Exam III Flashcards

1
Q

What are the primary functions of the lower extremity?

A

Support the body, provide a stable foundation when standing, and allow locomotion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

In general, how are the bones, joints, muscles, and blood vessels of the lower extremity different from the upper extremity?

A

Bones are heavier and stronger
Joints are stronger and more stable
Muscles are more powerful and less capable of delicate movements
Blood vessels are larger

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

The pelvic bone consists of a single bone on each side, known as what?

A

Innominate bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What three parts does each innominate bone consist of?

A

Ilium, ischium, and pubis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

This structure is a large depression on the lateral aspect of each innominate and it receives the head of the femur to form the hip joint.

A

Acetabulum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

This is the horseshoe shaped articular surface of the acetabulum.

A

Lunar surface

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Is the rough non-articular center portion of the acetabulum

A

Acetabular fossa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

This structure is the outside edge of the acetabulum and is bridged by the transverse acetabular ligament.

A

Acetabular notch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

This is the largest and uppermost portion of the innominate bone.

A

Ilium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

This is the “L” shaped bone of the innominate, which consists of a body and a ramus.

A

Ischium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

This bone of the innominate consists of a body and two rami and articulates with the pubis from the opposite innominate.

A

Pubis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

This is a large oval opening found at the inferior aspect of each innominate and is closed by a piece of connective tissue known as the obturator membrane.

A

Obturator foramen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

The ___ pelvis is bounded by the lumbar vertebrae, laterally by the ilium and anteriorly by the abdominal wall; it helps to support and protect much of the abdominal viscera

A

False or major pelvis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

The ___ pelvis is bounded posteriorly by the sacrum and coccyx, laterally and anteriorly by the ilium, ischium, and pubis; this portion of the pelvis surrounds the birth canal in females.

A

True or minor pelvis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the functions of the pelvic bone?

A
  • Protects the pelvic viscera
  • Transmits body weight to the limbs and absorbs the stresses of muscular activity
  • Allows locomotion by causing the pelvic bone to swing from side to side
  • In the female, provides bony support for the birth canal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

This is the term used to describe differences in bone structure and physical characteristics between males and females.

A

Sexual dimorphism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

In terms of general structure how does the male pelvis differ from a female’s?

A

Male: thicker; prominent processes; longer
Female: thinner; processes not so prominent; shorter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

In terms of pelvic inlet and outlet how does a male pelvis differ from a female’s?

A

Male: Inlet-heart shaped; Outlet- Narrower
Female: Inlet-round or oval; Outlet-farther apart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

In terms of anterior iliac spine, how does a male pelvis differ from a female’s?

A

Male: Closer together
Female: Farther apart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

In terms of greater sciatic notch, how does a male pelvis differ from a female’s?

A

Male: Narrower
Female: Wider

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

In terms of obturator formaen, how does a male pelvis differ from a female’s?

A

Male: Round
Female: Triangular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

In terms of acetabulum, how does a male pelvis differ from a female’s?

A

Male: Face laterally
Female: Face more anteriorly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

In terms of symphysis pubis, how does a male pelvis differ from a female’s?

A

Male: Longer
Female: Shorter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

In terms of pelvic arch, how does a male pelvis differ from a female’s?

A

Male: Acute angle
Female: Obtuse angle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the name for a typical male pelvis?

A

Android pelvis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the name for a typical female pelvis?

A

Gynecoid pelvis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

`What is the name for an exaggerated male pelvis?

A

Anthropoid pelvis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the name for an exaggerated female pelvis?

A

Platypelloid pelvis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

A fracture of this bone can result from direct trauma or during a fall on the feet or knees. This fracture has a high morbidity and mortality rate due to hemorrhagic shock and subsequent organ damage.

A

Fracture of the pelvis
Most common fracture sites include: pubic rami, acetabulum, region of the sacroiliac joint and the most lateral aspect of the ilium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

This is a common painful contusion injury of the soft tissue associated with the iliac crest. They are common in contact sports and usually result in a painful hematoma in the area of the injury.

