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Phase 1 Anatomy > Anatomy - Lower limbs > Flashcards

Anatomy - Lower limbs Flashcards

1
Q

What is the pelvis made of?

A
  • two hip bones (innominate)
  • sacrum
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2
Q

What bones make up the leg?

A
  • tibia and fibula
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3
Q

What is the ‘top’ of the foot?

A

the dorsum

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4
Q

Hip joint

A
  • synovial ball and socket joint (between acetabulum and proximal femur)
  • allows: flexion and extension, abduction and adduction, medial and lateral rotation of lower limb
  • stable and quite mobile
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5
Q

Knee joint

A
  • synovial hinge joint (between distal femur and tibia)
  • allows: flexion and extension
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6
Q

Ankle joint

A
  • synovial hinge joint (between distal ends of tibia and fibula with the talus)
  • allows: flexion and extension of the foot
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7
Q

Flexion of the ankle joint is also known as…

A
  • plantarflexion
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8
Q

Extension of the ankle joint is also known as…

A
  • dorsiflexion
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9
Q

The pelvis takes the weight of the body and…

A

transmits it to the lower limbs

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10
Q

What are the three bones that make up each hip bone?

A
  • pubic bone
  • ilium
  • ischium
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11
Q

Where do the pubic bone, ilium and ischium fuse?

A

acetabulum (which is the socket of the hip joint)

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12
Q

Where do the hip bones articulate anteriorly with each other?

A

pubic symphysis

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13
Q

Where do the hip bones articulate posteriorly with the sacrum?

A

sacroiliac joints

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14
Q

What do the superior and inferior pubic rami surround?

A

the obturator foramen

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15
Q

Obturator foramen (in life)

A
  • almost completely closed over by the obturator membrane and muscles attached to it
  • a small gap in the membrane and the muscles (the obturator canal), allows vessels and nerves to pass between the pelvis and thigh
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16
Q

What is the obturator canal?

A
  • small gap in membrane and the muscles
  • allows blood vessels and nerves to pass between the pelvis and the thigh
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17
Q

Iliac crest

A
  • palpable
  • uppermost part of the ilium
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18
Q

ASIS

A

anterior superior iliac spine

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19
Q

AIIS

A

anterior inferior iliac spine

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20
Q

Examples of important posterior landmarks

A
  • ischial tuberosity
  • ischial spine
  • greater and lesser sciatic notches
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21
Q

Ischial tuberosity

A
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22
Q

Ischial spine

A
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23
Q

Greater and lesser sciatic notches

A
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24
Q

Describe the femur

A
  • head (articulates with acetabulum of pelvis to form the hip joint)
  • neck (extends from the head)
  • shaft
  • greater and lesser trochanters (lie distal to the neck)
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25
Q

What are greater and lesser trochanters?

A

they are sites of muscles attachment

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26
Q

Intertrochanteric line

A
  • lie between greater and lesser trochanters
  • on anterior surface of the femur
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27
Q

Trochanteric fossa

A
  • small hollow
  • on medial aspect of greater trochanter
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28
Q

Linea aspera

A
  • bony vertical ridge on the posterior aspect of the shaft of the femur
  • site of muscle attachment
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29
Q

Medial and lateral femoral condyles

A
  • distal end of femur expanded to form these
  • articulate with the proximal tibia at the knee joint
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30
Q

Adductor tubercle

A
  • superior to medial femoral condyle
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31
Q

The Patella

A
  • lies anterior to the knee joint
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32
Q

What are the possible movements of the hip joint?

A
  • flexion and extension
  • abduction and adduction
  • medial (internal) and lateral (external) rotation
  • circumduction
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33
Q

What do muscles in the anterior thigh do to the thigh at the hip joint?

A

flex the thigh

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34
Q

What do muscles in the medial thigh do to the thigh at the hip joint?

A

adduct the thigh

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35
Q

What do the muscles in the posterior thigh do to the thigh at the hip joint?

