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MSCT-LM > W5 Lower limb > Flashcards

W5 Lower limb Flashcards

(62 cards)

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1
Q

• Leg general

A 
o	Three compartments separated by interosseous membrane and intermuscular septa
o	Muscles of the leg plantarflex and dorsiflex the foot
o	Invert (supinate) and evert (pronate)
o	Extend and flex toes
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2
Q

• Anterior compartment

A 
o	4 muscles: tibialis anterior, extensor hallucis longus, extensor digitorum longus, fibularus teritus
o	Deep fibular nerve
o	Anterior tibial artery
o	Dorsiflexion and inversion of foot
o	Extension of toes
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3
Q

• Tibialis anterior

A

o Anterior compartment
o Dorsiflexes and inverts foot
o Deep fibular nerve

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4
Q

• Extensor hallucis longus

A

o Anterior compartment
o Dorsiflexes foot and extends great toe
o Deep fibular nerve

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5
Q

• Extensor digitorum longus

A

o Anterior compartment
o Dorsiflexes foot and extends lateral four toes
o Deep fibular nerve

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6
Q

• Fibularus tertius

A

o Anterior compartment
o Dorsiflexes foot
o Deep fibular nerve

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7
Q

• Lateral compartment

A

o 2 muscles
o Superficial fibular nerve
o Fibular artery
o Eversion and plantar flexion

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8
Q

• Fibularis longus

A

o Lateral compartment
o Plantarflexes and everts foot
o Superficial fibular nerve

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9
Q

• Fibularis brevis

A

o Lateral compartment
o Everts foot
o Superficial fibular nerve

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10
Q

• Posterior compartment

A 
o	3 superficial muscles 
o	4 deep muscles
o	Tibial nerve
o	Posterior tibial artery
o	Plantar flexion and inversion of foot
o	Flexion of toes
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11
Q

• Gastrocnemius

A

o Posterior compartment
o Superficial
o Plantarflexes foot and flexes knee
o Tibial nerve

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12
Q

• Soleus

A

o Posterior compartment
o Superficial
o Plantarflexes foot
o Tibial nerve

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13
Q

• Plantaris

A

o Posterior compartment
o Superficial
o Plantarflexes foot and knee
o Tibial nerve

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14
Q

• Tibialis posterior

A

o Posterior compartment
o Deep
o Plantarflexes and inverts foot
o Tibial nerve

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15
Q

• Flexor digitorum longus

A

o Posterior compartment
o Deep
o Flexes lateral four toes and inverts foot
o Tibial nerve

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16
Q

• Flexor hallucis longus

A

o Posterior compartment
o Deep
o Flexes great toe and inverts foot
o Tibial nerve

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17
Q

• Popliteus

A 
o	Posterior compartment
o	Deep
o	Stabilizes and unlocks knee joint 
o	(rotates femur laterally from fixed tibia)
o	Tibial nerve
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18
Q

• Lumbar plexus

A

o Anterior rami of L1-L4

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19
Q

• Sacral plexus

A

o Anterior rami of L4-S5

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20
Q

• Lumbosacral plexus

A

o Combo of lumbar and sacral

o Provide sensory and motor innervation to lower limb

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21
Q

• Femoral nerve

A

o L2, L3, L4
o Motor branches to anterior compartment muscles and pectineus
o Two sensory branches: anterior cutaneous nerve to the thigh and saphenous nerve
o Saphenous nerve goes through adductor canal to supply sensation to medial leg and malleolus

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22
Q

• Obturator nerve

A

o L2, L3,L4
o Motor branches to medial compartment of thigh and adductor magnus
o Cutaneous branch to skin above medial side of knee

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23
Q

• Sciatic nerve

A

o L4, L5, S1, S2, S3

o Divides into tibial and common fibular nerves proximal to popliteal fossa (behind knee)

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24
Q

• Common fibular nerve

A

o L4, L5, S1, S2
o Branch of sciatic nerve
o Splits into superficial fibular nerve and innervates lateral compartment of leg and overlying skin of foot)
o And deep fibular nerve that innervates anterior compartment of leg and overlying skin of leg and between great and 2nd toe

