Lower Extremity Flashcards
(239 cards)
1
Q
What type of joint is the hip joint?
A
Synovial, ball and socket
2
Q
What is the strongest ligament in the body?
A
Iliofemoral ligament (holds femur in place)
3
Q
What movement of the hip joint has the most range?
A
Flexion (135deg)
4
Q
Which is the largest muscle compartment in the thigh?
A
Anterior compartment
5
Q
What commonly causes “numb bum” syndrome?
A
Damage to the superior cluneal nerves (arising from dorsal rami of L1, L2, & L3) often from skin incision for harvesting bone from iliac crests. Leads to sensory loss to skin of gluteal region
6
Q
What are the (3) superficial muscles of the gluteal region?
A
Gluteus maximus
Gluteus medius
Gluteus minimus
7
Q
Gluteus maximus origin (proximal)
A
Outer surface of ilium, adjacent posterior surface of sacrum and coccyx
8
Q
Gluteus maximus insertion (distal)
A
Iliotibeal tract of fascia lata, gluteal tuberosity of femur
9
Q
Gluteus maximus actions
A
Extends and laterally rotates hip joint
10
Q
Gluteus maximus nerve supply
A
Inferior gluteal nerve (L5, S1, S2)
11
Q
Gluteus medius origin (proximal)
A
Outer surface of ilium inferior to iliac crest
12
Q
Gluteus medius insertion (distal)
A
Lateral surface of greater trochanter
13
Q
Gluteus medius actions
A
Abducts femur at hip joint and medially rotates thigh
14
Q
Gluteus medius nerve supply
A
Superior gluteal nerve (L4, L5, S1)
15
Q
Gluteus minimus origin (proximal)
A
Outer surface of ilium between middle and inferior gluteal lines
16
Q
Gluteus minimus insertion (distal)
A
Anterior surface of greater trochater
17
Q
Gluteus minimus actions
A
Abducts femur at hip joint and medially rotates thigh
18
Q
Gluteus minimus nerve supply
A
Superior gluteal nerve (L4, L5, S1)
19
Q
Tensor fasciae latae origin (proximal)
A
Anterior superior iliac spine (ASIS) and outer edge of iliac crest
20
Q
Tensor fasciae latae insertion (distal)
A
Iliotibial tract of upper part of thigh
21
Q
Tensor fasciae latae actions
A
Flexes, medially rotates, and abducts thigh
22
Q
Tensor fasciae latae nerve supply
A
Superior gluteal nerve (L4, L5, S1)
23
Q
What are the (6) short lateral rotators of the thigh?
A
Piriformis Obturator internus Obturator externus Gemellus superior Gemellus inferior Quadratus femoris
24
Q
Piriformis origin (proximal)
A
Internal surface of sacrum
25
Piriformis insertion (distal)
Upper border of greater trochanter
26
Piriformis actions
Laterally rotates thigh
27
Piriformis nerve supply
S1 & S2 from sacral plexus
28
What is found immediately deep to the piriformis?
Sciatic nerve
29
Gemellus superior origin (proximal)
Spine of ischium
30
Gemellus superior insertion (distal)
Upper border of greater trochanter
31
Gemellus superior actions
Laterally rotates thigh
32
Gemellus inferior origin (proximal)
Ischial tuberosity (inferior to spine)
33
Gemellus inferior insertion (distal)
Upper border of greater trochanter
34
Gemellus inferior actions
Laterally rotates thigh
35
Obturator internus origin (proximal)
Pelvic surface of obturator membrane and surrounding bone
36
Obturator internus actions
Laterally rotates thigh
37
Obturator externus origin (proximal)
Outer surface of superior and inferior rami of pubis and ramus of ischium surrounding obturator foramen
38
Obturator externus insertion (distal)
Trochanteric fossa of femur
39
Obturator externus actions
Laterally rotates thigh
40
Obturator externus nerve supply
Obturator nerve (L2, L3, L4)
41
Quadratus femoris origin (proximal)
Ischial tuberosity
42
Quadratus femoris insertion (distal)
Below intertrochanteric crest
43
Quadratus femoris actions
Laterally rotates thigh
44
What are the 4 hamstring muscles?
