Exam 4 - Limbs (upper & lower) Flashcards
describe the angle of the femur
sits at in inward angle of about 130 degrees
where is the greater sciatic foramen (above piriformis) in relation to the nearby ligament? whats in it?
above the piriformis, above sacrospinous lig
- superior gluteal vessels & nerve
where is the lesser sciatic foramen? what’s in it?
under piriformis, above sacrospinous lig, around obturator foramen
- obtuator internus, pudendal n
where is the greater sciatic foramen (below piriformis) in relation to the nearby ligament? whats in it?
under piriformis, above sacrospinous lig
- sciatic n, inferior gluteal vessels & nerve
where is the sublinguinal space? what’s in it?
under inguinal lig
- femoral vessels & nerve, psoas
where is the inguinal canal? what’s in it?
above inguinal lig
- reproductive vessels & nerves
which side is the tibia on? what about fibula?
tibia = big toe (medial)
fibula = pinkie (lateral)
extension vs flexion of hip
flex hip = leg forward
extend hip = leg back
abduct vs adduct hip
abduct = leg away from body
adduct = leg towards body
extension vs flexion of knee
extend = knee back
flex = knee to supine position
dorsiflexion vs plantar flexion of foot
dorsi = foot up
plantar = foot points down
what is the fascia lata?
connective tissue lining the thigh
- attaches to inguinal lig
- thickens on the sides to make the IT band
- limits bulging, increases muscle efficiency, helps venous and lymph return
- contains an opening for the saphenous v to reach femoral v
what are the three compartments of the thigh? three compartments of the leg?
thigh = anterior, medial, posterior
leg = anterior, lateral, posterior
spinal levels of lateral-femoral cutaneous n
L2-3
spinal levels of femoral n
L2-4
spinal levels of obturator n
L2-4
spinal levels of superior gluteal n
L4-S1
spinal levels of inferior gluteal n
L5-S2
spinal levels for the n. to the piriforimis
L5-S2
spinal levels for the n. to the obturator internus
L4-S1
spinal levels for the perforating cutaneous n
S2-S3
spinal levels for the. to the quadratus femoris and inferior gemellus
L4-S1
spinal levels for the sciatic n.
L4-S3
spinal levels for the posterior cutaneous n. of thigh
S1-S3
INN of gluteus max
inferior gluteal n
INN of gluteus medius & minimus
superior gluteal n
INN of tensor fascia latae
superior gluteal n
INN of piriformis
n. to piriformis
INN of obturator internus
n. to obturator internus
INN of superior gemellus
n. to obturator internus
INN of inferior gemellus
n. to quadratus femoris
INN of quadratus femoris
n. to quadratus femoris
what is the main function of the gluteal region muscles?
abduct hip
- also does some rotation of hip
what does action does the gluteus maximus do that the other ones don’t?
extends hip
what is important to avoid in intragluteal injections?
above piriformis to avoid sciatic and other structures
- occurs in superior & lateral quadrant
what is piriformis syndrome?
overuse of piriformis makes it inflammed which compresses the sciatic n.
- causes glute pain or radiating pain to posterior leg
what three muscles are apart of the triceps coxae?
obturator internus
superior gemellus
inferior gemellus
where is the subinguinal space?
b/w the pelvis, iliopsoas, pectineus, and inguinal lig
where is the femoral triangle?
b/w the inguinal lig, adductor longus, sartorius
where is the adductor canal?
b/w sartorius, adductor longus & magnus, vastus medialis
where is the adductor hiatus?
opening in adductor magnus
where do femoral hernia’s occur?
thru the femoral triangle in the saphenous vein opening
- part of the ileum pushes thru opening
what muscles are in the anterior compartment of the leg? (7)
IT band
iliopsoas
sartorius
quadriceps femoris (4)
what main nerve supplies the anterior compartment of the thigh?
Femoral Nerve (L2-4)
what main actions do the muscles in the anterior compartment of the thigh do?
flex hip
extend knee
where is the sartorius?