A

Hip Pointers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

This bone has three primary centers of ossification, five secondary centers of ossification, and it completes its ossification between 20-22 years of age

A

Pelvic bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

This is the longest, heaviest, and strongest bone in the body. It has one primary center of ossification, four secondary centers, and completes ossification by 15 years in females and 17.5 years in males.

A

Femur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

The way the neck of the femur meets the shaft of the bone creates an angle known as what?

A

Angle of inclination

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is a typical angle of inclination at birth? Adulthood?

A

About 145 degrees at birth and 125 degrees as an adult

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the function of the angle of inclination?

A

It allows greater mobility at the hip joint by increasing the leverage of the muscles that attach to the proximal part of the femur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

This condition is characterized by an increase in the angle of inclination, which can occur with developmental dysplasia of the hip.

A

Coxa valga

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

This condition is characterized by a decrease in the angle of inclination, which occurs in fractures of the proximal part of the femur and in the condition known as rickets. Causes a mild shortening of the affected limbs.

A

Coxa vara

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

This is a fracture through the neck of the femur and what we commonly call a “broken hip”

A

Subcapital fracture of the femur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

This condition is often caused by a subcapital fracture of the femur interrupting the blood supply to the femoral head, leading to degeneration of the head.

A

Avascular necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

This is a large triangular shaped sesamoid bone that develops within the common tendon of insertion of the quadriceps. It has a single ossification center that completes ossification by 10 years in females and 13 in males.

A

Patella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is the main function of the patella?

A

To provide additional leverage to the quadriceps during the last part of extension of the leg.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Fractures due to ____ trauma usually result in a patella that is broken into a number of small fragments that are not displaced.

A

Direct

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Fractures due to ____ trauma are usually the result of the quadriceps muscles contracting suddenly and causing a transverse fracture through the body of the patella. These fractures can be displaced or non-displaced.

A

Indirect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Severe pain, swelling and tenderness, and inability to carry out extension at the knee joint are common symptoms of what clinical condition?

A

Fracture of the patella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

This condition is characterized by a patella in which the superior lateral portion of the bone remains unossified.

A

Patella emarginata

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

This condition is characterized by the superior lateral portion of the patella ossifying independently. This is clinically significant in being able to distinguish this condition from a fracture of the patella.

A

Bipartite or tripartite patella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

This is a condition in which there is a softening and fissuring of the articular cartilage on the posterior aspect of the patella. It is usually caused by trauma, overuse or muscle weakness, which causes misalignment of the patella. Is usually accompanied by a dull pain around or under the patella that worsens with exercise or going from a position of flexion to extension at the knee joint

A

Chondromalacia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

This is the connective tissue investment (deep fascia) of the thigh region. It provides a dense sheath for the thigh and prevents the quadriceps from bulging outward during contraction.

A

Fascia lata

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

This is the thickened lateral aspect of the fascia lata, which received insertions from teh tensor fascia lata and gluteus maximus muscles.

A

Iliotibial tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

This is an opening found in the proximal anterior aspect of the fascia lata that allows the great saphenous vein to reach its termination at the femoral vein.

A

Saphenous opening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

This is an overuse syndrome, which occurs at the distal end of the iliotibial band where it repetitively rubs over the lateral condyle of the femur, thus irritating and inflaming the bursae. It is often an overuse of the gluteus maximus pulling on the iliotibial tract, which causes this.

A

Iliotibial band syndrome (ITBS)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What movements of the femur can be carried out at the hip joint?

A

Flexion, extension, hyperextension, abduction, adduction, lateral rotation, and medial rotation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What muscles compose the anterior hip region?

A

Iliacus, psoas major, and psoas minor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What is the origin of the iliacus?

A

Iliac fossa and sacrum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What is the insertion of the iliiacus?

A

Lesser trochanter of the femur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What is the action of the iliacus?

A
  • Flexion of the femur at the hip joint
  • Flexion of the vertebral column
  • Helps maintain posture (integrity of the vertebral column)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What is the nerve supply of the iliacus?

