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Medicine 2 Week 6 - 11 > Introduction to Lower Limb > Flashcards

Introduction to Lower Limb Flashcards

1
Q

Tibial & Fibular Sides of the Leg

A

Tibial - Medial

Fibular - Lateral

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2
Q

Peroneal

A

Fibular (synonym)

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3
Q

Which of the extensor/flexor groups is anterior and which is posterior (Legs)

A

Extensor - Anterior

Flexors - Posterior

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4
Q

Ilium

A
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5
Q

Pubis

A
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6
Q

Ischium

A
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7
Q

Inguinal Ligament

A
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8
Q

Inguinal Ligament Attachments

A

Anterior Superior Iliac Spine to Pubic Tubercle

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9
Q

Acetabulum

A

Socket of Pelvis

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10
Q

Anterior Superior Iliac Spine and Anterior Inferior Iliac Spine

A
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11
Q

Iliac Crest

A
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12
Q

Ischial Tuberosity

A
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13
Q

Greater & Lesser Trochanters of the Femur

A
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14
Q

Intertrochanteric Crest

A

(Posterior)

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15
Q

Intertrochanteric Line

A

(Anterior)

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16
Q

Linea Aspera

A

(Posterior)

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17
Q

Adductor Tubercle

A
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18
Q

Which bone articulates at the distal end of the femur

A

Tibia

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19
Q

Patella

A
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20
Q

Femural Condyles

A

(Posterior)

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21
Q

Tibial Tuberosity

A
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22
Q

Medial and Lateral Malleolus

A

Medial is formed by tibia, lateral by fibula

Bony protrusions on either side of your foot

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23
Q

What are tarsal bones

A

Bones at the base of the foot equivalent to the carpal bones of the hand

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24
Q

How many tarsal bones are there

A

7

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25
Q

What are the Tarsal Bones

A 
Talus
Calcaneus
Navicular Bone
Cuboid Bone
Lateral/Intermediate/Medial Cuneiform

**TALUS COVERS NAVICULAR, NAVICULAR COVERS CUNEIFORM

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26
Q

Fascia Lata

A

Deep fascia of the thigh, very strong and thickened laterally

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27
Q

Discuss the fascia of the lower limb

A

Forms a stocking around the leg
Site of muscle attachment
Thickened Laterally
Divides the anterior, medial and posterior compartment by attatching to the linea aspera

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28
Q

Gluteus Maximus

A
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29
Q

Gluteus Medius

A
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30
Q

What muscle is deep to gluteus medius

A

Gluteus minimus

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31
Q

Piriformis

A
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32
Q

Role of the hamstrings

A

Extensors of Hips and Flexors of the Knee

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33
Q

Muscles making up the hamstrings

A

Biceps Femoris
Semimembranosus
Semitendinosus

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34
Q
A

Semitendinosus has long tendon, semimembrunosus has long membranous region

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35
Q

Where do the hamstrings originate

A

Ischeal Tuberosity

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36
Q

Where do the hamstrings insert

A

Fibula (biceps) or Tibia

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37
Q

Common site of hamstring injuries

A

Ischial tuberosity associated with tearing of the proximal attachment

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38
Q

Role of muscles at the anterior thigh

A

Flexors of hip & extensors of knee

**Most muscles do one or the other

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39
Q

Heads making up the Quadriceps

A

Rectus Femorus

Vastus Lateralis
Vastus Intermedius
Vastud Medialis

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40
Q

Which of part of this muscle is the rectus femorus

A
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41
Q

Where is the vastus intermedius located in this diagram

A

Posterior to the rectus femorus (not visible)

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42
Q

Innervation of Quadriceps Femoris Muscle

A

Femoral Nerve (L2-L4)

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43
Q

Functions of quadriceps

A

Flexion of the hip (only rectus femorus)

Extension of knee (all heads)

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44
Q

How do the quadriceps muscles work together to extend the knee

A

They come together at the knee where they unite at the quadricpes tendon

Within it is the patella

This carries on to form the patella ligament and attaches at the tibial tuberosity

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45
Q

Sesamoid Bone

A

Bone embedded within a tendon (e.g. patella)

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46
Q

Iliacus

A
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47
Q

Psoas Major

A
48
Q

Iliopsoas and its parts

A

Iliacus

Psoas Major

49
Q

Function of iliopsoas

A

Flexon & external rotation of thigh at hip
Flexion of trunk at hip
Lateral flexion of trunk (psoas major only)

