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Lower Limb Flashcards

1
Q

Lower limb fascia

A
  1. Subcutaneous superficial
    A. Loose CT
    B. Fat
    C. Cutaneous n.
    D. Superficial v.
    E. Lymphatic vessels and nodes
    F. Fascia hip and thigh continuous w/ abdominal wall and buttocks
    G. Knee - loses fat and blends w/ deep fascia
    1. Fat reappears below knee
  2. Deep fascia- investing surrounding each muscle
    A. Limits outward expansion
    B. Compresses muscle and veins => contraction more efficient
    C. Thigh = fascia lata
    D. Leg= crural fascia
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2
Q

Myofascial compartments of the lower limb

A 
Defined by deep fascia
1. Compartments have distinct:
  A. Biomechanic functionality
  B. Innervation
  C. Blood supply
2. Gluteal compartment
3. Thigh (3 compartments)
  A. Anterior
  B. Medial
  C. Posterior
4. Leg (3 compartments)
  A. Anterior
  B. Lateral
  C. Posterior
5. Foot (3 zones)
  A. Hindfoot
  B. Mid foot
  C. Forefoot
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3
Q

Gluteal compartment

A 
Less straightforward compartmentalization
1. Muscles
  A. Gluteus Maximus
  B. Gluteus medius
  C. Gluteus minimus 
  D. Tensor fascia lata
  E. Piriformis
  F. Gemelli sup and inf
  G. Obturator internus
  H. Quadratus femuris
2. Fxn
  A. Abduction
  B. Extension
  C. Lat hip rotation
  D. Medial hip rotation
3. Innervation: branches sacral plexus
4. Supply:
  A. Sup and inf gluteal a. 
  B. Medial circumflex femoral a.
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4
Q

Anterior compartment of the thigh

A 
1. Muscles
  A. Sartorious
  B. Quadratus femoris
    1. Rectum femoris
    2. Vastus lateralis
    3. Vastus intermedius
    4. Vastus medialis
2. Fxn:
  A. Flex hip
  B. Extend knee
3. Innervation: femoral n.
4. Supply: femoral a.
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5
Q

Medial compartment of thigh

A 
1. Muscles
  A. Pectineus 
  B. Adductor longus
  C. Adductor brevis
  D. Adductor magnus
  E. Gracilis 
  F. Obturator externus
2. Fxn: 
  A. Adductor thigh (primary)
  B. Flex thigh
  C. Lateral rotate thigh
  D. Extend thigh
  E. Flexes leg
3. Innervation: obturator n.
4. Supply:
  A. Femoral a.
  B. Obturator a.
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6
Q

Posterior compartment of thigh

A 
1. Muscles 
  A. Hamstrings
   1. Biceps femoris (short and long heads)
   2. Semitendinosus 
   3. Semimembranosus
2. Fxn: 
  A. Flex knee (primary)
  B. Med/lat rotation leg when knee flexed
  C. Extend thigh
  D. Extend trunk when thigh and leg flexed
3. Innervation: tibial n.
4. Supply: no exclusive major a.
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7
Q

Anterior compartment of leg

A 
1. Muscles
  A. Tibialis ant
  B. Extensor digitorum longus
  C. Fibularis tertius
  D. Extensor hallucinate longus 
2. Fxn: dorsiflex ankle
3. Innervation: deep fibular n.
4. Supply: ant tibial a.
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8
Q

Lateral compartment of leg

A 
1. Muscles
  A. Fibularis longus
  B. Fibularis brevis
2. Fxn: 
  A. Eversion subtalar and transverse tarsal joints
  B. Assist plantar flexion ankle
3. Innervation: superficial fibular n.
4. Supply: perforating branches 
  A. Ant tubular a. (Ant)
  B. Fibular a. (Post)
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9
Q

Posterior compartment of leg

A 
1. Muscles
  A. Gastrocnemius
  B. Soleus
  C. Plantaris 
  D. Tibialis posterior
  E. Flexor digitorum longus
  F. Flexor hallucis longus 
  G. Popliteal
2. Fxn: 
  A. Plantar flex ankle
  B. Inversion subtalar and transverse tarsal joints
  C. Flex toes
3. Innervation: tibial n.
4. Supply: 
  A. Post tibial a. 
  B. Fibular a.
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10
Q

