Lower Limb

Question 1

what types of muscles are found in the anterior compartment of the lower limb and then the posterior compartments

Answer 1

In the lower limb, the anterior compartments (thigh and leg) contain extensor muscles.

The posterior compartments (thigh and leg) contain flexor muscles.

Question 2

describe the venous drainage of the lower limb

Answer 2

anterior thigh part 1
slide 6 and 7

Venous blood from superficial structures of the lower limb will drain into the following:
Dorsal venous arch (located on the dorsum of the foot)
Short saphenous vein (located on the posterior aspect of the leg – see next slide)
Great saphenous vein (located on the medial aspect of the leg and medial thigh)
The great saphenous vein drains into the femoral vein within the femoral triangle.

Question 3

briefly describe the arterial supply of the lower limb

Answer 3

anterior thigh part 1
slide 8

The principal artery within the lower limb is the femoral artery – a continuation of the external iliac artery.

The femoral artery gives off the profunda femoris artery as a branch. This vessel is also known at the deep artery of the thigh.

The femoral artery enters the adductor hiatus and on passing through this opening the vessel becomes the popliteal artery.

Question 4

name the Quadriceps group of muscles

Answer 4

Rectus femoris m.
Vastus medialis m.
Vastus intermedius m. (next slide) Vastus lateralis m.

Question 5

what forms the base, medial border, lateral border and apex of the femoral triangle

Answer 5

The base of the femoral triangle is formed by the inguinal ligament.

The medial border is formed by the lateral border of the adductor longus m.

The lateral border is formed by the medial border of the sartorius m.

The apex is located where the sartorius and adductor longus mm. overlap.

Question 6

what forms the floor of the femoral triangle

Answer 6

Pectineus muscle

Iliopsoas muscle (ilacus m. located within the iliac fossa and psoas major muscle located on the posterior abdominal wall join together). This muscle is a powerful flexor of the lower limb at the hip joint.

Question 7

describe the contents of the femoral triangle

Answer 7

The following structures are located within the femoral triangle, from medial to lateral:
Femoral vein Femoral artery Femoral nerve

Both the femoral vein and femoral artery are enclosed within the femoral sheath (a tube of fascia).

Note that the femoral nerve is not enclosed within the femoral sheath.

Question 8

what structures are located in the femoral sheath

Answer 8

The femoral sheath is sub- divided into 3 compartments:

Lateral compartment: contains the femoral a.

Intermediate compartment: contains the femoral v.

Medial compartment: contains the femoral canal

Question 9

describe the boundaries of the sub-sartorial canal

Answer 9

The boundaries of the sub-sartorial canal are:

Anteromedially:
sartorius m.

Anterolaterally: vastus medialis m.

Posteriorly: adductor longus m. and adductor magnus m.

Question 10

• Name the structures that travel within the sub-sartorial canal

Answer 10

Femoral artery
Femoral vein
Saphenous nerve (a cutaneous branch of the femoral nerve) Nerve to vastus medialis

Question 11

what type of movement occurs at the ankle joint

Answer 11

The following movements take place at the ankle joint: dorsiflexion (extension of the foot at the ankle joint) and plantarflexion (flexion of the foot at the ankle joint).

Question 12

what movements take place at the sub-tala joint

Answer 12

Anterior and Lateral Compartments of the Leg. Dorsum of Foot. lecture
slide 4

inversion and eversion

Note that both of these movements take place at the sub-talar joint and not at the ankle joint

Question 13

function of tibialis anterior m

Answer 13

inversion

works w. tibialis posterior

Question 14

function of extensor digitorum longus m

Answer 14

extend (bring towards you) all toes except great toe

Question 15

function of extensor hallucis longus m

Answer 15

extend great toe

Question 16

combined function of
tibialis anterior m
extensor digitorum longus m
extensor hallucis longus m

Answer 16

extend for at ankle joint

dorsiflexion

Question 17

combined function of fibularis longus m and fibularis brevis m

Answer 17

evert foot

Question 18

what nerve may be damaged if there is a fraction of the neck of the fibula

Answer 18

common fibular nerve

Question 19

what two nerves does the common fibular nerve split in to

Answer 19

superficial fibular nerve

deep fibular nerve

Question 20

what muscles does the superficial fibular nerve innervate

Answer 20

fibularis longus and brevis muscles

Question 21

what muscles does the deep fibular nerve innervate

Answer 21

tibialis anterior
extensor digitorum longus
extensor hallucis longus

then in the foot:
extensor digitorum brevis
extensor hallucis brevis

Question 22

what artery provides arterial supply to the muscles in the anterior compartment of the leg

Answer 22

anterior tibial artery

Question 23

what artery supplies the lateral compartment of the leg

Answer 23

fibular artery

Question 24

name the terminal branches of the popliteal artery

Answer 24

anterior tibial artery

posterior tibial artery

Question 25

name the three ligaments of the hip joint

Answer 25

Iliofemoral ligament: this y-shaped ligament prevents hyperextension of the hip joint Ischiofemoral ligament Pubofemoral ligament

Question 26

function of illiofemoral ligament

Answer 26

this y-shaped ligament prevents hyperextension of the hip joint

Question 27

describe the arterial supply of the hip joint

Answer 27

The hip joint receives arterial supply from: | Medial and lateral circumflex femoral arteries – both of these vessels arise as branches of the profunda femoris artery.