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25
• Tibial nerve
o L4, L5, S1, S2, S3 | o Innervates posterior compartment of leg and is sensory to overlying skin and plantar surface of the foot
26
• Obturator canal
o Through obturator foramen passing inferior to the superior pubic ramus o Obturator nerve passes through here
27
• Greater sciatic foramen
``` o Below piriformis muscle:  Sciatic nerve  Inferior gluteal nerve  Posterior femoral cutaneous nerve  Nerves to obturator internus and quadratis femoris ``` o Above piriformis muscle  Passing between gluteus medius and minimus  Superior gluteal nerve
28
• Lesser sciatic foramen
o Pudendal nerve passes from gluteal region into perineum
29
• Inferior to inguinal ligament
o Femoral nerve o Femoral branch of genitofemoral nerve o Lateral cutaneous nerve of thigh
30
• Obturator sensory endpoint
o Medial thigh above the knee
31
• Femoral sensory endpoint
o Medial malleolus
32
• Tibial sensory endpoint
o Lateral malleolus (sural nerve)
33
• Superficial fibular sensory endpoint
o Dorsum of the foot
34
• Deep fibular sensory endpoint
o Between the first two toes
35
• Deep fibular nerve lesions
o Anterior compartment syndrome | o Anterior tarsal tunnel syndrome at the extensor reticulum
36
• Anterior compartment syndrome
o Deep fibular nerve o Drop foot o Inability to dorsiflex the foot causing patient to use high steppage gait to walk o Sensory loss in triangular region between the first and second toes
37
• Anterior tarsal tunnel syndrome at the extensor reticulum
o Deep fibular nerve o Weakness in toe extension o Sensory loss in triangular region between the first and second toes
38
• Superficial fibular nerve lesions
o High lesion at the head of fibula | o Low lesion with lateral ankle sprain
39
• High lesion at the head of fibula
o Superficial fibular nerve o Loss of foot eversion and or subtalar pronation and ankle stability o Loss of sensation on lateral leg, lateral malleolus and dorsum of the foot
40
• Low lesion with lateral ankle sprain
o Superficial fibular nerve o No weakness o Loss of sensation on lateral leg, lateral malleolus and dorsum of the foot
41
• Tibial nerve lesions
o Popliteal region from knee trauma such as dislocation or a blow o Tarsal tunnel entrapment at the medial malleolus
42
• Popliteal region from knee trauma such as dislocation or a blow
o Tibial nerve o Unable to plantarflex or invert/supinate foot effecting gait o Loss of toe flexion, abduction and adduction o Patient will not push off o Loss of sensation on the posterolateral aspect of lower one third of leg, lateral malleolus and lateral border of the foot, heal and sole of foot and toes
43
• Tarsal tunnel entrapment at the medial malleolus
o Tibial nerve o Loss of intrinsic foot function o Loss of sensation on the anterior sole of the foot and plantar surface of the toes
44
• Femoral nerve lesion
o Anterior dislocation of the femur from trauma or injury from pelvic of hip surgery, abdominal or hernia repair o Inability to flex the thigh or extend the knee o Will be locked in extension of knee o Loss of sensation to medial side of leg, medial malleolus (saphenous nerve) or medial knee (medial cutaneous nerve)
45
• Obturator nerve lesion
o Compression in the obturator tunnel from pelvic fracture or injury, pregnancy or tumor o Inability to adduct the hip o Weakness of knee flexion (gracilis) and hip external rotation (obturator externus) o Difficulty with gait exhibiting an externally rotated foot o Loss of sensation to medial patch of skin just above knee o May also complain of groin or pubic symphysis pain
46
• Femoral artery
o Continuation of external iliac artery in the abdomen o Becomes femoral when it passes under inguinal ligament and enters femoral triangle in the anterior thigh o Supplies most of the thigh and all of the leg and foot
47
• Femoral triangle
o Bordered by inguinal ligament superiorly o Lateral border is sartorious muscle o Medial border is adductor longus o Femoral nerve, artery, vein, and lymphatics pass through here under inguinal ligament into the triangle o Femoral sheath covers vein, artery, and lymphatics o Femoral pulse can be felt in femoral triangle just inferior to inguinal ligament and midway between anterior aspect of iliac spine and pubic symphysis
48
• Other vessels supplying gluteal region
o Superior and inferior gluteal arteries o Obturator artery in medial compartment of thigh o All are branches of the internal iliac artery in pelvis o Follow the path of their nerves
49
• Collateral circulation of hip joint
o Anastomoses between branches of deep femoral (medial and lateral femoral circumflex and 1st perforating branch), branches of obturator artery and branches of superior and inferior gluteal arteries o Insufficiency of medial femoral circumflex artery is most common cause of avascular necrosis of the femoral neck and head
50
• Collateral circulation of knee joint
o Anastomoses of descending branch of lateral femoral circumflex and descending genicular branch of femoral artery, genicular branches from popliteal artery, circumflex fibular artery and recurrent branches of popliteal artery o Descending genicular branch of femoral artery branches just before femoral artery enters adductor canal at the adductor hiatus o Form a robust anastomotic network around the joint
51
• Compartment syndrome
o Deep or investing fascia (fascia lata) do not expand so swelling in the compartment leads to increased pressure which will compress the muscles, blood vessels, and nerves o Acute: caused by trauma such as car accident, crush injury, surgery o Chronic: repetitive activities such as running, pressure increases during activity o Most common in leg and forearm o Relieved by cutting skin and fascia (fasciotomy)
52
• Ankle joint
o Synovial hinge joint between talus, tibia and fibula o Allows for dorsiflexion and plantarflexion of the foot on the leg o Distal ends of fibula and tibia are anchored by medial (deltoid) and lateral ligaments to create a deep socket for upper body of the talus
53
• Lateral ligament
o Composed of three ligaments o Most commonly sprained (foot inversion) o Posterior talofibular ligament o Anterior talofibular ligament (most commonly injured) o Calcaneofibular ligament
54
• Medial (deltoid) ligament
o Four parts based on inferior points of attachment o Tibionavicular part o Tibiocalcaneal part o Posterior tibiotalar part o Anterior tibiotalar part o Sprain of ligament occurs by foot eversion
55
genitofemoral
- lumbar plexus | - L1, L2
56
lateral femoral cutaneous
- lumbar plexus | - L2, L3
57
femoral
- lumbar plexus | - L2, L3, L4
58
obturator
- lumbar plexus | - L2, L3, L4
59
superior gluteal nerve
sacral plexus | L4, L5, S1
60
inferior gluteal nerve
sacral plexus | L5, S1, S2
61
sciatic
sacral plexus | L4, L5, S1, S2, S3
62
posterior femoral cutaneous
sacral plexus | S1, S2, S3

MSCT-LM (14 decks)

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