Lower Limb Neurovasculature Flashcards Preview

Jonathan's Locomotor > Lower Limb Neurovasculature > Flashcards

Flashcards in Lower Limb Neurovasculature Deck (67):
1

Which spinal segments make up the lumbar plexus

L1 to L4

2

What are the first two branches of the lumbar plexus? Which spinal do they come from?

iliohypogastric and ilioinguinal
L1

3

Where do iliohypgastric and ilioinguinal nerves travel? What do they supply?

they slip into the neurovascular plane between abdominal muscles, supplying the abdo wall

4

What is the motor supply of iliohypogastric and ilioinguinal nerves

the lower most fibres of IOM and TA, which is the roof of inguinal canal

5

Why do pregnancy women sometimes feel pins and needles down the lateral side of the thigh?

The increased body size can cause compression of lateral cutaneous nerve just adjacent to the ASIS, causing sensory abnormalities

6

Which lumbar segments give rise to lateral cutaneous nerve of the thigh?

L2 and L3

7

Which lumbar segments give rise to genitofemoral nerve?

L1 - femoral branch
L2 - genital branch

8

Which nerve supplies the spermatic cord?

genital branch of the genitofemoral nerve

9

What does the femoral branch of the genitofemoral nerve supply?

the skin over the femoral triangle

10

T/F Femoral nerve is from the posterior division of the ventral rami

True, posterior division supplies the extensors

11

T/F Femoral nerve supplies the psoas as it is a muscle of the anterior compartment

False, psoas gets segmental supply from the nerves within

12

Which muscles does the femoral nerve supply?

quads, sartorius, lateral compartment of the pectineus

13

What is the sensory terminal branches of femoral nerve?

intermediate and medial cutaneous nerves of the thigh

saphenous nerve

14

What does the saphenous nerve supply?

the sensory component medially along the knee, leg and ankle, right down to the first metatarsal

15

T/F Femoral nerve supplies all of the sensory component for anterior and medial part of the thigh

False, femoral branch of genitofemoral supplies the supero-medial thigh, and obturator supplies a patch of the medial side just above the knee

16

Which compartment does the obturator supply?

medial compartment of the thigh

17

T/F Obturator nerve divides into the anterior and posterior divisions before giving suppy to gracilis

False, it supplies the gracilis, then split into anterior and posterior divisions

18

Which muscles does the anterior division of obturator travel between

adductor longus and adductor brevis

19

Which muscles does the posterior division of obturator travel between

adductor brevis and adductor magnus

20

What is the sensory supply of the obturator nerve?

pelvic peritoneum
medial side of thigh just above the knee

21

Which nerve roots make up the sacral plexus

ventral nerves of S1-4, plus L5, and the leftover of L4

22

Which muscle is a useful landmark for the sacral plexus

piriformis

23

Which muscles does 1) superior gluteal nerve 2) inferior gluteal nerve supply?

1) gluteus medius and minimus
2) gluteus maximus

24

Is posterior cutaneous nerve of the thigh a branch of the sciatic?

No

25

T/F Sciatic nerve has both anterior and posterior division fibres

True, anterior and posterior of L4, L5, S1-S3

26

When does sciatic nerve divide into its terminal branches

at the apex of the popliteal fossa, 2/3 way down the thigh

27

T/F Posterior dislocation of the hip joint will damage the sciatic nerve

True

28

What are the sensory branches of the femoral nerve?

medial and intermediate cutaneous branches

saphenous branch

29

T/F the terminal branches of sciatic nerve arises from the same segment and division of the sacral plexus

False, tibial nerves gets the anterior division of L4,L5, S1-3

Common fibular gets posterior division of L4,L5, S1, S2

30

Describe the course of descend of the tibial nerve in the leg

from the popliteal fossa, it slips beneath and soleal arch, between the superficial and deep posterior compartments

31

T/F The tibial nerve is posterior to the lateral malleolus

False, it is posterior to the medial malleolus

32

What is the sensory branch off the tibial nerve?

