Dr. E lower limb Flashcards by Esther Gui

unique componenet of scaroiliac jt =

its 2 types of jts
1. snynovial jt = antero-inferiorly
2. syndesmosis jt = posterior-superiorly

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tibia is = (Weight/non-weight bearing )

TIBIA = WEIGHT bearing

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fibula = non-weight/weight bearing

fibula = NON weight-bearing

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pattella = ___ bone

sesamoid bone

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tibia = medial malleous
fibula = lateral malleolus

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which membrane connects fibula and tibia

interosseous mem.

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which is the only bone that connects with leg bones

TALUS

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which foot bone = transmits most of the body weight from talus to ground

calcaneus (heel bone)

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which foot bone has the tuberosity of navicular and if too prominent -> press against medial part of shoe = pain

navicular

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shelf projects from the medial calcaneus

talar shelf

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leg drained by which 2 veins

superifical and deep veins

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which has more valves and is less likely to have varicose veins

deep veins = more valves
superfical = less valves = more varicose veins

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great and small saphenous veins are (deep/superficial veins)

superficial veins

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dorsal digital vein of great toe + dorsal venous arch of the foot =

great saphenous vein -> empties into femoral vein

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small saphenous veins arises on the lateral side of foot from which (#) dorsal digit vein of which (#) digit w/ venous arch

5th dorsal digit vein of 5th digit

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great saphenous -> femoral
small saphenous -> popliteal

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t/f deep veins travel with arteries and usually paired

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account for over 90% of venous return from lower extremeties

venae comitantes

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deep leg veins drain into which v

popliteal v

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DVT = MOST COME FROM DEEP VEINS

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ant. comp. muscles of thigh = flex () at hip & extend () at knee
post. comp. = extend thigh and flex ()
medial comp. = adduct or abduct thigh

ant. comp. muscles of thigh = flex femur at hip & extend leg at knee

post. comp. = extend thigh and flex leg

medial = adduct thigh

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ALL ant. comp. of thigh = which n.

ACTION =

FERMORAL NERVE

A: hip flexion & knee extension

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pectineus (add to medial rot.)
iliopsoas (CHIEF FLEXOR of the thigh, postural muscle, inserts on the lesser trochantor)
sartorius (goes across your thigh, CROSS-legged sitting position, weak, synergist muscle)
quadriceps femoris = (I: tibial tuberosity via patellar ligament, part of quadriceps femoris; extend at knee, all quad fem msucles have same I, N, A)

ant thigh m

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medial comp. thigh muscles
N.

aka adductor group
obturator n.

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which muscle of med. comp. is the only adductor to cross and act on knee

gracilis

adductor longus is the most ant. of the adductor group adductor brevis is deep to (2) muscles

deep to pectineus and adductor longus

only muscle with additional n. for medial comp. thigh muscle

adductor magnus obturator AND sciatic n. can extend and adduct

femoral triangle contents (lat. - med.) (NAVEL)

f. n f. a f. v empty space lymphatics

ARTERy of leg top to bottom

femoral (starting) -> profunda femoris -> circumflex femoral arteries -> lateral/medial cf a.

which circumflex artery is the most IMP. since it supplies most of the blood for head & neck of femor

MEDIAL FEMORAL CIRCUMFLEX ARTERY

1. which (2) gluteus muscles adduct, med rotate femur; supports body during gait 2. which gluteus muscle extend, laterally rotate femur

1. glue med & min 2. glut max

obturator internus superior & inferior gemelli quad. femoris what muscle group

the lateral rotators; the deep layer consists of smaller muscles which are lateral hip rotoators; stabilize hip jt, working w/ strong ligaments of the hip jt to steady femoral head in acetabulum

innervation for lateral rotators all come off which which nerve roots

L5, S1

piriformis N, A

S1, 2 A: abduct, lat rotate femur

which head of biceps femoris is NOT a hamstring

short head of biceps femoris - only crosses knee jt, n= fibular division of sciatic n

which msucle group arise from the ischial tuberosity and innervated by tibial division of sciatic nerve