Hindfoot

A
  1. Talus

2. Calcaneus

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11
Q

Midfoot

A
  1. Navicular
  2. Cuboid
  3. Cuniforms (3)
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12
Q

Forefoot

A
  1. Metatarsals

2. Phalanges

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13
Q

Foot fascia

A

Deep fascia continuous

  1. Proximally w/ inf extensor retinaculum
  2. Laterally and posteriorly w/ plantar fascia
  3. Plantar fascia -> plantar aponeurosis divides -> 5 digital sheaths
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14
Q

Foot muscles

A 
1. Most plantar surface
  A. 4 layers, 4 compartments
2. Dorsum 2 groups
3. Fxn:
  A. Maintain arch
  B. Assists pronation/supination
4. Innervation: medial and lateral plantar n.
5. Supply: 
  A. Dorsalis pedis a. 
  B. Plantar a. 
6. Extensor digitorum brevis
7. Extensor hallucis brevis
8. Abductor hallucis
9. Flexor digitorum brevis
10. Flexor hallucis brevis
11. Adductor hallucis
12. Abductor digiti minimi
13. Flexor digiti minimi brevis
14. Opponents digiti minimi
15. Quadratus plantae 
16. Lumbar I also
17. Plantar interossei
18. Dorsal interossei
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15
Q

Lumbosacral plexus

A

Union lumbar plexus (ant rami T12-L4) and sacral plexus (L4-S4) via lumbosacral trunk

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16
Q

Lumbar plexus

A 
1. Contribution subcostal n. (T12)
    A. Lumbar plexus -> skin lateral hip
2. Iliohypogastric n. (L1)
3. Ilio-inguinal n. (L1) - thru inguinal canal
4. Lateral femoral cutaneous n. (L2-L3)
5. Femoral n.(L2-L4)
6. Genitofemoral n. (L1-L2)
7. Obturator n. (L2-L4)
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17
Q

Iliohypogastric n. (L1)

A

Lumbar plexus

  1. Skin anterolateral hip
  2. Internal oblique m.
  3. Transverse abdominus m.
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18
Q

Ilio-inguinal n. (L1)

A

Lumbar plexus - Thru inguinal canal

  1. Skin scrotum/labia majora
  2. Internal oblique m.
  3. Transverse abdominus m.
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19
Q

Lateral femoral cutaneous n. (L2-L3)

A

Lumbar plexus

1. Skin anterolateral thigh

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20
Q

Femoral n. (L2-L4)

A 
Lumbar plexus
1. Muscular branches
   A. Iliacus m. (L2-L4)
   B. Psoas major m. (Ant rami L1-L3) 
   C. Part pectineus
   D. Ant compartment thigh
2. Anterior cutaneous br. (L2-L4)
   A. Skin ant and med thigh
3. Saphenous n. : skin med leg
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21
Q

Genitofemoral n. (L1-L2)

A 
Lumbar plexus
1. Femoral br. : skin over femoral triangle
2. Genital br.:
   A. Cremaster m.
   B. Mons pubis
   C. Labia majora
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22
Q

Obturator n. (L2-L4)

A

Lumbar plexus

  1. Obturator externus
  2. Medial compartment thigh
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23
Q

Sacral plexus

A
  1. Superior gluteal (L4-S1)
  2. Inferior gluteal (L5-S2)
  3. Posterior femoral cutaneous (S1-S3)
  4. Direct muscular branches
    A. N. To piriformis (S1-S2)
    B. N. To obturator internus (L5-S2)
    C. N. To quadratus femoris (L4-S1)
  5. Sciatic (L4-S3)
    A. Tibial n. (L4-S3)
    B. Common fibular n. (L4-S2)
  6. Pudendal n. (S2-S4)
  7. N. To levator ani and coccygeus (S3-S4)
  8. Pelvic splanchnic (S2-S4)
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24
Q

