SM MSK Anatomy - Lower Limb, Femoral Triangle, Glute, Foot, Gait Flashcards

SM 223a, Lab 2, Lab 3, Lab 4, Lab 5

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1
Q

Which structure is labeled by #12?

Function?

Innervation?

A

Vastus lateralis

Knee extension (inserts on greater trochanter of femur)

Femoral nerve

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2
Q

What view of the femur is this?

A

Posterior view

(You can see the intercondylar notch in between the medial and lateral condyles)

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

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3
Q

Which structure is labeled by #12?

A

Semitendinosus

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4
Q

Which muscle is labeled by #4?

A

Piriformis

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5
Q

Which vessel is most likely to be damaged by a femoral neck fracture?

What is the consequence?

A

Medial femoral circumflex artery

This can lead to necrosis of the femoral head

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6
Q

Which gait phase is showin in picture 3?

Which muscles are active?

A

Mid stance

The foot on the ground is supporting the whole weight of the body

  • Quadriceps femoris is extending the knee as the body moves over the planted foot
  • Gluteus medius, gluteus minimus, an dtensor fascia late are contracting to hold up the hip of the other (swinging) leg
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7
Q

Which structure is labeled by #9?

A

Semimembranosus

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8
Q

Which nerve supplies the big toe compartment of the foot?

What actions does it control?

A

Medial plantar nerve (branch of the tibial nerve)

Abduction and flexion of the hallux

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9
Q

Which structure is indicated by #2?

What is its primary function?

A

Piriformis

Lateral rotation of the hip

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10
Q

Which structure is labeled by #10?

What is its function?

What are its attachments?

A

Tibialis posterior

Foot inversion, plantarflexion

Tibia, fibula, interosseous membrane + sole of the foot (tarsals)

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11
Q

What are the components of the sciatic nerve?

A

Tibial nerve

Common fibular nerve

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12
Q

Hip extensors are found in the _________ compartment of the thigh, and are supplied by the _________ nerve

A

Hip extensors are found in the posterior** compartment of the thigh, and are supplied by the **tibial (sciatic) nerve

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13
Q

Which structure is labeled by #2?

A

Inguinal ligament

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14
Q

Which structures are in group A?

A

Superficial femoral artery, and vein

Femoral nerve

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15
Q

Identify the structures of the lateral compartment of the leg.

What innervates them?

A

Fibularis longus (5)

Fibularis brevis (6)

Superficial fibular nerve

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16
Q

Which muscles acts to invert the foot?

A

Tibialis posterior, Tibialis anterior

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17
Q

What are the nerve branches of the lumbo-sacral plexus?

A
  • Obturator
  • Femoral
  • Superior gluteal
  • Inferior gluteal
  • Sciatic nerve
    • Tibial nerve
    • Common fibular nerve
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18
Q

Which structure is labeled by #5?

A

Tibial nerve

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19
Q

Which structure is labeled by #1?

A

Tibia

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20
Q

Which nerve supplies the areas indicated in yellow (#2 and #2a)?

A

2a is supplied by the saphenous nerve, a branch of the femoral nerve

Femoral nerve

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21
Q

A physician would like to block cutaneous nerves in order to remove a small subcutaneous lipoma from the medioanterior surface of the thigh. The branches of which nerve should be blocked?

A. sural

B. tibial

C. musculocutaneous

D. femoral

A

D. femoral

Supplies the anterior surface of the thigh. May also block branches fo the obturator nerve.

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22
Q

Which structure labels the anterior cruciate ligament?

Which structure labels the posterior cruciate ligament?

A

Anterior cruciate ligament = #2

Posterior cruciate libament = #1

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23
Q

Which dermatomes are important for making the diagnosis of sciatica?

A

S1 and S2

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24
Q

Which structure is labeled by #3?

A

Femoral artery and femoral vein

Fig. 59.7 Adapted from Gilroy et al. Atlas of Anatomy, second edition, Fig. 29.34 B.

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25
Q

During which period of the gait is the gluteus medius most active?

What is it doing?

A

Mid-stance

It is pulling the torso over the weight-bearing leg so it doesn’t droop to the swinging side

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26
Q

Hip adductors are found in the _________ compartment of the thigh, and are supplied by the ________ nerve

A

Hip adductors are found in the medial** compartment of the thigh, and are supplied by the **obturator nerve

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27
Q

Which picture shows valgus knee?

Which one shows varus knee?

A

A = valgus

B = varus

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28
Q

Which areas are supplied by the femoral nerve?

A

Areas indicated in yellow and labeled #2 and #2a

  • # 2 is supplied by the femoral nerve
  • # 2a is supplied by the saphenous nerve, a branch of the femoral nerve
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29
Q

Which is the best area (the one with the least possibility of overlap with other dermatomes) to test for normal sensation in the L1 dermatome?

A

Over the inguinal ligament

(In the Anataomy Lab 2 ppt it says that this is FYI only, but one of the review questions was about this so…)

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30
Q

Which structure is labeled by #7?

What is its function?

A

Medial collateral ligament

Stabilizes the knee medially

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31
Q

Where will you find the neurovasculature of the posterior lower leg?

A

Deep to the soleus, superficial to flexor digitorum longus/tibialis posterior/flexor hallucis longus

aka - between the superficial and deep compartments of the posterior leg

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32
Q

Which structure is labeled by #3?

A

Medial collateral ligament

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33
Q

Lateral compartment of the leg

  • Muscles:
  • Function:
  • Innervation:
A

Lateral compartment of the leg

  • Muscles: Fibularis longus, fibularis brevis
  • Motion: Eversion of the foot, plantarflexion (flexion) of the foot
  • Innervation: Superficial fibular nerve (comes from sciatic)
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34
Q

Which nerve supplies the little toe compartment of the foot?

What actions does it control?

A

Lateral plantar nerve (branch of the tibial nerve)

Abduction and flexion of the 5th digit

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35
Q

Which structure is labeled by #3?

A

Medial malleolus

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36
Q

Which structure is labeled by #8?

A

Medial epicondyle of the femur

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

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37
Q

Which structure is labeled by #10?

Function?

Innervation?

A

Short head of biceps femoris

Hip extension, knee flexion

Sciatic nerve (common fibular division)

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38
Q

Which structure is labeled by #17?

What does it innervate?

A

Common fibular nerve

Separates into the superficial fibular nerve (lateral compartment of the leg) and deep fibular nerve (anterior compartment of the leg)

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39
Q

Which structure is labeled by #3?

A

Iliacus

(Part of the iliopsoas)

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40
Q

Which vein is labeled by #2?

Where does it join the deep venous system?

A

Greater saphenous vein

Empties into the femoral vein at the saphenous opening
(in the crease of the hip)

(lesser saphenous vein = back of the leg, dumps into popliteal vein))

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41
Q

Which nerve is labeled by #21?

What does it innervate?

A

Medial plantar nerve (branch of the tibial nerve)

Flexor hallucis brevis, abductor hallucis, most medial lumbrical

(analogous to the median nerve of the hand)

The lateral plantar does everything else (like the ulnar nerve does in the hand)

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42
Q

Which structure is labeled by #3?

A

Anterior superior iliac spine

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43
Q

Which structure is labeled by #4?

A

Lateral malleolus (part of the fibula)

Fig. 56.3 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 27.1 A, 27.1 B.

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44
Q

Which structure is labeled by #1?

A

Psoas major

Part of the iliopsoas

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45
Q

Which actions are controlled by the inferior gluteal nerve?

A

Hip extension, lateral rotation

The inferior gluteal nerve innervates the gluteus maxiumus

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46
Q

Which structure is indicated by #3?

What is its primary function?

A

Quadratus femoris

Lateral rotation of the hip

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47
Q

Which structure is labeled by #13?

A

Gracilis

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48
Q

Which structure is labeled by #2?

A

Popliteal artery

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49
Q

Which nerve is labeled by #3?

What does it innervate?

A

Superficial fibular nerve (part of the sciatic nerve)

Innervates the lateral compartment of the leg

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50
Q

17 labels the plantar aponeurosis that has been removed. The view is immediately deep to this structure

Describe the structure labeled by #11

  • Muscle:
  • Function:
  • Attachments:
  • Innervation:
A
  • Muscle: Flexor digitorum brevis
  • Function: Flex MTP and PIP in toes 2-5
  • Attachments: Calcaneal tuberosity, middle phalanges of toes 2-5
  • Innervation: Medial plantar nerve (Branch of tibial nerve)
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51
Q

Posterior compartment of the leg

  • Motion:
  • Innervation:
A

Posterior compartment of the leg

  • Motion: Flexion aka Plantarflexion
  • Innervation: Tibeal nerve (comes from sciatic)
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52
Q

Which number labels the greater trochanter?

