BRS - LEA Highlights Flashcards
what is the pelvic girdle?
bony ring formed by the hip bones (ilium, ischium, pubis), and the sacrum that provides a strong connection b/w the trunk and lower limb
what is the strongest ligament of the hip joint?
iliofemoral ligament (forms an inverted Y shape);
limits hyperextension
what are the boundaries of the femoral triangle?
- bounds: inguinal ligament, sartorius, adductor longus
- floor: iliopsoas, pectineus, and adductor longus
- roof: fascia lata, cribriform fascia
what are the contents of the femoral triangle?
- from lateral to medial
- femoral nerve
- femoral sheath, containing (femoral artery, vein, and deep lymphatics)
what are the bounds of the popliteal fossa?
bounds:
- semimembranosus,
- semitendinosus,
- biceps femoris,
- medial and lateral heads of the gastrocnemius,
- plantaris
what are the contents of the popliteal fossa?
- popliteal vessles
- common peroneal and tibial nerves
- small saphenous vein
what is the pes anserinus?
- “goose foot”
- combined tendinous expansions of the sartorious, gracilis, and semitendinosus;
- attaches these muscles to the medial tibial condyle
what is the clinical use of the SEMITENDINOSUS tendon?
semitendinosus tendon may be used for surgical reconstruction of the ANTERIOR CRUCIATE LIGAMENT
anterior cruciate ligament:
function
- prevents excessive anterior translation (sliding) of the tibia in relation to the femur
- prevents hyperextension of the knee joint
- taut during EXTENSION of knee, relaxed during flexion
posterior cruciate ligament:
function
- prevents excessive POSTERIOR translation (sliding) of the tibia in relation to the femur
- prevents hyper-flexion of the knee joint
- taut during FLEXION of knee, relaxed during extension
what graft can be used for surgical repair of the anterior cruciate ligament?
patellar ligament
what may be used for autografts of the long flexors of the fingers?
plantaris tendon
medial (deltoid) ligament:
function
prevents OVEREVERSION of the foot
lateral ligament of the ankle:
composition and function
- (anterior and posterior talofibular and calcaneofibular ligaments)
- resists INVERSIONof the foot
the long and short plantar (plantar calcaneocuboid) ligaments support what?
supports the LATERAL side of the longitudinal arch of the foot
spring ligament
(other name and function)
- plantar calcaneonavicular (plantar CN ligament)
- supports the head of the talus and the medial longitudinal arch
- **the ligament is fairly elastic, hence its name
describe and explain the gluteal gait
- aka “gluteus medius limp”
- waddling gait with pelvis falling (or drooping) toward the unaffected side when the opposite leg is raised
- CAUSED by paralysis the gluteus medius muscle
common site for intramuscular injection of medications.
why?
superior lateral quadrant of the gluteal region;
to avoid injury to the underlying sciatic nerve and other neurovascular structures
piriformis syndrome:
define
- condition in which the piriformis muscle irritates and places pressure on the sciatic nerve;
- causes pain in the lower back, buttocks, and referred pain along the course of the sciatic nerve (sciatica)
sciatica:
define
pain in the lower back, buttocks, and referred pain along the course of the sciatic nerve caused by piriformis syndrome
positive trendelenberg sign
(cause and presentation)
- causes:
- fx of femoral neck
- hip dislocation (head of femur)
- weakness and paralysis of the gluteus medius (abductor)
- presentation: if R gluteus medius muscle is paralyzed, the left side (sound side) of the pelvis falls (sags) instead of rising (normally, pelvis rises on unsupported side)
hamstring injuries
- pulled or torn hamstrings;
- very painful and common in persons involved in running, jumping, and quick-start sports
what causes avulsion of the ischial tuberosity?
(the origin of the hamstrings)
forcible flexion of the hip with the KNEE EXTENDED can cause avulsion of hamstring origin
femoral hernia:
define and sequelae
- passes thru the femoral ring and canal
- lies lateral and inferior to the pubic tubercle and deep and inferior to the inguinal ligament
- its sac is formed by parietal peritoneum
- strangulation of femoral hernia –> interfere w/ blood supply to herniated intestine –> death of tissue
groin injury:
define and mechanism
- pulled groin; strain, stretching, or tearing of the origin of the flexor and adductor of the thigh
- often occurs in quick-start sports (sprinting/football),
which patients commonly strain their adductor longus?
may occur in horseback riders and produce pain bc the riders ADDUCT their thighs to keep from falling off the horse
what is the strongest extensor of the thigh at the hip?
- gluteus MAXIMUS is strongest extensor of thigh at the hip
- esp important when walking uphill, climbing stairs, rising from sitting position
iliopsoas muscle:
function, attachment
- fxn: powerful flexor of the thigh
- attaches at lesser trochanter
which muscle(s) can (1) flex the thigh at the hip joint, and
(2) extend the leg at the knee?
- tensor fascia lata
- rectus femoris
hamstring:
muscles and group fxn
- muscles:
- semitendinosus
- semimembranosus
- long head of biceps femoris
- fxn: extend the thigh at the hip, and flex leg at the knee
dorsal versus plantar interossei
actions
- dorsal interossei ABduct the toes, and flex MP joints
- plantar interossei ADduct the toes, and flex MP joints
Remember: PAD and DAB
(MP = metatarsophalangeal)
cc: anterior tibial compartment syndrome
define, cause
- ischemic necrosis of the muscles of the anterior compartment of the leg
- caused by compression of the anterior tibial artery and its branches by swollen muscles following excessive exertion
- accompanied by extreme tenderness and pain on anterolateral aspect of the leg
genu valgum
name, define, causes
- “KNOCK-KNEE”
- condition in which the tibia is BENT or TWISTED LATERALLY, and the knees are abnormally close together
- cause:
- normal in early childhood
- can occur w/ damage to medial collateral ligament in adults
genu varum:
name, define, cause
- “BOW-LEGGED”
- condition in which tibia is bent MEDIALLY
- cause: resulting from collapse of LATERAL collateral ligament
shin splint:
define, cause, types
- painful condition caused by swollen muscles in the ANTERIOR COMPARTMENT of the leg, along the shin bone (tibia), particularly the tibialis anterior muscle
- caused by athletic overexertion
- can be mild form of anterior compartment syndrome
MUSCLE CRAMP:
define, causes, location
- sudden, involuntary, painful contractoin of the muscles
- caused by:
- muscle fatigue from prolonged sitting,
- overexertion,
- dehydration, or
- depletion or imbalance of salt and minerals (electrolytes) as well as
- poor blood supply to leg muscles
- common in calf muscle, hamstrings, quadriceps
patellar (knee-jerk) reflex:
action, & which vertebra does it test
- patellar ligament is tapped –> sudden contraction of the quadriceps femoris
- tests L2-L4 (femoral nerve): its afferent and efferent impusles are transmitted in femoral nerve
ankle-jerk (achilles) reflex:
define, tests
- reflex twitch of the triceps surae (i.e. the medial and lateral heads of the gastrocnemius and the soleus muscles)
- induced by tapping the tendo-calcaneus –> plantarflexion of foot
- TIBIAL NERVE (afferent and efferent limbs are carried in tibial nerve)
effect of damage to obturator nerve
causes weakness of adduction & lateral swinging of the limb during walking bc of the unopposed abductors