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MSK- Assessment 1 > Lower Limb I and II > Flashcards

Lower Limb I and II Flashcards

(62 cards)

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1
Q

Innervation of the lower limb- sources of cutaneous nerves

A

Lumbar plexus, sacral plexus, posterior rami of lumbar and sacral nerves

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2
Q

Lumbar plexus is formed by and innervates

A

L1-L4
Anterior and medial thigh
Upper anterior leg; medial leg

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3
Q

The sacral plexus formed by and innervates

A

Anterior rami of the S1-S4 and contributions from L4 and L5

Lower buttocks
Posterior thigh and leg
Lower anterior leg and foot

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4
Q

Posterior rami of lumbar and sacral nerves innervate

A

Upper buttocks

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5
Q

Dermatomes of the anterior region:
Dermatomes of the posterior region:
Dermatomes of the coccygeal region:

A

L1-L5
S1-S2
S3-S5

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6
Q

Tract of the small (lesser, short) saphenous vein

A

Origin is from the lateral side of the dorsal venous arch of the foot
Ascends from behind lateral malleolus along lateral side of the tendon calcaneus, crosses the latter to the middle of the back of the leg, runs straight upward to pierce the deep fascia in the lower popliteal space
Terminates in popliteal vein between the heads of the gastrocnemius muscle

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7
Q

Tract of the great (long) saphenous vein

A

Origin is from the dorsal venous arch of the foot
Ascends in front of the medial malleolus, along the medial side of the leg, posterior to the medial condolences of the tibia and femur, along the medial side of the thigh to the saphenous opening

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8
Q

The fascia lata is reinforced laterally by the longitudinal fibers of

A

The iliotibial tract/band: IT band
The common aponeurotic tendon of the gluteus Maximus and tensor fascia latae muscles
Specialization of the fascia lata that inserts on the iliac tubercle and the medial condolences of the tibia to make the IT band

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9
Q

The arterial blood supply of a joint is derived from

A

The periarticular anastomosis of blood vessels, which is fed by branches of the arteries passing the joints.

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10
Q

Nerve supply to a joint- hilton’s law

A

Rich innervation
Supplied by all the nerves which innervate the muscles producing movement at that joint
Nerve supply to a joint represents its major source of self-defense against mechanical insult

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11
Q

Immovable joints:

Structure, description, example

A

Fibrous- fibrous connections, sutures of skull

Cartilaginous- interposition of cartilaginous plate, epiphyseal cartilages

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12
Q

Slightly movable joints:

Structure, description, and example

A

Fibrous- ligamentous connection, between tibia and fibula

Cartilaginous- connection by fibrocartilage pad, between pubic bones and intervertebral disc

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13
Q

Freely movable joint:
Structure, description, examples
Movements

A

Synovial- complex joint bound by joint capsule containing synovial fluid, numerous examples: subdivided by range of movement (knee, hip, ankle)
Can be categorized as a simple or complex articulation
Gliding, angular, circumduction, rotation

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14
Q

Hip joint is made up of:

type and movements

A

Ball and socket (enarthrosis)
Circumduction of lower limb, lateral rotation and medial rotation.
(Acetabulum and head of the femur)

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15
Q

Ligaments of the hip joint

A 
Acetabular labrum
Transverse acetabular
Round ligament (ligamentum capitis femoris)
Iliofemoral (Y ligament of Bigelow)
Pubofemoral
Ischiofemoral
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16
Q

The anterior compartment of the thigh:

Function, innervation, blood supply

A

Flexor of the hip joint and extensor of the knee
Femoral nerve
Femoral artery

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17
Q

Muscles of the anterior thigh: flexors of the hip joint

A

Pectineus
Sartorius
Psoas major and minor
Illiacus

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18
Q

Pectineus muscle:

Proximal and distal attachments, innervation, main actions

A

Pubis
Pectineal line of femur (line from lesser trochanter)
Femoral nerve, some obturator nerve
Adducts and flexes thigh

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19
Q

Sartorius muscle:

Proximal and distal attachments, innervation, and main action

A

ASIS
Medial surface of proximal tibia
Femoral nerve
Flexes, abducts, laterally rotates thigh, flexes knee joint

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20
Q

Psoas major muscle

A

T12 and lumbar vertebral bodies
Lesser trochanter of femur
Anterior rami of lumbar nerves (L1-L3)
Flexes the thigh