A

Femoral nerve (L2, L3, and L4)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

What is the origin of the psoas major?

A

Bodies and transverse processes of the lumbar vertebrae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What is the insertion of the psoas major?

A

Lesser trochanter of the femur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What are the actions of the psoas major?

A
  • Flexion of the femur at the hip joint
  • Flexion of the vertebral column
  • Helps maintain posture (integrity of the vertebral column)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What is the nerve supply of the psoas major?

A

Femoral nerve (L2, L3, L4)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Weakness of what muscles will result in a marked disability in carrying out such activities as stair climbing, walking up inclines, and getting up from reclined positions.

A

Psoas major and iliacus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Since the bulk of these muscles are found within the abdominal cavity, many of the organs of the abdomen are superficial to them (kidneys, parts of the lower intestinal tract, pancreas, appendix) and several of the vertebral joints and the sacroiliac joint are found deep to them; any disease or inflammation of these structures may result in pain when the muscles are contracting. What muscles are being described?

A

Psoas major and iliacus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What is the origin of the psoas minor?

A

Bodies of the lumbar vertebrae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What is the insertion of the psoas minor?

A

Iliopubic eminence of the pubis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What the action of the psoas minor?

A

Flexion of the pelvic bone (upward movement)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What is the nerve supply of the psoas minor?

A

L1 (sometimes L2)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What muscles compose the anterior thigh muscles?

A

Sartorius, rectus femoris, vastus lateralis, vastus medialis, vastus intermedius

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What is the origin of the sartorius?

A

Anterior superior iliac spine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What is the insertion of the sartorius?

A

Superior medial shaft of the tibia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What is the action of the sartorius?

A
  • Flexion at the hip joint and knee joint (functions when both are carried out at the same time)
  • Abducts and laterally rotates the femur
  • Medially rotates the leg
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What is the nerve supply of the sartorius?

A

Femoral (L2, L3, L4)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What muscles compose the quadriceps femoris?

A

Rectus femoris, vastus lateralis, vastus intermedius, vastus medialis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

What is the insertion for the quadriceps femoris?

A

Base of the patella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What is the nerve supply of the quadriceps femoris?

A

Femoral (L2, L3, L4)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What is the origin of the rectus femoris?

A
  • Anterior inferior iliac spine

- Acetabulum of the pelvic bone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What is the origin of the vastus lateralis?

A

Greater trochanter and linea aspera of the femur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What is the origin of the vastus medialis?

A

Linea aspera of the femur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

What is the origin of the vastus intermedius?

A

Anterior-lateral aspect and linea aspera of the femur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

What are the actions of the quadriceps femoris?

A
  • All muscles: extend the leg at the knee joint, tonus of the muscle plays a role in strengthening the knee joint
  • The rectus femoris is also involved with:flexion of the femur at the hip joint
  • When the articularis genu is present it is involved with: retraction of the synovial membrane of the knee joint to help stabilize the knee
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Occasionally a distinct bundle of muscle fibers separates from the deepest layers of the vastus intermedius, which attaches to the synovial membrane of the knee joint. It is known as what?

A

Articularis genu

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

An individual with atrophy of these muscles will have difficulty extending their leg against resistance and will usually press on the distal end of the femur during walking to prevent flexion from occurring at the knee joint.

A

Quadriceps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

This muscle is tested with the patient lying down sitting with their legs flexed at the knee joint, the patient is then asked to extend their knee against resistance.

A

Quadriceps

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

This is a term used to indicate a cramping or spasm of the quadriceps. It is also used to indicate trauma to the muscles, which can cause tearing of muscle fibers and lead to the formation of a painful hematoma and bruising.

A

Charley horse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

This condition is a painful overuse injury of the common tendon of insertion of the quadriceps and/or the patellar ligament. It is common in individuals who participate in activities where there is continuous jumping or running. Individuals will complain of pain and soreness in the area of the common tendon or patellar ligament and this pain is intensified with activity.

