lower limbs living anatomy pp

Question 1

what is the normal anteversion angle for different ages

Answer 1

Question 2

what influences anteversion

Answer 2

W sitting promotes it

tailor sitting prevents it (crossed legs)

Question 3

what is the blood supply of the hip joint *

Answer 3

there is a trochanteric anastomosis:

medial femoral circumflex a

lateral ‘’

superior and inferior gluteal a - from internal iliac

acetabular branch to head (in ligament of head) from obturator a (ant division of internal iliac)

Question 4

identify these features of the femoral artery angiogram *

Answer 4

1 external iliac

2 common femoral

3 superficial femoral

4 profunda femoris

5 lateral circumflex femoral

6 perforating artery

Question 5

identify these features of the popliteal artery angiogram *

Answer 5

• A popliteal artery
• B anterior tibial a
• C tibiofibular trunk
• D Fibular a
• E posterior tibial

•

•Red arrow – growth plate in tibia

Question 6

feel the popliteal arterial pulse *

Answer 6

flex the knee to relax the hamstrings

palpate the artery against the posterior tibia at the inferior part of the popliteal fossa

Question 7

landmarks for safe injection in gluteal region *

Answer 7

Question 8

where do you do self administered injections *

Answer 8

below the greater trochanter

Question 9

describe tredelenburg gait *

Answer 9

if R hip abductors are paralysed - L hip hip will drop when lift left food because of lack of lifting support

the pelvis will drop on the non-affected side

for the trendelenburg test - subject stands upright on both feet, examiner stands behind and notes level of iliac crests - a drop indicated weakness of abductors on opposite sides

Question 10

how does compartment syndrome heal *

Answer 10

fibrosis and contracture

Question 11

symptoms of ischemic limb - ie from compartment syndrome *

Answer 11

• Pain, greater than expected
• Pallor of the limb, patchy
• The limb is cool
• Pulses absent
• Movement, passive extension is very painful

Question 12

cross section of compartments of the thigh *

Answer 12

Question 13

cross section of compartments and fascia of leg *

Answer 13

Question 14

what spinal levels is the tibial nerve from *

Answer 14

l4 5 s1 2 3

Question 15

what spinal levels is the common peroneus nerve from *

Answer 15

l4 5 s1 2

Question 16

effect of femoral nerve injury *

Answer 16

l2 3 4

motor - quadriceps paralysis = weakness of knee, difficulty with stairs

sensory - anterior and medial thigh loss, medial side of leg and medial border of foot (not big toe)

Question 17

effect of obturator nerve injury *

Answer 17

l2 3 4

motor - paralysis of adductors of thigh (except hamstring part of adductor magnus) - cross legging effected

insignificant sensory loss on medial side of thigh

also supply pelvis - pain on medial side of thigh could be from ovarian tumours

Question 18

effect of common peroneal nerve injury *

Answer 18

sciatic is l4-s3

motor - foot extensors and evertors paralysed, foot drop and inverted (because tibialis posterior is still functioning) - peroneal muscles, tibialis anterior and EDL and EHL are affected

sensory loss in anterior and lateral side of leg and dorsum of foot

Question 19

effect of tibial nerve injury *

Answer 19

sciatic is l4-s3

motor - hamstrings and muscles of back of leg and sole of foot - foot in dorsiflexed and everted - gastrocnemius, soleus, tibialis posterior, FHL and FDL and all intrinsic foot flexors, interossei and lumbricles are affected

sensory - loss in sole of foot

Question 20

effect of whole sciatic nerve injury (

Answer 20

motor - hamstrings and all muscle below knee paralysed

foot in plantar flexed (foot drop) - because of its own weight

sensory - loss below knee except narrow area on medial side of leg and foot - saphenous nerve area, not the big toe

Question 21

what is sciatica *

Answer 21

pain radiating from lower back into buttock, posterior/lateral thigh and into leg

cause - herniated intervertebral disc - L4/5 or L5/S1 - compression of L5/S1 part of sciatic nerve

Question 22

effect of ACL and PCL damage *

Answer 22

ACL - walking upstairs limited

PCL - walkimg downstairs limited

Question 23

what are the movements at the ankle joint *

Answer 23

Question 24

what is the support for the arches *

Answer 24

passive - plantar aponeurosis, plantar calcaneonavicular lig (spring lig), long plantar lig (calcaneo-cuboid-metatarsal), short plantar lig (calcaneocuboid)

dynamic support - intrinsic muscles - tibialis anterior and posterior, FHL, peroneus longus

Question 25

what is involved in inversion of the foot and how do you test it *

Answer 25

Question 26

what is involved in eversion of the foot and how do you test it *

Answer 26

Question 27

upper limb - what is involved in the scapulothoracic joint *

Answer 27

latissimus dorsi

rhomboids

trapezius

serratus anterior

Question 28

what is the antebrachial vein - upper limb *

Answer 28

in anterior forearm between basilic and cephalic veins

branch from any of the veins

Question 29

describe the clinical significance of the ‘crows foot’

Answer 29

femoral nerve passes through the semimembrinosis and tendinosis - if irritated refers pain to medial side of our feet