Lower Limb Flashcards
What makes up the roof of the femoral triangle?
Fascia lata
What forms the floor of the femoral triangle?
Pectineus
Iliopsoas
Adductor longus muscles
What forms the superior border of the femoral triangle?
Inguinal ligament
Where does the inguinal ligament run?
From the anterior superior iliac spine to the pubic tubercle
What forms the lateral border of the femoral triangle?
Medial border of the sartorius
What forms the medial border of the femoral triangle?
Medial border of the adductor longus muscle
What is the role of the inguinal ligament in the femoral canal?
Acts as a flexor retinaculum - supports the contents of the femoral triangle during hip flexion
List the contents, from lateral to medial, of the femoral triangle:
Femoral nerve
Femoral Artery
Femoral Vein
Femoral canal - deep lymph nodes
What contains the femoral nerve artery and vein?
The femoral sheath (a fascial compartment)
What ligament does the femoral artery cross;
The inguinal ligament
Where does the femoral artery cross the inguinal ligament?
Midpoint between pubic symphysis and anterior superior iliac spine
What vessel lies close to the femoral triangle?
The great saphenous vein
Where does the great saphenous vein empty?
into the femoral vein within the femoral triangle
Where is the femoral canal located?
Anterior thigh, within the femoral triangle.
What comprises the medial border of the femoral canal?
The lacunar ligament
What forms the lateral border of the femoral canal?
The femoral vein
What forms the anterior border of the femoral canal?
The inguinal ligament
What forms the posterior border of the femoral canal?
Pectineal ligament
Superior ramus of pubic bone
Pectinus muscle
What is the opening of the femorla canal called
The femoral ring
What is contained in the femoral canal?
Lymphatic vessels - these drain the deep inguinal lymph nodes
Deep lymph node - lacunar node
Empty space
Loose connective tissue
What is the role of the empty space within the femoral canal?
To allow venous dilation of the femoral vein in increased venous return or increasing abdominal pressures.
Where is a femoral hernia located
Inferolateral to the pubic tubercle
What is another name for the adductor canal?
Hunter;s canal
or
Subsartorial canal
Where is the adductor canal?
Thigh - from the apex of the femoral triangle to the adductor hiatus of the adductor magnus
What is the role of the adductor canal?
It serves as a passageway between the anterior thigh and posterior leg
What forms the anteromedial border of the adductor canal?
Sartorius
What forms the lateral border of the adductor canal?
Vastus medialis
What forms the posterior border of the adductor canal?
Adductor longus
Adductgor magnus
What is the adductor hiatus?
End point of the adductor canal
A gap between the adductor and the hamstring attachments of the adductor magnus muscle
List the contents of the adductor canal:
Femoral artery
Femoral vein
Nerve to the vastus medialis
Saphenous nerve
What is the largest cutaneous branch of the femoral nerve:
The saphenous nerve
What does the femoral artery and vein become when they exit the adductor canal?
Popliteal artery and vein
When might the adductor canal be useful in surgery?
Can be used to provide anaesthetic block t the saphenous nerve - this allows for proceedures involving the distal thigh, femur, knee and lower leg to be numb.
What structures are used to locate the anatomical location of the saphenous nerve?
The femoral artery and sartorius muscle
What forms the superomedial border of the popliteal fossa?
Semimembranosus
What forms the superolateral border of the popliteal fossa?
Biceps femoris
What forms the inferomedial border of the popliteal fossa?
Medial head of the gastrocnemius
What forms the inferolateral border of the popliteal fossa?
Lateral head of the gastrocnemius and plantaris
What forms the floor of the popliteal fossa?
Posterior surface of the knee joint capsule
Popliteal muscle
Posterior femur
What two layers form the roof of the popliteal fossa?
The popliteal fascia
Skin
List the contents of the popliteal fossa from medial to laterl:
Popliteal artery
Popliteal vein
Tibial nerve
Common fibular nerve (aka common peroneal nerve) - alongside the biceps femoris tendon
What structures are the most superficial contents of the popliteal fossa?
