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

1
Q

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

A
  1. ) Gluteal region
  2. ) Thigh
  3. ) Leg
  4. ) Ankle and foot
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2
Q

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

A

Anteriorly

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3
Q

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

A
  1. ) Upper rotate laterally

2. ) Lower rotate medially

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4
Q

Like the upper limb, the lower limb is divided into

A

Anterior and posterior regions

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5
Q

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

A

Posterior anatomical comparment

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6
Q

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

A

Knee flexors

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7
Q

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

A

Anterior anatomical compartment

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8
Q

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

A

Knee extensors

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9
Q

In general, anterior compartment muscles of the lower limb are

A

Extensors

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10
Q

In general, posterior muscles of the lower limb are

A

Flexors

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11
Q

Innervation of the lower limb is via branches of the

A

Lumbosacral plexus

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12
Q

The lumbosacral plexus consists of ventral rami of spinal nerves

A

L2-S3

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13
Q

In general, posterior division fibers of the lumbosacral plexus innervate

A

Anterior compartment muscles

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14
Q

In general, anterior division fibers innervate

A

Posterior compartment muscles

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15
Q

What are the four terminal nerves of the lumbosacral plexus?

A

Femoral, Obturator, Tibial, and Common Fibular

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16
Q

For the femoral nerve, what is the

  1. ) Rami
  2. ) Division
  3. ) Compartment
A
  1. ) L2-L4
  2. ) Posterior
  3. ) Anterior thigh
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17
Q

For the Obturator nerve, what is the

  1. ) Rami
  2. ) Division
  3. ) Compartment
A
  1. ) L2-L4
  2. ) Anterior
  3. ) Medial thigh
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18
Q

For the Tibial nerve, what is the

  1. ) Rami
  2. ) Division
  3. ) Compartment
A
  1. ) L4-S3
  2. ) Anterior
  3. ) Posterior thigh, leg, sole of the foot
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19
Q

For the common fibular nerve, what is the

  1. ) Rami
  2. ) Division
  3. ) Compartment
A

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

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20
Q

Arterial supply to the lower limb is via branches of the

A

Internal iliac and femoral arteries

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21
Q

In general, internal iliac branches supply the

A

Gluteal region

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22
Q

In general, femoral artery branches supply the

A

Rest of the lower limb

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23
Q

Branches of the iliac and femoral arteries anastamose at the

A

Cruciate anastomosis

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24
Q

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

A

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

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25
Q

The Superior Gluteal artery

  1. ) Is a branch of?
  2. ) Supplies?
A
  1. ) Internal illiac

2. ) Gluteal region

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26
Q

The Inferior Gluteal artery

  1. ) Is a branch of?
  2. ) Supplies?
A
  1. ) Internal iliac

2. ) Gluteal region

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27
Q

The Obturator artery

  1. ) Is a branch of?
  2. ) Supplies?
A
  1. ) Internal iliac

2. ) Medial thigh and head of femur

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28
Q

The Deep Femoral artery

  1. ) Is a branch of?
  2. ) Supplies?
A
  1. ) Femoral

2. ) Thigh

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29
Q

The Medial Femoral Circumflex artery

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

2. ) Hip and Thigh

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30
Q

The Lateral Femoral Circumflex artery

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

2. ) Hip and thigh

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31
Q

The Perforating artery

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

2. ) Posterior Thigh

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32
Q

The Genicular artery

  1. ) Is a branch of?
  2. ) Supplies?
A
  1. ) Popliteal

2. ) Knee

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33
Q

The Anterior Tibial artery

  1. ) Is a branch of?
  2. ) Supplies?
A
  1. ) Popliteal

2. ) Anterior Leg

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34
Q

The Posterior Tibial artery

  1. ) Is a branch of?
  2. ) Supplies?
A
  1. ) Popliteal

2. ) Posterior Leg

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35
Q

The Fibular artery

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

2. ) Posterior and Lateral Leg

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36
Q

The Medial Plantar artery

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

2. ) Medial Sole

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37
Q

The Lateral Plantar artery

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

2. ) Lateral Sole

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38
Q

The veins of the lower limb ultimately drain into the

A

Femoral or internal iliac veins

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39
Q

The veins of the lower limb include the

-comprise the muscular venous pump system

A

Superficial veins, deep veins, and perforating veins

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40
Q

Located between the muscles

A

Deep veins

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41
Q

Connect the deep veins and superficial veins

A

Perforating veins

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42
Q

How does the venous system in the legs work?

A

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

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43
Q

Have one way valves to prevent backflow

A

Perforating veins

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44
Q

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

A

Great Saphenous Vein

45
Q

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

A

Great saphenous vein

46
Q

Major lymph nodes of the lower limb includes the

A

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

47
Q

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

A

Hip abductors, medial rotators, lateral rotators, and extensors

48
Q

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

A

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

49
Q

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

A

Gluteus medius, gluteus minimus, and tensor fascia lata

50
Q

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

A

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

51
Q

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

A

Lateral rotators of the thigh and hip

52
Q

What are the EXTENSORS of the thigh at the hip?