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21
Q

Psoas minor muscle

A

T12/L1 vertebral bodies
Iliopubic eminence
Anterior rami of lumbar nerves (L1-L2)
Flexes the thigh

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22
Q

Iliacus muscle

A

Iliac crest/fossa
Tendon of the psoas major/lesser trochanter
Femoral nerve
Flexes thigh

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23
Q

Muscles of the anterior thigh: extensor of the knee

A

Quadriceps femoris: rectus femoris, vastus lateralis, vastus medialis, vastis intermedus

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24
Q

Rectus femoris

A

AIIS
Via quadriceps tendon to base of patella; the patellar tendon attaches the patella to the tibial tuberosity
Femoral nerve
Extends legs/flexes thigh

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25
Vastus lateralis
Greater trochanter and linea aspera of femur Via quadriceps tendon to base of patella Femoral nerve Extends leg
26
Vastus medialis
Intertochanteric line and linea aspera of femur Via quadriceps tendon to base of patella Femoral nerve Extend leg
27
Vastus intermedius
Shaft of the femur Via quadriceps tendon to base of patella Femoral nerve Extends the leg
28
Femoral nerve cutaneous branches
Anterior cutaneous branches | Saphenous nerve
29
Medial compartment of the thigh: | Function, origin/insertion, innervation, blood supply
Adductor compartment Origin on bone around the obturator foramen and insert into femur Obturator nerve Profounda femoris and obturator arteries
30
Muscles of the medial compartment of the thigh
Adductor longus and brevis Adductor Magnus Gracious Obturator externus
31
Adductor longus
Pubic bone Linea aspera of femur Obturator nerve Adducts thigh
32
Adductor brevis
Pubic bone Pectineal line and linea aspera of femur Obturator nerve Adducts thigh
33
Adductor magnus | Adductor part
Ischiopubic ramus Shaft of the femur Obturator nerve Adducts and flexes thigh
34
Adductor Magnus | Hamstring part
Ischial tuberosity Adductor tubercle of femur Tibial division of sciatic nerve Adducts and extends thigh
35
Gracilis
Pubic bone Medial condyles of tibia Obturator nerve (L2,3) Adducts thigh, flexes leg, rotates leg medially
36
Obturator externus
Margins of obturator foramen and obturator membrane Posterior side of femur; on and around greater trochanter of femur Obturator nerve (L3,4) Laterally rotates thigh, steadies head of femur in acetabulum
37
Boundaries of the femoral triangle
``` Superiorly- inguinal ligament Medially- medial border of the adductor longus muscle Laterally- sartorius muscle *mnemonic So I May Always Love Sally SAIL ```
38
Deep fascia of the thigh (fascia lata) has a defect in it called
Saphenous opening- great saphenous vein passes through here and drains into the femoral vein
39
Contents of the femoral triangle (from lateral to medial)
Femoral nerve and its branches Femoral sheath and its contents: femoral artery, femoral vein and its proximal tributaries (great saphenous), and deep inguinal lymph nodes and associated lymph vessels in femoral canal
40
The femoral sheath contains a medial compartment called:
Femoral canal- entrance into the canal is the femoral ring (a rigid structure bound by ligaments and a muscle)
41
Lymphatics of the lower limb- vessels
Drain entire lower limb, perineum, trunk of body inferior to the transumbilical plane Superficial- lie in superficial fascia; some follow great saphenous vein, others drain foot and leg and join those associated with the lesser saphenous vein or drain into popliteal nodes Deep- accompany blood vessels
42
Lymphatics of the lower limb- nodes
Popliteal nodes- in popliteal fossa Superficial inguinal- horizontal group (inferior and parallel to inguinal ligament and drains penis, scrotum, labia, perineum, buttock, abdominal wall) and vertical group (along terminal great saphenous vein and drains its associated vessels) Deep inguinal- deep to the deep fascia along the medial side of femoral vein and receive drainage from deep lymphatics of the lower extremity and from superficial nodes
43
Adductor canal (subsartorial tunnel/Hunter's canal)
Middle third of the thigh, extends from the apex of the femoral triangle to the adductor hiatus in the tendon of the adductor Magnus muscle Provides intermuscular passage for femoral artery and vein, saphenous nerve, and nerve to the vastus medialis muscle. Vessels emerge into popliteal fossa and become popliteal vessels.
