Lower limb Flashcards
What are the superficial gluteal muscles
Gluteus maximus
Gluteus medius
Gluteus minimus
Tensor fascia lata
Function of gluteus Maximus
Main extensor of the hip
Function of gluteus medius
Abduct the thigh
Medially rotate the thigh at hip
Function of gluteus minimus
Abduct the thigh
Medially rotate the thigh
Name A-E
A- Gluteus medius
B- Iliac crest
C- Gluteus maximus
D- Gluteus minimus
E- Obturator internus
Innervation of gluteus Maximus
Inferior gluteal nerve L5-S2
Innervation of gluteus medius
Superior gluteal nerve L4-S1
Innervation of gluteus minimus
Superior gluteal nerve L4-S1
What are the deep gluteal muscles
Piriformis
Superior and inferior gemelli
Obturator internus
Quadratus femoris
Function of piriformis
Abduction of the thigh
Lateral rotation of the thigh
Function of piriformis
Abduction of the thigh
Lateral rotation of the thigh
Function of superior and inferior gemelli
Abduction of the thigh
Lateral rotation of the thigh
Function of obturator internus
Abduction of the thigh
lateral rotation of the thigh
Function of quadratus femoris
Lateral rotation of the thigh
Innervation of piriformis muscle
Anterior rami of S1 S2 (nerve to piriformis
Innervation of superior and inferior gemelli
Superior - nerve to obturator internus L5-S2
Inferior - nerve to quadratus femoris L4-S1
Innervation of quadratus femoris
Nerve to quadratus femoris L4-S1
Innervation of obturator internus
Nerve to obturator internus L5-S2
Name A-K
A- gluteus maximus
B- Piriformis
C- Superior gemelli
D- Obturator internus
E- Inferior gemelli
F- Ischial tuberosity
G- gluteus medius
H- Gluteus minimus
I- Tensor fascia lata
J- quadratus femoris
K- iliotibial band
Where do the gluteal muscles attach to
Greater trochanter of femur
How do nerves enter and exit the pelvis and perineum
Through greater and lesser sciatic foramen
What structures form the greater and lesser sciatic foramen
Sacrotuberous ligament
Sacrospinous ligament
Name A-E
A- greater sciatic foramen
B- sacrospinous ligament
C- Lesser sciatic foramen
D- sacrotuberous ligament
E- obturator foramen
Greater sciatic foramen allows
Nerves to exit/enter the pelvis
Lesser sciatic foramen allows
Nerves to exit/enter the perineum
The greater sciatic foramen is further divided into 2 parts by
Piriformis muscle - divides into suprapiriform and infrapiriform parts
What nerves passes through the greater sciatic foramen
Sciatic nerve L4-S3
Pudendal nerve S2-S4
Posterior cutaneous nerve of thigh S1-S3
Inferior gluteal nerve
Nerve to obturator internus
Nerve to quadratus femoris
Nerve roots of pudendal nerve
S2-S4
Innervation of pudendal nerve
motor:
- external urethral sphincter
- external anal sphincter
Sensory:
- perineum
- external genitalia
- external skin around anus
Nerve roots of posterior cutaneous nerve of thigh
S1-S3
Posterior cutaneous nerve of thigh innervation
Sensory - posterior thigh
Describe the anatomical course of sciatic nerve
Enters the thigh via greater sciatic foramen
Inferior to piriformis
Splits into tibial and common fibular nerves at distal 1/3 of thigh
What are the muscles in the anterior compartment of thigh
Sartorius
Pectineus
Iliopsoas
Quadriceps femoris - rectus femoris, vastus lateralis, vastus medialis, vastus intermedius
Where does psoas major originate from
T12-L4
Where does iliopsoas muscle attach to
Lesser trochanter of femur
Where does quadriceps femoris origin from
ASIS
Where does quadriceps femoris attach to
Quadricep tendon -> patella -> patellar tendon -> tibial tuberosity
Name A-J
A- Iliacus
B- tensor fascia lata
C- Rectus femoris
D- Vastus lateralis
E- Psoas major
F- Pectineus
G- Sartorius
H- Vastus medialis
I- Quadricep tendon
J- Patellar tendon
Function of sartorius
Flexion of thigh
Lateral rotation of thigh
Function of iliopsoas
Flexion of thigh
Function of pectineus
Flexion of thigh
Function of quadriceps femoris
Extension of leg
Innervation of the iliopsoas
Iliacus - femoral nerve L2-L4
Psoas major - anterior rami of L1-L3
Innervation of quadriceps femoris
Femoral nerve L2-L4
Innervation of sartorius
Femoral nerve L2-L4
Innervation of pectineus
Femoral nerve L2-L4
What structures form the extensor mechanism of leg
Quadriceps femoris muscle
Quadricep tendon
Patella
Patellar tendon
What are the borders of femoral triangle
