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Anatomy - Year 3 > MSK 5 - Lower Limbs 1 > Flashcards

MSK 5 - Lower Limbs 1 Flashcards

1
Q

How many bones is the hip bone composed of?

A

3 seperate bones on each side

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2
Q

What 3 bones form hip bone?

A
  • 3 bones on each side
    • Ilium
    • Ischium
    • Pubis
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3
Q

What is a?

A

Anterior superior iliac spine (ASIS)

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4
Q

What is b?

A

Iliac crest

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5
Q

What is c?

A

Iliac fossa

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6
Q

What is d?

A

Pubic tubercle

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7
Q

What is e?

A

Pubic crest

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8
Q

What is f?

A

Obturator foramen

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9
Q

What is g?

A

Acetabular cavity

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10
Q

What is h?

A

Ischial spine

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11
Q

What is i?

A

Ischial tuberosity

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12
Q

What bone is 1?

A

Ilium

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13
Q

What bone is 2?

A

Ischium

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14
Q

What bone is 3?

A

Pubis

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15
Q

What is the longest bone in the body?

A

The Femur is the longest bone in the body and runs from the hip joint to the knee joint, it is exclusively found in the thigh

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16
Q

What is a?

A

Neck of femur

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17
Q

What is b?

A

Lesser troachanter of femur

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18
Q

What is c?

A

Lateral condyle of femur

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19
Q

What is d?

A

Greater trochanter of femur

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20
Q

What is e?

A

Medial condyle of femur

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21
Q

What is f?

A

Head of femur

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22
Q

What is g?

A

Intertrochanteric line

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23
Q

What does the femur articular with proximally?

A

The femoral head articulates with the acetabulum of the hip to form the hip joint

The two hemi-pelvises articulate in the midline at the pubic symphysis

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24
Q

What does the femur head articulate with?

A

Acetabulum of hip

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25
Q

What are the superficial veins of the lower limb?

A

The two superficial veins are the great sephenous vein and lesser sephenous vein

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26
Q

What are the great and lesser sephanous veins tributaries of?

A

Dorsal venous arch of foot

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27
Q

What does the great sephanous vein drain into?

A

Femoral vein at medial aspect of thigh

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28
Q

Does great sephanous vein drain into femoral vein at lateral or medial aspect of thigh?

A

Medial

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29
Q

What is A?

A

Great sephanous vein

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30
Q

What is B?

A

Lesser sephanous vein

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31
Q

What is C?

A

Dorsal venous arch

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32
Q

Which superficial vein ascends anterior to the medial malleolus of the tibia?

A

Great saphenous vein

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33
Q

Which superficial vein ascends posterior to the lateral malleolus?

A

Lesser saphenous vein

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34
Q

Which superficial vein empties into the femoral vein?

A

Great saphenous vein

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35
Q

Which superficial vein empties into the popliteal vein?

A

Lesser saphenous vein

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36
Q

What are varicose veins?

A

Valves are present in the saphenous vein to prevent pooling of blood in the legs

If these valves become incompetent, the thin vessels dilate, and become torturous forming varicose veins

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37
Q

What is it called when varicoe veins become inflammed?

A

Thrombophlebitis

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38
Q

What do the deep veins of lower leg ascend with?

A

Their respective major arteries

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39
Q

How does blood ascend in the deep veins?

A

Muscle contractions

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40
Q

What is deep vein thrombosis?

A

If a thrombus occurs in the deep veins of the lower leg this is called a deep vein thrombosis.

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41
Q

What are possible complications of DVT?

A

If a thrombus becomes dislodged and migrates away its source it is called an embolus.
If this lodges in the lungs then it is a pulmonary embolus, a potentially life-threatening clinical condition.

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42
Q

What are the 3 groups of lymphatics where lymph from lower limbs drains?

A
  1. Superficial inguinal
  2. Deep inguinal
  3. Popliteal
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43
Q

Lymphatics accompanying the following drain where:

  • great sephanous vein
  • lesser sephanous vein
A
  • Greater sephanous vein
    • Superficial inguinal nodes
  • Small sephanous vein
    • Popliteal lymph nodes
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44
Q

Where must an infection be to cause enlargement of inguinal lymph nodes?

A

Any structure inferior to level of umbilicus, including lower limbs

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45
Q

How does sensory supply of lower limbs differ from upper limbs?

