Important Stuff To Know Semester 2 Year 1

Question 0

Where and how is the adductor canal formed?

Answer 0

Begins at the apex of the femoral triangle through he overlapping of sartorious on adductor longus. It is an intermuscular passageway and allows passage of the femoral vessels and nerves

Question 1

What are the borders and contents of the femoral triangle?

Answer 1

Apex: junction of the medial border of sartorious, crossing of the lateral border of adductor longus
Medial border: adductor longus
Lateral border: sartorious
Base: inguinal ligament
Floor: Iliopsoas and pectineus
Roof: fascia Lara and cribriform fascia, subcutaneous tissue and skin

Contents (lateral to medial)
Femoral nerve
Femoral vein
Deep inguinal lymph

Question 2

What is the femoral sheath and how is it formed?

Answer 2

It is a prolongation of the transversal is and Iliopsoas fascia, it transmits he femoral artery and vein as well as lymph

Question 3

What is the femoral canal?

Answer 3

The smallest and most medial compartment of the femoral sheath, is involved in allowing for inflammation of the femoral vein as it transports blood back to the heart, also contains lymph

The opening at its superior end is called the femoral ring and it ends at the saphenous opening

Question 4

What are the boundaries of the femoral ring?

Answer 4

Lateral: fibrous septum between the canal and femoral vein
Posterior: superior pubic ramps and overlying fascia
Medial: lacunae ligament
Anterior: medial part of the inguinal ligament

Question 5

What is the pathway of the femoral artery?

Answer 5

Is the continuation of the external iliac artery,
Begins at the lower border of the inguinal ligament,
decends down the thigh through the lateral compartment of the femoral sheath,
Travels centrally down the femoral triangle, entering adductor canal at the apex,
Exits the adductor canal through the adductor hiatus as the popliteal artery

Question 6

What are the branches of the femoral artery?

Answer 6

Superficial epigastric
Superficial circumflex iliac
Superficial external pudendal
Deep external pudendal arteries
Profuna femoral artery
Medial circumflex femoral
Lateral circumflex femoral

Question 7

What are the boundaries and contents of the adductor canal?

Answer 7

Anterior and laterally: 
vastus medialis
Posteriorly:
Adductor longus and Magnus
Medially:
Sartorious

Contents:
Femoral artery
Femoral vein
Saphenous nerve
Nerve to vastus medialis

Question 8

What are the divisions of the internal iliac artery and which arteries are in each division?

Answer 8

Posterior and anterior divisions

Posterior division:
Superior gluteal
Iliolumbar
Lateral sacral

Anterior division:
Umbilical
Obturator
Middle rectal
Inferior gluteal
Internal pudendal

Question 9

What arteries of the internal iliac artery are specific to males and females?

Answer 9

Males:
Artery to ductus deferens
Inferior vesicle artery

Females:
Vaginal artery
Uterine artery

Question 10

Pathway of the superior gluteal artery

Answer 10

Runs posteriorly down the pelvis, through the greater sciatic foramen before running superiorly above pisiformis into the gluteal region

Question 11

Pathway of the iliolumbar artery

Answer 11

Passes superiorly out of the pelvis, runs laterally to the psi as muscle

Question 12

What is the pathway of the lateral sacral artery?

Answer 12

Runs lateral to the anterior sacral foramina, supplying structures surrounding it

Question 13

What is the pathway of the obturator artery?

Answer 13

Runs along the lateral pelvic wall along with the obturator artery and vein, it then passes through the obturator foramen into the thigh

Question 14

What is the pathway of the inferior gluteal artery?

Answer 14

Exits the pelvis through the inferior part of the greater sciatic foramina, passing inferior to piriformis into the gluteal region

Question 15

What arteries enter the pelvic cavity?

Answer 15

Both internal iliac arteries
Both gonadal arteries
Median sacral artery
Superior rectal artery

Question 16

What nerves pass through the lateral border of psoas?

Answer 16

Iliohypogastric
Ilioinguinal
Lateral femoral cutaneous nerve of the thigh
Femoral nerve

Question 17

What nerves pass through the medial border of psoas?

Answer 17

Obturator nerve
Lumbosacral trunk
Accessory obturator nerve

Question 18

What nerves pass through the anterior border of psoas?