Superior- inguinal ligament
Medially- Adductor longus
Laterally- Sartorius
Floor- iliopsoas and pectineus
Roof- deep fascia
Name A-E
A- Inguinal ligament
B- Sartorius
C- Adductor longus
D- Iliopsoas
E- Pectineus
What are the contents of femoral triangle, from lateral to medial
NAVL (nerve -> artery -> vein -> lymph)
Femoral nerve
Femoral artery
Femoral vein
Lymphatics (in femoral canal)
What structures are surrounded by femoral sheath
Femoral artery and vein
Name A-D
A- femoral nerve
B- femoral sheath
C- femoral canal
D- great saphenous vein
What is the nerve root of femoral nerve
L2-L4
Function of femoral nerve
Motor- anterior thigh
Sensory - anterior thigh and medial leg (saphenous nerve is a branch of femoral)
Describe the sensory innervation of the anterior thigh
Anterior cutaneous nerve (branch of femoral)
Lateral cutaneous nerve L2-L3
Obturator nerve L2-L4
Ilioinguinal nerve
Genitofemoral nerve
What are the muscles in the posterior compartment of thigh
Semitendinosus
Semimembranosus
Biceps femoris - long and short head
Name A-D
A- semitendinosus
B- semimembranosus
C- Biceps femoris long head
D- Biceps femoris short head
Function of semitendinosus
Flexion of leg
Extension of thigh
Function of semimembranosus
Flexion of leg
Extension of thigh
Function of biceps femoris
Flexion of leg
Extension of thigh
All muscles of the posterior thigh origin from
Ischial tuberosity except short head of biceps femoris
Where does the short head of biceps femoris origin from
Linea aspera of femur
Attachment of biceps femoris
Lateral side of fibula
Innervation of semitendinosus
Tibial nerve L5-S2
Innervation of semimembranosus
Tibial nerve L5-S2
Innervation of biceps femoris
Long head - tibial nerve L5-S2
Short head - Common fibular nerve
What are the borders of popliteal fossa
superomedial - semimembranosus
superolateral - biceps femoris
Inferomedial - medial head of gastrocnemius
Inferolateral - lateral head of gastrocnemius
Name A-I
A- tibial nerve
B- semitendinosus
C- popliteal artery
D- popliteal lymph nodes
E- semimembranosus
F- popliteal vein
G- medial head of gastrocnemius
H- common fibular nerve
I- lateral head of gastrocnemius
Contents of popliteal fossa
Lots of fat
Popliteal artery, vein
Tibial nerve
Common fibular nerve
Popliteal lymph nodes
What can happen to the popliteal fossa in knee OA
Baker’s cyst - build up of synovial fluid at popliteal fossa
What are the muscles in the medial thigh compartment
Adductor longus
Adductor brevis
Adductor Magnus
Obturator externus
Gracilis
Name A-E
A- pectineus
B- Adductor brevis
C- Adductor longus
D- Adductor Magnus
E- Adductor brevis
Name A
Obturator externs
What are the 2 components of adductor Magnus
Hamstring part (ischiocondylar part)
Adductor part (pubofemoral part)
Function of adductor brevis
Adduction of thigh
Function of adductor longus
Adduction of thigh
Function of adductor magnus
Adduction of thigh
Adductor part - flexion of thigh
Ischiocondylar part - extension of thigh
Function of obturator externus
Adduction of thigh
Lateral rotation of thigh
Function of gracilis
Adduction of thigh
Flexion of leg
Innervation of muscles in the medial compartment of thigh
Obturator nerve L2-L4
Except hamstring part of adductor Magnus - tibial nerve
Name A-J
A- Lateral cutaneous nerve
B- Obturator nerve
C- Femoral nerve
D- Lateral cutaneous nerve of calf (branch of common fibular)
E- Saphenous nerve
F- Superficial fibular nerve
G- Sural nerve
H- Deep fibular nerve
I- Posterior cutaneous nerve
J- Medial calcaneal branches of tibial nerve
What is the main blood supply of the lower limb
Femoral artery
The femoral artery is a continuation of
External iliac artery
At which point does external iliac artery become the femoral artery
Once it enters the inguinal ligament into the femoral triangle
The femoral artery branches into ______ at _______
The femoral artery branches into profunda femoris (deep femoral artery) at the femoral triangle
What are the 3 main branches of deep femoral artery
Medial circumflex artery
Lateral circumflex artery
Perforating arteries
What structure do medial and lateral circumflex arteries supply
Femoral head
medial circumflex is the main supply
What structures do the perforating arteries supply
Medial and posterior thigh by perforating the adductor Magnus