A

However, the major difference is that the sensory supply comes from the lumbar and sacral plexus (not just the brachial plexus).

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46
Q

What dermatome supplies the anterior of knee?

A

L3

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47
Q

What dermatome supplies the big toe?

A

L5

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48
Q

What dermatome supplies the little toe?

A

S1

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49
Q

What dermatome supplies:

  • A
  • B
  • C
  • D
A

A - L1

B - S3

C - S4

D - L2

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50
Q

What dermatome supplies:

  • E
  • F
  • G
  • H
A

E - L3

F - L4

G - L5

H - S1

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51
Q

What dermatome supplies:

  • I
  • J
  • K
  • L
A

I - S2

J - L2

K - S3

L - S4

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52
Q

What dermatome supplies:

  • M
  • N
  • O
  • P
A

M - coccyx

N - S5

O - L3

P - S2

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53
Q

What dermatome supplies:

  • Q
  • R
  • S
  • T
A

Q - L5

R - L4

S - S1

T - L5

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54
Q

In general, what plexus supplies sensory innervation to:

  • anterior leg
  • posterior leg
A

Anterior leg - lumbar plexus

Posterior leg - sacral plexus

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55
Q

What dermatome supplies the:

  • testicles
  • penis
A

Testicles - S4

Penis - S3

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56
Q

What kind of joint is the hip joint?

A

Ball and socket

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57
Q

Why is the hip joint more stable than the shoulder joint?

A

The ball of the hip is entirely surrounded by the socket of the pelvis, whereas the shoulder is more similar to a golf ball resting on a tree

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58
Q

What is the ring of cartilage called that surrounds the acetabulum of hip

A

Acetabular labrum

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59
Q

What part of the acetabular cavity does the acetabular labrum cover?

A

The rim, increases the depth of the acetabulum

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60
Q

What are the 3 main ligaments of the hip joint?

A
  1. Ilio-femoral ligament
  2. Pubofemoral ligament
  3. Ischiofemoral ligament
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61
Q

What do the following ligaments prevent:

  • ilio-femoral
  • pubofemoral
A
  • Ilio-femoral
    • Prevents hyperextension of hip joint
  • Pubofemoral
    • Prevents hyper abduction of hip joint
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62
Q

What is 1?

A

Ilio-femoral ligament

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63
Q

What is B?

A

Pubofemoral ligament

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64
Q

What is C?

A

Ischiofemoral ligament

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65
Q

What movements can be done at the hip?

A
  1. Flexion
  2. Extension
  3. Abduction
  4. Adduction
  5. Internal rotation
  6. External rotation
  7. Circumduction (combination of above)
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66
Q

What are the muscles of hip flexion?

A
  • Iliacus
  • Psoas major
  • Pectineus
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67
Q

What is 1?

A

Iliacus

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68
Q

What is 2?

A

Psoas major

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69
Q

What is 3?

A

Pectineus

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70
Q

Iliacus:

  • origin
  • insertion
  • innervation
A
  • Origin
    • Inner pelvis and posterior abdominal wall
  • Insertion
    • Greater trochanter of femur
  • Innervation
    • Lumbar plexus
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71
Q

Psoas major:

  • origin
  • insertion
A
  • Origin
    • Inner pelvis and posterior abdominal wall
  • Insertion
    • Greater trochanter of femur
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72
Q

At the insertion on the greater trochanter of femur what happens?

A

Iliacus and psoas major share a common tendon, becoming called iliopsoas muscle

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73
Q

Pectineus:

  • origin
  • insertion
A
  • Origin
    • Pubis bone
  • Insertion
    • Femur
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74
Q

What supplies:

  • iliacus
  • psoas major
  • pectineus
A

Hip flexors all supplies by lumbar plexus

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75
Q

What are the 3 functional groups of the hip extensors?

A
  1. Gluteus maximus
  2. Hamstrings (composed of 3 muscles)
  3. Posterior part of adductor magnus
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76
Q

What is the main extensor of the hip joint?

A

Gluteus maximus

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77
Q

Is the gleteus maximus superficial or deep muscle?

A

This is a large superficial muscle which you sit on! It is used when standing from a sitting position, and when climbing stairs.

78
Q

What innervates the extensors of the hip?

