Lower Limb

Question 1

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)

Answer 1

Pelvic Girdle

Question 2

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

Answer 2

Obturator Foramen

Question 3

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

Answer 3

Femoral Triangle

Question 4

-Lateral Border: Sartorius m.
-Medial Border: Adductor Longus m.
-Superior Border: Inguinal Ligament

Floor:
-Medial: Pectineus m.
-Lateral: Iliopsoas m.

Answer 4

Femoral Triangle

Question 5

Runs from the ASIS to the Pubic Tubercle
-Thick, tough cord-like material

Answer 5

Inguinal Ligament

Question 6

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

Answer 6

Iliopsoas Muscle

Question 7

NAVEL: Lateral to medial

Answer 7

Femoral Nerve
Femoral Artery
Femoral Vein
Empty Space
Lymph Nodes

Question 8

How to palpate Inguinal Ligament?

Answer 8

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

Question 9

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)

Answer 9

Lacunar Ligament

Question 10

The entrance into the femoral canal. Lies behind the inguinal ligament
-Medial Border: Lacunar Ligament
-Lateral border: Femoral Vein

Answer 10

Femoral Ring

Question 11

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

Answer 11

Great Saphenous Vein

Question 12

Leg?

Answer 12

Knee to ankle

Question 13

Thigh?

Answer 13

Knee to hip

Question 14

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

Answer 14

Adductor Canal (Hunter’s Canal/Subsartorial Canal)

Question 15

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)

Answer 15

Adductor Magnus muscle

Question 16

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

Answer 16

Sciatic Nerve

Question 17

-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.

Answer 17

Popliteal Fossa

Question 18

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)

Answer 18

Plantaris Muscle

Question 19

Origination of muscles of the popliteal fossa

Answer 19

Medial Epicondyle of the Femur: Medial Muscles
Lateral Epicondyle of the Femur: Lateral Muscles

Question 20

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

Answer 20

Popliteus Muscle

Question 21

Enters the popliteal fossa and splits into Common Fibular Nerve (lateral) and Tibial Nerve (Medial)

Answer 21

Sciatic Nerve

Question 22

Contents of the Popliteal Fossa

Answer 22

-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)

Question 23

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

Answer 23

Sural Nerve

Question 24

Nerve that goes behind the medial malleolus
-Gives off Lateral and Medial Plantar Nerves and a Calcaneal Branch (heel)

Answer 24

Tibial Nerve

Question 25

Nerve that runs with the Anterior Tibial Artery, which changes its name to the Dorsalis Pedis Artery when it passes the ankle joint

Answer 25

Deep Fibular Nerve

Question 26

Gives off the Medial and Intermediate Dorsal Cutaneous Nerves

Answer 26

Superficial Fibular Nerve

Question 27

Nerve that runs behind the Lateral Malleolus.
-Gives off the Lateral Dorsal Sural Cutaneous Nerve

Answer 27

Sural Nerve

Question 28

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

Answer 28

Saphenous Nerve

Question 29

Sensation to the medial portion of the foot/ankle (plantar and dorsal)

Answer 29

Saphenous Nerve

Question 30

Sensation to the area between Great toe and 2nd toe (dorsal)

Answer 30

Deep Fibular Nerve

Question 31

Sensation to almost all of the dorsum of the foot

Answer 31

Superficial Fibular Nerve

Question 32

Sensation to the medial, plantar aspect of Great Toe - 3rd toe and medial aspect of 4th toe

Answer 32

Medial Plantar Nerve

Question 33

Sensation to the lateral, planter aspect of foot and 4th toe

Answer 33

Lateral Plantar Nerve

Question 34

Sensation to the plantar surface of the heel

Answer 34

Calcaneal Branch of the Tibial Nerve

Question 35

Sensation to the lateral aspect of the foot (plantar and dorsal side)

Answer 35

Sural Nerve

Question 36

Which 5 nerves do you anesthetize with a ring block?

Answer 36

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

Question 37

How to palpate the Dorsalis Pedis Artery?

Answer 37

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.