Answer 18

Genitofemoral nerve

Question 19

What are the main branches of the external iliac artery?

Answer 19

Inferior epigastric
Deep circumflex iliac
Femoral artery

Question 20

What are the branches of the femoral artery?

Answer 20

Superficial epigastric artery
Superficial circumflex iliac artery
Superficial external pudendal artery
Deep external pudendal arteries

Question 21

What is the pathway of the femoral artery?

Answer 21

Continuation of the external iliac artery at the inferior border of the inguinal ligament, passes through the lateral compartment of the femoral sheath, deep to the fascia lata and adjacent to psoas and pectineus muscles

Question 22

What is another name for the adductor canal?

Answer 22

Hunters canal

Question 23

What is the pathway of the popliteal artery?

Answer 23

Continuation of the femoral artery at the adductor hiatus, passes inferiorlaterally through the popliteal fossa, ends at the inferior border of popliteus by dividing into anterior and posterior tibial arteries

Question 24

What are the branches of the popliteal artery?

Answer 24

Medial and lateral superior genicular arteries Middle genicular artery Medial and lateral inferior genicular arteries (These all form genicular anastomoses)

Question 25

What is the pathway of the small saphenous vein?

Answer 25

Travels between the heads of gastrocs, enters the popliteal fossa, pierces the deep fascia and the drains into the popliteal vein

Question 26

What are the contents of the anterior compartment of the leg?

Answer 26

``` Anterior tibial artery and vein Deep fibular nerve Tibial is anterior Extensor hallucis longus Extensor digitorum longus Fibularis tertius ```

Question 27

What is the superior extensor retinaculum of the leg?

Answer 27

A band of deep fascia that holds down the tendons of the anterior compartment of the leg and prevents them from bow stringing Passes from the fibula to the tibia, proximal to the malleoli, it is pierced by tibialis anterior tendon and invaginates to form a continuous synovial sheath

Question 28

What is the inferior extensor retinaculum?

Answer 28

A y shaped thickening of fascia inferior to the superficial extensor retinaculum. It loops around the tendons of EDL and FT to share a common synovial sheath Attaches from the medial malleolus and navicular and plantar app neurosis medially and to the calcaneus medially

Question 29

What is the extensor expansion?

Answer 29

A membranous structure over the dorsal aspect of each proximal phalanx, divides into 2 lateral slips and a central slip. The two lateral slips insert into e base of the distal phalanx The central slip inserts into the base of the middle phalanx

Question 30

What are the structures of the anterior ankle from medial to lateral?

Answer 30

``` Remember Tom Has Absolutely No Determination as a mnemonic Tibial is anterior Extensor hallucis longus Anterior tibial artery Deep fibular nerve Extensor digitorum longus ```

Question 31

What are the branches of the dorsalis pedis artery?

Answer 31

Lateral tarsal artery Arcuate artery Deep plantar artery 1st dorsal metatarsal artery

Question 32

What is the pathway of the dorsalis pedis artery?

Answer 32

Passes deep to inferior extensor retinaculum between the tendons of EHL and EDL, at the 1stmetatarsal cleft it divides into 1stdorsal metatarsal artery and deep plantar artery

Question 33

What is the pathway of the anterior tibial artery?

Answer 33

Passes through the superior Interosseus hiatus, descends on the anterior surface of the Interosseus membrane, between tib ant and EDL, passes deep to extensor retinaculum becoming the dorsalis pedis artery

Question 34

What is the pathway of hue he posterior tibial artery?

Answer 34

Begins at the distal portion of popliteus as a branch of the popliteal artery Passes deep psoas and runs inferno medially over tibial is posterior Runs posterior to the medial malleolus and deep to the flexor retinaculum where it enters the foot

Question 35

What are the branches of the posterior tibial artery?

Answer 35

Circumflex fibular artery Fibular artery Nutrient artery of the tibia Medial malleolar branch

Question 36

How is the great saphenous vein formed and where does it run?

Answer 36

Formed by the union of the dorsal vein of the great toe and the dorsal venous arch, runs anterior to the medial malleolus, posterior to the medial condyle of the knee before moving superb medially through the saphenous opening, emptying into the femoral vein

Question 37

How is the small saphenous vein formed and where does it run?

