Leg and Foot Flashcards
Surface anatomy:
What bony prominence do we sit on?
Ischial tuberosity
Surface anatomy:
what spinal level are the iliac crests usually level with?
L4 Vertebra
Surface anatomy:
what bony structure lies below the dimples of venus?
Posterior superior iliac spine (and sacroiliac joints)
Surface anatomy:
where can the greater trochanter be palpated?
superior lateral thigh
Surface anatomy:
at the top of the natal cleft, what bony structure can be palpated?
the coccyx
Surface anatomy: what bony prominence can be palpated bilaterally on the anterior pelvis?
Anterior superior iliac spine
Surface anatomy:
where can you palpate the pubic symphysis in males and females?
females - beneath the mons pubis
males - just superior to the proximal attachment of the penis
Surface anatomy:
What position must the leg be in to allow passive movement of the patella?
extension - relax quadriceps allowing movement of the patella within the quadriceps tendon
Surface anatomy:
what bone forms the medial malleolus?
Tibia
Surface anatomy:
what bone forms the bony prominences felt on each lateral surface of the knee, particularly when flexed?
femur (condyles)
Surface anatomy:
What is the name of the bony prominence that we kneel on?
tibial tuberosity
Surface anatomy:
what bone forms the lateral malleolus?
fibula
Surface anatomy:
what joint forms the ball of the foot?
1st metatarsal-phalangeal joint
Surface anatomy:
what bone forms the heel of the foot?
calcaneus
Surface anatomy:
can you palpate the head of fibula?
yes - on the lateral surface of the knee
Surface anatomy:
where can you feel the head of the talus?
distal to the medial malleolus - best felt when the foot is inverted passively
Surface anatomy:
what is the significance of Holden’s line?
junction between scarpa’s (superficial membranous abdominal fascia) and the fascia Lata (deep investing fascia of the thigh)
crosses the hip joint capsule (helpful!)
Surface anatomy:
what pulse can be found in the femoral triangle? how can you locate this exactly?
femoral
mid-inguinal point - half way between the PS and ASIS
Surface anatomy:
where can the dorsalis pedis pulse be found?
just lateral to extensor hallucis longus tendon
osteology: what is the main function of the false pelvis?
supporting lower abdominal viscera
osteology:
what are the borders of the pelvis brim/inlet?
posterior - sacral promontory and wings (ala)
lateral - arcuate line of ilium (x2) and pectineal lines of superior pubic rami (otherwise known as the iliopectineal line)
(the above 2 borders combined = linea terminalis)
anterior - pubic symphysis
osteology:
what are the borders of the pelvic outlet?
posterior - coccyx
lateral - ischial tuberosities and the sacrotuberous ligaments
anterior - ischiopubic rami inferior border (pubic arch)
osteology:
list as many differences as you can between the male and female pelvis?
female pelvis:
- wider
- lighter
- oval shaped pelvic inlet/brim (less prominent sacral promontory - more heart shaped in males)
- less prominent ischial spines - larger bispinous diameter
- greater angles sub-pubic arch
- shorter, more curved sacrum
osteology:
what bones make up the hip bones?
ilium, pubis and ischium
osteology:
what articulations are there within the adult pelvic girdle?
sacroiliac
sacrococcygeal
pubic symphysis
osteology:
at what age does the triradiate cartilage ossify leading to fusion of the 3 parts of the hip bone?
15-17 years
osteology:
where is the triradiate cartilage found?
acetabulum of the pelvis (in children under 17 years)
osteology:
what are the names of the 2 surfaces of the ilium?
gluteal surface (external) and iliac fossa (internal)
osteology:
where is the greater sciatic notch located?
indentation in the posterior aspect of the ilium - the sacrospinous ligament makes this into a foramen known as the greater sciatic foramen
osteology:
where is the lesser sciatic notch?
indentation in the posterior ischium - the sacrotuberous and sacrospinous ligaments make this into the lesser sciatic foramen
osteology:
what makes up the obturator foramen ?
pubis and ischium
osteology:
what makes up the obturator foramen ?
pubis and ischium
osteology:
where is the intertrochanteric line?
anterior aspect of proximal femur located between the two trochanters
osteology:
where is the intertrochanteric crest?
posterior aspect of proximal femur between the two trochanters - the quadrate tubercle is located here where quadratus femoris inserts
osteology:
where is the pectineal line?