A

Jumper’s knee (Patellar tendonitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

The patellar reflex is carried out by tapping the patellar ligament and is used to test for the segmental innervation of what?

A

L2, L3, and L4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

What muscles compose the medial thigh?

A

Gracilis, pectineus, adductor longus, adductor brevis, and adductor magnus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

What is the common action of the medial thigh muscles?

A

Adduction of the femur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

What is the common nerve supply of the medial thigh muscles?

A

Obturator nerve (L2, L3, L4)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

What is the origin of gracilis?

A

Ramus of the ischium and inferior ramus of the pubis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

What is the insertion of gracilis?

A

Superior medial shaft of the tibia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

What is the action of gracilis?

A

Flexion of the leg and adduction of the femur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

What is the nerve supply of gracilis?

A

Obturator nerve (L2, L3, L4)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Due to the fact that this muscle is a relatively weak adductor, it can be removed without noticeable loss of action and surgeons can transplant it to replace a damaged muscle, typically in the hand.

A

Gracilis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

What is the origin of the pectineus?

A

Superior ramus (pubic pecten) of the pubis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

What is the insertion of the pectineus?

A

Pectineal line of the femur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

What is the action of the pectineus?

A

Adduction of the femur and flexion at the hip joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

What is the nerve supply of the pectineus?

A

Femoral (L2, L3, L4) and obturator (L2, L3, L4)

99
Q

What is the origin of the adductor longus?

A

Superior ramus of the pubis

100
Q

What is the insertion of the adductor longus?

A

Linea aspera of the femur

101
Q

What is the action of the adductor longus?

A

Adduction of the femur

102
Q

What is the nerve supply of the adductor longus?

A

Obturator (L2, L3, L4)

103
Q

What is the origin of the adductor brevis?

A

Inferior ramus of the pubis

104
Q

What is the insertion of the adductor brevis?

A

Pectineal line and linea aspera of the femur

105
Q

What is the action of the adductor brevis?

A

Adduction of the femur

106
Q

What is the nerve supply of the adductor brevis?

A

Obturator (L2, L3, L4)

107
Q

What is the origin of the adductor magnus?

A

Ramis of the ischium and pubis

108
Q

What is the insertion of the adductor magnus?

A

Linea aspera and adductor tubercle of the femur

109
Q

What is the action of the adductor magnus?

A

Adduction of the femur and extends the femur at the hip joint

110
Q

What is the nerve supply of the adductor magnus?

A

Obturator (L2, L3, L4) and sciatic (L4-S3)

111
Q

The tendon of insertion for the adductor magnus has a slit like opening, which leads into the popliteal fossa. This opening is where the femoral vessels become the popliteal vessels. What is it called?

A

Hiatus tendinous (adductor hiatus)

112
Q

This is a condition in which there is a stretching of the origin of an adductor muscle beyond their tensile strength.

A

Pulled groin (adductor strain). A strain of the iliopsoas is also classified as a pulled groin

113
Q

What muscles compose the posterior hip?

A

Tensor fascia lata, gluteus maximus, gluteus minimus, gluteus medius, pirifomis, superior gemellus, obturator internus, inferior gemellus, obturator externus, and quadratus femoris

114
Q

What is the origin of the tensor fascia lata?

A

Crest of the ilium

115
Q

What is the insertion of the tensor fascia lata?

A

Iliotibial tract

116
Q

What is the action of the tensor fascia lata?

A

Flexes, abducts, and medially rotates the femur. Also helps to stabilize the knee joint

117
Q

What is the nerve supply of the tensor fascia lata?

A

Superior gluteal (L4, L5, S1)

118
Q

This is the largest muscle by weight in the human body and is associated with the assumption of the erect posture and bipedal locomotion.

A

Gluteus maximus

119
Q

This bursa separates the superior part of the gluteus maximus from the greater trochanter

A

Trochanteric bursa

120
Q

This bursa separates the inferior part of the gluteus maximus from the iscial tuberosity

A

Ischial bursa

121
Q

The trochanteric and ischial bursae collectively are known as the what?