Answer 37

Formed by the union of the dorsal vein of the little toe and the dorsal venous arch, It runs posterior to the lateral malleolus and runs between the two heads of gastrocs, it empties into the popliteal vein

Question 38

What are the borders and contents of the popliteal fossa?

Answer 38

``` Superomedial border: Biceps femoris Superolateral border: Semitendonosis and semimembranosis Inferomedial border: Medial head of gastrocnemius Inferolateral border: Lateral head of gastrocnemius Roof: Skin and fascia Floor: Popliteal ligament, popliteus, popliteal surface of the femur ``` ``` Contents: Popliteal artery and vein Common fibular nerve Tibial nerve Terminal branch of the posterior femoral cutaneous nerve of the thigh Small saphenous vein Popliteal lymph nodes and vessels Fat ```

Question 39

What are the borders and content of the femoral triangle?

Answer 39

``` Medial border: Adductor longus Lateral border: Sartorious Base: Inguinal ligament Floor: Iliopsoas and pectineus Roof: Fascia lata and cribriform fascia, subcutaneous tissue and skin Apex: Formed by the junction of adductor longus and sartorious, making the adductor canal ``` ``` Contents: Femoral artery Femoral vein Femoral nerve Great saphenous vein Femoral sheath and it's contents Deep inguinal lymph node and vessels Saphenous opening ```

Question 40

What four structures pass through the adductor canal?

Answer 40

Femoral artery Femoral vein Saphenous nerve Nerve to vast us medialis

Question 41

How is the adductor hiatus formed?

Answer 41

In the tendon of adductor Magnus

Question 42

What are the compartments of the retroinguinal space, what exists in these compartments and how is it formed?

Answer 42

Contains a vascular and muscular compartment, these are separated by the iliopectineal arch, which is a thickening of the psoas fascia Muscular compartment contents: Iliacus Psoas Femoral nerve Vascular compartment: Femoral artery Femoral vein Lymphatic a

Question 43

What are the walls of the inguinal canal and what is its contents?

Answer 43

``` Anterior: Aponeurosis of external oblique Posterior wall: Transversalis fascia Roof: Formed by arching fibres of transverse abdominis, and internal oblique, Transversalis fascia Floor: Inguinal ligament, reinforced by the lacunar ligament ``` ``` Contents: Blood vessels, lymph vessels and the ilioinguinal nerve Males: spermatic chord Females: Round ligament of the uterus ```

Question 44

Ligaments of the hip

Answer 44

Iliofemoral (attaches from the AIIS to the intertrocahanteric line) Pubofemoral (attaches from the obturator crest to the iliofemoral ligament) Ischiofemoral (attaches from the ischial part of the acetabular rim to the neck of the femur)

Question 45

What is the function of the articulate capsule of the hip?

Answer 45

Is a loose, fibrous capsule that helps with free movement of the hip

Question 46

What kind of joint is the hip joint and what movements occur here?

Answer 46

``` Is a multi axial, synovial ball and socket joint, allows for ; Flexion and extension Abduction and adduction Internal and external rotation Circumduction ```

Question 47

What are the attachments of the knee joint capsule?

Answer 47

``` Superiorly: Femur Inferiorly: Articulate margins of the tibia Anteriorly: Sides of the patella and patella ligament ```

Question 48

What are the ligaments of the knee?

Answer 48

``` Fibular collateral lig Tibial collateral lig Patella lig Oblique popliteal lig Arcuate popliteal lig Cruciate ligs (ACL, PCL) Menisci ```

Question 49

What is the function of the oblique popliteal ligament and what is it made of?

Answer 49

Is an expansion of semimembranosis tendon, reinforces the joint capsule posteriorly and attaches from the medial tibial condyle to the lateral femoral condyle

Question 50

How does the knee lock?

Answer 50

Femur medially rotates on the tibia Stability becomes increased, muscle contraction decreases Unlocks when popliteus laterally rotates femur 5 degrees

Question 51

What type of joint is the proximal, superior tibiofibular joint?

Answer 51

Plane type synovial joint, allow for anterior and posterior movements during dorsi and plantar flexion of the foot

Question 52

What type of joint is the distal tibio-fibular joint?

