Exam 6 Lower Extremity 61X Flashcards
What are some of the main branches of the Sacral Plexus?
Sciatic Nerve
Superior Gluteal Nerve
Inferior Gluteal Nerve
Pudendal Nerve (Supplies Perineum)
What are some of the main branches of the Sacral Plexus?
Sciatic Nerve Superior Gluteal Nerve Inferior Gluteal Nerve Pudendal Nerve: -Supplies Perineum
The Superior Gluteal Nerve of the Sacral Plexus innervates what?
Gluteus Minimus
Gluteus Medius
Tensor Fasciae Latae
A Characteristic motor loss resulting in weakened abduction of thigh by the gluteus medius, disabling gluteus medius limp, and gluteal gait (compensatory list of the body to weakened gluteal side, is seen with injury to what nerve?
Superior Gluteal Nerve Injury
Weight supported on both feet with no injury will have what positioning of the pelvis?
Pelvis is evenly supported and does not sag
When no injury is to the superior gluteal nerve is present if weight is borne by one foot what will the muscles of the lower extremity do?
Muscles on the same side will hold the pelvis so it will not sag
What will occur if the gluteus medius and gluteus minimus are inactive due to superior gluteal nerve injury when weight is borne by one foot?
Pelvis fall on the side of the raised limb
-Steady action is lost
What is a positive Trendelenburg sign?
Hip drop on one side (raised leg) or during walking
The Gluteus Maximus is innervated by what nerve of the sacral plexus?
Inferior Gluteal Nerve
The Piriformis Muscle is innervated by what nerve of the Sacral Plexus?
Nerve to Piriformis
The Sural Nerve is a sensory nerve in the calf region is made up of collateral branches of what two nerves?
Tibial Nerve
Common Fibular Nerve
The Sural Nerve is a sensory nerve in the calf region is made up of collateral branches of what two nerves?
Tibial Nerve
Common Fibular Nerve
The Tibial Nerve, branch of the Sciatic Nerve, furthers divides into what?
Medial Plantar Nerve
Lateral Plantar Nerve
The Common Fibular Nerve (Common Peroneal), branch of the Sciatic Nerve, furthers divides into what?
Deep Fibular Nerve
Superficial Fibular Nerve
The Tibial Nerve innervates what?
-Gastrocnemius
-Plantaris
-Soleus
-Popliteus
-Tibialis Posterior
-Flexor Digitorum Longus
-Flexor Hallucis Longus
FOOT:
-Medial Plantar
-Lateral Plantar
What branch of the Tibial Nerve innervates the Abductor Hallucis, Flexor Digitorum Brevis, Flexor Hallucis Muscles and First Lumbrical Muscles?
Medial Plantar Nerve
The Lateral Plantar Nerve, a branch of the Tibial Nerve innervates what structures?
- Plantar Muscles of Foot (Remaining)
- Skin over Lateral 1/3 of Plantar Surface of Foot
The Tibialis Anterior, Extensor Hallucis Longus, Fibularis Tertius, Extensor Digitorum Longus, Extensor Digitorum Brevis muscles, and skin on adjacent sides of great and second toe are innervated by what nerve?
Deep Fibular (Branch of Common Fibular)
The Tibialis Anterior, Extensor Hallucis Longus, Fibularis Tertius, Extensor Digitorum Longus, Extensor Digitorum Brevis muscles, and skin on adjacent sides of great and second toe are innervated by what nerve?
Deep Fibular (Branch of Common Fibular)
Where does the Sciatic Nerve exit the pelvic cavity?
Greater Sciatic Foramen below the Piriformis
What occurs in about 10% of the population in relation to the sciatic nerve?
Nerve passes through Piriformis (Conditions which cause the muscle to shorted and contract increase nerve compression)
What occurs in about 10% of the population in relation to the sciatic nerve?
Nerve passes through Piriformis (Conditions which cause the muscle to shorted and contract increase nerve compression)
Piriformis Syndrome can have what symptoms?
Buttock pain
Sciatic Symptoms in leg
-Sciatic component of pain in the leg can be in dermatome of any nerves that comprise the sciatic nerve (L4,L5,S1, S2)
What is the treatment for Piriformis Syndrome?
Release of contracted piriformis muscle w/combination of exercises, acupuncture, trigger point injections
-Surgery (Release from attachment to superior part of greater trochanter of femur)
Why is the gluteal region a common site for intramuscular injections? What has to be considered about this area?
- Muscles are thick and large (Good Absorption)
- Area of Sciatic Nerve
Intramuscular injections in the gluteal region should be made in what area?
Superior to line extending from Posterior Superior Iliac Spine to Superior Border of Greater Trochanter
What are the three of the four muscles of the Quadriceps Femoris muscle group that can be identify as surface features?
Rectus Femoris
Vastus Lateralis
Vastus Medialis
(Vastus Intermedius is deep to the three)
What muscle that is not part of the Quadriceps Femoris muscle group is able to be identified as a surface feature of the thigh?
Sartorius
What makes up the Iliotibial Tract?
Aponeurosis of Tensor Fasciae Lata plus the Gluteus Maximus Muscles
What makes up the Iliotibial Tract?