Which muscle makes this mark?

A

9

Gluteus medius and minimus

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53
Q

Which structure is labeled by #7?

A

Adductor magnus

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54
Q

Which structure is labeled by #10?

A

Quadriceps femoris tendon

All of the muscles of quadriceps femoris come together to form the quadriceps tendon

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55
Q

Which structure is labeled by B?

Which movements occur here?

A

Upper ankle (talocrural) joint

Flexion and extension

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56
Q

Which structure is circled?

A

Medial collateral ligament of the ankle

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57
Q

Which muscles insert into the IT band?

A

Gluteus maximus, tensor fasciae latae

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58
Q

Which structure is labeled by #5?

A

Calcaneus

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59
Q

What kind of bone is labeled by #1?

A

Distal phalanx of the foot

(This is the 5th distal phalanx)

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60
Q

Which structures are labeled by #13?

A

Extensor digiotorum brevis

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61
Q

Which structure is labeled by #3?

A

Iliofemoral ligament

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62
Q

What muscle “unlocks” the knee?

A

Popliteus

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63
Q

Which structure is labeled by #1?

A

Adductor magnus

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64
Q

Which structure is labeled by #16?

What does it innervate?

A

Tibial nerve

Posterior compartment of the leg

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65
Q

Describe the structure labeled by #8

  • Muscle:
  • Function:
  • Attachments:
  • Innervation:
A
  • Muscle: Quadratus femoris
  • Function: Extension, external rotation of the femur
  • Attachments: Ishcial tuberosity, femur (Intertrochanteric crest)
  • Innervation: Sacral plexus (L5, S1)
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66
Q

Which structure is labeled by #18?

A

Gastrocnemius (lateral head)

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67
Q

Which structure is labeled by #20?

A

Tendon of extensor hallucis longus

(#8 = extensor hallucis longus)

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68
Q

What kind of bone is labeled by #8?

A

Proximal phalanx of the foot

(This is the 1st proximal phalanx)

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69
Q

Which structures are labeled by #12?

A

Tendons of extensor digitorum longus

(Extensor digiotorum longus = #7)

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70
Q

Which structure is labeled by #1?

A

Iliotibial tract

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71
Q

Describe the hip flexors

  • Primary muscles:
  • Nerve:
A

Hip flexors

  • Primary muscles: Iliopsoas, rectus femoris
  • Nerve: Femoral
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72
Q

Which muscles are important for lateral balance of the trunk during walking or running?

A

Gluteus medius

Gluteus minimus

(Abduction to pull the trunk back over the leg)

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73
Q

Which structure is labeled by #1?

A

Lesser trochanter of the femur

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

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74
Q

Which structure is labeled by #15

A

Medial head of gastrocnemius

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75
Q

Which gait phase is showin in picture 2?

Which muscles are active?

What are the joints doing?

A

Loading response

  • Quadriceps femoris to prevent knee from flexing completely (this would cause us to collapse)
    • Eccentricallly active
  • Gluteus maximus and hamstrings extend the hip
  • Knee flexes passively to accept the weight of the body (shock absorption)
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76
Q

Which structure is labeled by #4?

A

Posterior tibial artery

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77
Q

A patient has lost feeling between their hallux and 2nd toe.

Which nerve is damaged?

Which other functions should you test?

A

Deep fibular nerve

Innervates the anterior compartment of the leg, becomes cutaneous between the hallux and 2nd toe

Test toe and ankle extension (dorsiflexion); More proximal injuries to the ulnar nerve will cause weakness with these movements

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78
Q

Which structure is labeled by #11?

A

Extensor digitorum longus

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79
Q

Which structure is labeled by #6?

A

Ischial tuberosity

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80
Q

Which structure is labeled by #14?

A

Tibialis posterior

(Also #11)

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81
Q

Describe gluteus maximus

  • Function:
  • Attachments:
  • Innervation:
A

Gluteus maximus

  • Function: Thigh extension, external rotation, abduction (superior fibers), adduction (inferior fibors)
  • Attachments: Sacrum, ilium, thoracolumbar fascia, iliotibial tract, femur (gluteal tuberosity)
  • Innervation: Inferior gluteal nerve (L5 to S2)
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82
Q

Describe the highlighted muscle

  • Collectively:
  • Function:
  • Part 1:
    • Attachments: Iliac crest, lesser trochanter of femur
    • Innervation: Femoral nerve
  • Part 2:
    • Attachments: Vertebrae, lesser trochanter of femur
    • Innervation: Ventral rami of spinal nerves
  • Part 3:
A
  • Collectively: Iliopsoas muscle
  • Function: Hip flexion
  • Part 1: Iliacus
    • Attachments: Iliac crest, lesser trochanter of femur
    • Innervation: Femoral nerve
  • Part 2: Psoas major
    • Attachments: Vertebrae, lesser trochanter of femur
    • Innervation: Ventral rami of spinal nerves
  • Part 3: Psoas minor
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83
Q

If a patient cannot flex their hip, which nerve is most likely injured?

A

Femoral nerve

Innervates the anterior compartment of the thigh; necessary for hip flexion and knee extension

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84
Q

Which structure is labeled by #11?

A

Adductor magnus

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85
Q

Which structure is labeled by #2?

A

Femoral artery

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86
Q

Which actions are controlled by the obturator nerve?

A

Hip adduction

Obturator innervates the medial compartment of the thigh (where the hip adductors live)

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87
Q

Which artery is labeled by C?

A

Lateral circumflex artery (goes to the anterior side)

Medial circumflex artery goes to the posterior side

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88
Q

Which structure is labeled by #2?

A

Biceps femoris

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89
Q

Which structures make up the illiopsoas?

A

1 - Psoas major

2 - Psoas minor

3 - Iliacus

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90
Q

Which structure is labeled by #13?

A

Tibia

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91
Q

Which structures are in group C?

A

Deep femoral artery and vein

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92
Q

Which structure is circled?

A

Lateral collateral ligament of the ankle

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93
Q

Which vessel is labeled by #9?

Where does it come from?

What does it supply?

A

lateral plantar artery

  • Branch of the posterior tibial artery
  • Lateral sole of the foot and toes
  • Contributes to the plantar arch (18), which anastomosis wtih the dorsalis pedis
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94
Q

The foot plantarflexes and extends (dorsiflexes) at the ___________ joint and inverts and everts at the ____________ joints

A

The foot plantarflexes and extends (dorsiflexes) at the upper ankle** joint and inverts and everts at the **lower ankle and transverse tarsal joints

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95
Q

A 61-year-old male presents with symptoms of intermittent claudication in his left leg (pain/cramping in muscles due to blockage or narrowing of their arterial supply). Coronal maximum-intensity projection from a high-resolution magnetic resonance angiogram demonstrates a complete occlusion (large white arrow) with a large collateral (arrowhead) of the _____________ artery. His right leg is normal

A. Common femoral

B. Deep femoral

C. Superficial femoral

D. Popliteal

E. Lateral femoral circumflex

A

C. Superficial femoral

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96
Q

Which structure is labeled by #6?

A

Medial head of the gastrocnemius

(Triceps surae = gastrocnemius (5, 6) + soleus (7)

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97
Q

Which structure is labeled by #15?

A

Flexor digitorum longus

(Also #12)

Flexor hallucis longus and flexor digitorum longus cross each other at the heel

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98
Q

Which artery is labeled by #19?

A

Posterior tibial artery

Branch of the popliteal artery (6)

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99
Q

Which structure is labeled by #7?

Function?

Innervation?

A

Rectus femoris

Hip flexion, knee extension

Femoral nerve

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100
Q

Which structure is labeled by F?

A

5th metatarsal

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101
Q

What actions are controlled by the superior gluteal nerve?

A

Hip abduction, lateral balance

Innervates gluteus medius and gluteus minimus

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102
Q

Which compartment of the leg is supplied by the deep fibular nerve?

What actions does this nerve control?

A

Anterior compartment

  • Ankle extension (dorsiflexion)
  • Toe extension (dorsiflexion)
  • Ankle inversion
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103
Q

Which structure is labeled by #9?

A

Extensor digitorum longus

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104
Q

Which strucutre is labeled by #6?

A

Semitendinosus

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105
Q

Which structure is labeled by E?

A

Shaft of the femur

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106
Q

Which structure is labeled by #5?

A

Lateral head of the gastrocnemius

(Triceps surae = gastrocnemius (5, 6) + soleus (7)

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107
Q

Which structure is labeled by #2?

A

Patella

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108
Q

Which structure is labeled by #8?

A

Extensor hallucis longus

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109
Q

Which structure is labeled by #1?

Which vessels can you see through this structure?

