Lower limb

Question 1

Lumbar plexus made up of ventral rami from what spinal levels?

Answer 1

L2-S4

Question 2

5 key nerves of lumbosacral plexus? (flexor + extensor)

Answer 2

Extensors: Femoral (knee) + obturator (hip)
Flexors: Sciatic –> tibial (knee, plantar flexors), fibular (dorsiflexors)
*also superior/inferior gluteal nerves

Question 3

2 main fascia of lower limb

Answer 3

Fascia lata (thigh)
Crural fascia (deep fascia of shank)

Question 4

Arterial supply of lower limb

Answer 4

Abdominal aorta –> common iliac –> internal iliac (pelvis) + external iliac (leg) –> under inguinal ligament –> deep artery of thigh –> through adductor hiatus –> popliteal arterial –> bifucates into anterior tibia –> dorsal pedal & posterior tibial –> medial plantar & fibular

Question 5

what are the 4 gluteal compartments?

Answer 5

Iliopsoas
Gluteals
Deep rotators (lateral rotation, incld piriformis)
Hip adductors

Question 6

Role of iliopsoas muscles? Which 2 muscles? Innervation

Answer 6

1) Psoas
2) Iliacus
Function: hip flexion
Nerve: femoral

Question 7

Role of gluteal muscles? Which muscles? innervation?

Answer 7

Gluteus maximus –> hip extension, lat rotation; inferior gluteal nerve
Glut med/min/tensor fascia lata –> Hip abduction, medial rotation; superior gluteal nerve

Question 8

___ is important for landmarking the sciatic nerve

Answer 8

Piriformis (doesn’t INNERVATE this though)

Question 9

Fibular nerve AKA

Answer 9

Peroneal

Question 10

3 compartments of thigh + innervation

Answer 10

Medial (adductors) - obturator
Posterior (flexors) - Sciatic (tibial)
Anterior (extensors - femoral

Question 11

4 compartments of leg + innervation

Answer 11

Anterior (extensors) = deep peroneal
Posterior (flexors) deep/superficial - sciatic
Lateral (abductors) - superficial peroneal N

Question 12

Muscles of anterior compartment of thigh

Answer 12

Quadriceps femoris: rectus femoris, vastus intermedius/medialis/lateralis
Sartorius

Question 13

Quadriceps femoris attached to patella via what?

Answer 13

Patellar tendon
(patella connected to tibial tuberosity by patellar LIGAMENT which is actually continuous with the tendon)

Question 14

Which muscles of the anterior compartment of the thigh are dual joint?

Answer 14

Sartorius + rectus femoris (knee extension + hip flexion)

Question 15

Muscles of medial compartment of thigh

Answer 15

Adductor longus, gracilis
Deeper: adductor brevis + adductor magnus
(Main innervation = obturator; main function = hip adduction, flexion + medial rotation)

Question 16

Important gateway for structures to move from anterior thigh into posterior leg

Answer 16

Adductor hiatis (in adductor magnus)

Question 17

Muscles of posterior compartment of thigh

Answer 17

Hamstrings:
Biceps femoris (long + short heads) - lateral
Semitendinosis + semimembranosus (medial)
(Innervation: sciatic nerve - tibial)

Question 18

Muscle of anterior compartment of the leg

Answer 18

Tibialis anterior
Extensor digitorum longus
Extensor hallucis longus
N = deep fibular (peroneal)
Ankle dorsiflexion/digit extension

Question 19

Muscles/nerves of lateral compartment of the leg

Answer 19

Fibularis longus
Fibularis brevis
N = superficial fibular (peroneal)
Ankle eversion

Question 20

Which muscle helps maintain plantar arch by crossing beneath foot and inserting at 1st metatarsal

Answer 20

Fibularis longus

Question 21

Fibularis longus/brevis travel behind ___ and are held in place by ____

Answer 21

Lateral malleolus

Peroneal retinaculum

Question 22

Muscles of the superior posterior compartment of the leg

Innervation?

Answer 22

Gastrocnemius (lateral/medial heads)
Soleus (deep)
N = tibial

Question 23

The triceps surae is what? How does it attach to the calcaneus?

Answer 23

Gastrocs + soleus

Attaches via Achilles’ (calcaneal) tendon

Question 24

Muscles of deep posterior compartment

Innervation?

Answer 24

Tib post
flexor digitorum longus
flexor hallucinus longus
N = tibial nerve

Question 25

Muscles of deep posterior compartment of leg travel around ___ to get to foot under what? Order of structures inside?

Answer 25

Medial malleolus Flexor retinaculum "Tom Dick and Not Harry" TP, FDL, Posterior Tib A, Post. Tib N, FHL (ant ti post)

Question 26

Socket of the hipbone (where head of femur fits) | What deepens this?

Answer 26

Acetabulum | Acetabular labrum

Question 27

3 important ligaments of hip joint

Answer 27

Iliofemoral Pubofemoral Ischiofemoral

Question 28

When walking, which muscle contracts on swing leg? Which on the supported leg?

Answer 28

``` Quadratus Lumborum (unsupported leg) Gluteus medius (supported leg) ```

Question 29

What is the "unhappy triad" knee injury?

Answer 29

Damage to ACL + medial meniscus + MCL | Force to lateral femur

Question 30

Cruciate ligaments are in the ____ but outside the ___

Answer 30

In the joint capsule | outside the synovial membrane

Question 31

PCL injury would happen why?

Answer 31

Hyperextension of knee or blow to tibial tuberosity

Question 32

Structures on the __ side of the knee are more secure/attached, on the __ side more forgiving

Answer 32

``` Medial = attached Lateral = mobile ```

Question 33

Define meniscus

Answer 33

Fibrocartilage shock absorbers that deepen + stabilize articulating surfaces

Question 34

Medial meniscus is __ mobile and __ injury prone. Why?

Answer 34

Less mobile More injuries Because connected to MCL

Question 35

Pes Anserine

Answer 35

"Goose Foot" | Insertion of sartorius, gracilis, semitendinosis (on medial side of tibia)

Question 36

Medial palpable tuberosity on foot = what bone?

Answer 36

Navicular

Question 37

Main ankle joint

Answer 37

Talocrural joint (talus + tib/fib (mortise))

Question 38

What joint allows foot to invert/evert?

Answer 38

Subtalar joint (talus, calcaneus, navicular

Question 39

2 ligaments of ankle that are injured in high ankle sprain?

Answer 39

Ant/Post tibiofibular ligament (stabilize inferior tibiofibular joint)

Question 40

Talocrural joint: - 3 stabilizing lateral ligaments - 1 main medial ligament

Answer 40

Lateral: anterior/posterior talofibular + calcaneofibular | Medial = deltoid ligament

Question 41

What might be damaged in an inversion sprain?

Answer 41

Anterior talofibular ligament | Calcaneofibular ligament