Biceps femoris
Semitendiosus
Semimembranosus
Adductor magnus
45
Which hamstring muscle is innervated by the common peroneal (lateral) component, as opposed to the tibial component, of the sciatic nerve?
The short head of biceps femoris
46
Biceps femoris origin (proximal)
Long head: Ischial tuberosity
| Short head: linea aspera
47
Biceps femoris insertion (distal)
Lateral aspect of the head of fibula
48
Biceps femoris actions
Flexes at knee joint
Long head extends thigh
Laterally rotates leg when knee is flexed
49
Biceps femoris nerve supply
Long head: tibial part of sciatic nerve
| Short head: common peroneal (fibular) art of sciatic nerve
50
Semitendinosus origin (proximal)
Ischial tuberosity
51
Semitendinosus insertion (distal)
Medial surface of shaft of tibia
52
Semitendinosus actions
Extends thigh at hip, flexes leg, medially rotates leg when knee is flexed
53
Semitendinosus nerve supply
Tibial portion of sciatic nerve
54
Is the semimembranosus deep or superficial to the semitendinosus?
Semimembranosus is deep to semitendinosus
55
Semimembranosus origin (proximal)
Ischial tuberosity
56
Semimembranosus insertion (distal)
Posterior part of medial condyle of tibia
57
Semimembranosus actions
Extends thigh at hip, flexes leg, medially rotates leg when knee is flexed
58
Semimembranosus nerve supply
Tibial portion of sciatic nerve
59
Adductor magnus origin (proximal)
Inferior ramus of pubis (adductor part)
| And ischial tuberosity (hamstring part)
60
Adductor magnus insertion (distal)
Linea aspera, adductor tubercle of femur
61
Adductor magnus actions
Adducts thigh at hip
| Assists in extension of thigh (hamstring part)
62
Adductor magnus nerve supply
Obturator nerve (L2, L3, L4)
63
What roots make up the sciatic nerve?
L4, L5, S1, S2, S3
64
What roots make up the femoral nerve?
L2, L3, L4
65
What roots make up the obturator nerve?
L2, L3, L4
66
What roots make up the superior gluteal nerve?
L4, L5, S1
67
What roots make up the inferior gluteal nerve?
L5, S1, S2
68
What roots make up the posterior cutaneous nerve of thigh?
S1, S2, S3
69
What roots make up the pudendal nerve?
S2, S3, S4
70
What is the order of the branches of the lumbrosacral plexus?
```
Sciatic (L4-S3)
Femoral (L2–L4)
Obturator (L2-L4)
Superior gluteal (L4-S1)
Inferior gluteal (L5-S2)
Posterior cutaneous (S1-S3)
Pudendal (S2-S4)
```
71
What is the superior medial border of the popliteal fossa?
Semitendinosus
72
What is the superior lateral border of the popliteal fossa?
Biceps femoris (long head)
73
What is the inferior borders of the popliteal fossa? (Medial and lateral)
Gastronemius, medial and lateral heads
74
What innervates the flexors (anterior compartment) of the thigh?
Femoral nerve
75
What innervates the adductors (medial compartment) of the thigh?
Obturator nerve
76
What innervates the extensors of the thigh?
Sciatic nerve
77
What innervates most of the abductors of the thigh?
Gluteal nerve
78
Psoas major origin (proximal)
Transverse processes and bodies of L1-L5 vertebrae
79
Psoas major insertion (distal)
Merges with iliacus and inserts as iliopsoas into the lesser trochanter of femur
80
Psoas major actions
Flexes thigh at hip
| Flexes vertebral column (bending forward)
81
Psoas major nerve supply
L2, L3
82
Iliacus origin (proximal)
Iliac fossa
83
Iliacus insertion (distal)
Merges with soas major and inserts as iliopsoas into lesser trochanter of femur
84
Iliacus actions
Flexes thigh at hip
85
Iliacus nerve supply
L2, L3
86
Sartorius origin (proximal)
Anterior superior iliac spine (ASIS)
87
Sartorius insertion (distal)
Medial surface of proximal tibia
88
Sartorius actions
Flexes, abducts and laterally rotates thigh a hip
Flexes leg at knee
Medially rotates leg with flexed knee
89
Sartorius nerve supply
Femoral nerve (L2, L3, L4)
90
What are the (4) quadriceps femoris?
