Anatomical Spaces of Clinical Important in the Lower Limb Flashcards
What does the inguinal ligament form the anatomical boundary between?
- Abdomen
- Thigh
Where does the inguinal ligament extend from/to?
- From ASIS
- To pubic tubercle
What passes through the inguinal canal?
- Spermatic cord (male)
- Round ligament (female)
What reinforces the inguinal ligament at the floor, medially and laterally?
- F = in-rolled lower edge of inguinal ligament
- M = lacunar ligament
- L = transversalis fascia
What procedures and carried out at the femoral triangle?
- Detection of femoral pulse
- Cannulation of femoral artery
Boundaries of femoral triangle
- Inguinal ligament (superior)
- Sartorius (lateral)
- Adductor longus (medial)
- Iliacus, psoas major, pectineus, adductor longus (floor)
- Superficial fascia, deep fascia of thigh (roof)
Contents of the femoral triangle (lateral to medial)
- Femoral nerve
- Femoral artery
- Femoral vein
- Femoral lymph nodes
What does the femoral sheath contain?
- Femoral artery
- Femoral vein
Which artery is the main source of blood for the lower limb?
Femoral artery
Origin of femoral artery (and where each change occurs)
- Descending aorta –> common iliac artery (L3-4)
- Common iliac –> external iliac artery (L5/pelvic inlet)
- External iliac –> femoral artery (inguinal ligament)
Where does the femoral artery run from and to?
- From inguinal ligament
- To adductor canal
Midpoint of inguinal ligament vs mid-inguinal line
- MOIL = midpoint between ASIS + pubic tubercle
- MIL = midpoint of imaginary line between ASIS + pubic symphysis
Boundaries of gluteal region
- Iliac crest (superior)
- Gluteal fold (inferior)
What contributes to the prominence of the buttock?
- Thick layer of fat (panniculus adiposus)
- Lower part of a muscle (gluteus maximus)
- Transverse crease of skin (gluteal fold)
Which nerve is at risk making intramuscular injections in the gluteal region?
Sciatic nerve
How do you make a safe intramuscular injection in the gluteal region?
- Palpate greater trochanter + ischial tuberosity
- Draw horizontal line between these
- Draw vertical line bisecting this horizontal line
- This makes 4 quadrants
- Injection must be made in upper outer quadrant
What is the popliteal fossa?
Diamond-shaped space behind the knee
What does the popliteal fossa contain?
- Tibial nerve
- Common peroneal nerve
- Posterior femoral cutaneous nerve
- Popliteal artery
- Popliteal vein
- Popliteal lymph nodes
Where does the anterior tibial artery commence?
Bifurcation of popliteal artery
What does the anterior tibial artery give rise to and where?
- Dorsalis pedis
- Beyond extensor retinaculum
What does the dorsalis pedis divide into and where?
- First dorsal metatarsal + deep plantar arteries
- First metatarsal space
Where does the posterior tibial artery pass in the leg?
- Deep to soleus
- Superficial in lower 1/3 leg
What does the posterior tibial artery divide into and where?
- Medial + lateral plantar arteries
- Below the ankle
What does the great/long saphenous vein drain?
Medial part of venous plexus of foot
Where does the great/long saphenous vein begin and end?
- Begins in medial margins vein of foot
- Ends in femoral vein (3cm below inguinal ligament)
Where does the great/long saphenous vein ascend?
- In front of medial malleolus
- Along medial side of leg
What does the small/short saphenous vein drain?
Lateral side of venous plexus of foot
Where does the small/short saphenous vein begin and end?
- Begins behind lateral malleolus
- Ends in popliteal vein
How does the small/short saphenous vein ascend?
- Along lateral margin of tendo calcaneous
- Cross it obliquely to reach middle of back of leg
- Perforates deep fascia in popliteal fossa to popliteal vein