44
Boundaries of the adductor canal
Vastus medialis anteriorly and laterally Adductors longus and Magnus posteriorly Sartorius medially- overlies the canal, forming its roof
45
Blood supply to the hip joint
Medial and lateral circumflex femoral arteries- main to head of femur Retinacular (nutrient) arteries arise from medial circumflex pass along femoral neck beneath capsule Artery of the ligament of head of femur- branch of obturator artery that provides 0-20% of blood supply to head of femur in adults
46
Innervation to the skin of gluteal region
Superior clunial nerves (posterior rami, L1-3) Iliohypogastric nerve Medial clunial nerves (posterior rami, S1-S3) Inferior clunial nerves (from posterior femoral nerves)
47
Ligaments of the gluteal region
Sacrospinous ligament Sacrotuberous ligament Create the greater and lesser sciatic foramen
48
Muscles that insert onto the iliotibial tract
Gluteus Maximus and tensor fasciae latae
49
Muscles of the gluteal region- superficial group | Actions, attachments, blood and nerve supply
Abduction and extension of thigh External surface of ilium IT tract/gluteal tuberosity (Maximus) or greater trochanter (med, min) Inferior and superior gluteal vessels and nerves Gluteus Maximus, minimus, medius, and tensor fascia latae
50
Gluteus Maximus
Ilium and sacrum and sacrotuberous ligament IT tract and proximal femur Inferior gluteal nerve Extends thigh and assists in lateral rotation Raises trunk from bent forward position Extends hip in step up*
51
Gluteus medius
Lateral surface of ilium Greater trochanter of femur Superior gluteal nerve Abduct and medially rotates thigh
52
Gluteus minimus
Lateral surface of ilium Greater trochanter of femur Superior gluteal nerve Adducts and medially rotates thigh
53
Tensor fascia latae
``` ASIS IT tract Superior gluteal nerve Abducts and medially rotates thigh Helps extend knee joint by tensing fascia on lateral side of thigh ```
54
Muscles of the gluteal region- deep group | Action, attachments, names
Small lateral rotators and stabilizers of hip joint Attach from sacrum and ischium to greater trochanter and adjacent to it Piriformis Obturator interns Superior and inferior gemeli Quadratic femoris
55
Piriformis muscle
Anterior surface of the sacrum Greater trochanter Nerve to the piriformis Laterally rotates thigh
56
Obturator internus
Obturator foramen and membrane Greater trochanter Nerve to obturator internus Laterally rotates thigh
57
Superior and inferior gemeli
Superior- ischial spine, greater trochanter, nerve to obturator internus, laterally rotates thigh Inferior- ischial tuberosity, greater trochanter, nerve to quadratic femoris, laterally rotates thigh
58
Quadratus femoris
Ischial tuberosity Intertrochanteric crest of femur Nerve to the quadratus femoris Laterally rotates thigh
59
Structures passing above and below the piriformis muscle
Above- superior gluteal vessels and nerve Below- inferior gluteal vessels and nerve, sciatic nerve, posterior femoral cutaneous nerve, superior gemellus muscle, tendon of the obturator internus muscle, inferior gemellus muscle, quadratus femoris muscle.
60
Blood supply to the gluteal region
Superior gluteal artery- largest branch of internal iliac artery, enters gluteal region through greater sciatic foramen superior to piriformis muscle, under gluteus Maximus to supply buttocks Inferior gluteal artery- another branch of internal iliac artery, enters the gluteal region through greater sciatic foramen inferior to piriformis muscle and descends on medial side of sciatic nerve, supples buttocks and back of thigh.
61
Nerve supply to the superficial gluteal region
Superior gluteal nerve (L4-S1) passes through the greater sciatic foramen immediately superior to piriformis muscle, passes between medius and minimus to supply them and the tensor fascia latae muscles Inferior gluteal nerve (L5-S2) traverses the greater sciatic foramen just inferior to the piriformis muscle and supplies the gluteus maximus
62
Sciatic nerve- segments and tract
A common sheath that encases two nerves L4-S3 segments of the sacral plexus Emerges from greater sciatic foramen inferior to the piriformis muscle Travels in the posterior compartment of the thigh and posterior to the adductor Magnus muscle Divides into tibial nerve and common fibular nerve

MSK- Assessment 1 (7 decks)

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