A

These muscles are supplied by branches from the sacral plexus (L4 to S3), a common theme for muscles found in the posterior aspect of the pelvis and thigh.

79
Q

What movement is A?

A

Adduction

80
Q

What is B?

A

Abduction

81
Q

In what compartment of thigh are adductor muscles found?

A

Medial compartment

82
Q

What nerve supplies most of the adductor compartment?

A

The adductor compartment is mostly supplied by the obturator nerve (aside from the posterior part of adductor magnus)

83
Q

What part of the adductor compertment is not supplied by the obturator nerve?

A

Posterior part of adductor magnus

84
Q

What plexus does the obturator nerve come from and how does it exit the pelvis?

A

Comes from lumbar plexus

Exits pelvis via obturator canal

85
Q

What is 1?

A

Gluteus medius

86
Q

What is 2?

A

Gluteus minimus

87
Q

What is 3?

A

Piriformis

88
Q

What are the hip adductors?

A
  • Adductor longus
  • Adductor brevis
  • Adductor magnus
  • Gracilis
  • Obturator externus
89
Q

What compartment of thigh does hip adduction?

A

There is no specific abductor compartment of the thigh, but rather the deep gluteal muscles carry out this role via. their attachment to the greater trochanter of the femur.

90
Q

Attachment of muscles to what allows hip abduction?

A

Greater trochanter of femur

91
Q

What are the hip abductors?

A
  • Gluteus maximus
  • Gluteus medius
  • Gluteus minimus
  • Piriformi
92
Q

What is the most superficial muscle in the gluteal region?

A

Gluteus maximus is largest and most superficial

93
Q

What is 1?

A

Gluteus medius

94
Q

What is 2?

A

Gluteus minimus

95
Q

What is 3?

A

Piriformis

96
Q

Why are abductors of hip essential for normal walking gait?

A

Every time you raise one leg off the ground, the abductors of the opposite side of the pelvis contract to provide stability

97
Q

Nerves from what plexus supplies the abductor compartment?

A

Sacral plexus

98
Q

At what joint does rotation of lower limbs occur at?

A

Rotation of the lower limb only occurs effectively at the hip joint

99
Q

What is:

  • lateral rotation of hip
  • medial rotation of hip
A

Turning the inside of the foot to face forward, requires lateral rotation of the hip
Turning the inside of the foot to face backwards, requires medial rotation of the hip

100
Q

Muslces that allow external rotation attach where?

A

Muscles involved in external rotation cross the joint on the posterior side.
These lie deep within the pelvis and attach onto or around the greater trochanter.

101
Q

What muscles are involved in external rotation?

A
  • Piriformis
  • Obturator internus
  • Obturator externus
  • Superficial and inferior gameli
  • Quadratus femoris
102
Q

Muscles involved in internal and external rotation are anterior or posterior?

A

External rotation - posterior

Internal rotation - anterior

103
Q

What are the medial rotators of the hip joint?

A
  • Quadratus femoris
  • Piriformis
  • Tensor fascia lata
104
Q

Muscles of the thigh can be organised into what?

A
  • 3 compartments
    • Anterior
    • Posterior
    • Medial
105
Q

How many heads does the quadriceps femoris have?

A

4 heads

106
Q

What are the 4 heads of the quadriceps femoris?

A
  • Rectus femoris
  • Vastus lateralis
  • Vastus medialis
  • Vastus intermedius
107
Q

What is 1?

A

Sartorius

108
Q

What is 2?

A

Rectus femoris

109
Q

What is 3?

A

Vastus intermedius

110
Q

What is 4?

A

Vastus lateralis

111
Q

What is 5?

A

Adductor longus

112
Q

What is 6?

A

Gracilis

113
Q

What is 7?

A

Adductor brevis

114
Q

What is 8?

A

Adductor magnus

115
Q

What is 9?

A

Gluteus maximus

116
Q

What nerve innervates the quadratis femoris muscles?

A

Femoral nerve (L2-L4)

117
Q

What are the nerve roots of the femoral nerve?

A

L2-L4

118
Q

What is the action of rectus femoris on the hip joint?

A

Stabilises hip joint

119
Q

What happens to the 4 distal parts of the quadriceps femoris?