A

Gluteal bursae

122
Q

What is the origin of the gluteus maximus?

A

Posterior gluteal line of the ilium, sacrum and coccyx, and posterior ligaments of the sacroiliac joint

123
Q

What is the insertion of the gluteus maximus?

A

Gluteal tuberosity of the femur and the iliotibial tract

124
Q

What is the action of the gluteus maximus?

A

Extends and laterally rotates the femur, helps stabilize the pelvic bone, and stabilizes the knee joint

125
Q

What is the nerve supply of the gluteus maximus?

A

Inferior gluteal (L5, S1, S2)

126
Q

Weakness of this muscle will cause patients to have difficulty getting from a sitting position to a standing position.

A

Gluteus maximus

127
Q

What is the origin of the gluteus medius?

A

External surface of the ilium

128
Q

What is the insertion of the gluteus medius?

A

Greater trochanter of the femur

129
Q

What is the action of the gluteus medius?

A

Abducts the femur, medially rotates the femur, and helps keep the pelvic bone steady when the foot on the opposite side is raised off the ground.

130
Q

What is the nerve supply of the gluteus medius?

A

Superior gluteal (L4, L5, S1)

131
Q

What is the origin of the gluteus minimus?

A

External surface of the ilium

132
Q

What is the insertion of the gluteus minimus?

A

Greater trochanter of the femur

133
Q

What is the action of the gluteus minimus?

A

Abducts the femur, medially rotates the femur, and helps keep the pelvic bone steady when the foot on the opposite side is raised off the ground.

134
Q

What is the nerve supply of the gluteus minimus?

A

Superior gluteal (L4, L5, S1)

135
Q

This is a simple test which is used if one suspects atrophy and weakness of the gluteus medius and minimus muscles. When the muscles are weak the pelvis will drop on the unaffected side when the foot is raised off of the ground.

A

Trendelenburg test

136
Q

This condition is a type of abnormal locomotion due to atrophy and weakness of the gluteus medius and minimus. With this type of locomotion, there is displacement of the body (falling of the pelvis) on the unaffected side.

A

Gluteal/Trendelenburg gait

137
Q

Weakness of these two muscles cause postural deviations, which result in the vertebral column deviating toward the side where the pelvis is low, giving rise to a “C” curve in the column

A

Gluteus medius and minimus

138
Q

What is the origin of the pirifomis?

A

Anterior surface of the sacrum (within the pelvic cavity)

139
Q

What is the insertion of the piriformis?

A

Greater trochanter of the femur

140
Q

What is the action of the piriformis?

A

Lateral rotation of the femur

141
Q

What is the nerve supply of the pirifomis?

A

S1 and S2

142
Q

This condition is a common cause of pain in the gluteal region due to compression of the sciatic nerve by the piriformis muscle. This is common in sports which require extensive lateral rotation of the femur.

A

Pirifomis muscle syndrome or sciatica

143
Q

What is the origin of the superior gemellus?

A

Spine of the ischium

144
Q

What is the insertion of the superior gemellus?

A

Greater trochanter

145
Q

What is the action of the superior gemellus?

A

Lateral rotation of the femur

146
Q

What is the nerve supply of the superior gemellus?

A

L4, L5, S1, S2

147
Q

What is the origin of the obturator internus?

A

Internal surface of the obturator membrane

148
Q

What is the insertion of the obturator internus?

A

Greater trochanter of the femur

149
Q

What is the action of the obturator internus?

A

Lateral rotation of the femur

150
Q

What is the nerve supply of the obturator internus?

A

L4, L5, S1, S2

151
Q

What is the origin of the inferior gemellus?

A

Tuberosity of the ischium

152
Q

What is the insertion of the inferior gemellus?

A

Greater trochanter of the femur

153
Q

What is the action of the inferior gemellus?

A

Lateral rotation of the femur

154
Q

What is the nerve supply of the inferior gemellus?

A

L4, L5, S1, S2

155
Q

What is the origin of the obturator externus?

A

External surface of the obturator membrane

156
Q

What is the insertion of the obturator externus?

