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Lower Limb > lower limb workbook > Flashcards

lower limb workbook Flashcards

1
Q

Functions of the pelvis

A
  • Transfer of weight from upper axial skeleton to lower limb, especially during movement
  • Provides attachment for a number of muscles and ligaments used in locomotion
  • Contains and protects the abdomin and pelvic visera
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2
Q

What movements are possible at the hip joint?

A 
Flexion
Extension
ABduction
ADduction 
Medial rotation
Lateral rotation
Circumduction
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3
Q

How does the acetabulum strengthen and stabilise the hip joint?

A
  • Encompasses head of femur = decreased risk of femur head slipping out of acetabulum.
  • Acetabular labrum increases the depth of the acetabulum = larger articular surface
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4
Q

How do the ligaments of the hip joint strengthen and stabilise the hip joint?

A
  • Iliofemoral, pubofemoral and ischiofemoral ligaments are strong and stabilise the joint
  • Have unique orientation = become tighter when joint is extended = increased stability and decreased energy needed to stay strong
  • Also the muscles and ligaments work in a reciprocal fashion at hip joint
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5
Q

Iliotibial tract + function

A
  • Iliotibial tract = thickening of the fascia lata forming a longitudinal band
  • Movement: acts as an extensor, abductor and lateral rotator of the hip, with an additional role in providing lateral stabilisation to the knee joint.
  • Compartmentalisation: The deepest aspect of ITT extends centrally to form the lateral intermuscular septum of the thigh and attaches to the femur.
  • Muscular sheath – forms a sheath for the tensor fascia lata muscle.
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6
Q

How does piriformis exit the pelvis to reach the gluteal region?

A
  • Passes laterally and inferiorly throught the greater sciatic foramen, splitting it in two.
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7
Q

Where is a safe place to perform intramuscular injections in the gluteal region?

A
  • Care must be taken to avoid hitting the sciatic nerve
  • Superolateral quadrant of the buttock = over gluteus medius in a triangel bound by ASIS, the tubercle of the iliac crest and the greater trochanter.
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8
Q

Structures passing through the greater sciatic foramen superior to piriformis

A
  • Superior gluteal nerve
  • Superior gluteal artery
  • Superior gluteal vein
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9
Q

Structures passing through the greater sciatic foramen inferior to piriformis

A
  • Sciatic nerve
  • N. to quadratus femoris
  • N. to obturator internus
  • Posterior cutaneous nerve of the thigh
  • Pudendal nerve
  • Inferior gluteal nerve
  • Perforating cutaneous nerve
  • Inferior gluteal artery and vein
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10
Q

What structures pass through the lesser sciatic foramen?

A

Passing in = Tendon of obturator internus and internal pudendal vein
Passing out = N to obturator internus and internal pudendal artery and pudendal nerve

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11
Q

Muscles of the hamstrings

A
  • Semimebranosus
  • Semitendinosus
  • Long head of biceps femoris
  • Hamstring part of adductor magnus

All considered hamstrings due to their common origin on the ischial tuberosity and innervation by the tibial portion of the sciatic nerve.

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12
Q

Borders of the popliteal fossa

A
  • Biceps femoris
  • Semimembranosus and semitendinosus
  • Medial head of gastrocnemius
  • Lateral head of gastrocnemius
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13
Q

Contents of the popliteal fossa

A
  • Popliteal artery
  • Popliteal Vein
  • Tibial nerve
  • Common fibular nerve
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14
Q

Floor and roof of the popliteal fossa

A 
Floor = Posterior surface of the knee joint capsule
Roof = Popliteal fascia (containing small saphenous vein) and skin
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15
Q

What separates the posterior compartment of the leg into superficial and deep compartments?

A

The transverse intermuscular septum

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16
Q

What are the three articulations of the knee?

A
  • Medial femerotibial
  • Lateral femerotibial
  • Femeropatellar
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17
Q

Mechanisms to prevent dislocation of the patella

A

Vastus medialis pulls at a much more oblique angle than the other three quadriceps = prevents the patella from being pulled too laterally
Bony ridge on the lateral femoral condyle

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18
Q

What is avulsion?

A

Avulsion = tearing away
Avulsion fracture = a bone fracture occurring when a fragment of bone tears away from the main mass of bone as a result of physical trauma

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19
Q

What are the menisci and where are they situated?

A

Two C-shaped wedges of fibricartilage

Attached to the facets on the intercondylar region of the tibial plateau, between the femoral condyles and the tibia.

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20
Q

Function of the menisci?

A
  • Increased joint congurency
  • Decreased weight evenly
  • Shock absorption
  • Assist in locking mechanism of knee
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21
Q

What movements are possible at the knee?

A
  • Extension
  • Flexion
  • Lateral rotation
  • Medial rotation
22
Q

Why is the femoral triangle clinically important?

A
  • Vascular access
  • Femoral hernia
  • Vascular surgery
  • Lymphatic spread of disease
23
Q

What are the borders of the femoral triangle?

