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Flashcards in Lower Limb 1 Deck (65):
1

Name the two main superficial veins of the lower limb

Great saphenous vein
Small saphenous vein

2

Which superficial vein ascends anterior to the medial malleolus of the tibia?

Great saphenous vein

3

Which vein ascends posterior to the lateral malleolus?

Small saphenous vein

4

Which superficial vein empties into the femoral vein?

Great saphenous vein

5

Which superficial vein empties into the popliteal vein?

Small saphenous vein

6

Varicose veins are more common in which superficial vein?

Great saphenous vein

7

What route do the deep veins of the lower limb take?

Accompany all the major arteries in the limbs

8

Give 3 important arrangements of lymph nodes

Superficial inguinal
Deep inguinal
Popliteal lymph nodes

9

Lymphatic vessels accompanying the great saphenous vein end where?

Superficial inguinal nodes

10

Lymphatic vessels accompanying the small saphenous vein enter what group of lymph nodes?

Popliteal lymph nodes

11

Enlargement of inguinal lymph nodes are common due to infection where?

Lower limb
Trunk inferior to the umbilicus (such as the perineum)

12

The medial knee is what dermatome?

L3

13

The little toe is what dermatome?

S1

14

The hip joint is what type of joint?

Ball and socket synovial joint

15

What is the acetabular labrum?

Fibrocartilaginous ring

16

What is the function of the iliofemoral ligament?

Prevents hyperextension of the hip joint

17

What is the function of the pubofemoral ligament?

Prevents hyper abduction of the hip joint

18

Name the 3 ligaments of the hip joint

Iliofemoral ligament
Ischiofemoral ligament
Pubofemoral ligament

19

Name all the movements permitted at the hip joint

Flexion/ extension
Abduction/ adduction
External (medial)/ internal (lateral) rotation
Circumduction

20

Name the 3 main hip flexors

Iliacus
Psoas major
Pectineus

21

What is the chief flexor of the thigh?

Psoas

22

What is the main extensor of the hip joint?

Gluteus maximus

23

Name some other extensors apart from the gluteus maximus

Hamstrings (comprised of 3 individual muscles)
Adductor magnus (posterior part)

24

Name the 6 muscles of the medial (adductor) compartment of the thigh.

Which two muscles arent always included in this group?
Why?

Gracilis
Adductor magnus
Adductor Longus
Adductor Brevis
Obturator externus
Pectineus

Obturator Externus is sometimes excluded from this group
-Spatially, it is in this location, but functionally, it is more similar to the other lateral rotator group muscles

Pectineus is also sometimes excluded from this group
-It has the same function as the others in this group, but different innervation – namely, the femoral nerve

25

What nerve generally supplies the adductor compartment of the thigh?

Obturator nerve

26

How does the obturator nerve exit the pelvis?

Via the obturator canal which passes through the obturator foramen

27

Why are the abductors of the hip joint essential for a normal walking gait?

Each time one limb is raised from the ground that side of the pelvis becomes unsupported and will tend to drop

It is the contraction of the abductors on the opposite side of the pelvis which prevent this.

(Contraction of deep gluteal muscles on the supporting leg)

28

Lateral (external) rotators cross the hip joint on which side?

Posterior

29

The piriformis and obturator internus arise and insert where?

Both arise from inner pelvic walls and exit the pelvis via the greater and lesser sciatic foramina to attach to the greater trochanter of the femur

30

Medial (internal) rotators cross the hip joint on the anterior surface

Which muscles are the medial rotators of the hip joint?

Gluteus Medius
Gluteus Minimus
Tensor fasciae latae

31

The muscles of the thigh are organised into 3 compartments.

What are they?

Anterior/ quadriceps/ extensors (of the knee)
Medial/ adductors (of the hip)
Posterior/ hamstrings/ flexors (of the knee)

32

How many heads does quadriceps femoris have?

Name them

4 (quad)

Rectus femoris
Vastus lateralis
vastus intermedius
Vastus medialis

33

Which nerve innervates the anterior thigh muscles?

Femoral nerve

34

What is the action of the rectus femoris on the hip joint?

Stabilises (helps fix in position)
Helps iliopsoas flex hip joint

35

The 4 parts of the quadriceps femoris unite to form the quadriceps tendon proximal to the patella.

What does this continue as?
Where does it insert?

Continues as the patellar ligament distal to the patella

Attachment on the tibial tuberosity

36

What are the 3 actions of sartorius on the hip joint?

