LOWER LIMB Flashcards
(222 cards)
1
Q
The hip bone is formed by the fusion of the ____, _____, and _____
A
Ilium
pubis
ischium
2
Q
It forms the lateral part of the hip bone
A
Ilium
- Consists of the body, and ala
- ASIS, AIIS, PIS, greater sciatic notch, ilaic fossa, and gluteal lines
3
Q
Forms the anterior part of the acetabulum and the anteromedial part of the hip bone.
A
Pubis
- Comprises the body, the superior ramus, and the inferior ramus
4
Q
Forms the posteroinferiorpart of the acetabulum and the lower posterior part of the hip bone
A
Ischium
- consists of the:
- body
- Ramus: joins the inferior pubic ramus to form the ischiopubic ramus
5
Q
Incomplete cup-shaped cavity on the lateral side of the hip bone in which the head of the femur fits
A
Acetabulum
- Includes the acetabular notch, which is bridged by the transverse acetabular ligament
- Formed by the
- ilium - superiorly
- ischium - posteroinferiorly
- pubis - anteromedially
6
Q
Longest and strongest bone of the body
A
Femur
7
Q
Head of the femure=
A
- forms about 2/3 of asphere
- directed medially, upward, and slightly forward to fit into the acetabulum
- Has a depression in its articular surface
-
FOVEA CAPITIS FEMORIS
- ligamentum capitis femoris attached
-
FOVEA CAPITIS FEMORIS
8
Q
Fracture of the ____ of the femur is a rare injury caused by posterior hip dislocation in advanced age
Presents as a shortened lower libe with medial rotation
A
Head
9
Q
Fracture of the ____ of the femur results in ischemic necrosis if the neck and head due to interruption of blood supply by the medial femoral circumflex artery
Presents as shortened with lateral rotation
A
Neck
10
Q
is a femoral fracture throuc the trochanters and is a form of the extracapsular hip fracture.
A
Pertrochanteric fracture
11
Q
In fracture of the middle third of the femoral shaft, the proximal segment os pulled by the ______ and ______ and the distal fragment is rotated backward byt the two heads of the gastrocnemius
A
Quadriceps and the hamstrings
12
Q
Neck of the femur
A
- Common site of fractures
- forms an angle of about 125 degrees with the shaft
- separated from the shaft in front by th intertrochanteric line
- iliofemoral ligament is attached
13
Q
projects upward from the junction of the neck with shaft
Procides insertion for the gluteus medius and minimus, piriformis, and obturator internus muscles
A
Greater trochanter
- Receives the obturator externus tendon on the medial aspect of the trochanteric fossa
14
Q
Lies in the angle between the neck and the shaft
Projects at the inferior end of the intertrochanteric crest
A
Lesser trochanter
Provides an isertion for the iliopsoas tendon
15
Q
Is the rough line on ridge on the body (shaft) of the femur
Exhibits lateral and medial lips that provide attachments for many muscles and the 3 intermuscular septa
A
Linea aspera
16
Q
Is a small prominence at the uppermost part of the medial femoral condyle.
Provides an isertion for the adductor magnus muscle
A
Adductor Tubercle
17
Q
A dislocated knee or fractured distal femur may injure the _____ because of its deep position adjacent to the femur and the knee joint capsule.
A
Popliteal artery
18
Q
Transverse patellar fracture results from a blow to the knee or from sudden contraction of the quadriceps muscle. The proximal fragment of the patella is pulled superiorly by the quadriceps tendon, and the distal fragment remain with the _________
A
Patellar ligament
19
Q
Is a fracture of the lateral tibial condyle that is caused by an automobile bumper, and it is usually associated with a common peroneal nerve injury
A
Bumper fracture
20
Q
Weight bearing medial bone of the leg
A
Tibia
-
Tibial tuberosity
- patellar ligament inserts
- medial and lateral condyles that articulate with the condyles of the femur
-
Medial malleolus with a malleolar groove
- tendons of the tibialis posterior and flexor digitorum longus
-
Another groove (posterolateral to the malleolus groove)
- tendon of the flexor hallucis longus
21
Q
Has little or no function in weight bearing but provides attachment for muscles
Has a head(apex) that provides attachment for the fibular collateral ligament of the knee
A
Fibula
- Has a projection called the lateral malleolus that articulates with the trochlea of the talus; lies more inferior and posterior than the medial malleolus; and provides attachment for the anterior talofibular, posterior talofibular, and calcaneofibular ligaments.
- It also has the sulcus
- For the peroneus longus
- peroneus brevis
22
Q
is a fracture of the lower end of the fibula, often accompaanied by fracture of the medial malleolus or rupture of the deltoid ligament.