A

Saphenous opening

Inside we can see the femoral artery and femoral vein

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110
Q

Which nerve is labeled by #5?

What does it innervate?

Where does it come from?

A

Sural nurve

Provides sensory information in the calf region

Made up of branches from the tibial nerve and common fibular nerve (Which come from the sciatic nerve)

=> Sciatic nerve pain can radiate to the calf

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111
Q

Which structure is labeled by #4?

A

Adductor longus

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112
Q

Which structure is labled by #2?

(Flexor digitorum brevis has been reflected)

A

Flexor digitorum longus

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113
Q

Which joint is indicated by the red line? (#3)

A

Lower ankle aka subtalar joint

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114
Q

If a patient cannot extend (dorsiflex) their ankle, which nerve is most likely injured?

A

Deep fibular nerve

Innervates the anterior compartment of the leg

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115
Q

Which nerve supplies the interossei of the foot?

What actions does it control?

A

Lateral plantar nerve (branch of the tibial nerve)

  • Abduction of the toes
  • Adductionof the toes
  • Flex the MCP joints
  • Extend the IP joints
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116
Q

The structures outlined in purple are collectively called the…

A

Tarsals

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117
Q

A twenty five year old man receives a gunshot wound to the calf. The emergency room physician is concerned about damage to the vessels of the leg. The examiner pictured below is testing for patency of which vessel?

A

Posterior tibial artery

The posterior tibial artery passes posterior to the medial malleolus of the tibia. This is where the posterior tibial artery passes through the tarsal tunnel

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118
Q

Which structures stabilize the knee medially?

A
  • Medial (aka tibial) collateral ligament
  • Tendons of the “pes anserinus”
    • Semitendinosus
    • Gracilis
    • Sartorius
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119
Q

Which nerves of the lower leg originate primarily from the sacral region?

A

Superior gluteal

Inferior gluteal

Sciatic (tibial and fibular)

(Others are from lumbar)

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120
Q

Which structure is labeled by #8?

List the names of each part (#9-#12)

A

Quadriceps femoris

  • 9: Vastus intermedius
  • 10: Rectus femoris (only part of quadriceps that flexes the hip)
  • 11: Vastus medialis
  • 12: Vastus lateralis

Fig. 59.7 Adapted from Gilroy et al. Atlas of Anatomy, second edition, Fig. 29.34 B.

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121
Q

Loss of sensation in the toes may indicate damage to which nerve?

A

Fibular nerve (superficial branch)

The fibular nerve supplies the areas in blue, labeled #4 or #4a

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122
Q

Which structure is labeled by #2?

A

Head of the fibula

Fig. 56.3 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 27.1 A, 27.1 B.

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123
Q

Which structure is labeled by #4?

A

Calcaneus

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124
Q

Which structure is labeled by #19?

A

Extensor hallucis brevis

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125
Q

What is the function of the anterior cruciate ligament?

A

Prevents the tibia from sliding anteriorly relative to the femur

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126
Q

What is the purpose of the calcaneal tendon

A

Calcaneal tendon = Achilles tendon

Attaches the gastrocnemius (medial and lateral heads) and the soleus to the calcaneus

This allows these muscles to felx (plantarflex) the foot)

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127
Q

What kind of bone is labeled by #7?

A

Metatarsal

(This is the 1st metatarsal)

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128
Q

What is the most common type of ankle sprain?

A

Injury to the lateral collateral ligament of the ankle

Caused by hyperinversion

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129
Q

Which structure is labeled by #1?

A

Patella

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130
Q

Which strucutre is labeled by #7?

A

Semimembranosus

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131
Q

Which structure is labeled by #5?

What is its function?

A

Posterior cruciate ligament

Prevents the tibia from sliding too far backward

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132
Q

Describe the hip adductors

  • Primary muscles:
  • Nerve:
A

Hip adductors

  • Primary muscles: Adductor group
    • Adductor longus
    • Adductor magnus
    • Adductor brevis
    • Gracilis
  • Nerve: Obturator
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133
Q

Describe the posterior compartment of the leg

  • Muscles:
  • Actions:
  • Nerve:
  • Skeletal landmarks (attachments):
A

Posterior leg

  • Muscles:
    • Superficial: Triceps surae (Gastrocnemius)
    • Deep: Flexor digitorum longus, triceps surae (Soleus) Flexor hallucis longus, Tibialis posterior
  • Actions:
    • Superficial: Plantarflexion of the ankle
    • Deep: Plantarflexion of the foot and toes, inversion of the foot
  • Nerve:
    • Tibeal nerve (comes from sciatic)
  • Skeletal landmarks (attachments):
    • Heel of calcaneus, medial malleolus of tibia
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134
Q

Which muscles make up the deep posterior leg?

What are their functions?

A

Flexor digitorum longus

Tibialis posterior

Flexor hallucis longus

Plantarflex the foot, flex the toes

Tibialis posterior inverts the foot at the ankle

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135
Q

Which view of the lower leg is this?

A

Posterior view

Fig. 56.3 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 27.1 A, 27.1 B.

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136
Q

Which nerve is labeled by #3?

What does it innervate?

A

Superficial fibular nerve

Innervates the lateral compartment of the leg

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137
Q

Which structure is labeled by #4?

A

Medial meniscus

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138
Q

Which gait phase is showin in picture 1?

Which muscles are active?

A

Initial contact

  • Quadriceps femoris is extending the knee
  • Hamstrings are preventing hyperextension
    • Eccectrically active
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139
Q

Which structure is labeled by #17

A

Tendon of tibialis anterior

(#6 = tibialis anterior)

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140
Q

Which structure is labeled by #6?

A

Gracilis

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141
Q

Which is the best area (the one with the least possibility of overlap with other dermatomes) to test for normal sensation in the S1 dermatome?

A

Pinkie toe (digit 5)

(In the Anataomy Lab 2 ppt it says that this is FYI only, but one of the review questions was about this so…)

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142
Q

Which nerve runs with the lesser saphenous vein?

A

Sural nerve

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143
Q

Which structure is labeled by #4?

A

Greater trochanter of the femur

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

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144
Q

What causes IT band syndrome?

A

Friction between teh iliotibial band and the greater trochanter and/or the lateral condyle of the femur

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145
Q

The exercise depicted below (moving from position 1 to position 2) primarily involves contraction of the _________ muscles.

Which nerve supplies these muscles?

A

The exercise depicted below (moving from position 1 to position 2) primarily involves contraction of the hip adductor muscles.

Supplied by the obturator nerve

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146
Q

Which structure is labeled by #7?

A

Lateral condyle of the femur

(Articulates with lateral condyle of the tibia)

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

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147
Q

Which structure is labeled by #26?

A

Fibular artery

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148
Q

A 75 year old woman fell and landed on her hip. The given X-ray reveals fragmentation of her proximal femur. Which of the following muscles is pulling on the detached piece of femur displacing it?

A. Gluteus maximus

B. Ilopsoas

C. Rectus femoris

D. Gluteus medius

E. Adductor magnus

A

D. Gluteus medius

Greater trochanter is fractured; the gluteus medius inserts here

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149
Q

What kind of bone is labeled by #9?

A

Distal phalanx of the foot

(This is the 1st distal phalanx)

The hallux does not have a middle phalanx

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150
Q

Which joint is indicated in red?

A

Upper ankle joint

Articulaton between tibia, fibula, and talus

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151
Q

Which structure is labeled #4?

A

Calcaneus

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152
Q

List the pathway of the vein on the tibial side of the lower limb, from its most proximal point to its entry into the deep venous system

A
  • Dorsal venous arch
    • Passes in front of the medial malleolus
  • Greater saphenous vein
    • Through saphenous opening
  • Femoral vein (part of the deep venous system)
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153
Q

If a patient cannot adduct their hip, which nerve is most likely injured?

A

Obturator nerve

Innervates the medial compartment of the thigh, where the adductors live

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154
Q

Describe the medial rotators of the hip

  • Primary muscles:
  • Nerve:
A

Medial rotators of the hip

  • Primary muscles: Gluteus medius, gluteus minimus
  • Nerve: Superior gluteal
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155
Q

Which structure is labeled by #2?

A

Iliofemoral ligament

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156
Q

Which areas are supplied by the fibular nerve?

A

Areas indicated in blue and labeled #4 or #4a

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157
Q

Anterior compartment of the leg

  • Motion:
  • Innervation:
A

Anterior compartment of the leg

  • Motion: Extension aka Dorsiflexion
  • Innervation: Deep fibular nerve (comes from sciatic nerve)
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158
Q

Which number labels the ischial tuberosity?

Which muscle makes this mark?

A

26

Hamstrings (except short head of biceps femoris)

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159
Q

Which structure is labeled by #6?

A

Medial meniscus of the knee

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160
Q

Which structure is labeled by #7?

