For the femoral nerve, what is the 1. ) Rami 2. ) Division 3. ) Compartment

1. ) L2-L4 2. ) Posterior 3. ) Anterior thigh

For the Obturator nerve, what is the 1. ) Rami 2. ) Division 3. ) Compartment

1. ) L2-L4 2. ) Anterior 3. ) Medial thigh

For the Tibial nerve, what is the 1. ) Rami 2. ) Division 3. ) Compartment

1. ) L4-S3 2. ) Anterior 3. ) Posterior thigh, leg, sole of the foot

Introduction to the Lower Limb, Gluteal Region, and Hip Joint Flashcards by Joel Glotfelty

The lower extremity is comprised of four major regions from proximal to distal, they are

) Gluteal region
) Thigh
) Leg
) Ankle and foot

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The limbs begin development in the same position with the palms and the soles of the feet facing

Anteriorly

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During the 6th to 8th weeks they undergo rotation in opposite directions about their long axis. How do the upper and lower limbs rotate?

) Upper rotate laterally

2. ) Lower rotate medially

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Like the upper limb, the lower limb is divided into

Anterior and posterior regions

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As a result of limb rotation, the ventral muscle mass of the lower limb occupies the

Posterior anatomical comparment

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As a result of limb rotation, the ventral muscle mass of the lower limb occupies the posterior anatomical compartment and functionally contains

Knee flexors

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As a result of limb rotation, the dorsal muscle mass occupies the

Anterior anatomical compartment

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As a result of limb rotation, the dorsal muscle mass occupies the anterior anatomical compartment and functionally contians

Knee extensors

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In general, anterior compartment muscles of the lower limb are

Extensors

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In general, posterior muscles of the lower limb are

Flexors

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Innervation of the lower limb is via branches of the

Lumbosacral plexus

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The lumbosacral plexus consists of ventral rami of spinal nerves

L2-S3

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In general, posterior division fibers of the lumbosacral plexus innervate

Anterior compartment muscles

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In general, anterior division fibers innervate

Posterior compartment muscles

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What are the four terminal nerves of the lumbosacral plexus?

Femoral, Obturator, Tibial, and Common Fibular

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For the femoral nerve, what is the

) Rami
) Division
) Compartment

) L2-L4
) Posterior
) Anterior thigh

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For the Obturator nerve, what is the

) Rami
) Division
) Compartment

) L2-L4
) Anterior
) Medial thigh

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For the Tibial nerve, what is the

) Rami
) Division
) Compartment

) L4-S3
) Anterior
) Posterior thigh, leg, sole of the foot

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For the common fibular nerve, what is the

) Rami
) Division
) Compartment

1.) L4-S2
2.) Anterior
3.)
Anterior leg: Deep fibular
Lateral leg: Superficial fibular

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Arterial supply to the lower limb is via branches of the

Internal iliac and femoral arteries

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In general, internal iliac branches supply the

Gluteal region

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In general, femoral artery branches supply the

Rest of the lower limb

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Branches of the iliac and femoral arteries anastamose at the

Cruciate anastomosis

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The cruciate anastomosis take the shape of a cross and involves the

Inferior gluteal, medial and lateral femoral circumflex, and 1st perforating artery

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The Superior Gluteal artery 1. ) Is a branch of? 2. ) Supplies?

1. ) Internal illiac | 2. ) Gluteal region

The Inferior Gluteal artery 1. ) Is a branch of? 2. ) Supplies?

1. ) Internal iliac | 2. ) Gluteal region

The Obturator artery 1. ) Is a branch of? 2. ) Supplies?

1. ) Internal iliac | 2. ) Medial thigh and head of femur

The Deep Femoral artery 1. ) Is a branch of? 2. ) Supplies?

1. ) Femoral | 2. ) Thigh

The Medial Femoral Circumflex artery 1. ) Is a branch of? 2. ) Supplies?

1. ) Deep Femoral | 2. ) Hip and Thigh

The Lateral Femoral Circumflex artery 1. ) Is a branch of? 2. ) Supplies?