Answer 52

It is a fibrous joint, allows for anterior and posterior movements during dorsi and plantar flexion of the foot

Question 53

What muscles are in the different layers of the foot?

Answer 53

First layer: Abductor hallucis Flexor digitorum brevis Abductor digitorum brevis Second layer: Lubricals Quadratus plantae Third layer: Adductor hallucis Flexor hallucis brevis Flexor digits mining brevis Fourth layer: Dorsal and plantar Interossei

Question 54

What are the compartments of the foot and what muscles sure in each of them?

Answer 54

Medial, central, lateral, Interosseus and dorsal ``` Medial: Abductor hallucis Flexor hallucis brevis Tendon of flexor hallucis longus Medial plantar nerves and vessels ``` ``` Central: Flexor digitorum brevis Flexor digitorum longus tendons Quadratic plantae Adductor hallucis Tendon of flexor hallucis longus Lateral plantar nerves and vessels ``` Lateral compartment: Abductor digiti minimi Flexor digiti minimi brevis Interosseus compartment: Metatarsals Dorsal and plantar Interosseus muscles Deep plantar and metatarsal vessels Dorsal compartment: Extensor hallucis brevis Extensor digitorum brevis Neurovascular structures of the dorsum of the foot

Question 55

What is the plantar fascia and what does it join up with?

Answer 55

It is the fascia of the sole and joins up with the medial and lateral plantar fascia with the dorsal fascia It makes up the plantar aponeurosis which is a thickening in the central part of the plantar fascia, it assists in maintaining the longitudinal arches The plantar aponeurosis attaches to the calcaneus adjoins up with the fibrous sheaths of the 5 digits

Question 56

What is the plantar calcaneonavicular (spring) ligaments function?

Answer 56

The spring ligament arises from the Sustentaculum tali to the navicular, it helps to support the head of the talus in the TCN joint, it also maintains the longitudinal arches of the foot

Question 57

What are the three parts of the foot and what is each made up of?

Answer 57

The hind foot, the mid foot and the forefoot Hind foot: Calcaneus and talus Mid foot: Cuboid, navicular and cuneiforms Forefoot: Metatarsals and phalanges

Question 58

What are the arches of the foot and what bones fall in them?

Answer 58

Medial longitudinal arch, lateral longitudinal arch and the transverse arch ``` Medial longitudinal arch: Calcaneus Talus Navicular Cuneiforms Metatarsals 1-3 Phalanges of digits 1-3 ``` ``` Lateral longitudinal arch Calcaneus Cuboid Metatarsals 4-5 Phalanges of digits 4-5 ``` Transverse arch: Cuboid Cuneiforms

Question 59

What is the angle of inclination and what is a norm for this angle?

Answer 59

The angle which is formed between the union of the neck of the femur and the shaft. Usually between 115-140 degrees. The norm value for the angle of inclination is 126 degrees. It's orientation allows it to bring the femur medially towards the femur, it also allows the head of the femur to sit in the acetabulum better

Question 60

What is the Q angle and what is a normal value for the Q angle?

Answer 60

The Q angle is the angle between the femur and tibia of the knee, it is formed between the line from the ASIS to the mid patella and from the mid patella to the tibial tuberosity It is usually 13 degrees in men and 18 degrees in women

Question 61

What are perforating veins and where are they found?

Answer 61

Perforating veins are veins that move blood from the superficial layers to the deep. They perforate deep fascia to assist with venous return. They have valves within them that prevent back flow of blood and contract with muscles to improve venous return. They are found in the deep fascia

Question 62

What is the pathway of the posterior femoral cutaneous nerve?

Answer 62

Passes through the greater sciatic foramen, runs inferiorly to piriformis, it then decends under gluteus maximus. It then decends down the posterior thigh beneath the fascia lata. It then pierces fascia posterior to the knee

Question 63

What is the pathway of the obturator nerve?

Answer 63

Ventral rami of l2-l4, passes the medial border of psoas, decends inferiorly throug the pelvis, enters the obturator canal, splits into anterior and posterior divisions The anterior division passes between adductor longus and adductor brevis, it then pierces the fascia lata to become the cutaneous branch of the obturator nerve The posterior division decends through obturator externals, passing anterior to adductor Magnus