Rectus femoris
Vastus lateralis
Vastus medialis
Vastus intermedius
91
Rectus femoris origin (proximal)
Anterior inferior iliac spine (AIIS)
92
Rectus femoris insertion (distal)
Patella via quadriceps tendon
| Tibial tuberosity via patellar ligament
93
Rectus femoris actions
Extends leg at knee
| Flexes high at hip
94
Rectus femoris nerve supply
Femoral nerve (L2, L3, L4)
95
Vastus lateralis origin (proximal)
Greater trochanter, intertrochanteric line, linea aspera of femur
96
Vastus lateralis insertion (distal)
Patella via quadriceps tendon
| Tibial tuberosity via patellar ligament
97
Vastus lateralis actions
Extends leg at knee
98
Vastus lateralis nerve supply
Femoral nerve (L2, L3, L4)
99
Vastus medialis origin (proximal)
Intertrochanteric line, medial lip of linea aspera of femur
100
Vastus medialis insertion (distal)
Patella via quadriceps tendon
| Tibial tuberosity via patellar ligament
101
Vastus medialis actions
Extends leg at knee
102
Vastus medialis nerve supply
Femoral nerve (L2, L3, L4)
103
Vastus intermedius origin (proximal)
Anterior and lateral shaft of femur
104
Vastus intermedius insertion (distal)
Patella via quadriceps tendon
| Tibial tuberosity via patellar ligament
105
Vastus intermedius actions
Extends leg at knee
106
Vastus intermedius nerve supply
Femoral nerve (L2, L3, L4)
107
Pectineus origin (proximal)
Superior pubis ramis
108
Pectineus insertion (distal)
Posteriorly, below lesser trochanter, on linea aspera
109
Pectineus actions
Flexes, adducts, medially rotates thigh
110
Pectineus nerve supply
```
Femoral nerve (L2, L3, L4)
Sometimes obturator nerve (L2, L3, L4)
```
111
Gracilis origin (proximal)
Pubic bone (inferior ramus)
112
Gracilis insertion (distal)
Upper part of medial surface of tibia
113
Gracilis actions
Adducts thigh at hip
Flexes leg at knee
Medially rotates leg with flexed knee
114
Gracilis nerve supply
Obturator nerve (L2, L3, L4)
115
What (3) muscles make up the guy ropes of the thigh?
Gracilis
Semitendinosus
Sartorius
116
Adductor longus origin (proximal)
Pubic bone
117
Adductor longus insertion (distal)
Medial lip of linea aspera
118
Adductor longus actions
Adducts thigh at hip
119
Adductor longus nerve supply
Obturator nerve (L2, L3, L4)
120
Adductor brevis origin (proximal)
Pubic bone
121
Adductor brevis insertion (distal)
Linea aspera
122
Adductor brevis actions
Adducts thigh at hip
123
Adductor brevis nerve supply
Obturator nerve (L2, L3, L4)
124
What is the name of the hole that the femoral artery passes through? (What direction)
Adductor hiatus
| Anterior in thigh, posterior in leg
125
What are the lateral, medial, and superior borders of the femoral triangle?
Lateral: sartorius
Medial: adductor longus
Superior: inguinal ligament
126
What are the (3) major contents of the femoral triangle?
Femoral vein
Femoral artery
Femoral nerve
127
What is the name of the femoral artery and vein after they pass through the adductor hiatus?
Popliteal artery and vein
128
What muscles and nerve are affected in Trendelenburg gait? (Hip drop)
Weakess of hip abducor muscles (gluteus medius and gluteus minimus) on opposite side from drop.
Innervated by superior gluteal nerve
129
What bones are a part of the knee joint?
Femur, tibia, patella
130
What type of joint is the knee joint?
Modified hinge joint
131
What are the (9) muscles that flex the leg at the knee?
Primary: hamstrings (Biceps femoris, semitendinosus, semimembranosus, adductor magnus)
Secondary: sartorius, gracillis, gastrocnemius, plantaris, popliteus
132
What are the (4) muscles that extend the leg at the knee?
Rectus femoris
Vastus medialis
Vastus intermedius
Vastus lateralis
133
What is the largest sesamoid bone in the body?