A

The 4 parts of the quadriceps unite to form the quadriceps tendon proximal to the patella. Distal to the patella this continues as the patellar tendon, inserting into the anterior aspect of the tibia.

120
Q

What does the quadriceps tendon continue as distal to patella?

A

Patellar tendon

121
Q

Where does the patellar tendon insert?

A

Anterior aspect of tibia

122
Q

To which part of the tibia does the patellar ligament attach?

A

Tibial tuberosity

123
Q

Why are the quadriceps unique in there action?

A

Although the quadriceps are located in the anterior thigh, they have opposing actions on 2 joints. They flex the hip joint, whilst extending the knee joint.

124
Q

What action do the quadriceps have on:

  • hip
  • knee
A
  • Flexion of hip joint
  • Extension of knee joint
125
Q

How can the quadriceps flexing the hip but extending the knee embryologically be explained?

A

This can be explained through embryological development. In the first trimester, the lower limb bud rotates from a lateral, extended position to one where the original anterior surface becomes the sole of the foot, as seen in an adult.

In this final anatomical position, hip and knee movements occur in opposition to one another. The quadriceps flex the hip, whilst extend the knee joint.

126
Q

What is the longest muscle in the body?

A

Sarortius muscle

127
Q

What is the most superficial muscle in the anterior compartment of thigh?

A

Sartorius muscle

128
Q

Sartorius:

  • origin
  • insertion
  • action
A
  • Origin
    • Anterior superior iliac spine
  • Insertion
    • Pes anserinus on medial aspect of tibia
  • Action
    • Flexion of hip
    • Abduction of hip
    • Lateral rotation of hip
    • Flexion of knee
129
Q

How is the sartorius able to carry out the same action at the hip and knee?

A

This is possible as it spirals around the thigh from lateral to medial, crossing the hip joint anteriorly and the knee joint posterior-medially.

130
Q

With the sartorius muscle, what 2 others insert ontot he pes amserinus on medial aspect of tibia?

A

? and ?

131
Q

How do the muscles in the medial compartment of the thigh act on the hip joint?

A

Adduct

132
Q

Which nerve innervates the medial thigh muscles?

A

Obturator nerve

133
Q

Through which bony foramen does the obturator nerve enter the thigh?

A

Obturator foramen

134
Q

What is 1?

A

Adductor brevis

135
Q

What is 2?

A

Adductor longus

136
Q

What is 3?

A

Adductor canal

137
Q

What structures pass through the adductor canal?

A
  • Femoral artery
  • Femoral vein
  • Saphenous nerve
138
Q

What fossa do the structures that pass throught the adductor canal enter?

A

Popliteal fossa

139
Q

What do the neurovascular structures on the anterior aspect of limb enter through?

A

Femoral triangle

140
Q

The femoral triangle of lower limbs is equivalent to what of upper limbs?

A

Axilla

141
Q

What are the following boundaries of the femoral triangle:

  • medial
  • lateral
  • base
  • floor
A
  • Medial
    • Adductor longus muscle
  • Lateral
    • Sartorius muscle
  • Base
    • Inguinal ligament
  • Floor
    • Iliopsoas muscle laterally
    • Pectineus muscle medially
142
Q

What muscles forms the floor of the femoral triangle:

  • medially
  • laterally
A
  • Medially
    • Pectineus muscle
  • Laterally
    • Iliopsoas muscle
143
Q

What are the 3 major structures present in the femoral triangle?

A
  1. Femoral nerve
  2. Femoral artery
  3. Femoral vein
144
Q

What is the connective tissue tube that surrounds proximal parts of femoral vessels called?

A

Femoral sheath

145
Q

What femoral vessels does the femoral sheath not surround?

A

Femoral nerve

146
Q

What does the femoral sheath create next to the femoral vessels?

A

Femoral canal

147
Q

Is the femoral canal found medial or lateral to femoral vessels?

A

Medial

148
Q

What does the femoral canal contain?

A

Lymphatics

149
Q

What are in the following compartments of the femoral sheath:

  • lateral
  • intermediate
  • medial
A
  • Lateral
    • Femoral artery
  • Intermediate
    • Femoral vein
  • Medial
    • Deep inguinal lymph nodes
150
Q

What are the contents of the femoral canal?

A
  1. Fat and loose connective tissue
  2. Deep inguinal lymph node (Cloquet node)
151
Q

What lymph node is found in the femoral canal?

