L9 - Morphol plan of lower limb COPY Flashcards
LOWER LIMB OVERVIEW
i) why are modifications needed in relation to the upper limb?
ii) name three things the lower limb is adapted for?
iii) which muscle group lay anterior? which lay posterior? what does this layout allow?
iv) what happens in development that brings the posterior compartment anterior? what week does this happen?
i) bipedalism
ii) locomotion, weight bearing, high stress
iii) ant = extensors
post = flexors
- allows good propulsion
iv) medial rotation during development brings posterior anterior - happens week 6-8
PELVIS SKELETON
i) label diagram
ii) name three things (two nerves and a muscle) that pass through the greater sciatic foramen
iii) which nerve passes through the obturator foramen?
iv) what part of the pelvis does the femur articulate with?
i) A - anti superior iliac spine, B - ant inferior iliac spine, C - pubis, D - ischiopubic ramus, E - ischial tuberosity, F - greater sciatic foramen, G - acetabulum
joint 1 - sacroiliac
ligament 1 - sacrotuberous lig
ligament 2 - sacrospinous lig
ii) piriformis, gluteal nerves and sciatic nerve pass through greater sciatic foramen
iii) obturator nerve passes ob foramen
iv) femur articulates with the acetabulum
FEMUR SKELETON
i) label diagram
ii) which area is commonly fractured? what movement does this area allow
iii) where does the gluteus maximus insert onto the femur?
iv) where do the adductor muscles attach?
i) A - head, B - neck, C - adductor tubercle, D - lateral epicondyle, E - medial epicondyle, F - lesser trochanter, G - greater trochanter, H - gluteal tuberosity, I - linea aspera
J/K - lat/med condyles
ii) neck of femur is common fractured > allows adduction
iii) glut max ins onto gluteal tuberosity
iv) adductor muscles att to linea aspera
TIBIA, FIBULA AND FOOT SKELETON
i) label diagram
ii) how many tarsal bones? metarsal bones? how many phalanges in the foot?
iii) where does the quadriceps insert?
iv) which part articulates with the femur?
i) lat/med condyles, B - tibial tuberosity, C - lateral malleolus,
D - medial malleolus, E - tibia, F - fibula
1 - tarsals, 2 - metatarsals, 3- phalanges
ii) 7 tarsal bones, 5 metarsals, 14 phalanges
iii) quad inserts into tibial tuberosity (via patella)
iv) lat and medial condyles articulate with femur
MOVEMENTS
i) name four pairs of movements the limb can do? name another movement? what movement cant it do?
ii) what type of joint is the hip? which 3 pairs of movements can it do? what extra movement can it do?
iii) what type of joint is the knee? what pair of movements can it do? what can it also do some of?
iv) what two main movements does the ankle joint do?
v) what 3 pairs of movements do the joints of the foot do?
i) flexion/extension, adduction/abudction, med/lat rotation and pronation/supination
- also circumducts but cant do opposition
ii) hip = ball and socket
- flex/exten, adduc/abduc, int/ext rot as well as circumduct
iii) knee = hinge joint
- flex/exten and some rotation
iv) ankle joint does dorsi and plantar flexion
v) joints of foot do inversion/eversion, exten/flex, supination/pronation
GLUTEAL MUSCLES
i) what are the three major muscles? what two actions does each do? which is the most sup > deep
ii) which two muscles have the same action?
iii) which muscle also supports the extended knee? what structure does it do this via? explain
iv) what are they important for?
i) glut max (most sup) - extension and lat rotation of thigh
glut med - abduction and med rotation of thigh
glut min (deep) - abduction and med rotation of thigh
ii) gluteus medius and minimus have same action
iii) gluteus max supports extended knee via the iliotibial tract
- glut max contracts when standing straight to tighten the tract and stabilise the knee
iv) important for locomotion
GLUTEUS MAXIMUS
i) where does it originate and insert? (2)
ii) which nerve supplies it? what is this a branch of?
iii) label diagram
iv) which structure tenses the IT tract to stablise the knee?
v) what is the action?
