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C&M Lower Limb > Week 2 L2: Thigh and Knee > Flashcards

Week 2 L2: Thigh and Knee Flashcards

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1
Q

The lumbosacral plexus gives rise to 3 major branches that innervate the lower limb. What are they?

A
  • femoral nerve
  • obturator nerve
  • lumbosacral trunk
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2
Q

Which ventral rami are the obturator and femoral nerve from?

A

L2, L3 and L4

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3
Q

Which 2 nerves are bound together to make the sciatic nerve?

A

common fibular part and tibial part

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4
Q

Which part of the lower limb does the tibial part of the sciatic nerve innervate?

A

posterior

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5
Q

Which part of the lower limb does the common fibula part of the sciatic nerve innervate?

A

anterior and lateral parts

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6
Q

What is the bone of the thigh?

A

femur

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7
Q

Which bone does the femur articulate with at the knee joint?

A

tibia (large bone of leg)

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8
Q

Which features are seen on the anterior femur?

A
  • shaft
  • adductor tubercle
  • patellar surface
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9
Q

Which features are seen on the posterior femur?

A
  • medial and lateral lips of the linea aspera
  • medial and lateral supracondylar lines
  • medial and lateral condyles
  • intercondylar notch
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10
Q

What are the tibial plateaus?

A

flattened regions of the proximal tibia that articulate with the femoral condyles

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11
Q

What is the anatomical name for the knee cap?

A

patella

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12
Q

What movements are allowed at the knee joint?

A

flexion and extension and a very small degree of rotation

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13
Q

What are the 3 articulations at the knee joint?

A

2 femorotibial - articulation between femur and tibia

1 femoropatella - articulation between femur and patella

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14
Q

What are the menisci?

A
  • crescent shaped ligaments
  • 2 plates of fibrocartilage that deepens the tibial plateau
  • thicker at external margins
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15
Q

What are the functions of the menisci?

A
  • increase joint congruency between the femoral condyles and tibial plateau
  • distribute weight evenly
  • shock absorption
  • assist in locking mechanism
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16
Q

Is the knee joint more stable and congruent in flexion or extension?

A

extension is most congruent and most stable

in flexion, less of the femoral condyles are in contact with the proximal tibia so it is less stable

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17
Q

What are the two collateral ligament in the knee?

A
  1. Fibula collateral ligament

2. Tibial collateral ligament

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18
Q

What is the difference in the fibula collateral and tibial collateral ligament?

A

tibial collateral ligament is attached to the meniscus whereas the fibula collateral ligament isn’t

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19
Q

What is the function of the:

  1. Fibula collateral ligament
  2. Tibial collateral ligament
A
  1. Prevents adduction of the leg at the knee

2. Prevents abduction of the leg at the knee

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20
Q

What is the function of the anterior cruciate ligament?

A
  • prevents anterior displacement of tibia on femur

- prevents hyperextension

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21
Q

What is the function of the posterior cruciate ligament

A
  • prevents posterior displacement of tibia on femur

- prevents hyperflexion

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22
Q

What are the muscles in the enclosed by what?

A

fascia lata

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23
Q

Where do the extensor muscles of the knee lie?