A

Extensor digitorum longus

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161
Q

Which structure is labeled by #11?

A

Tibialis posterior

(Also #14)

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162
Q

Which structures together make up the gastrocnemius?

A

5 - Lateral head

6 - Medial head

(Gastrocnemius heads + soleus = triceps surae)

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163
Q

Which structure is labeled #2?

A

Fibula

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164
Q

Which structure is labeled by #1?

A

Gluteus maximus

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165
Q

Describe varus knee

A

The knee is displaced laterallly

Weight bearing results in further bowing

(Picture B)

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166
Q

Which structure is labeled by #7?

A

Soleus

(Triceps surae = gastrocnemius (5, 6) + soleus (7)

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167
Q

If a patient cannot flex their knee, which nerve is most likely injured?

A

Tibial nerve

Innervates the posterior thigh and posterior leg

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168
Q

Which blood vessels supply the dorsum of the foot?

A

Dorsalis pedis (11), arcuate artery (19), deep plantar artery (15)

These are branches from the anterior tibial artery

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169
Q

Which structure is labeled by #5?

A

Lesser trochanter of the femur

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170
Q

Which structure is labeled by #14?

A

Tibeal tuberosity

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171
Q

Which structure is labeled by F?

Which muscle attaches here?

A

Adductor tubercle

Adductor magnus

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172
Q

Which structure is labeled by #6?

A

Lateral sural cutaneous nerve

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173
Q

Which structure is labeled by #4?

A

Extensor digitorum longus

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174
Q

Which artery is labeled by D?

A

Superficial femoral artery

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175
Q

Which structure is labeled by #3?

A

Ischial spine

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

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176
Q

List the muscles in the anterior compartment of the leg

What is their innervation?

Which artery supplies them?

A
  • Tibialis anterior (4, 14)
  • Extensor digitorum longus (5, 10)
  • Extensor hallucis longus (12, 16)

Deep fibular nerve

Anterior tibial artery

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177
Q

Which structure is labeled by #7?

A

Common iliac vein

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178
Q

Which nerve is labeled by #2?

What does it innervate?

A

Common fibular nerve

  • Lateral leg via superficial fibular nerve (26)
  • Anterior leg via deep fibular nerve (24)
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179
Q

Which areas are supplied by the tibial nerve?

A

Areas indicated in purple and labled #5 or #5a

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180
Q

Which structure is labeled by #4?

A

Greater trochanter of the femur

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181
Q

Which structure is labeled by #2?

What is its function?

What is its innervation?

A

Gluteus medius

​Hip abduction

Superior gluteal nerve

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182
Q

Which structure is labeled by #1?

A

Iliotibial tract

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183
Q

Which structure is labeled by #3?

A

Medial malleolus (of the tibia)

Fig. 56.3 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 27.1 A, 27.1 B.

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184
Q

Which structure is labeled by #11?

A

Gastrocnemius (medial head)

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185
Q

Which structure is labeled by #3?

A

Flexor digitorum longus

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186
Q

Which structure is labeled by #3?

A

Patelar ligament

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187
Q

Which phase of the gait is shown in this picture?

Which muscles are active?

A

Pre-swing

  • Adductor longus
  • Rectus femoris
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188
Q

Which gait phase is showin in picture 4?

Which muscles are active?

A

Initial swing

  • Rectus femoris and iliopsoas flex the hip to swing it forward
  • Hamstrings flex the knee to shorten the swing leg

(The next panel would be quadriceps femoris contracting to extend the knee later in the swing)

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189
Q

Which structure is labeled by #5?

A

Deep fibular nerve

(Also #1 - both branches are the deep fibular nerve)

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190
Q

Describe triceps surae

  • Muscles + Attachments:
  • Location:
  • Function:
  • Innervation:
A
  • Muscles:
    • Medial head of gastrocnemius
      • Femur + Calcaneus via calcaneal (achilles) tendon
    • Lateral head of gastrocnemius
      • Femur + Calcaneus via calcaneal (achilles) tendon
    • Soleus
      • Tibia, fibula + Calcaneus via calcaneal (achilles) tendon
  • Location: Superficial posterior compartment of the leg
  • Function: Flex the foot (plantarflex) the foot
  • Innervation: Tibial nerve
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191
Q

Which structures together make up the triceps surae?

A

5 - Lateral head of the gastrocnemius

6 - Medial head of the gastrocnemius

7 - Soleus

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192
Q

Which nerve is labeled by #2?

Which compartment does it innervate?

A

Femoral nerve

Innervates the anterior compartment of the thigh

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193
Q

Which bones make up the upper ankle joint?

Describe teh movement at this joint

A

Tibia, fibula, talus

Hinge joint

Flexion and extension only

(Inversion and eversion occur at the subtalar (aka lower ankle) joint)

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194
Q

Which structure is labeled by #6?

A

Flexor hallucis longus

The only muscle of the deep posterior leg that descends posterior to the posterior tibial artery and tibial nerve

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195
Q

Which structure is labled by #10?

(Flexor digitorum brevis has been reflected)

A

Abductor hallucis

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196
Q

Which movement shows eversion?

Which shows inversion?

Which ligament is stretched in each motion?

A
  • A = inversion
    • Stretches the lateral (fibular) collateral ligament
  • B = eversion
    • Stretches the medial (deltoid or tibular) collateral ligament
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197
Q

Which nerve supplies the areas indicated in purple (#5 or #5a)?

A

Tibial nerve

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198
Q

What kind of bone is labeled by #3?

A

Proximal phalanx of the foot

(This is the 5th proximal phalanx)

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199
Q

Which structure is labeled by #2?

A

Tibial tuberosity

200
Q

Which structure is labeled by #2?

A

Anterior tibeal artery

(Also #7)

201
Q

Which structures are labeled by #3?

What do they supply?

A

Inferior gluteal artery, vein, and nerve

Supplies the gluteus maximus

202
Q

Which structure is labeled by #5?

A

Ischiofemoral ligament

203
Q

Describe the lateral rotators of the hip

  • Primary muscles:
  • Nerve:
A

Lateral rotators of the hip

  • Primary muscles: Gluteus maximus, small rotators
  • Nerve: Inferior gluteal (Gluteus maximus), various (small rotators)
204
Q

Which structure is labeled by H?

A

Navicular

(boat shaped, aritculates with the talus)

205
Q

Which structure is labeled by #5?

A

Lateral malleolus (part of the fibula)

Fig. 56.3 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 27.1 A, 27.1 B.

206
Q

Describe structure #5

  • Muscle:
  • Function:
  • Attachments:
  • Innervation:
A
  • Muscle: Piriformis
  • Function: External rotation, abduction, extension of thigh, stabilize hip joint
  • Attachments: Sacrum, greater trochanter of femur
  • Innervation: Sacral plexus (S1, S2)
207
Q

Which structure is labeled by #7?

A

Medial condyle of the femur

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

208
Q

Which structure is labeled by #11?

(Where the artery and vein are emerging)

A

Adductor hiatus

The popliteal artery and vein are emerging through it

The femoral artery and vein become the popliteal when they cros through the adductor hiatus

209
Q

Which structure is labeled by #9?

What is its function?

A

Quadriceps femoris tendon

Connects quadriceps femoris to the patella

210
Q

Which structure is labeled by #12?

A

Extensor hallucis longus

211
Q

Which phase of the gait is shown in this picture?

Which muscles are active?

What are they doing?

A

Initial swing

  • Biceps femoris
    • Flex the knee
  • Anterior leg muscles (dorsiflexors aka extensors)
    • Prevent toe from draging
  • Iliopsoas + rectus femoris
    • Flex the hip
212
Q

What is the function of the posterior cruciate ligament?

A

Prevents the tibia from sliding posteriorly relative to the femur

213
Q

Which structure is labeled by #6?

A

Extensor hallucis longus

214
Q

Which structure is labeled by #2?

A

Ilium (body of th ilium)

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

215
Q

Which nerves of the lower leg originate primarily from the lumbar region?

A

Femoral and obturator

(Others are from sacral)

216
Q

What is this gait called?

Damage or weakness in which structures might cause this?

A

Trendelenbrg gait

Caused by any of the following on the side of the hip that is raised

  • Gluteus medius or minimus weakness
  • Superior gluteal nerve damage

Results in the person leaning toward the side of the weakness or damage

217
Q

Which structure is labeled by #12?

A

Posterior femoral cutaneous nerve

218
Q

Which structure is labeled by #3?

What is its function

A

Plantar aponeurosis

Thick layer of fascia deep to the skin of the sole of the foot; supports the longitudinal arch of the foot

Inflammation -> plantar fasciitis

219
Q

Which structure is labeled by #11?

Function?

