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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
anterior cruciate ligament attachments
spans between the tibial intercondylar eminence and the lateral condyle of the femur
26
posterior cruciate ligament attachments
spans between the tibial intercondylar eminence and the medial condyle of the femur
27
over-inversion of ankle injuries
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
fibula articulations
proximally and distally with tibia | ankle joint with talus
29
common fibular nerve relation with fibula
nerve found on posterior and lateral surface of fibular neck
30
ovoid hiatus
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
fascia lata and transplantation
popular choice due to high concentration of connective tissue fibers and vascularity
32
muscles of gluteal region - superficial and deep | and blood supply
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
innervation of superficial gluteal muscles
superior gluteal nerve | EXCEPT gluteus maximus innervated by inferior gluteal nerve
34
superior gluteal nerve damage
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
innervation of deep gluteal muscles
all are innervated by a nerve specific to each muscle EXCEPT gemellus superior: nerve to obturator internus gemellus inferior: nerve to quadratus femoris
36
landmark of gluteal region
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
muscles of anterior compartment of thigh and | innervation
pectineus, sartorius, quadriceps femoris, iliopsoas (psoas major + iliacus) femoral nerve EXCEPT psoas major by anterior rami of L1-3
38
quadriceps femoris muscles
vastus lateralis, vastus intermedius, vastus medialis, rectus femoris
39
thigh anterior compartment muscles function
``` iliopsoas: Hip flexion quadriceps femoris: knee extension pectineus: flexion and adduction of hip sartorius: at hip flexion, abduction, lateral rotation at knee, flexion ```
40
femoral nerve damage
can't extend knee
41
thigh medial compartment of muscles innervation, blood supply function
gracilis, obturator externus, adductor brevis, adductor longus and adductor magnus obturator nerve, obturator artery hip adduction
42
groin strain
strain of adductor muscles from explosive movements or stretching treatment: RICE protocol - rest, ice, compression, elevation
43
thigh posterior compartment of muscles | function
"hamstrings" biceps femoris, semitendinosus and semimembranosus hip extension, knee flexion NB: adductor magnus in medial thigh has hamstring part with similar function
44
posterior thigh muscles innervation
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
sciatic nerve spinal cords
L4 - S3
46
femoral nerve spinal cords
L2 - L4
47
muscles in the anterior compartment of the leg
tibialis anterior, extensor digitorum longus, extensor hallucis longus, fibularis tertius
48
anterior leg muscles function
dorsiflex and invert the foot at the ankle joint | digitorum longus and extensor hallucis longus also extend the toes
49
anterior leg muscles innervation and blood supply
deep fibular nerve, anterior tibial artery
50
common fibular/peroneal nerve spinal cords
L4 - S1
51
common peroneal nerve injury
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
lateral leg muscles compartment
fibularis longus and brevis
53
lateral leg muscles function
eversion of foot (sole outwards)
54
lateral leg muscles innervation
superficial fibular (peroneal) nerve
55
lateral leg muscles and lateral malleolus relation
tendons of muscles attach posteriorly to lateral malleolus | tendons of anterior muscles attach medially
56
where does common peroneal structure pass and bifurcate
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
Posterior leg muscles Function Innervation
Gastrocnemius, plantaris, soleus, popliteus, tibialis posterior, flexor digitorum longus, flexor hallucis longus Plantarflexion, flexion of toes, inversion Tibial nerve
58
Injury to medial collateral ligament leads to
medial meniscus tear (they are attached to each other)

MRCS (12 decks)

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