1. ) Deep Femoral | 2. ) Hip and thigh

The Perforating artery 1. ) Is a branch of? 2. ) Supplies?

1. ) Deep Femoral | 2. ) Posterior Thigh

The Genicular artery 1. ) Is a branch of? 2. ) Supplies?

1. ) Popliteal | 2. ) Knee

The Anterior Tibial artery 1. ) Is a branch of? 2. ) Supplies?

1. ) Popliteal | 2. ) Anterior Leg

The Posterior Tibial artery 1. ) Is a branch of? 2. ) Supplies?

1. ) Popliteal | 2. ) Posterior Leg

The Fibular artery 1. ) Is a branch of? 2. ) Supplies?

1. ) Posterior Tibial | 2. ) Posterior and Lateral Leg

The Medial Plantar artery 1. ) Is a branch of? 2. ) Supplies?

1. ) Posterior Tibial | 2. ) Medial Sole

The Lateral Plantar artery 1. ) Is a branch of? 2. ) Supplies?

1. ) Posterior Tibial | 2. ) Lateral Sole

The veins of the lower limb ultimately drain into the

Femoral or internal iliac veins

The veins of the lower limb include the -comprise the muscular venous pump system

Superficial veins, deep veins, and perforating veins

Located between the muscles

Deep veins

Connect the deep veins and superficial veins

Perforating veins

How does the venous system in the legs work?

Muscle contraction compresses deep veins, forcing blood superiorly. When muscles relax, blood from superficial veins moves through perforating veins and into the deep veins. Then the process repeats

Have one way valves to prevent backflow

Perforating veins

A notable superficial vein because it is frequently used as a graft in heart by-pass surgery

Great Saphenous Vein

Located distally as it passes anterior to the medial malleolus in the superficial fascia

Great saphenous vein

Major lymph nodes of the lower limb includes the

Superficial (vertical) and deep inguinal nodes, and the popliteal (behind the knee) nodes

Muscles of the gluteal region can be organized into which four functional groups?

Hip abductors, medial rotators, lateral rotators, and extensors

Which muscles function in ABduction of the thigh at the hip?

Gluteus medius, gluteus minimus, and tensor fascia lata (anterior thigh)

What are the MEDIAL rotators of the thigh at the hip?

Gluteus medius, gluteus minimus, and tensor fascia lata

What are the LATERAL rotators of the thigh at the hip?

Piriformis, obturator internus, Gemelli, Quadratus femoris, Gluteus maximus, and obturator externus

The piriformis, obturator internus, Gemelli, Quadratus femoris, Gluteus maximus, and obturator externus are all

Lateral rotators of the thigh and hip

What are the EXTENSORS of the thigh at the hip?

Gluteus maximus and Hamstrings (Posterior thigh)

Muscles of the gluteal region are supplied primarily by the

Superior and inferior gluteal arteries -branches of the internal iliac

Collateral circulation about the hips is provided by the

Cruciate anastomosis

The medial and lateral circumflex femoral artery, 1st perforating artery and the inferior gluteal artery participate in the

Cruciate anastomosis

Caused by compression of the sciatic nerve by the piriformis muscle as they emerge through the greater sciatic foramen

Piriformis syndrome (compression)

Piriforis syndrome involves what physical symptoms?

Radiating pain down the limb and muscle weakness

A ball-and-socket joint between the head of the femur and the acetabulum of the coxal bone

Hip joint

Enhanced by a deep bony socket, a fibrocartilagenous acetabular labrum, extracapsular ligaments and strong muscles crossing it

Hip joint stability

The bones of the hip joint are the

Bony pelvis and femur

The greater trochanter is the attachment site for

Hip abductors and rotators

The Lesser trochanter is the attachment site for the

Illipsoas (hip flexor)

The intertrochanteric line is the attachment site of the

Illiofemoral Ligament

The linea Aspera is the attachment site for the

Hip Adductors

The hip joint is supported by 3 extracapsular ligaments, all of which resist hyperextension. They are the