ASIS (lateral) -> medial side of tibia
where is the rectus femoris?
illium -> patella tendon
- inbetween vastus lateralis & medius
where is the vastus lateralis?
top of femur (lateral side) -> patella tendon
where is the vastus medialis?
top of femur (medial side) -> patella tendon
where is the vastus intermedius?
top of femur (under other quad muscles) -> patella tendon
what spinal levels does the patellar reflex test? what is this doing to the body when you hit the patellar tendon?
L3-L4
- stretches the quad muscles, in response to this, the body thinks it’s falling so it quickly flexes the leg
what muscles are in the medial compartment of the thigh? (6)
pectineus
adductor longus
adductor brevis
adductor magnus
gracilis
obturator externus
what is the main INN of the medial compartment of the thigh?
Obturator Nerve (L2-4)
what main actions do the muscles of the medial compartment of the thigh do?
adduct the hip, medially rotate
where is the pectineus?
pubis -> top part of femur
where is the adduct. longus?
pubis -> linea aspera
- inserts lower than adduct. brevis
where is the adduct. brevis?
pubis -> linea aspera
- inserts higher than adduct. longus
- below the adduct. longus
where is the adduct. magnus?
pubis -> entire shaft of femur
- below all the other adductor muscles
where is the gracilis?
pubis -> medial tibia
what are the two heads of the adductor magnus?
adductor part (superior)
hamstring part (inferior)
what are the INN exceptions for the medial compartment of the thigh?
pectineus = femoral n
adduct. magnus (hamstring) = tibial division of sciatic
what muscles are in the posterior compartment of the thigh? (3)
semimembranosus
semitendinosus
biceps femoris
what is the main nerve for the posterior compartment of the thigh?
Tibial Nerve (L5-S2)
what is the main action of the posterior compartment of the thigh?
Extend hip
Flex knee
Where is the semitendinosus?
bottom of pelvis -> medial tibia
- above semimembranosus
- MEDIAL SIDE OF THIGH
Where is the semimembranosus?
bottom of pelvis -> medial tibia
- below semitendinosus
- MEDIAL SIDE OF THIGH
Where is the biceps femoris?
bottom of pelvis -> fibula
- LATERAL SIDE OF THIGH
what are the two heads of the biceps femoris?
Long Head (more medial)
Short Head (more lateral)
what is the INN exception for the posterior compartment of the thigh?
biceps femoris (short head) = common fibular n
what three muscles attach to the pes anserinus of the knee? what is the action of these muscles here?
semitendinosus, gracilis, sartorius
- stabilizes the lateral knee
what muscles flex the hip?
ANTERIOR COMPARTMENT (iliopsoas, sartorius, rectus femoris)
- adductor longus & brevis = medial
what muscles extend the hip?
POSTERIOR COMPARTMENT (semi’s, biceps femoris)
- adductor magnus = medial
what muscles adduct the hip?
MEDIAL COMPARTMENT (pectineus, gracilis, adductors)
- quadratus femoris = butt
what muscles abduct the hip?
BUTT MUSCLES (glutes, piriformis, obturator, gemellus)
what muscles medially rotate the hip?
BUTT MUSCLES (glutes)
- semitend & mem = posterior
- adductor long & brevis = medial
what muscles laterally rotate the hip?
BUTT MUSCLES (glutes, piriformis, obturator, gemellus, quad)
where is the pubofemoral ligament?
attaches the pubis to femur
where is the iliofemoral ligament?
attaches hip to femur (on top of head)
- anterior side
where is the ischiofemoral ligament>
attaches hip to femur (on top of head)
- posterior side
what makes the cruciate anastomosis? (4)
- medial circumflex femoral a (deep femoral)
- lateral circumflex femoral a (deep femoral)
- first perforating a. (deep femoral)
- inferior gluteal (int. iliac)
what is important about the cruciate anastomosis?
these arteries come off of the deep femoral a. and internal iliac a. and has a branch that goes directly to the popliteal a.
- this allows for blood flow even if the femoral a. is obstructed
what is the blood flow of the thigh?
external iliac -> femoral (deep femoral) -> popliteal a.
internal iliac -> superior & inferior gluteal a., obturator a.
what blood supplies the anterior compartment of the thigh?
femoral & deep femoral a
what blood supplies the medial compartment of the thigh?
obturator & deep femoral a.
what blood supplies the posterior compartment of the thigh?
deep femoral a.
where is the ACL?
