Ch 62 Consolidated Neurovasculature of the Lower Limb Flashcards
The lumbosacral plexus supplies the entire _ and _ innervation of the lower limb
muscular and cutaneous
The lumbosacral plexus is formed by the ventral rami of the spinal nerves _ thru _
L1 - S4
The lumbosacral plexus can be subdivided into the _ and _ plexus
lumbar and sacral plexus
Ventral ramus L4 bifurcates into an upper division that is part of the _ plexus and a lower division which is part of the _ plexus
lumbar
sacral
The lumbar plexus is derived from the ventral rami _ to _ and the _ division of ventral ramus _
L1 to L3
upper division
L4
The lumbar plexus is found on the _ wall of the abdomen within the substance of the _ _ muscle
posterior
psoas major m
The lumbar plexus supplies structures on the _, _, and _ sides of the _
medial, lateral, anterior
thigh
The sacral plexus is derived from the lower division of ventral ramus _ and ventral rami _ to _.
L4
L5 to S4
The sacral plexus is found on the _ wall of the pelvis just medial to the _ muscle
lateral
piriformis
The sacral plexus mainly supplies the structures of the _ region, posterior _, _, and _.
gluteal
thigh
leg
foot
2 main nerves of the lumbar plexus
Femoral n
Obturator n
The femoral nerve is derived from ventral rami _, _, and the _ division of _.
L2, L3
upper division
L4
The femoral nerve emerges _ to the psoas major muscle and courses deep to the _ ligament and continues distally as it passes thru the _ _ and into the anterior thigh
laterally
inguinal
femoral triangle
Branches of the femoral nerve supply all the muscles of the anterior thigh including the _ part of the iliopsoas m, the _, _ _, _ _, _ _, _ _, and the _ muscle of the medial thigh group
iliacus part
sartorius m
rectus femoris m
vastus lateralis m
vastus medialis m
vastus intermedius m
pectineus m
The femoral nerve gives off cutaneous branches including the _ and the _ _ _ nerve
Saphenous n
Anterior Femoral Cutaneous n
The saphenous nerve supplies the skin of the anterior medial _ and medial _.
leg
foot
The anterior femoral cutaneous nerve supplies the skin of the anterior _.
thigh
The obturator nerve is derived from the ventral rami _, _, and the upper division of _.
L2, L3, L4
The obturator nerve emerges _ to the psoas major muscle and courses inferiorly along the _ wall of the pelvis, dividing into _ branches before passing thru the _ _.
medial
lateral
2
obturator foramen
The anterior branch of the obturator nerve courses antero-inferiorly between the _ _ and _ muscles which it innervates in addition to the _ muscle and the skin of the mid-medial _.
Adductor Longus m
Adductor Brevis m
Gracilis m
thigh
The posterior branch of the obturator nerve courses postero-inferiorly between the _ _ and _ muscles and innervates the _ _ muscle and the _ part of the _ _ muscle.
ADDuctor Brevis m
ADDuctor Magnus m
Obturator Externus m
ADDuctor part of the ADDuctor Magnus m
Additional cutaneous branches of the lumbar plexus that supply skin around the lower abdominal wall, proximal thigh, and external genitalia. These nerves include the _, _, and _ nerves
Iliohypogastric n
Ilioinguinal n
Genitofemoral n
The _ _ _ nerve is a branch of the lumbar plexus and supplies the lateral thigh.
Lateral Femoral Cutaneous n
The sacral plexus is made up of 12 main nerves:
Superior Gluteal n
Inferior Gluteal n
Nerve to Quadratus Femoris and Inferior Gemellus m
Nerve to Obturator Internus and Superior Gemellus m
Nerve to Piriformis m
Posterior Femoral Cutaneous n
Pudendal n
Sciatic n
Tibial n
Common Fibular n
Superficial Fibular n
Deep Fibular n
The superior gluteal nerve consists of the _ division of the ventral ramus _ and the ventral rami _ and _.
Lower Division
L4
L5
S1
The superior gluteal n supplies the _ _ and _ muscles and the _ _ _ muscle.
Gluteus Medius m
Gluteus Minimus m
Tensor Fascia Latae m
The inferior gluteal nerve consists of the ventral rami of _, _, and _.
L5, S1, and S2
The inferior gluteal nerve supplies the _ _ muscle.
Gluteus Maximus m
The nerve to the quadratus femoris and inferior gemellus consists of the _ division of _ and the ventral rami of _ and _
lower division
L4
L5
S1
The nerve to the quadratus femoris and the inferior gemellus supplies the _ _, the _ _, and the _ _ muscles
Gluteus Maximus m
Quadratus Femoris m
Inferior Gemellus m
The nerve to the obturator internus and superior gemellus consist of ventral rami of _, _, and _.