sural nerve, supplying the skin over the posterior compartment

33

What does the tibial nerve divide into at the foot

Medial and lateral plantar nerves for the sole

34

Describe the course of the common fibular nerve from the popliteal fossa

travels medial to biceps, to the lateral side of the knee and winds around the fibula. Then it turns medially and sink into the substance of tibialis anterior

35

What is the sensory branch off the common fibular at the leg region?

the communicating sural nerve

36

T/F Common fibular nerve is deep to the lateral head of gastrocnemius

False, it is superficial. Its superficial location makes it prone to injury

37

What can happen if we fracture the head of fibula

lose motor and sensory supply by the common fibular nerve, and you get a foot drop

38

What does the deep fibular nerve supply?

motor for the anterior compartment and EDB
sensory to the triangle between 1st and 2nd toes

39

T/F Deep fibular nerve travels along the interosseous membrane

True

40

What does the superficial fibular nerve supply?

motor to lateral compartment and sensory to lower lateral leg and dorsum of foot

41

The superficial fibular nerve initially runs deep in the lateral compartment. When does it become superficial?

After supplying fibularis longus and brevis

42

What is the major branch of femoral artery

profunda femoris

43

How does profunda femoris travel?

It travels with adductor magnus, sending off perforating branches

44

T/F Femoral artery and profunda femoris both enter the posterior compartment of the thigh

False, femoral artery does, at the adductor hiatus. Profunda femoris stays in the anterior compartment

45

The ascending branch of profunda femoris supplies the head of the femur. What are the names of the two branches?

medial circumflex
lateral circumflex

46

What are the branches of popliteal artery?

geniculate branch around the knee
Splits into anterior and posterior tibial at the inferior border of popliteus

47

What the femoral sheath contain?

femoral artery, femoral vein

femoral nerve is NOT included

48

T/F femoral vein lies medial to the femoral artery in the femoral sheath

True, so it can expand into the femoral canal

49

Where is the femoral ring?

at the top of the femoral canal

50

what is directly posterior to the femoral ring?

pectineus

51

Why does strangulation often occur to the herniated content through the femoral ring?

Because the boundary of the femoral ring is especially rigid

52

Which major neurovascular structures can be found in the popliteus?

popliteal artery, popliteal vein, tibial nerve

53

T/F Popliteal vein is the most superficial structure in the popliteal neurovascular bundle

False, tibial nerve is

54

Which nerve does the anterior tibial artery travel with?

deep fibular nerve, along the interosseous membrane

55

Which branch comes off the posterior tibial artery?

fibular artery, going to the evertor compartment

56

Which artery becomes the dorsalis pedis artery after crossing the extensor retinaculum

anterior tibial artery

57

Does posterior tibial artery travel medially or laterally at the ankle?

medially

58

How does compartment haematoma lead to increased compartmental pressure?

initial bleeding + the oedema from ischaemia

59

What are the five P's of compartment syndrome

pain
pale
pulseless
parasthetic
paralysed

60

T/F Deep veins often run in pairs (vena commitantes)

True

61

Which veins does the dorsal venous arch drain into?

medially, into the great saphenous vein

laterally, into short saphenous vein

62

T/F the drainage pathway between dorsal venous arch and great saphenous vein is posterior to the medial malleolus

False, it is anterior to the medial malleolus

63

From an anterior view, when does the great saphenous vein disappear from view

at the level of the knee

64

How does great saphenous vein drain into deep venous structure?

at the superior thigh, through the saphenous opening in the fascia lata and join with the femoral vein

65

how does short saphenous drain into deep venous structure

at the superior leg, pierce the fascia to join up with anterior and posterior tibial veins, and eventually join the popliteal vein

66

What happens to the superficial veins when there is defect in the communicating valves

veins are engorged, tortuous and full of blood

67

Why do you get brown pigmentation and varicose ulcers with defects in communicating valves?

Due to increased capillary pressure, squeezing blood into soft tissue