Lower Extremity, Topnotch Flashcards
Innervation to the anterior thigh muscles
Femoral nerve
Quadriceps muscles (4)
1) Vastus lateralis
2) Vastus intermedius
3) Vastus medialis
4) Rectus femoris
Iliopsoas muscles (3)
1) Psoas major
2) Psoas minor
3) Iliacus
Common innervation of quadriceps muscles
Femoral nerve
ASIS is origin of what muscle
Sartorius
AIIS is origin of what muscle
Rectus femoris
Common insertion of iliopsoas muscles
Lesser trochanter
Common insertion of adductor muscles of leg
Linea aspera
Common insertion of hamstrings
Adductor tubercle of femur
Hamstring muscles (4)
1) Semitendinosus
2) Semimebranosus
3) Adductor magnus
4) Biceps femoris
Common origin of hamstrings EXCEPT short head of biceps femoris
Ischial tuberosity
Origin of short head of biceps femoris
Linea aspera and lateral supracondylar ridge of femur
Adductor canal: Runs from ___ to ___
Apex of femoral triangle to adductor hiatus in the adductor magnus tendon
Gluteal region: Superficial muscles
Gluteus maximus
Gluteal region: Intermediate muscles (2)
1) Gluteus medius
2) Gluteus minimus
Gluteal region: Deep group
1) Piriformis
2) Obturator internus
3) Superior and inferior gemelli
4) Quadratus femoris
Gluteal region, muscle group-action: Superficial
Extensor of thigh
Gluteal region, muscle group-action: Intermediate
Abductor and medial rotator of thigh
Gluteal region, muscle group-action: Deep group
Lateral rotator of thigh
Common origin of gluteal muscles
Outer surface of ilium
Common insertion of gluteal muscles EXCEPT gluteus maximus and quadrates femoris
Greater trochanter of femur
Insertion of gluteus maximus
Iliotibial tract (tensor fascia lata)
Insertion of quadrates femoris
Quadratus tubercle
Muscles that act at thigh: Flexion
Anterior compartment
Muscles that act at thigh: Extension
Posterior compartment + gluteus maximus
Muscles that act at thigh: Adduction
Medial compartment
Muscles that act at thigh: Abduction
Gluteus medius and minimus
Muscles that act at thigh: Medial rotation
Gluteus medius and minimus
Muscles that act at thigh: Lateral rotation
GQ POG
Nerve paralysis: Waddling gate
Superior gluteal nerve
Lumbar plexus: Formed within what muscle
Psoas major
Lumbar plexus: Nerve roots
Anterior rami of L1-4
Iliohypogastric nerve: Root
L1
Iliohypogastric nerve: Emerges from
Lateral border of psoas
Iliohypogastric nerve: Runs in front of
Quadratus lumborum
Iliohypogastric nerve: Supplies
Skin of lower anterior abdominal wall
Ilioinguinal nerve: Root
L1
Ilioinguinal nerve: Emerges from
Lateral border of psoas
Ilioinguinal nerve: Runs in front of
Quadratus lumborum
Ilioinguinal nerve: Passes into
Inguinal canal
Ilioinguinal nerve: Supplies
Skin of groin and scrotum/labia majora
Genitofemoral nerve: Emerges from
Anterior surface of psoas
Genitofemoral nerve: Root
L1-2
Genitofemoral nerve: Genital branch supplies
Cremaster muscle
Genitofemoral nerve: Femoral branch supplies
Skin of thigh
Lateral femoral cutaneous nerve: Root
L2-3
Lateral femoral cutaneous nerve: Emerges from
Lateral border of psoas
Lateral femoral cutaneous nerve: Crosses the
Iliacus
Lateral femoral cutaneous nerve: Enters the thigh behind
Inguinal ligament
Lateral femoral cutaneous nerve: Supplies
Skin over lateral surface of thigh
Femoral nerve: Root
L2,3,4
Femoral nerve: Emerges from
Lateral border of psoas
Femoral nerve: Supplies
1) Anterior compartment of thigh
2) Skin on anteromedial aspect of thigh and medial foot
Obturator nerve: Root
L2,3,4
Obturator nerve: Emerges from
Medial border of psoas
Obturator nerve: Supplies
1) Medial compartment of thigh
2) Skin on medial aspect of thigh
Largest branch of lumbar plexus
Lumbar nerve
Lumbosacral plexus: Lies in front of
Piriformis
Lumbosacral plexus: Formed by
Anterior rami of L4-5, S1-4
Largest branch of lumbosacral plexus
Sciatic nerve
Sciatic nerve: Root
L4-5, S1-3
Lumbosacral plexus: Branches to the lower limb
1) Sciatic
2) Superior gluteal
3) Inferior gluteal
4) Nerve to quadratus femoris
5) Nerve to obturator internus
6) Posterior cutaneous nerve of thigh
Lumbosacral plexus: Branches to the pelvis and perineum
PPPP
1) Pudendal
2) Pelvic splanchnic
3) Piriformis, nerve to
4) Perforating cutaneous nerve
Pudendal nerve: Roots
S2,3,4
Pelvic splanchnic nerve, Roots
S2,3,4
Perforating cutaneous nerve supplies
Lower medial part of buttocks
Largest nerve in the body
Sciatic nerve
Sciatic nerve supplies
1) Skin of leg and foot
2) Muscles of posterior thigh
Nerve paralysis: (+) Trendelenburg sign
Superior gluteal nerve
Nerve paralysis: Difficulty in extending thigh at hip as in climbing stairs or rising from a chair