Innervation?

A

Biceps femoris

Hip extension, knee flexion

9: Long head; sciatic nerve (tibial division)
10: Short head, sciatic nerve (common fibular division)

220
Q

Which structure is labeled by #12?

A

Patellar ligament

Attaches patella to tibial tuberosity

221
Q

What kind of bone is labeled by #2?

A

Middle phalanx of the foot

(This is the 5th middle phalanx)

222
Q

Describe the structure labeled by #16

  • Muscle:
  • Function:
  • Attachments:
  • Innervation:
A
  • Muscle: Abductor hallucis
  • Function: Abdux the hallux
  • Attachments: Calcaneus, proximal phalanx of the hallux
  • Innervation: Medial planter nerve (Branch of the tibial nerve)
223
Q

What is a sesamoid bone?

A

A bone that develops within a tendon

(ex: patella)

224
Q

Which structures form the ball and socket part of the hip joint?

A

Acetabulum of the pelvis

Femoral head

225
Q

Which structure is labeled by #2?

A

Sciatic nerve

226
Q

If a patient cannot flex their knee, which nerve is most likely injured?

A

Tibial nerve

Innervates the posterior thigh and posterior leg

227
Q

Which structure is labeled by #2?

What is its function?

A

Anterior cruciate ligament

Prevents the tibia from sliding anteriorly relative to the femur

228
Q

Which is the best area (the one with the least possibility of overlap with other dermatomes) to test for normal sensation in the L5 dermatome?

A

Medial side of the second toe

(In the Anataomy Lab 2 ppt it says that this is FYI only, but one of the review questions was about this so…)

229
Q

Which structure is labeled by #7?

A

Pubis (medial portion of the pubis)

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

230
Q

Which structure is labeled by #2?

A

Transverse ligament of the knee

231
Q

Which muscle is labeled by #3?

A

Gluteus minimus

232
Q

Which structure is labeled by #3?

A

Biceps femoris (Short head)

233
Q

Identify the ischial tuberoisty

A
234
Q

Which structure is labeled by #14?

A

Tibial tuberosity

235
Q

Which structure is labeled by C?

Which muscles attach to it?

A

Lesser trochanter of the femur

Iliopsoas

236
Q

What are the functions of the cruciate ligaments?

A

The cruciate ligaments act to prevent anterior-posterior sliding of the tibia on the femur.

  • ACL – prevents tibia from sliding forward
  • PCL – prevents the tibia from sliding backward
237
Q

Which structures are labeled by #6?

A

Gemellus superior and inferior

238
Q

Which structure is labeled by #3?

A

Adductor brevis

239
Q

Which phase of the gait is shown in this picture?

Which muscles are active?

What are they doing?

A

Mid swing

  • Hip flexors (Iliopsoas, rectus femoris)
  • Dorsiflexors (extensors)
    • Prevent foot from slapping down
240
Q

The bones of the knee joint (Tibia, fibula, femur) do not fit snugly together. Which pieces of cartilage improve this fit?

A

The medial meniscus and lateral meniscus

241
Q

Describe the hip extensors

  • Primary muscles:
  • Nerve:
A

Hip extensors

  • Hamstrings - Sciatic nerve
    • Tibeal portion, except short head of biceps femoris (common fibular nerve)
  • Gluteus maximus - Inferior gluteal nerve
242
Q

Which phase of the gait is shown in this picture?

Which muscles are active?

What are they doing?

A

Mid-stance

  • Gluteus medius - prevents the pelvis on the swinging leg from dropping; contract to keep the torso above the leg on the ground, rather than drooping over the swinging leg
  • Gastrocnemius, soleus - Late mid-stance as we get ready to push off of the foot?
243
Q

Which structure is labeled by #20?

What is its function?

A

Popliteus

It unlocks the knee

(Note: the knee locks when you fully extend it and put weight on it; this decreses the muscular effort required for standing)

244
Q

Which artery is labeled by E?

A

Popliteal artery

245
Q

Which structure is labeled by #1?

A

Lateral condyle of the tibia

Fig. 56.3 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 27.1 A, 27.1 B.

246
Q

Which structure is labeled by #5?

A

Lateral epicondyle of the femur

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

247
Q

Which structures are labeled by #4?

What do they supply?

A

Superior gluteal vein, artery, and nerve

Supply gluteus medius and gluteus minimus

248
Q

Which structure is labeled by #5?

A

Medial epicondyle of the femur

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

249
Q

During a softball game a ball hits a player on the lateral side of the knee. She presents with the inability to dorsiflex her foot. What nerve is damaged?

A

Deep fibular nerve -> inability to dorsiflex the foot

However, if she is hit in the lateral knee, the common fibular nerve is likely injured; it has not yet split into its superficial and deep branches. Eversion of the foot is likely absent as well.

250
Q

Which areas are supplied by the obturator nerve?

A

Areas indicated in orange and labeled #3

251
Q

Which structures are labeled by #9?

A

Extensor digitorum brevis

252
Q

Describe the muscle shown in this picture

  • Muscle + Attachments
    • 1.
    • 2.
    • 3.
    • 4.
  • Function:
  • Innervation:
A
  • Muscle: Hamstrings
      1. Semimembranosus
        * Ischial tuberosity, medial condyle of tibia
      1. Semitendinosus
        * Ischial tuberosity, tibial tuberosity
      1. Biceps femoris (long head)
        * Ischial tuberosity, lateral condyle of tibia, head of fibula
      1. Biceps femoris (short head)
        * Femur, lateral condyle of tibia, head of fibula
  • Function: Extend hip, flex knee
  • Innervation: Sciatic nerve
    • Tibial tract for all except the short head of biceps femoris
253
Q

Which structure is labeled by #8?

A

Lateral epicondyle of the femur

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

254
Q

Which structure is labeled by #3?

A

Talus

255
Q

Which structure is labeled by#5?

A

Tibial nerve

Runs alongside the tibeal artery

256
Q

Which structures is labeled by #7?

What does it supply?

A

Sciatic nerve

Supplies the back of the thigh and all of the leg

  • Tibial tract
    • Most of the posterior thigh, except the short head of biceps femoris
    • Posterior leg (deep and superficial compartments
  • Fibular tract
    • Short head of biceps femoris
    • Anterior leg (deep fibular nerve)
    • Lateral leg (superficial fibular nerve)
257
Q

Identify the pubis

A
258
Q

Describe the structure labeled by #10

  • Muscle:
  • Function:
  • Attachments:
  • Innervation:
A
  • Muscle: Adductor longus
  • Function: Adduct the femur, stabilize the hip joint
  • Attachments: Pubis, femur
  • Innervation: Obturator (L2-L4)
259
Q

What are the primary ligaments of the ankle?

A
  • Lateral (fibular) collateral
    • Injured during hyperinversion
  • Medial (deltoid or tibial) collateral
    • Injured during hypereversion
260
Q

Which actions are controlled by the superficial fibular nerve?

A

Ankle flexion

Ankle eversion

The superficial fibular nerve innervates the lateral compartment of the leg

261
Q

Label the boundaries of the femoral triangle

  • A:
  • B:
  • C:

Label the structures within the femoral triangle

  • 1:
  • 2:
  • 3:
A

Label the boundaries of the femoral triangle

  • A: Inguinal ligament
  • B: Sartorius
  • C: Adductor longus

Label the structures within the femoral triangle

  • 1: Femoral nerve (most lateral structure)
  • 2: Femoral artery
  • 3: Femoral vein (most medial structure)
262
Q

Which vessel is labeled by #3?

Where does it join the deep venous system?

A

Great saphenous vein

Empties into the femoral vein at the saphenous opening (#1)

263
Q

If a patient cannot invert their ankle, which nerves might be injured?

A

Tibial nerve and/or deep fibular nerve

Both participate in ankle inversion

264
Q

Which strucutre is labeled by #3?

A

Biceps femoris

265
Q

Which actions are controlled by the tibial nerve?

A
  • Hip extension
  • Knee flexion
  • Ankle, toe flexion
    • Plantarflexion
  • Ankle inversion
  • Toe adduction and abduction

Tibial nerve innervates the posterior thigh and leg

266
Q

Which structure is labeled by #5?

A

Deep femoral artery

Fig. 59.7 Adapted from Gilroy et al. Atlas of Anatomy, second edition, Fig. 29.34 B.

267
Q

Hip flexors are found in the _________ compartment of the thigh, and are supplied by the ________ nerve

A

Hip flexors are found in the anterior** compartment of the thigh, and are supplied by the **femoral nerve

268
Q

Which structures comprise the rotator cuff of the hip?

A
  • Hip extensors
    • Gluteus maximus
  • Lateral rotators
    • Piriformis
    • Quadratus femoris
  • Hip Abductors
    • Gluteus medis
    • Gluteus minimus
269
Q

Where is the fibular nerve most likely to be injured?