Aponeurosis of Tensor Fasciae Lata plus the Gluteus Maximus Muscles
What are the Compartments of the Thigh?
Anterior Compartment Medial Compartment (Adductor Group) Posterior Compartment (Hamstrings)
What is found in the Posterior Compartment (Hamstrings) of the Thigh?
-Muscles: Biceps Femoris Semitendinosus Semimembranosus -Other: (Gluteus Maximus, kinda) -Sciatic nerve
What is found in the Anterior Compartment of the Thigh
Muscles: -Pectineus (Transitional muscle between anterior and medial compartment -Iliopsoas: -Psoas Major -Psoas Minor -Iliacus -Sartorius -Quadriceps Femoris: -Rectus Femoris -Vastus Lateralis -Vastus Medialis -Vastus Intermedius -Other: (Femur is in this location)
What is found in the Medial Compartment (Adductor Group) of the Thigh?
Muscles: -Pectineus (Transitional Muscle between Anterior and Medial Compartment) -Adductor Longus -Adductor Brevis -Adductor Magnus -Gracilis -Obturator Externus -Other Structures: Deep Fascia Femoral Artery Femoral Vein
Which muscles of the Anterior and Medial Compartments are not part of the free appendage and so they may be categorized as “extrinsic” muscles of the thigh?
Iliopsoas: Psoas Major, Psoas Minor, Iliacus
Pectineus
Obturator Externus
Name the primary nerves of the Anterior, Medial, and Posterior Compartments?
Anterior: Femoral Nerve
Medial: Obturator Nerve
Posterior: Sciatic Nerve
What is the Origin and Insertion of the Sartorius Muscle?
Origin: Anterior Superior Iliac Spine (ASIS)
Insertion: Pes Anserine Tendon at Upper tibia
What is the Action and Innervation of the Sartorius Muscle?
Action:
-Flexes, Abducts, and Laterally rotates femur at hip
-Flexes leg at knee
Innervation: Femoral Nerve
Name some of the Characteristics of the Sartorius Muscle?
- Longest Muscle in Body
- AKA Tailor’s Muscle
- Superior Portion: Lateral Border of Femoral Triangle
What is the Origin and Insertion of the Iliopsoas Muscles?
Origin:
- Psoas Major:
- Transverse Processes and Bodies of Lumbar Vertebrae
- Iliacus: Iliac Fossa of Ilium
- Insertion: Lesser Trochanter of Femur
What is the Action and Innervation of the Iliopsoas Muscles?
- Action: Flex torso and thigh w/respect to ea other, rotate thigh laterally
- Innervation:
- Psoas: Lumbar Spinal Nerves
- Iliacus: Femoral Nerve
What is the Origin and Insertion of the Tensor Fasciae Latae?
- Origin: Anterior Superior Iliac Spine (ASIS) and Iliac Crest
- Insertion: Tibia Via Iliotibial Tract (ITB)
What is the Action and Innervation of the Tensor Fasciae Latae?
-Action: Flexes, Abducts, and Medially rotates thigh at hip joint
HELPs: Stabilize and steady the hip and knee joints by putting tension on ITB fascia
-Innervation: Superior Gluteal Nerve
What is the Origin and Insertion of the Rectus Femoris?
- Origin: Anterior Inferior Iliac Spine (AIIS)
- Insertion: Patella via quadriceps tendon then tibial tuberosity via patellar ligament
What is the action and innervation of the Rectus Femoris?
- Action: Extends Leg at Knee, Flexes Thigh at Hip
- Innervation: Femoral Nerve
What is the Origin and Insertion of the Vastus Lateralis?
- Origin: Grater Trochanter and Linea Aspera of Fermur
- Insertion: Patella via quadriceps tendon then tibial tuberosity via patellar ligament
What is the Action and Innervation of the Vastus Lateralis?
Action: Extends Leg at Knee
Innervation: Femoral Nerve
What is the Origin and Insertion of the Vastus Medialis?
- Origin: Linea Aspera of Femur
- Insertion: Patella via quadriceps tendon then tibial tuberosity via patellar ligament
What is the Action and Innervation of the Vastus Medialis?
Action: Extends leg at Knee
Innervation: Femoral Nerve
What is the Origin and Insertion of the Vastus Intermedius?
- Origin: Superior Anterior and Lateral Surfaces of Femur
- Insertion: Patella via quadriceps tendon then tibial tuberosity via patellar ligament
What is the Action and Innervation of the Vastus Intermedius?
Action: Extends leg at knee
Innervation: Femoral Nerve
What are the boundaries of the Femoral Triangle, in which femoral nerves and vessels pass through this space?
- Superior (Base): Inguinal Ligament (External Oblique)
- Lateral: Sartorius
- Medial: Adductor Longus
- Floor: Iliopsoas and Pectineus
How are the Major vessels and nerves arranged in the superior aspect of the femoral triangle? (Lateral to Medial)
Femoral Nerve Femoral Artery Femoral Vein Lymphatics (NAVL) -Femoral Sheath covers these
What area of the femoral triangle allows distension of femoral vein, is normally filled w/ extraperitoneal fat? What are the openings called in this structure?
Femoral Canal
- Femoral Ring (Proximal End)
- Saphenous Hiatus (Distal End)