Anterior Thigh, Leg and Dorsal Foot

Question 1

What is the action rule for the anterior compartment of the thigh?

Answer 1

flex hip joint and extend knee joint

Question 2

What nerve innervates the anterior compartment of the thigh?

Answer 2

the femoral nerve, which emerges lateral to psoas major

innervates muscles in this compartment and skin on the anterior medial thigh

Question 3

What branch of the femoral nerve innervates the skin on the anteromedial aspect of the knee, leg and foot

Answer 3

the sapheneous nerve

Question 4

What are the muscles in the anterior component of the thigh

Answer 4

• Quadriceps femoris (rectus femoris, vastus lateralis, vastus intermedius, vastus medialis)
• Iliopsoas
• Sartorius
• Pectineus

Question 5

What are the 4 muscles that make up quadriceps femoris?

Answer 5

rectus femoris

vastus lateralis

vastus intermedius

vastus medialis

join distally to form quadriceps tendon (patella is embedded in quadriceps tendon)

Question 6

Origin of the rectus femoris muscle?

Answer 6

AIIS

Question 7

Where can bursitis occur in the knee?

Answer 7

in the prepatellar bursa (btwn skin and patella)

in suprapatellar bursa (deep to quadriceps tendon)

Question 8

What are you checking when you check patellar tendon reflex?

Answer 8

the integrity of the femoral nn. and the L2-L4 spinal nerves. lack of or weak response indicates nerve damage

Question 9

origin and insertion of iliopsoas muscles

Answer 9

iliacus- iliac fossa

psoas- lumbar vertebrae

both insert onto lesser trochanter of femur

Question 10

Action of iliopsoas muscle

Answer 10

flex hip joint

Question 11

Origin and insertion for sartorius

Answer 11

origin: ASIS

Insertion: medial aspect of proximal tibia

Question 12

Actions for sartorius

Answer 12

flex, abduct and laterally rotate the hip. Flex knee joint

Question 13

Origin and insertion for pectineus?

Answer 13

Origin: pubis

Insertion: proximal femur

Question 14

Action of pectineus? innervations?

Answer 14

weakly flex hip joint, adduct hip joint

innervations: femoral n. but may also receive a branch from obturator n.

Question 15

Rules for the medial compartment of the thigh

Answer 15

Origin: pubis
Action: adduct hip joint
Innervation: obturator nerve (L2-L4)

Question 16

Muscles of the medial compartment of the thigh

Answer 16

adductor longus, adductor brevis, adductor magnus, gracilis, obturator externus

Question 17

What 2 muscles is the obturator nerve run between?

Answer 17

adductor longus and adductor brevis

Question 18

Adductor magnus

Answer 18

consists of 2 parts:

• adductor part: follows compartment rules
• hamstrings part: origin-ischial tuberosity, action- extend hip joint, innervation: tibial nerve

Question 19

Where does gracilis insert? What are its actions?

Answer 19

medial aspect of proximal tibia

weakly adducts hip, flex/medially rotates hip joint

Question 20

Origin/insertion of obturator externus?

Answer 20

origin: external aspect of obturator membrane

inserts onto proximal femur

Question 21

actions of obturator externus?

Answer 21

laterally rotates and stabilize hip joint

Question 22

What are the 3 compartments of the leg?

Answer 22

anterior, posterior (superficial and deep), lateral

Question 23

What is compartment syndrome?

Answer 23

When swelling within a compartment compromises blood flow and/or innervation to the tissues within that space

Question 24

Rules for the anterior compartment of the leg

Answer 24

action: dorsiflex ankle joint, extend toes

innervation rules: deep fibular n. (L4-S1) (from common fibular nerve)

Question 25

deep fibular nerve

Answer 25

aka peroneal nerve innervates muscles of anterior leg compartment and dorsal foot and the skin of the dorsal foot between the hallux and the second digit

Question 26

What are the muscles of the anterior leg?

Answer 26

tibialis anterior, extensor hallucis longus, extensor digitorum longus, fibularis (peroneus) tertius (may be absent 8% or fused with extensor digitorum longus

Question 27

Insertion of tibialis anterior muscle? action?

Answer 27

medial cuneiform & base of 1st metatarsal dorsiflex ankle joint and invert foot

Question 28

What are shin splints?