L5, S1, and S2
The nerve to the obturator internus and superior gemellus supplies the _ _ and _ _ muscles.
Obturator Internus m
Superior Gemellus m
The nerve to the piriformis arises from the ventral rami of _ and it supplies the _ muscle.
S2
Piriformis m
The posterior femoral cutaneous nerve arises from the ventral rami of _, _, and _.
S1, S2, and S3
The posterior femoral cutaneous nerve supplies the _ of the _ thigh.
skin
posterior
The pudendal nerve arises from the ventral rami of _, _, and _.
S2, S3, and S4
The pudendal nerve supplies the majority of structures in the _ and _ wall
pelvis
pelvic wall
The sciatic nerve is derived from the _ division of ventral ramus _ thru the ventral rami of _
lower
L4
S3
The sciatic nerve is composed of both the _ part and the _ _ part of the sciatic nerve wrapped in a common _.
tibial
common fibular
epineurium
As the sciatic nerve exits the pelvis, it courses _ the piriformis muscle continuing inferiorly and deep to the _ _ muscle towards the posterior thigh.
below
Gluteus Maximus m
In the posterior thigh, the sciatic nerve courses between the _ muscles.
hamstring
In the thigh, the tibial part of the sciatic nerve innervates the extensor portion of the _ _muscle and the long head of the _ _ muscle, the _ muscle, and the _ muscle.
ADDuctor Magnus m
Biceps Femoris m
Semitendinosus m
Semimembranosus m
The common fibular part of the sciatic nerve innervates the short head of the _ _ muscle.
Biceps Femoris m
The tibial and common fibular parts of the sciatic nerve divide into the _ and _ _ nerves in the lower _ of the thigh just proximal to the _ _.
Tibial n
Common Fibular n
1/3
Popliteal Fossa
The tibial nerve travels inferiorly thru the midline of the _ _, sitting _ to the popliteal vein and artery.
Popliteal Fossa
superficial
The tibial nerve courses between the heads of the _ muscles, deep to the _ muscle, and enters the _ compartment of the leg as it courses distally.
Gastrocnemius m
Soleus m
Deep compartment
The tibial nerve passes deep to the flexor retinaculum on the _ side of the ankle where it divides into the _ and _ _ nerves. These both supply the _ surface of the foot.
medial
medial and lateral plantar n
plantar
The tibial nerve innervates all 7 muscles of the posterior leg:
Gastrocnemius m
Soleus m
Plantaris m
Popliteus m
Tibialis Posterior m
Flexor Digitorum Longus m
Flexor Hallucis Longus m
After arising from the sciatic nerve in the lower 1/3 of the thigh, the common fibular nerve descends on the _ side of the _ _.
lateral
popliteal fossa
The common fibular nerve winds around the fibula and divides into the _ and _ nerves
deep and superficial nerves
The common fibular nerve directly innervates _ muscles in the leg unlike its branches.
0
The superficial fibular nerve courses inferiorly in the _ compartment of the leg between the _ _ and _ _ muscles, innervating both.
lateral compartment
Fibularis Longus m
Fibularis Brevis m
The superficial fibular nerve supplies the skin of the _ leg and _ of the foot except the webspace between the first and second toes.
lateral
dorsum
The deep fibular nerve passes from the _ to the _ compartment of the leg.
lateral to anterior
The deep fibular nerve innervates the entire anterior leg including (4 items)
Tibialis Anterior m
Extensor Hallucis Longus m
Extensor Digitorum Longus m
Fibularis Tertius m
The deep fibular nerve also innervates the _ _ _ muscle on the dorsum of the foot.
Extensor Digitorum Brevis m
The deep fibular nerve supplies the _ between the first and second toes.
webspace (ew)
The abdominal aorta divides into the right and left _ _ arteries at the level of _.
common iliac a
LV4
The common iliac artery courses inferiorly and laterally for about cm before dividing into the _ and _ arteries along the _ _.