A

Gluteus maximus and Hamstrings (Posterior thigh)

53
Q

Muscles of the gluteal region are supplied primarily by the

A

Superior and inferior gluteal arteries

-branches of the internal iliac

54
Q

Collateral circulation about the hips is provided by the

A

Cruciate anastomosis

55
Q

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

A

Cruciate anastomosis

56
Q

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

A

Piriformis syndrome (compression)

57
Q

Piriforis syndrome involves what physical symptoms?

A

Radiating pain down the limb and muscle weakness

58
Q

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

A

Hip joint

59
Q

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

A

Hip joint stability

60
Q

The bones of the hip joint are the

A

Bony pelvis and femur

61
Q

The greater trochanter is the attachment site for

A

Hip abductors and rotators

62
Q

The Lesser trochanter is the attachment site for the

A

Illipsoas (hip flexor)

63
Q

The intertrochanteric line is the attachment site of the

A

Illiofemoral Ligament

64
Q

The linea Aspera is the attachment site for the

A

Hip Adductors

65
Q

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

A
  1. ) Illiofemoral ligament
  2. ) Ischiofemoral ligament
  3. ) Pubofemoral ligament
66
Q

The strongest hip ligament is the

A

Illiofemoral ligament

67
Q

A weak intracapsular ligament that contains the foveal artery within it

A

Round ligament of the femur

68
Q

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

A

Anteroposterior axis toward the unsupported limb

69
Q

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

A

Hip Abductors

70
Q

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

A

Flexion and Extension respectively

71
Q

Pelvic tilt about the transverse axis is controlled by the

A

Gluteus maximus and tensor fascia lata muscles

72
Q

Resist hip extension

A

Hip ligaments

73
Q

Which muscles serve as the major flexors of the hip?

A

Illiopsoas, Tensor fascia lata, and rectus femoris

74
Q

Which muscles are weak flexors of the hip?

A

Pectineus, Sartorius, and adductors

75
Q

Which muscles serve as major extensors of the hip?

A

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

76
Q

Which muscle serves as a weak extensor of the hip?

A

Adductor Magnus

77
Q

Which muscles serve as the primary abductors of the hip?

A

Gluteus medius and gluteus minimus

78
Q

Which muscles serve as weak abductors of the hip?

A

Tensor fascia lata, sartorius, piriformis, and obturator externus

79
Q

Which muscle serve as the primary adductors of the hip?

A

Adductor magnus, adductor lingus, and adductor brevis

80
Q

Which muscles serve as weak adductors of the hip?

A

Pectineus and Gracilis

81
Q

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

A

Tensor fascia lata, gluteus medius, and gluteus minimus

82
Q

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

A

Obturator internus, Gemelli, Obturator Externus, and quadratus femoris

83
Q

Which muscles serve as weak lateral rotators of the hip?

A

Piriformis, gluteus maximus, and sartorius

84
Q

Arterial blood supply is provided to the hip primarily from the

A

Medial femoral circumflex and lateral femoral circumfls arteries

85
Q

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

A

Trochanteric anastomosis

86
Q

The head of the femur is supplied primarily by the

-also receives some blood from the foveal artery, a branch of the obturator artery

A

Medial femoral circumflex artery

87
Q

Sensory innervation of the hip is via branches of the

A

Femoral, obturator, gluteal, and sciatic nerves

88
Q

Fairly common injuries in postmenopausal women with osteoporosis

A

Fractures of femoral neck

89
Q

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

A

Round periosteum and branches of the medial femoral circumflex artery

90
Q

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

-requires hip reconstruction

A

Avascular necrosis

91
Q

Common occurring in about 1.5/1000 live births

A

Congenital hip dislocation

92
Q

Congenital hip dislocation appears disproportionately in

A

Baby girls (8:1)

93
Q

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

A

Congenital hip dislocations

94
Q

Acquired hip dislocation is uncommon do to the

A

Strength of hip joint

95
Q

If the hip dislocates due to trauma it is in which direction

-frequently fractures both femoral head and acetabulum

A

Posterior

96
Q

The gluteal region functions in

A

Hip abduction, extension, and lateral rotation

97
Q

The anterior thigh functions in

A

Hip flexion and knee extension

98
Q

The medial thigh functions in

A

Hip adduction

99
Q

The posterior thigh functions in

A

Hip extension and knee flexion

100
Q

The anterior leg functions in

A

Ankle dorsi flexion and digit extension

101
Q

The lateral leg functions in

A

Ankle eversion

102
Q

The posterior leg functions in

A

Ankle plantar flexion and digit flexion

103
Q

The primary nerve of the gluteal region is the

A

Superior and inferior gluteal nerve

104
Q

The primary nerve of the anterior thigh is the

A

Femoral nerve

105
Q

The primary nerve of the medial thigh is the

A

Obturator

106
Q

The primary nerve of the posterior thigh is the

A

Tibial nerve

107
Q

The primary nerve of the anterior leg is the

A

Deep fibulae nerve

108
Q

The primary nerve of the lateral leg is the

A

Superficial fibulae nerve

109
Q

The primary nerve of the posterior leg is the

A

Tibial nerve