1. ) Illiofemoral ligament 2. ) Ischiofemoral ligament 3. ) Pubofemoral ligament

The strongest hip ligament is the

Illiofemoral ligament

A weak intracapsular ligament that contains the foveal artery within it

Round ligament of the femur

When weight bearing on a single limb, as occurs during gait or standing on one leg while the other is raised, the pelvis will tilt about the

Anteroposterior axis toward the unsupported limb

The tilt of the pelvis toward the unsupported limb is controlled by the

Hip Abductors

Similarly during gait as the line of gravity shifts anterior and posterior to the transverse axis of the hip joint the pelvis will tilt in

Flexion and Extension respectively

Pelvic tilt about the transverse axis is controlled by the

Gluteus maximus and tensor fascia lata muscles

Resist hip extension

Hip ligaments

Which muscles serve as the major flexors of the hip?

Illiopsoas, Tensor fascia lata, and rectus femoris

Which muscles are weak flexors of the hip?

Pectineus, Sartorius, and adductors

Which muscles serve as major extensors of the hip?

Gluteus maximus, semitendinosus, semimembranosus, and biceps femors (ong head)

Which muscle serves as a weak extensor of the hip?

Adductor Magnus

Which muscles serve as the primary abductors of the hip?

Gluteus medius and gluteus minimus

Which muscles serve as weak abductors of the hip?

Tensor fascia lata, sartorius, piriformis, and obturator externus

Which muscle serve as the primary adductors of the hip?

Adductor magnus, adductor lingus, and adductor brevis

Which muscles serve as weak adductors of the hip?

Pectineus and Gracilis

Which muscles serve as the primary medial rotators of the hip?

Tensor fascia lata, gluteus medius, and gluteus minimus

Which muscles serve as the primary lateral rotators of the hip?

Obturator internus, Gemelli, Obturator Externus, and quadratus femoris

Which muscles serve as weak lateral rotators of the hip?

Piriformis, gluteus maximus, and sartorius

Arterial blood supply is provided to the hip primarily from the

Medial femoral circumflex and lateral femoral circumfls arteries

The medial and lateral femoral circumflex arteries anastomose around the neck of the femur forming the

Trochanteric anastomosis

The head of the femur is supplied primarily by the -also receives some blood from the foveal artery, a branch of the obturator artery

Medial femoral circumflex artery

Sensory innervation of the hip is via branches of the

Femoral, obturator, gluteal, and sciatic nerves

Fairly common injuries in postmenopausal women with osteoporosis

Fractures of femoral neck

Fractures of the femoral neck near the femoral head frequently tear the

Round periosteum and branches of the medial femoral circumflex artery

The bone tissue supplied by the torn medial femoral circumflex artery can become necrotic, resulting in -requires hip reconstruction

Avascular necrosis

Common occurring in about 1.5/1000 live births

Congenital hip dislocation

Congenital hip dislocation appears disproportionately in

Baby girls (8:1)

Inability to abduct the limb and the affected limb appearing shorter are clinical signs of

Congenital hip dislocations

Acquired hip dislocation is uncommon do to the

Strength of hip joint

If the hip dislocates due to trauma it is in which direction -frequently fractures both femoral head and acetabulum

Posterior

The gluteal region functions in

Hip abduction, extension, and lateral rotation

The anterior thigh functions in

Hip flexion and knee extension

The medial thigh functions in

Hip adduction

The posterior thigh functions in

Hip extension and knee flexion

The anterior leg functions in

Ankle dorsi flexion and digit extension

The lateral leg functions in

Ankle eversion

The posterior leg functions in

Ankle plantar flexion and digit flexion

The primary nerve of the gluteal region is the

Superior and inferior gluteal nerve

The primary nerve of the anterior thigh is the

Femoral nerve

The primary nerve of the medial thigh is the

Obturator

The primary nerve of the posterior thigh is the

Tibial nerve

The primary nerve of the anterior leg is the

Deep fibulae nerve

The primary nerve of the lateral leg is the

Superficial fibulae nerve

The primary nerve of the posterior leg is the

Tibial nerve