Caused by forced eversion of the foot
A
Pott’s fracture (Dupuytren’s fracture)
23
Q
A t-shaped fracture of the distal femur with displacement of the condyles. It may be caused by a blow to the flexed knee of a person riding pillion on motorcycle
A
Pillion fracture
24
Q
Fracture of the fibular neck may be cause an injury to the _______________
A
Common peroneal nerve
(winds laterally around the neck of the fibula)
This results in paralysis of all muscles in the anterior and lateral compartments of the leg (dorsiflexors and evertors of the foot), causing foot drop
25
Tarsus consists of 7 tarsal bones
* Talus
* Calcaneus
* navicular bone
* cuboid bone
* 3 cuneiform bones
26
Transmits the weight of the body from the tibia to the foot and is the only tarsal bone without attachments
Talus
* Neck - **sulcus tali**
* **interosseous ligaments** between the talus and the calcaneus
* Body - with **groove** on its posterior surface
* f**lexor hallucis longus tendon**
* Head
* keystones of the **medial longitudinal arch** of the foot
27
Largest and strongest bone of the foor and lies below the talus
Forms the heel of the foot, articulates with the talus superiorly and the cuboid anteriorly, and provides an attachment for the **achilles tendon**
Calcaneus
* **Sustentaculum tali** (medial projection)
* supports the head of the talus (with the spring ligament)
* **groove on its interior surface**
* Flexor hallucis longus tendon
* uses the sustentaculum tali as **pulley**
28
Is a boat shaped tarsal bone lying between the head of the talus and the three cuneiform bones
Navicular bone
29
Most lateral laterally placed tarsal bone and has a **groove** for the **peroneus longus muscle tendon**
Serves as the keystone of the **lateral longitudinal arch** of the foot
Cuboid bone
30
Are 3 wedge shaped bones that form a part of the emdial lonhgitudinal and poximal transverse arches
Articulate with the navicular bone posteriorly and with 3 metatarsals anteriorly
Cuneiform bones
31
Consists of five metatarsal and has prominent medial and lateral sesamoid bones on the first metatarsal
Metatarsus
32
Phalanges consists of ____ bones
14 (2 in the first 2 digit, and 3 in each of the others)
33
is a fatigue fracture of one of the metatarsals, which may result from prolonged walking.
March fracture (stress fracture)
34
Hip (coxal) joint
* multiaxial ball and socket synovial joint
* has a cavity deepened by the fibrocartilaginous **acetabular labrum** and is completed below by the **transverse acetabular ligament**, which bridges and converts the **acetabular notch** into a foramen for passage of **nutrient vessels** and nerves
* **Receives blood from**
* medial and lateral femoral circumflex
* superior and inferior gluteal
* obturator - the posterior branch give rise to the artery of the ligamentum teres capitis femoris
* **Innervated by**
* femoral
* obturator
* sciatic
* superior gluteal
* nerves to the quadratus femoris, the acetabulum
35
is a compelte fibrocartilage rim that deepens the articular socket for the head of the femur and consequently stabilizes the hip joint
Acetabular labrum
36
Fibrous capsule
* Attached proximally to the margin of the acetabulum and to the transverse acetabular ligament
* attached distally to the neck of the femur
* Encloses part of the head an dmost of the neck of the femur
* Reinforced
* Anteriorly: **Iliofemoral ligament**
* Posteriorly: **ischiofemoral ligament**
* inferiorly: **pubofemoral ligament**
37
Posterior hip dislocation
* 90%
* tearing of the joint capsule
* fractured femoral head lies posterior to the acetabulum or the ischim
* rupture of both the posterior acetabular labrum and the ligamentum capitis
* Injury to the sciatic nerve
* shortened flexed, adducted, and medially rotated
38
Anterior dislocation
* tearing of the joint capsule anteriorly with movement of the femoral head out of the acetabulum
* the femoral head is displaced anteroinferior to the acetabulum or the pubic bone
* Slightly flexed, abducted, and laterally rotated
39
Medial (central or intrapelvic) dislocation of the hip joint
* medial tearing of the joint capsule
* dislocated femoral head lies medial to the pubic bone
* Accompanied by acetabular fracture of the bladder
40
axis of the femoral shaft \>135 degrees
Coxa valga
41
Axis of the femoral shaft \<135 degrees
Coxa vara
42
Largest and most important ligament that reinforces the fibrous capsule anteriorly and is in the form of an inverted Y
Iliofemoral ligament
* Resists hyperextension and lateral rotation at the hip joint during standing
* attached proximally to the anterior-inferior iliac spine and the acetabular rim and distally to the intertrochanteric line and the front of the greater trochanter of the femur
43
Reinforces the fibrous capsule posteriorly
Ischiofemoral
* extends from the ischial portion of the acetabular rim to the neck of the femur medial to the base of the greater trochanter, and limits extension and medial rotation of the thigh
44
Reinforces the fibrous capsule inferiorly
Pubofemoral ligament
45
Arises form the floor of the acetabular fossa and attaches to the fovea capitis femoris
Ligamentum teres capitits (Round ligament of head of femur)
46
Fibrous band that bridges the acetabualr norch and converts it into a foramen. through which the nutrient vessels enter the joint
Transverse acetabular liogament
47
Largest and mist complicated joint.
