Lower Limb Flashcards
What are the sciatic nerve roots?
L4 - S3 (lumbosacral plexus).
What is the largest nerve in the body?
The sciatic nerve.
What does the sciatic nerve give motor innervation to?
Muscles of the posterior thigh and hamstring of adductor magnus
When the sciatic nerve terminates it bifurcates into 2 nerves. What are they?
- Tibial.
- Common fibular.
What are the 3 main long bones in the lower limb?
- Femur (proximal).
- Fibula (distal and lateral).
- Tibia (distal and medial).
What nerve innervates the muscles in the anterior compartment of the thigh?
The femoral nerve, L2-4.
What is the action of the majority of the muscles in the anterior compartment of the thigh?
Extension of the leg at the knee.
What is the innervation to iliacus?
Femoral nerve L2-4.
What muscles make up quadriceps femoris?
- Vastus medialis.
- Vastus intermedius.
- Vastus lateralis.
- Rectus femoris.
What attaches the patella to the tibia?
The patella ligament.
What is the innervation of quadriceps femoris?
Femoral nerve, L2-4.
What is the origin of sartorious?
ASIS.
What is the action of sartorious?
Flexion, abduction and lateral rotation at the hip. Flexion at the knee
What is the innervation to sartorious?
Femoral nerve, L2-4.
What nerve innervates the muscles in the medial compartment of the thigh?
Obturator, L2-4.
Name the 5 muscles found in the medial compartment of the thigh.
- Gracilis.
- Obturator externus.
- Adductor brevis.
- Adductor longus.
- Adductor magnus.
What is the action of adductor brevis, adductor longus and adductor magnus.
Adduction of the thigh
What is the innervation of adductor brevis, adductor longus and adductor magnus.
Obtruator nerve, L2-4.
What forms the superior border of the femoral triangle?
The inguinal ligament.
What muscle forms the medial border of the femoral triangle?
Adductor longus.
What muscle forms the lateral border of the femoral triangle?
Sartorious.
What are the contents of the femoral triangle?
Femoral nerve, femoral artery, femoral vein and lymph nodes. NAV lateral to medial.
What is the femoral canal and what does it contain?
A potential space medial to the femoral vein. It contains lymph nodes.
What are the contents of the femoral sheath?
Femoral artery, veins and lymphatics.
What is the surface marking for the femoral artery?
2cm below the mid-inguinal point.
Where is the femoral artery pulsation palpable?
Below the mid-inguinal point.
Name the arteries in between the aorta and the femoral artery?
Aorta -> common iliac arteries -> external iliac arteries -> femoral artery.
Name the 2 main branches of the femoral artery.
- Profunda femoris artery.
2. Superficial femoral artery.
Name all the major veins blood flows through from the femoral vein to the heart?
Femoral vein -> external iliac vein -> common iliac vein -> IVC -> hear
Which joints does the femoral nerve supply?
The hip and knee.
In what muscle is the obturator nerve formed
Psoas major.
When does the external iliac artery become the femoral artery?
When it crosses under the inguinal ligament into the femoral triangle.
What artery does the obturator arise from?
The internal iliac artery
Name the 3 glutei muscles.
- Gluteus maximus.
- Gluteus medius.
- Gluteus minimus.
3
What is the innervation of gluteus maximus?
Inferior gluteal nerve.
What is the action of gluteus maximus?
Extension of the thigh
What is the action of gluteus medialis and minimus?
Abduction of the lower limb.
What is the innervation of gluteus medialis and minimus?
Superior gluteal nerve.
What are the nerve roots of the sciatic nerve?
L4-S3.
What does the sciatic nerve innervate?
The muscles of the posterior thigh and the hamstring part of adductor magnus.
What does the sciatic nerve bifurcate into?
The tibial and common peroneal (common fibular) nerves.
What 3 muscles make up the hamstrings?
- Biceps femoris (lateral).
- Semimembranous (medial).
- Semitendinous.
What is the action of the muscles in the posterior compartment of the thigh?
Extension at the hip and flexion at the knee.
What is the innervation of the muscles in the posterior compartment of the thigh?
Sciatic nerve L4-S3.
What is the dermatome of the inguinal region?
T12.
What is the dermatome of the big toe?
L5.
What is the dermatome of the little toe?
S1.
What is the dermatome of the patella?
L3.
Name 3 muscles in the anterior compartment of the leg.
- Tibialis anterior.
- Extensor digitorum longus.
- Extensor hallucis longus.
What are the actions of the muscles in the anterior compartment of the leg?
Dorsiflexion and inversion. The extensors also extend the toes.
What is the innervation to the muscles in the anterior compartment of the leg
Deep peroneal nerve (L4-5).
What is the action of tibialis anterior?
Dorsiflexion and inversion of the foot.
Describe inversion of the foot.
Turning the ankle so that the plantar surface of the foot faces medially.
What is the action of extensor digitorum longus?
