Anatomy lower limb Flashcards
Gluteus maximus innervation
Inferior gluteal nerve (L5, S1, S2)
Gluteus medius
Gluteus minimus
Tensor fascia latae
innervation
Superior gluteal nerve (L5, S1)
Gluteus maximus job
Extend thigh
Gluteus medius
Gluteus minimus
Tensor fascia latae
Abducts thigh + mainly stabilizer (steadies pelvis on leg wen opposite leg is raised)
deep muscles of gluteal region-job Piriformis Obturator internus Superior gemellus Inferior gamellus Quadratus femoris
Lateral rotation of thigh at hip joint
anterior compartemnt thigh innervation
femoral nerve (except Psoas major-Ventral rami of lumbar nerves (L1-L3) and pectinous (fem + obturator nerve)
quadiceps femoris job
rectus femoris, vastus medialis, vastus intermedius, vastus lateralis
extensors of the leg at the knee
Flexors of the thigh at the hip (other gp of anterior compartment)
pectineus
satorius
Iliacus (the other part of illiopsoas)
Psoas major (one part of Iliopsoas)
blood supply of thigh
gluteal: inferior and superior arteries
anterior compartemnt: femoral artery and deep (femoral) artery
medial compartment: obturator artery and deep (femoral) artery
posterior compartment: deep (femoral artery) and femoral artery
medial compartment of thigh job
- are all adductors of the thigh at the hip except obturator externus
- All of them also flex except adductor longus n obturator externus (rotates thigh laterally at hip)
medial compartment of thigh innervation
all obturator nerve except
Hamstring part of Adductor magnus-tibial part of sciatic nerve
posterior compartment of thigh job
• flexors of the leg at the knee + extensors of the thigh at the hip (except the short head of the biceps femoris- Flexes leg, rotates laterally)
hamstrings=
Semitendinosus
Semimembranosus
Biceps femoris long head
originate from ischial tuberosity
posterior compartment of thigh innervation
hamstrings: Tibial nerve (from sciatic) – L5, S1, S2
biceps femurs short head:Fibular division of sciatic nerve
Biceps femoris long head protects
sciatic nerve
UNHAPPY triad
due to lateral blow to side of knee where thigh is rotated n leg is straight
head n neck of femur blood supply
medial circumflex n artery of ligament of head of femur
innervation of piriformis
anterior rami of S1-S2
obturator internus and superior gamellus innervation
nerve to obturator internus (L5-S1)
inferiror gamellus and quadratus femoris
nerve to quadratus femoris (L5,S1)
obturator externus job
lateral rotation of thigh
pectineus job
flex n adduct thigh at hip
lateral circumflex femoral artery
supplies anterior part of gluteal region
knee joint ligaments -stop it from moving horizontally
medial collateral (tibial collateral) ligament (MCL) lateral collateral (fibular collateral) ligament (LCL)
helps stoping too much adduction/abduction
knee joints ligaments -stops moving anterior and posterior
Anterior cruciate ligament prevents anterior movement of tibia
Posterior cruciate ligament prevents posterior movement of tibia
posterior oblique ligament
at the back of knee joint
reflection of semimembranous
menisci of knee joint
lateral meniscus
medial meniscus
Lateral menisci more promiment, deeps the ‘hole’ more than medially
GREY
flexors of hip
iliopsoas, pectineus, satorius
GREY
extend hip
gluteas maximus
hamstings
GREY
abduct hip
glut med, glut min, tensor fascia latae
GREY
adduct hip
medial compartment (minus obturator internus) aka the adductors + gracilis
GREY
rotate hip medially
glut med n glut min
GREY
rotate hip laterally
deep muscles of gluteal region
= piriformis, obturator internus, superior gamellus, inferior gamellus, quadratus femoris
GREY
flex knee
hamstrings, gracillis, satorius, gastrocnemius
GREY
extend knee
quadriceps femoris
GREY
rotate knee medially
semimtendinosus, semimembranosus
GREY
rotate laterally
biceps femoris
unhappy triad
anterior cruciate ACL
medial collateral MCL
medial meniscus
intramuscular injectsion
to avoid sciatic nerve
INJURY TO COMMON FIBULAR (PERONEAL) NERVE
due to injury/trauma at head of fibula that compresses the nerve
• Patient wont be able to evert the foot.
• and gets foot drop (cos cant dorsifelx at ankle)
INJURY TO TIBIAL NERVE
patient cant plantarflexion + hav weakened inversion of foot (leading to shuffling gait)
femoral nerve lesion
mite get
wasting of quadriceps
weakness in leg extension
weakness in thigh flexion
obturator nerve issue
weakness in adduction
midpnt of inguinal ligament from ASIS to pubic tubercle
to get u nerve
mid inguinal line (mid pnt of the inguinal line)-from asis to pubic symphesis
to get artery
fracture at proximal femur
distal fragment is pulled upwards and rotated laterally
leg gets shortened n laterally rotated
garden of femoral neck fractures
garden I= incomplete fracture through neck
II= complete fracture but still stuck togez
III=complete fracture n partially displaced
IV= complete fracture n completely displaced
femoral nerve palsy could get in
femorla shaft fracture
DISTAL FEMUR INJURIES
• Condyle separation à joint misalignment
– What structure is vulnerable to injury?-femoral artery
• Long recovery period
posterior knee dislocation
in car or hyperextension of knee
may damage popliteal artery
posterior cruciate ligament injury
in car or hyperflexion
great saphenous injury
Can become varicose (swollen, twisted and lengthened) ,
can thrombose. Which can lead to a deep vein thrombosis
SUPERIOR GLUTEAL NERVE INJURY
- Hip dislocation/subluxation, greater trochanter fracture
* get positive Trendelenburg test (pelvis on unsupported side descends) or swing-out gait
Risk of strangulation of herniated section of bowel
blcoks blood supply to part of the bowel-=necrosis =>gangrene.
Inguinal hernia
occurring in the groin
Femoral hernia
occurring high on the thigh, where the leg joins the body, just below inguinal ligament
Patellar dislocation
• Lateral – what normally counteracts lateral pull on patella? Vastus medialis
ACL rupture
• Happens in SPORT, wen THIGH ROTATES WHILE LEGS ARE PLANTED
popping” sound
PCL tear:
• OCCURS WEN LEG IS FLEXED AT THIGH, n FORCE PUSHES POSTEIRORLY,
TCL aka MEDIAL COLLATERAL LIGAMENT tear
- Blow to lateral side of extended knee or twisting of knee
* Do Valgus stress test – TCL laxity
Meniscal tears:
Which one commonly tears? MEDIAL MENISCUS
- Positive McMurray’s test:
- If clicking felt when knee hyperflexed, varus stressed, and leg extended =medial meniscus
- If clicking with valgus stress =lateral meniscus
Get joint locking, giving way, pain,
Pain on lateral rotation of the tibia on the femur indicates injury of the lateral meniscus (Fig. B5.34A), whereas pain on medial rotation of the tibia on the femur indicates injury of the medial meniscus
Prepatellar bursitis/Housemaid’s knee:
• Friction between skin and patella; swelling on anterior aspect of knee
Subcutaneous infrapatellar bursitis/Clergyman’s knee:
bursa bw skin n patellar ligament (bottom ligament)
