Lower Limb 2

Question 1

What is the pelvic girdle?

Answer 1

Bony ring consisting of the sacrum and right and left hip bones
Joined anteriorly at pubic symphysis and posteriorly at sacroiliac joints

Question 2

What does the pelvic girdle consist of?

Answer 2

Two hip bones, sacrum, coccyx

Question 3

What are the 4 articulations of the pelvic girdle?

Answer 3

Sacroiliac joints
Pubic symphysis
Sacrococcygeal symphysis

Question 4

What is the greater sciatic foramen a route for?

Answer 4

Structures entering/leaving the pelvis

Question 5

What is the lesser sciatic foramen a route for?

Answer 5

Structures entering/leaving the perineum

Question 6

What muscles are in the superficial layer of the gluteal region?

Answer 6

Gluteus maximus
Gluteus medius
Gluteus minimus
Tensor fasciae latae

Question 7

What is the nerve supply to tensor fascia latae, gluteus minimus and medius?

Answer 7

Superior gluteal nerve

Question 8

What are the nerve roots of the superior gluteal nerve?

Answer 8

L4-S1

Question 9

What muscles are in the deep layer of the gluteal region?

Answer 9

Piriformis
Obturator internus
Superior gemelli 
Inferior gemelli 
Quadratus femoris

Question 10

What is the fascia lata?

Answer 10

Deep fascial investment of the whole thigh, beginning proximally around the iliac crest and ending at the bony prominences of the tibia

Question 11

What is the iliotibial tract?

Answer 11

Longitudinal thickening of the fascia lata (strengthened from fibres of the gluteus maximus)

Question 12

What muscles attach to the iliotibial tract?

Answer 12

Thickened aponeuroses or the tensor fascia latae and gluteus maximus

Question 13

On what muscle does the sacral plexus sit?

Answer 13

Piriformis

Question 14

What are the nerve roots making up the sacral plexus?

Answer 14

S1-4 and L4-5 makes it the lumbosacral plexus

Question 15

What are the main branches of the sacral plexus?

Answer 15

Sciatic and pudendal nerve

Question 16

What are the other branches of the sacral plexus?

Answer 16

Superior and inferior gluteal
Posterior femoral cutaneous
Nerve to piriformis, nerve to quadratus femoris, nerve to obturator internus, nerve to levator ani and coccygeus

Question 17

What is the innervation of gluteus maximus?

Answer 17

Inferior gluteal nerve

Question 18

What are the nerve roots of the inferior gluteal nerve?

Answer 18

L5-S2

Question 19

What are the nerve roots of the sciatic nerve?

Answer 19

L4-S3

Question 20

From where does the sciatic nerve emerge?

Answer 20

Inferior to the piriformis

Question 21

What are the two terminal branches of the sciatic nerve?

Answer 21

Common fibular and tibial nerve

Question 22

What is the action of the sciatic nerve?

Answer 22

Innervates all posterior thigh and hamstring portion of adductor magnus and all lower leg and foot by its terminal branches

Question 23

What are the muscles making up the hamstrings (L–>M)?

Answer 23

Biceps femoris (long and short head)
Semitendiosus
Semimembranosus

Question 24

What are the actions of the hamstrings?

Answer 24

Extend the hip and flex the knee

Biceps femoris also laterally rotates the hip and knee
Semitenidosus/semimembranosus also medially rotate the hip and knee

Question 25

What innervates the hamstrings?

Answer 25

Sciatic nerve

Question 26

What kind of joint is the knee?

Answer 26

Synovial hinge

Question 27

What actions can occur at the knee joint?

Answer 27

Flexion and extension | Small active and passive rotations

Question 28

What are the articular surfaces of the knee?

Answer 28

Medial and lateral condyles of the femur Tibia Posterior surface of the patella 2 femorotibial articulations (M and L) between the lateral and medial femoral and tibial condyles and 1 femoropatellar articulation between the patella and femur

Question 29

What bone is not involved in the knee joint?

Answer 29

Fibula

Question 30

What does the stability of the knee depend on?

Answer 30

Strength and action of surrounding muscles and their tendons | Ligaments connecting the femur and tibia

Question 31

What is the most important thing that stabilises the knee?

Answer 31

Quadriceps femoris (esp vastus medialis and lateralis)

Question 32

What are the ligaments of the knee joint thickenings of?

Answer 32

The joint capsule

Question 33

What are the ligaments of the knee?

Answer 33

Fibular/lateral collateral Tibial/medial collateral ACL and PCL

Question 34

Where does the fibular collateral ligament extend from?

Answer 34

Lateral epicondyle of femur to the lateral surface of the head of the fibular

Question 35

Where does the popliteus tendon pass?

Answer 35

Deep to the LCL and separates it from lateral meniscus

Question 36

Where does the tibial collateral ligament extend from?

Answer 36

Medial epicondyle of femur to medial condyle and upper part of the medial surface of the tibia

Question 37

What is the MCL attached to?

Answer 37

At its midpoint firmly attached to medial meniscus | Tearing of MCL can lead to tearing of medial meniscus as a result

Question 38

What is the appearance of the cruciate ligaments?

Answer 38

Cross to form an X

Question 39

What is the function of ACL?

Answer 39

Prevent femur sliding posteriorly on the tibia and prevents posterior dislocation and hyperextension of the knee

Question 40

What is the function of the PCL?

Answer 40

Prevents femur sliding anteriorly on the tibia

Question 41

Why is the ACL more prone to injury and hard to repair?

Answer 41

Weaker than PCL | Poorer blood supply

Question 42

What are menisci?

Answer 42

C shaped plates of fibrocartilage on the articular surface of the tibia

Question 43

How can you distinguish between the lateral and medial menisci?

Answer 43

Medial - C shaped and firmly attached to deep surface of MCL Lateral - circular, no attachment and therefore more mobile

Question 44

What are the functions of the menisci?

Answer 44

Deepen articular surface of tibia --> increased stability of joint Act as shock absr

Question 45

What are the functions of the menisci?

Answer 45

Deepen articular surface of tibia --> increased stability of joint Act as shock absorbers by increasing SA to further dissipate forces

Question 46

What is the unhappy triad?

Answer 46

Impacts to knee generally come from lateral direction putting stress on medial collateral ligament, ,which tears in turn tearing the medial meniscus This puts a bit load on ACL which also tears Leading to the three injuries

Question 47

What movements occur at the knee joint?

Answer 47

Flexion | Extension

Question 48

What are the flexors of the knee joint?

Answer 48

Hamstrings Gracilis Sartorius Popliteus

Question 49

What are the extensors of the knee joint?

Answer 49

Quadriceps femoris

Question 50

What muscles make up the quadriceps femoris?

Answer 50

Vastus lateralis, vastus medialis, vastus intermedius, rectus femoris

Question 51

What are bursae?

Answer 51

Synovial fluid filled sacs between moving structures

Question 52

What are the four bursae in the knee?

Answer 52

Suprapatellar Prepatellar Infrapatellar Semimembranosus

Question 53

What bursa communicates with the synovial cavity of the knee? What is the clinical significance of this?

Answer 53

Suprapatellar Abrasions/penetrating injuries superior to patella may result in suprapatellar bursitis which may allow bacteria to spread to the knee joint

Question 54

What is bursitis?

Answer 54

Infection and inflammation of the bursa

Question 55

What is bursitis?

Answer 55

Infection and inflammation of the bursa E.g. housemaids knee