Anatomy of Lower Limb Flashcards
Where do nerves enter and exit pelvis and peritoneum?
Greater sciatic foramen - pelvis
Lesser sciatic foramen - peritoneum
What forms the sciatic formamen?
What one runs vertically?
What one runs horizontally?
Sacrotuberous (vertically)
- from sacrum to ischial tuberosity
+ sacrospinous ligaments (horizontally)
- from sacrum to ischial spine
What forms the borders of the quatrants of the gluteal region?
Superior to femoral bone - horizontal line
Along iliac crest - vertical line
Where is the best region for gluteal injection?
Superior outer
What nevres are found in the gluteal region?
What do they all innvervate?
Sciatic (L4-S3)
- most of skin - via tibial and common fibular branches
- ALL leg and foot muscles
Pudendal (S2-S4) - perineum
Posterior cutaneous nerve of thigh (S1-S3)
Where does the sciatic nerve exit gluteal region?
Where does it seperate?
Piriformis
Gluteal region
What nerve has its own blood supply?
Sciatic - largest nerve in body
What is contained within the femoral triangle?
Nerve Artery Vein Empty space Lympthatics (femoral canal)
NAVEL
Name the 3 compartments of thigh and leg
Both anterior and posterior
Thigh - medial
Leg - lateral
Flexors of thigh and extensors of leg are found where?
What are their names?
Anterior compartment of thigh
Flexors of thigh
- sartorius
- pectineus
- iliopsoas
Extensor of leg
- quadriceps femoris (don’t get confused with quadratus femoris in the bum)
What is the longest muscle in the body?
Sartorius
What nerve innervates anterior thigh?
Femoral nerve (L2, L3, L4) Apart from psoas major (L1,L2,L3)
What muscles are contained within the medial compartment of the thigh?
What nerve innervates them?
Adductors of thigh
- Adductor brevis
- Adductor longus
- Adductor magnus (largest)
- Gracilis (longest - inserts on medial tibia)
- Obturator externus
All obturator nerve (L2, L3, L4)
- apart from hamstring part of adductor magnus
Where are extensors of thigh and flexors of leg found?
Name the muscles found in this region?
What innervates this region?
Posterior compartment of thigh
- semimembranosus
- semitendinosus
- biceps femoris
Tibial division of sciatic nerve (L5, S1, S2)
- apart from short head biceps femoris
What can the short head biceps femoris not do?
Extend the thigh
What nerve innervates anterior compartment of leg?
What are the muscles found in the anterior leg?
Deep fibular nerve (L4,L5)
Tibularis anterior
Extensor digitorum longus
Extensor hallucis longus
Femoralis tertius
What muscle in the posterior compartment of leg can be harvested and is not present in everyone?
Plantaris
What nerve innervates the posterior compartment of leg?
Name the muscles of the deep region
Name the muscles of the superficial region
Tibial nerve (S1, S2)
Deep
- Tibularis posterior
- Flexor digitorum longus
- Flexor hallicus longus
Superficial
- Popliteal
- Plantaris
- Soleus
- Gastrocnemius
What part of the femur enters the hip joint?
Head of femur into acetabulum
How does the hip joint get its blood supply?
Medial and lateral circumflex arteries - branches of deep femoral artery
Poor function of what muscle causes Trendelenburg’s Gait?
Describe Trendelenburg’s Gait
Gluteus medius
Causes dropping of hip on unaffected side when lifting unaffected leg
Name the 4 superior muscles of the gluteal region
How are they innervated?
Gluteus maximus
Gluteus medius
Gluteus minimus
Tensor fascia latae
Superior gluteal
- apart from gluteus maximus = inferior gluteal
What muscles are responsible for: Lateral rotators of hips Medial rotators of hips Extensors of hips Abductors of hips Hip stabilisers
Superficial muscle of gluteus
- Medial rotation
- Abductors
- Extensors
Deep muscles of gluteus
- Lateral rotation
- Hip stabilisers
Name the 4 deep muscles of the gluteal region
How are they innervated?
Piriformis
Gemelli
Obturator internus
Quadratus femoris
Sacral plexus
What are the borders of the femoral triangle?
Superiorly - inguinal canal Laterally - sartorius Medially - adductor longus Roof - fascia lata Floor - iliopsoas and pectineus
What is contained in the femoral sheath?
Femoral artery and vein
What compartment of the leg is responsible for dorsiflexion of the ankle and extensors of the foot?
Anterior compartment
Name the muscles of the lateral leg
What nerve innervates this region?
What are they responsible for?
Femoralis longus
Femoralis brevis
Superficial fibular nerve
Evert foot (lift pinky toes)
What is the thickest and strongest tendon in the body?
What two muscles does the tendon come from?
This tendon is used in ankle jerk reflex - what is the normal response?
What level of vertebrae is this testing?
Calcaneal tendon (Achille’s tendon)
Gastrocnemius and soleus
Plantarflexion
S1,S2 (tibial nerve)
What is the name of the tendon/ligament that attaches superiorly and inferiorly from the patellar?
Superior - quadriceps tendon
Inferior - patellar ligament
What cruciate ligament runs more lateral side of femur to medial tibia?
ACL
PCL is opposite
What is the name for the semilunar shaped fibrocartilage discs found attached to the tibial condyles?
Menisci
What are the name of the ligaments found most medially and laterally on the knee joint?
Medial and lateral collateral ligaments
What are the 3 articulations of the knee?
2 x femerotibular
1x femeropatellar
What kind of joint is the hip joint?
What part acts as the ball?
What part acts as the socket?
Ball n socket synovial joint
Ball = head of femur Socket = acetabulum
What is the acetabular labrum?
Fibro-cartilage lip which extends the socket - allows for a tighter fit
What are the 3 ligaments found in the hip joint?
Anteriorly
- Iliofemoral
- Pubofemoral
Posteriorly
- Ischiofemoral
What artery does the ligamentum teres cover?
(the ligamentum teres is an internal ligament that runs from the acetabulum to the head of femur)
What is this artery a branch of?
Artery to head of femur - unimportant in adults
Obturator artery
What provides the main blood supply to the hip joint?
What artery provides the hip joint with a small portion of supply? (it runs within the ligamentum teres)
Retinacular branches of the Lateral and cirumflex branches from the deep femoral artery
Obturator artery
The thickest hyaline cartilage of the body is found on the articular surface of which bone?
Patella
What are the 3 main bones of the pelvis?
Ilium
Pubis
Ischium
What part of the pubis bone forms the pubic symphysis (joint where right and left hip bones articulate with each other)?
What are the other two parts of the pubis bone and what part of the hip bone do they help to form?
Pubic body
Superior and inferior pubic rami
- form part of obturator foramen
From what part of the foot does the great and small saphenous vein orginiate?
Dorsal venous arch
