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Lowerr Limb Flashcards

(105 cards)

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1
Q

Which ligament helps form the lesser sciatic foramen?

A

sacrotuberous

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2
Q

Whats the difference between sciatic notches and foramen?

A

notches are on bones, Foramen formed when ligaments cross over

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3
Q

What runs through the obturator foramen?

A

obturator VAN - specifically the canal (formed from the membrane)

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4
Q

WHat is the femoral region?

A

referred to as the thigh - includes the femur which helps connect the hip and knee

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5
Q

How is body weight transferred throughout the body?

A

From the vertebral column –> through sacroiiliac joint –> to the pelvic girdle –> through the hip joint –> femur–> knee joint –> tibia (fibula does not transfer weight) –> ankle joint –> talus

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6
Q

What are the 3 bones that form the “hip” bone

A

Ilium, Ischium and pubis

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7
Q

The acetabulum is specifically part of which bone?

A

ilium

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8
Q

What is the ischiopubic ramus?

A

Where the ramus of the ischium joins the inferior ramus of the pubis

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9
Q

How to tell right hip from left hip

A
  • acetabulum lateral
  • ASIS in front
  • iscial spine and ischial tuberosity posterior
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10
Q

Head of teh femur articulates with?

A

lunate surface of acetabulum

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11
Q

WHat is the longest and heaviest bone in the body

A

femur

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12
Q

Surgical head of femur vs anatomical neck?

A

surgical neck is more distal and skinner

anatomical is just around the head and widerq

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13
Q

WHat is the fovea?

A

medially placed depression in the head of the femur that houses the ligament of the head of femur - everywhere is is covered with hyaline cartilage

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14
Q

T or F the lesser trochanter is lateral to the greater?

A

false , more medial and smaller

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15
Q

Intertrochanteric line vs Intertrochanteric crest

A

Line - ridge running from grreater to lesser trochanter (anterior surface)
Crest- joints the trochanters posteriorly

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16
Q

What are the 2 large masses at the distal end of teh femur and what do they articulate with?

A

femoral condyles - medial and lateral

articulate with tibial condyles to form the knee joint

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17
Q

Normal angle of inclination

A

average = 126 degrees
angle between head of femur and neck
less in females because wider hips
*advantage is that it places the head of the femur more perpendicualr to the acetablum but places more stress on the neck of the femur

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18
Q

torsion angle

A

same things as angle of declination
between head and neck of femur –> the femoral condyles (superior)
average = 7-12 degrees

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19
Q

Spiral line vs pectineal line

A

pectineal line comes from the lesser trochanter and stops

spiral line comes from the front and becomes the linea aspera

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20
Q

Name the ligaments that reinforces the hip joint

A

Iliofemoral ligament - supports it Anterior and superior (Y shaped)
pubofemoral - inferior and anterior
ischiofemoral - posteriorlly

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21
Q

iliofemoral ligament

A

Y shaped
supports the hip joint anterior and superiorly
AIIS ad acetabular rim –> intertrochanteric line
prevents hyper extension
holds the head of femur in the acetabulum

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22
Q

pubofemoral

A

supports the hip joint anterior and inferior
oturator crest of pubic bone–> merge with joint capsule
tight during extension and abduction
resists excessive abduction

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23
Q

ischiofemoral ligament

A

reinforces the joint posteriorly
weak
ischial part of acetabulum –> neck of femur

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24
Q

ligament of head of femur

A

synovial fold
conducts a blood vessel - acetabular brach of obturator artery
ataches to the transverse acetabular lig and fovea

