Flashcards in Lower limb anatomy Deck (42):
What is the sensory innervation of the thigh?
anterior cutaneous nerve of the thigh (branch of feoral nerve - L2-L4)
posterior cutaneous branch of the thigh (branch of lumbosacral plexus L2-3)
cutaneous bracch of the obturator nerve (L2-L4)
What does the saphenous nerve supply?
anteromedial aspects of the knee and leg and the medial aspect of the foot where it accompanies the great sapahenous vein
Name the 4 bellies of the quadricepts groups and their proximal and distal attacahments.
rectus femoris - ASIS --> patella then tibial tuberosity
vastus lateralis - Shaft of femur --> patella then tibial tuberosity
vastus intermedius - Shaft of femur --> patella then tibial tuberosity
vastus medius - Shaft of femur --> patella then tibial tuberosity
What are the 2 lines that define the quadrants of the gluteal region?
1 - greater trochanter to PSIS
2 - Extended from midpoint of iliac crest
What are the 3 main nerves of the gluteal region and what are there nerve roots?
Sciatic nerve (L4 -S3)
Pudendal nerve (S2-4)
Posterior cutaneous nerve of thigh (S1-3)
Where must intragluteal injections be given and why?
Upper outer (superolateral) quadrant of the buttox in order to avoid injury ot the sciatic nerve
What is the largest nerve in the body?
Sciatic nerve (L4 - S3)
What is the iliotibial tract?
thickening of the deep fascia of the thigh (fascia lata)
runs from ASIS to lateral aspect of later tibial condyle at Gerdy tubercle
What is the most superficial muscle of the posterior compartment of the lower limb?
Decribe the attachments of gastrocnemius.
2 heads and 2 muscle bellies (medial and lateral). Both attach distally to the calcaneous via the achilles tendon
Proximally they attach to their respective femoral condyle.
Therefore gastrocnemius crosses both knee and ankle joints giving it weak knee flexor and powerful ankle plantar-flexor.
Which tendon is immediately deep to gastrocnemius?
Distally, where does plantaris insert?
What is immediately deep to plantaris tendon?
Soleus (this also inserts into calcaneous via achilles tendon distally)
Where does soleus insert proximally?
The enck of the fibula and the soleal line of the tibia
What nerve innervates soleus and gstrocnemius?
Tibial nerve (S1-S2)
State the names of the branches of the popliteal arery and where they come off.
Popliteal artery divides immediately distal to the popliteal fossa into anterior and posterior tibial arteries.
Posterior tibial artery then gives off the fibular artery in the proximal half of the compartment.
What happens to the posterior tibial artery in the foot?
It terminates by dividing into the medial and lateral plantar arteries.
How does the fibular artery supply the lateral compartment of the leg?
It send perforating branches through the posterior intermuscular septum to supply the lateral compartment of the leg
Name the deep muscles of the posterior compartment of the leg?
Flexor digitorum longus (medially)
Flexor hallucis longus (laterally)
Tibialis posterior (deep to the proximal part of the 2 flexors)
What is the term for deep fascia of the leg?
Which nerves create the medial and lateral sural nerves?
medial - tibial nerve
Lateral - common fibular nerve
Where does the sciatic nerve most commony divide?
At the superior apex of the popliteal fossa into the tibial nerve and common fibular nerve
In the popliteal fossa, describe the route of both the comon fibular nerve and tibial nerve.
Tibial nerve - descends vertically through the fossa
common fibular nerve - skirts the ateral border of the fossa
Name the superficial muscles of the posterior leg.
What is the functon of the deep muscles of the leg?
Plantar flex the ankle and toes
Tibialis posterior also helps tibialis anterior with the inversion of the foot
What nerve supplies the deep muscles of the leg?
In the deep compartment of the leg, where does the tibial nerve run?
courses through deep to soleus in the company of the posterior tibial artery and veins
Within the deep compartment, form anterior to posterior, name the structures whihc exit this compartment to reach the sole of the foot passing posterior to the medial malleolus ad deep to flexor retinaculum.
tendon of Tibialis posterior
tendon of flexor Digitorium longus
posterior tibial Artery
tendon of flexor Hallucis longus
Where is the common fiblar nerve vulnerable to compression?
Against the neck of the femur
What is the blood supply to the head of the femur?
- intramedullary artery of shaft of femur
- medial and lateral circumflex branche of profunda femoris
- artery of ligamentum teres
Where does the tibialis posterior tendon insert and what is it's function?
Inserts predominantly onto the medial navicular and serves to support the medial arch of the foot (as well as being a plantarflexor and invertor of the foot).
What nerves are involved in the ankle jerk reflex?
S1 and S2
What is the most superficial muscle of posterior leg?
Name the structure the femoral artery and vein pass through into the popiteal fossa.
What is in the popliteal fossa?
Tibial nerve and branches
common fibular nerve
popliteal artery, vein and lymph nodes
What is the order of the NVB in the popliteal fossa in terms of superficial to deep?
Where does the sciatic nerve most commony divide?
Suerior aspect of popliteal fossa into tibial nere and common fibular nerve
Within the popliteal fossa where are the sural nerves?
Mainly in the superficial fascia
What lies deep to the lateral head ofgastrocneumius in 90% of us?
Small plantaris muscle
What is the main role of ACL?
to prvent abnormal internal rotation of the tibia
What does PCL do?
prevents hyperextension and anterior translation of the femur