Lower Limb 1 Flashcards
What are the two superficial veins in the leg?
Great saphenous
Small saphenous
Where does the great saphenous descend?
Anterior to medial malleolus
Where does the small saphenous descend?
Ascends posterior to the medial malleolus
Where does the great saphenous vein empty into?
Femoral vein
Where does the small saphenous vein empty into?
Popliteal vein
What are varicose veins?
Dilated superficial veins due to incompetent valves
More common in great saphenous vein
What is DVT?
Venous status caused by thrombus formation
Caused by muscular inactivity, external pressure, e.g. bandages
What are the important groups of lymph nodes draining the lower limb?
Superficial inguinal
Deep inguinal
Popliteal lymph nodes
Lymphatic vessels accompanying the great saphenous vein end where?
In the superficial inguinal nodes
Lymphatic vessels accompanying the small saphenous vein enter where?
The popliteal lymph nodes
What may cause enlargement of the inguinal lymph nodes?
Infection of the lower limb and trunk inferior to the umbilicus
What is the S1 dermatome?
Little toe
What is the L3 dermatome?
The knee
What kind of joint is the hip?
Ball and socket
Why is the hip more stable than the shoulder?
Femoral head almost completely surrounded by hip socket
What is the acetabular labrum?
Fibrocartilaginous collar around edge of acetabulum that increases the depth of the acetabulum and increases stability of joint as more of femoral head fits in
What is the fovea?
Pit that is the attachment of the ligament of the head of the femur
What are the hip ligaments?
Ischiofemoral
Pubofemoral
Iliofemoral
What does iliofemoral ligament do?
Prevents hyperextension of hip
What does the pubofemoral ligament do?
Prevents hyperabduction of the hip
What does the ischofemoral ligament do?
Prevent hyperextension of the hip
What movements occur at the hip joint?
Flexion Extension Abduction Adduction Lateral and medial rotation Circumduction
What are the hip flexors?
ILIOPSOAS
Pectineus
What are the hip extensors?
Gluteus maximus is chief extensor, hamstrings, adductor magnus
What are the adductors of the hip?
Obturator externus, gracilis, adductor longus, adductor brevis, adductor magnus
What nerve supplies the adductor compartment?
Obturator nerve
Where does the obturator nerve leave the pelvis?
Obturator canal via the obturator foramen
Weakness of the hip abductors leads to what type of gait?
Trendelenburg gait
What muscles internally rotate the hip?
Gluteus maxmimus
Gluteus minimus
Tensor fascia latae
What are the quadriceps femoris?
Four headed muscle
Rectus femoris, vastus lateralis, vastus medialis, vastus intermedius
What nerve innervates the anterior thigh muscles?
Femoral nerve
What is the action of the rectus femoris?
Flexion of hip and knee
KICKING MUSCLE
What do the rectus femoris unite to form?
Quadriceps tendon, continues as patellar ligament distal tot he knee and attaches to the tibia
Where does the patellar ligament attach?
Tibial tuberosity
What is the action of sartorius?
Flexion, abduction, lateral rotation at hip and flexion of knee
What are the adductor muscles?
Obturator externus, adductor longus, brevis, magnus and gracilis
What structures pass through adductor canal?
Femoral artery
Femoral vein
Saphenous nerve
Nerve to vastus medialis
Femoral artery enters the thigh midway between which two bony surface markings?
ASIS and pubic tubercle
What large branch of the femoral artery passes posteriorly towards the hamstrings?
Profunda femoris artery
What is the femoral vein a continuation of?
Popliteal vein
What does the femoral vein drain into?
External iliac vein
What veins drain into the femoral vein in the femoral triangle?
Profunda femoris vein
Great saphenous vein
What is the course of the femoral nerve?
Passes deep to inguinal ligament and enters femoral triangle lateral to the femoral vessels
What muscles does the femoral nerve supply?
Anterior thigh muscles - sartorius, quadriceps femoris, iliacus, pectineus
What is the action of pectineus?
Flexion and adduction of the hip
What is the femoral triangle?
Triangular depression below the inguinal ligament
What forms the medial and lateral boundary of the femoral triangle?
Medial - adductor longus
Lateral - sartorius
What structure forms the base of the femoral triangle?
Inguinal ligament
What are the contents of the femoral triangle (L–>M)?
Femoral nerve, femoral artery, femoral vein, femoral canal and lymph nodes
What is the femoral sheath?
Funnel shaped fascial tube which surrounds proximal parts of the femoral vessels (not femoral nerve) and creates the femoral canal medial to them which contains the lymphatic vessels
The femoral sheath is loosely divided into 3 compartments, what are these?
Lateral - femoral artery
Intermediate - femoral vein
Medial - femoral canal
What is a femoral hernia?
femoral ring weak in anterior abdominal wall - site of femoral hernia
In which gender are femoral hernias more common?
Females
Inguinal more common in men
What is the adductor canal/hunter’s canal?
As femoral neurovascular structures leave apex of femoral triangle, they begin to burrow beneath the musculature to create a tunnel, the adductor canal
It passes through the adductor hiatus within the tendon of the adductor magnus and emerges into popliteal fossa
What are the two main branches of the lumbar plexus?
Obturator nerve and femoral nerve
Where does the lumbar plexus sit?
On the psoas major muscle
What nerve roots make up the lumbar plexus?
L1-4
What nerve roots make up the obturator nerve?
L2-4
What nerve roots make up the femoral nerve?
L2-4
