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MRCS A > Lower Limb > Flashcards

Lower Limb Flashcards

1
Q

What is the path of the small saphenous vein?

A

Passes on the lateral side of dorsum of foot, then passes below + behind lateral malleolus.

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2
Q

What is the path of great saphenous vein?

A

Passes on medial side of dorsum of foot, and in front of medial malleolus

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3
Q

What accompanies the small saphenous vein?

A

Sural nerve

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4
Q

What accompanies the great saphenous vein?

A

Saphenous nerve

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5
Q

What is the iliotibial tract?

A

Thickened lateral part of deep fascia, between iliac crest + lateral part of tibial tuberosity

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6
Q

What muscles are attached to the iliotibial tract?

A

Tensor fascia lata
Gluteus maximus muscle

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7
Q

What is the saphenous opening?

A

Found in deep fascia
Small opening
4cm below + lateral to pubic tubercle

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8
Q

What four muscles make up the gluteal region?

A
  1. Gluteus Maximus
  2. Gluteus medius
  3. Gluteus minimus
  4. Tensor fascia lata
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9
Q

What is the nerve supply to the gluteal region muscles?

A

Superior gluteal nerve
Except for the gluteus maximus which is supplied by the inferior gluteal nerve

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10
Q

What is the action of the gluteal region muscles?

A

Medial rotation
Except the gluteus maximums which does lateral rotation

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11
Q

What are the abductors of the hip?

A

Gluteus medius + gluteus minimus

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12
Q

What is the normal action of the abductors of the hip?

A

Prevent the tilting of the pelvis to the unsupported side

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13
Q

What is the cause of Trendelenburg gait?

A

Paralysis of gluteus medius/minimus muscle or injury to superior gluteal nerve

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14
Q

What is Trendelenburg sign?

A

Trunk is flexed from side to side in each step

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15
Q

What are the four small lateral rotator muscles of the hip joint?

A

Piriformis muscle
Obturator internus
Gemelli
Quadratus Femoris

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16
Q

What muscles are attached to the greater tuberosity?

A

POGQ
Abductors (gluteus medius/minimus)
Lateral Rotators (piriformis, obturator, gemelli, quadratus)

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17
Q

What structures pass through the greater sciatic foramen?

A

Piriformis
Structures above piriformis - superior gluteal vessels + superior gluteal nerve
Structures below piriformis - infer

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18
Q

What structures pass through both sciatic foramen?

A

Nerve to obturator internus muscle
Internal pudendal vessels
Pudendal nerve

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19
Q

What muscles make up the anterior chamber of thigh?

A

Sartorius
Psoas Major
Iliacus
Quadriceps

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20
Q

What nerve supplies the muscles of the anterior thigh?

A

Femoral nerve

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21
Q

What is the origin of the psoas major?

A

Transverse processes of T12 + all lumbar vertebrae

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22
Q

What is the insertion of the iliopsoas muscle?

A

Lesser trochanter of the femur

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23
Q

What are the four heads of quadriceps?

A

Vastus medialis
Vastus Lateralis
Vastus intermedius
Rectus femoris

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24
Q

What is the insertion of the quadriceps?

A

Forms a common tendon
Inserted into upper border of patella, through ligamentum patellae into tibial tuberosity

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25
Q

What are the boundaries of the femoral triangle?

A

Roof: skin, superficial/deep fascia
Medial: adductor longus
Lateral: sartorius muscle
Base: inguinal ligament
Apex: overlap of sartorius on adductor longus
Floor: APPI
Adductor longus, Pectineus, Psoas major, Iliacus

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26
Q

What are the contents of the femoral triangle?

A

Nerves:
genitofemoral nerve, lateral cutaneous branch of thigh, femoral nerve + branches

Blood vessels:
femoral artery, vein

Lymph node:
deep inguinal lymph nodes

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27
Q

What are the boundaries of the femoral sheath?

A

Anterior: fascia transveralis
Posterior: fascia iliaca
Medial + lateral: fusion of 2 fascia

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28
Q

What are compartments of the femoral sheath?

A

3 compartments
Lateral = femoral artery + femoral branch of genitofemoral nerve
Middle = femoral vein
Medial = femoral canal (fat + LN)

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29
Q

What are the boundaries of femoral canal?

A

Anterior: fascia transversalis
Posterior: fascia iliaca
Lateral: medial septum of sheath
Medial: fusion of anterior/posterior fascia
Apex: fusion of wall
Base: femoral ring

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30
Q

What are the boundaries of the femoral ring?

A

Anterior: inguinal ligament
Posterior: pectineal line + ligament
Medial: lacunar ligament
Lateral: femoral vein

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31
Q

What is the importance of the femoral canal?

