Anatomy of the Lower Limb Flashcards
what are the 6 regions of the lower limb?
gluteal femoral knee leg ankle foot
what is the acetabulo-femoral joint and what type of joint is it?
hip joint
ball and socket synovial joint
what movements does the hip joint allow?
flexion/extension
abduction/adduction
medial/lateral rotation
circumduction
what is the purpose of the spiral formation of ligaments in the hip joint?
brings 2 sides closer together when twisted and makes it more stable when standing
what are the 3 ligaments in the hip?
iliofemoral
ischiofemoral
pubofemoral
what is the primary blood supply to the head of the femur?
medial circumflex femoral artery
genu prefix?
knee
femoral triangle contents?
NAVY from medial to lateral - femoral Nerve femoral Artery femoral Vein lYmphatics
what is the ligamentum teres?
round ligament of the femur
how might a femoral neck fracture result in ischaemia
can cause damage to intracapsular retinacular arteries which surround it
what type of joint is the knee and what does this allow?
modified synovial hinge joint
allows flexion/extension and slight rotation to help stabilise
what are the 3 main joints/articulations of the knee?
medial and lateral tibiofemoral
patellofemoral
(additional joint on lateral side - proximal tibiofibular joint)
what muscles help to stabilise the knee?
quadriceps in the anterior thigh
what are the extracapsular ligaments?
ligaments outside of the knee joint capsule
- patellar ligament
- lateral collateral ligament (thin cord)
- medial collateral ligament (wide and flat)
what are the intra-articular ligaments?
ligaments within the knee joint capsule
- anterior cruciate (ACL)
- posterior cruciate (PCL)
ACL and PCL cross over inside the knee
what do the ACL and PCL do?
ACL - prevents anterior movement of tibia away from femur
PCL - prevents posterior movement of tibia away from femur
what are the menisci?
crescent shaped fibrocartilage that sit around the condyles of the femur like an egg cup, supporting them
what is the Q angle?
angle between the femur and tibia
usually non-existent as they should line up perfectly
genu varum = separation at lateral side
genu valgum = separation at medial side
how do nerves enter/exit pelvis?
via greater and lesser sciatic foramen (separated by sacrospinous and sacrotuberous ligament)
what do the greater and lesser sciatic foramen allow entry to?
greater = gluteal region lesser = perineum
where does the sciatic nerve originate and what does it innervate?
originates L4 - S3
supplies posterior thigh, leg, foot and most of skin (nothing in gluteal region)
where does the pudenal nerve originate and what does it supply?
S2-S4 supplies perineum (pelvic floor - 2,3,4 keeps guts off the floor)
where does the posterior cutaneous nerve of the thigh originate and what does it supply?
S1-S3
supplies skin over posterior thigh, popliteal fossa, lateral perineum and upper medial thigh
what are the superficial muscles of the gluteal region and what do they do?
gluteus maximus gluteus medius gluteus minimus tensor fascia latae extend, abduct and medially rotate)
how are the superficial gluteal muscles innervated?
inferior gluteal supplies gluteus
superior gluteal supplies the rest
what are the deep gluteal muscles and what do they do?
piriformis obturator internus gemelli quadratus femoris lateral rotation of thigh and hip stabilisation
what nerve supplies the deep gluteal muscles?
nerves from sacral plexus
what is a trendelenberg gait?
reduced function of superior gluteal nerve causing weak hip abduction by the gluteus medius
results in dropping of hip on opposite side (camp, swinging hips walk)
what are the 2 portions of the sciatic nerve? describe its course
tibial nerve (larger, medial)
common fibular (smaller, lateral)
exists inferior to piriformis
seen most laterally exiting greater sciatic foramen
how are compartments formed?
invagination of deep fascia form septums between groups of muscles
what are the 3 compartments of the thigh?
anterior, medial and posterior
what are the 3 compartments of the leg?
anterior, lateral, posterior
what is compartment syndrome and how is it treated?
increased pressure in a compartment (e.g from bleeding) can affect function of muscles, nerves and vessels
fasciotomy is performed to relieve pressure
what two types of muscle function are seen in the anterior thigh?
flexors of the thigh
extensors of the leg
name 3 muscles in the anterior thigh and what they do
sartorius = flexor of thigh
vastus = extensor of leg
rectus femoris = both
what nerve innervates muscles in anterior thigh?
femoral nerve (apart from psoas major)
what features form the boundaries of the femoral triangle?
superior = inguinal ligament medial = medial adductor longus lateral = medial sartorius floor = iliopsoas and pectineus roof = deep fascia (fascia lata)
what is contained within the medial compartment of the thigh and how are they innervated?
adductors of thigh - adductor muscles - gracilis - obturator innervated by obturator nerve
what s contained within the posterior compartment of the thigh and how are they innervated?
extensors of thigh and flexors of leg - semitendinous (cord like) - semimembranous (flat) - biceps femoris supplied by tibial part of sciatic nerve
what 2 groups of muscles exist in the posterior compartment of the leg?
superficial - plantarflexors of ankle
deep - flexors of toes and plantarflexors of ankle
what supplies muscles in posterior compartment of leg?
tibial nerve
what is contained within anterior compartment of the leg and what innervates them?
dorsiflexors of ankle and extensors of toes
innervated by deep fibular nerve
what is contained within the lateral compartment of the leg?
muscles which evert the foot and plantarflex ankle
innervated by superficial fibular nerve
what is deep fibular nerve palsy and what causes it?
reduced/absent dorsiflexion of ankle due to loss of muscle action in anterior leg compartment
what are the boundaries of the popliteal fossa?
superolaterally - biceps femoris
superomedially - semimembranous
inferiorly - gastrocnemius
roof - popliteal fascia
what are the contents of the popliteal fossa?
fat
end of small saphenous vein
tibial and common fibular nerves (sciatic)
popliteal vessels (anastomoses and collaterals)
what is the calcaneal tendon?
achilles tendon
strongest tendon in body
attaches to calcaneal tuberosity of calcaenous
tests S1 and S2 nerve root function via ankle jerk reflex
what 2 tendons join to form the achilles?
gastronaemus
soleus