posterior-medial proximal femur - converges with the gluteal tuberosity to form the linea aspera
osteology:
where is the linea aspera? List some of its functions.
posterior shaft of the femur
origin of vastus medialis and lateralis and short head of biceps femoris
insertion for adductor magnus, longus and brevis
osteology:
is the apex of the patella superior or inferior?
inferior
the base is superior
osteology:
What is the sustenaculum tali? (you’re welcome Ed)
a shelf-like projection on the medial surface of the calcaneus
It is a common point of insertion for ligaments of the ankle such as the tibiocalcaneal ligament (part of the deltoid ligament)
osteology:
Articulation between what bones allows plantar/dorsiflexion of the foot?
fibula, tibia and talus (talocrural joint)
osteology:
Articulation between what bones allows inversion and eversion of the ankle?
talus and calcaneus (subtalar joint)
connective tissues:
Name the intracapsular ligaments of the hip.
ligamentum teres (aka ligament to head of femur) transverse acetabular ligament
connective tissues:
name the extracapsular ligament of the femur. Of these - which are visible anteriorly?
pubofemoral
iliofemoral
(both of above anterior)
ischiofemoral
connective tissues:
What are the attachments of the tibial collateral ligament?
medial epicondyle of femur to medial tibia, and the medical meniscus
connective tissues:
what is the function of the ACL?
prevent anterior dislocation of the tibia (hence it attaches onto the ANTERIOR intercondylar area of the tibia)
connective tissues:
what is the function of the oblique popliteal ligament?
stabilise the knee posteriorly
connective tissues:
What ligaments make up the deltoid ligament?
Anterior and posterior tibiotalar
tibiocalcaneal
tibionavicular
connective tissues:
what are the 3 parts of the lateral ligament of the ankle?
talofibular anterior and posterior
calcaneofibular
Vasculature:
where does the plantar venous arch drain into?
posterior tibial veins
Vasculature:
where do the posterior tibial veins drain into?
popliteal vein
Vasculature:
when does the popliteal vein become the femoral vein?
adductor hiatus
Vasculature:
where does the dorsal venous arch of the foot drain into?
Great and small saphenous veins
Vasculature:
describe the path of the great saphenous vein
anterior to medial malleolus, up the medial leg, posterior to medial condyle of femur, up the medial thigh, joins the femoral vein at the saphenous opening in the fascia lata (passes through this opening from superficial to deep)
Vasculature:
describe the path of the small saphenous vein
passes posterior to the lateral malleolus, up the posterior aspect of the leg, passes between the 2 heads of gastrocnemius superficially before draining into the popliteal vein in the popliteal fossa
Vasculature:
Where do the superior and inferior gluteal veins drain into?
internal iliac vein
Vasculature:
where do the superior and inferior gluteal artery branch from?
Internal iliac artery
(superior from posterior division)
(inferior from anterior division)
Vasculature:
Describe how the femoral artery supplies the hip joint
femoral artery -> profunda femoris -> medial and lateral circumflex femoral arteries
(Artery to head of femur branches from the obturator artery - fairly insignificant)
Vasculature:
what branches of the femoral artery descend down the length of the thigh?
profunda femoris (descends about 2/3rds and more posterior)
descending branch of lateral circumflex femoral artery (desends anterio-laterally to the knee)
femoral artery itself (travels from anterior to medial to posterior)
Vasculature:
What are the branches of the popliteal artery?
anterior and posterior tibial arteries
Vasculature:
where does the fibular artery branch from?
posterior tibial artery
Vasculature:
Where do the medial and lateral plantar arteries branch from?
posterior tibial artery
Vasculature:
What is the dorsalis pedis a continuation of?
Anterior tibial artery
Nerves:
what are the branches of the lumbar plexus?
iliohypograstric ilioinguinal genitofemoral lateral cutaneous nerve of thigh femoral obturator
Nerves:
what is the motor and sensory function of the iliohypograstic nerve? An it nerve roots?
L1
motor: TA and IO
sensory: posterior-lateral gluteal skin and pubic region
Nerves:
what is the function of the ilioinguinal nerve? And its nerve roots?
L1
sensory: upper medial thigh and either:
- root and penis and anterior scrotum
- mons pubis and labia majora
motor: TA and IO
Nerves:
What are the nerve roots of the genitofemoral nerve and its functions?