Condylar type of synovial joint between two condyles of the femur and tibia. In Addition it inckudes a saddle joint between the femur and the patella
Knee joint
48
Knee joint
* Stabilized laterally
* biceps and gastrocnemius (lateral head) tendons, the iliotibial tract and the fibular collateral ligaments
* Stabilized medially
* sartorius, gracilis, gastrocnemius (medial head), semitendinosus, and semimembranosus muscles and the tibial collateral ligament
* Receives blood from
* genicular branches of the popliteal artery
* descending branch of the lateral femoral circumflex artery
* articular branch of the descending genicular artery, and the anterior tibial recurrent artery
* Innervated
* sciatic, femoral, obturator
49
ACL
* Arises from the intercondylar area of the tibia and passes upward, backward, and laterally to insert into the medial surface of the lateral femoral condyle
* Longer than PCL
* Prevents forward sliding of the tibia on the femur
* Taut during extension
* lax during flexion
50
PCL
* Arises from the posterior intercondylar area of the tibia and passes upward, forward, and medially to insert into the lateral surface of the medial epicondyle
* Shorter, straighter, and stornger
* Prevents backward sliding of the tibia on the femur
* Taut during flexion
* lax during extension
51
Medial Meniscus
* C shaped
* attached to the MCL and interarticualr area of the tibia
* acts as cushion or shock absorber and lubricates the articular surfaces by distributing fluid in a windshield wiper manner
52
Unhapapy tiad or O'Donoghue's triad of knee joint
* Rupture of the tibial collateral ligament
* Tearing of the ACL
* Injury to the Medial meniscus
53
lateral meniscus
* circular
* acts as a cushion, and faciliates lubrication
* Separated laterally from the fibular (or latera) collateral ligament by the tendon of the popliteal muscle
54
Transverse ligament
Binds the anterior horns (ends) of the lateral and medial semilunar cartilages (menisci)
55
MCL
* firmly attached to the medial meniscus
* prevents medial displacement of the two long bones and thus abduction of the leg at the knee
* taut on extension
56
LCL
* Taut on extenstion
* limits extention and adduction of the leg
57
Patellar tendon
* continuation of the quadriceps femoris tendon
* used for repair of ACL
58
Oblique Popliteal ligament
* Oblique expansion of the semimenranous tendon
* Resists hyperextension of the leg and lateral rotaion during the final phase of extension
59
Major bursa communicating with the knee joint cavity
Suprapatellar bursa
60
Prepatellar bursa
Lies over the surface of the patella
61
Consists of suncutaneous infrapatellar bursa and deep infrapaterallar bursa
Infrapatellar bursa
62
Known as the Pes Anserinus
Anserine bursa
* between the TCL and the tendons of
* Sartorius
* Gracilis
* Semitendinosus
63
Housemaid's knee
Prepatellar bursitis
64
Clergymen's knee
Infrapatellar
65
Swelling behinf the knee, caused by knee arthritis, meniscus injury, or herniation or tear of the joint capsule
Popliteal (baker's) cyst
66
Tibiofibular joints
* Proximal Tibiofibular
* plane type
* Distal tibiofibular joint
67
Talocrural (ankle) joint
* Hinge type (gynglymus) synovial joint betweem the tibia and fibula superiorly and the trochlea of the talus inferiorly
* dorsiflexion and plantar flexion
68
Medial (deltoid) ligament
Prevents overeversion of the foot and helps maintaiin the medial longitudinal arch
* 4 parts
* tibionavicular
* tibiocalcaneal
* anterior tibiotalar
* posterior tibiotalar
69
Lateral ligament
* resists inversion of the foot and may be torn during an ankle sprain
* Consists of
* anterior talofibular
* posteriro talofibular
* calcaneofibular (cord-like)
70
Talocalcaneal Joint
Subtalar
allows inversion and eversion of the foor
71
Talocalcaneonavicular joint
Ball and socket
supported by the spirng(plantar calcaneonavicualr) ligament
72
Calcaneocuboid joint
Supported by the short plantar and long plantar ligaments and by the tendon of the peroneus longus muscle
73
Collective term for the talonavicular part of the talocalcaneonavicular joint and the calcaneocuboid joint
Transerse tarsal (midtarsal) joint
74
Tasrometatarsal joints
Plane synovial joint that strengtheb the transverse arch
75
Metatarsophalangeal joint
Ellipsoid (condyloird) synovial joint
76
localized swelling at the medial side of the first metata
Bunion
77
Interphalangeal joint
Hinge type (ginglymus) synovial joints)
78
Innervates the skin on the anterior and lateral aspects of the thigh
Lateral femoral cutanaeous nerve
| (L2-L3)
79
consist of superior (3 lumbar), middle (3 sacral) and inferion nerves
Innervate the skin of the gluteal region
Clunial nerves
80
Arises from the sacral plexus (S1-S3)
Innervates the skin of the buttock, thigh and calf
Posterior femoral cutaneous nerves
81
Arises from the femoral nerve in the femoral traingle
Innervates the skin in the medial side of the leg and foot
Vulnerable to injury (proximal portion) during surgery to repair varicose veins
Saphenous nerve
82
Arises form the Common peroneal nerve in the popliteal fossa
may have a communciating branch
