Lower Limb Flashcards
Suspends the lower extremity.
Formed by the:
-Ilium
-Ischium
-Pubis
-Anterior Superior Iliac Spine (big knot of bone)
-Anterior Inferior Iliac Spine
-Acetabulum (socket that accommodates head of femur to form the hip joint)
-Obturator Foramen
-Pubic Tubercle & Superior Pubic Ramus
-Inferior Pubic Ramus (also called Ischial Pubic Ramus - formed of contributions from ischium & pupis)
-Ischial Tuberosity (lower area of ischium where you sit on)
Pelvic Girdle
An opening that has muscles on the inside (Obturator Internus) and on the outside (Obturator Externus), and an Obturator Membrane that fills the opening that lies between the two.
-Upper boundary is formed by the Superior Pubic Ramus
-Inferior border is formed by the Inferior Pubic Ramus
Obturator Foramen
Contains:
-Femoral Nerve, Artery, and Vein
-Empty Space (Femoral Canal - very small)
-Lymph Nodes - 10 Superficial and 3-5 Deep with one very large called Cloquet’s Node
-Lacunar Ligament
-Termination of the Great Saphenous Vein
Femoral Triangle
-Lateral Border: Sartorius m.
-Medial Border: Adductor Longus m.
-Superior Border: Inguinal Ligament
Floor:
-Medial: Pectineus m.
-Lateral: Iliopsoas m.
Femoral Triangle
Runs from the ASIS to the Pubic Tubercle
-Thick, tough cord-like material
Inguinal Ligament
Muscle that is the result of two muscles the begin in the pelvis, pass deep to the inguinal ligament, and combine their tendons to attach to the Lesser Trochanter of the Femur.
-Psoas Major + Iliacus m.
-Famous Insertion: Lesser Trochanter of the Femur
Iliopsoas Muscle
NAVEL: Lateral to medial
Femoral Nerve
Femoral Artery
Femoral Vein
Empty Space
Lymph Nodes
How to palpate Inguinal Ligament?
Lie down on an edge where you can hang hip off of. Put leg into hyperextension and the ligament will pop up.
-From ASIS to Pubic Tubercle
Curved fibers off of the Inguinal Ligament right before it gets to the Pubic Tubercle.
-Attaches to the Superior Pubic Ramus along the Pectinate Line
-Continues on over to attach to the Pubic Tubercle
-Curvature faces posteriorly and laterally.
-Forms the medial border of the femoral ring (entrance into the femoral canal)
Lacunar Ligament
The entrance into the femoral canal. Lies behind the inguinal ligament
-Medial Border: Lacunar Ligament
-Lateral border: Femoral Vein
Femoral Ring
The longest vein in the lower limb.
-Begins on the medial dorsal aspect of foot in the form of a dorsal venous arch
-Passes anteriorly to the Medial Malleolus (bump on the tibia).
-Continues up leg, past knee to thigh, and empties into the Femoral Vein
-Gains access to the Femoral Vein via an opening in the Fascia Lata (investing fascia around the thigh)
-Enters the Femoral Triangle via the Saphenous Hiatus (Foramen Ovale) to drain into the Femoral Vein
-Used for CBG
Great Saphenous Vein
Leg?
Knee to ankle
Thigh?
Knee to hip
Formed by the Sartorius muscle overlapping the Adductor Longus muscle, creating an opening for vessels to go into.
-Formed by the Adductor Longus, Sartorius, and Vastus Medialis muscle.
-Contains the Nerve to the Vastus Medialis m., the Saphenous nerve (Branches of the femoral nerve), femoral artery, and femoral vein.
-Conducts vessels in a medial and posterior direction
Adductor Canal (Hunter’s Canal/Subsartorial Canal)
Split in the tendon of this muscle creates an opening where the femoral artery & vein pass through and change their names to the popliteal artery and vein
-Allows access of femoral artery & vein from anterior thigh to the posterior knee (popliteal fossa)
Adductor Magnus muscle
Biggest nerve in the body
-Runs with the popliteal artery & vein
-Courses from hip down to adductor hiatus, exits via split in adductor magnus tendon that creates an opening
Sciatic Nerve
-Medial: Semitendinous & Semimembranosus
-Lateral: Biceps Femoris
-Floor: Popliteus m.