Superior gluteal n. (L4-S1)

A

Sacral plexus

  1. Gluteus medius
  2. Gluteus minimus
  3. Tensor fascia lata
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25
Inferior gluteal n. (L5-S2)
Sacral plexus | 1. Gluteus Maximus
26
Posterior femoral cutaneous n. (S1-S3)
Sacral plexus 1. Skin post buttock and thigh 2. Inferior clunial and perineal br
27
N. To obturator internus (L5-S2)
Sacral plexus 1. Obturator internus 2. Superior gemellus
28
N. To quadratus femoris (L4-S1)
1. Quadratus femoris | 2. Inferior gemellus
29
Tibial n. (L4-S3)
Sacral plexus - sciatic n. 1. Posterior compartment thigh (except short head biceps femoris) 2. Post compartment leg 3. Medial part adductor magnus 4. Supply Surat and dorsal region of foot A. Medial sural cutaneous B. Medial and lateral calcanae br. C. Lateral dorsal cutaneous 5. Medial plantar n. : medial intrinsic m. In sole of foot 6. Lateral plantar n. : lateral intrinsic m. In sole of foot
30
Common fibular n. (L4-S2)
``` Sacral plexus - sciatic 1. Short head biceps femoris 2. Superficial fibular n. A. Lateral compartment leg B. Intermediate dorsal cutaneous n. : skin dorsum of foot 3. Deep fibular n. A. Anterior compartment leg B. M. Dorsum of foot C. Cutaneous n. Of big toe and 2nd digit: skin between 1st and 2nd toes ```
31
Pudendal n. (S2-S4)
``` Sacral plexus: perineum 1. Sensory external genitalia 2. Muscular br. A. Perineal m. B. External urethral sphincter C. External anal sphincter ```
32
Pelvic splanchnic (S2-S4)
Pelvic viscera via inferior hypogastric and pelvic plexuses
33
Femoral triangle
Femoral n., a., v. 1. Superior border: inguinal canal 2. Medial border: adductor longus 3. Lateral border: sartorius 4. Floor: iliopsoas and pectineus 5. Roof: fascia lata and cribiform fascia, subQ tissue, skin
34
Saphenous opening
Hiatus in fascia lata 1. Efferent lymph vessels 2. Covered by cribiform fascia
35
Adductor hiatus
Femoral a. And v.
36
Popliteal fossa
Popliteal a., v., and tibial n. W/in | 1. Common fibular n. Exits laterally
37
Extensor retinaculum
1. Superior | 2. Inferior
38
Hip joint
1. Ball and socket 2. Head of femur and acetabulum 3. Designed for stability ove wide ROM 4. Transmits wt -> lower limb 5. Joint congruence greatest = quadrupedal position A. Hip 90 B. Abdomen 5 C. Lateral rotation 10 6. Lacunae surface (C-shaped) - articular surface acetabulum A. Acetabulum labrum: fibrocartilage attached semilunar acetabulum rim B. Transverse acetabulum lig: surrounds head of femur 7.
39
Hip joint ligaments
1. Capsule A. External fibrous B. Internal synovial membranous 2. Fibrous layer spiral around capsule - constrict and pull into acetabulum A. Inc stability and restrict extension B. Flexion -> unwinding -> inc mobility C. Iliofemoral lig: reinforces ant and sup 1. Limits extension D. Pubofemoral lig: reinforces ant and inf 1. Prevents over-abduction E. Ischiofemoral lig: reinforces post 1. Weakest of 3 3. Ant. Rotators weaker and fewer => and lig thicker and stronger 4. Post rotators stronger and more => post lig weaker and fewer 5. Lig of head of femur (ligamentum teres): little stabilization A. Synovial fold carries artery to head of femur
40
Hip joint movements
1. Flexion 2. Extension 3. Abduction 4. Adduction 5. Medial rotation 6. Lateral rotation 7. Circumduction 8. Trunk flexion from supine postition 9. Prevents pelvic drop while on one leg
41
Hip joint supply
1. Medial and lateral circumflex femoral a. 2. Retinacular a. 3. A. To head of femur (br of obturator a. - only in kids)
42
Hip joint innervation
Hilton’s law = n. Supplying m. Extending directly across joint also innervate joint