Innervates the skin on the psoterolateral side of the leg
Lateral sural cutaneous nerve
83
Arises from the tibial nerve in the popliteal fossa
Innervates the skin of the back of the leg and the lateral side of the ankle, heel, and foot
Medial sural Cutaneous nerve
84
Union of the medial and lateral sural nerves
innervates the skin on the back of the leg, and the alteral side of the ankle, heel, and foot
Sural nerve
85
Innervate skin on the lateral side of the lower leg and the dorsum of the foor
Dicides into a medial dorsal cutaneous nerves and an intermediate dorsal cutaneous nerve
Superfcial peroneall nerve
86
Supplies anterior muscles of the leg and foot and the skin of the contigous sides of the first and second toes
Deep peroneal nerve
87
Begins at the medial end of the dorsal venous arch
Passes through the saphenous opening (fossa ovalis) in the fascia lata
suitable vessel for use in coronary artery bypass
Great saphenous vein
88
Begins the the laterl end of the dorsal venous arch, behind the lateral malleolus
Terminates in the popliteal vein
Short saphenous vein
89
Superficial lymph vessels
Divided into
* medial group
* follows the great saphenous vein
* Lateral group
* follows the small saphenous vein
90
Deep lymph vessels
COnsists of the anterior tibial, posterior tibial and peroneal vessels
enter the popliteal lymph nodes
91
Superficial Inguinal group of LN
Located subcutaneously near the saphenofemoral junction and drains the superficial thigh region
Drains into the external iliac nodes
92
Deep inguinal group of LN
Deep to the fascia lata on the medial side of the femoral vein
93
Sacrotuberous ligament
* Converts with the sacrospinous ligament, the lesser sciatic notch into the lesser sciatic foramen
* Ischial tuberosity to the Posterior iliac spines, lower sacrum and coccyx
94
Sacrospinous ligament
Converte the greater sciatic notch into the greater sciatic foramen
95
Provides a pathway for the piriformis muscle, superior and inferior gluteal vessels and nerves, internal pudendal nerve, sciatic nerve, posterior femoral cutaneous nerve, and the nerves to the obturator internus and quadratus femoris muscles
Greater sciatic foramen
96
Provides a pathway for the tendon of the obturator internus, the nerve to the obturator internus and the internal oudendal vessels and pudendal nerve
Lesser sciatic foramen
97
Sructures that pass through both the greater and lesser sciatic Foramina
* pudendal nerve
* internal pudendal vessels
* nerve to the obturator internus
98
Gluteus maximus
O: Ilium, sacrum, coccyx, sacrotuberous ligament
I: Gluteal tuberosity, ilitotibial tract
N: inferior gluteal
A: Extend and rotates thih laterally
99
Gluteus medius
O: ilium between iliac cresym and anterior and posterior gluteal lines
I: Gretaer trochanter
N: Superior gluteal
A: Abducts and rotates thigh medially, stabilizes pelvis
100
Gluteus minimus
O: ilium between anterior and inferior gluteal lines
I: greater trochanter
N: superior gluteal
A: abducts and rotates thigh medially
101
Tensor fasciae lata
O: ilaic crest, ASIS
I: iliotibial tract
N: Superior gluteal
A: flexes, abducts, and rotates thigh medially
102
Piriformis
O: Pelvic surface of the sacrum, sacrotuberous ligament
I: Upper end of greater trochanter
N: Sacral (S1-S2)
A: Rotates thigh laterally
103
Obturator internus
O: ischiopubic rami, Obturator membrane
I: Greater trochanter
N: Nerve to obturator internus
A: Abduct and rotates thigh laterally
104
Superior gemellus
O: ischial spine
I: Obturator internus tendon
N: nerve to obturator internus
A: Rotates thigh laterally
105
Inferior gemellus
O: Ischial tuberositu
I: obturator internus tendon
N: nerve to quadratus femoris
A: Rotate thigh laterally
106
Quadratus femoris
O: ischial tuberosity
I: intertrochanteric crest
N: nerve to quadratus femoris
A: rotates thigh laterally
107
Forms lateral and medial intermuscular septa
Fascia lata
108
is a condition in which the piriformis muscle irritates and places pressure on the sciatic nerve, causing pain in the buttocks and referring pain along the course of the sciatic nerve.
Piriformis syndrome
Sciatica
109
Senn in a fracture of the femoral neck, dislocated hip joint, or weakness and paralysis of the gluteis medius, minimus causing inanbility to abduct the hip
Trendelenburg sign
110
Semitendinosus
O: ischial tuberosity
I: Medial surface of upper part of tibia
N: Tibial portion of sciatic nerve
A: Extends thigh, flexes and rotates leg medially
111
Semimebranosus
O: ischial tuberosity
I: Medial condyle of tibia
N: Tibial portion of sciatic nerve
A: Extends thigh, flexes and rotates leg medially
112
Biceps femoris
O: long head from ischial tiberosity, short head from line aspera and upper supracondylar line
I: head of fibula
N: Tibial (long head) and common peroneal (short head) divisions of sciatic nerve
A: Extends thigh, flexes and roates leg laterally
113
Femoral Triangle
* Superiorly: inguinal ligament
* Laterally: sartorius
* Medially: adductor lingus
* Floor: iliopsoas,pectineus, adductor longus
* Roof: fascia lata, cribriform fascia
Lateral to medial (NAVY) - nerve, artery, vein, lymphatics
114
Abdominal opening of the femoral canal.
