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ANAT30007 > Lecture 17: Neurovasculature of the Lower Limb > Flashcards

Lecture 17: Neurovasculature of the Lower Limb Flashcards

1
Q

What does the lumbosacral plexus consist of?

A

upper lumbar plexus (L1-4) and lower lumbosacral (L4-S3) plexus

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2
Q

What is the role of the lumbosacral plexus?

A

supplies sensory and motor innervation to lower limb

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3
Q

What do ventral rami give rise to?

A

anterior and posterior divisions

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4
Q

Which nerves emerge from the lateral border of psoas?

A

iliohypogastric and ilioinguinal nerve
lateral cutaneous nerve of thigh
femoral

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5
Q

Which nerve passes over the anterior surface of psoas?

A

genitofemoral nerve

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6
Q

Which nerve emerges from the medial border of psoas?

A

obturator nerve

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7
Q

What is the largest branch of the lumbar plexus?

A

the femoral nerve

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8
Q

What does the femoral nerve supply motor innervation to?

A

iliopsoas + anterior compartment muscles (sartorius, quadriceps) and pectineus

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9
Q

What does the femoral nerve supply cutaneous innervation to?

A

anteromedial thigh (anterior cutaneous nerve) and medial leg and hindfoot (saphenous nerve)

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10
Q

What is the path of the obturator nerve?

A

descends behind and medial to psoas; passes through obturator canal within the obturator foramen

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11
Q

What does the obturator nerve supply motor innervation to?

A

muscles of the medial compartment of the thigh (and sometimes pectineus)

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12
Q

What does the obturator nerve supply cutaneous innervation to?

A

inferomedial thigh

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13
Q

Where does the sciatic nerve exit the pelvis?

A

via greater sciatic foramen, deep to gluteus maximus, commonly below piriformis

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14
Q

Where does the sciatic nerve commonly split?

A

at popliteal fossa apex

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15
Q

What is the path of the tibial part of the sciatic nerve?

A

descends along posterior thigh and leg, behind medial malleolus deep to flexor retinaculum, to plantar aspect of foot (medial and lateral plantar nerves)

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16
Q

What does the tibial part of the sciatic nerve supply motor innervation to?

A

muscles of posterior compartment of thigh and leg, intrinsic muscles of foot

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17
Q

What does the tibial part of the sciatic nerve supply cutaneous innervation to?

A

posterior leg and lateral foot (sural nerve) and plantar foot

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18
Q

What are the two terminal branches of the fibular part of the sciatic nerve?

A

superficial fibular nerve and deep fibular nerve

19
Q

What does the superficial fibular nerve supply innervation to?

A

motor: lateral compartment of leg
cutaneous: lower lateral leg and dorsum of foot

20
Q

What does the deep fibular nerve supply innervation to?

A

motor: muscles of anterior compartment of leg and foot (EDB, EHB)
cutaneous: cleft between great and 2nd toe

21
Q

How are peripheral nerves damaged?

A

injury (e.g. falls) or medical conditions (diabetic neuropathy)

22
Q

What are the signs and symptoms of peripheral nerve damage?

A 
sensory loss (weakness, numbness, pain)
motor loss (paralysis or paresis)
signs and symptoms are distal to the lesion
23
Q

What happens as the lower limb develops?

A

lower limb rotates medially

24
Q

How can the sciatic nerve be injured in a clinical setting?

A

can be injured by an incorrectly placed IM injection in the gluteal region resulting in hamstring paralysis, impaired leg function and foot drop

25
Q

What are characteristics of superficial veins of the lower limb?

A

larger, fewer one-way valves, within superficial fascia; drain skin and superficial fascia; approx. 10% venous return

26
Q

What are characteristics of deep veins of the lower limb?

A

paired venae comitantes accompany smaller arteries in distal areas; many one-way valves; approx. 90% venous return

27
Q

What is the role of perforating veins?

A

perforate deep fascia of muscles to allow blood to flow from superficial to deep veins; possess one-way valves

28
Q

What is an example of a factor that promotes venous return?

A

the muscle pump system

29
Q

What is the great saphenous vein formed from?

A

medial dorsal venous arch (medial malleolus)

30
Q

What is the small saphenous vein formed from?

A

lateral dorsal venous arch (lateral malleolus)

31
Q

How is blood carried from the foot back to the heart?

A

deep veins on dorsum of foot -> anterior tibial vein -> popliteal vein -> femoral vein

32
Q

What occurs during venous disease?

A

valves become incompetent and blood flows back into superficial system
as a result veins become engorged, swollen and tortuous

33
Q

Where do superficial lymphatic vessels lie?

A

in the skin and subcutaneous tissues

frequently accompany superficial veins

34
Q

What do superficial veins drain into?

A

deep lymphatic vessels at constant sites in the limbs

35
Q

What do deep vessels drain?

A

areas deep to the fascia and accompany deep veins of the region

36
Q

What are two major deep nodes?

A

deep popliteal and deep inguinal nodes

37
Q

How is blood supplied to the lower limb?

A

abdominal aorta -> common iliac artery -> external iliac artery -> femoral artery -> popliteal artery -> anterior / posterior tibial artery -> dorsal pedal / medial and lateral plantar / fibular arteries

38
Q

What are the arteries of the gluteal region?

A

superior and inferior gluteal arteries

39
Q

What is the femoral artery?

A

continuation of external iliac artery once passes under the inguinal ligament

40
Q

What is the path of the femoral artery?

A

travels down anteromedial aspect of the thigh, then through adductor canal -> passes through adductor hiatus to become popliteal artery

41
Q

What does the profunda femoris artery branch from?

A

the lateral aspect of the femoral artery, coursing inferiorly on the medial aspect of the femur

42
Q

What are the three major branches of the profunda femoris artery?

A

lateral circumflex, medial circumflex and perforating femoral artery

43
Q

What are the arteries of the foot?

A

medial plantar artery, lateral plantar artery (deep plantar arch)
dorsalis pedis artery, arcuate artery

ANAT30007 (15 decks)

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