Clinical Anatomy of the Lower Limb Flashcards
What 4 bones make up the pelvis?
Ilium, ischium, pubic bone and sacrum
There are lots of vessels within the pelvis, what is the significance of this?
Lots of potential for bleeding in pelvic fractures
Which nerves are found in the pelvis and are responsible for bladder and bowel control?
Pudendal nerve and pelvic splanchnic nerves
What nerve is sensitive to injury of the greater sciatic notch?
Sciatic nerve
Which internal structures can be damaged with pelvic trauma?
Urethra, bladder, rectum and uterus
Anatomically, what makes the femoral head susceptible to AVN?
Ring anastomosis of vessels at the base of the femoral neck
Which hip fractures should be replaced?
Intracapsular
What are the roles of the gluteus maximus?
Extension and external rotation of hip
The gluteus medius is the chief of which movement?
Hip abduction
A trendelenberg test implies damage to which nerve?
Superior gluteal nerve
What happens in an abnormal Trendelenberg test?
The pelvis will tilt away from the stance leg
What is the most powerful flexor of the thigh? What is it attached to?
Iliopsoas- attached to the lesser trochanter
The adductors of the thigh are mainly supplied by what nerve?
Obturator
The quadriceps muscles are supplied by which nerve? If there is damage to these muscles then the patient won’t be able to do what?
Femoral - won’t be able to straight leg raise
What type of bone is the patella? It is attached to the tibial tubercle via what?
Sesamoid bone- via the patellar tendon
Which hamstring muscle can be used as a tendon graft for reconstructions?
Semitendinosis
Which hamstring muscle is most likely to tear?
Biceps femoris
Why can some hip pathology be felt in the knee?
Joint sensory supply from the obturator nerve
What is the first range of movement that will be lost in a damaged hip?
Internal rotation
The adductor canal goes through which muscle?
Adductor magnus
What type of cartilage are menisci? What is their function?
Fibrocartilage - shock absorbers
Which meniscus is fixed? Which is mobile?
Medial = fixed, lateral = mobile
Which meniscus is more likely to tear?
Medial
Which ligament of the knee resists vagus stress?
Medial collateral
Which ligament of the knee resists varus stress and helps to resist external rotation?
Lateral collateral
Which ligament of the knee resists internal rotation and anterior translation of the tibia?
Anterior cruciate
Which ligament of the knee resists posterior/anterior translation of the tibia and presents knee hyperextension?
Posterior cruciate
On average, our anatomical axis of the lower limb is at 6 degrees valgus. What does this allow?
The centres of the hip, knee and ankle align perfectly (allows distribution of load between medial and lateral compartments)
Genu varum results in a lot of stress on which compartments?
Medial
Give two examples of bursitis in the lower limb?
Achilles tendonitis or plantar fasciitis
Do inflamed bursae usually go away?
Usually recurrent
What muscle is the most powerful dorsiflexor of the leg?
Tibialis anterior
What nerve supplies the anterior leg?
Deep fibular
What nerve supplies the posterior leg?
Tibial
What nerve supplies the lateral leg?
Superficial fibular
What happens in compartment syndrome?
Swelling causes increased pressure which occludes venous drainage causing secondary ischaemia
What is the treatment for compartment syndrome?
Fasciotomy
How many ankle ligaments must be affected to have an instability injury?
2
What type of injury are lateral ankle sprains?
Inversion injury
What should you always look for on an x-ray of an ankle?
Talar shift
What muscles in the foot can assist flexion of the MTP joints and extension of the PIPs and DIPs?
Lumbricals
An imbalance of the flexor and extensor tendons of the foot can cause what?
Claw/hammer toe deformities