Dorsiflexion of the foot and extension of the toes
What is the blood supply to the muscles in the anterior compartment of the leg?
Anterior tibial artery
Name 2 muscles in the lateral compartment of the leg.
Peroneal brevis and longus.
What are the actions of the muscles in the lateral compartment of the thigh?
Eversion and plantarflexion.
What is the innervation to the muscles in the lateral compartment of the thigh?
Superficial peroneal nerve.
Name 2 superficial muscles in the posterior compartment of the thigh.
Soleus and gastrocnemius.
How many heads does gastrocnemius have?
2 - medial and lateral. They form the inferior borders of the popliteal fossa
What are the 2 actions of gastrocnemius?
Plantarflexion at the ankle and flexion at the knee.
What other muscle combines to form the calcaneal tendon with gastrocnemius?
Soleus.
What is the action of soleus?
Plantarflexion.
What is the innervation to the posterior compartment of the leg?
Tibial nerve.
In what compartment of thelower limb are the hamstrings located
The posterior thigh
Name 4 deep muscles in the posterior compartment of the leg.
- Popliteus.
- Flexor digitorum longus.
- Flexor hallucis longus.
- Tibialis posterior.
How many tarsal bones are there?
7.
Which nerve winds around the neck of the fibula?
The common peroneal nerve
How do the superficial and deep veins of the leg communicate?
Via perforators which pass through the deep fascia.
What veins drain the superficial leg?
Short and long saphenous veins. The short saphenous vein drains the posterior leg
What area of the foot receives skin sensation from the deep peroneal nerve?
Dorsum of the first web space.
How can you test tibialis anterior?
Dorsiflexion at the ankle.
Which muscle compartment is supplied by the deep peroneal nerve?
Anterior leg.
Which artery is the dorsal pedis artery a branch of?
The anterior tibial artery.
What is the anterior tibial artery a branch of?
The popliteal artery. (Popliteal artery is a branch of the femoral artery).
What are the actions of the peroneii muscles?
Eversion of the foot
What muscles make up the peroneii muscles
- Peroneal longus.
- Peroneal brevis.
What nerve innervates the peroneii muscles?
Superficial peroneal nerve.
How can you test the peroneii muscles?
Eversion against resistance
Why is the blood supply to the shaft of the tibia relatively poor
The tibia has few muscles attached it. Attached muscles are responsible for supplying the majority of blood to a bone
How do you test the gastrocnemius
Ask the patient to stand on their tip toes.
Which segments of the spinal cord are you testing when you elicit the ankle jerk reflex?
S1,2.
Which segments of the spinal cord are you testing when you elicit the knee jerk reflex?
The femoral head articulates with the acetabulum of the pelvis.
What is the main function of the hip joint?
To bear weight - its range of movements is therefore limited.
What is the intrascapular ligament of the hip joint
The ligament of the head of the femur.
Give 2 features of the acetabulum which add stability to the hip join
- It is deep and encompasses nearly all of the head of the femur.
- It is surrounded by the acetabular labrum which increases its depth and provides a larger articular surface
What nerves innervate the hip joint?
Sciatic, obturator and femoral.
Any nerve supplying a muscles which moves a joint also innervates the joint
What are the 2 articulations of the knee joint?
- Tibiofemoral.
2. Patellofemoral.
Give 3 functions of the medial and lateral menisci.
- Shock absorbers.
- Permit some rotation.
- Deepen the articulating surfaces and so increase stability.
What are the medial and lateral menisci both attached to?
The intercondylar area of the tibia.
What bones do the cruciate ligaments attach to?
The femur and the tibia.
What type of joint is the ankle joint?
Hinge, synovial.
What movements are permitted at the ankle joint?
Dorsiflexion and plantarflexion.
Which muscles of the leg are responsible for dorsiflexion?
Tibialis anterior, extensor hallucis longus and extensor digitorum longus (anterior compartment).
Which muscles of the leg are responsible for plantarflexion?
Gastrocnemius and soleus (posterior compartment).
What 3 bones make up the ankle joint?
Tibia, fibula and talus.
What binds the tibia and fibular?
Tibiofibular ligaments.
What muscles support the pelvis when standing on one leg?
Gluteus medius and minimus.
What is the action of popliteus?
Twists the tibia on the femur to unlock the knee.
What are the functions of the quadriceps?
Extension at the knee and flexion at the hip
What is the function of the patella?
Transfers force from the quadriceps over the knee to the tibia.
What are the attachments of the patella
Quadriceps femoris tendon superiorly and patellar ligament inferiorly.
What is the blood supply to the anterior compartment of the leg?
Anterior tibial artery.
What is the blood supply to the posterior compartment of the leg?
Posterior tibial artery.
What is the blood supply to the lateral compartment of the leg?
Peroneal artery.
What is the innervation to the anterior compartment of the leg?
Deep peroneal nerve.
What is the innervation to the posterior compartment of the leg?
Tibial nerve.
Which muscles flex the knee?
Hamstrings - posterior thigh.