i) originates from the ilium
- inserts into the gluteal tuberosity of the femur and the IT tract
ii) supp by inferior gluteal nerve (branch of sacral plex)
iii) A - iliotibial trac, B - glut max, C - tensor fascia latae
iv) tensor fascia latae also tenses IT tract to stab knee
v) action is to laterally rotate and extend
GLUTEUS MEDIUS/MINIMUS
i) where do they originate and insert?
ii) what are they supplied by? what is this a branch of?
iii) what is their action?
iv) label diagram
i) origin from ilium and insert into greater trochanter of femur
ii) supp by superior gluteal nerve (branch of sacral plex)
iii) adduct and lateral rotate thigh
iv) A - glut max, B - glut med, C - glut min
SMALL MUSCLES OF GLUTEAL REGION
i) what are they equivalent to? how many muscles are there? where do they sit in relation to hip joint?
ii) what is their action (2)
iii) where does piriformis orig and insert? which nerve runs below it?
iv) what is it supplied by?
v) label diagram
i) equiv to the rotator cuff muscles
- 5 muscles that sit posterior to hip joint
ii) stabilise hip and lat rotate thigh
iii) piriformis orig from sacrum and inserts into greater trochanter of the femur
- sciatic nerve runs below
iv) supplied by branches of sacral plex
v) A - piriformis, B - sciatic nerve, C - ischium
ANTERIOR COMPARTMENT OF THE THIGH
i) which muscle group sit here?
ii) which two main muscles are found here? where do they orig/insert?
iii) what is the action of each muscle?
iv) which nerve supplies the whole compartment
v) label diagram
i) extensors
ii) quadriceps - orig from anterior inferior iliac spine/femur
and insert to tinilar tuberosity via patella ligament
sartorius - orig at ASIS and inserts to tibia
iii) quads - extend leg at knee and flex thigh at hip (rectus femoris only)
sartorius - flexes thigh and knee (cross legs)
iv) femoral nerve supplies whole compart
v) A - quadriceps, B - sartorius, C - fascia lata
QUADRICEPS
i) what four muscles make it up?
ii) where do each originate from? where do they all come together to form? where does this insert? what structure is this via?
iii) what is the action of these muscles
iv) label diagram
i) rectus femoris, vastus lateralis, vastus medialis, vastus intermedius
ii) rectus femoris orig from ASIS and rest orig from femur
- all come together to form quadriceps tendon which inserts to tibial tuberosity via patella ligament
iii) powerful extensors
iv) A - rectus femoris, B - vastus lateralis, C - vastus medialis,
D - vastus intermedius
1 - ASIS. 2 - quad tendon, 3 - patella, 4 - patellar ligament,
5 - tibial tuberosity
POSTERIOR COMPARTMENT OF THIGH
i) which three muscles make up the hamstrings?
ii) where does each origin and insert?
iii) what is the action of each?
iv) what nerve supplies the compartment?
v) which four actions do the hamstrings perform?
vi) label diagram
i) biceps femoris (long and short head), semimembranosus, semitendinosus
ii) all origin at ischial tuberosity apart from short head of biceps that orig at femur
- long and short head biceps > fibula
- semitendinosus and membranosus > tibia
iv) sciatic nerve supplies whole compartment
v) extension of thigh, flexion of leg, med rotate (ten and mem) and lat rotation (biceps)
vi) A - biceps femoris long head, B - biceps short head,
C - semitendinosus, D - semimembranosus, E - ischial tuberosity
MEDIAL COMPARTMENT OF THE THIGH - SUP/MID LAYER
i) what muscle group sit in this compartment? what three actions do they have?
ii) which three muscles sit in the superficial layer? where do they origin/insert?
iii) which muscle sits in the middle layer? where does it origin/insert?
iv) which nerve supplies this compartment? what are there two exceptions?
v) label digram
i) adductor muscles
- adduct thigh, medial rotate and extend thigh
ii) superficial layer - pectineus, adductor longus and gracilis
- pectineus/adduc longus - orig pubis and inserts linea aspera
- gracilis - from pubis to medial tibia (adduc and flex leg at knee)
iii) mid layer = adductor brevis
- orig from pubis and ins to linea aspera
iv) supp by obturator nerve (except pectineus - femoral and hamstring part of AM - sciatic)
v) A - pectineus, B - adductor longus, C - gracillis, D - adductor brevis
MEDIAL COMPARTMENT OF THE THIGH - DEEP LAYER
i) which muscle sits in this layer? which two parts is it divided into?
