Basic Anatomy - Lower Extremities Flashcards
Quadriceps/Patellar tendon - common insertion of what thigh muscles?
Quadriceps femoris
Rectus femoris: origin
Anterior iliac spine - function: flex at hip joint and extend at knee joint
Common insertion of Iliacus and Psoas muscles
Lesser trochanter of femur
Thigh has three compartments: if the anterior compartment were flexors then the medial compartment would be?
ADDUCTORS - posterior were extensors
Medial thigh compartments - adducts the thigh is innervated by what nerve?
Obturator nerve
All are medial thigh muscles except:
Adductor longus, Adductor brevis, Gracilis, Pectineus, Adductor magnus
Pectineus - anterior thigh muscle
Common insertion of adductor muscles
Linea aspera of femur
Adductor tubercle of femur is the insertion of hamstring part of
Adductor magnus - both has adductor and extensor function
Nerve blocked during s femoral vein catheterization
Genitofemoral nerve
Anterior thigh muscles : flexors of the thigh and extensors of the leg is innervated by?
Femoral nerve
Extensors of the thigh - posterior thigh muscles - flexor of the leg is innervated by?
Sciatic nerve
Common origin of hamstring muscles
Ischial tuberosity
Common origin of Gluteal muscles:
Outer surface of ilium
What is the superior border of the femoral triangle (contains nerve, artery and vein of femoral branch)
Inguinal ligament
Medial - adductor longus
Lateral - sartorius
Greater trochanter of femur is the common insertion for gluteal muscles except what muscles?
Gluteus maximus - gluteal tuberosity
Quadratus femoris - quadrate tubercle
Lumbar plexus formed within the ___muscle by the ventral rami of L1-L4
Psoas major muscles
Largest branch of lumbar plexus, lateral border of Psoas
Femoral nerve - L2, L3, L4 - supplies the muscles on the anterior thigh and skin on antero-medial aspect
Quadriceps femoris is composed of what?
Rectus femoris
Vastus lateralis
Vastus medialis
Vastus intermedius
Lumbosacral trunk is composed of
L4 joins L5
Hernial sac of a femoral hernia is located?
BELOW and LATERAL to pubic tubercle
Obturator nerve is from ___. Medial border of Psoas, supplies medial thigh muscles and skin on the medial aspect of the thigh
L2, L3 and L4
Sacral plexus lies on the posterior pelvic wall in front of what muscle?
Piriformis muscle
Sciatic nerve (L4-S3) leave the pelvis through ____ foramen
Greater Sciatic Foramen
Superior gluteal (L4-S1) innervates the ___ muscles
Gluteus medius/ Gluteus minimus
Inferior gluteal nerve (L5-S2) innervates the ___ muscle.
Gluteus maximus
Sacral plexus is formed by the anterior rami of ___
L4 and L5 and S1 - S4
Pudendal nerve is from?
S2, S3 and S4
Lesion: weakend abduction of thigh by gluteus medius, “ waddling gait”, sagging of pelvis on the unsupported limb, (+) Trendelenburg sign
Superior gluteal nerve injury
Patient had an accident resulting to weakness in the ability to laterally rotate and extend the thigh at hip joint. Has difficulty extending the thigh from flexed position: climbing stairs and rising from a chair. What lesion and muscle involved?
Inferior gluteal nerve injury - affecting the Gluteus maximus
Sciatic nerve lesions as a result of a posterior dislocation of the femur commonly compressed what roots of the sacral plexus?
L5 and S1 roots are commonly compressed - pain radiates into the L5 and S1 dermatomes of the leg and foot
Safest site for the intramuscular injections in the buttock?
Supeolateral part of the buttock - avoid hitting nerves and vessels
Lesion with diminished patellar tendon reflex. Weakness in ability to flex the thigh at hip joint and ability to extend the leg at knee joint
Femoral nerve lesion
Lesion that has no motor loss but more on pain and paresthesia in the skin of the medial aspect of the leg and foot. Usually lesioned during surgical procedure of the leg
Saphenous nerve lesion
Accident results to paresthesia in the skin of medial thigh and unable to adduct the thigh at the hip
Obturator nerve lesions - most commonly lesioned in the pelvis
Refers to increased neck shaft angle changes
COXA VALGA - while COXA VARA is decreased neck shaft angle
Classification used for femoral neck fracture
Garden classification
True/False: during femoral neck fracture, femur is shortened with lateral rotation.