43
Tibiofemoral joint
``` Knee joint 1. Hinge joint 2. Femoral and tibial condyles 3. Mechanically weak 4. Stability from surrounding muscles, tendons, and lig 5. Infrapatellar fold: median, vertical fold of synovial membrane that occupies most inercondylar space 6. Ligaments 7. Movements A. Flex B. Extension C. Slight gliding and rotation 8. Genicular arterial anastomoses A. Genicular brs of femoral B. Popliteal C. Ant 7 post recurrent brs 9. Innervation A. Ant - femoral B. Post - tibial C. Lateral - common fibular D. Medial - saphenous 10. Med and lat patellar retinacula ```
44
Capsular ligaments of knee joint
1. Patellar: receives med and lat patellar retinacula 2. Fibular collateral: lateral epicondyle -> fibular head 3. Tibial collateral lig: medial epicondyle -> medial tibia A. Weaker than FCL B. Attached to medial meniscus 4. Oblique popliteal lig: semimenbranosus tendon A. Medial tibial condyle -> lateral femoral condyle 5. Arcuate popliteal lig: size inverse to size fabella (lateral head gastrocnemius)
45
Articular ligaments of knee
``` 1. Cruciate lig: pivot for rotary motion A. Anterior (ACL) : weaker 1. Limits posterior rolling of femur w/ flexion 2. Posterior femur displacement 3. Hyperextension 4. Anterior drawer test B. Posterior (PCL) : limits 1. Anterior polling w/ extension 2. Anterior femur displacement 3. Post tibia displacement 4. Stability w/ flexed-knee activities (walking down-hill) 2. Menisci: deeper articular surface and absorb shock A. Medial: larger 1. C-shaped 2. Less mobile 3. Attached MCL B. Lateral: smaller 1. Nearly circular 2. More mobile 3. Bursae: synovial filled sacs A. Prepatellar B. Infrapatellar C. Suprapatellar: infection cal spread to jt D. Popliteal E. Anserine F. Gastrocnemius ```
46
Tibiofibular joints
``` 1. Prox and distal A. Plane joints B. Ligaments 1. Ant and post ligs of fibular head C. Movements: slight movement during dorsiflexion D. Supply: 1. Inf lat genicular a. 2. Ant tibial recurrent a. E. Innervation 1. Common fibular n. 2. N. To popliteus ```
47
Tibiofibular syndesmosis
``` Interosseus membrane 1. Fibrous jt. Between shafts 2. Ligaments A. Ant interosseus B. Post tibiofibular 3. Movements: resist downward pull on fibula A. Slight movement during dorsiflexion 4. Supply A. Perforating br of fibular a. B. Med malleolar br of ant and post tibial a. 5. Innervation A. Fibular n. B. Tibial n. C. Saphenous n. ```
48
Ankle joint
1. Hinge joint 2. Distal tibia/fibula and talus + tibiofibular lig = malleolar mortise 3. Grip talus during movement 4. Strongest during dorsiflexion: more snug 5. Unstable during plantar flex: loose w/in mortise A. Most injuries occur in plantar flexion 6. Ligaments A. Ant and post inf talofibular and calcaneofibular lig: reinforce laterally B. Deltoid lig: reinforce medial 1. Stabilizes during eversion 2. Prevents subluxation 7. Movements A. Dorsiflexion B. Plantarflexion 8. Supply A. Malleolar br of fibular a. B. Ant and post tibial a. 9. Innervation A. Saphenous B. Tibial C. Fibular : deep and superficial D. Crural
49
Foot joints
1. Subtalar (talocalcaneal) 2. Transverse tarsal 3. Intertarsal 4. Tarsometatarsal 5. Intermetatarsal 6. Metatarsophalangeal and interphalangeal A. Flexion B. Extension 7. Ligaments A. Plantar calcaneonavicular (spring) 1. Supports head talus 2. Transfer wt from talus 3. Maintain longitudinal arch B. Long plantar lig: maintain longitudinal arch C. Plantar calcaneocuboid (short plantar) 1. Maintain longitudinal arch
50
Foot arches
