Lecture 28 - Lower Limb 3 Flashcards
What is the name for the back of the knee?
Popliteal fossa
Where do the major arteries of the lower limb lie?
Why?
Flexor surfaces
Protection
Where do the major arteries of the lower limb start?
Head of femur, pelvis
What are the main arteries of the leg?
Femoral artery
Popiteal artery
Tibial artery
Where do the arteries of the leg stem from?
Iliac artery
What is the main branch of the femoral artery?
What is its role?
Profunda femoris
It supplies the head of the femur
How can the femoral artery be used for cardioangiography?
A cannula is inserted in the femoral artery
Dye is injected, and travels up the coronary arteries
This due is used to visualise the coronary arteries and can indicate whether there is a blockage
What is the largest nerve in the body?
Sciatic nerve
Where are the main venous sinuses in the lower limb?
Soleus
Why is the saphenous vein important?
It used to be used for coronary artery grafts
Radial artery is more commonly used nowadays
What are the main superficial veins of the lower limb?
Dorsal venous arch
Great saphenous
Small saphenous
Where do the lymphatics of the lower limb run?
They follow the superficial veins of the lower limb
To where do the lymphatics of the lower limb drain ?
First: Inguinal nodes (superficial and deep)
Second:
Follow aorta up to drain into the thoracic duct
From where do the nerves of the lower limb arise?
Lumbosacral plexus
Which nerves arise from the lumbosacral plexus?
Gluteal (x2)
Sciatic
Obturator
Femoral
What does the femoral nerve supply?
Muscle:
• Quadriceps
Sensory:
• Skin of medial aspect of thigh and leg
From which segments does the femoral nerve arise?
L2-4
From which segments does the obturator nerve arise?
L2-4
What does the obturator nerve supply?
Adductor muscles
Skin on medial aspect of thigh
Where does the popliteal nerve branch?
Into what does it branch?
It branches at the popliteal fossa
It branches into:
• Tibial nerve
• Common fibular nerve
What is sciatica?
Compression of one of the sciatic nerve roots
- pain
- numbness
- weakness
In various parts of the leg and foot
From which segments does the siatic nerve arise?
L4,5 & S1-3
Where must injections into the buttock be performed?
Why?
Upper lateral quadrant
So as to avoid the sciatic nerve
What does the tibial nerve supply?
All the posterior muscles of the leg
Where does the tibial nerve run?
Vertically down the posterior aspect of the leg
Where does the tibial nerve split?
At ankle, to form:
- medial plantar nerve
- lateral plantar nerve
What is Jogger’s foot?
Compression of the plantar nerves below the medial arch
What is tarsal tunnel syndrome?
Compression of the tibial nerve in the tarsal tunnel
What does the common fibulae nerve supply?
What does it branch into to do this?
Superficial fibular nerve
• Lateral compartment
Deep fibular nerve
• Deep fibular nerve
Where does the common fibulae nerve run?
In the lateral compartment of the leg
What is foot drop?
Compression of the common fibular nerve at the lateral knee
What does L5 intervertebral disc prolapse cause?
What are the symptoms?
Damage to sciatic nerve root
- Pain
- Weakness
- Diminished reflexes
- Atrophy
- Paraesthesia
What is anterior compartment syndrome?
Compression of deep fibular nerve
What is the clinical significance of the obturator nerve?
It runs very close to the ovary
–> could indicate the first sign of an ovarian cyst
What does the sciatic nerve supply?
Posterior muscles of the thigh
Which nerve innervates the anterior compartment of the leg?
Deep fibular nerve
Which nerve innervates the lateral compartment of the leg?
Superficial fibular nerve
Which artery supplies the anterior compartment of the leg?
Anterior tibial artery
Which artery supplies the lateral compartment of the leg?
Fibular artery
What things lead to compression of the tibial nerve?
- Jogger’s foot
* Tarsal tunnel syndrome
Which nerve runs through the tarsal tunnel?
Tibial nerve
What things lead to compression of the common fibular nerve?
- Anterior compartment syndrome
* trauma to lateral knee –> foot drop
What things can injure the sciatic nerve?
- injections
- hamstring strains
- disc prolapse, L5
How does the femoral nerve go down into the thigh?
Passes under the inguinal ligament
Is the great saphenous vein superficial or deep?
Superficial
What is the clinical significance of veins in the leg?
- varicose veins
- deep vein thrombus / embolus
- saphenous vein grafts
Which nerve forms the sensory innervation of the lateral leg?
Common fibular nerve
Which nerve forms the sensory innervation of the medial leg?
Femoral nerve
What sensation does the tibial nerve supply?
Plantar surface of foot and ankle
