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Lower limb Flashcards

1
Q

What root is extension of big toe

A

L5

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2
Q

Which tendon lies medial to dorsals pedis

A

Extensor hallicus longus

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3
Q

Origin of triceps heads

A

The long head arises from the infraglenoid tubercle. The fleshy lateral and medial heads are attached to the posterior aspect of the humerus between the insertion of the teres minor and the olecranon fossa.

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4
Q

Ligaments of syndesmosis

A

Antero-inferior tibiofibular ligament
Postero-inferior tibiofibular ligament
Inferior transverse tibiofibular ligament
Interosseous ligament

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5
Q

Where sural nerve ends

A

Posterior to distal fibula

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6
Q

Arteries of leg and foot

A

Femoral
3 branches- profunda
Medial and lateral circumflex

Goes posterior to adductor hiatus to become popliteal

Anterior tibial branches off first
Then divides into posterior tibial and peroneal

Anterior tibial- dorsalis pedis then medial and lateral tarsal

Posterior tibial- medial and lateral plantar

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7
Q

Relations of posterior tibial artery

A

Ant- tibialis post
FDL

Post
Tibial nerve
Gastric and soleus

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8
Q

Which structure lies in between PCL and popliteal artery

A

Oblique popliteal ligament

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9
Q

Content of adductor canal

A

femoral artery, femoral vein (posterior to the artery), nerve to the vastus medialis and the saphenous nerve

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10
Q

Which muscle is the end of the adductor canal in

A

Adductor Magnus

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11
Q

Borders of adductor canal

A

Roof- sartorius
Laterally- vatus medals
Posteriorly- adductor Lingus and Magnus

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12
Q

Structures that pass posterior to lateral mallelous and superficial/deep to peroneal retinaculum

A

Superficial- sural nerve
Short saphenous vein

Deep
Peroneus longus and brevis

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13
Q

How many compartments in lower leg

A

4

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14
Q

Muscles of superficial lower leg

A

Gastrocnemius, Soleus, Plantaris

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15
Q

Which nerve is closely related to posterior tibial artery

A

Tibial nerve

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16
Q

Borders of popliteal fossa

A

Superomedial – semimembranosus.
Superolateral – biceps femoris.
Inferomedial – medial head of the gastrocnemius.
Inferolateral – lateral head of the gastrocnemius and plantaris.

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17
Q

Flexor retinaculum attachments

A

Medial malleolus and medial calcaneus

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18
Q

Innervation of dorsal Muscles of foot

A

EHB
EDB- both deep fibular nerve

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19
Q

Location and function of fibulas tertius

A

Anterior
Eversion and dorsiflexion of the foot.

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20
Q

Attachment of fibulas bravis vs longus

A

Longus- 1st
Brevis- 5th

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21
Q

Tensor fascia lata attachment, innervation and action

A

Attachment- ASIS to lateral condyle of tibia
innervation- superior gluteal
Action- abduct and medially rotate lower limb

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22
Q

Order of attachment of deep gluteal muscles to greater tronchater

A

Piriformis
Superior gemilli
Obturator internus
Inferior gemilli
Quadratus femoris

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23
Q

Nerves that innervates TA and internal oblique

A

Iliohypogastric and ilioinguinal

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24
Q

Sensory function of iliohypogastric, ilioinguinal, genitofemoral

A

IH- Skin of the suprapubic region and posterolateral aspect of gluteal region.

II- Innervates the skin on the superior antero-medial thigh. In males, it also supplies the skin over the root of the penis and anterior scrotum. In females, it supplies the skin over mons pubis and labia majora.

GF- The genital branch innervates the skin of the anterior scrotum (in males) or the skin over mons pubis and labia majora (in females). The femoral branch innervates the skin on the upper anterior thigh.

