Anatomy Lecture 1 - Overview of the Lower Limb Flashcards
3 functions of the lower limb?
Supports body weight
Locomotion
Maintains balance
Where is the gluteal region?
Anatomical area located posteriorly to the pelvic girdle the proximal end of the femur
What does the muscles of the gluteal region do?
Move the lower limbs at the hip joint
See diagram 1
See diagram 1
What make up the superficial muscle group of the gluteal region? (4)
Gluteus maximus
Gluteus medius
Gluteus minimus
Tensor fascia latae
See diagram 2
See diagram 2
Purpose of the superficial muscle group of the gluteal region?
Extensors, abductors and medial rotators of thigh
What muscles make up the deep muscle group of the gluteal region? (4)
Piriformis
Obturator internus
Gemelli
Quadratus femoris
Purpose of the deep muscle group of the gluteal region?
Lateral rotators of thigh and hip stabilisers
What nerves supply the deep muscle group of the gluteal region?
Sacral plexus
How do nerves enter/ exit the pelvis and perineum?
Via the greater and lesser sciatic foramen
What forms the greater and lesser sciatic foramen?
Sacrotuberous and sacrospinous ligaments
See diagram 3
See diagram 3
What quadrant of the gluteal region are injections usually given in?
Superolateral quadrent
What roots do the sciatic nerves arise from?
L4 - S3
Why is the size of the sciatic nerve important?
It is the largest nerve in the body
What does the sciatic nerves supply?
Posterior thing, all leg and foot muscles and most of the skin
What roots does the pudendal nerves arise from?
S2-S4
Purpose of the pudendal nerves?
Principal nerve to the perineum
What roots does the posterior cutaneous nerves of the thigh arise from?
S1 - S3
What does the posterior cuteness nerves of the thigh supply?
Skin over posterior thigh, popliteal fossa, lateral perineum and upper medial thigh
See diagram 4
See diagram 4
Where does the sciatic nerve usually exit?
Inferior to piriformis
Does the sciatic nerve have a blood supply?
Yes, the artery to the sciatic nerve
What does the sciatic nerve supply in the gluteal region?
Nothing
Where does the sciatic nerve pass in the thigh?
Posterior thigh
What does the sciatic nerve divide into at the distal thigh?
Tibial nerve
Common fibular nerve
See diagram 5
See diagram 5
What is the femoral triangle?
An anatomical location in the upper inner thigh
Superior boundary of the femoral triangle?
Inguinal ligament
Medial boundary of the femoral triangle?
Lateral border of the adductor longus
Lateral boundary of the femoral triangle?
Medial border of the sartorius
Floor boundary of the femoral triangle?
Iliospsoas and pectineus
Roof boundary of the femoral triangle?
Deep fascia (fascia lata)
See diagram 6
See diagram 6
See diagram 7
See diagram 7
What is compartment syndrome?
Increased pressure within one of the body’s compartments caused by swelling of tissue or increase in fluid (bleeding) - affects functions of the nerves or muscles
Treatment of acute compartment syndrome?
Fasciotomy (relieves pressure)
Compartments of the thigh?
Anterior, medial and posterior compartmetns
Compartments of the leg?
Anterior, posterior and lateral compartments
Flexors of the thigh contained within the anterior compartment of the thigh?
Pectineus
Iliopsoas (soas major/ min + iliacus)
Sartorius
Rectus femoris
Extensor of the leg contain within the anterior compartment of the thigh?
Quadriceps femoris (vastus lateralis, vastus medialis, vastus intermedius, rectus femoris)
What nerves are contained within the anterior compartment of the thigh?
Femoral nerve
Psoas major
What roots make up the femoral nerve?
L2, L3, L4
Innervation of the muscles of the anterior compartment of the thigh?
Femoral nerve (L2, 3, 4) - all muscles except: Psoas major = L1, L2, L3 of lumbar plexus
What group of muscles are contained in the medial compartment of the thigh?