A

extend the thigh

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36
Q

What are the possible movements of the knee joint?

A

flexion and extension

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37
Q

What do the muscles in the anterior thigh do to the leg at the knee joint?

A
  • extend the leg
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38
Q

What do the muscles in the posterior thigh do to the leg at the knee joint?

A
  • flex the leg
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39
Q

Fascia lata

A
  • deep fascia
  • surrounds the thigh like a sleeve
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40
Q

Iliotibial band (tract)

A
  • thickening of the lateral part of the fascia lata
  • attaches to lateral aspect of the proximal tibia and is important for stabilising the knee joints
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41
Q

Intermuscular septa

A
  • extend from the fascia from fascia lata to linea aspera
  • separate the thigh into anterior, medial and posterior compartments
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42
Q

How many muscles are in the anterior compartment of the thigh?

A
  • 7
    (they primarily act as extensors of the knee, some act on the hip joint)
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43
Q

What are the muscles in the anterior compartment of the thigh innervated by?

A
  • femoral nerve (spinal nerves L2-L4)
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44
Q

What are the muscles in the anterior compartment of the thigh?

A
  • quadriceps femoris (x4)
  • sartorius
  • iliopsoas
  • pectineus
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45
Q

Quadriceps femoris

A
  • prime extensor of the knee
  • forms the bulk of the anterior thigh
  • converge onto the quadriceps tendon which runs over the patella to insert onto the tibial tuberosity via the patellar ligament
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46
Q

Name the Quadriceps femoris

A
  • Rectus femoris
  • Vastus lateralis
  • Vastus medialis
  • Vastus intermedius
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47
Q

Patellar ligament

A

distal portion of the common tendon of the quadriceps femoris, which is continued from the patella to the tibial tuberosity

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48
Q

Rectus femoris

A
  • lies in midline of anterior thigh of the anterior thigh
  • attached to the AIIS proximally
  • can contribute to flexion of the hip as it crosses it
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49
Q

Vastus lateralis

A
  • lies lateral to the rectus femoris
  • attaches to the linea aspera on the posterior aspect of the femoral shaft
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50
Q

Vastus medialis

A
  • lies medial to rectus femoris
  • attaches to the linea aspera
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51
Q

Vastus intermedius

A
  • lies deep to rectus femoris
  • attaches to anterior aspect of femoral shaft
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52
Q

Linea aspera

A
  • prominent longitudinal ridge or crest that runs along the axis of the femur
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53
Q

Sartorius

A
  • lies superficially in anterior thigh
  • attaches proximally to ASIS
  • inserts on the medial aspect of the proximal tibia
  • crosses both the hip and knee joints
  • flexes and laterally rotates the hip joint and can flex the knee joint
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54
Q

Ilipsoas

A
  • lies proximally in anterior thigh
  • psoas major and iliacus converge via a common tendon onto the lesser trochanter of the femur
  • prime flexor of the hip joint
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55
Q

Pectineus

A
  • lies in proximal anterior thigh, medial to iliopsoas
  • it attaches proximally at the superior pubic ramus and distally on the femur, just inferior to the lesser trochanter
  • flexes and adducts the hip joint
56
Q

How many muscles does the medial compartment of the thigh contain?

A
  • 5 muscles
57
Q

Describe the muscles of the medial compartment of the thigh

A
  • primarily act as adductors of the hip
  • innervated by obturator nerve (spinal nerves L2-L4)
58
Q

What is the importance of the muscles of the medial compartment being able to adduct?

A
  • adductors play an important role in normal gait as they help to draw the leg back towards the midline as we walk
59
Q

Name the muscles of the medial thigh

A
  • adductor brevis
  • adductor longus
  • adductor magnus
  • gracilis
  • obturator externus
60
Q

True or false? Adductor brevis and adductor longus have similar points of attachment to the pubic bone

A

true, adductor brevis just lies deep to the longus

61
Q

Where does the obturator nerve lie?