5cm
internal and external iliac a
pelvic brim
The internal iliac artery courses inferiorly and posteriorly along the wall of the pelvis giving off branches to pelvic organs (including the _ _ artery) and 2 branches that supply the _ region, called the superior and inferior _ arteries.
internal pudendal a
gluteal
superior and inferior gluteal a
The superior gluteal artery exits the pelvis to enter the gluteal region _ the piriformis muscle with the superior gluteal nerve and courses between the _ _ and _ muscles.
above
gluteus medius and minimus m
The inferior gluteal artery leaves the pelvis to enter the gluteal region _ the piriformis muscle with the inferior gluteal nerve and lies _ to the _ _ muscle.
below
deep
gluteus maximus m
The external iliac artery continues inferiorly towards the thigh and as it courses deep to the _ ligament it changes names to the _ artery.
inguinal
femoral a
The femoral artery lies _ to the femoral nerve and _ to the femoral vein in the femoral triangle.
medial
lateral
The femoral triangle is found in the _ portion of the anterior thigh
superior
In the proximal thigh, the femoral artery gives off the large _ _ artery whose branches supply the _ and _ muscles.
Profunda Femoris a
ADDuctor and hamstring muscles
The femoral artery courses thru the anterior thigh and passes to the distal posterior thigh thru the _ _ where it becomes the _ artery.
ADDuctor hiatus
Popliteal a
The popliteal artery courses distally thru the _ _ where it lies _ to the popliteal vein and tibial nerve.
popliteal fossa
deep
At the lower portion of the popliteal fossa, the popliteal artery divides into the _ and _ _ arteries.
anterior and posterior tibial a
After coming off the _ artery, the anterior tibial artery immediately passes thru a gap in the interosseus membrane as it courses from the _ to the _ compartment of the leg.
popliteal a
posterior to anterior compartment
The anterior tibial artery continues to course distally in the anterior compartment of the leg with the _ _ (peroneal) nerve.
Deep Fibular (Peroneal) Nerve
The anterior tibial artery changes it names to _ _ at the level of the medial and lateral _.
Dorsalis Pedis a
malleoli
The dorsalis pedis artery supplies the _ of the foot.
dorsum
The posterior tibial artery descends thru the deep posterior leg coursing with the _ nerve.
tibial n
In the proximal leg, the posterior tibial artery gives off the _ artery.
fibular (peroneal) a
The posterior tibial artery courses deep to the _ _ on the medial side of the ankle.
flexor retinaculum
The posterior tibial artery terminates by dividing in to the _ and _ _ arteries.
medial and lateral plantar a
The medial and lateral plantar arteries course with the medial and lateral plantar nerves and supply the _ surface of the foot.
plantar
The fibular artery is a _ branch of the posterior tibial artery and supplies the _ _ muscles of the leg on the _ side.
proximal
deep posterior
lateral
The fibular artery’s branches terminate at the _ and do not enter the foot.
ankle
Blood is returned from the lower limb by 2 sets of veins:
deep and superficial veins
_ veins course with an artery of the same name and they drain the same area supplied by their associated artery.
Deep
_ to the knee, the deep veins are paired on each side of their associated artery and this arrangement is called _ _.
Distal
Venae Comitantes
_ veins originate in the foot, course proximally thru the _ tissue and terminate by joining the _ veins.
Superficial
subcutaneous
Deep
The 6 major superficial veins of the lower limb are:
Plantar Digital v
Dorsal Digital v
Dorsal Metatarsal v
Dorsal Venous arch
Greater Saphenous v
Lesser Saphenous v
Plantar digital veins course along the _ surface of the toes.
inferior
Dorsal digital veins course along the _ surface of the toes
superior
Dorsal metatarsal veins are formed by joining of the _ and _ _ veins.
dorsal and plantar digital veins
The dorsal metatarsal veins are found in the _ surface of the metatarsals.
superior
The _ _ _ is formed by the joining of the _ _ veins and is found on the _ surface of the foot.
dorsal venous arch
dorsal metatarsal v
superior
The dorsal venous arch gives off both _ veins.
saphenous v
The longest vein in the body is the _ _ vein
Greater Saphenous v
The greater saphenous vein arises from the _ side of the dorsal venous arch.
medial
The greater saphenous vein courses _ to the medial malleoli and then _ along the medial border of the leg.
anteriorly
superiorly
The greater saphenous vein courses _ to the medial condyles of the tibia and femur and _ along the medial border of the thigh.
posteriorly
superiorly
As the greater saphenous vein courses thru the fascia in the upper thigh it terminates by entering the _ _ in the femoral triangle.
femoral vein
The lesser saphenous vein arises from the _ side of the dorsal venous arch
lateral
The lesser saphenous vein courses anterior to the medial malleoli _ to the lateral malleoli and then _ along the posterior border of the leg`
anterior
posterior
superiorly
The lesser saphenous vein terminates by joining the _ vein in the _ _.
popliteal v
popliteal fossa