Femoral ring
* anterior: inguinal ligament
* lateral: femoral vein
* Medial: lacunar ligament
* Posterior: pectineal ligament
115
Femoral canal
transmits lymphatics from the lower limb and perineum to the peritoneal cavity
SIte of femoral herniation
Medial to the femoral vein in the femoral sheath
116
Femoral hernia
* More common in women
* passes through the femoral ring
* lateral and inferior to the pubic tubercle and deep and inferior to the inguinal ligament
* Sac is formed by the parietal peritoneum
117
Iliacus
O: iliac fossa, ala of sacrum
I: lesser trochanter
N: femoral
A: flexes thigh (with psoas majotr)
118
Sartorius
O: ASIS
I: Upper medial side of tibia
N: femoral
A: flexes and rotates thigh laterally, flexes and roates leg medially
119
Rectus femoris
O: AIIS, Posterior-superior rim of acetabulum
I: Base of patella, tibial tuberosity
N: femoral
A: flexes thigh, extends leg
120
Vastus medialis
O: Intertrochanteric line, linea aspera, medial intermuscular septum
I: medial side of patella, tibial tuberositu
N: femoral
A: Extends leg
121
Vastus lateralis:
O: intertrochanteric line, greater trochanter, linea aspera, gluteal tuberosity, lateral intermuscular septum
I: lateral sife of patella, tibial tuberosity
N: femoral
A: Extends leg
122
Vastus intermedius
O: Upper shaft of femur, lower lateral intermuscular septum
I: Upper border of patella, tibial tuberotsity
N: femoral
A: extends leg
123
Adductor longus
O: Body of pubis below its crest
I: Middle 3rd of linea aspera
N: obturator
A: Adducts and flexes thigh
124
Adductor brevis
O: Body and inferior pubic ramus
I: Pectineal line, upper part of linea aspera
N: Obturator
A: Adducts and flexes thigh
125
Adductor magnus
O: Ischiopubic ramus; ischial tuberotsity
I: Pectineal line, uppert part of linea aspera
N: obturator and sciatic (tibial part)
A: Adducts, flexes, and extends thigh
126
Pectineus
O: Pectineal line of pubis
I: Pectineal line of femur
N: Obturator and femoral
A: Adducts, flexes thigh
127
Gracilis
O: Body and inferior pubic ramus
I: Medial surface of upper quarter of tibia
N: obturator
A: Adducts and flexes thigh, flexes and rotates leg medially
128
Obturator externus
O: Margin of obturator foramen and obturator membrane
I: intertrochanteric fossa of femur
N: Obturator
A: rotates thigh laterally
129
Formed by a prolongation of transverslais and iliac fasciae in the thigh.
Femoral sheath
* contains
* femoral artery and vein
* branch of genitofemoral nerve, femoral canal
* The femoral nerve lies outside the femoral sheath, lateral to the femoral artery
130
Begins at the aoex of the femoral triangle and ends at the adductor hiatus
Lies between the adductor magnus and longus muscles and the vastus medialis muscle, and is covered by the sartorius muscle and fascia
Adductor canal
131
The aooerture in tendon of insertion of the adductor magnus.
Allows the passage of the femoral vessels in the popliteal fossa
Adductor hiatus (Hiatus Tendineus)
132
Oval gap in the fascia lata below the inguinal ligametn that is covered by the cribriform fascia, which is a part of the superficial fascia of the thigh
Provides a pathway for the greater saphenous vein.
Saphenous Opening (Saphenous hiatus) or Fossa Ovalis
133
Groin or pulled groin
Strain, stretching, or tearing of the origin of the flexor and adductor of the thigh and often ccurs in sports that require quick starts
134
The ______ is a relatively weak membrane of the adductor group of muscles, and thus surgeons often transplant this msucle or part of it, with nerve and blood vessels, to replace a damaged muscle in the hand. the proximal muscle attachements are in the inguinal region or groin
Gracilis
135
Muscle strains of the ________ may occur in horseback riders and produce pain because the riders adduct their thighs to keep from falling from the animal
Adductor longus
136
Popliteal fossa
* superomedially :the semitendinosus and semimembranosus muscle
* superolaterally: biceps muscle
* Inferolaterally: lateral head of the gastrocnemius and plantaris muscle
* inferomedially: medial head of the gastrocnemius muscle
* Contains the
* popliteal vessels
* common peroneal and tibial nerves
137
The combined tendinous expansions of the sartorius gracilis and semitendinosus muscles at the medial border of the tuberosity of the tibia
Pes anserinus
May be used for surgical repair of ACL
138
characterized as ischemic necrosis of the muscles of the anterior compartment of the leg. It occurs presumabbly as a result of compression of arteries (anterior tibial artey and its branches) by swollen muscles following excessive exertion
Anterior tibial compartment syndrome
139
Painful condition of the anterior compartment of the leg along the thin bone (tibia) caused by swollen muscles in the anterior compartment, particularly the tibialis anterior muscle, following atheletic overexertion
Shin splint
140
Sudden involuntary painful contraction of muscles of the lower limb. It is used by muscle fatugue from polonged sitting, overexertion, dehydration, and depletion or imbalance of salt and minerals (electrolytes) such as calcium, sodium, potassium and magnesium as well as apoor blood supply to leg muscles
Muscle cramp
* The most commonly affected muscles are the calf muscle, hamstrings and quadriceps.
141
Condition of limping caued by ischemia of the muscles in the lower limbs, chiefly the calf muscles and is seen in occlusive peripheral arterial diseases particularly in the popliteal artery and its branches.