The patella
134
What muscle prevents lateral dislocation of the patella?
The vastus medialis provides an asymmetrical pull to prevent lateral dislocation
135
What is the primary lateral rotator of the flexed knee?
Biceps femoris
136
What are the (4) primay medial rotators of the flexed knee?
Semimembranosus, semitendinosus, gracilis, sartorius
137
Popliteus origin (proximal)
Lateral surface of lateral condyle of femur
138
Popliteus insertion (distal)
Upper part of posterior surface of tibia
139
Popliteus actions
Rotates leg medially when femur is fixed
Rotates thigh laterally when foot is fixed on floor
Flexes leg a knee
140
Popliteus nerve supply
Tibial nerve (L4, L5, S1)
141
What (2) ligaments prevent hyperextension of the knee?
Medial and lateral collateral ligaments
142
What are the (6) ligaments of the knee joint?
Anterior and posterior cruciate ligament
Lateral and medial collateral ligament
Lateral and medial meniscus
143
Which meniscus is wider?
Medial meniscus
144
Which meniscus is closer to being a complete circle?
Lateral meniscus
145
Where do the anterior and posterior cruciate ligaments start and end?
Anterior: starts lateral and posterior, ends medial and anterior
Posterior: starts medial and anterior, ends lateral and posterior
146
Which meniscus and collateral ligament do not touch (gap between)?
Lateral side
147
What are ruptured in “O’Donoghue’s unhappy triad”?
Medial collateral ligament
Anterior cruciate ligament
Medial meniscus
148
What are the (3) bursa around the patella?
Suprapatellar bursa
Prepatellar bursa
Infrapatellar bursa
149
Which bursa is affected in “Housemaid’s knees”/surfers knobs?
Prepatellar bursa
150
Gastrocnemius origin (proximal)
Lateral condyle and posterior surface of femur
151
Gastrocnemius insertion (distal)
Posterior surface of the calcaneus
152
Gastronemius actions
Plantar flexes foot
| Flexes leg at knee
153
Gastrocnemius nerve supply
Tibial nerve (S1, S2)
154
Soleus origin (proximal)
Posterior surface of tibia (soleal line)
Upper third of posterior surface of fibula
Fibrous arch between tibia and fibula
155
Soleus insertion (distal)
Posterior surface of the calcaneus
156
Soleus actions
Plantar flexes foot
157
Soleus nerve supply
Tibial nerve (S1, S2)
158
Plantaris origin (proximal)
Lateral supracondylar ridge of femur
| Oblique popliteal ligament
159
Plantaris insertion (distal)
Posterior surface of the calcaneus
160
Plantaris actions
Plantar flexes foot
| Flexes leg
161
Plantaris nerve supply
Tibial nerve (L4, L5, S1)
162
Flexor digitorum longus origin (proximal)
Medial part of posterior surface of tibia
163
Flexor digitorum longus insertion (distal)
Bases of distal phalanges of toes 2-5
164
Flexo digitorum longus actions
Flexes distal phalanges of lateral four toes
Asists in plantar flexing foot
Inverts foot
165
Flexor digitorum longus nerve supply
Tibial nerve (L5, S1)
166
Flexor hallucis longus origin (proximal)
Lower 2/3 of posterior surface of shaft of fibula
Posterior intermuscular septum
Interosseous membrane
167
Flexor hallucis longus insertion (distal)
Base of distal phalanx of great toe
168
Flexor hallucis longus actions
Flexes distal phalanx of great toe
Assists in plantar flexing foot
Inverts foot
169
Flexor hallucis longus nerve supply
Tibial nerve (L5, S1, S2)
170
Tibialis posterior origin (proximal)
Lateral part of posterior surface of tibia
Interosseous membrane
Proximal half of posterior surface of fibula
171
Tibialis Posterior insertion (distal)
```
Tuberosity of navicular bone
Cupboid
Cuneiformis
2-4 metatarsals
Sustentaculum tali of calcaneus
```
172
Tibilalis posterior actions
Plantar flexes foot
| Inverts foot
173
Tibialis posterior nerve supply
Tibial nerve (L5, S1)
174
What are the (3) tibiofibular joints?