The tibial and common femoral (peroneal) nerves
What are the tibial and common fibular (peroneal) nerves branches of?
The sciatic nerve
What muscle does the common fibular (common peroneal) nerve follow?
Biceps femoris
What vessel pierces the popliteal fascia and passes between the gastrocnemius two heads?
The small saphenous vein
What vessel does the small saphenous vein drain into?
The popliteal vein
What is the deepest structure of the popliteal fossa?
The popliteal artery.
Give two differentials for swelling in the popliteal fossa:
Baker’s cyst
Anuerysm of the popliteal artery
What is a Baker’s cyst:
Inflammation and swelling of the semimembranosus bursa
What vessel is at risk of compression in a popliteal anuerysm?
Tibial nerve
What clinical signs are suggestive of tibial nerve compression?
Absent / weakened plantar flexion
Parasthesia of the foot and posterolateral leg
List the contents of the tarsal tunnel from anterior to posterior:
Tibialis posterior tendon
Flexor digitorum longus tendon
Posterior tibial artery and vein
Tibial nerve
Flexor hallicus longus tendon
What is tarsal tunnel syndrome:
Entrapement and compression of the tibial nerve as it passes through the tarsal tunnel
What are some clinical signs of tarsal tunnel syndrome?
Altered sensation on sole of foot
Weakness / wasting of intrinsic foot muscles
What acts as the floor of the tarsal tunnel?
Medial aspect of the tibia, talus and calcaneus
What converts the tarsal tunnel into a tunnel?
The flexor retinaculum
Where is the flexor retinaculum of the tarsal tunnel located?
Spans obliquely between the medial malleolus and the medial tubercle of the calcaneus
What forms the roof of the tarsal tunnel?
The flexor retinaculum
Where does the ligamentum teres attach?
The fovea of the femoral head
What is the angulation of the femoral neck.
135 degrees
What muscles attach to the greater trochanter?
Piriformis
Gluteus minimus
Gluteus medius
What muscles attach to the lesser trochanter?
Iliopsoas
Where is the intertrochanteris line?
Ridge of bone running inferomedial, on anterior surface, betweent he two trochanters.
What attaches at the intertrochanteric line?
Iliofemoral ligament
Anterior attachement for the hip joint capsule
Where does the quadratus femoris attach?
The quadrate tubercle - a rounded tubercle on the intertrochanteric crest (posterior femur)
Define intracapsular hip fractures:
Occuring within the hip capsule
Can damage medial femoral circumflex artery leading to avascular necrosis
Define extracapsular hip fractures:
Blood supply remains in tact.
What is the name of the roughened patch of bone on the posterior femoral surface?
Linea aspera
Where does the gluteus maximus attach?
The gluteal tuberosity of the femur
Where does the adductor magnus attach?
The adductor tubercle of the distal femur
Where are the medial and lateral condyles of the femur?
The posterior aspext of the femur
Where are the medial and lateral epicondyles located?
The sides of the distal end of the femur
What attaches to the epicondyles?
Medial and lateral collateral ligaments
Where does the ACL attach?
Medial aspect of the lateral condyle
Where does the PCL attach?
Lateral aspect of the medial condyle
What is the ost common site for a femoral fracture?
The neck
Forceful contraction of which ligament can lead to an avulsion femur fracture?
Iliopsoas
What is the strongest ligament of the hip joint?
The iliofemoral ligament
Where is the quadrate tubercle located?
The intertrochanteric crest (a ridge of bone connecting the two trochanters)
Where is the proximal tibia is the main point of attachment for ligaments and menisci of the knee?
The intercondylar eminence
Where does the patellar ligament attach?
The tibial tuberosity
What binds the tibia and fibula together
The interosseus membrane
Where in the distal tibia does it bind to the fibula?
The fibular notch - lateral.
What tendon passes on a groove on the posterior tibia
The tibialis posterior
Where in the tibia most commonly is fractured?
The shaft
Fractures of the proximal tibia are called ________
Tibial plateau fractures
What classification system is used in tibial fractures?
The Schatzker classification
What movement can lead to a fractured medial malleolus?
