last minute f this Flashcards
retroinguinal space: muscular vs. vascular compartments
- muscular compartment: iliopsoas m. and femoral n.
- vascular compartment: femoral a., femoral v., lymphatic vessels draining inguinal LN
3 femoral sheath compartments
- lateral: fem a.
- middle: fem v.
- medial: lymphatic
- aka “femoral canal” = covered by “femoral ring”
- continuous with abdominal cavity
- aka “femoral canal” = covered by “femoral ring”
superficial inguinal lymph nodes
Drains:
- all SF structures in LE
- anal canal (below pectinate line)
- skin below umbilicus
- scrotum
- vulva
Two types:
- superior horizontal group
- inferior vertical group
- What part of the fascia lata contains vertical fibers?
- Where does #1 attach?
- iliotibial tract
- Gerdy’s tubercle
What attaches to the adductor tubercle?
adductor head of the adductor magnus m.
blood supply to the ligament of the head of the femur
acetabular branch of the obturator a.
things that insert into the gluteal tuberosity
- gluteus maximus m.
- adductor magnus m. (parts)
things that insert into the pectineal line of the femur
- pectineus m.
- abductor brevis m.
boundaries of the adductor canal
- anteromedial: sartorius m.
- lateral: vastus medialis m.
- posterior: adductor longus m & adductor magnus m.
trace lymphatic drainage of gluteal region (superficial gluteal structures)
superficial tissues of gluteal region > superficial inguinal nodes > external iliac nodes
trace lymphatic drainage of gluteal region (deeper gluteal structures)
superior and inferior gluteal nodes > internal and external iliac nodes > common iliac nodes > lumbar (caval) LN > cisterna chyli > thoracic duct
greater sciatic foramen
- superior gluteal nva
- inferior gluteal nva
- pudendal n
- sciatric n
- posterior femoral cutaneous n
- n to quadratus femoris
- n to obturator internus
- internal pudendal av
- piriformis m
lesser sciatic foramen
PIN and tendon of obturator internus m.
2 things different between the superior and inferior gemelli
origin and innervation
arterial supply of the quadratus femoris m.
medial femoral circumflex artery
safe place for intragluteal injections
- anterior and lateral (to line formed by PSIS and greater trochanter)
- between 2nd digit on ASIS and 3rd digit on tubercle of iliac crest
injection site for anesthetic block of sciatic nerve
few cm inferior to midpoint of junction of PSIS and superior part of greater trochanter
medial rotators of flexed leg/lateral rotators of flexed leg
medial rotators: semitendinosus and semimembranosus m.
lateral rotators: biceps femoris m.
perforating branches supply
- vastus medialis
- adductor magnus
- posterior thigh
floor of the popliteal fossa
- popliteal surface of femur
- oblique popliteal ligament
- posterior surface of the proximal tibia
2 branches of the descending genicular artery
- saphenous branch
- articular branch
what supplies the articular capsule and ligaments of knee joint?
genicular anastamosis
superficial and deep popliteal lymph nodes
- superficial: cutaneous fluid (small saphenous vein)
- deep: leg and foot (popliteal vein)
- *proximal drainage accompanies femoral v to deep inguinal nodes
most common distal femoral fracture
metaphyseal fx (transverse fx across shaft)
transverse fx involving epiphyseal plate
physeal fractures (Salter-Harris classificaton)
Salter-Harris Classification
- through growth plate
- through growth plate and metaphysis
- through growth plate and epiphysis
- through all
- crush injury
- enlargement of gastrocnemius-semimembranosus bursa
- assoc w/ DJD or joint injury
- complications:
- enlargement > similar to DVT
- rupture > thrombosis or muscle rupture
Popliteal/Baker’s Cysts
- enlargement of artery due to weakening of arterial wall
- most common true version of this diagnosis
- symptoms due to: thromboembolism, mass effect, rupture
- present w/: claudication or ischemic pain at rest, sens/motor, pain behind knee
peripheral aneurysm
- atherosclerosis leading to occlusion
- lack of blood flow > pain
- present w/: claudication, ischemic pain at rest, diffuse pain, non-healing ulcer, gangrene
2 types of weighted MRI
- T1: longitudinal relaxation time - time to realign with MF (fluid = dark)
- T2: transverse relaxation time - time to lose phase coherence (fluid = light)
2 types of transducers for US
- high-frequency: 7-15, superficial structures
- low-frequency: 1-3.5, deep structures
tibial nerve and posterior tibial vessels are deep to what structure?
transverse crural intermuscular septum
fabella is typically on which head of the gastrocnemius?
lateral head (to provide leverage)
proprioceptive organ for foot position (high density of prioprioceptive receptor end organs)
plantaris m.
used in reconstructive surgery of hand tendons
plantaris tendon
largest deep posterior muscle
flexor hallucis longus m.
palpate the dorsalis pedis pulse
lateral to the EHL tendon (or medial to the EDL tendon)
deep fascia of the leg continuous with the fascia lata
crural fascia
ridge on the lateral surface of the calcaneus
fibular trochlea
functions of musces with “fibularis” in the name
- fibularis tertius: dorsiflexion and eversion
- fibularis longus and brevis: plantarflexion and eversion
from where do the dorsalis pedis a. and deep fibular n. emerge?
emerge beneath the inferior border of the extensor retinaculum
proximal attachment of the plantar aponeurosis
medial tubercle of the calcaneus
calcar femorale
dense, vertically oriented bone in posteromedial aspect of proximal femur
Stinchfield test
supine and resist hip flex with straight leg at 45 deg
(+) if pain
test: intraarticular pathology (OA)
failure of superolateral portion of the patella to fuse
bipartite patella
Screw Home
- tibia externally rotates 5 degrees in last 15 degrees extension
- cruciates tighten and decreasee quad work while standing
- popliteus unlocks tibia via IR to initiate flexion
Thessaly test
stands on affected leg at 20 deg knee flexion the nrotates on leg
(+) pain
transverse tarsal joints made of
- calcenocuboid joint
- talonavicular joint
2 important intertarsal joints
transverse tarsal joint & subtalar joint
surgical amputation of foot
across transverse tarsal joint