Proximal joint: synovial
Middle joint: interosseous membrane (syndesmosis)
Distal joint: syndesmosis with very strong ligaments
175
What are the (3) ligaments of the distal tibiofibular joint?
Anterior inferior tibiofibular ligament
Posterior tibiofibular ligament
Interosseous ligament
176
What type of joint is the ankle (talocrural) joint
Hinge joint between talus and distal ends of tibia and fibula
177
What are the (7) tarsal bones? From medial to lateral and proximal to distal
```
Talus
Calcaneus
Navicular
Cuboid
Cuneiform 1
Cuneiform 2
Cuneiform 3
```
178
What is the strongest ligament in the ankle?
Deloid/medial ligament
| Connects the medial malleolus to the talus, sustentaculum tali, and navicular bone
179
What are the primary inverters of the foot?
Tibialis anterior and tibialis posterior
180
What are the primary everters of the foot?
Peroneus longus, peroneus brevis, peroneus tertius
181
What joints do eversion and inversion take place?
```
Subtalar joint (b/w talus and calcaneus)
Transverse tarsal joint (talonavicular and calcaneocuboid joints)
```
182
What innervates the anterior compartment of the leg?
Deep fibular (peroneal) nerve
183
What innervates the lateral compartment of the leg?
Superficial fibular (peroneal) nerve
184
What innervates the posterior compartment of the leg?
Tibial nerve
185
What are the (3) primary plantarflexors of the foot? (Also the superficial layer of the calf)
Gastrocnemius
Soleus
Plantaris
186
What are the (3) muscles of the deep layer of the leg?
Tibialis posterior
Flexor digitorum longus
Flexor hallucis longus
187
What are the (2) muscles of the lateral compartment of the leg?
Peroneus/fibularis longus
| Peroneus/fibularis brevis
188
Peroneus/fibularis longus origin (proximal)
Upper 2/3 of lateral surface of fibula
189
Peroneus/fibularis longus insertion (distal)
Lateral side of medial cuneiform
| Base of 1st metatarsal
190
Peroeus/fibularis longus actions
Plantar flexes and everts foot
191
Peroneus/fibularis longus nerve supply
Superficial peroneal/fibular nerve (L4, L5, S1)
192
Peroneus/fibularis brevis origin (proximal)
Lower 2/3 of lateral surface of fibula
193
Peroneus/fibularis brevis insertion (distal)
Lateral side of base of 5th metatarsal
194
Peroneus/fibularis brevis actions
Plantar flexes and everts foot
195
Peroneus/fibularis brevis nerve supply
Superficial peroneal/fibular nerve (L4, L5, S1)
196
What are the (4) muscles of the anterior compartment of the leg?
Tibialis anterior
Extensor digitorum longus
Extensor hallucis longus
Peroneus/fibularis tertius
197
Tibialis anterior insertion (distal)
Medial side and plantar surface of medial cuneiform bone
| Base of 1st metatarsal
198
Tibialis anterior actions
Dorsiflexes foot at ankle
| Inverts foot
199
Tibialis anterior nerve supply
Deep peroneal/fibular nerve (L4, L5, S1)
200
Extensor hallucis longus insertion (distal)
Base of distal phalanx of great toe
201
Extensor hallucis longus actions
Extends great toe
| Dorsiflexes and inverts foot
202
Extensor hallucis longus nerve supply
Deep peroneal/fibular nerve (L4, L5, S1)
203
Extensor digitorum longus insertion (distal)
Into extensor expansion on dorsal surface of four lateral toes and then bases of middle and distal phalanges
204
Extensor digitorum longus actions
Extends toes
| Dorsiflexes foot
205
Extensor digitorum longus nerve supply
Deep peroneal/fibular nerve (L4, L5, S1)
206
Peroneus/fibularis tertius insertion (distal)
Dorsal surface of base of 5th metatarsal
207
Peroneus/fibularis tertius actions
Dorsiflexes and everts foot
208
Peroneus/fibularis tertius nerve supply
Deep peroneal/fibular nerve (L4, L5, S1)
209
What are the (3) intrinsic muscles of the first layer of the foot?