What deficits will result?

A

As it winds around the fibula

At this point, it is the common fibular nerve; both superficial and deep branches will be affected

  • Loss of superficial fibular nerve -> loss of lateral leg muscle function (fibularis longus and fibularis brevis)
    • -> loss of foot eversion
  • Loss of deep fibular nerve -> loss of anterior leg muscle function (extensor digitorum longus, extensor hallucis longus, and tibialis anterior)
    • -> Loss of foot and ankle extension (dorsiflexion)
  • > Foot drop/slapping gait
270
Q

Which structure is labeled by #8?

A

Dorsalis pedis artery

(Branch off of the anterior tibeal nerve)

271
Q

Which structure is labeled by #2?

A

Psoas minor

(Part of the iliopsoas)

272
Q

Which structure is labeled by #6

A

Obturator foramen

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

273
Q

Which structure is labeled by #13?

A

Gracilis

274
Q

Which structure is labeled by #2

A

Talus

275
Q

Which structure is labeled by #4?

A

Lesser trochanter of the femur

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

276
Q

Identify the iliac crest

A
277
Q

A former ballet dancer shows severe arthritic change in the talus and all bones that articulate with it. Which bone has been spared?

A) Calcaneus

B) Cuboid

C) Fibula

D) Navicular

E) Tibia

A

B) Cuboid

(Note: The tarsals were not listed in the structures we had to know, but this was one of the review questions in the slide)

278
Q

What features of the hip joint limit its range of motion in comparison to the shoulder joint?

A
  • Deep socket of the acetabulum
  • Tight articulation between the femoral head and the acetabulum
    • There is more overlap between the femoral head and the acetabulum than between the head of the humerus and the glenoid
  • Thick, strong intrinsick ligaments
    • Iliofemoral and ischiofemoral
279
Q

Which structure is labeled by #4?

A

Common fibular nerve

280
Q

Cardiac catheterization is the insertion of a catheter into a chamber or vessel of the heart. The femoral artery is often utilized for this purpose. The pulses of the femoral artery will be felt…

A. Medial to the femoral nerve

B. Medial to the femoral vein

C. Medial to the femoral canal

A

A. Medial to the femoral nerve

Pulses are felt in arteries

The femoral artery (2) is between the femoral nerve (1) and the femoral vein (3)

281
Q

Which compartment of the leg is supplied by the superficial fibular nerve?

What actions does this nerve control?

A

Lateral compartment

Ankle eversion

282
Q

Which view of the lower leg is this?

A

Anterior view

Fig. 56.3 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 27.1 A, 27.1 B.

283
Q

Which nerve supplies the areas indicated in blue (#4 and #4a)?

A

Fibular nerve

284
Q

Which nerve is labeled by #1?

What does it innervate?

A

Saphenous nerve

Provides sensory innervation to the skin along the saphenous vein (Surface of the medial leg, medial malleolus, part of the sole of the foot)

285
Q

Which number labels the lesser trochanter?

Which muscle makes this mark?

A

20

Iliopsoas

286
Q

List the pathway of the vein on the fibular side of the lower limb, from its most proximal point to its entry into the deep venous system

A
  • Dorsal venous arch
    • Passes behind the lateral malleolus
  • Lesser saphenous vein
    • Through popliteal fossa
  • Popliteal vein (part of the deep venous system)
287
Q

Which structure is labeled by #6?

A

Lateral condyle of the femur

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

288
Q

Which strucutre is labeled by #2?

A

Vastus lateralis

289
Q

Which structure is labeled by #6?

A

Rectus femoris

(Part of quadriceps femoris)

290
Q

Which structure is indicated by #1?

What is its primary function?

A

Gluteus maximus

Hip extension

291
Q

Which structure is labeled by #3?

A

Lateral head of gastrocnemius

292
Q

Which structure is labeled by #3?

A

Tibialis posterior

In the lower leg, it sits between flexor digitorum longus and flexor hallucis longus

However, flexor digitorum longus crosses both tibialis posterior and flexor hallucis longus as it descends behind the medial malleolus (but anterior to the tibial nerve and posterior tibial artery)

293
Q

Which structure is labeled by #4?

A

Calcaneus

294
Q

The nerves on the dorsal side of the foot are branches of the ____________ nerves

A

The nerves on the dorsal side of the foot are branches of the superficial and deep fibular nerves

295
Q

Which structure is labeled by #11?

A

Patella

296
Q

Which nerve is labeled by #16?

What does it innervate?

A

Deep fibular nerve

  • Anterior compartment of the leg
  • Becomes cutaneous between the hallux and 2nd toe => sensory innervation
    • Testing sensation between the hallux and 2nd toe can test the integrity of the deep fibular nerve
297
Q

Which structure is labeled by #6?

A

Fibularis brevis

(#8 = tendon of fibularis brevis)

298
Q

Which structure is labeled by #4?

A

Tensor fasciae latae

299
Q

The saphenous nerve is a terminal branch of the ______ nerve

A

The saphenous nerve is a terminal branch of the femoral nerve

300
Q

Loss of sensation in the medial thigh and medial leg may idicate damage to which nerve?

A

2 = femoral nerve

Femoral nerve

(Yellow, #2 and #2a)

301
Q

Which vein is labeled by #4?

Where does it join the deep venous system?

A

Lesser saphenous vein

Empties into the popliteal vein at the popliteal fossa

302
Q

Which structure is labeled by #12?

What is its function?

Attachments?

Innervation?

A

Flexor digitorum longus (Also #15)

Flex (plantarflex) the foot and toes

Tibia, distal phalanges (Analagous to flexor digitorum profundus of hand)

Tibial nerve

303
Q

A girl steps on piece of glass and reports loss of sensation on the lateral third of the sole of the foot. What muscle is also likely paralyzed?

A) Third lumbrical

B) Fibularis longus

C) Flexor hallucis brevis

D) First lumbrical

E) Abductor hallucis

A

A) Third lumbrical

The lateral plantar nerve is damaged; it innervates all of the lumbricals except the first lumbrical

(The medial plantar nerve innervates flexor hallucis brevis, first lumbrical, and abductor hallucis; the lateral plantar nerve does everything else)

304
Q

Which phase of the gait is shown in this picture?

Which muscles are active?

What are they doing?

A

Terminal swing

  • Quadriceps femoris
    • Exend the knee
  • Hamstrings
    • Prevent hyperextension of the knee
  • Ankle dorsiflexors (extensors)
    • Prevent foot from slapping down
  • Iliopsoas, rectus femoris
    • Flex the hip
305
Q

Which structure is labeled by #6?

A

Ischial spine

306
Q

If a patient cannot abduct their hip, which nerve is most likely injured?

A

Superior gluteal nerve

Innervates gluteus medius and minimus; necessary for hip abduction

307
Q

Which structure is labeled by #8?

A

Adductor longus

308
Q

What is the difference between the patellar tendon and the patellar ligament?

A

Patellar tendon: Attatches quadriceps femoris to the patella

Patellar ligament: Attaches the patella to the tibia

309
Q

Which structure is labeled by #10?

A

Popliteal artery and vein

310
Q

Which structure is labeled by #5?

A

Ischial tuberosity

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

311
Q

Where in the gluteal region are intramuscular injections made?

Why?

A

Superiolateral region

Avoid damage to nerves and vessels

312
Q

Damage to which nerve would result in pain or sensory loss on the medial side of the lower leg?

A

Saphenous nerve

Cuteneous branch of the femoral nerve

Note: This would not result in any motor deficit

313
Q

Which structure is labled by #3?

What is their action?

(Flexor digitorum brevis has been reflected)

A

Lumbricals

Flex MTP and extend PIP and DIP joints of the toes

They attach to the tendons of flexor digitorum longus

314
Q

Describe the hip abductors

  • Primary muscles:
  • Nerve:
A

Hip abductors

  • Primary muscles: Gluteus medius, gluteus minimus
  • Nerve: Superior gluteal
315
Q

Describe the muscle labeled by #4

  • Muscle:
  • Function:
  • Attachments:
  • Innervation:
A
  • Muscle: Tibialis anterior
  • Function: Foot dorsiflexion (extension) and inversion
  • Attachments: Tibia, medial foot
  • Innervation: Deep fibular nerve
316
Q

Which structure is labeled by #1?

A

Head of the tibia

Fig. 56.3 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 27.1 A, 27.1 B.

317
Q

Which structure is labeled by #15?

A

Flexor hallucis brevis

318
Q

Which structure is labeled #1?

A

Tibia

319
Q

If a patient cannot climb stairs, which nerve is most likely injured?