Twisting inwards / over inversion of the tibia / ankle
Rarely occurs in isolation and the lateral malleolus is also fractured usually
What tendon passes posterior to the medial malleolus?
Tibialis posterior
What are the 3 main articulatios of the fibula?
Proximal tibiofibular joint
Distal tibiofibular joint
Ankle joint
Where on the fibula can the common fibular nerve be located?
Posterior and lateral surfaces of the proximal fibular neck
Where on the fibula is most prone to fractures?
The lateral malleolus
What does the common fibular nerve branch into?
The superficial and deep fibular nerves
Where is the patella located?
Within the patellofemoral groove of the femur
What type of bone is the patella
A sesamoid bone
What are the two main functions of the patella?
Extension of the leg - enhances leverage of quadriceps tendon
Protection
What direction do most patella fractures pccur?
Lateral
Whayt is a common mechanism of injury for a patellar dislocation?
Sudden or forceful twisting of the knee
Sudden contraction of what ligament may lead to a patellar fracture?
Quadriceps
The base of the patella connects to the __________ tendon
Quadraceps
The apex of the patella connects to the __________ tendon
Patellar
Where does the fascia lata begin proximally?
Around the iliac crest and inguinal ligament
Where does the fascia lata end?
The bony prominences of the tibia
What does the intermuscular septa originate from and create?
The fascia lata (at its deepest aspect)
The anteior, medial and lateral thigh compartments
Where is the saphenous opening
The fascia lata, inferior to the ingional ligament
What is the role of the saphenous opening?
Sevrves as entry point for efferent lymph and great saphenous vein to drain into the superficial inguinal lymph nodes and femoral vein respectivelt
What is the tensor fascia lata?
A gluteal muscle
What functions does the tensor fascia lata perform?
Hip flexion
Hip internal rotation
Hip abduction
What innervates the tensor fascia lata?
The superior gluteal nerve
What is the iliotibial tract?
A longitudinal thickening of the fascia lata
Where is the iliotibial tract located?
Lateral thigh
Extends from iliac tubercle to the lateral tibial condyle
What are the 3 main function of the iliotibial tract?
Movement (extends, abduct and lateral rotation of hip)
Compartmentalistion
Muscular sheath around tensor fascia lata
Where does the tensor fascia lata attach posteriorly?
The saccrum and coccyx
Where does the fascia lata connect laterally?
Iliac crest
Where does the tensor fascia lata attach anteriorly?
Inguinal ligament
Superior pubic rami
Where does the tensor fascia lata attach medially?
Inferior ischiopubic rami
Ischial tuberosity
Sacrotuberous ligament
What inserts into the iliotibial tract?
Tendon from the gluteus maximus
Tensor fascia lata tendon
What is the continuation f=of the fascia lata?
The crural fascia
What muscles are collectively known as the superficial abductors and extenders?
Gluteus maximus
Gluteus medius
Gluteus minimus
Tensor fascia lata
What group of muscles (aka deep lateral rotators) are responsible for lateral femur rotation
Quadratus femoris
Piriformis
Gemellus superior and inferior
Obturator internus
What vessels are branches of the internal iliac artery?
Superior and inferior gluteal arteries
What innervates the gluteus maximus?
The inferior gluteal nerve
What does the superior gluteal nerve innervate?
Gluteus medius
Gluteus minimis
Tensor fascia lata
What clinical sign is suggestive of superior gluteal nerve injury?
Trendelenburg Sign
What muscle is used to locate the sciatic nerve and lies immediately inferior to the superior gluteal nerve?
Piriformis
What muscle travels through the greater sciatic foramen>
Piriformis
What muscle tendon runs between the superior and inferior gemelli?
The obturator internus tendon
What does the nerve to the obturator internus innervate?
The obturator internus
The superior gemelli
What muscles are responsible for medial rotation of the hip?
Gluteus medius, minimus and tensor fascia lata.
Where are the deep gluteal muscles located?
Underneath the gluteus minimus
What deep gluteal muscle is the most superior?
The piriformis
What nerve innervates the piriformis?