``` Distribute wt, absorb shock, springboard for propulsion, and add to foot adaptability 1. Transfer wt A. Tibia -> talus B. Post to calcaneous C. Ant to ball of foot D. Lateral to heads MT3-5 2. Longitudinal arch -> med and lat A. Medial: higher, more imp 1. Calcaneous 2. Talus 3. Navicular 4. 3 cuneiforms 5. MT1-3 B. Lateral: lower, flatter 1. Calcaneous 2. Cuboid 3. MT4-5 3. Transverse arch A. Cuboid B. 3 cuniforms C. Bases of MT 4. Passive support A. Transverse arch: shape of bones B. Longitudinal arch 1. Plantar aponeurosis 2. Long plantar lig 3. Short plantar 4. Spring lig 5. Dynamic support A. Reflexive bracing action intrinsic muscles (active and tone contraction) B. Transverse arch 1. Fibularis longus 2. Tibialis posterior C. Longitudinal arch 1. Flexor hallucis 2. Flexor digitorum longus ```
51
L2 dermatome
Upper lateral thigh
52
L3 dermatome
Medial knee
53
L4 dermatome
Medial malleoli
54
L5 dermatome
Medial foot
55
S1 dermatome
lateral foot/heal
56
S2 dermatome
Popliteal fossa
57
Gluteus Maximus
1. Fxn: extend thigh, assists lateral rotation thigh 2. Prox: ilium, sacrum/coccyx, sacrotuberous lig 3. Distal: iliotibial tract, gluteal tuberosity 4. Innervation: inf gluteal n. (L5-S2)
58
Gluteus medius and minimus
1. Prox: external ilium 2. Distal: greater trochanter femur 3. Innervation: superior gluteal (L4-S1) 4. Fxn: abducts, medially roatates thigh, prevents pelvic drop
59
Tensor fasciae latae
1. Prox: ASIS 2. Distal: iliotibial tract 3. Innervation: superior gluteal n. (L4-S1) 4. Fxn: abducts, medially rotates thigh, prevents pelvic drop
60
Piriformis
1. Prox: sacrum 2. Distal: greater trochanter 3. Innervation: N. To piriformis (S1-S2) 4. Fxn: laterally rotatable extended thigh, abducts flexed thigh, steadies head of femur in acetabulum
61
Obturator internus
1. Prox: pelvic surface obturator membrane 2. Distal: greater trochanter 3. Innervation: N. To obturator internus (L5-S2) 4. Fxn: laterally rotates extended thigh, abducts flexed thigh, steadies head of femur in acetabulum
62
Superior gamellus
1. Prox: ischial spine 2. Distal: greater trochanter 3. Innervation: N. To obturator internus 4. Fxn: laterally rotates extended thigh, abducts flexed thigh, steadies head of femur in acetabulum
63
Inferior gemellus
1. Prox: ischial tuberosity 2. Distal: greater trochanter 3. Innervation: N. To quadratus femoris (L4-S1) 4. Fxn: laterally rotates extended thigh, abducts flexed thigh, steadies head of femur in acetabulum
64
Quadratus femoris
1. Prox: ischial tuberosity 2. Distal: intertrochanteric crest of femur 3. Innervation: N. To quadratus femoris (L4-S1) 4. Fxn: laterally rotates thigh, steadies head of femur in acetabulum
65
Iliopsoas
Psoas major, minor, and iliacus 1. Prox: T12-L5 vertebrae and IV discs, iliac fossa, sacral algae, and anterior sacroiliac lig 2. Distal: common tendon onto lesser trochanter 3. Innervation: psoas - ant rami L2-L4, iliacus - femoral n. (L2-L4) 4. Fxn: major flexes thigh, stabilize hip joint, flexes trunk on fixed thigh
66
Sartorius
1. Prox: ASIS 2. Distal: supermedial tibia 3. Innervation: femoral n. (L2-L4) 4. Fxn: flexes, abducts, and laterally rotates thigh, flexes leg, medially rotates leg when knee is flexed
67
Quadriceps femoris
Rectus femoris, vastus medialis, vastus intermedius, vastus lateralis 1. Prox: ASIS (rectus femoris), Linea aspera (vastus lateralis and medialis), femoral shaft (vastus intermedius) 2. Distal: common quadriceps tendon to base of patella (cont w/ patellar tendon) 3. Innervation: femoral n. (L2-L4) 4. Fxn: major extensor of knee, steadies hip joint, rectus femoris flexes hip
68
Pectineus