Intermittent claudication
* main symptom is leg pain that occurs during walking and intesifies until walking is impossible
142
Tibilias anterior
O: lateral tibial condyle, interosseous membrane
I: first cuneiform, first metatarsal
N: Deep peroneal( fibular)
A: Dorsiflexes and inverts foot
143
Extensor hallucis longus
O: Middle half of the anterior surface of fibula, interosseous membrane
I: Base of distal ohalanx of bif toe
N: Deep peroneal (fibular)
A: Extend big toe, dorsiflexes and inverts foot
144
Extensor digitorum longus
O: lateral tibial condyle, upper 2/3 of fibula, interosseous membrane
I: Bases of middle and distal phalanges
N: Deep peroneal (fibular)
A: Extends toes, dorsiflexes and everts foot
145
Peroneus (fibularis) tertius
O: distal one and 3rd of fibula, interosseous membrane
I: Base of fifth metatarsal
N: Deep peroneal (fibular)
A: Dorsiflexes and everts foot
146
Lateral peroneus longus
O: lateral tibial condyle, head and upper lateral side of fibula
I: base of first metatarsal, medial cuneifor,
N: Superficial peroneal (fibular)
A: everts and plantar flexes foot
147
Peroneus brevis
O: Lower lateral side of the fibula, intermuscular septa
I: Base of fifth metatarsal
N: superficial peroneal (fibular)
A: everts and plantar flexes foot
148
Superficial groups of the posterior muscles
Gastrocnemius
Soleus
Plantaris
149
Deep group of the posterior muscles of the leg
Popliteus
Flexor hallucis longus
FLexor digitorum longus
Tibialis posterior
150
Gastrocnemius
O: lateral (lateral head) and Medial (medial head) femoral condyles
I: Posterior aspect of calcalneus
N: tibial
A: flexes knee, planter flexes foot
151
Soleus
O: upper fibula head, soleal line on tibia
I: Posterior aspect of calcaneus via tendo calcaneus
N: tibial
A: Plantar flexes foot
152
Plantaris
O: upper fibula head, soleal line on tibia
I: Posterior surface of calcaneus
N: tibial
A: flexes leg, plantar flexes foot
153
Popliteus
O: Lateral condle of femur, popliteal ligament
I: Upper posterior side of tibia
N: tibia
A: Flexes by unlocking knee and rotates leg medially
154
Flexor hallucis longus
O: Lower 2/3 of fibula, interosseus membrane, intermuscular septa
I: base of distal phalanx of big toe
N: tibial
A: Plantar flexes foot, flexes distal phalanx of big toe
155
Flexor digitorum longus
O: Middle psoterior aspect of tibia
I: Distal phalanx of lateral four toes
N: Tibial
A: Flexes lateral four toes, plantar flexes foot
156
Tibilias posterior
O: interosseus membrane, upper parts of tibia
I: tuberosity of navicualr, sustentacula tali, 3 cuneiforms, cuboid, bases of metatarsal 2-4
N: Tibial
A: Plantar flexes and inverts foot
157
sense of restless unpleasant discomform inside the legs when sitting or lying down, accompanied bu irresistble urge to move the legs
Restless leg syndrome
158
Broad band of deep fascia extending between the tibia and fibula above the ankle
Superior Extensor Retinaculum
159
Y shaped band of deep fascia that forms loop of tendons of the EDL and peroneus terties and then divides into an upper band which atatches to the medial malleolus and a lower band, which attaches to the deep fascia of the foor and the plantar aponeurosis
Inferior Extensor retinaculum
160
Extensor digitorum brevis
O: dorsal surface of calcaneus
I: Tendons of extensor digitorum longus
N: Deep peroneal
A: extends toes
161
Extensor hallucis brevis
O: dorsal surface of calcaneus
I: base of proximal phalanx of big toe
N: deep peroneal
A: Extends big toe
162
Adductor hallucis
O: medical tubercle of calcaneus
I: Base of proximal phalanx of big toe
N: medial plantar
A: Abducts big toe
163
Flexor digitorum brevis
O: Medial tubercle of calcaneus
I: Middle phalanges of laterl four toes
N: Medial plantar
A: FLexes middle phalanges of lateral four toes
164
Abductor digiti minimi
O: Medical and aleral tubercles of calcaneus
I: proximal phalanx of little toe
N: lateral plantar
A: Abducts little toe
165
Quadratus plantae
O: medial and lateral side of calcaneus
I: Tendons of flexor digitorum longus
N: lateral plantar
A: AIds in flexing toes
166
Lumbricals (4)
O: Tendons of flexor digitorum longus
I: Proximal phalanges, extensor expansion
N: First by medial plantar, lateral 3 by lateral plantar
A: Flex metatarsophalangeal joints and extend interphalangeal joints
167
Flexor hallucis brevis
O: cuboid, 3rd cuneiform
I: Proximal phalnx of big toe
N: medial Plantar
A: Flexes big toe
168
Adductor hallucis
* Oblique head
* O: Bases of metatarsal 2-4
* Transverse head
* O: Capsule of lateral 4 metatarsophalangeal joint
I: Proximal phalanx of big toe
N: lateral plantar
A: Adducts big toe
169
Flexor digiti minimi
O: base of metatarsal 5
I: Proximal phalanx of little one
N: Lateral plantar
A: Flexes little toe
170
Plantar interossei (3)
O: Medial sides of metatarsals 3-5
I:Medial sides of base of proximal phalanges 3-5
N: lateral plantar
A: Adduct toes, flex proximal and extend distal phalanges
171
Dorsal interossei (4)
O: adjacent shafts of metatarsals
I: Proximal phalanges of second toe (medial and lateral sides) and 3rd and 4th toes (lateral sides)
N: lateral plantar
A: Abduct toes, flex proximal and extend distal phalanges
172
Flexor retinaculum
* Forms tarsal tunnel
* hold 3 tendons and blood vessels and a derve
* Anterior to posterior (Tom Dick ANd Harry or Tom Drives A Very Nervous Horse)
* tibilias posterior
* flexor Digitorum longus
* posterior tibial Artery and vein
* Tibial Nerve
* Flexor hallucis longis
173
complex symptom resulting from compression of the tibial nerve or its medial and lateral plantar branches in the tarsal tunnel, with pain, numbeness and tingling sensations on the ankle, heel, and sole of the foot
Tarsal tunnel syndrome
174
tendon insertion of the triceps surae into the tuberosity of the calcaneus
Tendo calcaneus (Achilles tendon)
175
Force eversion of the foot avulses the \_\_\_\_\_\_\_\_\_\_
Medial malleoulus or ruptures the deltoid ligament
176
Forced inversion avulses the \_\_\_\_\_\_\_\_
Lateral mallaelous or tears the lateral collateral ligament
177
Ankle sprain (inversion injury)
Results from rupture of the calcaneofibibular and talofibular ligaments and a fracture of the lateral malleolus caused by inversion of the foot
178
Radiates from the calcaneal tuberosity (tiber calcanei) toward the toes and provides attachment to the short flexor muscle of the toes
Plantar Aponeurosis
179
Formed and maintained by interlocking of the talus, calcaneus, navicular and cuneiform and 3 medial metatarsal bones
Medial longitudinal arch
* As its keystone = head of the talus
180
Formed by the calcaneus, the cuboid bone, and the lateral 2 metatarsal bones.
