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Lower limb Flashcards

1
Q

Where can the femoral artery be felt?

A

Middle inguinal point

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2
Q

What kind of joint is the hip joint?

A

Ball and socket synovial

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3
Q

What fractures of the femur are common in the elderly and how do they present?

A

Neck of femur fracture. Presented by shortened and externally rotated leg.

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4
Q

What are the bones of the lower limb - minus the foot?

A 
Hip bone
Femur
Patella
Tibia
Fibula
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5
Q

How are the tibia and fibula joined?

A

Interosseous ligament

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6
Q

What is the clinical significance of the medial malleolus of the tibia?

A

Great saphenous vein can be quickly accessed anterior to it

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7
Q

What bones are found in the foot?

A

Distal, middle and proximal phalanges
tarsals - medial, intermediate and lateral cunieform, cuboid, navicular, talus and calcaneus
Metatarsals

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8
Q

What are the muscle compartments of the thigh?

A

Anterior, medial and posterior

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9
Q

What are the muscle compartments of the leg?

A

Anterior, lateral deep and superficial posterior

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10
Q

What are the symptoms of compartment syndrome?

A

Pain, palor, pulseless and paraesthesia

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11
Q

What is the treatment for compartment syndrome?

A

Fasciotomy

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12
Q

Anterior compartment of the thigh

A

Supplied by the femoral artery and femoral nerve.

Composed of the sartorius, ilipsoas and quadriceps muscles

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13
Q

What does the anterior compartment of the thigh do?

A

Knee extension and hip flexion

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14
Q

What muscles make up the quadriceps?

A

Rectus femoris
vastus medius
vastus intermedius
vastus lateralis

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15
Q

Medial compartment of the thigh

A

Supplied by the obturator nerve and profunda femoris/ obturator artery. Composed of the obturator externus, gracilis, adductor magnus, adductor brevis and adductor longus

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16
Q

Posterior compartment of the thigh

A

Supplied by the sciatic nerve and profunda femoris artery.

Made up of the biceps femoris - long and short head, semimembranosus and semitendinosus

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17
Q

What does the medial compartment of the thigh do?

A

Adduction of thigh

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18
Q

What does the posterior compartment of the thigh do?

A

Flexion of knee and extension of hip

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19
Q

Where should an intramuscular injection be given?

A

Upper lateral quadrant of the gluteal region to avoid damaging the sciatic nerve

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20
Q

What are the muscles of the gluteal region?

A

Gluteus maximus
Gluteus minimus
Gluteus medius

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21
Q

Gluteus maximus

A

Thick extensor, assists with lateral rotation. Innervated by inferior gluteal nerve. Located superficially to the gluteus minimus and inferior to the gluteus medius

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22
Q

Gluteus medius

A

abducts and medially rotates lower limb. Innervated by the superior gluteal nerve. Found superior to the gluteus maximus and minimus

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23
Q

Gluteus minimus

A

abducts and medially rotates the lower limb. Innervated by the superior gluteus nerve. Found deep to the gluteus maximus

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24
Q

Trendelenburg gait

A

When there is damage to the superior gluteal nerve, causing weakness of the abductor muscles - gluteus medius and minimus. The opposite side to the side affected drops when walking.