The nerve to the piriformis
What muscle forms the lateral walls of the pelvic cavity?
Obturator internus
What deep muscle travels through the lesser sciatic foramen?
Obturator internus
What does the nerve to the quadratus femoris innervate?
The quadratus femoris
The inferior gemelli
What is the most inferior deep gluteal muscle?
The quadratus femoris
What nerve root does the femoral nerve originate from?
L2 - L4
What nerve innervated the anterior thigh compartment?
Femoral
What is the arterial supply to the anterior thigh compartment?
The femoral artery
List the muscles of the anterior compartment of the thigh?
- Iliopsoas –> psoas major and iliacus
- Quadriceps: Rectus femoris Vastus medialis Vastus intermedius, Vastus lateralis
- Sartorius
- Pectineus
Which muscle of the quadriceps is the only muscle to cross both the hip and knee joint, and what is its movement role?
Rectus femoris
Extends knee and flexes hip
What anteior thigh muscle does NOT perform knee extension
The iliopsoas
What is the movement of the iliopsoas
Flexion of the thigh at the hip joint
What is the longest muscle in the body?
The sartorius
What movemetns does the sartorius perform?
Hip flexion
Hip abduction
Hip lateral rotation
Knee flexion
What are the attachements of the sartorius?
Anterior superior iliac spine
Superior medial tibial surface
What muscle is tested when suspicious of femoral nerve palsy?
Quadriceps femoris
What innervates the major psoas muscle?
Anterior rami of L1-L3
What muscle is supplied by both the femoral nerve and the nerve to the obturator externus
The pectineus muscle
What muscle lies directly on top of the iliac fossa?
The iliacus
What is the collective term for the miscles of the medial thigh compartment?
The hip adductorsq
List the miscles of the medial thigh compartment:
Gracillis
Obturator externus
Adductor Brevis
Adductor longus
Adductor magnus
What are the two parts of the adductor magnus
An adductor component and hamstring
What are the movements of the two parts of the adductor magnus?
Adductor: Adduction and flexion of thigh
Hamstring: Adduction and extension of thigh
What are the nerve supplies to the adductor magnus?
Adductor: obturator nerve
Hamstring: Tibial component of sciatic nerve
What are the nerve roots for the obturator nerve?
L2-L4
What are the nerve roots for the sciatic nerve?
L2-S3
What nerve is the main innervator of the medial compartment of the thigh?
The obturator nerve
What is the main arterial supply to the medial compartment of the thigh?
The obturator artery
What muscle separates the antior and posterior branches of the obturator nerve?
The adductor brevis
What is the smallest muscle of the medial thigh compartment?
The obturator externus
What is the most superficial muscle of the medial thigh compartment?
The gracilis
What movements does the obturator externus contribute to?
Adduction of hip
lateral rotation of the thigh
What movemetns does the gracilis muscle contribute to?
Adduction of the thigh at the hip
Flexion of the leg at the knee
Stain of the adductor muscles is known as what?
Groin strain
What is the collective name for muscles of the posterior thigh compartment?
Hamstrings
What nerve innervates the posterior thigh compartment?
The sciatic nerve
List the muscles of the posterior thigh compartment:
Biceps femoris
Semitendinosis
Semimembranosus
What innervates the biceps femoris?
Long head: tibial part of the sciatic nerve
Short head: common fibular branch of the sciatic nerve
List the movements aided by the biceps femoris:
Knee flexion
Thigh extension
Lateral rotation of the knee and hip
What bone in the lower leg does the biceps femoris insert onto?
The fibula
What muscles of the posterior thigh contribute to medial rotation of the thigh at the hip and knee joints?
Semimembranosus
Semitendinosus
Where do all muscles of the posterior thigh originate from?
The ischail tuberosity of the pelvis
What is the collection action of the hamstring muscles?
Knee flexion
What is the mechanism of action of the anterior compartment of the (lower) leg?
Dosiflexion and inversion of the foot
What nerve supplies the anterior compartment of the lower leg?
Deep fibular nerve
What are the nerve roots for the deep fibular (peroneal) nerve?
