Lower Extremity Flashcards
What is the name of the deep fascia of the leg which covers the thigh and gluteal muscles?
What does this aid in?
Fascia Lata
Venous Return
The femoral neurovascular bundle travels beneath what structure?
The inguinal ligament
From laterally to medial, name the structures the pass through the inguinal ligament.
Femoral Nerve
Femoral Artery
Femoral Vein
Inguinal Lymph Nodes
(Remember NAVL)
The ________ vein quickly branches off the femoral vein and passes through the _______ canal
Saphenous
Femoral
What are the THREE main nerves of the lower extremity?
From which plexus do they originate?
Obturator (Lumbar Plexus)
Femoral (Lumbar Plexus)
Sciatic (Sacral Plexus)
T/F: All motor and almost all sensory BELOW THE KNEE in innervated by branches of the femoral nerve
False
It is innervated by the sciatic nerve
The femoral nerve is a branch of the ________ plexus and supplies the _________ compartment of the thigh.
Which lumbar vertebrae is this derived from?
Lumbar Plexus
Anterior Compartment
L2, L3, L4
The sciatic nerve is derived from the ________ plexus and will supply the __________ compartment of the thigh and lower leg
Lumbosacral Plexus
Posterior Compartment
What are the ‘roots’ of the lumbosacral plexus?
L4 L5 S1 S2 S3 S4
The gluteal and sub-gluteal muscles are innervated by branches of the _______ plexus
Sacral
T/F: External genitalia are innervated by the lumbar plexus?
False
They are innervated by the sacral plexus
Which fibers of the sacral plexus compose the pudendal Nerve?
S2, S3, S4
Remember…. “S2, S3, S4 keep you pudendum off the floor”
Holding the hips in flexion for and extended period of time could injury what nerves?
Femoral Nerve
Obturator Nerve
Applying deep lateral lower leg pressure for an extended period of time could injury which nerve of the lower leg?
Common Fibular Nerve
Which branch of the common illiacs supplies the gluteal and subgluteal muscles?
Internal Illiac
Which branch of the common illiacs supplies blood to the legs?
External illiac
Which TWO branches of the posterior internal illiac supply the gluteal muscles?
Superior gluteal artery
Inferior gluteal artery
Which branch of the anterior internal illiac supplies the perinuem and the external gentilia?
Internal Pudenal Artery
Which branch of the anterior interior illiac supplies the adductor muscles?
Obturator Artery
The external illiac artery becomes the _______ artery once it passes through the ________ ligament
Femoral Artery
Inguinal Ligament
Which branches of the femoral artery supply the head and neck of the femur?
Medial Femoral Artery
Lateral Femoral Circumflex
Which branch of the femoral artery supplies the adductors, hamstrings, and quadriceps?
Deep Femoral Artery
As the femoral artery continues to travel inferiorly down the leg, it will eventually become what artery?
The Popliteal Artery
The popliteal artery will give off what branches, which supply the knee?
Geniculars
As the popliteal artery travels inferiorly it will split into what TWO arteries?
Where and what do each of these supply?
Anterior Tibal Artery
- Anterior Leg muscles
Posterior Tibal Artery
- Flexor Muscles, arch of the feet
The obturator artery travels through which foramen of the pelvis?
Obturator Foramen
T/F: The obturator artery supplies blood to the femoral head
True
What may happen to the femoral if its blood supply is compromised?
What are causes of this?
Avascular Necrosis
Femoral Neck Fx (Trauma)
Radiation & Chemotherapy
Steroid Use
Alcohol Abuse
The great saphenous vein empties into the _________ vein and the small saphenous vein empties into the _________ vein
Great saphenous vein empties into the femoral vein
Small saphenous vein empties into the popliteal vein
Is the femoral vein a deep or superficial vein?
Saphenous vein?
Femoral Vein: Depp
Saphenous Vein: Superficial
T/F: The femoral artery is a common cannulation site for cardiac procedures
True
Which muscles compose the deep posterior compartment of the lower leg?
Superficial posterior compartment?