Question 28

describe innervation of the hip joint

Answer 28

The hip joint receives innervation from the sciatic, obturator and femoral nerves.

Question 29

innervation of piriformis m

Answer 29

innervated by nerve to piriformus

Question 30

innervation of superior gemellus m

Answer 30

nerve to obturator internus

Question 31

innervation of inferior gemellus m

Answer 31

nerve to quadrates femoris

Question 32

innervation of quadrates femoris m

Answer 32

innervated by nerve to quadratus femoris

Question 33

innervation of gluteus Maximus

Answer 33

inferior gluteal nerve

Question 34

innervation of gluteus medius

Answer 34

superior gluteal nerve

Question 35

innervation of gluteus minimus

Answer 35

superior gluteal nerve

Question 36

movement produced by gluteus Maximus m

Answer 36

extensor of lower limbs at hip joint

Question 37

movement produced by gluteus medius m

Answer 37

abduction of lower limb at hip joint

Question 38

movement produced by gluteus minimus m

Answer 38

abduction of lower limb at hip

Question 39

what is the Clinical Relevance: Gluteus Medius and Gluteus Minimus Muscles

Answer 39

Both the gluteus medius and gluteus minimus muscles will keep the pelvis level when the lower limb at the same side of the body is weight-bearing, thereby preventing pelvic drop (image B). Image C shows pelvic drop following paralysis of the gluteus medius and gluteus minimus mm.

Question 40

movement produced by the piriformis m

Answer 40

lateral rotation of the lower limb

Question 41

movement produced by the Superior gemellus m., Obturator internus m., Inferior gemellus m., Quadratus femoris m.

Answer 41

work with piriform to produce lateral rotation of the lower limb at the hip joint

Question 42

biceps femoris origin, insertion, innervation and actions

Answer 42

ACTION: - assist gluteus with extension of ll at hip - flexion of ll at knee - allows for small amount of lateral rotation when there is flexion at the knee ORIGIN: - Long head: ischial tuberosity - short head: lines aspera INSERTION: - head of fibula INNERVATION: - sciatic nerve

Question 43

semitendinosus origin, insertion, innervation and actions

Answer 43

ACTION: - assist gluteus with extension of ll at hip - flexion of ll at knee - allow small amount of medial rotation when there is flexion at the knee ORIGIN: - ischial tuberosity INSERTION: - upper anterior aspect of proximal tibia INNERVATION: - sciatic nerve

Question 44

semimembranosus origin, insertion, innervation and actions

Answer 44

ACTION: - assist gluteus with extension of ll at hip - flexion of ll at knee - allow small amount of medial rotation when there is flexion at the knee ORIGIN: - ischial tuberosity INSERTION: - proximal tibia - higher up than semitendinosus INNERVATION: - sciatic nerve

Question 45

Boundaries and contents of popliteal fossa

Answer 45

upper lateral boundary: - biceps femoris m upper medial boundary: - semitendinosus and semimembrenosus gastrocnemius m = lower lateral and medial boundaries Roof: - skin and fascia Floor: - popliteal muscle CONTENTS: - popliteal artery and vein - tibial nerve - common fibular nerve

Question 46

innervation and ac ton of gastrocnemius

Answer 46

tibial n flex ll at knee flex foot at ankle (plantarflex)

Question 47

innervation and action of soleus

Answer 47

tibial n tendon joins calcaneal tendon so therefore plantarfelxion

Question 48

innervation and action of tibias posterior

Answer 48

tibial n invert foot

Question 49

innervation and action of flexor hallucis longus

Answer 49

tibial n flex great toe

Question 50

innervation and action of flexor digitorum longus

Answer 50

tibial n flex all digits of foot except big toe

Question 51

innervation and action of popliteus

Answer 51

tibial n unlocks the knee joint

Question 52

boundaries and contents of tarsal tunnel

Answer 52

The floor is a concave surface formed by the medial aspect of the tibia, talus and calcaneus. It is converted into a tunnel by the flexor retinaculum, which spans obliquely between the medial malleolus and the medial tubercle of the calcaneus to form the roof. Contents: The tarsal tunnel acts as a passageway for tendons, nerves and vessels to travel between the posterior leg and the foot. Its contents (anterior to posterior) are: ``` Tibialis posterior tendon Flexor digitorum longus tendon Posterior tibial artery and vein Tibial nerve Flexor hallucis longus tendon The mnemonic Tom, Dick and a Very Nervous Harry can be used to aid recall of these structures. ```