True
Anterior leg muscles - dorsiflexion and extension are innervated by what nerve?
Deep Peroneal Nerve
Lateral leg muscles - plantar flexion and evertion are innervated by what nerve?
Superficial peroneal nerve
Posterior leg muscles - plantar flexion and flexion- is innervated by what?
Tibial nerve
Gastrocnemius and Soleus: collectively called ______
Triceps Surae - composed the Achilles Tendon
It is the only muscle of the posterior leg muscles that cannot plantar flex.
Popliteus
Landmark of Dorsalis pedis artery/ dorsalis pedis pulse
Between malleoli or 1st intermetatarsal space
Great saphenous drains into
Femoral veins while Small saphenous drains into Popliteal vein
What are the cutaneous nerves of the legs?
- Lateral cutaneous nerve
- Superficial peroneal nerve
- Saphanous nerve
True/false: Peroneus: plantar flex and evert foot while Tibialis planter flex and invert
True
Lesion: can’t stand on tiptoes with paresthesia on skin of posterior leg, sole and lateral foot
Tibial nerve lesion
Lesion due to compression of neck of fibula, hip fracture or dislocation of femur results to footdrop and steppage gait, pain and paresthesia in lateral leg and dorsum of the foot
Common Peroneal/Fibular nerve lesions
Lesion results to weakness on Eversion of foot
Superficial Peroneal lesions
Lesion: footdrop and paresthesia in the skin of the webbed space between the great toe and the second toe
Deep Peroneal lesions
Anterior superior iliac spine is the origin of what thigh muscle?
Sartorius - lateral rotation
Muscles of gluteal region: extensor of the thigh
Gluteus maximus
Fascial tunnel from apex of the femoral triangle to the adductor hiatus; contents - femoral vein/artery, saphenous nerve and nerve to vastud medialis
Adductor canal/Subsartorial canal/Hunter’s canal
Nerve supply of the knee joint except:
Femoral n. Obturator n. Common peroneal n. Tibial n. Superficial peroneal n.
Superficial nerve - branch from common peroneal nerve
Causes flexion of the knee joint except: Gracilis, Sartorius, Popliteus, Quadriceps femoris
Quadricep femoris - causes extension of knee joint not extension
Extra capsular ligament involved in a forced adduction
Lateral collateral ligament
Extra capsular ligament involved in forced abduction of the tibia
Medial collateral ligament
Intracapsular ligament that prevents forward sliding of the tibia on the femur. Posterior displacement of the femur on tibia Lax during FLEXION
Anterior cruciate ligament
Intracapsular ligament prevent backward sliding of the tibia on the femur, anterior displacement of the femur on tibia. Lax during EXTENDSION
Posterior cruciate ligaments
Ligament attaches to the anterior aspect of tibia and courses posteriorly and externally to attach to the lateral condyle of the femur.
Anterior cruciate ligaments
Ligament attaches to the posterior aspect of tibia and courses anteriorly and internally to attach to the medial condyle of the femur.
Posterior cruciate ligaments
Commonly injured structures of the knee:
Terrible Triad - tibial collateral ligament, medial meniscus, and ACL
Comprises the Unhappy Triad of O’Donoghue
ACL, MCL, Medial meniscus
Refers to the forward sliding of the tibia on the femur due to rupture of the anterior cruciate ligaments
Anterior drawer sign
Refers to the backward sliding of the tibia on the femur caused by rupture of the Posterior Cruciate Ligaments
Posterior Drawers Sign
Refers to the collapse of the lateral compartment of the knee and rupture of the medial/tibial collateral ligament. Tibia is bent or twisted laterally
Knock knee/Genu Valgum
Refers to the collapse of the medial compartment of the knee and rupture of the lateral/fibular collateral ligament. Tibia is bent medially
Bowleg/ Genu Varum
Bones that composed the ankle joint?
Tibia, fibula, and Talus