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25
Roots of sacral plexus
S1-S4 Receives some from L4,5
26
Motor and sensory function of pudendal
Motor Functions: Innervates the skeletal muscles in the perineum, the external urethral sphincter, the external anal sphincter, levator ani. Sensory Functions: Innervates the penis and the clitoris and most of the skin of the perineum.
27
Branches of femoral nerve and supply
Anterior- pectinous, sartorius, sensory of thigh Posterior- vastus, saphenous
28
Root of femoral nerve and motor supply
L2,3,4 Illacus Pectineus Sartorius Quads
29
Sensory supply of obturator nerve
MID part of medial thigh
30
Branches of obturator nerve and roots
L2,3,4 Anterior (to AB)- between AB and AL Adductor longus, brevis, gracili Posterior (to AB) descends between AB and Magnus Adductor Magnus Obturator externes
31
Roots of sciatic nerve
L4-S3
32
Branches of tibial nerve
Medial calcaneal branches: These arise within the tarsal tunnel, and innervate the skin over the heel. Medial plantar nerve: Innervates the plantar surface of the medial three and a half digits, and the associated sole area. Lateral plantar nerve: Innervates the plantar surface of the lateral one and a half digits, and the associated sole area.
33
Function of popliteus
“unlocks” the knee by laterally rotating the femur on the tibia. Flexes fully extended knee
34
Root of tibial
L4-S3 Same as sciatic
35
Root of common fibular
L4-S2
36
Branch of deep fibular
Lateral branch – innervates two of the intrinsic muscles of the foot (extensor digitorum brevis and extensor hallucis brevis). Medial branch – innervates the skin of the webbed space between the 1st and 2nd toes.
37
Branches of obturator artery and supply
Anterior branch – This supplies the pectineus, obturator externus, adductor muscles and gracilis. Posterior branch – This supplies some of the deep gluteal muscles.
38
Branches of popliteal artery
Ant Tibial (deep fibular nerve)- from dorsalis pedis Tibioperoneal trunk- post tibial (accompanies tibial nerve) and peroneal Post tibial- forms Medial and lateral plantar- deep plantar arch
39
Veins draining into femoral vein
Long saphenous Profunda femoris vein
40
Route of small saphenous and drainage
Post to lateral malleolus Post At the level of the knee, the short saphenous vein passes between the two heads of the gastrocnemius muscle and empties into the popliteal vein
41
Normal angle between femoral neck and shaft
130
42
Where obturator interns and externes insert
Medial greater trochanter
43
What does the dorsalis pedis artery pass under
Inferior extensor retinaculum
44
What crosses doralis pedis
EHL
45
What does the femoral artery pass under, that if retracted can improve access
Sartorius
46
What structure runs under long saphenous vein close to origin and may be damaged in ligation
Deep external pudendal artery
47
At what level does the sciatic nerve usually bifurcate into the tibial and common peroneal nerves?
Superior aspect of popliteal fossa
48
Sings for lateral cutaneous nerve of thigh entrapment
Tinel sign at inguinal lig Runs under
49
Innervation of foot muscles
Medial- FHB, FDB, Abd H, 1st lumbrical Lateral- Abd DM, 2-4th lumbricals, QP, Add H(deep), FDM(superficial), palmar and dorsal interossei EHB, EDB- deep fibular
50
Psoas major attachment and innveration
Originates from the transverse processes and vertebral bodies of T12 – L5. Lesser trochanter Innervation L1-3
51
Illiacus major attachment and innveration
Femoral nerve Originates from the surface of the iliac fossa and anterior inferior iliac spine, inserting into the lesser trochanter of the femur.
52
QL attachment and innervation
Originates from the iliac crest and iliolumbar ligament. The fibres travel superomedially, inserting onto the transverse processes of L1 – L4 and the inferior border of the 12th rib. Anterior rami of T12 – L4 nerves.
53
Long saphenous vein stripped, now parasetheisa above ankle
Saphenous nerve injury
54
Order of popliteal fossa content
Nerve Vein Artwey
55
Profunda artery femoral branch surface anatomy
3cm below inguinal ligament
56
Popliteal artery continues into what
Peronteal tibial trunk
57
Attachments of ACL
Medial wall of lateral femoral condyle to intercondylar eminence of tibia
58
Attachments of PCL
Medial femoral condyle to intercondylar eminence of tibia
59
Main tendon for medial arch
TP
60
Which muscles attach to linea aspera
Adductor longus and briefs Biceps originate here
61
Floor of femoral triangle
Pectineus Ilipsoas Adductor loungus
62
Superficial to deep of lateral knee joint
Skin LCL Popliteus tendon- runs between Lateral meniscus
63
Knee flexion for lachman test
20-30
64
Movement of femur to aid knee flexion
Internal rotation - popliteus Posterior roll back
65
Which bone articulate with tibia distally
Talus
66
Which bones articulator with calcaneus
Cuboid, navicular, talus
67
What articulates with talus
Tibia, fibular, navicular, calcaneus No muscles
68
Sciatic nerve relative to biceps and where does it bifurcate
Deep to long head Crosses posterior surface of OI, S/I gemellus and QF Splits at apex of popliteal fossa
69
What is the medial calcanea a branch of
Tibial
70
Main cutaneous branch from tibial in popliteal fossa
Medial sural cutaneous nerve
71
Roots of lateral femoral cutaneous
L2,3
72
What each metatarsal articulates with
First with medial cuneiform Second- 3 cuneiforms 3rd- lateral 4th - lateral and cuboid 5th- cuboid only
73
Ligaments supporting medial arch
Short plantar- calcaneocuboid Plantar calcaneonavicular Interosseous - talocalcaneal Deltoid Long plantar
74
Fracture associated with posterior hip dislocation
Acetabulum
75
Gluteus maximus attachment
Gluteal tuberosity of femur
76
Arteries supplying trochanteric anastomosis
Medial and lateral circumflex femoral Superior gluteal
77
What does femoral sheath contain and what forms it
Contains femoral vessels and canal Continuation of TF
78
Which joint is a modified synovial joint
Knee
79
What is the saphenous nerve found between at ankle
Medial malleolus and TA
80
Postion of content in adductor canal
Artery anterior Vein posterior
81
Gluteus medius attachment
Lateral aspect of greater trochanter
82
Which bone articulates on the anterior surface of the talus
Navicular
83
Structure most likely damaged anterior to medial malleolus
Saphenous
84
EDL compared to TA
EDL is lateral
85
Most common patella dislocation
Lateral - due to quads
86
Diathrodal joint
Synovial joint
87
Hip joint when most tight and most relaxed
Tight in extensions Relaxed in flexion
88
Iliofemoral ligament function
Strongest ligament Prevents overextension of hip AIIS to intertronchanteric line of femur
89
Bursa of knee
Anterior Supra- patellar Pre Subcut Infra Deep infra Lateral Iliotibial Lateral Coll Medial Pes anserinus MCL Posterior Semimembranous Popliteus Lateral gastroc Medial gastroc
90
Ligaments of hip joint attachments
Intracapsular Ligament of femur Extracapsular Iliofemoral- AIIS to IT Pubofemoral- superior pubic rami to IT Ischiofemoral- body of ischium to greater trochanter-posterior
91
Ligament and muscle strength of hip joint
Ant- ligaments strongest, muscles weakest Post- ligaments weakest, muscles strongest
92
Muscles causing medial and lateral rotation of the hip
Lateral rotation – biceps femoris, gluteus maximus, piriformis, assisted by the obturators, gemilli and quadratus femoris. Medial rotation – anterior fibres of gluteus medius and minimus, tensor fascia latae
93

eMRCS questions (45 decks)

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