Nerves and vessels of the lower limb Flashcards Preview

Anatomy of the limbs > Nerves and vessels of the lower limb > Flashcards

Flashcards in Nerves and vessels of the lower limb Deck (36):
1

Where do nerves to the lower limb emerge from?

Lumbosacral plexus
L2-S3

2

What does the femoral nerve supply?

Anterior compartment of thigh

3

What does the obturator nerve supply?

Medial (adductor) compartment of thigh

4

What does the sciatic nerve supply?

Posterior thigh
Anterior and posterior leg
Foot

5

Which muscle is an important landmark in relation to the nerves and vessels of the gluteal region?

Piriformis muscle- one of the lateral rotator group of gluteal muscles

6

What does the sciatic nerve divide into?

Tibial nerve
Common peroneal nerve

7

What does the tibial nerve supply?

Posterior compartment of the leg- superficial and deep calf muscles

8

What does the tibial nerve divide into?

Medial and lateral plantar nerves at the sole of the foot

9

What do the medial and lateral plantar nerves supply?

Muscles of the foot and regions of sensation in the foot

10

What does the common peroneal nerve divide into?

Deep and superficial peroneal nerves

11

What are the roots of the femoral nerve?

L2-4, posterior fibres

12

What are the roots of the obturator nerve?

L2-4, anterior fibres

13

What are the roots of the sciatic nerve?

L3-S3, anterior and posterior fibres

14

What are the roots of the superior gluteal nerve?

L4-S1

15

What are the roots of the inferior gluteal nerve?

L5-S2

16

What does the superior gluteal nerve supply?

Gluteus medius and minimus, tensor fascia lata

17

What does the inferior gluteal nerve supply?

Gluteus maximus

18

What is the segmental motor supply to hip flexors?

L2-3

19

What is the segmental motor supply to hip extensors?

L4-5

20

What is the segmental motor supply to knee extensors?

L3-4

21

What is the segmental motor supply to knee flexors?

L5-S1

22

What is the segmental motor supply to ankle dorsiflexors (extensors)?

L4-5

23

What is the segmental motor supply to ankle plantarflexors (flexors)?

S1-2

24

When assessing nerve function, what is seen in a root injury such as prolapsed intervertebral disc at L5/S1?

Motor- loss of eversion
Sensory- loss of sensation outer border of foot
Reflex- loss of ankle jerk (S1)
Autonomic- minimal

25

When assessing nerve function, what is seen in a lesion of common peroneal nerve at fibular neck?

Motor- foot drop
Sensory- dorm of foot at least
Reflex- none
Autonomic- minimal

26

What arteries supply the lower limb?

Abdominal aorta
Common iliac arteries (internal and external)
Femoral artery (deep femoral artery is main supply to thigh)
Popliteal artery
-Posterior tibial artery
-Anterior tibial artery
-Peroneal artery
-Dorsalis pedis

27

What do the femoral artery and vein pass through from the anterior compartment to the popliteal fossa?

Hiatus of adductor magnus muscle

28

What are the superficial veins of the lower limb?

Dorsal venous arch
Long saphenous vein
Short saphenous vein
Perforating veins
Sapheno-femoral junction
Blood flow is from superficial to deep.

29

What are the deep veins of the lower limb?

Run alongside arteries, venae comitantes
'Muscle pump' in the calf.
Anterior and posterior tibial veins
Popliteal vein (receives SSV)
Profunda femoris vein
Femoral vein (receives LSV)
External iliac vein

30

When may cut-down of the LSV at medial malleolus be required?

To administer fluids in a shocked patient, ATLS
2cm lateral and proximal to medial malleolus

31

What happens in arterial embolism?

Sudden occlusion
Acute ischaemia
Intermittent claudication (muscle pain commonly in calf during activity, associated with arterial disease)

32

What is compartment syndrome?

The neuromuscular compartments of the limbs are enclosed in fibrous sheaths which confines them
Ischaemia caused by trauma-induced increased pressure in a confined limb compartment
Commonly the anterior, posterior and lateral compartments of the leg

33

What is required in acute compartment syndrome (trauma-associated)?

Emergency fasciotomy to prevent death of muscles in the affected compartment

34

How do varicose veins occur?

Perforating veins connecting superficial and deep veins contain a valve that allows flow only from superficial to deep.
If the valve is compromised, blood is pushed from deep to superficial veins, leading to varicose veins.

35

Why is the muscle pump in the calf important?

In the leg, deep vessels are sandwiched between layers of calf muscles.
During walking and running, contractions of these muscles squeeze the thin-walled veins and push blood up them.
Immobility means less efficient venous return from the foot and leg
Sluggish deep venous return can lead to deep vein thrombosis.

36

What is the purpose of elastic surgical socks?

Compress superficial veins, promoting more vigorous deep venous return to prevent DVT.