Inferior gluteal nerve
Nerve paralysis: Gluteus maximus gait
Inferior gluteal nerve
Gait in which patient thrusts the torso posteriorly in an attempt to counteract weakness of affected muscle
Gluteus maximus gait
Nerve paralysis: Foot drop
Sciatic nerve/common peroneal
Nerve paralysis: Compression due to posterior dislocation of femur
Sciatic nerve
Most commonly compressed nerve roots of sciatic nerve
L5-S1
Syndrome in which involved muscle places pressure and irritates the sciatic nerve causing pain in the buttocks and referred pain along course of sciatic nerve
Piriformis syndrome
Pain that radiates down he back of thigh into lower back
Sciatica
Nerve paralysis: Abscess of psoas major muscle
Femoral nerve
Nerve paralysis: Pain and paresthesia in the skin of the medial aspect of the leg and foot
Saphenous nerve
Nerve paralysis: Sites of injury, saphenous nerve
1) Surgical removal of saphenous vein
2) Lacerated as it pierces the wall of the adductor canal
Obturator nerve is most commonly injured at the
Pelvis
Nerve paralysis: Inability to adduct thigh at hip
Obturator nerve
Nerve paralysis: Paresthesia at the medial thigh
Obturator nerve
Femur: Normal neck shaft angle in young child
160 degrees
Femur: Normal neck shaft angle in young adult
125 degrees
Femur: Decreased neck shaft angle
Coxa vara
Femur: Increased neck shaft angle
Coxa valga
Femur: Fracture of shaft, position of proximal fragment
1) Flexed by iliopsoas
2) Abducted by gluteus medius
3) Laterally rotated by gluteus maximus
Femur: Fracture of shaft, position of distal fragment
1) Pulled up by hamstrings and quadriceps
2) Adducted by adductor muscles
Femur: Neck fracture, position of femur
1) Shortened
2) Pulled upward by quads, hamstrings, and adductors
3) Laterally rotated
Subcapital vs trochanteric neck fracture: Elderly
Subcapital
Subcapital vs trochanteric neck fracture: Young
Trochanteric
Major blood supply to the femoral head
Medial femoral circumflex
Most common direction of femoral head dislocation
Posterior
Triceps surae muscles
1) Gastrocnemius
2) Soleus
How many layers of muscle does the foot have
4
All sole muscles are innervated by lateral plantar nerve except
???
Dorsalis pedis artery pulse, landmark
Between the malleoli or 1st inter metatarsal space
Posterior tibial artery pulse, between tendons of
FDL and FHL
Lateral cutaneous nerve of leg is a branch of
Common peroneal nerve
Superficial peroneal nerve of leg is a branch of
Common peroneal nerve
Saphenous nerve is a branch of
Femoral nerve
Muscles: Evert and plantar flex the foot
Peroneus muscles
Muscles: Invert and plantar flex the foot
Tibialis muscles
Nerve: Posterior compartment of leg
Tibial nerve
Nerve: Lateral compartment of leg
Superficial peroneal
Nerve: Anterior compartemtn of leg
Deep peroneal
Nerve: Plantarflexion of foot
Tibial nerve
Nerve: Eversion and plantar flexion of foot
Superficial peroneal
Nerve: Dorsiflexion of foot
Deep peroneal
Nerve paralysis: Can’t stand on tiptoes
Tibial nerve
Most frequently injured nerve in the lower limb
Common peroneal
Nerve paralysis: Compressed at neck of fibula
Common peroneal
Nerve paralysis: Paresthesia of skin of webbed space between great toe and second toe
Deep peroneal
Nerve paralysis: Steppage gait
Common peroneal
Type of joint between femur and tibia
Synovial hinge
Type of joint between patella and femur
Synovial gliding
Nerve supply of knee joint
1) Femoral
2) Obturator
3) Common peroneal
4) Tibial
Anterior vs posterior cruciate ligaments: Lax during flexion
ACL
Anterior vs posterior cruciate ligaments: Lax during extension
PCL
Anterior vs posterior cruciate ligaments: Prevents forward sliding of tibia on femur
ACL
Anterior vs posterior cruciate ligaments: Prevents backward sliding of tibia on femur
PCL
Terrible triad/Unhappy triad of O’ Donoghue
1) ACL
2) MCL
3) Medial meniscus
Injury, MCL vs LCL: Forced abduction of tibia on femur
MCL
Injury, MCL vs LCL: Forced adduction of tibia on femur
LCL
Injury-affected structure/s: Blow to the lateral aspect of knee
1) MCL
2) Medial meniscus
Injury-affected structure: Blow to anterior aspect of flexed knee
ACL
Injury-affected structure: (+) anterior drawer sign
ACL
Injury-affected structure: (+) posterior drawer sign
PCL
Nerve supply of ankle joint (2)
1) Deep peroneal
2) Tibial
Talipes calcaneovalgus vs equinovarus: Foot is dorsiflexed and everted
Calcaneovalgus
Talipes calcaneovalgus vs equinovarus: Foot is plantar flexed and inverted
Equinovarus
Aka clubfoot
Talipes
Ultimate lymphatic drainage of lower limb
Deep inguinal nodes