Biceps Femoris - long head - short head Semimembranosus Semitendinosus

Pes Anserinus - conjoined tendons insert on the anteromedial proximal tibia

medial to lat. **S**artorius **G**racilis Semi**tendin**osus **S**elena **G**omez **T**ries

sacral plexus nerve roots =

L4,5 & S1,2,3

sciatic or pudenal nerve - tibial erve - common fibular (peroneal) nerve, superior gluteal nerve (L4,5, S1), inferior glut. n (L5, S1, S2)

sciatic

pedenal or sciatic nerve - anal & urethral sphincters, External genitialia - posterior cutaneous n. of thigh (S1-3) - N. to quad fem. (L4,5, S1) - N. to obturator internus (L5, S1,2)

pudenal

which 3 arteries does the internal iliac artery give rise to

1. obturator artery 2. sup. gluteal artery 3. inf. gluteal artery

veins of the gluteal region are tributaries of ____ veins

internal iliac veins

which veins of gluteal region accompany arteries

superior & inferior gluteal veins IMP. bc they communivate w/ tributaries of the femoral veins, and in DVT of femoral vein they shunt blood past the obstruction

which gluteal vein accom/ arteries and drain blood from perineum -> internal iliac vein

internal pudenal veins

lymph from deep tiss. follows gluteal vessels -> gluteal lymph nodes -> internal, external, and common iliac LN -> lymar LNs lymph from superficial tissue -> ?? which nodes

external iliac nodes

_ continuation of the femoral a. after passing adductor hiatus at inf. border of popliteus - divides into ant. & post. tibial arteries

sciatic n. -> tibial & fibular n. tibial (larger/smaller) branch -> sural n fibular n. -> common fib. n.

sciatic n. -> **tibial** & **fibular** n. tibial **larger** branch -> sural n

which n. is derived from: **medial sural cutaneous n.** (from tibial n.) **sural communication branch** of com. fib. n.

sural n.

as popliteal artery descends -> which 3 branches form

**Anterior** tibial arery (through the gap of interos. mem. to supply ant. comp.) **fibular** artery (supplies lateral comp.) **posterior** tibial artery (splits into **medial & lat. plantal a.** after wraping around medial malleolus)

anterior leg group n.

deep fibular

tibialis anterior (+ invert foot) exnsor hallucis longus extensor digitorum longus fibularis tertius (+ evert foot) A: Extend & dorsiflex which muscle group which I on 5th MT

ant. comp. leg FIB. tertius - inserts of 5th MT

lat. com. of leg =

fibularis longus & brevis

terminal branch of common fibular n. = suplies whch muscle group

superfial fibular n. lateral muscles of leg

muscles of posterior leg & n. A. which is absent in 5-10% of pop- used for reconstructive surgery which does not cross over the knee jt. & just helps w/ standing

gastrocnemius soleus plantaris n. = tibial n. A: plantarflex plantaris - absent soleus does not cross knee jt

deep muscle group of post. comp: most act on ankle & foot jts, which muscle acts on the knee jt?

popliteus

flexor hallucis longus (A: felx **great toe** & plantal flex foot) flexor digitorum longus (flex & plantor flex foot) tibials posterior (invert, plantar flex; main functn. = support medial longitudinal arch during weight bearing which msucle group

deep post. comp. leg

3 tendons deep to post. muscle of leg (classic boards q); from posterior to medial malleous innervated by which nerve

**T**ibialis Posterior Flexor **D**igitorum longus Flexor **H**allucis longus Tom Dick & Harry all n. by tibial n.

Eversion muscles Inversion (2nd letter rule)

Eversion - pErineus longus - pErineus brevis - pErineus terius **I**nversion -t**I**bilias ant. -t**I**bilias post.

anthing digitorum think digits hallucis - big toe

which 2 nerves supply intrinsic muscles of the foot

med. and lat. plantar nerves + some deep fibular n.

in the foot: ANT. tibial artery -> becomes WHAT

DORSAL ARTERY OF THE FOOT/dorsalis pedis a.

a region of the lower, anterior abdominal wall, or groin (INGUINAL CANAL) - Herniation occurs through (what) triangle ○ Lateral border - Inferior epigastric vessels ○ Medial - Rectus abdominis ○ Inferior - Inguinal ligament

**Hesselbach**’s triangle

DIRECT inguinal hernias - occur DIRECTLY (MEDIAL/LATERAL to epigastric vessels)

MEDIAL to epigastric vessels

indirect hernias - occur (medial/lateral to epigastric vessels)

indirect = LATERAL

WHICH hernia is more common ?

INDIRECT = more hernias LATERAL to epigastric vessels

contents of inguinal canal

spermatic cord ilioinguinal nerve genital branch of genitofemeral nerve

hernias that canNOT be pushed back in the abdomen -> lose blood sup.

incarcerated hernia