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25
Duchenne's gait
Pelvic tilt
26
Anterior compartment of the leg
Supplied by the deep fibular nerve and anterior tibial artery. Composed of: extensor hallucis longus, extensor digitorum longus, tibialis anterior and fibularis tertius
27
What does the anterior compartment of the leg do?
Dorsiflexion of foot and inversion of foot at ankle joint
28
What happens when there is damage to the common fibular/ peroneal nerve?
Foot drop as the muscles of the anterior compartment are paralysed because the deep fibular nerve arises from the peroneal nerve.
29
Saphenous nerve?
Supplies a medial portion of the leg
30
Lateral compartment of the leg
Supplied by the superficial fibular nerve and fibular artery. Composed of the fibularis longus and brevis
31
What does the lateral compartment of the leg do?
Eversion of the foot
32
Superficial posterior compartment of the leg
Supplied by the tibial nerve and posterior tibial artery. Composed of the gastrocnemius, soleus and plantaris
33
What does the superficial posterior compartment of the leg do?
Plantarflexion at ankle joint
34
Deep posterior compartment of the leg
Supplied by the tibial nerve and posterior tibial artery. Composed of the flexor digitorum longus, flexor hallucis longus, tibialis posterior and popliteus
35
Role of popliteus
laterally rotates the femur, unlocking knee joint, allowing flexion
36
Role of flexor hallucis longus
flexes big toes
37
Role of flexor digitorum longus
flexes lateral 4 toes
38
Role of tibialis posterior
Inverts and plantar flexes the foot
39
Sciatica
Pain in the buttocks or legs that is caused by the sciatic nerve becoming compressed or irritated.
40
What sensation does the femoral nerve supply?
Anterior thigh and medial leg
41
What sensation does the lateral femoral cutaneous nerve supply?
Lateral thigh
42
What sensation does the sciatic nerve supply
All of the posterior thigh and leg, anterior leg and foot - except medial part of leg
43
Myotome for hip flexion
L2
44
Myotome for knee extension
L3
45
Myotome for ankle dorsiflexion
L4
46
Myotome for great toes extension
L5
47
Myotome for ankle plantar flexion/ eversion/ hip extension
S1
48
Arterial supply of the lower limb
Abdominal aorta > common iliac > external iliac > femoral > popliteal > anterior tibial > fibular and posterior tibial arteries. Anterior tibial becomes dorsalis pedis artery in foot. Posterior tibial artery enters through tarsal tunnel and splits into lateral and medial plantar arteries
49
Deep veins of the lower limb
Veins from dorsal arch form anterior tibial vein. On plantar foot medial and lateral plantar veins arise and combine to form the posterior tibial and fibular veins > popliteal vein > femoral vein > external iliac > common iliac > inferior vena cava
50
Superficial veins of the lower limb
great saphenous vein from dorsal venous arch - into femoral vein small saphenous from dorsal venous arch - empties into popliteal vein
51
What forms the femoral triangle?
Iliopsoas, sartorius, adductor longus, pectineus and inguinal ligament
52
What is found in the femoral triangle?
Femoral nerve, femoral artery, femoral vein
53
Valgus
Abnormal abduction
54
Varus
Abnormal adduction
55
Coxa valgus
Increase in the femoral neck shaft angle
56
Coxa varus
Decrease in the femoral neck shaft angle
57
Genu valgus
Knock knee, condition where the knees angle in and touch each other when the legs are straightened. Lower leg angled outwards.
58
Genu varus
Outward bowing at the knee
59
Another name for the hip bone?
Innominate bone
60
When do the 3 hip bones fuse?
During puberty
61
Ligaments of the hip?
``` Transverse acetabular Ligamentum teres - Iliofemoral Pubofemoral Ischiofemoral ```
62
What is important about the ligamentum teres?
Contains the ligamentum teres artery that supplies blood to the femoral head during childhood, less so in adulthood, which is why there is still risk of AVN if there is a femoral neck fracture.
63
What does the iliofemoral ligament do?
limits extension
64
What does the pubofemoral ligament do?
Limits abduction
65
What does the ischiofemoral ligament do?
Limits extension
66
Legg-calve pethes disease
A childhood condition that occurs when blood supply to the femoral head is interrupted temporarily and the bone begins to die. The bone gradually breaks apart and can lose its shape.
67
Symptoms of Legg-calve Pethes disease
A limp and pain, shortening of the leg
68
Clinical presentation of neck of femur fractrure
Laterally rotated and shortened
69
Clinical presentation of shaft of femur fracture
Shortened leg only
70
What are the ligaments involved in the knee joint?
Anterior cruciate and posterior cruciate Lateral and medial collateral Patellar
71
What do the collateral ligaments fo?
Act to stabilise the hinge joint
72
What does the ACL do?
Prevents anterior dislocation of the tibia onto the femur
73
What does the PCL do?
Prevents posterior dislocation of the tibia onto the femur
74
What is the unhappy triad
Damage to one of the medial meniscus, medial collateral ligament and anterior cruciate ligament causes damage to the rest.
75
What is the most common knee pathology
