Lower limb 1 Flashcards
The 2 superficial veins of lower limb
Great and small saphenous
Which superficial vein ascends anterior to medial malleolus?
Great saphenous
Which vein ascends posterior to lateral malleolus?
Small saphenous
Which veins does small and great saphenous empty into?
great saphenous -> femoral vein
small spaehnous -> popliteal vein
What is varicose veins and which vein is most common affected
Dilated superficial veins due to incompetent valves
Great saphenous is most commonly affected
Important Lymph nodes in the lower limbs
Superficial and deep inguinal
Popliteal
Hip joint type
Synovial ball and socket
Why is hip joint more stable than shoulder joint?
Deeper socket
More stability
Weight bearing
What is the acetabular labrum?
Fibrocartilaginous ring surrounding hip joint
Increases depth of socket -> more stability
Function of acetabular labrum
Allow head of femur to articulate with pelvis
Deepend the joint -> more stability
3 main ligaments of hip joint
ilio-femoral
pubo-femoral
ischio-femoral
(all the bones of the pelvis -> femur)
Iliofemoral and ischiofermoral ligament prevents what?
Hyperextension of hip joint
Pubofemoral ligament prevents what?
Hyperabduction of hip joint
Movements permitted at hip joint
flexion & extension
abduction & adduction
circumduction
medial & lateral rotation
Chief flexor of thigh
Iliopsoas
(formed by the union of the illiacus and psoas major as they insert onto the hip joint)
Flexors of the thigh
iliopsoas
pectineus
sartorius
quadriceps femoris (rectus femoris, vastus medialis & lateralis)
Extensors of hip joint
Gluteus maximus
Hamstrings (biceps femoris, semitendinosis & semimembranosus)
Adductor magnus
Main extensor of hip joint
Gluteus maximus
When is gluteus maximus strong and when is it relatively inactive?
Strong -> Sitting & limbing stairs
Inactive -> walking
What compartment of the thigh muscles is responsible for adduction?
Medial
adductor muscles
adductor magnus
adductor longus
adductor brevis
gracilis
obturator externus
pectineus
Innervation of adductor compartment
Obturator nerve
How obturator nerve exits the pelvis?
In the obturator canal, which is in the obturaor membrane, which is in the obturator foramen
What muscles abduct the hip?
gluteus medius
gluetus minimus
piriformis
gemelli
obturator internus
TFL
quadratus femoris
What prevents the pelvis dropping when 1 leg is raised?
Abductors on the opposite side
(hence why Trendelenberg’s sign is caused by weak abductor muscles)
Medial rotators of hip joint
gluteus minimus
glutues medius
TFL
4 heads of quariceps femoris?
recuts femoris
vastus medialis
vastus lateralis
vastus intermedius
Which nerve innervates quadriceps?
Femoral nerve (L2-4)
Action of rectus femoris on hip
Stabilisation
helps iliopsoas flex
What forms quadriceps tendon and what does this continue as?
Quadriceps tendon -> 4 parts of quadriceps unite proximal to patella
cotinues as -> patellar ligamaent
Quadriceps action on knee
Extension
3 actions of sartorius on hip
flexion
lateral rotation
abduction
sartorius action on knee
flexion
What movement shows action of sartorius muscle?
Place heel on opposite patella
Why does sartorius both flex hip and knee joint?
Spirals around thigh from lateral to medial
Crosses hip anteriorly and knee posteriorly
5 medial thigh muscles
adductor magnus
adductor longus
adductor brevis
gracilis
obturator externus
Innervation of medial thigh muscles
Obturator nerve (L2 -> L4)
Structures passing through adductor hiatus
Femoral artery & vein
They then enter the popliteal fossa
Femoral artery is a continuation of which artery?
External iliac artery
Where does external iliac artery –> femoral artery?
Middle of inguinal ligament
Femoral artery enters thigh midway between which 2 bony structures?
ASIS and pubic symphysis
(in the femoral triangle)
Branch of femoral artery passing posteriorly towards hamstrings?
Profunda femoris artery
Femoral vein is a continuation of which vein?
Popliteal
Femoral vein passes under inguinal ligament to become..
External iliac vein
(veins go up remeber you mug)
2 important veins draining into femoral triangle
profundal femoris vein
great saphenous vein
Cannulation of femoral vein is used for what?
Cardiac angiography
Largest branch of lumbar plexus (T12 -> L5)
Femoral nerve
what is the femoral triangle
Triangular depression below inguinal ligament
medial border of femoral triangle
adductor longus
(apex of feomral triagnle= where the adducor longus crosses over the sartorius)
Lateral border of femoral triangle
sartorius
base (top) of femoral triangle
inguinal ligament
3 main contents of femoral triangle
femoral vein (most medial)
femoral artery
femoral nerve (most lateral)
(all the femoral shite)
what is the femoral sheath
Funnel shaped fascial tube which surrounds proximal part of femoral vessels (femoral artery & vein)
Creates femoral canal medial to them
the femoral canal contains:
- lymphactics
- fat
- loos connective tissue
It fucking does not surround the femoral nerve
what is this
A femoral hernia
Due to a weak femoral ring (top of femoral canal)
F>M
mnemonic for femoral canal contents
NAVEL
N= femoral nerve
A= femoral artery
V= femoral vein
E= emplty space (femoral canal)
L= Lymph nodes
What is the adductor canal?
femoral triangle structures leave distally (at the base) and burrow beneath muscles to create canal
AKA Hunter’s canal
How does adductor canal reach popliteal fossa?
Passes through adductor hiatus within tendon of adductor magnus
Emerges posterior to knee
Adductor canal serves a role in which name change?
(Anterior) Femoral artery –> (posterior) Popliteal artery
When does anterior femoral artery –> posterior popliteal artery name change occur?
Adductor hiatus
Adductor canal contents
femoral artery & vein
saphenous nerve
nerve to vastus medialis
Why is it called Hunter’s canal?
John Hunter ligated the femoral artery in adductor canal to treat popliteal artery aneurysms
Where does lumbar plexus nerves emerge?
Through psoas major
On posterior abdominal wall
2 major nerves of lumbar plexus
femoral nerve
obturator nerve
Lumbar plexus roots
T12-L5
Where in the femoral triangle to femoral hernias occur
Posterior and inferior to the inguinal ligaments
Femoral hernias are more comon in women
Which LN is this
Inguinal group
What muscles attach to the greater trochanter of femur
Gluteus medius & mimimus
Piriformis
Obturator internus & externus
What muscles attach to the lesser trochanter of the femur
Psoas major
Illiacus
What muscles attach to the ischial tuberosity
Adductor magus
Hammys
Where does the rectus femoris originate
Anterior inferior iliac spine
What musscles attach to the ischial spine
Gemellus
Levator ani
Coccygeus
What are the 3 borders of the adductor (hunters) canal
Medial -> sartorius
Lateral -> vastus medialis
Posterior (apex) -> adductor longus