L4 - S1
What is the arterial supply to the anterior compartment of the lower limb?
Anterior tibial artery
List the muscles of the anterior lower limb?
Tibialis anterior
Extensor digitorum longus
Extensor hallicus longus
Fibularis tertius
What is the main movement of the extensor digitorum longus?
Extension of the lateral four toes
Dorsiflexion of the foot
What is the main movement of the extensor hallicus longus?
Extension of the great toe
Dorsilflexion of the foot
What is the main movements of the fibularis tertius?
Eversion and dorsiflexion of the foot
What clinical sign is suggestive of damage to either the common or deep fibular nerve / anterior muscles of the lower limb?
Foot drop - loss of dorsiflexion
What muscle both produces dorsiflexion and inversion of the foot?
Tibialis anterior
Where in the foot does the anterior tibiliar attach?
Base of the 1st metatarsal
List the muscles of the lateral lower limb compartment:
Fibularis longus
Fibularis Brevis
What is the main function of the lateral lower leg compartment?
Eversion of the foot
What is the nerve that innervates the lateral lower leg?
THe superficial fibular nerve
Which muscle is larger and more superficial in the lateral leg compartment?
Fibularis longus
Where does the fibularis longus insert in the foot?
Medial cuneiform and base of metatarsal 1
What is the movements associated with the fibularis longus?
Eversion and plantar flexion of the foot
(Note: also supports lateral and transverse foot arch)
What muscle passes posteriorly to the lateral malleolus?
The fibularis longus
What movements are performed by the fibularis brevis?
Eversion of the foot
Where does the fibularis brevis insert in the foot?
Tubercle of the 5th metatarsal
What is foot eversion?
Turning the sole of the foot outwards
List the muscles of the superficial, posterior compartment of the lower leg from most superficial to least:
Gastrocnemius
Soleus
Plantaris
What nerve innervates the superficial posterior muscles of the lower leg?
The tibial nerve
Where do the 3 muscles of the superficial posterior leg insert in the foot?
The calcaneus
List the muscles of the deep posterior leg compartment:
Popliteus
Flexor digitorum longus
Flexus hallicus longus
Tibialis posterior
Which muscle of the deep posterior leg compartment only acts on the knee?
The popliteus
What nerve innervates the deep compartment of the posterior leg?
The tibial nerve
What muscles form the calcaneal tendon?
The soleus, the gastrocnemius (and the plantaris which can be absent in 10% of people)
What muscles are associated with both plantarflexion of the foot (at the ankle joint) and flexion at the knee joint?
Gastrocnemius
Plantaris
What is the movement associated with the soleus?
Plantarflexion of the foot (at the ankle joint)
Which muscle of the posterior leg compartment has two heads?
The gastrocnemius
What is the movement associated with the flexor digitorum longus?
Flexion of the lateral 4 toes.
What movements are associated with the flexor hallicus longus?
Flexion of the great toe.
What is the movement of the tibialis posterior?
Inversion and plantarflexion of the foot.
(NOTE: also contributes to the medial arch of the foot)
How many tarsal bones are there?
7
HOw many metatarsals are there?
5
What bones make up the hindfoot?
Talus and calcaneus
What bones make up the midfoot?
Navicular, cuboid and cuneiforms
What bones make up the forefoot?
The metatarsals and the phalanges
What tarsal is repsonsible for transmitted the entire weight of the body to the foot?
the Talus
Name the three articulations of the Talus:
Superiorly: ankle joint - tibia and fibula
Inferiorly: subtalar joint - calcaneus
Anteriorly: talonavicular joint - navicular
Which bone is more commonly known as the heel bone
The calcaneus
How many muscles attach onto the talus?
None
Which tarsal is at high risk of avascular necrosis and why?
Talus
Has no muscles inserting onto it - relies solely of vascular supply of fascial structures
What is the largest tarsal bone?
Calcaneus
What are the two articulations of the calcaneus?
superiorly: talus
Anteriorly - cuboid
What tendon attaches onto the calcaneus and where does it attach?
Calcaneal tuberosity - achilles tendon
What tendon attaches to the navicular and on what surface?