Inferior:
-Medial: Medial head of the Gastrocnemius
-Lateral: Lateral head of the Gastrocnemius running with Plantaris m.
Popliteal Fossa
A tiny muscle that runs with the Lateral head of the Gastrocnemius.
-Runs from femoral condyle with the muscles of the calf. Similar to palmaris longus in the hand where not everyone has one; small muscle with long tendon that inserts into Achilles tendon (heel)
Plantaris Muscle
Origination of muscles of the popliteal fossa
Medial Epicondyle of the Femur: Medial Muscles
Lateral Epicondyle of the Femur: Lateral Muscles
Muscle that runs diagonally, important for bending the knee.
-Unlocks the knee joint
-Produces medial rotation of the tibia
-Takes joint from extension to flexion
Popliteus Muscle
Enters the popliteal fossa and splits into Common Fibular Nerve (lateral) and Tibial Nerve (Medial)
Sciatic Nerve
Contents of the Popliteal Fossa
-Sciatic Nerve terminal branches: Tibial Nerve and Common Fibular Nerve
-Popliteal Artery & Vein
-Short Saphenous Vein (runs up back of calf and drains into popliteal vein)
Formed by a branch off of the Tibial Nerve called the Medial Sural Cutaneous Nerve and a branch off of the Common Fibular Nerve called the Lateral Sural Cutaneous Nerve.
-These descend down posterior calf, where they give off a sural communicating nerve that interconnects medial with lateral sural nerves to form _____.
-Supplies sensation to the lateral aspect of the foot
Sural Nerve
Nerve that goes behind the medial malleolus
-Gives off Lateral and Medial Plantar Nerves and a Calcaneal Branch (heel)
Tibial Nerve
Nerve that runs with the Anterior Tibial Artery, which changes its name to the Dorsalis Pedis Artery when it passes the ankle joint
Deep Fibular Nerve
Gives off the Medial and Intermediate Dorsal Cutaneous Nerves
Superficial Fibular Nerve
Nerve that runs behind the Lateral Malleolus.
-Gives off the Lateral Dorsal Sural Cutaneous Nerve
Sural Nerve
Distal continuation of the femoral nerve. Longest nerve in the body
-Descends down the Adductor canal, but doesn’t exit via Adductor Hiatus like everything else.
-Exits at a junction between semitendinosus and semimembranosus tendons. Crack in between tendons is where this exits, continuing down the medial side of the leg/ankle
-Provides sensation to the medial aspect of the foot and ankle
-Runs with the Greater Saphenous Vein
Saphenous Nerve
Sensation to the medial portion of the foot/ankle (plantar and dorsal)
Saphenous Nerve
Sensation to the area between Great toe and 2nd toe (dorsal)
Deep Fibular Nerve
Sensation to almost all of the dorsum of the foot
Superficial Fibular Nerve
Sensation to the medial, plantar aspect of Great Toe - 3rd toe and medial aspect of 4th toe
Medial Plantar Nerve
Sensation to the lateral, planter aspect of foot and 4th toe
Lateral Plantar Nerve
Sensation to the plantar surface of the heel
Calcaneal Branch of the Tibial Nerve
Sensation to the lateral aspect of the foot (plantar and dorsal side)
Sural Nerve
Which 5 nerves do you anesthetize with a ring block?
1) Tibial Nerve - behind medial malleolus
2) Saphenous Nerve - anterior medial malleolus
3) Sural Nerve - behind lateral malleolus
4) Deep Fibular Nerve - between the two malleoli
5) Superficial Fibular Nerve - 1-2 inches distal to Deep Fibular location
How to palpate the Dorsalis Pedis Artery?
Dorsiflex big toe, should see a tendon sticking out of the Extensor Hallicus Longus m.
-Go off lateral edge of that tendon to find the Dorsalis Pedis a.