L1 and L2
sensory:
- genital branch - anterior scrotum or mons pubis and labia majora (very similar to ilioinguinal)
- femoral branch - upper anterior thigh
motor: cremasteric muscle
Nerves:
what are the nerve roots of the the lateral cutaneous nerve of thigh?
L2 and L3
Nerves:
what are the nerve roots of the femoral nerve and its functions?
L2-L4
sensory: anterior thigh and medial leg (saphenous nerve)
motor: anterior compartment of thigh + pectineus and iliacus
Nerves:
What are the nerve roots of the obturator nerve and its functions?
L2-L4
motor: medial compartment of thigh + obturator externus and pectineus
sensory: upper medial thigh
Nerves:
What are the nerve roots of the superior gluteal nerve and its functions?
L4, L5 and S1
Glut min and med (Trendelenburg gait in SGN injury)
Nerves:
What are the nerve roots of the inferior gluteal nerve and what does it innervate?
L5, S1, S2
Glut max
Nerves: What are the nerve roots of the sciatic nerve?
L4-S3 (Big nerve!)
Nerves: What is the sensory function of the sciatic nerve?
Tibial portion: supplies the skin of the posterolateral leg, lateral foot and the sole of the foot (sural nerve, medial and lateral plantar nerves)
Common fibular portion: lateral leg and dorsum of foot (lateral sural nerve, superficial fibular and deep fibular)
Nerves:
What is the motor function of the sciatic nerve?
Tibial portion: hamstrings other than short head of biceps femoris, hamstring portion of adductor magnus, posterior leg and sole of foot muscles (tibial nerve gives rise to both medial and lateral plantar nerves)
common fibular portion: short head of biceps femoris, lateral leg and anterior leg as well as extensor digitorum brevis (on dorsum of foot)
Nerves: What are the nerve roots and functions of the posterior cutaneous nerve of thigh?
S1-S3
sensory: posterior thigh (+ a bit of posterior leg and perineum)
Nerves: What are the nerve roots and functions of the pudendal nerve?
S2,3 and 4 (keeps piss and shit off the floor!!)
motor: perineal muscles, levator ani, external urethral sphincter, external anal sphincter
sensory: penis, clitoris, perineal skin
Anatomical areas:
What are the borders of the femoral triangle ?
Superior: inguinal ligament
medial: medial border of adductor longus
lateral: medial border of sartorius
Anatomical areas:
what are the contents of the femoral triangle?
NAVEL (lateral to medial)
Femoral nerve, Artery, Vein, Empty space, lymphatics
Anatomical areas:
What structures are found in the femoral sheath?
Femoral artery and vein (this is also where the femoral canal lies - space for hernias)
Anatomical areas:
what are the borders of the adductor canal?
anteriormedial: sartorius
lateral: vastas medialis
posterior: adductor longus and magnus
Anatomical areas:
What structures pass through the adductor canal?
femoral artery
femoral vein
nerve to vastas medialis
saphenous nerve (largest cutaneous branch of femoral)
Anatomical areas:
What is the adductor hiatus and what passes through it?
Gap between the insertion sites of adductor magnus
femoral artery and vein pass through (to become the popliteal vessels)
Anatomical areas:
What borders the popliteal fossa?
superior:
- medial - semimembranosus
- lateral - biceps femoris
inferior:
medial and lateral: head of gastrocnemius
Anatomical areas:
from medial to lateral, what passes through the popliteal fossa?
Popliteal artery, vein, tibial nerve, common fibular nerve
connective tissue:
What is the femoral sheath an extension of?
transversalis fascia
Anatomical areas:
what ring would a femoral hernia pass through?
femoral ring (different to the deep inguinal ring)
vasculature:
Where do the superficial epigastric, superficial circumflex iliac, superficial external pudendal and deep external pudendal branch from?
femoral artery just distal to the inguinal ligament
what nerve can be found in the groove between iliacus and psoas?
femoral nerve
where can you locate the obturator artery?
remove obturator externus and the obturator artery will be revealed
alternatively approach from the pelvis and see it passing through the obturator foramen
what nerves and arteries supply adductor magnus?
obturator nerve - adductor portion
tibial portion of sciatic nerve - hamstring portion
obturator, deep femoral and femoral artery
where can you locate the superior gluteal artery, vein and nerve?
between piriformis and gluteus medius
reflect glut medius to see them running over gluteus minimus
what does the sciatic nerve run beneath?
biceps femoris