A

anterior thigh

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24
Q

Where do the flexor muscles of the knee lie

A

posterior thigh

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25
What are the muscles found in the anterior thigh?
1. iliopsoas 2. Pectineus 3. Quadratus femoris 4. Sartorius 5. Tensor fascia lata
26
What is the function of the pectineus?
flexes and abducts the hip
27
What is the function of the quadratus femoris?
4 muscles- "the quads" - extension of the knee - 1 of them flexes the hip
28
Where does the sartorius muscle originate and insert?
originates at the ASIS and inserts onto the medial tibia
29
What does the sartorius muscle do?
flexes the hip, laterally rotates the hip and flexes the knee it takes a diagonal course across the medial thigh, crossing the hip and knee so it will act on both
30
Which nerve innervates the quadratus femoris?
femoral nerve L2-L4
31
What are the 4 muscles that make up the quadriceps femoris, and which one also flexes the hip
1. Vastus intermedius 2. Vastus Lateralis 3. Vastus medialis 4. Rectus femoris (attaches to AIIS so also flexes hip)
32
Where does the vastus lateralis originate and insert?
- originates at greater trochanter/ linear aspera | - attaches to posterior femur
33
Where does the vastus medialis originate and insert?
- originates at intertrochanteric line / linea aspera | - attaches to posterior femur
34
What does the great saphenous vein drain into?
femoral vein
35
``` What is the: 1. Superior border 2. Medial border 3. Lateral border of the femoral triangle ```
1. Inguinal ligament 2. Adductor longus 3. Sartorius
36
What does the saphenous nerve innervate?
skin of medial aspect of leg and foot
37
Which are the adductor muscles in the medial thigh and which one also weakly flexes the knee?
1. Adductor brevis 2. Adductor longus 3. Adductor magnus (deeper muscle) 4. Gracillis (weakly flexes knee) 5. Pectineus 6. Obturator externus (deeper muscle)
38
Where does the adductor brevis originate and insert?
origin: body of pubis/ inferior ramus insert: pectineal line/ linear aspera
39
Where does the adductor longus originate and insert?
Origin: body of pubis Insert: middle 1/3 linea aspera
40
Where does the gracilis originate and insert?
Origin: body of pubis/ inferior ramus Insert: tibia
41
Where does the pectineus originate and insert?
Origin: superior pubic ramus to pectineal line
42
What are the two parts of the adductor magnus and where do each originate and insert?
Adductor part: inferior pubic ramus to gluteal tuberosity and linear aspera Hamstring part: ischial tuberosity to adductor tubercle
43
Which nerve is the adductor part of the adductor magnus innervated by?
obturator nerve
44
Which nerve is the hamstring part of the adductor magnus innervated by?
tibial nerve
45
What is the function of: 1. The adductor part of the adductor magnus? 2. The hamstring part of the adductor magnus?
1. Adducts the hip | 2. Extensor of the hip
46
What is the adductor hiatus?
passage way for femoral artery and vein into the popliteal fossa
47
Where does the obturator externus originate and insert?
obturator foramen --> trochanteric fossa
48
Which nerve innervates the medial thigh?
obturator nerve
49
Where does the obturator nerve exit the pelvis and which muscle does it overlie in the medial thigh?
- exits pelvis through obturator foramen | - overlies adductor brevis
50
Where do the hamstrings in the posterior thigh arise from?
ischial tuberoisty
51
What is the function of the hamstrings?
extend the hip and flex the knee
52
Which nerve are the hamstrings innervated by?
tibial nerve
53
What is the popliteal fossa?
diamond-shaped fossa behind the knee
54
What are the boundaries of the popliteal fossa?
Medial: Semitendinosus and semi membranosus Lateral: biceps femoris Inferior: medial and lateral heads of gastrocneumius
55
When the femoral artery and vein enter the popliteal fossa through the adductor hiatus, what is the name of the vessels they become?
popliteal vessels
56
Which division of the sciatic nerve runs directly through the popliteal fossa?
tibial nerve
57
What is 'locking' the knee?
as the knee joint approaches full extension, the femur undergoes a few degrees of medial rotation on the tibia
58
How is the knee 'unlocked'
by the popliteus muscle which laterally rotates the femur
59
Which artery supplies the anterior thigh?
femoral artery
60
which artery supplies the posterior thigh and hamstring?
profunda femoris
61
Which artery supplies the lateral thigh?
lateral femoral circumflex artery
62
The anastomoses around the knee is formed by branches by which arteries?
femoral, popliteal and anterior/posterior tibial arteries
63
What are bursae around the knee?
fluid filled pouches
64
What is meant by an 'unhappy triad'?
- combined knee injury - excessive lateral twisting of the flexed knee or blow to the lateral side of extended knee - tears the tibial collateral ligament which is attached to the medial meniscus which also then tears - ACL may tear too
65
The muscles of the thigh are surrounded by a strong layer of fascia called?
fascia lata --> divides the thigh into anterior, medial and posterior compartments
66
What is the iliotibial tract?
thickened band of the fascia lata on the lateral side of thigh
67
What are the muscles of the anterior thigh?
1. Quadriceps muscles - vastus intermedius, vastus lateralis, vastus medialis and rectus femoris 2. Sartorius, pectineus and iliopsoas
68
Which common tendon do the quadriceps converge onto?
quadriceps tendon
69
How is the patella connected to the tibial tuberosity?
via the patellar ligament
70
Which quadricep muscle lies deep to rectus femoris?
vastus intermedius
71
What is the common insertion of the quadricep muscles?
tibial tuberosity
72
What is the knee jerk reflex?
- peripheral neurological examination - tests femoral nerve (and the spinal nerve it contains L2, L3, L4) - finds half way point between patella and tibial tuberosity and taps with tendon hammer
73
Which 2 muscles form the medial and lateral floor of the femoral triangle?
medial floor - pectineus | lateral floor - iliopsoas
74
What are the muscles in the medial thigh?
- adductor brevis - adductor longus - adductor magnus - obturator externus - gracilis - pectineus
75
Is a patella fracture more common in males or females?
females
76
Muscles of the anterior thigh generally act as?
hip flexors and knee extensors
77
What forms the: 1. Floor of popliteal fossa 2. Roof of popliteal fossa
1. Popliteus muscle | 2. fascia lata
78
The popliteal artery is the direct continuation of which vessel?
superficial femoral artery
79
The popliteal vein leaves the popliteal fossa and enters the anterior thigh via the adductor hiatus, continuing proximally as which vessel?
femoral vein
80
What is a sesamoid bone?
bone embedded within a tendon or a muscle e.g patella
81
What nerve innervates the popliteus?
tibial

C&M Lower Limb (4 decks)

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