Flexor digitorum brevis
Abductor hallucis
Abductor digiti minimi
210
Flexor digitorum brevis attachments
Calcaneus
| Toes 2-5
211
Flexor digitorum brevis actions
Flexes toes 2-5
212
Flexor digitorum brevis nerve supply
Medial plantar nerve (branch from tibial nerve)
213
What are the (4) intrinsic muscles of the second layer of the foot?
Lumbricals (4)
Quadratus plantae/flexor accessorius
Flexor hallucis longus
Flexor digitorum longus
214
Quadratus plantae attachments
Calcaneus
| Tendons of flexor digitorum longus
215
Quadratus plantae actions
Assists flexor digitorum longus in flexion of toes 2-5
216
Quadratus plantae nerve supply
Lateral plantar nerve (branch of tibial nerve)
217
Which muscle corrects the sideways pull of the flexor digitorum longus to the pinky toe?
Quadratus plantae
218
What are the (3) intrinsic muscles of the third layer of the foot?
Flexor hallucis brevis
Adductor hallucis
Flexor digiti minimi brevis
219
What are the (2) intrinsic muscles of the fourth layer of the foot?
Dorsal interossei
| Plantar interossei
220
What is the only intrinsic muscle in the dorsum of the foot?
Extensor digitorum brevis
221
What are the (4) ligaments that support the longitudinal arches?
Plantar calcaneonavicular ligament (spring ligament)
Plantar calcaneocuboid ligament (short plantar ligament)
Long plantar ligament
Plantar aponeurosis
222
Why is white matter white?
Because the myelin on the axons makes it appear white
223
What are the (3) major symptoms of Horner’s syndrome?
Ptosis (drooping eyelid)
Miosis (constricted pupil)
Anhidrosis (decreased secretions)
224
What nerve(s) are affected in Klumpke’s paralysis?
C8 & T1
225
Does the lumbrosacral plexus arise from ventral or dorsal rami of spinal nerves?
Ventral rami of L1-L5, S1-S3
226
What divisions form the obturator nerve?
Anterior of L2, L3, L4
227
What divisions form the femoral nerve?
Posterior divisions of L2, L3, L4
228
What are the distal divisions of the sciatic nerve?
```
Tibial nerve (anterior L4-S3)
Common peroneal/fibular nerve (posterior L4-S3)
```
229
What (11) muscles are innervated by the tibial nerve? (Not including plantar branches)
```
Semitendinosus
Biceps femoris (long head)
Adductor magnus
Semimembranosus
Gastrocnemius
Plantaris
Soleus
Popliteus
Tibialis posterior
Flexor digitorum longus
Flexor hallucis longus
```
230
What (4) muscles are innervated by the medial plantar nerve (branch of tibial nerve)?
Abductor hallucis
Flexor digitorum brevis
Flexor hallucis brevis
1st lumbrical
231
What are the (7) muscles innervated by the lateral plantar nerve (branch of tibial nerve)?
```
Quadratus plantae
Abductor digiti minimi
Flexor digiti minimi brevis
3 lateral lumbricals
All dorsal interossei
All plantar interossei
Adductor hallucis
```
233
What (2) muscles are innervated by the superior gluteal nerve?
Gluteus medius
| Gluteus minimus
234
What muscle is innervated by the inferior gluteal nerve?
Gluteus maximus
235
What muscle is innervated by the common peroneal/fibular nerve?
Biceps femoris (short head)
236
What (2) muscles are innervated by the superficial peroneal/fibular nerve?
Peroneus/fibularis longus
| Peroneus/fibularis brevis
237
What (5) muscles are innervated by the deep peroneal/fibular nerve?
```
Tibialis anterior
Extensor hallucis longus
Extensor digitorum longus
Peroneus/fibularis tertius
Extensor digitorum brevis
```
238
What are the (8) muscles innervated by the femoral nerve?
```
Psoas
Iliacus
Rectus femoris
Sartorius
Vastus lateralis
Vastus intermedius
Vastus medialis
Pectineus
```
239
What nerve innervates the first interdigital cleft?
Deep peroneal/fibular nerve
240
What are the (6) muscles innervated by the obturator nerve?
```
Pectineus
Obturator externus
Adductor brevis
Adductor longus
Gracilis
Adductor magnus
```
