Lower Limb 2 Flashcards

(93 cards)

1
Q

Where do the neurovascular structures of the anterior aspect of lower limb enter through?

A

Femoral triangle

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2
Q

What is the medial boundary of the femoral triangle?

A

Adductor longus muscle

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3
Q

What is the lateral boundary of the femoral triangle?

A

Medial border of the sartorius muscle

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4
Q

Which structure form the base of the femoral triangle?

A

Inguinal ligament

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5
Q

Which muscles form the vast proportion of the femoral triangle?

A

Pectineus, iliopsoas and adductor longus muscle

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6
Q

What are the 3 major structures present in the femoral triangle?

A

Femoral nerve, artery and vein

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7
Q

What is the femoral sheath?

A

Funnel shaped connective tissue tube which surrounds the proximal parts of the femoral vessels but not the nerve
Creates femoral canal medial to these vessels

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8
Q

What are the 3 compartments of the femoral sheath?

A

Lateral - femoral artery
Intermediate - femoral vein
Medial - femoral nerve

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9
Q

What are the contents of the femoral canal?

A

Fat and loose connective tissue
Lymphatic vessels

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10
Q

Describe femoral hernia

A

Femoral ring is a weak area in the anterior abdominal wall
Activities that increase intra-abdominal pressure can cause abdominal contents to push into area and become trapped
More common in females

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11
Q

Where does the femoral artery begin?

A

Inguinal ligament as continuation of external iliac artery

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12
Q

What 2 bony surface markings does the femoral artery enter thigh between?

A

Anterior iliac spine and pubic symphysis

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13
Q

What is the deep artery of the thigh?

A

Profundus femoris

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14
Q

What is the femoral vein a continuation of?

A

Great saphenous vein

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15
Q

What does the femoral vein become?

A

External iliac vein as passes under inguinal ligament

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16
Q

Which 2 important veins drain into femoral triangle?

A

Profunda femoris and greater saphenous vein

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17
Q

What is the largest branch of the lumbar plexus?

A

Femoral nerve

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18
Q

Where does the femoral nerve enter the thigh?

A

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

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19
Q

What is the adductor canal?

A

Neurovascular structures of anterior thigh pass distally towards apex of femoral triangle and pass deep to musculature where wrapped in fascial sheath

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20
Q

Where does the adductor canal extend to?

A

Extends until it reaches an anatomical opening in the adductor magnus muscles called adductor hiatus

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21
Q

What is the artery which leaves the adductor hiatus?

A

Journey through allowed anterior femoral artery to become posterior popliteal artery

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22
Q

What is the roots of lumbar plexus?

A

L1-L4
T12 contributes to the lumbar plexus 50% of the time

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23
Q

What is E?

A

Ilio-hypogastric nerve

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24
Q

What is F?