1. Prox: superior ramus of pubis 2. Distal: pectineal line of femur 3. Innervate: femoral n. (L2-L4) and obturator n. (L2-L4) 4. Fxn: adducts, laterally rotates, and weakly flexes thigh
69
Adductor longus
1. Prox: body of pubis 2. Distal: linae aspera 3. Innervation: obturator n. (L2-L4) 4. Fxn: adducts thigh
70
Adductor brevis
1. Prox: inferior pubic ramus 2. Distal: linea aspera 3. Innervation: obturator n. (L2-L4) 4. Fxn: adducts thigh
71
Adductor magnus
1. Prox: ischiopubic ramus and ischial tuberosity 2. Distal: gluteal tuberosity, linae aspera, adductor tubercle of femur 3. Innervation: adductor part - obturator n. (L2-L4), Hamstring part - tibial n. (L4-S3) 4. Fxn: adducts thigh, laterally rotates, flexes hip, extends thigh
72
Gracilis
1. Prox: inferior pubic ramus 2. Distal: superomedial tibia 3. Innervation: obturator n. (L2-L4) 4. Fxn: adducts thigh, flexes leg, helps medially rotate leg
73
Obturator externus
1. Prox: obturator foramen and membrane 2. Distal: trochanteric fossa of femur 3. Innervation: obturator n. (L2-L4) 4. Fxn: laterally rotates thigh
74
Semitendinosus
1. Prox: ischial tuberosity 2. Distal: superomedial tibia 3. Innervation: tibial n. (L4-S3) 4. Fxn: extends thigh, flexes and medially rotates leg when flexed
75
Semimembranosus
1. Prox: ischial tuberosity 2. Distal: posterior part medial tibial condyle 3. Innervation: tibial n. (L4-S3) 4. Fxn: extends thigh, flexes and medially rotates leg when flexed
76
Biceps femoris
1. Prox: ischial tuberosity (long head), linea aspera (short head) 2. Distal: lateral side fibular head 3. Innervation: long head- tibial n. (L4-S3), short head- common fibular n. (L4-S2) 4. Fxn: extends thigh, flexes and laterally rotates leg
77
Tibialis anterior
1. Prox: superolateral tibia, interosseous membrane 2. Distal: 1st (medial) cuneiform and base MT1 3. Innervation: deep fibular n. (L4-S2) 4. Fxn: dorsiflexion and inversion
78
Extensor digitorum longus
1. Prox: fibular head, lateral tibial condyle, interosseous membrane 2. Distal: base distal phalanges 2-5 3. Innervation: deep fibular n. (L4-S2) 4. Fxn: dorsiflexion, eversion, extends digits 2-5
79
Fibularis (peroneus) tertius
1. Prox: distal fibula 2. Distal: base MT5 3. Innervation: deep fibular n. (L4-S2) 4. Fxn: dorsiflexion, eversion
80
Extensor hallucis longus
1. Prox: superomedial fibula, interosseous membrane 2. Distal: base distal phalanx of hallux 3. Innervation: deep fibular n. (L4-S2) 4. Fxn: dorsiflexion, extends hallux
81
Fibularis (peroneus) longus
1. Prox: fibular head 2. Distal: base of MT1 and medial cuneiform 3. Innervation: superficial fibular n. (L4-S2) 4. Fxn: plantarflexion, eversion, supports transverse arch
82
Fibularis (peroneus) brevis
1. Prox: inferolateral fibula 2. Distal: tuberosity of MT5 3. Innervation: superficial fibular n. (L4-S2) 4. Fxn: plantar flexion, eversion
83
Gastrocnemius
1. Prox: medial and lateral femoral epicondyles 2. Distal: calcaneal tendon at calcaneal tuberosity 3. Innervation: tibial n. (L4-S3) 4. Fxn: plantarflexion
84
Soleus
1. Prox: fibular head, soleal line 2. Distal: calcaneal tendon at calcaneal tuberosity 3. Innervation: tibial n. (L4-S3) 4. Fxn: plantarflexion
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Plantaris
Variably present 1. Prox: lateral supracondylar line of femur 2. Distal: calcaneal tendon at calcaneal tuberosity 3. Innervation: tibial n. (L4-S3) 4. Fxn: weakly assist plantarflexion
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Popliteus