Injury to the collateral ligaments caused by side ward force.
76
How to assess collateral ligament damage?
Pain on medial rotation = medial ligament damaged and pain on lateral rotation = lateral ligament damaged
77
How can the ACL or PCL be torn?
Hyperextension of the knee or force to the back of the knee - ACL or front - PCL.
78
How to test damage to the cruciate ligaments?
Anterior/ posterior drawer test. Involves pulling the tibia forwards or backwards. If it moves the ligament has been damaged.
79
What are the 2 joints of the tibia and fibular?
Distal and proximal tibiofibular joints
80
What are the ligaments of the proximal tibiofibular joint?
Anterior and posterior superior tibiofibular ligaments lateral collateral ligament of knee biceps femoris
81
What are the supporting structures of the distal tibiofibular joints?
Interosseous membrane anterior and posterior inferior tibiofibular ligaments Inferior transverse tibiofibular ligament
82
What type of joint is the ankle joint?
Synovial hinge joint between the tibia and fibular with the talus of the foot.
83
Ligaments of the ankle joint?
Medial ligament | Lateral ligament
84
What makes up the lateral ligament of the ankle?
Anterior talofibular Posterior talofibular Calcaneofibular
85
Subtalar joint
articulation between the talus and calcaneus. It is a synovial plane joint
86
The ligaments of the subtalar joint
Posterior, medial and lateral talocalcaneal ligaments | Interosseous talocalcaneal ligament
87
Calcaneal fracture
Crush type injury, the talus is driven into the calcaneus. There will be pain on inversion and eversion
88
What spinal nerves are in the lumbar plexus?
L1-L4
89
Where do spinal nerves leave the spinal cord?
Intervertebral foramina
90
What are the main nerve branches of the lumbar plexus?
``` Iliohypogastric nerve Ilioinguinal nerve Genitofemoral nerve Lateral cutaneous nerve of the thigh Obturator nerve Femoral nerve ```
91
Where is the lumbar plexus
Within the psoas major and anterior to transverse vertebral processes
92
Iliohypogastric nerve root
L1
93
Iliohypogastric nerve sensory function
posterolateral gluteal skin in pubic region
94
Motor function of iliohypogastric nerve
internal oblique and transversus abdominis
95
ilioinguinal nerve root
L1
96
Motor function of ilioinguinal nerve
Internal oblique and transversus abdominis
97
Sensory function of ilioinguinal nerve
Skin of upper middle thigh and over the genitals
98
Genitofemoral nerve root
L1 and L2
99
Motor function of genitofemoral nerve
Cremasteric muscle
100
Sensory function of genitofemoral nerve
Upper anterior thigh and genital area
101
Lateral cutaneous nerve of thigh root
L2 and L3
102
Motor function of Lateral cutaneous thigh nerve
none
103
Sensory function of lateral cutaneous thigh nerve
Anterior and lateral thigh down to knee
104
Obturator nerve root
L2,3,4
105
Motor function of obturator nerve
Obturator externus, pectineus, adduction longus, brevis and magnus and gracilis
106
Sensory function of obturator nerve
Skin over medial thigh
107
Femoral nerve root
L2,3,4
108
Motor function of femoral nerve
Quadriceps femoris muscles, iliacus, pectineus and sartorius
109
Sensory function of femoral nerve
Skin on anterior thigh and medial leg
110
What spinal nerves are in the sacral plexus?
S1-4
111
How does the lumbarsacral trunk form?
The anterior spinal nerves of S1-4 join with the 4th and 5th lumbar roots
112
What are the major nerves of the sacral plexus?
``` Superior gluteal nerve Inferior gluteal nerve Sciatic nerve Posterior femoral cutaneous Pudendal nerve ```
113
What are the main destinations of the sacral plexus branches?
Leave pelvis via greater sciatic foramen or remain in the pelvis
114
Superior gluteal nerve root
L4,5 and S1 leaves via the greater sciatic foramen
115
Motor function of superior gluteal nerve
Gluteus minimus, medius and tensor fascia lata
116
Sensory function of superior gluteal nerve
None
117
Inferior gluteal nerve root
L5, S1 and 2 leaves via greater sciatic foramen
118
Motor function of inferior gluteal nerve
Gluteus maximus
119
Sensory function of inferior gluteal nerve
None
120
Sciatic nerve root
L4,5, S1,2,3
121
Motor functions of sciatic nerve
Posterior compartment of leg and thigh and hamstring component of adductor magnus and sole of foot Supplies the common fibular nerve and so innervates all muscles of anterior and lateral compartments of leg and extensor digitorum brevis
122
Sensory function of sciatic nerve
Posterolateral and medial surfaces of foot, sole of foot. Through common fibular - skin on anterolateral of leg and dorsal aspect of foot
123
Posterior femoral cutaneous nerve root
S1-3
124
Motor functions of posterior cutaneous femoral nerve
None
125
Sensory function of posterior cutaneous femoral nerve
Skin on posterior of thigh and leg and perineum
126
Pudendal nerve root?
S2-4
127
Motor function of pudendal nerve
perineum skeletal muscles, sphincters ,levator ani
128
Sensory functions of pudendal nerve
Penis and clitoris and perineum
129
What is an inguinal hernia
When part of the intestine protrudes through a weak spot in the abdominal muscles, resulting in a painful bulge

Anatomy (16 decks)

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