1.93 Nerve and Blood Supply to Lower Limb Flashcards
Where is weight distributed during sitting?
Ischial tubersosities
What are compartments separated by?
Connective tissue septa
What are the thigh compartments?
Anterior - extensor
Medial - adductor
Posterior - flexor
What are the leg compartments?
Anterior - extensor
Lateral - peroneal
Posterior - flexor
What are the four areas of transition?
Inguinal canal - external iliac to femoral
Femoral triangle - NAVY
Adductor hiatus - Femoral to popliteal
Popliteal fossa - Popliteal artery and vein, braches of sciatic
Explain the nerve supply to the lower limb?
Femoral nerve - anterior thigh - L2 - L4
Obturator nerve - medial thigh - L2-L4
Sciatic nerve - supplies everything else - L4 - S3
Gluteal nerves - superior gluteal (L4-S1) - inferior gluteal (L5-S1)
What is the motor innervation to the lower limb?
• Femoral • Anterior • Obturator • Medial thigh • Sciatic • Posterior, plantar • Two nerves running together as one - like headphone wires • Split just above the popliteal fossa • Gluteal • Gluteal region • Common fibular (peroneal) • Lateral, anterior leg • Tibial Posterior leg
Explain the femoral nerve…
• Formation – root values L2-L4 • Lots of branches • Course – under inguinal ligament, femoral triangle • Divisions – branches innervate iliacus, psoas and pectineus • Function – motor • Anterior compartment of thigh – quadriceps femoris • Rectus femoris • Vastus lateralis • Vastus interior • Vastus medialis • Function – sensory • Anterior thighaff • Antero-medial knee Medial leg and foot
What is found in the pelvic foramina?
• Obturator canal • Bony foramen • Obturator membrane • Greater sciatic foramen • Greater sciatic notch • Sacrospinous ligament • Sacrotuberous ligament • Lesser sciatic foramen • Lesser sciatic notch Sacrotuberous ligament
Explain the obturator nerve…
• Formation • Lumbar plexus - root values L2-L4 • Course • Posterior abdominal wall • Obturator foramen/canal • Function – motor • Medial compartment of thigh • Obturator externus • Function – sensory Upper medial thigh
Explain the sciatic nerve…
• Formation • Lumbosacral plexus • Root values L4-S3 • Course • Through Greater sciatic foramen • Beneath piriformis NB: Can be variation in course with respect to piriformis
What are the branches of the sciatic nerve…
Perineoal - lateral
Fibula -lateral
Branches - tibia and fibula
Branches into deep and superficial branches
What is the blood supply to the lower limb…
• External iliac becomes femoral artery
• Femoral gives off deep branch (profunda femoris)
• Profunda femoris has circumflex and perforating branches
Internal iliac gives off superior gluteal, obturator and inferior gluteal branches
what is the blood supply to the knee?
Femoral becomes popliteal
Give off genicular branches
Popliteal branches to anterior and posterior tibial arteroes
What do the tibial arteries supply?
• Posterior tibial artery gives off branch - fibular artery
• Posterior tibial becomes plantar artery in foot
Anterior tibial artery becomes dorsalis pedis in foot