50
Q

Sartorius

A

Forms lateral boundary of femoral triangle

51
Q

Name these Hip Adductors

A
52
Q

Where does the adductor magnus lay relative to the rest of the hip adductors

A

Posterior/Deep

53
Q

Which hip adductor is the weakest

A

Gracilis - often used in transplantation

54
Q

Groin Strain

A

The pulling/tearing of one of the proximal attachments of a hip adductor/flexor

55
Q

Plantar vs Dorsal aspect of foot

A

Plantar is side on the floor (heel, arch, ball, etc)

Dorsal is the side with your toenails

56
Q

Plantarflexion

A
57
Q

Role of calf muscles

A

Plantarflexion

58
Q

Action of muscles in lateral compartment of lower leg

A

Eversion

59
Q

Groups of Calf Muscles and their roles

A

Superficial Group - All plantarflex ankle
Deep Group - Most Planterflex ankle/flex toes

**Superficial generates most force

60
Q

Superficial Calf Muscles

A

Gastrocnemius medial and lateral Heads

Soleus (just deep to it)

61
Q

Discuss the insertion of the superficial calf muscles

A

These muscles come together to form the calcaneal tendon (achilles tendon) and attaches over onto calcaneus (tarsal bone forming the heel)

62
Q

Triceps Surae

A

Another name for Superficial Calf Muscles (since it is made of 3 heads)

Important for venous return since it is constantly active

63
Q

Which group of muscles produce produce 93% of planterflexion force

A

Triceps Surae

64
Q

Which calf muscles of the deep calf muscles plantarflex the ankle

A

Flexor Digitorum Longus

Flexor Hallucis Longus

65
Q

Which calf muscle inverts the foot

A

Tibialis Posterior (TP)

  • *ALSO SOMEWHAT ASSISTS IN PLANTARFLEXION
  • *DEEPEST MUSCLE OF POSTERIOR LEG
66
Q

Role of popliteus (calf muscle)

A

Major stabiliser of knee

67
Q

What are the everter muscles of the foot

A

Fibularis Longus & Brevis

**In lateral compartment of lower leg

68
Q

Relation of fibularis longus & brevis with lateral malleolus

A

Tendons pass posterior to the lateral malleolus and attaches at lateral aspect of foot

69
Q

Relation between fibularis brevis and longus

A

Fibularis longus is superficial to brevis

70
Q

Fibularis Tertius

A

Secondary eversion muscle in anterior compartment

Not a main everter

71
Q

Relation between tendons of fibularis longus and tibialis posterior

A

The fibularis longus tendon comes across the dorsal aspect of the foot and passes over the tibialis poster tendon to keep it in place

72
Q

Muscles in the anterior compartment of the lower leg

A

Tibialis Anterior
Extensor Digitorum Longus
Extensor Hallucis Longus

73
Q

Nerve Roots of Lumbar and Sacral Plexus

A

Lumbar L1-4

Sacral L4-S4

74
Q

Terminal Branches of the Lumbosacral Plexus

A 
Femoral Nerve
Obturator Nerve
Superior Gluteal Nerve
Inferior Gluteal Nerve
Sciatic Nerve
75
Q

Nerves in Sciatic Nerve

A

Common Fibular Nerve

Tibial Nerve

76
Q

What does the Femoral Nerve Innervate

A

Most of the anterior compartment (quads) of the thigh

77
Q

What does the Obturator Nerve Innervate

A

Most of the medial compartment of thigh (Adductors)

78
Q

What do the Gluteal Nerves Innervate

A

Some muscles of the gluteal region

79
Q

What does the Sciatic Nerve Innervate

A

Posterior compartment of thigh

80
Q

What does the Common Fibular Nerve Innervate

A

Superficial Branch - Lateral compartment of leg

Deep - Anterior compartment of leg

81
Q

What does the Tibial Nerve Innervate

A

Posterior Compartment of Leg

82
Q

Why is the piriformis an important anatomical landmark

A

The Sciatic Nerve comes out below it

The inferior gluteal neurovascular bundle (VAN) passes below it and innervates the gluteus maximus

The superior VAN passes above it and innervates gluteus minimus and medius

83
Q

Popliteal Fossa

A

Diamond Shaped space behind the knee

84
Q

Contents of the popliteal fossa

A

Sciatic Nerve splitting out of sheath releasing tibial nerve into fossa

Sural Nerve (cutaneous)