1. Prox: lateral surface lateral condyle of femur 2. Distal: posterior tibia and soleal line 3. Innervation: tibial n. (L4-S3) 4. Fxn: weakly flexes knee and unlocks it by rotating femur , medially rotates tibial of unplanted limb
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Flexor hallucis longus
1. Prox: distal fibula 2. Distal: base distal phalanx of hallux 3. Innervation: tibial n. (L4-S3) 4. Fxn: flexes hallux, weakly plantarflexion ankle
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Flexor digitorum longus
1. Prox: posteromedial tibia 2. Distal: bases distal phalanges digits 2-5 3. Innervation: tibial n. (L4-S3) 4. Fxn: plantarflexion, inversion, flexes MTP joints
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Tibialis posterior
1. Prox: interosseous membrane 2. Distal: navicular tuberosity, cuneiforms, bases MT2-4 3. Innervation: tibial n. (L4-S3) 4. Fxn: plantarflexion, inversion, supports medial longitudinal arch
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Tom Dick And Very Nervous Harry
Ant to post 1. Tibialis posterior tendon 2. Flexor Digitorum longus 3. Artery (posterior tibial) 4. Vein 5. Nerve (tibial) 6. Flexor Hallucis longus
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Extensor digitorum brevis
1. Prox: calcaneus 2. Distal: base middle phalanges 2-4 3. Innervation: deep fibular n. (L4-S2) 4. Fxn: extends MTP and PIP digits 2-4
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Extensor hallucis brevis
1. Prox: calcaneus 2. Distal: base proximal phalanx hallux 3. Innervation: deep fibular n. (L4-S2) 4. Fxn: extends MTP hallux
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Abductor hallucis
1. Prox: calcaneal tuberosity, plantar aponeurosis 2. Distal: base proximal phalanx hallux 3. Innervation: medial plantar n. (S2-S3) 4. Fxn: abducts and flexes hallux
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Flexor digitorum brevis
1. Prox: calcaneal tuberosity, plantar aponeurosis 2. Distal: both sides middle phalanges digits 2-5 3. Innervation: medial plantar n. (S2-S3) 4. Fxn: flexes digits 2-5
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Flexor hallucis brevis
Medial and lateral heads 1. Prox: cuboid and lateral (3rd) cuneiform 2. Distal: both sides base proximal phalanx of hallux 3. Innervation: medial - medial plantar n. (S2-S3), lateral - lateral plantar n. (S2-S3) 4. Fxn: flexes proximal phalanx of hallux
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Adductor hallucis
Oblique and transverse heads 1. Prox: bases MT2-4, plantar lig 2. Distal: base proximal phalanx of hallux 3. Innervation: lateral plantar n. (S2-S3) 4. Fxn: adducts hallux
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Abductor digiti minimi
1. Prox: calcaneal tuberosity, plantar aponeurosis 2. Distal: lateral side of base of proximal phalanx of 5th digit 3. Innervation: lateral plantar n. (S2-S3) 4. Fxn: abducts and flexes 5th digit
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Flexor digiti minimi brevis
1. Prox: base MT5 2. Distal: base proximal phalanx 5th digit 3. Innervation: lateral plantar nerve (S2-S3) 4. Fxn: flexes proximal phalanx digit 5
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Opponens digiti minimi
Variable 1. Prox: long plantar lig, fibular longus tendon sheath 2. Distal: 5th MT 3. Innervation: lateral plantar n. (S2-S3) 4. Fxn: pulls 5th MT in plantar and medial direction
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Quadratus plantae
1. Prox: calcaneal tuberosity 2. Distal: tendon flexor digitorum longus 3. Innervation: lateral plantar n. (S2-S3) 4. Fxn: assists flexor digitorum longus in flexing digits 2-5