Deep:
Flexor Digitorum Longus
Flexor Hallicus Longus
Tibialis Posterior
Superficial:
Gastrocnemius
Soleus
+/- Plantaris
What actions are the posterior compartments of the lower leg responsible for?
Plantar Flexion
Toe Felxion
Which nerve innervated the posterior compartments of the lower leg?
Tibial Nerve
What muscles compose the anterior compartment of the lower leg?
Tibialis Anterior
Extensor Digitorum Longus
Extensor Hallicus Longus
What actions are the anterior compartment of the lower leg responsible for?
Dosriflexion
Inversion
Toe Extension
What nerve innervates the anterior compartment?
Deep Fibular Nerve
What muscles are located in the lateral compartment of the lower leg?
Peroneus Longus
Peroneus Brevis
What actions are the lateral compartment responsible for?
Plantar flexion
Eversion
What nerve innervates the lateral compartment of the lower leg?
Superficial Fibular Nerve
All nerves innervating the compartments of the lower leg are branches of the _________ nerve
Sciatic
Which nerve of the lower leg is a branch off of both the tibial and common fibular nerves?
This is a sensory nerve of the lower leg and foot.
Sural Nerve
Again, because it is a branch off the tibial and fibular nerves it is derived from the sciatic nerve
The sural nerve provides sensory to what parts of the leg?
Lateral Lower Leg
Lateral Foot
The saphenous nerve is a branch off what nerve?
Where does it provide sensory?
Femoral Nerve
Medial (some anterior and posterior) Lower leg
Synarthroses is used to describe a __________ (immovable/slightly movable/freely movable) joint
Immovable
Amphiarthroses is used to describe a __________ (immovable/slightly movable/freely movable) joint
Slightly Movable
Diarthroses is used to describe a __________ (immovable/slightly movable/freely movable) joint
Freely Movable
What are FOUR ways to classify a joint based on the material binding them together and/or the presence or absence of a joint cavity
Bony Fusion
Fibrous
Cartilagenous
Synovial
Ligaments connect ____ to _____
Bone to bone
Which has more movement?
Long Ligaments
or
Short Ligaments
Long Ligaments
What is the name of the long ligament that runs between the tibia and fibula?
This is often injured in high ankle sprains.
Syndesmoses
Do cartilagenous joints typically have a joint cavity?
No
Are cartilagenous joints highly mobile?
No
The symphysis pubis joint is a ________ (cartilagenous/synovial) joint
Cartilagenous Joint
Are synchondroses (cartilage union of bones) highly mobile or immobile?
Name two examples of the above
Immobile
Emphyseal Plates
First rib with the mandibrum
Intervertebral discs are an example of a ________ (synchondroses/symphyses/synovial joint)
Symphyses
Name TWO functions of a symphyses?
Shock Absorption
Provide Strength and Flexibility
What are the “spongy cushions” on the ends of bones to protect them from crushing or rubbing into one another?
Articular (Hyaline) Cartilage
What is the potential space between to bones in a joint referred to as?
Joint Cavity
What is the tissue surrounding a joint called?
This often has an inner and outer layer.
Articular (Joint) Capsule
Which layer of the joint capsule is composed of dense irregular connextive tissue that is continuous to the periosteum?
Outer Layer
Which layer of the joint capsule has a synovial membrane of loose connective tissue, makes synovial fluid, and lines all internal joint surfaces NOT covered by cartilage?
Inner
What portion of a synovial joint is formed from blood filtrate and rich in glycoproteins?
It also helps to nourish cartilage and lubricate the joint
Synovial Flood
Most reinforcing ligaments of a synovial joint are _________, which are thickened portions of the joint capsule
Capsular
T/F: Joints have a poor blood supply
False
Joints have a rich blood supply
Joints have extensive _______ beds in the synovial membranes
Capillary
Other than detecting pain……
What is another job nerves due in a synovial joint?
Monitor Stretch
What is the function of the meniscus in the knee?
Stabilization
What are the flattened sacs lined by synovial membranes in joints called?
These often are found where tendons, ligaments, muscles, and/or bone overlie one another to prevent friction
Bursae
What structure can be found on tendons to prevent friction?
Tendon Sheaths
What is the term for inflammation of a bursa?