A

Trochanteric fossa of the femur

157
Q

What is the action of the obturator externus?

A

Lateral rotation of the femur

158
Q

What is the nerve supply of the obturator externus?

A

Obturator (L2, L3, L4)

159
Q

What is the origin of the quadratus femoris?

A

Tuberosity of the ischium

160
Q

What is the insertion of the quadratus femoris?

A

Quadrate tubercle of the femur

161
Q

What is the action of the quadrate femoris?

A

Lateral rotation of the femur

162
Q

What is the nerve supply of the quadrate femoris?

A

L4, L5, S1, S2

163
Q

This movement of the femur is important in the control of the body’s balance and posture.

A

Lateral rotation

164
Q

What is the origin of the semitendinosus, semimebranosus, biceps femoris?

A

Iscial tuberosity

165
Q

What is the insertion of the semitendinosus?

A

Medial condyle and proximal posterior shaft of the tibia

166
Q

What is the insertion of the semimembranosus?

A

Medial condyle of the tibia

167
Q

What is the insertion of the biceps femoris?

A

Head of the fibula and lateral condyle of the tibia.

168
Q

What is the action of the hamstring muscles (semitendinosus, semimembranosus, and biceps femoris)?

A
  • All muscles carry out flexion of the leg at the knee joint.
  • All except the short head of the biceps femoris stabilize the hip joint and extend the femur
  • Semitendinosus and semimembranosus also medially rotate the leg
  • Biceps femoris laterally rotates the leg
169
Q

What is the nerve supply of the hamstring muscles (semitendinosus, semimembranosus, and biceps femoris)?

A

Sciatic nerve (L4-S3)

170
Q

What is the name given to the tendons of insertion of the semitendinosus, gracilis, and sartorius?

A

Pes Anserinus

171
Q

This type of injury is twice as common as strains of the quadriceps, it is seen in athletes who run very hard and have quick starts, and can be accompanied by painful hemorrhaging. Contributing factors include: running style, over developed quadriceps, and inadequate warm ups.

A

Pulled hamstring

172
Q

What kind of injury can result from forcible flexion of the hip when the knee is extended?

A

Avulsion fracture of the ischial tuberosity

173
Q

The lumbar plexus is formed from what?

A

The ventral rami of L1-L4

174
Q

What is the segmental innervation of the iliohypogastric nerve?

A

L1, sometimes T12

175
Q

What is the motor supply of the iliohypogastric nerve?

A

Internal oblique and transverse abdominis muscles

176
Q

What is the cutaneous supply of the iliohypogastaric nerve?

A

Proximal lateral aspect of the buttocks

177
Q

What is the segmental innervation of the ilioinguinal nerve?

A

L1

178
Q

What is the cutaneous supply of the ilioinguinal nerve?

A

Proximal medial aspect of the thigh

179
Q

What is the segmental innervation of the lateral (femoral) cutaneous nerve of the thigh?

A

L2 and L3

180
Q

What is the cutaneous supply of the lateral (femoral) cutaneous nerve of the thigh?

A

Lateral aspect of the thigh (both anterior and posterior)

181
Q

This condition is a compression neuropathy of the lateral femoral cutaneous nerve as it leaves the pelvic cavity beneath the inguinal ligament. It can sometimes be confused with certain hip disorders.

A

Meralgia Parethesia (lateral femoral cutaneous nerve entrapment)

182
Q

What is the segmental innervation of the genitofemoral nerve?

A

L1 and L2

183
Q

What is the motor supply of the genitofemoral nerve?

A

Cremaster muscle, which is found within the spermatic cord.

184
Q

What is the cutaneous supply of the genitofemoral nerve?

A

Genitalia and a small area below the inguinal ligament

185
Q

What is the segmental innervation of the femoral nerve?

A

L2, L3, and L4

186
Q

What is the motor supply of the femoral nerve?

A

Iliacus, psoas major, sartorius, quadriceps, and pectineus muscles

187
Q

What is the cutaneous supply of the femoral nerve?