A

Ilioinguinal nerve

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25
What is G?
Genitofemoral nerve
26
What is H?
Lateral cutaneous nerve
27
What is I?
Obturator nerve
28
What is J?
Femoral nerve
29
What are the 2 main motor nerves of lumbar plexus supplying the lower limb?
Obturator and femoral nerves
30
What is the main sensory nerve of the lumbar plexus supplying the lower limb?
Lateral cutaneous nerve
31
What is the nerve root value of the motor nerves from lumbar plexus?
L2, 3 and 4
32
What is the nerve root of the lateral cutaneous nerve?
L2 and 3
33
What are the ligaments creating the greater and lesser sciatic foramen?
Sacroiliac and sacrospinal ligaments
34
Which sciatic foramen is the route of structures entering of leaving the pelvis?
Greater sciatic foramen
35
Which sciatic foramen is the route of structures entering or leaving the perineum?
Lesser sciatic foramen
36
What is top left arrow pointing to?
Gluteus medius
37
What is the bottom left arrow pointing to?
Gluteus maximus
38
What is the right arrow pointing to?
Gluteus minimus
39
What is the nerve supply to gluteus maximus?
Inferior gluteal nerve
40
What is the nerve supply to gluteus medius and minimus?
Superior gluteal nerve
41
What is the nerve supply of tensor fascia lata?
Superior gluteal nerve
42
What are the actions of the gluteus maximus muscle?
Extends hip joint and assists in lateral rotation
43
What are the actions of the gluteus medius, minimus and tensor fascia lata?
Abduction and medial rotators of the hip joint
44
What is the deep fascia of the thigh called?
Fascia lata Extends posteriorly from anterior thigh and is thickened laterally to form the iliotibial tract
45
What 2 muscles attach to the iliotibial tract?
Tensor fascia lata and gluteus maximus
46
Why is the iliotibial tract important?
Stabilisation to the lateral aspect of the knee joint
47
Which muscles does the sacral plexus lie on?
Piriformis muscle
48
What are the ventral roots which make up the sacral plexus?
L4, L5 and S1-4
49
What does the sacral plexus supply?
Posterior aspect of lower limb including perineum
50
What are the 2 main branches of the sacral plexus?
Sciatic nerve and pudenal nerve
51
What is the root value of superior gluteal nerve?
L4-S1
52
What is the root value of the inferior gluteal nerve?
L5-S2
53
What plexus are the superior and inferior gluteal nerves from?
Sacral They are smaller motor branches off the sacral plexus
54
What are the other branches of the sacral plexus which innervate the lower limbs?
Nerve to piriformis Posterior cutaneous nerve to thigh Nerve to quadratus femoris Nerve to obturator internus
55
What is the largest nerve in the body?
Sciatic nerve
56
What is the nerve roots of the sciatic nerve?
L4-S3
57
What is the course of the sciatic nerve?
Passes through greater sciatic foramen, inferior to piriformis muscle, passing behind deep abductors to hip joint between ischial tuberosity and greater trochanter of the femur to enter posterior compartment of thigh
58
Where does the sciatic nerve split and what are the 2 nerves called?
Divides at popliteal fossa Into tibial nerve and common fibular nerve
59
Describe sciatica
L5 vertebrae is most common place Compression of nerve roots where proximal compression causes electric shock type pain passing from back to toes
60
What are the muscles in the posterior compartment of the thigh?
Hamstrings - 3 muscles
61
What are the 3 heads of the hamstrings?
Biceps femoris Semitendinosus Semimembranosus
62
What is the action of the hamstrings on the knee and hip joint?
Extend at hip joint and flex at knee joint
63
Which nerve supplies the posterior compartment of the thigh?
Sciatic nerve
64
Which branch of the femoral artery contributes blood supply to posterior muscle compartment?
Deep femoral artery
65
What is A?
Semitendinosus
66
What is B?
Semimembranosus
67
What is C?
Biceps femoris - long head
68
What is D?
Biceps femoris - short head
69
What is the most important muscle which stabilises the knee joint?
Quadriceps femoris
70
What is A?
Fibular collateral ligament
71
What is B?
Tibial collateral ligament
72
What is C?
Anterior cruciate ligament
73
What is D?
Posterior cruciate ligament
74
Where does the fibular/ lateral collateral ligament (LCL) stretch to and from?
Extends from lateral epicondyle of the femur to the lateral surface of head of the fibula Tendon on the popliteus muscle passes deep to LCL separating it from lateral meniscus
75
Where does the tibial/ medial collateral ligament (MCL) extend to and from?
Extends from medial epicondyle of femur to medial surface to tibia, with attachment to medial epicondyle of tibia MCL is attached onto medial meniscus at its midpoint
76
What does the anterior cruciate ligament prevent?
Prevents femur from sliding posteriorly on the tibia
77
What does the posterior cruciate ligament prevent?
Prevents femur from sliding anteriorly on the tibia
78
What movement causes disruption to the ACL and how is the healing sometimes impaired?
Twisting decelerating motions Poor blood supply to ACL
79
What is the function of the popliteus muscle?
When flexing from a fully extended position, the muscle rotates the femur laterally on the tibia allowing unimpeded movement of the joint
80
What are the menisci of the knee joint?
Crescent shaped plates of fibrocartilage on the articular surface of the tibia
81
What is B?
Medial meniscus
82
What is C?
Lateral meniscus
83
What is D?
Anterior cruciate ligament
84
What is E?
Posterior cruciate ligaments
85
What is the main function of the menisci?
Plays a role in shock absorption
86
Which meniscus adheres firmly to the deep surfaces of the tibial or medial collateral ligament?
Medial meniscus
87
What can cause disruption to the medial meniscus?
Any lateral impact on the knee joint risks damaging the medial meniscus and can damage both medial meniscus and ACL If cartilage loose in joint space then risk of knee locked in flexion or extensions
88
What anchors onto the patella?
Superiorly the quadratus femoris tendon Inferiorly the patellar ligament
89
What are the main bursae of the knee?
Suprapatellar, prepatellar, deep infrapatellar and subcutaneous infrapatellar
90
Which bursae communicates with the articular cavity of the knee joint?
Suprapatellar bursae - useful for assessing bursal distention for knee effusion
91
What is housemaid's knee?
Inflammation of small fluid filled sac in front of knee cap Occurs when spend long periods of time kneeling
92
What muscles are involved in knee flexion?
Hamstrings, gracilis, sartorius and popliteus
93
What muscles are involved in knee extension?
Quadriceps femoris