L14- Morphological plan of the lower limb Flashcards
What are the differences between the upper limbs and lower limbs?
Lower limbs are closer together than the upper limb
Extensors are anterior on the lower limb
Flexors are posterior on the lower limb
Why are the upper limbs closer than the lower limbs
For weight bearing
Locomotion
High stresses
Name the bones in the lower limb
Pelvis Femur Tibia Fibula Tarsal bones x7 Metatarsals x5 Phalanges x14
What are the borders of the greater sciatic foramen?
Sacrotuberous ligament
Sacrospinous ligament
Greater sciatic notch
Describe the limb movements of the lower limb
Flexion/extension Abduction/ adduction Lateral/ medial rotation Pronation/supination Circumduction
Describe the functional compartments of the thigh region
Anterior - extensors of the knee
Posterior - Flexors of the knee
Medial - adductors of the thigh
Name the gluteal muscles and their actions
Gluteus maximus - extensor & lateral rotator of the leg
Gluteus medius - abductor & medial rotator of the leg
Gluteus minimus - abductor & medial rotator of the leg
The gluteus maximus also has another function - name this function:
Supports the extended knee - so helps support you when you stand
Through which anatomical structure does the gluteus perform this other function?
Via the iliotibial tract
What is the origin and insertion of gluteus maximus?
Origin: Ilium
Insertion: ITB & gluteal tuberosity of the femur
What are the origin and insertions of the gluteus medium and minimus?
Origin: Ilium
Insertion: Greater trochanter of the femur
Gluteus maximus is supplied by which nerve?
The inferior gluteal nerve
Gluteus medius and minimus are supplied by which nerve?
Superior gluteal nerve
What is the function of the small muscles of the gluteal region?
Stabilise the hip
Lateral rotation of the extended thigh
What can the small muscles of the gluteal region be compared to in the upper limb?
Rotator cuff muscles
Name the small muscles of the gluteal region?
PIRIFORMIS (the biggest) Gemelius superior Obturator internus Gemelius inferior Quadrator femoris (square one)
Describe the course of piriformis
It comes from the sacrum, goes through the greater sciatic foramen and inserts onto the greater trochanter
Which nerves pops out from under the inferior border of piriformis?
Sciatic nerve
Inferior gluteal nerve
Which nerves comes out from the top of the piriformis?
Superior gluteal nerve
What is the function of the quadriceps muscle?
Extend the leg at the knee joint
Flex the leg at the hip joint
Name the four muscles that make up the quadriceps:
Rectus femoris
Vastus lateralis
Vastus intermedius
Vastus medialis
What is the origin and insertion of the quadriceps muscles?
Origin: AIIS & femur
Insertion: Tibial tuberosity
Describe the insertion of the quads?
All four muscles that make up the quad come together as the quadriceps tendon
The tendon passes over the knee and inserts into the tibial tuberosity
Describe the actions of the sartorius muscle
Allows you to cross your legs
- flexion of hip & knee joint & slight lateral rotation of the leg
Origin and insertion of the sartorius?
Origin: ASIS
Insertion: Tibia
The quadriceps tendon surrounds which structure?
Patella
After the patella, what does the quadriceps tendon become?
Patella ligament
Name the muscles that make up the hamstrings
Bicep femoris (long head & short head)
Semitendinosus
Semimembranosus
What are the origin and insertion of the hamstrings?
Origin: Ischial tuberosity
Insertion: Tibia
Name the muscles that make up the medial compartment of the thigh
Pectineus Gracilis Adductor longus Adductor brevis Adductor magnus
Name the parts of adductor magnus
Hamstring part
Adductor part
Which is the most superficial hamstring muscle?
Adductor longus
Name the superficial hamstring muscles
Adductor longus
Pectineus
Gracilis
Name the mid/intermediate hamstring muscles
Adductor brevis
Name the deepest hamstring muscles
Adductor magnus
Name the movements of the thigh:
Flexion Extension Abduction Adduction Medial rotation Lateral rotation
Name the muscles involved in FLEXION of the thigh
Rectus femoris
Sartorius
Iliopsoas - Iliacus & Psoas major
Name the muscles involved in EXTENSION of the thigh
Gluteus maximus
Hamstrings
Hamstring part of adductor magnus
Name the muscles involved in ABDUCTION of the thigh
Gluteus medius
Gluteus minimus
Name the muscles involved in ADDUCTION of the thigh
Adductor part of adductor magnus Adductor longus Adductor brevis Pectineus Gracilis
Name the muscles involved in MEDIAL AND LATERAL ROTATION of the thigh
Gluteus muscles
Hamstrings
Adductors
Short rotators
Which spinal nerves form the lumbar plexus?
Anterior primary rami of L1 to L4
Which nerves form the sacral plexus?
Anterior primary rami of L4 and L5 - via the lumbosacral trunk
Anterior primary rami of S1 to S4
The femoral nerve has contributions from which spinal nerves
L2 to L4
The obturator nerve has contributions from which spinal nerves?
L2 to L4
The sciatic nerve has contributions from which spinal nerves?
L4 to S3
The iliopsoas muscle is made up of two muscles, name these and the function of the iliopsoas
Iliacus
Psoas major
Iliopsoas is the strongest hip flexor in the body
The femoral nerve comes from?
Lumbar plexus
Describe the course of the femoral nerve
FN runs over iliac
Enters femoral triangle
In the femoral triangle it branches to supply the muscles anterior compartment of the thigh
& skin over anterior thigh
Name a branch of the femoral nerve
Saphenous nerve - the longest cutaneous nerve in the body
Where does the saphenous nerve sit?
Under sartorius
What does the saphenous nerve supply?
Medial side of the leg and foot
Which muscles does the obturator nerve supply?
Adductors in the medial compartment except pectineus & hamstring part of AM
Skin over medial thigh
Where does the obturator nerve come from?
Lumbar plexus
Where does the sciatic nerve come from?
Sacral plexus
What does the sciatic nerve supply?
Motor innervation to: posterior compartment of the thigh, leg and foot AND hamstring part of AM
Sensory innervation to: skin over leg and foot except medial side
What are the terminal branches of the sciatic nerve and where does it branch?
Common fibular and tibial nerves
in the popliteal fossa
Describe the blood supply in the leg
The external iliac artery becomes the femoral artery once past the inguinal ligament
Femoral artery becomes the popliteal artery past the popliteal fossa
Popliteal artery divides into the anterior and posterior tibial arteries
Name a branch of the femoral artery and where it passes through
Profunda femoris artery
passes through the adductor hiatus
What are the borders of the femoral triangle?
Lateral border: Medial edge of sartorius
Medial border: medial edge of adductor longus
Superior border: inguinal ligament
Which muscles make up the floor of the femoral triangle?
Pectineus
Adductor longus
Iliopsoas
Name the structures in the femoral triangle, medially to laterally
Femoral vein, femoral artery & femoral nerve (most lateral)
What does the profunda femoris supply?
Posterior comparment of the thigh