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MRCS > Anatomy Lower Limb > Flashcards

Anatomy Lower Limb Flashcards

1
Q

borders of femoral triangle

A

inguinal ligament, adductor longus, sartorius muscle

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2
Q

femoral triangle components

A

lateral to medial:

femoral nerve, artery and vein with femoral canal (empty space with lymph nodes and vessels)

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3
Q

femoral sheath components

A

femoral artery, femoral vein, femoral canal (allows vein to distend into the empty space in cases of increased venous return)

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4
Q

femoral artery pulse location

A

mid-inguinal point, midpoint between ASIS and pubic symphysis

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5
Q

femoral hernia site

A

bowels protrude through femoral canal
presents as lump inferolateral to the pubic tubercle
more common in women due to wider pelvis

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6
Q

popliteal fossa contents

A

all vessels and nerves passing from thigh to calf pass through fossa
medial to lateral: popliteal artery, popliteal vein, tibial nerve, common peroneal/fibular nerve

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7
Q

tarsal tunnel syndrome

A

tibial nerve compression, altered sensation at sole of foot

tibial nerve and other structures pass inferiorly to the medial malleolus

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8
Q

swelling in popliteal fossa DDx

A

1- baker’s cyst

2- popliteal artery aneurysm

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9
Q

baker’s cyst

A

inflammation of semimembranous bursa (medial border of popliteal fossa)

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10
Q

tarsals

A

proximal: talus, calcaneus
intermediate: navicular
distal: 3 cuneiforms, cuboid

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11
Q

ankle joint bones

A

talus, tibia, fibula

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12
Q

excessive dorsiflexion of the foot injury/fracture

A

neck of talus fracture, at high risk of avascular necrosis

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13
Q

Achilles tendon attaches to

A

calcaneal tuberosity

lies inferior to talus and creates heel of foot

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14
Q

3 methods for metatarsal fracture

A

1- direct blow to the foot
2- stress fracture (neck of 2nd and 3rd metatarsals, base of 5th)
3- excessive inversion (base of 5th), fibularis brevis muscle can avulse (‘tear off’) the base

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15
Q

cause of avulsion fracture of greater trochanter of femur

A

forceful contraction of gluteus medius

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16
Q

cause of avulsion fracture of lesser trochanter of femur

A

forceful contraction of iliopsoas

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17
Q

strongest ligament of hip joint

A

iliofemoral ligament attached to intertrochanteric line

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18
Q

neck of femur fracture presentation

A

shortened leg and externally rotated

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19
Q

proximal femur fractures classification

A

1- intracapsular: occurs within hip joint capsule. high risk of avascular necrosis of femoral head due to injury to medial femoral circumflex artery (neck fracture)
2- extracapsular: blood supply intact (trochanteric or subtrochanteric fracture)

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20
Q

femoral shaft fracture features

A

shortened leg
commonly spiral fracture
risk of femoral nerve and artery injury

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21
Q

patella type of bone

A

sesamoid because it is situated between 2 tendons

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22
Q

patella attachments

A

base of patella (superior aspect) attached to quadriceps tendon
apex of patella (inferior aspect) attached to patellar ligament, connected to tibial tuberosity

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23
Q

patella articulates with which bone

A

femur
on patella’s posterior surface, its medial facet articulates with medial condyle of femur
lateral facet with lateral condyle

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24
Q

intraosseous access in emergency cases locations

A

1- anteromedial surface, 2-3cm below tibial tuberosity

2- proximal to medial malleolus

25
Q

anterior cruciate ligament attachments

A

spans between the tibial intercondylar eminence and the lateral condyle of the femur

26
Q

posterior cruciate ligament attachments

A

spans between the tibial intercondylar eminence and the medial condyle of the femur

27
Q

over-inversion of ankle injuries

A

1- fracture at base of 5th metatarsal
2- spiral fracture of medial malleolus (tibia), can be associated with lateral malleolus (fibula) - associated more with eversion

28
Q

fibula articulations

A

proximally and distally with tibia

ankle joint with talus

29
Q

common fibular nerve relation with fibula

A

nerve found on posterior and lateral surface of fibular neck

30
Q

ovoid hiatus

A

opening in the fascia latta to allow passage of great saphenous vein and lymphatic vessels
femoral hernia can protrude through it (risk of strangulation and incarceration)

31
Q

fascia lata and transplantation

A

popular choice due to high concentration of connective tissue fibers and vascularity