Bursitis
What THREE things aid in joint stability?
Articular Surfaces (ie: Ball and socket)
Ligaments
Muscle Tone
Ligaments can only be stretched up to __% beyond normal until they tear
6%
T/F: Once a ligament is stretched, it can return to its normal length over time
False
Once a ligament is stretched it’ll stay stretched
Synovial joints allow for what types of movements
Pretty much all movements
Synovial Joints are classified by the shape of their articular surface…..
What are some examples of these?
Plane Hinge Pivot Condyloid Saddle Ball-and-Socket
The hip joint (femur + acetabulum) is what type of joint?
Ball and Socket
The knee joint (femur + patella) is what type of joint?
Plane
Allows for gliding of the patella
The Knee joint (Femur + Tibia) is what type of joint?
Hinge
What THREE external ligaments help secure the head of the femur in the acetabulum?
Iliofemoral
Pubofemoral
Ischiofemoral
What is also carried with the ligament of the head of the femur?
Its artery
The femur and tibia are both considered ___________ (monocondyloid, bicondyloid, polycondyloid)
Bicondyloid
The patellar ligament is a continuation of the ________ tendon
Quadriceps tendon
What ligaments are located on the medial and lateral aspects of the knee?
Lateral (Fibular) Collateral Ligament
Medial (Tibial) Collateral Ligament
What are the TWO cruciate ligaments of the knee?
Anterior Cruciate Ligament (ACL)
Posterior Cruciate Ligament (PCL)
Which ligament of the knee prevents anterior translation of the tibia?
ACL
Which ligament of the knee prevents posterior translation of the tibia?
PCL
Which ligament of the knee is commonly injured in “stop and twist” movements?
ACL
What are TWO functions of the foot?
Support your body weight
Act as a lever while walking to lift body weight upward
Which bone of the foot articulates with the tibia and fibula?
Talus
Which bone of the foot lies inferior to the talus?
Calcaneus
What SEVEN bones compose the tarus?
Calcaneous Talus Navicular Cuboid Cuneifom x3
The medial melleolus is the distal portion of which bone?
The lateral malleolus is the distal protion of which bone?
Medial: Tibia
Lateral: Fibula
During walking, the talus distributes half the weight onto the ________ and the other half onto the other tarsal bones.
Calcaneous
T/F: There is no true motion between tib-fib joint
True
What THREE ‘bones’ compose the talocrural joint?
Medial Malleolus
Lateral Malleolus
Talus
What TWO motions are the talocrural joint responsible for?
Plantar Flexion
Dorsi Flexion
What TWO bones compose the subtalar joint?
Talus
Calcaneous
What TWO motions are the subtalar joint responsible for?
Inversion
Eversion
What ligament of the foot supports the subtalar joint MEDIALLY?
Deltoid ligament
What ligaments of the foot supports the subtalar joint LATERALLT?
Anterior Talofibular (ATF) Posterior Talofibular (PTF) Calcaneofibular (CF)
What FIVE bones compose the midfoot?
Navicular
Cuboid
Cuneiform x3
The internal longitudinal arch of the foot is considered __________ (medial/lateral) while the external longitudinal arch of the foot is considered __________ (medial/lateral).
Medial
Lateral
Is the longitudinal arch of the foot higher on the medial or lateral side?
Medial Side
This is how the ‘instep’ is formed
Which toes are involved in the medial longitudinal arch?
Lateral longitudinal arch?
Medial: 1,2,3
Lateral: 4, 5
T/F: The plantar aponeurosis helps provide medial arch support in the foot
True
What is the very dense organized fascial layer that runs down the middle of the sole and helps maintain medial arch supprot?
Plantar Aponeurosis
What is the name of the disorder that effects the fascial tissue on the sole of the feet?
This is commonly due to overuse activities (ie: running) and pain typically localizes to the heel.
Plantar Fascitis
Are men or women more likely to get plantar fascitis?
Women
What ‘fascial band’ exsists to allow the flexor and extensor tendons of the foot to remain close to the bone?
Retinaculae
Examples:
Superior extensor retinaculum
Flexor retinaculum
Inferior extensor retinaculum