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Lumbricals
1. Prox: tendons flexor digitorum longus 2. Distal: dorsal digital expansion digits 2-5 3. Innervation: 1st - medial plantar n. (S2-S3), 2-4 - lateral plantar n. (S2-S3) 4. Fxn: flexes proximal phalanges, extends middle and distal phalanges digits 1-4
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Plantar interossei (3)
1. Prox: medal MT3-5 2. Distal: medial bases phalanges digits 3-5 3. Innervation: laterally plantar n. (S2-S3) 4. Fxn: adducts digits 3-5 and flexes MTPs (PADs from single MT)
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Dorsal interossei (4)
1. Prox: adjacent sides shafts MT1-5 2. Distal: medial side proximal phalanx 2nd digit (1st dorsal interossei) and lateral sides digits 2-4 (2-4th dorsal interossei) 3. Innervation: lateral plantar n. (S2-S3) 4. Fxn: abducts digits 2-4 and flexes MTPs (DABs from 2 MTs)
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Internal iliac a.
1. Superior gluteal A. Superficial branch: gluteus maximus and skin B. Deep branch: gluteus medius and minimus, tensor fascia lata 2. Inferior gluteal: gluteus Maximus, obturator internus, quadratus femoris, superior part hamstrings 3. Obturator a.: medial thigh and portion anterior thigh, head of femur (kids)
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External iliac a.
Continues as femoral inf to inguinal canal -> anterior and anteromedial thigh 1. Profunda femoris: posterior to adductor longus, perforating branches -> adductor magnus, hamstrings, vastus lateralis A. Medial circumflex: femoral head and neck via retinacular branches B. Lateral circumflex: portion lateral gluteal region
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Popliteal a.
Femoral -> popliteal at adductor hiatus -> anterior and posterior tibial a. 1. 5 superior, middle, inferior genicular arteries A. Capsule and lig of knee B. Join -> genicular anastomosis C. Collateral circ to leg during knee flexion 2. Muscular br. A. Hamstrings B. Gastrocnemius C. Soleus D. Plantaris 3. Anterior tibial: anterior compartment leg A. Dorsalis pedis: dorsal muscles foot 1. 1st dorsal MT a. : boat sides hallux and medial side 2nd digit 2. Deep plantar a. : joins lateral plantar a. In sole of foot -> deep plantar arch 3. Lateral tarsal a. And arcuate a. : arcuate arch A. 2nd, 3rd, and 4th dorsal MT a. -> dorsal digital a. 4. Posterior tibial a. : posterior and lateral compartment leg and foot A. Fibular a. : popliteal m. And lateral compartment leg m. B. Medial plantar a. C. Lateral plantar a.
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Superficial veins lower limb
W/in subcutaneous tissues and run independent from a. 1. Greater saphenous v. : dorsal vein of great toe + dorsal venous arch foot A. Ascends medial aspect lower limb B. Enters saphenous opening -> femoral v. 2. Small saphenous v. : lateral side foot from dorsal v. Little toe + dorsal venous arch A. Penetrates deep fascia and ascends between heads gastrocnemius 3. Perforating v. : valves shunt blood from superficial v. To deep v. Under deep fascia A. Penetrate deep fascia at oblique angle -> prevents backward flow w. Muscle contraction
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Deep veins lower limb
Under deep fascia, follow a. 1. Anterior tibial v. : receives blood from perforating v. In anterior leg 2. Posterior tibial v. : blood from medial and lateral plantar v. From plantar aspect foot 3. All flow -> popliteal c. -> femoral v. In thigh -> external iliac v.

Anatomy ICOM (34 decks)

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