Answer 28

anterior tibialis sprain, caused by repeated microtrauma/overexertion of this tibialis anterior and small tears in the periosteum overlying the tibia; inflammation can cause compartment syndrome

Question 29

insertion of extensor hallucis longus? action?

Answer 29

distal phalanx of the hallux extend hallux, weakly dorsiflex ankle joint

Question 30

insertion of extensor digitorum longus? action?

Answer 30

distal phalanges of digits 2-5 extend digits 2-5 (MTP, PIP and DIP joints), dorsiflex ankle joint

Question 31

fibularis tertius insertion? action?

Answer 31

base of 5th metatarsal dorsiflex ankle, evert foot

Question 32

LE nerve that is most often injured?

Answer 32

common fibular nerve, vulnerable to injury because it winds around the neck of the fibula injury to this nerve will effect: anterior compartment of the leg, dorsal foot, lateral compartment of the leg

Question 33

What is seen in a pt who has loss of dorsiflexion and toe extension?

Answer 33

drop foot, will compensate with "steppage gait" - exaggerated hip and knee flexion, may also exhibit foot slap

Question 34

What are the two muscles of the dorsal foot?

Answer 34

extensor digitorium brevis, extensor hallucis brevis

Question 35

What nerve innervates the dorsal foot?

Answer 35

deep fibular nerve (L5-S1)

Question 36

extensor digitorum brevis insertion? action?

Answer 36

extensor expansions of digits 2-4 extend digits 2-4 (MTP, PIP, DIP)

Question 37

extensor hallucis brevis insertion? action?

Answer 37

extensor expansion of the hallux extends the hallux (MTP, IP)

Question 38

What does the obturator artery supply blood to?

Answer 38

medial and posterior compartments of the thigh

Question 39

femoral artery

Answer 39

primary source of blood to LE continuation of the external iliac artery directly supplies blood to the anterior and medial compartments of the thigh

Question 40

What does the femoral artery become as it passes through the adductor hiatus?

Answer 40

popliteal artery

Question 41

where can you feel the femoral pulse?

Answer 41

just inferior to the midpoint of the inguinal ligament, compression at this location will stop blood flow through the femoral artery

Question 42

What is the deep artery of the thigh a branch of? What does it supply?

Answer 42

the femoral artery (largest branch) supplies the posterior compartment of the thigh (perforating branches also supply the medial compartment and the lateral aspect of the anterior compartment)

Question 43

Where are the lateral and medial circumflex arteries? what do they supply?

Answer 43

branches of the deep artery of the thigh lateral supplies lateral aspect of the thigh medial supplies most of the blood to the femoral head and neck

Question 44

Where is the anterior tibial artery? what does it supply?

Answer 44

branch off the popliteal artery, descends anterior leg with deep fibular nerve. Terminates at the ankle supplies anterolateral leg

Question 45

dorsalis pedis artery

Answer 45

major source of blood to the toes major branches: - arcuate artery - dorsal metatarsal arteries - dorsal digital arteries

Question 46

superficially, where does the dorsal foot drain?

Answer 46

the dorsal venous arch > great saphenous vein medially > small saphenous vein laterally

Question 47

what connects the superficial to deep veins int he anterior leg?

Answer 47

perforating veins

Question 48

What does the femoral vein receive blood from? where does it drain?

Answer 48

popliteal vein, deep vein of the thigh and great saphenous vein drains into external iliac vein

Question 49

What are the borders of the femoral triangle?

Answer 49

``` sartorius muscle (lateral) inguinal ligament (superior) adductor longus (medial) ```

Question 50

What are the contents of the femoral triangle?

Answer 50

NAVEL (lateral to medial) ``` nerve artery vein empty space lymph ``` femoral sheath holds everything except the femoral nerve

Question 51

femoral canal

Answer 51

medial compartment of the femoral triangle contains loose connective tissue, fat, lymphatic vessels and deep inguinal lymph nodes function is to allow expansive of the femoral vein when there is increased venous return

Question 52

femoral hernia

Answer 52

proximal opening of the femoral canal is called the femoral ring (area of weakness) normally enclosed by fatty tissue and parietal peritoneum abdominal viscera can protrude through the femoral ring into the femoral canal, forming a hernia femoral hernia lies in the femoral triangle, medial to femoral vein and inferior to the inguinal ligament occurs more often in females