Lateral longitudinal arch
Keystone: cuboid bone
181
Transverse arch
* **Proximal (metatarsal) arch**
* supported by the tendon of the peroneus longus
* **Distal arch**
* formed by the heads of five metatarsal bones
* maintained by the transverse head of the adductor hallucis
182
Long plantar (Plantar calcaneocuboid) ligament
Supports the lateral side of the longitudinal arch of the foot
183
Short plantar (plantar calcaneocuboid) ligament
Lies deep from the fornt of the plantar ligament and supports the lateral longitudinal arch
184
Supports the head of the talis and the medial ongitudinal arch
SPring (plantar calcaneonavicular) Ligament
Contains considerable numbers of elastic fibers to give elasticity to the arch and spring to the foot
185
Obturator Nerve
* Arises form the lumbar plexus and enter through the obturator foramen
* Anterior Branch
* Adductor longus
* Adductor brevis
* gracilis
* Pectineus muscle
* Posterior Branch
* decsend between the adductor brevis and adductor magnus
186
Damage to the ______ causes a weakness of adduction and a lateral swinging of the limb during walking because of unopposed abductors
Obturator nerve
187
Femoral nerve (L2-L4)
* Arise from the lumbar plexus passes deep to the inguinal ligament and lateral to the femoral sheath
* Gives rise to
* Muscular branches
* Articular branches
* cutaneous branches
188
Damage to the ________ causes impaired flexion of the hip and impaired extension of the leg resulting from paralysis of the quadriceps femoris
Femoral nerve
189
Superior gluteal nerve (L4-S1)
* Arise from the sacral plexus enter through the greater sciatic foramen above the piriformis
* Innervates
* Gluteus medius
* Gluteus minimus
* Tensor fasciae latae
* hip joint
190
Injury to the _________ causes characteristic motor loss, resulting in weakened abduction of the thigh by the gluteus medius, diasbling gluteus medium limp, and gluteal gait
Superior gluteal nerve
191
Inferior gluteal nerve
* Arises form the sacral plexus enters through the greater sciatic foramen
* Innervates
* Gluteus maximus
192
Posterior Femoral Cutaneous nerve (S1-S3)
* From the sacral plexus
* passes through the greater sciatic foramen below the piriformis
* innervates
* skin of the buttock, thigh, and calf as well as scrotum or labium majus
193
Sciatic nerve (L4-S3)
* From sacral plexus, largest nerve in the body
* Divides at the superior border of the popliteal fossa
* Tibial nerve
* Common peroneal nerve
* Enters through the greater sciatic foramen below the piriformis
* Innervates
* hamstring muscles (tibial division) except the short head of the biceps femoris
194
Damage to the _____ causes impaired extension at the hip and impaired flexion at the knee, loss of dorsiflexion, and plantar flexion at the ankle, inversion and eversion of the foot and peculiar gait
Sciatic nerve
195
Common peroneal nerve (L4-S2)
* Vulnerable to injury as it winds around the neck of the fibula
* gives rise to the
* lateral cutaneous sural nerve
* skin on the lateral part of the back of the leg
* Recurrent articular branch
* knee joint
196
Damage to the common peroneal nerve can be caused by fracture of the \_\_\_\_\_\_
fibula
* rsults in foot drop and loss of sesation on the dorsum of the foor and alteral aspect of the leg
* paralysis of all muscles in the anterior and lateral compartments of the leg
197
Superficial peroneal nerve
* less vulnerable to injury
* innervates
* peroneus longus and brevis
* pierces the deep fascia to become subcutaneous
198
damage to the _____ causes no foot drop but does cause loss of eversion of the foor
Superficial peroneal nerve
199
Damage to the _______ results in foot drop and high stepping gait
Deep peroneal nerve
200
Deep peroneal nerve
* Descends on the interosseus membrane
* Innervates the
* **anterior muscles of the leg**
* DIvides
* **lateral branch**
* extensor hallucis brevis and extensor digitorum brevis
* **Medial branch**
* accompanies the dorsalis pedis artery
* supply the skin on the adjacent sides of the 1st and 2nd toes
201
Tibial nerve
* gives rise to 3 articular branches
* gives rise to muscular branches on the posterior leg muscles
* Gives rise to the
* medial sural cutaneous nerve
* medial calcaneal branch to the skin of the heel and sole
* articular branches to the ankle joint
* Terminates by dividing into
* Medial plantar nerve
* Lateral plantar nerve
202
Damage to the _________ causes loss of plantar flexion of the foot and imoaired inversion
Tibial nerve
203
Medial plantar nerve
* Gives rise to common digital branches that divide into proper digital branches which supply the flexor hallucis brevis and the first lumbrical and the skin of the medial 3 and 1/2 toes
204
Lateral plantar nerve
* smaller terminal branch of the tibial nerve
* Divides into
* Superficial branch
* flexor digiti minimi brevis
* Deep bracnh
* plantar and dorsal interossei
* 3 lateral lumbricals
* adductor hallucis
205
Superior gluteal artey
* Fromt the internal iliac artery
* divides into
* superficial branch
* gluteus maximais
* anastomoses in the inferior gluteal and lateral sacral arteries
* Deep branch
* gluteus medius and minimus
* tensor fasciae latae
* Anastomoses with the lateral and medial circumflex and inferior gluteal arteries
206
Inferior Gluteal artery
* from the internal iliac artery
* enter through the greater sciatic foramen below the piriformis
* supplies
* gluteus maximus
* lateral rotators of the hips
* hamstrings (upper part)
* hip joint
* Enters the cruciate anastomis and also anastomses with the superior gluteal, internal pudendal, and obturator arteries
207
Obturator artery
* Arises from the internal iliac artey
* passes trough obturator foramen then divides
* Anterior
* in front of adductor brevis and gives rise to muscular branches
* Posterior
* Gives rise to acetabular branch
* sends an artery to the head of femur
208
defined as the vascular anastomoses between the obturator and external iliac systems.