Flexes
Abducts
Laterally rotates the thigh at hip joint

(it also flexes the knee joint)

37

The sartorius is able to carry out the same action (flexion) at the hip and knee, which is unusual.

How is this possible?

It spirals around the thigh from lateral to medial, crossing the hip joint anteriorly and the knee joint posteriorly

38

Adductor hiatus is in which muscle?

What passes through it?

Adductor magnus

Femoral artery and vein

39

The femoral artery is the main artery of the thigh.

It is a continuation of which artery?
At what point does this name change occur?

External iliac

Inguinal ligament

40

The femoral artery enters the thigh midway between which 2 bony surface markings?

Anterior superior iliac spine
Pubic tubercle

41

Name the large branch of te femoral artery which passes posteriorly toward the hamstrings

Profunda femoris (Deep femoral artery)

(Superficial femoral artery becomes the popliteal)

42

The femoral vein is a continuation of which vein?

Popliteal vein

43

The femoral vein passes under the inguinal ligament to continue as which larger vein?

External iliac vein

44

Which two important veins drain into the femoral vein in the femoral triangle?

Profunda femoris vein
Graet saphenous vein

45

Cannulation of which vein is used to carry out right cardiac angiography?

Femoral vein

46

What is the largest branch of the lumbar plexus?

Femoral nerve

47

What is the path of the femoral nerve once it is given off from the lumbar plexus?

Passes deep to the inguinal ligament and enters the femoral triangle lateral to the femoral vessels

48

List the muscles supplied by the femoral nerve

Sartorius
Pectineus
Iliacus
Quadriceps femoris

49

What are the similarities and differences between the femoral triangle and the axilla?

Femoral triangle is the equivalent of the axilla, but whereas the axilla is protected by the adducted upper limb, the femoral triangle is exposed because of our change from a quadripedal to a bipedal stance

50

Which structure forms the base of the femoral triangle?

Iliopsoas

51

What is the medial and lateral boundary of the femoral triangle?

Medial = Adductor longus muscle
Lateral = Sartorius muscle

52

Name the 3 major structures of the femoral triangle from lateral to medial

Nerve
Artery
Vein

(Vein medial -> V shape of legs)

53

What is the femoral sheath?

The femoral sheath is a funnel shaped fascial tube which surrounds the proximal parts of femoral vessels (but not the nerve) and creates the femoral canal medial to them, which contains lymphatic vessels

54

What are the 3 compartments of the femoral sheath?
What do they contain?

Lateral -> femoral artery
Intermediate -> femoral vein
Medial -> Deep inguinal lymph node (cloquet node)

55

What are the contents of the femoral canal?

Fat + loose connective tissue

A few lymphatic vessels and sometimes a deep inguinal lymph node (cloquet node)

56

The adductor canal is also called what?

Subsartorial canal
Hunter's canal

57

Describe the origin, route and termination of the adductor canal in detail.

As the femoral neurovascular structures leave the apex of the femoral triangle distally they begin to burrow beneath the muscularture to create a tunnel -> adductor canal

Canal continues to pass increasingly posteriorly through the thigh until it arrives at the plane of the adductor musculature.

Here it passes through the adductor hiatus within the tendon of adductor magnus and thereby emerges into the popliteal fossa, posterior to the knee joint.

58

Where does the anterior femoral artery become the posterior popliteal artery?

Adductor hiatus

59

What are the posterior, lateral and medial boundaries of the adductor canal?

Posteriorly = Adductor longus and magnus
Laterally = Vastus medialis
Medially = sartorius

60

Why is the adductor canal also called Hunter's canal?

John Hunter described the exposure and ligation of femoral artery in this canal for treating patients with aneurysm of popliteal artery

61

The lumbar plexus of nerves emerge where?

Through psoas major muscle on the posterior abdominal wall

62

Which nerve roots (ventral rami) contribute to the formation of the lumbar plexus?

L1-L4

63

What are the two main branches of the lumbar plexus?
What do they supply?

Obturator nerve which innervates the adductor compartment of the thigh

Femoral nerve which innervates the anterior compartment of thigh

64

What are the segmental values (root value) of the two major nerves of the lumbar plexus?

Obturator (L2-L4)
Femoral Nerve (L2-L4)

65

How do the obturator nerve and femoral nerve relate to the psoas muscle?

Obturator nerve = Medial to psoas major
Femoral nerve = lateral to psoas major