**Common fibular nerve goes laterally

85
Q

What forms the sural nerve

A

A branch coming off the tibial and a branch coming off the common fibular

86
Q

Role of the Sural Nerve

A

Cutaneous Nerve for the lateral aspects of the leg and foot

87
Q

Femoral Triangle Boundaries

A

Superior - Inguinal Ligament
Medial - Adductor Longus
Lateral - Sartorius

Floor - Pectineus

**APEX WHERE AL & S MUSCLES MEET

88
Q

Contents of Femoral Triangle

A

Femoral VAN (Medial to Lateral)
(Vein including Branches)
Lymphatic Drainage*

89
Q

Bondaries of Popliteal Fossa

A

Biceps Femoris
Semimembranosus
Semitendinous Tendon

Lateral & Medial Heads of Gastrocnemius

90
Q

Contents of Popliteal Fossa

A

Popliteal Vein
Popliteal Artery & Branches
Termination of Small Saphenous Vein

Nerves

Lymphatic Vessels & Nodes

91
Q

Discuss the path of the femoral nerve

A

From the femoral triangle, it innervates the various muscles around it

After this it carries on through the adductor canal as a sensory nerve (Saphenous Nerve) where it carries onto the medial aspect of the leg and provides the cutaneous innervation

92
Q

Discuss the path of the Tibial Nerve

A

It goes in the popliteal fossa then carries on in the posterior region of the leg region’s deep compartment

93
Q

Discuss the path of the Common Fibular Nerve

A

Comes off the sciatic, goes laterally and winds around the head of the fibula (it is exposed and at risk during injury)

It branches into a superficial branch that goes in the lateral department and a deep branch that goes in the anterior compartment

94
Q

Common trauma to nerves - Femoral Nerve

A

Anterior Thigh Trauma

95
Q

Common trauma to nerves - Superior Gluteal Nerve

A

Hip Surgery

96
Q

Common trauma to nerves - Sciatic Nerve

A

Posterior Hip Dislocation

97
Q

Common trauma to nerves - Common Fibular Nerve

A

Trauma/Fracture at neck of fibula

98
Q

Origins of Femoral Artery

A

Abdominal Aorta Bifurcates into Common Iliac

Branches into External and Internal Iliac arteries

Once the External Iliac goes under inguinal ligament it becomes the Femoral Artery which carries on down the thigh

99
Q

Main branch of femoral artery and its importance

A

Profunda Femoris Artery

This artery is important because it forms several branches that form important anatamoses at the hip

**Look at Post View

100
Q

What is the adductor hiatus

A

An opening in the Adductor Magnus muscle

101
Q

Path of the Femoral Artery

A

It goes down the thigh and goes through the adductor hiatus

It then goes posteriorly and becomes the popliteal artery

102
Q

Discuss the path of the Popliteal Artery till the end(s)

A

Popliteal Artery branches into the Anterior and Posterior Tibial Arteries

The Anterior goes down the anterior compartment of the leg to become the dorsal artery of the foot

The Posterior goes around the medial malleolus through to the foot

103
Q

Where can the Femoral Pulse be palpated

A

Midway across the Inguinal Ligament

104
Q

Where can the Popliteal Pulse be palpated

A

Deep in the popliteal fossa between the tendons

105
Q

Where can the Posterior Tibial Pulse be palpated

A

Posterior to the Medial Malleolus

106
Q

Where can the Dorsalis Pedis Pulse be palpated

A

Lateral to the Extensor Hallucis Longus Tendon

107
Q

Clinical Relevance of Femoral Triangle

A

Used to locate the Femoral Artery for Canulation

108
Q

Superficiality Relations of Great Saphenous Vein

A

Superficial to Fascia Lata

109
Q

Where does the Great Saphenous Vein join the Femoral Vein

A

In the Femoral Triangle (I think) through the Saphenous opening

110
Q

Lymphatic Drainage of Lower Limb

A

Lower limb drains directly or indirectly into the inguinal lymph nodes

111
Q

Femoral Sheath, Canal and Ring

A

Structure that surrounds the Artery, Vein and Lymphatic Vessel (Each in own compartment)
Femoral Nerve is outside of it

Femoral Canal is where the lymphatic vessel is (Medial Compartment)

Femoral Ring is the top end of that canal

112
Q

Clinical Relevance of Femoral Sheath/Canal

A

At risk of part of the digestive system entering the femoral ring if it’s weak; the abdominal contents may then come out of the inferior aspect and go through the saphenous opening

This creates a Femoral Hernia due to tissue strangulation

113
Q

Venous Drainage of Lower Limb

A

Small Saphenous Vein drains into the Popliteal Vein in the Popliteal Fossa

This then drains into the Femoral Vein

Perforating veins allow blood from superficial vein to drain into deeper veins

114
Q

Circulatory Problems most likely to affect the lower limb

A

Arterial Insufficiency
Venous Insufficiency

(Lymph)oedema

115
Q

Which Bones form the Pelvis

A

Ischium
Ilium
Pubis

Sacram

Medicine 2 Week 6 - 11 (54 decks)

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