Superficial And Osseous Lower Limb

Question 1

Gluteal Region
Boundary?
Composed of?

Answer 1

• transition between the trunk, superiorly, and the free lower limb, inferiorly
• posterior rounded buttock and the lateral hip region
• bounded by iliac crests, superiorly-the gluteal folds, inferiorly-the intergluteal fold (natal fold), medially-greater trochanter, laterally-ASIS to greater trochanter, anteriorly

Question 2

What composes the gluteal region?

Answer 2

-gluteal muscles and fat comprise the majority

Question 3

Thigh region

Answer 3

• inferior from the gluteal, abdominal, and perineal regions, superiorly
• to the knee region, posteriorly
• and ischiopubic ramus, medially

Question 4

Knee region

Answer 4

• includes the prominences of the distal femur, proximal tibia, and proximal fibula-as well as their joints, between them
• posterior knee includes the popliteal fossa, the fat-filled hollow transmitting neurovascular structures

Question 5

Leg region

Answer 5

-located inferior from the knee, through the narrow distal portion of the leg

Question 6

Ankle region

Answer 6

-flared portion between leg and foot, including medial and lateral malleoli

Question 7

Foot region

Answer 7

-includes most of the tarsus, as well as the metatarsus and phalanges

Question 8

Subcutaneous tissue location?

Answer 8

-lies deep from lower extremity skin, and superficial from lower extremity deep fascia

Question 9

Subcutaneous tissue consists of?

Answer 9

-loose connective tissue that contains variable amounts of fat, cutaneous nerves, superficial veins, superficial lymph vessels and nodes

Question 10

Subcutaneous tissue at the knee

Answer 10

-loses some of its fat and blends with the deep Fascia-although, fat resumes distal from the knee

Question 11

Subcutaneous tissue function?

Answer 11

-insulation, storage of fat, transmittal of vessels/nerves to and from the the skin

Question 12

Superficial veins location

Answer 12

-located superficial from deep fascia (while deep veins are located deep from deep fascia)

Question 13

Superficial vein valves

Answer 13

-both superficial and deep veins have valves (deep veins have more) (inferior veins have more)

Question 14

Musculovenous pump

Answer 14

-multiple valves partition the blood into shorter segments within the vein, fighting gravity and promoting the musculovenous pump

Question 15

Great saphenous vein tributaries?

Answer 15

-medial portion of the foot’s dorsal venous arch, and dorsal vein of the great toe

Question 16

Great saphenous vein path

Answer 16

• ascend anterior to the medial malleolus
• passes relatively posterior along the medical knee region (hand width from the medial margin of the patella)
• anastomoses freely with veins b/t it and the small saphenous vein
• transverse the cribriform fascia of subcutaneous tissue that covers the saphenous opening of the Fascia late, then terminates into the femoral vein

Question 17

how many valves does the great saphenous vein have?

Answer 17

• 10 to 12

- more numerous in the leg than in the thigh

Question 18

Small saphenous vein tributaries

Answer 18

-formed from the lateral portion of the foot’s dorsal venous arch, and dorsal vein of the little toe

Question 19

Small saphenous vein path

Answer 19

• ascends posterior to the lateral malleolus
• passes along the lateral border of the Achilles’ tendon
• ascends b/t the heads of the gastrocnemius
• crosses deep fascia, and empties to the popliteal vein

Question 20

Perforating veins of the great and small saphenous veins

Answer 20

• veins that shunt blood from superficial veins, across deep fascia, to deep veins
• have valves (only allow flow from superficial to deep)
• compress with muscle contraction

Question 21

Musculovenous pump

Answer 21

• as a muscle contracts within a covering of deep fascia, pressure within the compartment builds
• outward pressure compresses and squeezes the deep veins, making their blood flow out, with their valves assuring that flow is toward the heart.
• when muscle relaxes and pressure decreases, blood flows back in and the process repeats

Question 22

Superficial Lymphatics

Answer 22

-most lymph drains superficial lymph vessels that follow superficial veins to superficial inguinal nodes

Question 23

Superficial inguinal nodes

-2 subgroups

Answer 23

• vertical group=around the great saphenous

- horizontal group=inferior from the inguinal ligament

Question 24

Dermatomes

Answer 24

-individual spinal nerves, retain the segmental pattern (but distorted due to limb lengthening and medial rotation (pronation) during fetal development

Question 25

Cutaneous nerve distributions

Answer 25

- area of skin served by a cutaneous nerve after having mixed within the lumbar or sacral plexus - rather than dermatomes stripes. These are patch-like geographic areas across the limb-each being served by a different cutaneous nerve

Question 26

Lateral superior thigh skin | What is it called when it is impinged?

Answer 26

-inebriated by the lateral femoral cutaneous nerve Meralgia Paresthetica--impinged as it passes deep from the inguinal ligament (obesity or thigh clothing) and can cause pain of that cutaneous nerve distribution

Question 27

Pelvic Girdle

Answer 27

- bony ring, composed of sacrum, right and left hip bones, joined anteriorly at the pubic symphysis and posteriorly at the sacroiliac joints - attaches the free lower limb with the axial skeleton

Question 28

Hip bone/ Pelvic bone | -3 bones?

Answer 28

- ilium, pubis, and ischium | - converge at the acetabulum, initially separated by cartilage, called the triradite cartilage, fuse b/t ages of 16-25

Question 29

Ilium Body? Ala?

Answer 29

- largest and most superior - body forms the superior part of the acetabulum - ala is a broad wing-like posterolateral portion, for wide fleshy attachment of muscles

Question 30

Anterior superior and anterior inferior iliac spines (ASIS and AIIS)

Answer 30

-attachment sites of ligaments and tendons of the lower limb

Question 31

Iliac crest

Answer 31

-attachment site for thin sheet-like muscles and deep fascia, coursing from ASIS to PSIS

Question 32

Tubercle of the iliac crest (iliac tubercle)

Answer 32

- thickening of the crest 5-6cm posterior from the ASIS | - origin of the iliotibial tract

Question 33

posterior superior iliac spine

Answer 33

-attachment to skin, forming skin dimple- a surface landmark for the posterior extent of the iliac crest

Question 34

Posterior inferior iliac spine

Answer 34

-superior extent of the greater sciatic notch

Question 35

Fovea of femur

Answer 35

-attachment of the Ligament of the Head of the Femur

Question 36

Patella

Answer 36

- largest sesamoid bone in the body - base where quadriceps tendon attaches - apex where patella ligament attaches - posterior surface has a smaller medial facet and larger lateral facet (that articulate with the femoral trochlea

Question 37

Tibia

Answer 37

- second largest bone in the body | - transmits weight of everything superior from it, onto the Talus

Question 38

Fibula

Answer 38

- not weight bearing | - serves as muscle attachment and helps form the ankle joint

Question 39

Superficial Lymphatics

Answer 39

- majority of lymph drains along Lymphatics that follow superficial veins, to superficial nodes - eventually drain along external iliac and common iliac (deep) nodes