ANTERIOR of cross
- crosses from front of tibia to back of femur
- medial -> lateral
where is the PCL?
POSTERIOR of cross
- crosses from back of tibia to front of femur
- lateral -> medial
what is the function of the ACL?
prevent over extension of the knee
- prevents anterior displacement of tibia
what is the function of the PCL?
prevent over flexion of the knee
- prevents posterior displacement of tibia
where is the LCL? what’s it’s function?
lateral side of knee (connects femur to fibula)
- limits adduction of joint
- we don’t want to be lookin like a frog
where is the MCL? what’s it’s function?
medial side of knee (connects femur to tibia)
- limits abduction of joint
- we don’t want an inward knee (duck girl frrrr)
what is the unhappy triad of the knee?
torn MCL, ACL, medial meniscus
- occurs due to the tibia rotating medially (tears MCL) and hyperextension of the knee (tears ACL)
what are the three main muscles of the knee?
gastrocnemius
popliteus
plantaris
what nerve INN the knee muscles?
tibial n
what is the action of the three knee muscles?
flex knee
what muscles flex the knee?
POSTERIOR THIGH (semi, biceps)
- KNEE MUSCLES (gastroc, poplietus)
- sartorius = anterior
- gracilis = medial
what muscles extend the knee?
ANTERIOR THIGH (quad femoris)
what are the three ways you can stabilize an extended knee?
flat surfaces of femur & tibia together
shift gravity forward (pulls ACL)
lock knee joint (standing = med. rotate femur, sittiing = laterally rotate tibia)
what are the boundaries of the popliteal fossa?
semitend / mem
lateral head of gastrocnemius
biceps femoris
medial head of gastrocnemius
what three things run through popliteal fossa?
tibial n.
popliteal v.
popliteal a.
what muscles are in the anterior compartment of the leg? (4)
tibialis anterior
ex. digitorum longus
ex. hallucis longus
fibularis tertius
what main nerve INN the anterior compartment of the leg?
Deep Fibular n.
what are the main actions of the anterior compartment of the leg?
dorsiflex foot
extend toes & ankle
where is the tibialis anterior?
lateral tibia -> metatarsal 1
where is the ex. digitorum longus?
lateral tibia -> digits 2-5
where is the ex. hallucis longus?
top of fibula -> digit 1
- under ex. digitorum longus
where is the fibularis tertius?
bottom of fibula -> metatarsal 5
what are the lateral compartment leg muscles? (2)
fibularis longus
fibularis brevis
what nerve INN the lateral compartment of the leg?
Superficial Fibular Nerve
what is the main action of the lateral compartment leg muscles?
Evert foot
Plantarflex
where is the fibularis longus?
top part of lateral fibula -> goes on top of foot from lateral side and crosses to medial side and attaches to metatarsal 1
where is fibularis brevis?
bottom part of lateral fibula (under longus) -> metatarsal 5
what are the posterior compartment of the leg muscles? (6)
Gastrocnemius
Plantaris
Soleus
Flex. Digitorum Longus
Flex. Hallucis Longus
Tibialis Post.
what are the muscles of the triceps surae? (3)
gastrocnemius
plantaris
soleus
what is the main nerve that INN the posterior compartment of the leg?
TIbial Nerve
what is the main actions of the posterior compartment of the leg?
Plantarflex Foot
Flex Toes & Ankle
Invert Foot
where is the gastrocnemius?
bottom of femur -> calcaneus
- two heads!!
where is the plantaris?
bottom of lateral femur -> calcaneus
- used as a harvest tendon!!
where is the soleus?
top of tibia (med) -> calcaneus
where is the tibialis posterior?
top of tibia & fibula -> navicular of foot (big toe, medial side)
- under all the posterior muscles!
where is the flex. digitorum longus?
tibia (med) -> digits 2-5
where is the flex. hallucis longus?
middle of fibula (lat) -> digit 1