A

Inferior gluteal nerve

Innervates gluteus maximus; necessary for hip extension and lateral rotation

320
Q

Which structure is indicated by #5?

What is its primary function?

A

Gluteus medius

Hip abduction

321
Q

Which structure is labeled by A?

A

Acetabulum

(Head of the femur is right there too)

322
Q

Which structure is labeled by #1?

A

Iliac crest

323
Q

Which structure is labeled by #4?

A

Femoral vein

324
Q

Which structure is labeled by I?

A

Tibia

325
Q

Identify the ischium

A
326
Q

Which structure is labeled by #1?

A

Iliotibial tract

327
Q

Which structure is labeled by #10

A

Tibialis anterior

328
Q

Which structure is labeled by #2?

A

Lateral meniscus

329
Q

Which structure is labeled by #3?

A

Tibialis anterior

330
Q

Which structure is labeled by #2?

A

Neck of the femur

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

331
Q

Which structure is labeled by #10?

Which nerve runs alongside it?

A

Posterior tibial artery

Tibial nerve

332
Q

What is the purpose of most of the muscles and ligaments of the foot?

A

Support the longitudinal and transverse arches

333
Q

Which structure is labeled by #2?

A

Medial condyle of the tibia

Fig. 56.3 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 27.1 A, 27.1 B.

334
Q

Which structure is labeled by #1?

A

Iliac crest

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

335
Q

What view of the femur is this?

A

Anterior view

(Patellar surface is at the bottom between the medial and lateral condyles)

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

336
Q

Which structure is labeled by E?

A

Cuboid

(Most inferior tarsal)

337
Q

Which structure is labeled by B?

A

Great saphenous vein

(In the superficial fascia)

338
Q

Describe the structure labeled by #4

  • Muscle:
  • Function:
  • Attachments:
  • Innervation:
A
  • Muscle: Fibularis longus
  • Function: Evert the foot, plantarflex (flex) the foot
  • Attachments: Fibula, Medial cuneiform, 1st metatarsal
    • Forms a sling underneath the foot
  • Innervation: Superficial fibular nerve
339
Q

Which structure is labeled by #7?

What innervates it?

A

Gastrocnemius

Tibial nerve

340
Q

Which structure is labeled by #6?

A

Internal iliac vein

341
Q

Which structure is labeled by #9?

A

Vastus medialis

(Part of quadriceps femoris)

342
Q

Which structure is labeled by G?

A

Lateral epicondyle

343
Q

Which spinal nerves supply the lumbo-sacral plexus?

A

L2 - S3

344
Q

Which structure is labeled by #8?

A

Inferior vena cava

345
Q

Which nerve runs with the greater saphenous vein?

A

Saphenous nerve

346
Q

Which artery is labeled by B?

A

Common femoral artery

347
Q

Which structure is labeled #3?

A

Talus

348
Q

Which structure is labeled by #3?

A

Tibial tuberosity

Fig. 56.3 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 27.1 A, 27.1 B.

349
Q

Which structure is labeled by #9?

A

Medial malleolus of the tibia

350
Q

Which structure is labeled by #3?

A

Popliteal vein

351
Q

Which nerve supplies the lumbricals of the foot?

What actions does it control?

A

1st and 2nd lumbrical - Medial plantar nerve

3rd and 4th lumbrical - Lateral plantar nerve

  • Flex MCP
  • Extend IP
352
Q

What actions are controlled by the deep fibular nerve?

A
  • Ankle and toe extension
    • Dorsiflexion
  • Ankle inversion
353
Q

Which structure is labeled by #7?

What does it innervate?

A

Saphenous nerve

Skin of the medial leg

Fig. 59.7 Adapted from Gilroy et al. Atlas of Anatomy, second edition, Fig. 29.34 B.

354
Q

A girl falls off a bicycle and gets a cut immediately posterior to the medial malleolus. Which of the following structures might be damaged?

A) Tendon of the tibialis anterior muscle

B) Tendon of the fibularis (peroneus) longus muscle

C) Superficial fibular (peroneal) nerve

D) Sural nerve

E) Tibial nerve

A

E) Tibial nerve

355
Q

Which structure is labeled by #1?

A

Femoral nerve

356
Q

Which phase of the gait is shown in this picture?

Which muscles are active?

What are they doing?

A

Terminal stance

  • Gastrocnemius, soleus
    • Flex (plantarflex) the foot at the ankle joint to push of the ground and into the next step
357
Q

Which nerve is labeled by #8?

What does it innervate?

A

Lateral plantar nerve

Adductor hallucis, lateral lumbricals, interossei, quadratus plantae

(Analogous to the ulnar nerve - it innervates all of the intrinsic muscles of the foot except the most medial)

358
Q

Which structure is labeled by #10?

A

Popliteus

359
Q

Which structure is labeled by #2?

A

Femoral nerve

(Innervates the anterior compartment of the thigh)

Fig. 59.7 Adapted from Gilroy et al. Atlas of Anatomy, second edition, Fig. 29.34 B.

360
Q

If a patient cannot evert their ankle and has weakness with plantarflexion (flexion), which nerve is most likely injured?

A

Superficial fibular nerve

Innervates the lateral compartment of the leg

Note: the tibeal nerve also participates in ankle flexion (plantarflexion), but does not participate in ankle eversion

361
Q

Which structure is labeled by #4

A

Soleus

362
Q

Which structure is labeled by C?

What movements occur here?

A

Lower ankle (subtalar) joint

Eversion and inversion

363
Q

Which view of the foot is this?

A

Plantar (inferior) view

364
Q

Which structure is labeled by #6?

A

Head of the fibula

Fig. 56.3 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 27.1 A, 27.1 B.

365
Q

Which structure is labeled by #7?

A

Iliotibeal tract

366
Q

A physician asks a patient to stand on his tiptoes so she can evaluate lower limb function.

What nerve is she evaluating?

Which muscles?

A

Tibial nerve - innervates the posterior compartment of the leg

  • Triceps surae
    • Gastrocnemius
    • Soleus
  • Flexor digitorum longus
  • Tibialis posterior
  • Flexor hallucis longus
367
Q

Which structure is labeled by H?

A

Medial epicondyle

368
Q

Which vein is labeled by #2?

Where does it join the deep venous system?

A

Great saphenous vein

Empties into the femoral vein at the saphenous opening (in the crease of the hip)

369
Q

The sural nerve is a terminal branch of the ________ nerve

A

The sural nerve is a terminal branch of the tibial and fibular nerves

370
Q

After an auto accident a woman presents with a foot that is dorsiflexed and everted. Knee extension is normal, but she cannot stand on her toes. She has little sensation on the distolateral part of her calf. What nerve is damaged?

A) Common fibular

B) Deep fibular

C) Femoral

D) Superficial fibular

E) Tibial

A

E) Tibial

371
Q

Describe the posterior compartment of the thigh

  • Muscles:
  • Actions:
  • Nerve:
  • Skeletal landmarks (attachments):
A

Posterior compartment of the thigh

  • Muscles: Hamstrings
    • ​Semimembranosus, semitendinosus, biceps femoris
  • Actions: Hip extension, knee flexion
  1. Nerve: Sciatic (tibeal), fibular for short head of biceps femoris
    * Skeletal landmarks (attachments): Ischial tuberosity
372
Q

Describe valgus knee

A

The knee is displaced medially

(Picture A)

373
Q

Which structure is labeled by G?

Which movements occur here?

A

Transverse tarsal joint

Talus + navicular and calcaneus + cuboid

Inversion and eversion

374
Q

Which structure is labeled by #5?

A

Sartorius

375
Q

What kind of bone is labeled by #4?

A

Metatarsal

(This is the 5th metatarsal)

376
Q

Which structure is labeled by #11?

A

Tendon of fibularis brevis

377
Q

Which structure is labeled by #4?

(The part of the bone)

A

Head of the fibula

378
Q

Which structure is labeled by #2?

A

Pectineus

379
Q

Which structure is labeled by #13?

A

Flexor hallucis longus

(Also #16)

380
Q

Which structure is labeled by #1?

A

Anterior superior iliac spine

(Part of ilium)

381
Q

Which structure is labeled by #8?

A

Calcaneal tendon

382
Q

The tendon of what muscle inserts at the location labeled above?

  1. Gluteus medius
  2. Gluteus maximus
  3. Iliopsoas
  4. Rectus femoris
A

a. Gluteus medius (and minimus)

383
Q

Which structure is labeled by #1?

A

Greater trochanter of the femur

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

384
Q

Which structure is labeled by A?

A

Talus

385
Q

Which structures make up the hamstring?

A

3 - Biceps femoris

6 - Semitendinosus

7 - Biceps femoris

386
Q

Which actions are controlled by the femoral nerve?

