadriceps femoris 
    • rectus femoris
    • vastus lateralis 
    • vastus medialis 
    • vastus intermedius 

19

Sartorius

  • ASIS--> Medial tibia
  • Femoral n. 
  • flexes the knee
    • weakly abducts lateral rotates hit at thigh

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20

Iliopsoas

  • T12 v--> L4 v and illiac fossa--> lesser trochangter 
  • L2-L4 + femoral nerve
  • STRONG hip flexor and stabilize hip

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21

Pectineus

  • Superior pubis ramus (pectineal line)--> pectate line of trochanter
  • Femoral nerve
  • Actions
    • flexes hip;
    • adducts the thigh
    • weak medial roator thight

 

medial floor of femoral

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22

Rectus femoris

  • ASIS--> quadriceps tendion only one attaches to pelvis
  • femoral nerve
  • actions
    • extend the knee
    • weakly flexes hip** only quadricep muscle that does this! 

Anterior thigh muscle

Quadricpe femoris muscle 

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23

Vastus medialis 

  • Intertrochanteric line; meidal lip of linea aspera
  • Nerve to vastus medialis 
  • extend the knee

 

Quadricpe femoris muscle 

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24

Vastus lateralis

  • greater trochanter; lateral lip of linea aspera--> petallar ligament (tendon)

  • femoral 
  • extend knee

Quadricpe femoris muscle 

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25

Vastus intermedius

  • anteral and lateral shaft of tuberosity
  • Femoral Nerve
  • knee extensor 

 

Quadricpe femoris muscle 

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26

Where do all quadriceps attach? 

what are they?

tibal tuberosity they all make a petella tendon

rectus femoris

vastus medialis

vastus lateralis

vastus intermedius

27

What is the innervation of hte anterior thigh?

femoral L2,3,4 

femoral nerve L2-4 ~cutantous femoral branch of genitofemoral branch l1-2 lateral femoral cutaneous L2-3 anterior femoral chutaneous (f/ femoral) saphenous (f/ femoral)

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28

What is a strong hip flexor?

illio soasa

29

What are the boundries of the femoral triangle?

  • roof: fascia lata
  • base:inguinal lig
  • Med: add longus
  • Lat: sartourisu
  • Floor: iliopsas and pectineus

 

 

CONTENTS femoral nerve, artery, vein deep inguinal lymph nodes and associated lymphatic vessels 

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30

What are the conents of the femoral triangle?

  • Femoral nerve, artery and vein
  • deep inguinal lymph nodes
  • associated lymphatic vessels 

 

 

roof: fascia lata

base:inguinal lig

Med: add longus

Lat: sartourisu

Floor: iliopsas and pectineus

 

 

 

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31

Femoral sheath?

Whats anterior?

Whats posterior?

What are the compartments and what do they contain?

  • ant: transversalis fascial
  • Post: iliopsosas
  • Compartments: "Navel" medial to lateral Lateral compartment: femoral a Intermediate:
  • Nerves (vastus meadials and saphinus
  • Artery (femoral a.)
  • Vein (femoral v.)
  • Empty (femoral canal)
  • Lymphatics 

 

FEMORAL NERVE IS BEHIND NOT INCLUDED!!

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32

  1. Where is the femoral canal?
  2. What does it do?
  3. What is its superior margin?
  4. What is its continents?

  1. Most medial part of the femoral sheath
  2. allows the femoral vein to expand
    1. get bigger increae venous return, or during temporary stasis as with valsva maneuver
  3.  femoral ring
  4. contents
    1. deep inguinal lymph nodes
    2. associated lymphatic vessels
    3. LCT and fat

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33

  1. What are femoral hernias found?
  2. how big are they normally
  3. what can enter 
  4. More common in___ ?
  5. What is the bad thing?

  1. in the femoral ring because it is a weak area in the anterior abdominal wall

  2. tip of a small finger

  3. abdominal viscera

  4. women

  5. Child bearing 

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34

  1. The adductor canal is continuous with what?
  2. where is it located?
  3. What does it contain?
  4. What does it break up?
  5. What is another name for it?

  1. femoral triangle
  2.  located
    1. deep to satrorius m
    2. anterior to add. longs and magnus
    3. top: apex of femoral triangle
    4. bottom: addutor hiatus
  3. CONTENTS:
    1. femoral a and vein
    2. saphenous n
    3. n to vastus medialis
  4. adductor an dhamstring part of adductor magus
  5. Subsartorial canal 

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35

What are the actions of the medial compartment of the thigh?

What are the medial thigh muscles?

 

 

ADDUCTORS OF THE HIP!

all innervated by obturator n 

 ANTERIOR DIVISION L2-L3

  1.  gracilis-
  2. adductor longs
  3. adductor brevis

Posterior Division L3-L4

  1. aductor magnus (adductor part) 
  2. obturator externus:

36

Gracilis 

 

  • inferiorpubic ramus--> medial tibia
  • anterior division of obturator n
  • adduct the thigh
    • helps in knee flexion (only one)

 

*medial thigh muscle*

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37

Adductor longus

 

 

  • body of pubis--> linea aspera (?? not sure)
  • anterior division of obturator n
  • adduct thigh

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38

Adductor Brevis

 

 

  • Body and inferior pubic ramus--> linea asspera (?not sure)
  • anterior division of obturator n 
  • adduct thigh

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39

Adductor Magnus

What breaks up the who parts?

HAS TWO PARTS!!!

Adductor part

  • inferior pubic ramus--> gluteal tuberosity, linea aspera, medial supracondylar ridge
  • posterior division of obturator nerve
  • adducts the thigh and helps flex hip

 

Hamstring part:

  • ischial tuberosity--> gluteal tuberostity, linea aspera, medial supracondylar ridge
  • tibial part of sciatic n (L4-S3)
  • extend the hip 

Adductor canal breaks it up

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40

Obturator Externus

 

 

  • obturator foramen and membrane--> trochanteric fossa 
  • posterior division of obturator n
  • lateraly roate the thigh

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41

What is the innervation of the medial thigh?

Obturator l2,l3,l4

Posterior division

  • adductor part of adductor magnun
  • obtuator externus

anterior division

  • gracilis
  • adductor longus
  • adductor brevis

 

Cutaneous innervation: br of obturatior nerve

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42

Arteries of the thigh

  • Anterior Compartment: Femoral Artery:
    • lateral circumflex femoral a
      • ascending,
      • transverse, (supply hip)
      • descending brch. (supply knee)
    • medial circumfles femoral a

Medial compartment:

  •  Profunda femoris a
  • Obturator a: Acetabular br. 

Posterior Compartment: Peforating aa from deep femoral  (not in the picture)

 

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43

What are the veins of the thigh?

Superficial: Great saphenous v, (not in picture)

Deep:

  • peforating veins (not in picture)
  • deep femoral v
  • femoral v
  • external iliac v.

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44

What are varicose veins

blood from the deep veins goes back into the superfical veins because the great saphenous veins become dilated and the valves don't close.

results in a tortuous course  

45

What happens in the adductor hiatus?

the femoral vessels --> popliteal vesslesl 

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46

  1. What is hip pointer?

  1. contusions of the iliac grest
  2. ASIS
  3. contact or collision sports (or if you make some one really mad!)
  4. capillaries ruputre--> bleed--> infiltration of blood into muscles, tendons, soft tissues--> swelling--> PAIN!!