A

Deep inguinal lymph node (Cloquet node)

152
Q

What is a weak area in the anterior abdominal wall?

A

Femoral ring

153
Q

What can cause femoral hernia?

A

Similar to inguinal hernias, activities that increase intra-abdominal pressure can cause abdominal contents to push into this area and become trapped.

154
Q

Is femoral hernia more common in men or woman?

A

Woman

155
Q

What is the femoral artery a continuation of?

A

External iliac artery

156
Q

Where does the femoral artery begin?

A

It begins at the inguinal ligament as a continuation of the external iliac artery.

157
Q

What does the femoral artery enter the thigh between?

A
  • Between 2 bony surface markings
    • Anterior superior iliac spine
    • Pubis tubercle
158
Q

What is the deep branch of the femoral artery?

A

Profunda femoris (deep femoral artery)

159
Q

What is the femoral vein a contuation of?

A

Popliteal vein

160
Q

What does the femoral vein become and where?

A

Entering the femoral triangle and becoming the external iliac vein as it passes under the inguinal ligament

161
Q

What 2 important veins drain into the femoral vein in the femoral triangle?

A
  1. Profunda femoris vein
  2. Greater sephanous vein
162
Q

What is the largest branch of the lumbar plexus?

A

Femoral nerve

163
Q

Does the femoral nerve pass superficial or deep to inguinal ligament?

A

Deep

164
Q

Does the femoral nerve enter the femoral triangle medial or lateral to femoral vessels?

A

Lateral

165
Q

What is the adductor canal also called?

A

Subartorial canal or Hunter’s canal

166
Q

What is the adductor canal?

A

Fascial sheath

167
Q

What do the neurovascular structures of the anterior thigh pass distally towards the apex of femoral triangle?

A

They begin to pass deep through the musculature called in a fascial sheath called the adductor canal.

168
Q

What does the adductor canal reach after going deep?

A

Adductor hiatus

169
Q

The adductor hiatus is an anatomical opening in what muscle?

A

Adductor longus muscle

170
Q

What arterial change happens in the adductor canal?

A

The anterior femoral artery becomes the posterior popliteal artery

171
Q

What are the 2 plexuses that supplies the lower limbs?

A

Lumbar plexus

Sacral plexus

172
Q

What are the ventral roots of the lumbar plexus?

A

L1-L4

(T12 contributes 50% of the time)

173
Q

Through what do the ventral roots of the lumbar plexus emerge?

A

Through the psoas major muscle on the posterior abdominal wall

174
Q

What nerves does the lumbar pelxus give of immediately?

A
  • Lateral femoral cutaneous nerve
  • Femoral nerve
  • Obturator nerve
175
Q

What is A?

A

Lateral femoral cutaneous nerve

176
Q

What is B?

A

Femoral nerve

177
Q

What is C?

A

Obturator nerve

178
Q

What are the 2 main motor nerves of the lumbar plexus that supplies the lower limbs?

A
  1. Femoral nerve
  2. Obturator nerve
179
Q

Identify one main sensory nerve of the lumbar plexus supplying the lower limb?

A

Lateral femoral cutaneous nerve

180
Q

What are the nerve root values of:

  • lateral femoral cutaneous nerve
  • femoral nerve
  • obturator nerve
A
  • Lateral cutaneous nerve
    • L2-L3
  • Femoral nerve
    • L2-L4
  • Obturator nerve
    • L2-L4
181
Q

What nerve do the L1-L2 roots of lumbar plexus give of?

A
  • Ilioinguinal
  • Iliohypogastric
  • Genitofemoral
  • (covered in GI anatomy do not contribute to lower limbs aside from small sensory area by genitofemoral nerve in upper medial thigh)
182
Q

What is A?

A

Obturator nerve

183
Q

What is B?

A

Transversus abdominus

184
Q

What is C?

A

Internal oblique

185
Q

What is D?

A

Genitofemoral nerve

186
Q

What is E?

A

Ilio-inguinal nerve

187
Q

What is F?

A

Lateral femoral cutaneous nerve

188
Q

What is G?

A

Iliohypogastric nerve

189
Q

What is H?

A

Femoral nerve

190
Q

What is I?

A

Iliacus

Anatomy - Year 3 (18 decks)

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