ii) where does each part origin/insert? what part extends the thigh? what is each part innervated by
iii) name three actions
iv) what is the adductor hiatus? what passes through here?
v) label diagram
i) adductor magnus
split to adductor part & hamstring part
ii) adductor part - orig ischiopubic ramus > ins to linea aspera
hamstring part - orig ischial tuberosity > adductor tubercle (mid femur)
- hamstring part extends the thigh
- adductor part innerv by obturator nerve and hamstring part innervated by sciatic nerve
iii) adduction of thigh, medial rotation and extension of thigh (hamstring part)
iv) adductor hiatus is a space between the hamstring part of the adductor magnus > femoral vessels pass through
v) A - adductor magnus, B - adductor part, C - hamstring part,
D - adductor hiatus
MOVEMENTS OF THE THIGH
i) which three muscles are responsible for flexion at hip?
ii) which two muscles are responsible for abduction?
iii) which three muscles do extension?
iv) which five muscles do adduction?
v) which four muscle groups do med/lat rotation?
vi) where does the illiopsoas orig (2) and insert?
i) rectus femoris, sartorius and illiopsoas
ii) glut med and minimus
iii) glut maximus, hamstrings (bicep fem, semitend, semimem) and hamstring part of adductor mag
iv) adduc longus, adduc brevis, gracilis, pectinueus, adduc part of magnus
v) glut musc, hamstrings, adductors, short rotators
vi) illiacus from iluum and psoas from lumbar vert > lesser trochanter of femur
FEMORAL NERVE
i) which plexus does it come from?
ii) which vertebral segments does it span?
iii) what is it motor to? what is it sensory to?
iii) which nerve does it branch to? which muscle does this sit under? what does it innervate?
iv) label diagram
i) comes from lumbar plexus
ii) spans L2,3,4
iii) motor to anterior compartment of the thigh
- sensory to skin over anterior thigh, knee (saphenous nerve is medial side of foot and leg)
iii) branches to the saphenous nerve - sits under sartorius
- sensory to medial side of leg and foot
iv) A - femoral nerve, B - saphenous nerve
SCIATIC NERVE
i) which plexus does it come from? which vert levels does it span (5)
ii) which foramen in the pelvis does it travel through?
iii) what does it split into at the popliteal fossa?
iv) what does the common fibular split into?
v) what is it motor to? (3) what is it sensory to?
vi) label diagram
i) comes from the sacral plexus (L4,5 and S1,2,3)
ii) travels through greater sciatic foramen
iii) at pop fossa it split to tibial and common fibular
iv) common fib (peroneal) > superficial fib and deep fib
v) motor to post compart of thigh, leg and foot + hamstring part of adductor magnus
- sensory to skin over leg and foot (except medial side)
vi) A - sciatic nerve, B - tibial nerve, C - common fib, D - sup fib, E - deep fib
POPLITEAL VESSELS
i) which artery does the popliteal artery continue from?
ii) what form the upper lat and med borders of the pop fossa? what forms the lower lat and med borders?
iii) what does the sciatic nerve divide into in the pop fossa?
iv) label diagram
i) continues from the femoral artery
ii) upper lat border - bicep femoris, upper med border - semimem and ten, lower lat/med border - gastrocnemius
iii) sciatic nerve div to tibial and common fib in pop fossa
iv) A - sciatic nerve, B - popliteal artery, C - popliteal fossa
TIBIAL ARTERIES
i) what artery do they come from?
ii) where does the anterior tibial artery supply blood to? what does it pierce?
iii) what does the post tibial artery supply blood to? what is it sandwiched between?
iv) what does the posterior tibial artery pass under to get to the foot?
v) label diagram
i) popliteal artery
ii) ant tibial > ant compart of the leg > pierces interosseus membrane
iii) post tibial > post compart of leg > sandwich between deep flexors
iv) post tibial passes under the flexor retinaculum > foot
v) A - popliteal artery, B - ant tibial artery, C - tibial nerve,
D - post tibial artery