32
Q

muscles of gluteal region - superficial and deep

and blood supply

A

superficial: (abductor, extenders, medial rotation) gluteus maximus, gluteus medius, gluteus minimus, tensor fascia lata
deep: (lateral rotation) quadratus femoris, pirifomis, gemellus superior, gemellus inferior, obturator internus
superior and inferior gluteal arteries (from internal iliac artery)
ALL attach to greater trochanter

33
Q

innervation of superficial gluteal muscles

A

superior gluteal nerve

EXCEPT gluteus maximus innervated by inferior gluteal nerve

34
Q

superior gluteal nerve damage

A

Trendelenburg sign
paralysis of gluteus medius and minimus, pelvis no longer stabilized during motion and falls to the side of the raised leg
damaged nerve is on the opposite side of the raised leg

35
Q

innervation of deep gluteal muscles

A

all are innervated by a nerve specific to each muscle
EXCEPT gemellus superior: nerve to obturator internus
gemellus inferior: nerve to quadratus femoris

36
Q

landmark of gluteal region

A

piriformis - divides region into superior and inferior (superior gluteal nerve and artery emerges into gluteal region superior to piriformis)
also sciatic nerve enters region directly inferior to piriformis

37
Q

muscles of anterior compartment of thigh and

innervation

A

pectineus, sartorius, quadriceps femoris, iliopsoas (psoas major + iliacus)
femoral nerve EXCEPT psoas major by anterior rami of L1-3

38
Q

quadriceps femoris muscles

A

vastus lateralis, vastus intermedius, vastus medialis, rectus femoris

39
Q

thigh anterior compartment muscles function

A 
iliopsoas: Hip flexion
quadriceps femoris: knee extension
pectineus: flexion and adduction of hip
sartorius: at hip flexion, abduction, lateral rotation
at knee, flexion
40
Q

femoral nerve damage

A

can’t extend knee

41
Q

thigh medial compartment of muscles
innervation, blood supply
function

A

gracilis, obturator externus, adductor brevis, adductor longus and adductor magnus
obturator nerve, obturator artery
hip adduction

42
Q

groin strain

A

strain of adductor muscles from explosive movements or stretching
treatment: RICE protocol - rest, ice, compression, elevation

43
Q

thigh posterior compartment of muscles

function

A

“hamstrings”
biceps femoris, semitendinosus and semimembranosus
hip extension, knee flexion
NB: adductor magnus in medial thigh has hamstring part with similar function

44
Q

posterior thigh muscles innervation

A

biceps femoris: long head by tibial part of sciatic nerve, short head by common fibular part of sciatic nerve
semitendinous and semimembranous: tibial part of sciatic nerve

45
Q

sciatic nerve spinal cords

A

L4 - S3

46
Q

femoral nerve spinal cords

A

L2 - L4

47
Q

muscles in the anterior compartment of the leg

A

tibialis anterior, extensor digitorum longus, extensor hallucis longus, fibularis tertius

48
Q

anterior leg muscles function

A

dorsiflex and invert the foot at the ankle joint

digitorum longus and extensor hallucis longus also extend the toes

49
Q

anterior leg muscles innervation and blood supply

A

deep fibular nerve, anterior tibial artery

50
Q

common fibular/peroneal nerve spinal cords

A

L4 - S1

51
Q

common peroneal nerve injury

A

causes foot drop due to injury of deep fibular nerve and paralysis of anterior leg muscles
eversion flick when walking to flick the foot

52
Q

lateral leg muscles compartment

A

fibularis longus and brevis

53
Q

lateral leg muscles function

A

eversion of foot (sole outwards)

54
Q

lateral leg muscles innervation

A

superficial fibular (peroneal) nerve

55
Q

lateral leg muscles and lateral malleolus relation

A

tendons of muscles attach posteriorly to lateral malleolus

tendons of anterior muscles attach medially

56
Q

where does common peroneal structure pass and bifurcate

A

it passes through a small gap between parts of fibularis longus muscle (between head and neck of fibula)
it bifurcates after passing this gap

57
Q

Posterior leg muscles
Function
Innervation

A

Gastrocnemius, plantaris, soleus, popliteus, tibialis posterior, flexor digitorum longus, flexor hallucis longus
Plantarflexion, flexion of toes, inversion
Tibial nerve

58
Q

Injury to medial collateral ligament leads to

A

medial meniscus tear (they are attached to each other)

MRCS (12 decks)

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