A

in between the adductor brevis and adductor longus

62
Q

What is adductor Magnus?

A
  • large muscle
  • has an adductor part and a hamstring part (function differently and have different nerve supplies)
63
Q

Adductor part of the adductor Magnus

A
  • attaches to inferior pubic ramus and the linea aspera
  • acts as an adductor
  • innervated by obturator nerve
64
Q

Hamstring part of the adductor Magnus

A
  • attaches to the ischial tuberosity and adductor tubercle
65
Q

What is the adductor hiatus?

A
  • gap formed between the distal attachments of the two parts of adductor magnus
  • femoral artery and vein travel through the adductor hiatus to enter the posterior thigh
66
Q

Gracilis

A
  • most medial muscle
  • attaches to the pubic bone and medial aspect of tibia
  • it is a weak adductor and flexor of the hip
  • a weak flexor of the knee
  • not a prime mover
67
Q

Obturator externus

A
  • attached to the external surface of the obturator membrane
  • inserts on the femur near the greater trochanter
  • stabilises and laterally rotates the hip joint
68
Q

The femoral artery is a continuation of…

A

the external iliac artery

69
Q

Describe the course of the femoral artery

A

travels deep to inguinal ligament to enter proximal anterior thigh

70
Q

Branches of the femoral artery

A
  • large branch called PROFUNDA FEMORIS (deep thigh_
  • femoral artery will continue distally and transverses adductor hiatus
  • enters distal posterior thigh to become POPLITEAL ARTERY
71
Q

What is the obturator artery a branch of?

A
  • branch of internal iliac artery
72
Q

What does the obturator artery travel through?

A
  • obturator canal into medial compartment of thigh
73
Q

True or false? The obturator artery anastomoses with branches from the femoral artery

A

true

74
Q

Femoral vein

A
  • follows course of femoral artery
  • lies medial to it in proximal thigh
  • travels under inguinal ligament
  • is continuous with external iliac vein
75
Q

Obturator vein

A
  • follows course of obturator artery
  • travels through obturator canal
  • joins internal iliac vein in pelvis
76
Q

Femoral nerve

A
  • formed from L2-L4 spinal nerves
  • travels deep to inguinal ligament to enter proximal anterior thigh (lateral to femoral artery)
  • branches innervate anterior thigh muscles
  • saphenous nerve
77
Q

Saphenous nerve

A
  • sensory branch of femoral nerve
  • innervates skin over the leg
78
Q

Obturator nerve

A
  • L2-L4 spinal nerves
  • travels along lateral wall of pelvis and exits through obturator canal
  • emerges onto superficial surface of adductor brevis
  • gives rise to branches that innervate medial compartment muscles and skin over medial thigh
79
Q

What is the lateral border of the femoral triangle?

A

medial border of sartorius

80
Q

What is the medial border of the femoral triangle?

A

lateral border of adductor longus

81
Q

What is the superior border of the femoral triangle?

A

inguinal ligament

82
Q

What is the floor of the femoral triangle?

A
  • iliopsoas laterally
  • pectineus medially
83
Q

Contents of the femoral triangle?

A
  1. femoral artery
  2. femoral vein (medial to femoral artery)
  3. femoral nerve (lateral to femoral vein, deep to inguinal ligament to enter anterior thigh)
84
Q

Why are the femoral artery and vein vulnerable to penetrating injuries?

A
  • they lie superficially in the femoral triangle
  • because of their superficial position, bleeding vessels can be compressed at the mid-inguinal point
85
Q

What are the three ridges of the ileum of the pelvis?

A
  • anterior, posterior and inferior gluteal lines
86
Q

Greater and lesser sciatic notches

A
87
Q

What ligaments close the greater and lesser sciatic notches?
What do these form?

