ALS Lecture 10 - The Lower Limb, Muscle Groups DONE Flashcards
deep fascia is a _____ fibrous tissue that covers ____
fibrous, whole body under skin
it encloses different parts of the limbs into
compartments
what do compartments maximise? (2)
- maximise muscle work
- venous return
fascia lata is the
deep fascia in the thigh
fascia lata is continuous from
inguinal ligament, Scarpa’s fascia (abdomen)
fascia lata attaches to
pelvis superiorly
fascia lata runs distally down the knee, enclosing 2 muscle groups
- tensor fascia latae - hip flexors, knee extensors
2. gluteus maximus - hip abductors
2 openings of fascia lata
cribriform fascia, saphenous opening
what happens in the cribriform fascia opening of the fascia lata?
great saphenous vein drains into femoral vein
crural fascia is
continuation of fascia lata, deep fascia in the leg (knee-ankle)
crural fascia fuses to
tibia
crural fascia thickens to form the
extensor retinacula at ankle joint
label the diagram of the fasciae
done
muscles in the same compartment have the same/similar (3)
functions, blood supply, innervation
compartments of the thigh
anterior, middle, posterior
compartments of the leg
anterior, lateral, posterior
what separates the anterior and posterior compartments of the leg?
interosseous membrane
label the diagrams of the compartments of the leg and thigh
done
look at the diagrams of compartment syndrome
done
compartment syndrome is due to
increased pressure in compartment
increase in pressure could be due to (type and example, 3)
- within the compartment, e.g. intracompartmental haemorrhage
- constriction of compartment, e.g. scarring due to burns
- external compression, e.g. cast too tight
symptoms of compartment syndrome
6 Ps
pressure, pain on stretch, pulse present?, pink colour, paresis (foot drop), paraesthesia
label diagram of the 6 Ps of compartment syndrome
done
compartment syndrome treatment
fasciotomy (skin, superficial and deep fascia opened to relieve pressure)
gluteal region muscles act on ____, for which movements?
hip, abduction, rotation, extension
iliac region muscles do what?
flex hip
anterior thigh compartment has
hip flexors, knee extensors
medial thigh compartment has
hip adductors
posterior thigh compartment has
hip extensors, knee flexors
anterior leg compartment has
ankle extensors, dorsiflexors
medial leg compartment has
ankle evertors
posterior leg compartment has
ankle flexors, plantar flexors
anterior foot has
extensors
posterior foot has
flexors
muscles in anterior compartment of the thigh
rectus femoris, vastus muscles, sartorius, pectineus
vastus muscles
vastus medialis, vastus intermedius, vastus lateralis
rectus femoris crosses
knee and hip joint
rectus femoris movements
knee extension, hip flexion
vastus muscles attach to
femur with vast site of attachment
vastus muscles movement
knee extension
sartorius path
outer edge of pelvis (ASIS) to medial proximal tibia (crosses lateral to medial)
sartorius movement
flex hip, flex knee, lateral rotation
pectineus movement
hip adduction, some hip flexion
anterior compartment of the thigh innervation
femoral nerve (pectineus sometimes obturator)
anterior compartment of the thigh blood supply
femoral artery
label the diagram of the anterior thigh muscles
done
muscles in medial compartment of thigh
adductor brevis, adducot rlongus, adductor magnus, gracilis, obturator externus
label the diagram of the medial thigh muscles
done
gracilis course
down medial thigh, from pelvis to tibia
medial compartment of the thigh innervation
obturator nerve
medial compartment of the thigh blood supply
obturator artery
label the diagram of the posterior compartment of the thigh
done
posterior compartment of the thigh muscles are collectively known as the
hamstrings
muscles in the posterior thigh compartment
semitendinosus, semimembranosus, biceps femoris, adductor magnus
posterior compartment of the thigh innervation
sciatic, tibial nerve. short head of biceps femoris common fibular nerve.