Corona mortis
209
An aberrant obturator artery may arise form the _____ or _________ epigastric artery and is vulnerable during surgical repair of a femoral hernia
External iliac or inferior epigastric
210
Femoral artery
* Continuation of the external iliac artery
* Palpable pulsation
* vulnerable to injury (superficial position in the femoral traingle)
* Several branches
* **Superficial epigastric** - umbilcus
* **Superficial circumflex iliac** - ingunal ligament
* **Superficial external pudendal** - over spermatic cord
* **Deep External pudendal** - perineum, scrotum
* **Profunda femoris**
* 4 perforating arteries
* 1st perforating arteries sends an ascending branch which joins the cruciate anastomsis
* **Medial femoral circumflex**
* from femoral or pofunda femoris
* muscular branches and acetabular branch
* divides into
* ascending branch
* transverse branch - cruciate anastomoses
211
The ______ is clinically important because its branches run through the enck to reach the head and it supplies most of the blood to the neck and head of the femur
Medial femoral circumflex artery
212
The cruciate anastomosis of the buttok is formed by
* Ascending branch of the first prforating artery
* inferior gluteal artery
* transverse branches of the medial and lateral femoral circumflex
It bypasses an obstruction of the external ilial or femoral artery
213
Lateral femoral circumflex artery
* From the femoral or profunda femoris artery
* Divides into
* Ascending branch - vascular circle with medial femoral circumflex artery
* transverse branch - cruciate anastomosis
* descending branch - anastomoses with superior lateral genicualr branch
214
Descending genicular artery
* from the femoral artery
* DIvides into
* Articular branch
* anastomosis around the knee
* Saphenous branch
* superficial tissue and skin on the medial side of the knee
215
Popliteal artery
* Continuation of the femoral artery
* vulnerable to injury from the fracture of the femur and dislocation of the knee joint
* Gives rise to
* Superior lateral genicular artery
* Superior medial genicular artery
* Inferior lateral genicular artery
* Inferior medial genicular artery
* Middle genicular artery
216
usually results in edema and pain in the popliteal fossa
Popliteal aneurysm
217
Posterior tibial artery
* from the popliteal artery
* palpable pulsation
* Gives rise to
* **Peroneal (fibular artery)**
* lateral muscles in the posterior compartment
* Gives rise to p**osterior lateral malleolar branch**
* Terminates by dividing into
* **Medial Plantar artery**
* smaller
* gives rise to
* **superficial branch** - big toe
* **deep branch** - forms the 3 superficial gigital branches
* **Lateral plantar artery**
* larger
* forms the plantar arch by joining the deep plantar branch of the dorsalis pedis artery
218
Anterior tibial Artery
* From popliteal artery
* enters through a gap between the tibia and fibula
* Pulsations may be felt between the 2 malleoli and later to the extensor hallucis tendon
* Gives ris to
* anterior tibial recurrent
* anterior medial malleolar
* laterall malleolar
219
Dorsalis Pedis artery
* continuation of the anterior tibial artery
* gives rise to
* Medial tarsal
* lateral tarsal
* arcuate
* gives rise to the 2nd, 3rd, and 4th dorsal metatarsal arteries
* first dorsal metatarsal arteries
* Terminates as the deep plantar artery
* joins the lateral plantar artery to form the plantar arch
220
Popliteal vein
* Receives the small saphenous vein and those veins corresponding to the branches of the popliteal artery
* behind the popliteal artery
221
Femoral vein
* Accompanies the femoral artery as acontinuation of the popliteal vein throught the upper 2/3 of the thigh
* Has valves
* receives tributaries corresponding ti the branches of the femoral artery
* Joined by the great saphaenous vein
222
The limbs are rotated about their long axes but in opposite directions (\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_)
90 degree medial roation of the lower lib and 90 degree lateral rotation of the upper limb