A

Allows expansion of femoral vein in increased venous return
Can result in femoral hernia

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32
Q

What is the beginning of the femoral artery?

A

behind mid-inguinal point

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33
Q

What is the end of femoral artery?

A

lower end of adductor canal and as the popliteal artery

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34
Q

What is the clinical importance of the deep external pudendal artery?

A

Passes near the saphenous opening

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35
Q

What are the branches of the profunda fermoris artery?

A

Lateral and medial circumflex artery

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36
Q

What artery supplies the head of the femur?

A

Lateral and medial circumflex artery

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37
Q

What is the origin of the femoral nerve?

A

lumbar plexus

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38
Q

What are the roots of the femoral nerve?

A

posterior divisons of ventral rami of L2/3/4 spinal nerves

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39
Q

What does the femoral nerve supply?

A

Anterior compartment of thigh

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40
Q

Where does the saphenous nerve supply?

A

Branch of femoral nerve and supplies leg + foot

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41
Q

What are the boundaries of the popliteal fossa?

A

Upper medial: semimembranous + semitendonsus
Upper lateral: biceps femoris
Lower lateral: lateral head of gastrocnemius + plantaris
Lower medial: medial head of gastrocnemius

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42
Q

What are the contents of the popliteal fossa?

A

popliteal artery (deepest)
popliteal vein
common peroneal nerve
tibial nerve (superficial)

43
Q

What are the muscles of the anterior compartment of leg?

A

Tibialis anterior
Extensor digitorum longus
Extensor hallucis longus
Peroneus tertius

44
Q

What is the nerve supply of the anterior compartment of leg?

A

Deep peroneal nerve

45
Q

What is the action of the muscles of anterior compartment of leg?

A

Dorsiflexion of foot

46
Q

What is action of tibialis anterior?

A

Dorsiflexion of foot
Inversion of foot

47
Q

What is action of peroneus tertius?

A

Dorsiflexion of foot
Eversion of foot

48
Q

What are the branches of the deep peroneal nerve?

A

Muscular: anterior compartment of leg
Sensory: skin of 1st web space

49
Q

Where does the anterior tibial artery end?

A

Midway between 2 malleoli, in front of ankle joint by continuing as dorsalis pedis artery

50
Q

What muscles make up lateral compartment of leg?

A

Peroneus longus
Peroneus brevis

51
Q

What is action of lateral compartment of leg?

A

Eversion of foot
Plantar flexion of foot

52
Q

What are the branches of superficial peroneal nerve?

A

Muscles of lateral compartment of leg
Cutaenous:
Skin of dorsum of foot, except:
1. adjacent sides of big + 2nd toes
2. Lateral side of little toe = sural
3. Medial side of foot = saphenous

53
Q

What causes injury to common peroneal nerve?

A

fracture neck of fibula

54
Q

What happens as result of injury to common peroneal nerve?

A

Motor: paralysis of anterior + lateral compartment of leg
= loss of dorsiflexion + eversion of foot
Sensory: loss of sensation except to lateral side of little toe + medial side of foot

55
Q

What is the deformity seen in injury of common peroneal nerve?

A

Drop foot

56
Q

What muscles make up the superficial group of muscles in back of leg?

A

Gastrocnemus
Soleus
Plantaris

57
Q

What is the nerve supply of superficial group of muscles in back of leg?

A

Tibial Nerve

58
Q

What is the action of superficial group of muscles in back of leg?

A

Plantar flexion of foot

59
Q

What are the deep muscles of the back of leg?

A

Popliteus
Tibialis posterior
Flexor digitorum longus
Flexor hallucis longus

60
Q

What is the nerve supply to the deep muscles of the back of leg?

A

Tibial nerve

61
Q

What is the action of the deep muscles of the back of leg?

A

Plantar flexion of foot

62
Q

What is the action of the deep muscles of the back of leg?

A

Plantar flexion of foot

63
Q

What structures are found deep to the flexor retinaculum?

A

Tom Does Very Nice Hats
Tibialis posterior tendon (anterior)
Flexor digitorum longus tendon
Posterior tibial vessels
Tibial nerve
Flexor hallucis longus (posterior)

64
Q

Where does the lateral cutaenous root arise?

A

L2 + L3

64
Q

What does the branches of the saphenous nerve supply?

A

Skin of medial side of leg + dorsum of foot

64
Q

What nerves supplies the muscles of the medial compartement?

A

Obturator nerve

64
Q

What is meralgia paraesthetica?

A

entrapment of compression of nerve near ASIS + inguinal ligament

64
Q

What is the nerve supplying the skin over + below patella?