posterior compartment of the thigh blood supply
profunda femoris from femoral artery (perforating arteries)
label the diagram of the posterior compartment of the thigh
done
muscles in the gluteal region
gluteus maximus, gluteus medius, gluteus minimus, piriformis, obturator internus, superior and inferior gemelli, quadratus femoris, tensor fascia latae
gluteus maximus movement
hip extension
gluteus medius movement
hip abduction
gluteus minimus movement
hip abduction
piriformis movement
hip external rotation
obturator internus movement
hip external rotation
superior and inferior gemelli movement
hip external rotation
quadratus femoris movement
hip external rotation
tensor fascia latae movement
tenses fascia latae
gluteal region innervation
superior and inferior gluteal nerves for gluteus muscles
gluteal region blood supply
superior and inferior gluteal arteries from internal iliac artery
label the diagram of the gluteal region
done
label the diagram of the anterior crural compartment of the leg
done
muscles in the anterior crural compartment of the leg
tibialis anterior, extensor hallucis longus, extensor digitorum longus, fibularis peroneus tertius
tibialis anterior movement
inverts foot
extensor hallucis longus movement
extends big toe
extensor digitorum longus movement
extends other toes
fibularis peroneus tertius movement
inverts foot
anterior crural compartment of the leg innervation
deep fibular nerve, branch of common fibular, from sciatic
anterior crural compartment of the leg blood supply
anterior tibial, branch of popliteal
muscles of the lateral crural compartment of the leg movement
dorsiflex ankle
label the diagram of the lateral crural compartment of the leg
done
muscles in the lateral crural compartment of the leg
fibularis longus, fibularis brevis
lateral crural compartment of the leg innervation
superficial fibular nerve, branch of common fibular from sciatic
lateral crural compartment of the leg blood supply
fibular artery branches
label the diagram of the posterior crural compartment of the leg
done
posterior crural compartment of the leg is split into
superficial, deep
muscles of the superior area of the posterior crural compartment of the leg
gastrocnemius, soleus
gastrocnemius
2 head, crosses knee, converges at Achilles’ tendon
gastrocnemius movement
plantar flexor
soleus
converges at Achilles’ tendon
soleus movement
plantar flexor
plantaris is important for
proprioception
muscles of the deep area of the posterior crural compartment of the leg
tibialis posterior, flexor hallucis longus, flexor digitorum longus, popliteus
tibialis posterior movement
everts foot
flexor hallucis longus movement
flexes big toe
flexor digitorum longus movement
flexes other toes
popliteus
key to the knee
posterior crural compartment of the leg innervation
tibial nerve
posterior crural compartment of the leg blood supply
posterior tibial artery
label the diagram of the myotomes (know well)
done
label the diagram of the nerves vs. myotomes and the boxes
done
posterior division of L2, L3, L4 make up
femoral nerve
label the diagram of the dermatomes
done
label the diagram of the lumbosacral plexus
done
label the diagram of the anterior thigh
done
anterior thigh compartment is innervated by
femoral nerve
medial thigh compartment is innervated by
obturator nerve
lumbar plexus runs from
T12-L5
cutaneous innervation of the thigh
iliohypogastric, ilioinguinal, genitofemoral, lateral femoral cutaneous
anterior division of L2, L3, L4 make up
obturator nerve
label the diagram of the sacral plexus
done
label the diagram of the posterior thigh
done
everything below the knee is innervated by the
sacral plexus
sacral plexus gives rise to
superior gluteal, inferior gluteal, sciatic nerve
label the posterior and anterior diagrams of the leg
done
label the diagrams of the femoral and sciatic nerve
done
where is the safe injection site in the gluteal region?
upper outer quadrant
movement affected by damage to femoral nerve
knee extension, hip flexion
femoral nerve test
flex patient knee, press on shin, get them to extend knee (against resistance)
sensory deficits caused by damage to femoral nerve
medial thigh, anterior and medial leg
movement affected by damage to sciatic nerve
knee flexion, hip extension, distal limb movements
sciatic nerve test
get patient to lie on front, push back on calf, ask to flex knee
label/look at diagrams of nerve tests
done
sensory deficits caused by damage to sciatic nerve
posterior thigh, distal lower limb
label the 2 diagrams of the femoral triangle
done
boundaries of femoral triangle
inguinal ligament, sartorius, adductor longus
floor of femoral triangle
adductor longus, pectineus, iliopsoas
contents of the femoral triangle
N - femoral nerve, most lateral A - femoral artery, medial to nerve V - femoral vein, medial to artery E - empty space, femoral canal Y - deep inguinal lymph nodes, most medial
label the adductor canal diagrams
done
adductor canal course
from femoral triangle, behind sartorius, through hole in adductor magnus (adductor hiatus)
boundaries of adductor canal
sartorius (anterior), adductor longus and adductor magnus (medial/posterior), vastus medialis (lateral)
contents of adductor canal
femoral artery and vein, saphenous nerve
popliteal fossa is where?
posterior of knee joint
contents of popliteal fossa
popliteal artery and vein, tibial nerve, small saphenous vein
label the diagram of the popliteal fossa
done