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25
Transverse acetabular ligament
goes across the acetabular notch ( end of lunate surface) to make it a fossa helps hold the head of femur
26
what is the fascia lata
The fascia lata is the deep fascia of the thigh. It encloses the thigh muscles and forms the outer limit of the fascial compartments of thigh, which are internally separated by intermuscular septa. The fascia lata is thickened at its lateral side where it forms the iliotibial tract, a structure that runs to the tibia and serves as a site of muscle attachment.[1]
27
The fascia lata thickens laterally to form ..
IT band
28
IT band is an aponeurosis of which 2 muscles?
Glut max and tensor fascia lata
29
IT band extends from
iliac tubercle (external surface above the ASIS) --> anterolateral tibial tubercle (GERDY'S tubercle) on the lateral condyle of tibia
30
What are cluneal nerves?
superficial gluteal nerves that supply the skin - superior middle and inferior superior cluneal nerves - posterior rami of L1 L2 L3 Medial cluneal nerves - posterior rami of S1 S2 S3 inferior cluneal nerve - off the posterior cutaneous nerve of thigh ( S1 - S3)
31
T or F pudendal nerve does not supply any muscles in gluteal region?
True - exits through the lesser sciatic foramen to supply the perineum
32
What is the largest nerve in the body
Sciatic nerve - artery to sciatic nerve from he inferior gluteal artery
33
Sciatic nerve splits into ..
tibial nerve and common fibular
34
T or False the sciatic nerve innervates muscles of the gluteal region
FALSE - innervates posterior thigh muscles, leg and foot muscles
35
SUperior gluteal nerve
leaves through the greater sciatic foramen superior to piriformis innervates gluteus mediu, gluteus minimus and TFL L4-S1
36
Inferior gluteal nerve
leaves through greater sciatic foramen inferior to piriformis Innervates glut max L5 - S2
37
Nerve to quadratus femoris
leaves through greater sciatic foramen deep to sciatic nerve innervates the hip joint, inferior gemellus and quadratus femoris L4 L5-S1
38
Pudendal nerve
enters gluteal region through the greater sciatic foramen inferior to piriformis and then enters the perineum through lesser sciatic foramen supplies no structures in the gluteal region supplies perineum S2-S4
39
Nerve to obturator internus
greater sciatic foramen enter lesser sciatic foramen and pass to obturator interus supplies superior gemellus and obturator internus L5-S2
40
T or F - all deep nerves of the gluteal region leave the pelvis through the greater sciatic foramen?
TRUE
41
which nerve is the only nerve thAt emerges superior to the piriformis?
superior gluteal (inferior gluteal, sciatic, posterior cutaneus of thigh, nerve to quadratus femoris, pudendal and nerve to OI ARE ALL INFERIOR)
42
T or F: Arteries of the gluteal region arise directly or indirectly frmo the internal iliac artery?
T
43
What are tibial plateaus?
grooves on the top of medial and lateral tibial condyles
44
Where is the tibial tuberositty and what is its importance
anterior surface of tibia - where the patellar lig attaches from the hamstrings
45
Where is Gerdy tubercle
lateral edge of lateral condyle of tibia (where the IT band inserts)
46
intercondylar fossa of femur
fossa between the condyles and is seen posteriorly
47
soleal or popliteal line
seen posterior - lines up with head of fibula
48
ALl quad muscles have a common insertion into
the quadricep tendon which inserts onto the patella, then becomes the patellar lig as it inserts onto the tibial tuberosity
49
Adductor magnus origin and insertion
O: Adductor part: inferior ramus of pubic, ramus of ischium Hamstring part: ischial tuberosity I: Adductor part: gluteal tuberosity, linea aspera, medial supracondylar line Hanstring part: adductor tubercle of femur
50
WHat does the tendon of adductor magnus create?
Adductor hiatus
51
WHat is the adductor canal?
bounded anterior by the adductor longus and magnus; medially by the sartorius starts at the apex of the femoral triangle provides intermuscluar passage for the femoral atery and vein, saphenous nerve and nerve to vastus medialis **and delivering femoral vessels to the popliteal fossa to become popliteal vessels
52
Femoral artery is a continuation of which artery?
External iliac
53
Once the femoral artery goes through the adductor hiatus it becomes ...
popliteal artery
54
WHat is the largest bracnh of femoral artery
profunda femoris artery
55
Deep artery of the thigh is the same thing as profunda femoris* this artery gives off perforating fibers that supply ...
adductor magnus hamstring and vastus lateralis
56
Circumflex femoral arteries typically branch from
profundus femoris artery - but can directly come from femoral
57
which artery supplies most of the blood to the head and neck of femur?
medial circumflex femoral artery - from the posterior retinacular arteries
58
Obturator artery usually arises frommm
internal iliac
59
Obturator artery supplies
obturator externus, pectineus, adductors of thigh and gracilis Also has a branch that supplies the head of femur -actebaluar branch
60
Obturator nerve supplies
adductor longus and brevis gracilis pectineus posterior fibers = obturator externus and adductor magnus
61
SUperficial vein on the lateral side of leg
small saphenous
62
Deep vein on medial side of leg
Great saphenous
63
WHat is the terminal cutaneous branch of the femoral nerve
saphenous nerve
64
When the femoral artery and vein go through the adductor hiatus, what happens to sphenous nerve?
it becomes superficial by piercing through the sartorious and gracilis
65
What is pes anserinus?