The tibialis posterior
Plantar surface
List all the articulations of the navicular?
Posteriorly - talus
Laterally - cuboid
Anteriorly - three cuneiform bones
Which tarsal bone lies most lateral in the distal tarsal group?
Cuboid
What tendon attaches to the plantar surface of the cuboid
fibularis longus
List the attachements to the medial cuneiform:
Tibialis anterior
(Partial) Tibialis posterior
Fibularis longus
List the attachements to the lateral cuneifrom
Flexor Hallicus brevis
Where does a fracture most commonly occur in the talus?
Neck region
Describe the mechanism most commonly associated with talar fractures:
High energy injury
Foot is dorsiflexed - neck of talus pushes against tibia
Blood supply can be disturbed causing avascular necrosis
What area of the talus can be fractured by jumping from height:
Talar body fracture
IF a patient has a calcaneus fracture, what other area of the body should you be assessing for damage?
Lumbar spine and lower limb
What is the main mechanism of injury that causes calcaneus fractures:
Axial loading (eg falling from great height)
How are the metatarsals numnbered?
Medial to lateral
Describe the shape / structure of the metatarsal
Convex dorsally
Consist of a head neck shaft and base
List three ways in which the metatarsal bones can be fractured:
- Direct blow to foot (most common)
- Stress fracture - common in athletes, most commonly fractures neck of 2nd and 3rd metatarsals
- Excessive inversion of foot (avulsion of fibularis brevis - tearing off 5th metatarsal)
Where is the common fibular nerve found on the fibula?
Posterior and lateral surface of the fibular neck
how many surfaces are there on the fibula?
Three - anterior, lateral and posterior
What is the lateral surface on the distal end of the fibula known as?
The lateral malleolus
What movement causes fracture of the lateral malleolus of fibula?
Forced external rotation of ankle (spiral fracture)
Foot eversion (transverse fracture)
What forms the tibial plateu?
The medial and lateral condyles of the tibia
Where is the intercondylar eminence located?
Between the condyles, projecting upwards on either side - forming medial and lateral intercondylar tubercles.
What is the main site of attachment for ligaments and menisci of knee joint?
Intercondylar eminence - the intercondylar tubercles
What surface does the intercondylar tubercles articulate with?
Intercondylar fossa of the femur
What shape is the tibia shaft
Prism
Where is the tibial tuberosity?
Proximal anterior shaft of tibia
What ligament attaches to the tibial tuberosity?
Patella ligament
What landmark is noted on the posterior surface of proximal tibia?
Soleal line
What is the main role of the soleal line?
Origin of the soleus muscle
Note: Extends inferomedially and blends with the medial border of the tibia
What attaches to the lateral border of the tibia?
The interosseus membrane which binds the tibia and fibula
The groove on the posterior distal tibia allows for what tendon to pass?
Tibialis posterior
Where is the most common place for tibial fractiure?
The shaft
What mechanism of injury leads to fracture of the medial malleolus?
Over inversion of the ankle (twisting inwards)
Medial malleolus usually fractures in isolation. True or false
False
Usually the lateral malleolus will also fracture
What classification system is used for tibial fractures (proximal fractures)
Schatzker classification
What muscle originates at the greater trochanter?
Vasa lateralis (one of the quadriceps)
What muscles attach to the greater trochanter?
Gluteus minimis, gluteus medius and piriformis.
What movement can result in avulsion fracture of the greater trochanter?
Forceful contraction of the gluteus medius
Where is the lesser trochanter of the femur located/
Posteromedial side of the femur - inferior to the neck-shaft junction
What muscle attaches to the lesser trochanter?
The iliopsoas
Where is the intertrochanteric line of the femur located?
The inferomedial direction on anterior surface of femur (between two trochanters)
What ligament attaches to the intertrochanteric line?
Iliofemoral ligament
Also for anterior attachment of the capsule of the hip joint
What is the intertrochanteric crest?
The ridge between the two trochanters on the posterior surface
What name is given to the tubercle on superior half of the intertrochanteric crest?
