Living anatomy of the lower limb Flashcards
What is the round shape of the gluteal region due to?
Gluteus maximus
What does the gluteal fold mark?
inferior border of gluteus maximus
marks boundary between gluteal and posterior thigh regions
Which muscles contribute to the quadriceps?
- rectus femoris
- vastus lateralis
- vastus intermedius
Which 3 quadriceps are visible on the anterior surface of the thigh?
- vastus lateralis
- vastus medialis
- rectus femoris
Visible tendons on the foot are?
- tibialis anterior tendon
- extensor hallucis longus tendon
- extensor digitorum longus
Why are bony landmarks vital during physical examinations and surgery?
- evaluate normal development
- detect and assess fractures/dislocations
- locate blood vessels, nerves etc
What is the most prominent surface feature of the pelvic girdle and where does it run?
iliac crest
runs from ASIS to PSIS
Why is the PSIS difficult to palpate and how are they located ?
as they are normally covered by fat
located by permanent skin dimples lateral to the midline caused by attachment of the overlying fascia to the PSIS
What passes through the S2 spinous process and joins the dimples and where else does the line pass through?
a line
through the middle of the sacroiliac joints
and bifurcation of the iliac arteries
What structure within the vertebral canal terminates at this level (S2)?
filum terminale
What is the name of a line that joins the highest points of the iliac crests and passes through the intervertebral disc between L4 and L5?
supracristal plane
What landmark is used for lumbar puncture?
L4 and L5 - supracristal plane
Where can the tibia be palpated?
throughout the length of the leg
particularly prominent on the anteromedial surface of the leg - where it is only covered by skin and a thin layer of subcutaneous fat
Where is the fibula palpable?
only palpable at proximal and distal ends - head of fibula and lateral malleolus
What is the femoral triangle?
important area located on the anterior thigh - contains neuromuscular structures
How is the femoral artery used by clinicians?
used by interventional radiologists to access arterial system
insert catheters and stents into arteries all over the body - coronary and carotid arteries
arterial line
Boundaries of the femoral triangle
superior - inguinal ligament
lateral - medial border of sartorius muscle
medial - adductor longus muscle
roof - fascia kata
base - pectineus, iliopsoas and adductor longus
contents of femoral triangle
femoral nerve
femoral artery
femoral vein
lymphatics
NAVEL
Contents of the popliteal fossa
- popliteal vein
- popliteal artery
- tibial nerve
Serve - Sartorius
And - Artery
Volley - Vein
Next - Nevre
Ball - Biceps femoris
medial to lateral
Where does the common fibular nerve wrap around?
neck of fibula
What are 4 important pulse points routinely used in clinical examinations?
- femoral pulse point
- popliteal pulse point
- posterior tibial pulse point
- dorsalis pedis pulse point
Where is the femoral pulse palpated?
half way between ASIS and pubic tubercle
slightly inferior to the inguinal ligament
Where can you palpate the pulse of the popliteal artery and what is done to aid palpation?
popliteal fossa
aid - knee flexed and foot resting on ground/couch to relax the hamstrings
Where can the pulse of the posterior tibial artery be palpated?
posterior to the medial malleolus
Where can the dorsal is pedis artery be palpated?
lateral to the tendon of extensor hallucis longs
Why is it necessary to palpate all pulse points of the lower limb on examination?
to identify sufficient blood supply and perfusion
Where do the superficial veins of the lower limbs originate from?
dorsal venous arch of the foot
Course and drainage of the venous system of the lower limb
- dorsal venous arch
- medial side and lateral side
Medial side
- superiorly and anterior to the medial malleolus
- great saphenous vein
Lateral side
- Posterior to the lateral malleolus and up posterior surface of the leg as the small saphenous vein
- popliteal vein
What is the name given to swollen and enlarged veins with valves that no longer work?
Varicose veins
NOTE
know dermatomes
NOTE
know myotomes
Lateral external hip rotation
L5 and L1
Medial internal hip rotation
L1, L2 and L3
Abduction of hip
L5 and S1
Adduction of hip
L1, L2, L3 and L4
Inversion of foot (subtalar)
L4 and L5
Eversion of foot (subtalar)
L5 and S1
Dorsiflexion of metatarsophalangeal and phalangeal
L5 and S1
Plantarflexion of metatarsophalangeal and phalangeal
S1 and S2
Flexion of hip
L2 and L3
Extension of hip
L4 and L5
Extension of knee
L3 and L4
Flexion of knee
L5 and S1
Dorsiflexion of ankle
L4 and L5
Plantarflexion of ankle
S1 and S2
What reflexes can be tested?
ankle reflex
knee reflex
What ligament is tapped with a hammer and causes a knee reflex and what movement should you expect?
patella ligament
expect extension of leg at knee joint
How do you carry out an ankle reflex and what movement would you expect?
push the foot into dorsiflexed position
tap the calcaneal tendon superior to it’s insertion on the calcaneal bone
plantarflexion