insertion of sartorius, gracilis and semitendinosus | anteromedial surface of medial condyle of tibia
66
Explain NAVEL
in the femoral triangle from lateral to medial NERVE; ARTERY; VEIN; Empty space; LYMPHATICs
67
The femoral sheath is a inferior prolongation of
transversalis and iliopsoas fascia
68
T or F: the femoral sheath does not enclose the femoral nerve
true
69
purpose of the femoral sheath
allows the femoral artery and vein to glide deep to the inguinal ligament during hip movement
70
compartments of the femoral sheath
lateral: femoral artery intermediate: femoral vein medial: femoral canal -- ends at the saphenous opening ( where the great saphenous vein comes to form the femoral vein) * allows the vein to expand for blood flow * contains loose connective tissue, lymphatics and lymph nodes
71
Which ligament helps form the greater sciatic foramen?
sacrospinous
72
Muscles of anterior thigh, medial thigh and posterior thigh
anterior: iliopsoas, sartorius, rectus femoris, vastus lateralis, vastus intermedius and vastus medialis medial: adductor longus and brevis, adductor magnus, gracilis, obturator externus posterior: biceps femoris, semitendinosus, semiembranosus
73
What nerve supplies the anterior medial and posterior compartments
anterior: femoral medial: obturator (exception: pectineus some femoral); hamstring part=tibial) posterior: tibial (exception: short head = common fibular)
74
articularis genu
derivative of vastus intermedius attachs superiorly to the inferior part of anterior aspect of femur and inferiorly to the synovial membrane of the knee (suprapatellar bursa). Pulls the bursa superior during knee extension
75
WHat is the most anterior muscle in the medial compartment
adductor longus
76
What is the only adductor muscle to cross and act both at the knee and the hip
gracilis O: body and inferior ramus of pubis I: superior part of medial surface of tibia Inn: obturator A: adducts hip; flex knee and help medially rotate it
77
Significance of adductor hiatus
where the femoral artery and vein become popliteal
78
Insertion of gluteus medius
lateral surface of greater trochanter
79
quadratus femoris
``` O:lateral border of ischial tuberosity I: quadrate tubercle on intertrochanteric crest of femur and area inferior to it Inn: nerve to quadratus femoris A: laterally rotates hip pulls femoral head into acetabulum ```
80
When does glut max function best?
between flexed and standing position (rising from a chair and walking uphill)
81
Common origin for hamstrings
ischial tuberosity
82
When will you get the most hip extension? With knee flexed or extended?
extension: because hamstrings works to extend the hip and also flex the knee
83
Borders of popliteal fossa
superolaterally: biceps femoris superomedially: semimembranosus inferlaterally and infermedially: heads of gastroc roof: popliteal fascia floor: posterior capsule fascia covering the popliteus
84
contents of popliteal fossa
``` popliteal artery and vein termination of the small saphenous vein tibial and common fibular nerves posterior cutaneous nerve of the thigh lymph fat ```
85
popliteal artery splits into
anterior and posterior tibial arteries
86
deepest structure in the fossa
artery
87
most superficial structure
tibial nerve
88
describe sural nerve
medial sural cutaneous nerve from the tibial sural communicating branch of common fibular *supplies skin on the posterior and lateral aspects of the leg and lateral side of foot
89
Where is the common fibular nerve most vulnerable to injury?
When wraping around the neck of fibula
90
What forms the compartments of the leg?
intermuscular septa, interosseuous membrance and 2 leg bones
91
Anterior compartment of leg
``` tibilas anterior EDL EHL fibularis tertius *supplied by deep fibular *vasculature = anterior tibial artery ```
92
Where does the deep fibular nerve arise from?
between the fibularis longus and neck of the fibula
93
Where can you find anterior tibial artery
between tibilas anterior and extensor digitorum longus - ends at the ankle and becomes dorsalis pedis
94
Superficial fibular nerve supplies which compartment of the leg?
lateral | *fibularis longus and brevis
95
Shin splits are repetitve microtrauma to which muscle?
TA - inflammation of muscle reduces blood flow to the muscles and it becomes painful and tender to pressure
96
Injury to common fibular nerve?
``` paralysis of all anterior muscles of leg plus lateral compartment (loss of dorsiflexion causes foot drop) *waddle gait *swing gait *high step ```
97
This nerve can be damaged from wearing tight shoes
deep fibular - deep the the extensor retinaculum pain radiating to 1st dorsal webspace *usually called ski boot syndrome
98
WHat seperats the posterior muscles into superficaly and deep?
transverse intermusclar septum
99
posterior compartment
superficial: gastroc, soleus and plantaris deep: popliteus, FDL, FHL, TP
100
When is the gastroc most efficient
when the knee is extended
101
Which tendon in the leg is usually removed for grafting without causing disability
plantaris
102
Actions of popliteus
weakly flexes the knee and unlocks it by laterally rotating femur on fixed tibia *may also medially rotate tibia of unplanted limb
103
Which muscle gives the final thrust in order to continue to preswing during gait?
flexor hallucis longus * immediately after the triceps surae has delivered the thrust of plantarflexion to the ball of footm FHL gives flexion of big toe for preswing
104
Main role of Tibilas posteior
support the medial longitudinal arch during weight bearing
105
WHICH nerve divides into medial and lateral plantar nerves
tibial

Gross Anatomy (4 decks)

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