The quadrate tubercle
What attaches to the quadrate tubercle?
the quadratus femoris
Where is the linea aspera located on the femur?
Proximal surface of the shaft
What attaches to the gluteal tuberosity?
Gluteus maximus
What forms the =gluteal tuberosity?
Proximal medial border of the linea aspera forms the pectineal line - the lateral border of the pectineal line becomes the gluteal tuberosity.
What forms the popliteal fossa?
Widening of the distal linea aspera
What attaches to the medial supracondylar of the femur?
The adductor magnus
What tubercle is found of the medial supracondylar line of the distal femur?
The adductor tubercle
Which type of femoral neck fracture can lead to avascular necrosis - intra or extra capsular?
intracapsular
Can lead to damage of the medial femoral circumflex artery
What articulates with the medial and lateral condyles?
Posterior and inferior surfaces - tibia and menisci of the knee
Anterior surface - patella
Where do the medial and lateral collateral ligaments originate from?
Medial and lateral epicondyles
Where is the intercondylar fracture located?
Posterior distal femur
Where does the ACL attach?
Medial aspect of the lateral condyle - within the intercondylar fossa
Where does the posterior cruciate ligament attach in the femur?
Lateral aspect of the medial condyle within the intercondylar fossa
What type of bone is the patella classified as?
Sesamoid
How does the apex of the patella connect to the tibial tuberosity?
Patellar ligament
What surface of patella articulates with the femur?
Posterior - with articulating facets
what are the two main functions of the patella?
Extension of leg
Protection of anterior knee
What direction are most patellar dislocations?
Lateral
How does patellar dislocation occur?
High force impact or sudden twistin of the knee - eg hockey / football / rugby
Contraction of what muscle can result in a patellar fracture?
Quadriceps
What ligament attaches to the base of the patella?
Quadriceps
What ligament attaches to the apex of the patella?
Patellar ligament
What dermatome corresponds with the inguinal region and superior aspect of the medial thight?
L1
Where would L2 dermatome correspond with?
Middle and lateral anterior thigh
Which dermatome covers medial condyle of the femur and runs inferomedial across the thgih?
L3
L4 dermatome covers what area?
Medial malleolus
What dermatome covers the dorsal aspect of the foot until the third metatarsopharyngeal joint?
L5
The lateral calcaneus is covered by the ______ dermatome
S1
Which dermatome covers the popliteal fossa?
S2
Which dermatome covers the horizontal gluteal crease?
S3
The perianal region is supplied by the ___ and ____ dermatomes
S4 and S5
Cutaneous innervation of the space between 1st and 2nd tones on the dorsal foot is by?
The deep fibular nerve
The superficial fibular nerve provides cutaneous innervation to __________?
Dorsum of foot excluding the space between 1st -2nd toes.
Anterolateral aspect of the leg
The medial and lateral plantar nerves are branches of what nerve?
Tibial nerve
Where does the medial plantar nerve supply?
Medial 2/3rds of the sole (plantar surface) of the foot
Where does the lateral plantar nerve supply?
The lateral 1/3rd of the plantar / sole of the foot
The saphenous nerve is a branch of the ___________ nerve
Femoral
Where does the saphenous nerve provide cutaneous innervation?
Medial margin of the hindfoot and midfoot
Anteromedial aspect of the leg
What nerves form the sural nerve?
The tibial and common fibular nerves
Where does the sural nerve provide cutaneous innveration?
Lateral margin of hindfoot and midfoot
Posterolateral aspect of the leg
Where does the medial calcaneal nerve come from?
The tibial nerve
Where does the medial calcaneal nerve provide cutaneous innervation?
The medial aspect of the heel
What vessel lies directly anterior to the medial malleolus?
The great saphenous vein
What vessel is found posterior to the lateral malleolus?
The short saphenous vein
The popliteal artery continues into the __________ artery before dividing into the _______ and ______.
Tibia-peroneal trunk artery
Peroneal and posterior tibial arteries
What vessel is the lateral plantar artery a branch of?
the posterior tibial artery
The gastrocnemius gets its motor supply from the ___________ nerve.
Tibial nerve