A

Medial and intermediate aspect of the anterior thigh and the medial aspect of the leg and foot. This specific branch is known as the saphenous nerve

188
Q

What is the articular supply of the femoral nerve?

A

Hip and knee joints

189
Q

Damage to the femoral nerve may have what effects on motor function?

A
  • Leg cannot be extended (quadriceps)

- Flexion at the hip is diminished (iliopsoas)

190
Q

Damage to the femoral nerve may have what effects on sensory function?

A

Parasthesia in the medial and intermediate anterior aspect of the thigh and medial aspect of the leg and foot

191
Q

Compression of what nerve may occur within the adductor canal or where is exits the fascia to supply the medial leg?

A

Saphenous nerve

192
Q

What is the segmental innervation of the obturator nerve?

A

L2, L3, and L4

193
Q

What is the motor supply of the obturator nerve?

A

Pectineus, adductor magnus, adductor longus and brevis, gracilis, and obturator externus

194
Q

What is the cutaneous supply of the obturator nerve?

A

Skin on the medial aspect of the thigh

195
Q

What is the articular supply of the obturator nerve?

A

Hip and knee joints

196
Q

What is the segmental innervation of the accessory obturator nerve?

A

L3 and L4

197
Q

What does the the accessory obturator nerve supply when present?

A

Pectineus muscle and hip joint

198
Q

What spinal nerves supply the sacral plexus?

A

L4 and L5 (lumbosacral trunk), and S1, S2, S3, and S4

199
Q

Where does the sacral plexus primarily lie?

A

It largely lies on the piriformis

200
Q

What is the segmental innervation of the posterior femoral cutaneous nerve?

A

S1, S2, and S3

201
Q

What is the cutaneous supply of the posterior femoral cutaneous nerve?

A

Distal part of the buttocks, posterior thigh and popliteal fossa

202
Q

What is the segmental innervation of the superior gluteal nerve?

A

L4, L5, and S1

203
Q

What is the motor supply of the superior gluteal nerve?

A

Gluteus medius, gluteus minimus, and tensor fascia lata muscles

204
Q

What is the segmental innervation of the inferior gluteal nerve?

A

L5, S1, and S2

205
Q

What is the motor supply of the inferior gluteal muscle?

A

Gluteus maximus

206
Q

What is the segmental innervation of the pudendal nerve?

A

S2, S3, and S4

207
Q

The pudendal nerve is the main sensory nerve to what?

A

External genitalia

208
Q

What is the segmental innervation of the sciatic nerve?

A

L4, L5, S1, S2, S3

209
Q

What is the motor supply of the sciatic nerve?

A

Adductor magnus, semitendiosus, semimembranous, and biceps femoris

210
Q

What two parts does the sciatic nerve consist of?

A

Tibial nerve (anterior division) and the common fibular nerve (posterior division), which consists of the deep and superficial fibular nerves)

211
Q

What does the tibial nerve supply?

A

The muscles and most of the skin of the posterior leg and plantar surface of the foot

212
Q

What does the common fibular nerve supply?

A

The muscles and skin of the anterior leg, lateral leg, and dorsum of the foot

213
Q

Damage to what nerve can result in the atrophy of hamstring muscles, weak flexion of the leg, and foot drop? Additionally, loss of sensation below the knee except for an area along the medial side of the leg and foot can occur.

A

Sciatic nerve

214
Q

This is the condition caused by a compression, inflammation, and/or subluxation of L4-S3. Pain is usually experienced in the gluteal region, posterior thigh, and leg.

A

Sciatica

215
Q

What is the dermatome level of the proximal anterior thigh?

A

L1

216
Q

What is the dermatome level of the middle anterior thigh?

A

L2

217
Q

What is the dermatome level of the distal anterior thigh; posterior medial leg?

A

L3

218
Q

What is the dermatome level of the distal lateral thigh; medial leg and foot; digit one?

A

L4

219
Q

What is the dermatome level of the lateral leg; digits two, three, and four?