Where can the femoral pulse be palpated
at the femoral triangle, 2-3 cm inferior to midpoint of inguinal ligament
What can the femoral pulse be used for
To locate the femoral vein for cannulation
To locate the femoral nerve for nerve block procedures
What can the femoral artery be used for
As an access route for angiograms / valve replacements / coronary artery stenting
The popliteal artery is a continuation of
Femoral artery
Where is the popliteal artery located at
Popliteal fossa
What are the branches of popliteal artery
Anterior tibial
Posterior tibial
Fibular
Name A-G
A- external iliac artery
B- Inguinal ligament
C- Femoral artery
D- Popliteal artery
E- Anterior tibial artery
F- posterior tibial artery
G- fibular artery
Describe the course of anterior tibial artery
Pierces through the interosseous membrane to supply the anterior compartment of leg
What does the posterior tibial artery supply
Posterior compartment of leg
and the plantar surface of feet via its branches
What does the fibular artery supply
Lateral compartment of leg
Describe the course of posterior tibial artery
Supplies the posterior compartment of leg
Then exits the posterior compartment of leg to enter the plantar surface of foot by wrapping around the medial malleolus and through the flexor retinaculum of foot
Posterior tibial artery runs along with
Tibial nerve
Name A-I
A- popliteal artery
B- Tibial peroneal trunk
C- Posterior tibial artery
D- Tibial nerve
E- Anterior tibial artery
F- Fibular artery
G- Deep fibular nerve
H- Anterior tibial artery
I- Dorsalis pedis artery
What are the arteries supplying the foot
Dorsalis pedis artery
Medial and lateral plantar arteries
Metatarsal arteries
Digital arteries
Dorsalis pedis artery if a continuation of
Anterior tibial artery
The medial and lateral plantar arteries are continuations of
Posterior tibial artery
What is the branch of dorsals pedis artery
Arcutate artery which then branches into metatarsal arteries
What does the medial and lateral plantar arteries form
Deep plantar arch which branches into metatarsal arteries
What do the metatarsal arteries branch into
Digital arteries - end arteries
What is contraindicated in tissues supplied by end arteries such as digital arterie s
Adrenaline containing local anaesthetic - because it can cause vasoconstriction hence necrosis
Name A-I
A- anterior tibial artery
B- dorsalis pedis artery
C- Arcutate artery
D- metatarsal arteries
E- digital arteries
F- Deep plantar arch
G- Lateral plantar artery
H- Medial plantar artery
I- Posterior tibial artery
What is the main deep venous drainage of the lower limb
Femoral vein
Where is the deep venous drainage of lower limb located at
beneath deep fascia
Describe the course of deep venous drainage
From anterior and posterior tibial veins and fibular vein -> popliteal vein -> femoral vein -> external iliac vein
What is the main superficial venous drainage of lower limb
Saphenous vein
What veins drain the gluteal region
Inferior and superior gluteal veins drain into internal iliac vein
What is the main venous structure of the foot
Dorsal venous arch - drains into superficial veins
What veins drain into the anterior tibial vein
Some veins from the dorsal venous arch penetrate deep into leg
What veins drain into the posterior tibial and fibular veins
Medial and lateral plantar veins
Name A-L
A- Femoral circumflex vein
B- Femoral vein
C- Popliteal vein
D- Anterior tibial vein
E- Posterior tibial vein
F- Fibular vein
G- Dorsal venous arch
H- Lateral plantar vein
I- Medial plantar vein
J- Plantar venous arch
K- External iliac vein
L- Deep femoral vein
What are the main superficial veins of the lower limb
Small saphenous vein and Great saphenous vein
Describe the anatomical course of great saphenous vein
- Arises from medial aspect of the dorsal venous arch of the foot
- Ascends up the medial side of the leg
- Pierces the deep fascia of the thigh in the region of the femoral triangle
- drains into femoral vein in the anterior proximal thigh
Describe the anatomical course of small saphenous vein
- Arises from the lateral aspect of the dorsal venous arch of the foot
- Travels up the posterior midline of the leg with sural nerve
- Drains deep within the popliteal fossa into the popliteal vein