A

Superior border - inguinal ligament
Lateral border - medial border of the sartorius muscle
Medial border - medial border of adductor longus muscle

Roof - Fascia lata
Base/floor - pectineus, iliopsoas, adductor longus muscle

24
Q

What is the contents of the femoral triangle?

A
  • Femoral nerve
  • Femoral artery
  • Femoral vein
  • Femoral canal (lymphatics containing lymph nodes and vessels)
  • Empty space (allows veins, lymph vessels to distend so they can cope with different levels of flow)
25
Q

Boundaries of the adductor canal

A 
anterior = sartorius
lateral = vastus medialis
posterior = adductor longus and adductor magnus
26
Q

Contents of the adductor canal

A
  • femoral artery
  • femoral vein
  • nerve to the vastus medialis
  • saphenous nerve (the largest cutaneous branch of the femoral nerve)

on exiting the adductor canal the femoral vessels become the popliteal vessels

27
Q

Function of the adductor canal

A

Acts as a passageway for structures passing between the anterior thigh and the posterior leg

28
Q

Course of the adductor canal

A

Apex of the femoral triangle –> adductor hiatus of the adductor magnus

29
Q

What is the adductor hiatus?

A

A gap between the distal femur and adductor magnus through which the femoral vessels pass

30
Q

What is acute osteomyelitis?

A

An acute infection and inflammation of the bone and/or bone marrow

31
Q

What is a compound injury?

A

open or compund fractures are complicated breaks where the bone has broken through the skin or the initial injury has exposed the broken bone

32
Q

Function of the interosseous membrane

A
  • Separates the muscles of the anterior and posterior compartments of the leg
  • Provides a site of muscle attachment
33
Q

Function of the foramina in the interosseous membrane

A

Proximal formaina = passage of anterior tibial vessels between compartments
Distal foramina = perforating branch of the fibular artery

34
Q

What is the function of the retinaculum?

A

A fibrous band of fascia that covers/binds tendons and holds them in place

35
Q

Which muscle in the anterior compartment of the leg isnt present in all individuals?

A

Fibularis (peroneus) tertius

36
Q

What nerve is vulnerable to injury as it courses around the neck of the fibula? What does damage to this nerve cause?

A

The common fibular nerve

- Damage causes paralysis of dorsiflexor muscles = foot-drop + altered gait

37
Q

Tom
Dick
Nervous
Harry

A

Tibialis posterior
Flexor Digitorum longus
Tibial Nerve and posterior tibial artery
Flexor Hallucis longus

All pass posterior to the medial malleolus (anterior to posterior)

38
Q

What movements are possible at the ankle?

A

Dorsiflexion

Plantarflexion

39
Q

What movements are possible at the subtalar joint?

A

Eversion

Inversion

40
Q

What structures support the arches of the foot?

A

Passive Support:

  • Plantar aponeurosis
  • Long plantar ligament
  • Short plantar ligament
  • Plantar calcaneonavicular ligament

Dynamic support

  • Tibialis posterior
  • Tibialis anterior
  • Calcaneal tendon
  • Flexor hallucis longus
  • Fibularis longus
  • Intrinsic plantar muscles
41
Q

What is the function of the plantar aponeurosis?

A
  • Supports the longitudinal arch of the foot

- Protects deeper structures in the sole of the foot

42
Q

Dorsal interossei - number and function

A

Four dorsal interossei

Dorsal ABduct - DAB

43
Q

Platar interossei - number and function

A

Three plantar interossei

Plantar ADduct - PAD

44
Q

Which three quadriceps femoris muscles are visible on the anterior surface of the thigh?

A

Rectus femoris
Vastus lateralis
Vastus medialis

45
Q

`How to locate the PSIS?

A

Permanent skin dimples overly them caused by attachment of the overlying fascia to the PSIS.

A line joining these dimples passes through the S2 spinous process - this line passes through the middle of the sacroiliac joints and the bifurcation of the iliac arteries.

46
Q

What structure within the vertebral canal terminates at S2

A

The posterior longitudinal ligament

The dural sac

47
Q

Supracristal plane - location and landmark of what?

A

Passes through the intervertebral disk between L4 and L5

Lumbra puncture landmark

48
Q

Four pulse points in the limb used clinically

A
  • Femoral pulse point (halfway between ASIS and pubic tubercle
  • Popliteal pulse point (popliteal fossa)
  • Posterior tibial pulse point (posterior to medial malleolus)
  • Dorsalis pedis pulse point (lateral to tendon of extensor hallucis longus)
49
Q

Why would you assess all of the lower limb pulse points?

A

To assess peripheral perfusion

50
Q

What causes varicous veins?

A

Valve incompetence and dilation of veins due to increased pressure.

51
Q

Where would you test the knee reflex?

A

Tap the patella ligament halfway between the patella and the tibial tuberosity.

52
Q

Where would you test the ankle reflex?

A

Push the foot into the dorsiflexed postition and tap the calcaneal tendon superior to its insertion to the calcaneal bone.

Lower Limb (5 decks)

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