A

Infrapaterallar branch of saphenous nerve

64
Q

What muscles attach at the greater trochanter?

A

POGO
Piriformis
Obturator internus
Gemelli + Glutei
Obturator externus

65
Q

What is the action of the medial compartments of the thigh?

A

Adduction

65
Q

What are the roots of the obturator nerve?

A

anterior divisons of ventral rami of L2,3,4

65
Q

What does the cutaenous branch of obturator nerve?

A

skin of medial part of thigh

65
Q

Where does the adductor canal lie?

A

medial part of the middle 1/3 of thigh

65
Q

What are the contents of the adductor canal?

A

Arteries: femoral
Veins: femoral
Nerves: nerve to vastus medialis muscle + saphenous nerve
Lymphatics

65
Q

What muscles make up the back of the thigh (hamstring muscles)?

A

biceps femoris
semi-tendenosus
semi-membranosus

65
Q

Where is the insertion of the biceps femoris?

A

styloid process of fibula

65
Q

What nerve supplies the hamstring muscles?

A

Sciatic nerve

65
Q

What is the nerve supply of the biceps femoris?

A

Long head: tibial branch of sciatic nerve
Short head: common peroneal of sciatic nerve

65
Q

What is the origin + roots of sciatic nerve?

A

Sacral plexus
Terminal branch of plexus (L4/5, S1/2/3)

65
Q

Where does the sciatic nerve end?

A

Middle of back of thigh

65
Q

What are the boundaries of the adductor canal?

A

Antero-lateral wall: vastus medialis
Antero-medial wall: sartorius
Posterior: adductor longus + magnus

66
Q

What are the terminal branches of the sciatic nerve?

A

Branches into: tibial nerve + common peroneal nerve

66
Q

What are the branches of the tibial nerve?

A

Cutaenous branches:
- sural nerve to lateral side of leg + foot
- calcanean branches of heel

Muscular branches:
- long head of biceps
- posterior compartment of leg muscles

Terminal branches:
- lateral + medial plantar nerves

66
Q

What muscle is commonly injured in runners with explosive movement (especially if not warmed up)?

A

Biceps femoris

66
Q

What are the muscular branches of the sciatic nerve?

A

hamstring muscles
ischial part of adductor magnus

66
Q

Where does the common peroneal nerve divide?

A

lateral side of neck of fibula

high risk of injury if fractures

66
Q

What does the popliteal artery divide into?

A

Anterior + posterior tibial artery

66
Q

Where does the popliteal artery begin?

A

Opening in adductor magnus muscle

66
Q

What bones are in front of the cuboid bone?

A

4th + 5th metatarsal bones

67
Q

What are the contents of the adductor canal?

A

Arteries: femoral
Veins: femoral
Nerves: nerve to vastus medialis muscle + saphenous nerve
Lymphatics

67
Q

What are the boundaries of the adductor canal?

A

Antero-lateral wall: vastus medialis
Antero-medial wall: sartorius
Posterior: adductor longus + magnus

67
Q

Where is the insertion of the biceps femoris?

A

styloid process of fibula

68
Q

What is the nerve supply of the biceps femoris?

A

Long head: tibial branch of sciatic nerve
Short head: common peroneal of sciatic nerve

68
Q

What nerve supplies the hamstring muscles?

A

Sciatic nerve

68
Q

What is the origin + roots of sciatic nerve?

A

Sacral plexus
Terminal branch of plexus (L4/5, S1/2/3)

68
Q

What muscle is commonly injured in runners with explosive movement (especially if not warmed up)?

A

Biceps femoris

68
Q

Where does the sciatic nerve end?

A

Middle of back of thigh

68
Q

What are the muscular branches of the sciatic nerve?

A

hamstring muscles
ischial part of adductor magnus

68
Q

What are the terminal branches of the sciatic nerve?

A

Branches into: tibial nerve + common peroneal nerve

68
Q

What are the branches of the tibial nerve?

A

Cutaenous branches:
- sural nerve to lateral side of leg + foot
- calcanean branches of heel

Muscular branches:
- long head of biceps
- posterior compartment of leg muscles

Terminal branches:
- lateral + medial plantar nerves

68
Q

Where does the common peroneal nerve divide?

A

lateral side of neck of fibula

high risk of injury if fractures

68
Q

Where does the popliteal artery begin?

A

Opening in adductor magnus muscle

68
Q

What does the popliteal artery divide into?

A

Anterior + posterior tibial artery

68
Q

What bones are in front of the cuboid bone?

A

4th + 5th metatarsal bones

MRCS A (3 decks)

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