A

L5

220
Q

What is the dermatome level of the posterior lateral thigh and leg; lateral aspect of the foot; digit five?

A

S1

221
Q

What is the dermatome level of the medial posterior thigh and leg?

A

S2

222
Q

What is the dermatome level of the perineum?

A

S3

223
Q

What are the most important superficial cutaneous veins of the lower extremity?

A

Greater and lesser saphenous veins

224
Q

The greater and lesser saphenous veins arises from what structure?

A

Dorsal venous arch of the foot

225
Q

The great saphenous vein will pass through the saphenous opening of the fascia lata where is receives which three tributaries before terminating at the femoral vein?

A

Superficial circumflex iliac vein, superficial epigastric vein, and superficial or external pudendal

226
Q

Where does the lesser saphenous vein normally terminate?

A

At the popliteal vein in the poplitieal fossa. The mode of termination is variable however.

227
Q

This is a condition in which the veins become enlarged, twisted, and painful due to poorly functioning valves.

A

Varicose veins

228
Q

This surgery is the most common in America.

A

Coronary bypass

229
Q

What vessel is typically used for a coronary bypass? Why?

A

Great saphenous vein because it is readily accessible, has sufficient length, and contains a higher percentage of muscular and elastic fibers than do other superficial veins.

230
Q

What are the boundaries of the femoral triangle?

A
  • Superior: inguinal ligament
  • Lateral: sartorius
  • Medial: adductor longus
231
Q

What are the contents of the femoral triangle?

A

Femoral nerve, femoral sheath (femoral artery and vein), and inguinal lymph nodes

232
Q

What are the three compartments and contents of the femoral sheath?

A
  • Lateral compartment: femoral artery
  • Intermediate compartment: femoral vein
  • Medial compartment: femoral canal (lymph node)
233
Q

This type of condition is characterized by a protrusion of abdominal viscera through the femoral ring into the femoral canal.

A

Femoral hernia

234
Q

This is the main arterial supply of the lower extremity and is a continuation of the external iliac artery.

A

Femoral artery

235
Q

What are the branches of the femoral artery?

A

Superficial branches (superficial circumflex iliac, superficial epigastric, and superficial (external) pudendal), femoral profundus, lateral and medial circumflex, perforating arteries, and descending genicular artery

236
Q

This structure is a long narrow passageway found along the medial aspect of the thigh. It provides an important passageway for nerves and blood vessels, including the femoral artery, femoral vein, and saphenous nerve.

A

Adductor canal (Hunter’s canal)

237
Q

These arteries are branches of the internal iliac artery and leave the pelvic cavity via the greater sciatic notch.

A

Superior gluteal and inferior gluteal arteries

238
Q

The gluteus maximus, gluteus medius and minimus, and tensor fascia lata receive their blood supply from what artery?

A

Superior gluteal artery

239
Q

The gluteus maximus, obturator internus, quadratus femoris, and posterior thigh muscles receive their blood supply from what artery?

A

Inferior gluteal artery

240
Q

What are the boundaries of the popliteal fossa?

A
  • Lateral: biceps femoris adn the lateral head of the gastrocnemius
  • Medial: semimembranosus, semitendinosus, and the medial head of the gastrocnemius
  • Roof: deep fascia and skin
  • Floor: popliteal surface of the femur, posterior extrinsic ligaments of the knee joint and the popliteus muscle
241
Q

What are the contents of the popliteal fossa?

A

Popliteal artery and vein, lesser saphenous vein, common fibular nerve, tibial nerve, posterior femoral cutaneous nerve, and popliteal lymph nodes

242
Q

This is the deepest neurovascular structure of the popliteal fossa and is the distal continuation of the femoral artery.

A

Popliteal artery

243
Q

This structure is formed by the genicular branches of the popliteal artery and functions to provide collateral circulation to the leg during full flexion at the knee joint.

A

Genicular anastomosis

244
Q

The bifurcation of the popliteal artery may become the site of an ____ ____, which would result in the loss of blood to the leg and foot.

A

Arterial embolism