A
  • sacrotuberous and sacrospinous ligaments
  • form the greater and lesser sciatic foramina
88
Q

Ischial spine

A
  • projects from the posterior ischium
  • sacrospinous ligament attaches to it
89
Q

Ischial tuberosity

A
  • bulky prominence of bone at posterior aspect of ischium
  • muscles of posterior thigh and sacrotuberous ligament attach here
90
Q

What is the intertrochanteric crest?

A
  • ridge of bone between the trochanters on the posterior aspect of femur
91
Q

Gluteal tuberosity

A
  • inferior to trochanters on posterior aspect of the femur
  • site of muscle attachment
92
Q

Name the 4 muscles of the superficial gluteal muscles group

A
  1. gluteus maximus
  2. gluteus medias
  3. gluteus minimus
  4. tensor fascia latae
93
Q

Gluteus maximus

A
  • most superficial muscle
  • has several proximal attachments
  • extensor of hip
  • important for standing and sitting position
  • acts as a lateral rotator of the hip
  • it stabilises the knee joint (because it inserts onto the iliotibial tract)
94
Q

What are the proximal attachments of the gluteus maximus?

A
  • attached to most posterior parts of the posterior surface of the ilium
  • sacrotuberous ligament
  • sacrum
  • distally -> iliotibial tract (smaller proportion attaching onto the gluteal tuberosity)
95
Q

Gluteus medius

A
  • lies deep to maximus
96
Q

Gluteus minimus

A
  • lies deep to gluteus medius
97
Q

True or false? Both the gluteus medius and minimus have similar points of attachment

A
  • true
  • attach to anterior parts of the posterior ilium
  • insert onto the greater trochanter
98
Q

Movements allowed by gluteus medius and minimus

A
  • abduct and laterally rotate
  • due to their similar bony attachments
99
Q

What is the importance of gluteal medius and minimus?

A
  • play an important role in gait (walking, running etc.)
100
Q

Describe how gluteal medius and minimus are used

A
  • standing on one leg: medius and minimus contract to hold the pelvis level so it doesn’t tilt
  • if they are weak or paralysed in one limb the pelvis tilts to the contralateral side every time the contralateral leg is off the ground (resulting in a limp)
101
Q

Tensor fascia latae

A
  • attached to ASIS
  • inserts into the iliotibial band (which itself inserts onto lateral part of proximal tibia)
  • contraction tenses fascia lata and iliotibial band
  • stabilises knee when it is extended and also flexes the hip joint
  • NOT A PRIME MOVER THO
102
Q

Innervation of the superficial gluteal muscles

A
  • gluteal nerves
  • these leave the sacral plexus in pelvis via greater sciatic foramen
103
Q

Innervation of the gluteus maximus

A
  • inferior gluteal nerve
104
Q

Innervation of gluteus medius and minimus + tensor fascia latae

A
  • superior gluteal nerve
105
Q

What are the 4 deep gluteal muscles?

A
  1. piriformis
  2. superior and inferior gemelli
  3. obturator internus
  4. quadratus femoris
106
Q

What is the role of the deep gluteal muscles?

A
  • small muscles that primarily stabilise and laterally rotate the hip joint
107
Q

Insertions of the 4 deep gluteal muscles

A
  • all insert onto or close to the GREATER TROCHANTER
108
Q

Piriformis

A
  • key landmark
  • attaches to anterior surface of the sacrum
  • passes through the greater sciatic foramen
  • inserts onto the greater trochanter
  • nerves of the sacral plexus lie over it in the pelvis
  • sciatic nerve
109
Q

Sciatic nerve

A
  • emerges below inferior border of piriformis in gluteal region
  • divides into tibial and common peroneal (common fibular ) nerves in the posterior thigh
110
Q

Where do the other deep gluteal muscles arise from?

A
  • ischium
  • EXCEPT for obturator internus
111
Q

Obturator internus

A
  • arises from obturator membrane
  • its tendon passes through the lesser sciatic foramen
112
Q

What are the 4 muscles of the posterior thigh?