Adductors of the thigh
What muscles are contained in the medial compartment of the thigh?
Adductor longus Adductor brevis Adductor magnus Gracilis Obturator externus
See diagram 8
See diagram 8
See diagram 9
See diagram 9
What groups of muscles are contained within the posterior compartment of the thigh?
Extensors of thigh and flexors of leg
What muscles are contained in the posterior compartment of the thigh?
Semitendinosus
Semimembranosus
Biceps femoris
See diagram 10
See diagram 10
What groups of muscles are contained within the anterior compartment of the leg?
Dorsiflexors of ankle and extensors of toes
What muscles are contained in the anterior compartment of the leg?
Tibialis anterior
Extensor digitorum longus
Extensor hallucis longus
Fibularis tertius
What nerve is contained within the anterior compartment of the leg?
All deep fibular nerve
What are the roots of the all deep fibular nerve?
L4, L5
What groups of muscles are contained within the lateral compartment of the leg?
Evert foot
Weakly plantarflex ankle
What muscles are contained within the lateral compartment of the leg?
Fibularis longus
Fibularis brevis
What nerve is contained within the lateral compartment of the leg?
All superifical fibular nerve
What are the roots of the all superficial fibular nerve?
L5, S1, S2
See diagram 11
See diagram 11
What two groups of muscles are contained within the posterior compartment of the leg?
Superficial group
Deep group
What group of muscles are contained within the superficial group of the posterior compartment of the leg?
What muscles are in this group?
Plantar flexors of ankle
Gastrocnemius
Soleus
Plantaris
What group of muscles are contained within the deep group of muscles of the posterior compartment of the leg?
What muscles are in this group?
Popliteus
Flexor hallucis longus
Flexor digitorum longus
Tibialis posterior
See diagram 12
See diagram 12
What makes up the superolateral boundary of the popliteal fossa?
Biceps femoris
What makes up the supermodel boundary of the popliteal fossa?
Semimembranosus
What makes up the inferior boundary of the popliteal fossa?
Gastrocnemius
What makes up the roof of the popliteal fossa?
Popliteal fascia
Contents of the popliteal fossa?
Lots of dat
Terminal small saphenous vein
Popliteal vessels
Tibial and common fibular nerves
See diagram 13
See diagram 13
What does the superficial lymphatics of the lower limb follow?
Saphenous veins
What lymph nodes does the superficial lymphatics of the lower limb drain to?
Superficial inguinal lymph nodes
Where does the superficial inguinal lymph nodes drain to?
Where does the deep inguinal lymph nodes drain to?
Both = external iliac lymph nodes (some lymph from the superficial inguinal lymph nodes drain to the deep inguinal lymph nodes first)
Those following the small saphenous vein drain to the popliteal lymph nodes first
What do the deep lymphatics of the lower limb follow?
Deep veins
What does the small saphenous vein drain to first?
The popliteal lymph nodes
What do the deep lymphatics of the lower limb drain to?
Deep inguinal lymph nodes and then the external iliac lymph nodes
See diagram 14
See diagram 14
What type of joint is the hip joint?
Ball and socket
What makes up the ball of the hip joint?
Head of femur
What makes up the socket of the hip joint?
Acetabulum of hip
How is the hip joint multiacxial?
It can move in the following ways: Flexion - extension Abduction - adduction Medial - lateral roation Circumduction
See diagram 15
See diagram 15
See diagram 16
See diagram 16
What 3 arteries give the main blood supply to the hip joint?
Medial and lateral circumflex femoral arteries (give off retinacular arteries - branches of these arteries which supply the head of the femur)
Artery to head of femur
What does the lateral and medial circumflex arteries normally branch from?
Deep femoral artery
What is the artery to head of femur a branch of?
Obturator
See diagram 17
See diagram 17
What type of joint is the knee joint?
Hinge joint
What is the main movement of the knee?