A

Hip flexion, knee extension

Femoral nerve innervates the anterior compartment of the thigh

387
Q

Which structure is labeled by #5?

A

Adductor magnus

388
Q

Which structure is labeled by #8?

A

Fibularis brevis

(Also #6)

389
Q

What view of the foot is this?

A

Dorsal (superior) view

390
Q

Which structures are labeled by #6?

What are their more distal destinations?

A

Femoral artery, femoral vein, saphenous nerve

Femoral artery and femoral vein will pass through adductor hiatus on their way to the posterior leg/popliteal fossa

Saphenous nerve will travel with the great saphenous vein to innervate the skin of the medial leg

Fig. 59.7 Adapted from Gilroy et al. Atlas of Anatomy, second edition, Fig. 29.34 B.

391
Q

Identify the ischial spine

A
392
Q

Which structure is labeled by #4?

A

Common fibular nerve

393
Q

Describe the structure outlined in blue (middle outlined structure)

  • Muscle:
  • Function:
  • Attachments:
  • Innervation
A
  • Muscle: Adductor longus
  • Function: Adduct the thigh
  • Attachments: Pubis, femur
  • Innervation: Obturator nerve

Other superficial adductors in this picture:
Yellow = pectineus
Green = gracilis

394
Q

Which phase of the gait is shown in this picture?

Which muscles are active?

What are they doing?

A

Initial contact (heel-strike)

  • Quadriceps - knee extension
  • Hamstrings - eccentric action to prevent the leg from hyperextending
  • Dorsiflexors (extenstors) - dorsiflex the foot to prevent it from slapping
    • Muscles of the anterior compartment of the leg
395
Q

Which muscle is labeled by #1?

A

Gluteus medius

396
Q

Which structure is labeled by #3?

A

Saphenous vein

397
Q

List the muscles of the medial compartment of the thigh.

Which nerve supplies this compartment?

A
  • Pectineus
  • Adductor longus
  • Gracilis
  • Adductor brevis
  • Adductor magnus

Supplied by the obturator nerve

398
Q

Which strucutre is labeled by #4?

A

Medial malleolus

399
Q

Which structure is labeled by #5?

A

External iliac vein

(Femoral vein becomes external iliac vein when it crosses from the leg into the pelvis

400
Q

The tibial tuberosity has its own secondary ossification center and it may separate to varying degrees from the tibial shaft in a physically active adolescent (Osgood-Schlatter’s disease). Which muscle inserts on the tibial tuberosity causing the pull of the epiphysis away from the tibial shaft?

A. Adductor magnus

B. Iliopsoas

C. Quadriceps femoris

D. Sartorius

E. Gracilis

A

C. Quadriceps femoris

401
Q

Which structure is labeled by #1?

A

Iliac crest

402
Q

Which structure is labeled by D?

Which muscles attach to it?

A

Ischial tuberosity

Hamstrings

403
Q

Which artery is labeled by A?

A

Deep femoral artery

404
Q

Which structure is labeled by #4?

A

Ischium (body of the ischium)

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

405
Q

What type of gait deviation might yous ee in someone with a common fibular nerve injury?

A

Foot drop

The muscles of the anterior (dorsiflexor) compartment will not work, so they cannot hold the foot up; it will slap to the ground

Eversion will also be lost

406
Q

Which structure is labeled by #6?

Function?

Innervation?

A

Sartorius

Hip: Flexion, abduction external rotation

Knee: Flexion, internal rotation

Femoral nerve

407
Q

Describe the lateral compartment of the leg

  • Muscles:
  • Actions:
  • Nerve:
  • Skeletal landmarks (attachments):
A

Lateral leg

  • Muscles: Fibularis longus, fibularis brevis
  • Actions: Eversion of the foot, some plantarflexion
  • Nerve: Superficial fibular nerve (comes from sciatic)
  • Skeletal landmarks (attachments):
    • Head of fibula, lateral malleolus
408
Q

Which structure is labeled by D?

A

Calcaneus

409
Q

Which structure is labeled by #4?

A

Medial malleolus (part of the tibia)

Fig. 56.3 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 27.1 A, 27.1 B.

410
Q

List the labeled structures

        1. 5.
A
  1. Gluteus Medius
  2. Piriformis
  3. Gemellus
  4. Quadratus Femoris
  5. Adductor Longus
411
Q

Describe the anterior compartment of the leg

  • Muscles:
  • Actions:
  • Nerve:
  • Skeletal landmarks (attachments):
A

Anterior leg

  • Muscles:
    • Tibialis anterior, extensor digitorum longus, extensor hallucis longus
  • Actions:
    • Extension (dorsiflexion) of the ankle, inversion of the ankle
  • Nerve:
    • Deep fibular nerve (comes from sciatic)
  • Skeletal landmarks (attachments):
    • Lateral malleolus, medial malleolus of tibia
412
Q

Which structure is labeled by #7?

A

Fibularis longus

(Also #5)

413
Q

Which nerve is labeled by #8?

What does it innervate

A

Tibial nerve

Innervates the posterior compartment of the leg
(superficial and deep)

414
Q

A physician suspects that a patient has a herniated disc that is affecting the 4th lumbar spinal nerve (L4). Which is the best area (the one with the least possibility of overlap with other dermatomes) for the physician to test for normal sensation in the L4 dermatome?

A. The medial surface of the big toe

B. The anterior surface of the knee

C. The gluteal fold

D. The lateral malleolus

A

A. The medial surface of the big toe

(In the Anataomy Lab 2 ppt it says that this is FYI only, but one of the review questions was about this so…)

415
Q

Which structure is labeled by #3?

A

Greater trochanter of the femur

416
Q

Describe the highlighted muscle

  • 1:
  • 2:
  • 3:
  • Which part of the larger muscle is hidden?
  • Which highlighted muscle acts to flex the hip?
  • What function do all of these muscles share?
A

Quadriceps femoris

  • 1: Vastus lateralis
  • 2: Rectus femoris
  • 3: Vastus medialis
  • Hidden: Vastus intermedius
  • Hip flexor: Rectus femoris
  • All: Knee extension
417
Q

Which structure is labeled by #8?

What is its function?

A

Patellar ligament

Attaches the patella to the tibial tuberosity

418
Q

Which structure is indicated by #4?

What is its primary function?

A

Gluteus minimus

Hip abduction

419
Q

List the 7 phases of the gait cycle

A
  1. Initial contact
  2. Loading response
  3. Mid-stance
  4. Terminal stance
  5. Pre-swing
  6. Mid-swing
  7. Terminal swing
420
Q

Which structure is labeled by #1?

A

Inguinal ligament

Fig. 59.7 Adapted from Gilroy et al. Atlas of Anatomy, second edition, Fig. 29.34 B.

421
Q

Which structure is labeled by #8?

A

Vastus laterais

(Part of quadriceps femoris)

422
Q

Which structure is labeled by #29?

Which nerve follows this artery?

A

Anterior tibial artery

Deep fibular nerve

423
Q

Which structure is labeled by #3?

A

Lateral meniscus of the knee

424
Q

Which structure is labeled by #5?

A

Fibularis longus

425
Q

Which structure is labeled by #4?

A

Obturator nerve

Innervates the medial compartment of the thigh (adductors)

Fig. 59.7 Adapted from Gilroy et al. Atlas of Anatomy, second edition, Fig. 29.34 B.

426
Q

Which structure is labeled by #16?

A

Flexor hallucis longus

(Also #13)

Note: Flexor hallucis longus and flexor digitorum longus cross each other at the heel

427
Q

Which vessel is labeled by #20?

Where does it come from?

What does it supply?

A

Medial plantar artery

Branch of the posterior tibial artery

Medial sole of the foot and toes

428
Q

Which structure is labeled by #1?

What is its function?

A

Posterior cruciate ligament

Prevents the tibia from sliding posteriorly relative to the femur

429
Q

Which structure is labeled by #11?

A

Flexor hallucis longus

430
Q

Which structure is labeled by #1?

A

Adductor magnus

431
Q

Which structure is labeled by #7?

A

Ischial spine

432
Q

Which structure is labeled by #6?

A

Talus

433
Q

Which bones make up the lower ankle (subtalar) joint?

Describe the movement at this joint

A

Talus, calcaneus

Inversion and eversion

(Flexion and extension take place at the upper ankle joint)

434
Q

Which nerve supplies the area indicated in orange (#3)?

A

Obturator nerve

435
Q

Which strucutre is labeled by #5?

A

Sartorius

436
Q

Which structure is labled by #9?

(Flexor digitorum brevis has been reflected)

A

Flexor hallucis longus

437
Q

Which structure is labeled by #1?

A

1st proximal phalanx

438
Q

Which is the best area (the o