A
  1. semimembranosus
  2. semitendinosus
  3. biceps femoris (long and short head)
  4. hamstring part of adductor magnus
113
Q

Which muscles are referred to as the ‘hamstrings’ which span both the hip and knee joints?

A
  • semimembranosus
  • semitendinosus
  • long head of biceps femoris
114
Q

Where are the ‘hamstrings’ attached to?

A
  • proximally to ischial tuberosity
115
Q

Movement and innervation of the ‘hamstrings’?

A
  • extend the hip
  • flex the knee
  • innervated by tibial nerve
116
Q

Insertions of semimembranosus and semitendinosus

A
  • medial aspect of proximal tibia
117
Q

Insertions of long and short head of biceps femoris

A
  • they have a common tendon
  • inserts onto head of fibula
118
Q

Where does the short head of biceps of femoris arise from?

A
  • linea aspera
  • therefore it flexes the knee but does not move the hip but does not move the hip joint
119
Q

Innervation of the short head of biceps of femoris

A
  • common peroneal nerve
120
Q

Where does the hamstring part of the adductor magnus arise from?

A
  • arises from ischial tuberosity and inserts into adductor tubercle of femur
  • extends the hip but does not move into the knee joint
121
Q

Innervation of the hamstring part of the adductor magnus

A

innervated by tibial nerve

122
Q

Arterial supply of the hamstring muscles

A
  • supplied by three or four perforating arteries that arise from the profunda femoris
  • travel through small apertures in adductor magnus to reach the posterior compartment
123
Q

Arterial supply of lower thigh

A
  • femoral artery traverses the adductor hiatus to enter the region behind the knee
  • region is known as popliteal fossa
  • artery called after passing through here: popliteal artery
124
Q

Superior and inferior gluteal veins

A
  • follow corresponding arteries through the greater sciatic foramen into the pelvis
  • drain into the internal iliac vein
125
Q

Popliteal vein

A
  • in popliteal fossa it enters anterior thigh via adductor hiatus
  • now is known as femoral vein
  • ascends through anterior thigh
  • receives great saphenous vein in femoral triangle before travelling under inguinal ligament to become continuous with external iliac vein
126
Q

What spinal nerves make up the sciatic nerve?

A
  • L4-S3
127
Q

What does the tibial nerve innervate?

A
  • muscles of the posterior thigh and posterior leg
128
Q

What does the common peroneal (fibular) nerve innervate?

A
  • muscles of anterior and lateral leg
    (lesion of sciatic nerve can result in severe functional deficits)
129
Q

True or false? Both the tibial and common peroneal nerve innervate regions of skin of the lower limb

A

true

130
Q

What is the popliteal fossa?

A
  • diamond-shaped depression behind knee joint
131
Q

Borders of the popliteal fossa

A
  • superomedial: semimembranosus and semitendinosus
  • superolateral: biceps femoris
  • inferomedial and inferolateral: two heads of gastrocnemius
132
Q

What is the gastrocnemius?

A

superficial muscle in posterior leg

133
Q

Contents of the popliteal fossa

A
  • popliteal artery
  • popliteal vein
  • tibial nerve
  • common peroneal (fibular) nerve
134
Q

Popliteal artery

A
  • continuation of femoral artery
  • traverses adductor hiatus to enter popliteal fossa
  • flexing patient’s knee gives best chance of palpating it
  • Bifurcates into anterior and posterior tibial arteries which supply the leg
135
Q

Popliteal vein

A
  • formed by deep veins of leg
  • traverses adductor hiatus
  • continues as femoral vein
136
Q

Tibial nerve

A
  • descends through midline of fossa
  • innervates muscles of posterior leg
137
Q

Common peroneal (fibular) nerve

A
  • travels along the superolateral border of popliteal fossa alongside biceps of femoris
  • wraps around neck of fibula then splits into superficial and deep branch
  • superficial: innervates muscles of lateral leg
  • deep: innervates muscles of anterior leg

Phase 1 Anatomy (8 decks)

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