Flexion-extension (some medial-lateral rotation can occur when knee is flexed)
See diagram 18
See diagram 18
What stabilises the knee joint?
Ligaments
What 3 extra capsular ligaments helps to stabilise the knee joint?
Patellar ligamnet
Lateral (fibular) collateral ligament
Medial (tibial) collateral ligament
See diagram 19
See diagram 19
What 2 intra-articular ligaments help to stabilise the knee joint?
Anterior cruciate (ACL) Posterior curciate (PCL)
See diagram 19
See diagram 19
What is another name for the achilles tendon?
Calcaneal tendon
What is the thickest and strongest tendon in the body?
The calcaneal tendon
How long is the calcaneal tendon?
15cm
What does the calcaneal tendon attach to distally?
Calcaneal tuberosity of the calcaneus
What is the normal result of the ankle jerk reflex?
Plantarflexion
See diagram 20 and 21
See diagram 20 and 21
What are the 6 regions of the lower limb?
Gluteal Femoral (thigh) Knee Leg Ankle Foot
What innervates the gluteal muscles?
Gluteal nerves
What nerve innervates gluteus maximum?
What nerve innervates all other muscles?
Inferior gluteal nerve
Superior gluteal nerve
What is Trendelenburg’s gait?
an abnormal gait (as with walking) caused by weakness of the abductor muscles of the lower limb, gluteus medius and gluteus minimus. People with a lesion of superior gluteal nerve have weakness of abducting the thigh at the hip
What does the greater sciatic foramen allow?
Passageway for structures into the gluteal region
What does the lesser sciatic foramen allow?
Passageway for structures into the perineum
Does the sciatic nerve exit in the greater or lesser sciatic foramen?
Greater sciatic foramen
What is the contents of the femoral triangle from lateral to medial?
Femoral nerve
Femoral artery
Femoral vein
Lymphatics
In what type of people does chronic compartment syndrome sometimes occur?
Athletes - muscles become engorged with blood when exercising causing increased pressure (can cause pins and needles) - symptoms go away when relaxing
What nerves innervate the muscles of the medial compartment of the thigh?
All supplied by obturator nerve (L2, L3 and L4) except hamstring part of adductor magnus which is supplied by the tibial nerve
What are the roots of the obturator nerve?
L2, L3, L4
What are the 2 parts of the adductor magnus?
Hamstring part
Adductor part
What nerves supply the muscles of the posterior compartment of the thigh?
All are supplied by the tibial division of sciatic nerve (L5, S1, S2) except the short head biceps femurs (common fibular division of sciatic)
What are the roots of the tibial division of the sciatic nerve?
L5, S1, S2
What does the common fibular nerve divide into and where does this occur?
Divides into the superficial and deep fibular nerve around the head of the fibula
What nerve innervates the muscles of the posterior compartment of the leg?
Tibial nerve
What deepens the acetabulum of the pelvis?
The acetabular labrum (ring of cartilage that surrounds the acetabulum of the hip)
What forms the ligaments at the hip joint?
The thick part of fibrous layer of joint capsule
What creates a spiral from the pelvis to femur?
Iliofemoral ligament
Name the 3 ligaments of the hip joint?
Iliofemoral
Pubofemoral
Ischiofemoral
What purpose do the ligaments of the hip joint have?
To strengthen the joint capsule
What is the name of the ligament to the head of the femur at the hip joint?
Ligemanetum teres
How many articulations does the knee joint have?
3:
2 X femerotibial
1 X femeropatellar
What of the 3 types of joint is the knee joint?
Synovial joint (external fibrous layer and internal membranous layer which extends as bursae)
Is the knee or the hip joint stronger?
Hip joint
What muscle is used to unlock the knee?
Popliteus
What are the menisci of the name?
Names?
Crescent fibrocartilage in the knee joint
Medial and lateral
What 2 tendons join to form the calcaneal tendon?
Gastrocnemius and soleus