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MRCS Sciences deck > Lower Limb > Flashcards

Lower Limb Flashcards

1
Q

What is the innervation of the tensor fascia lata?

A

Superior gluteal nerve

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2
Q

Damage to which artery is MOST likely to cause avascular necrosis of the femoral head?

A

Medial circumflex

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3
Q

What is the nerve supply for the superior and inferior gemmelus

A

The superior gemellus muscle is innervated by the nerve to obturator internus, the inferior gemellus is innervated by the nerve to quadratus femoris.

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4
Q

Iliopsoas muscles innervation

A

The psoas major is innervated by anterior rami of L1-3, while the iliacus is innervated by the femoral nerve.

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5
Q

Which is the only muscle of the quadriceps group to cross both the hip and knee joints

A

Rectus femoris, The rest of the knee extension muscles stabilise the patella

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6
Q

Biceps femoris nerve innervation

A

Long head innervated by the tibial part of the sciatic nerve, whereas the short head is innervated by the common fibular part of the sciatic nerve.

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6
Q

Adductor Magnus innervation

A

Adductor component is obturator nerve
Hamstring component is sciatic

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6
Q

Identifying the common peroneal nerve

A

There is a small space between the parts of the fibularis longus that originate from the head of the fibula, and the neck of the fibula. The common fibular nerve passes through this gap, and is easily identified.

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7
Q

Which muscle unlocks the knee

A

Popliteus

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8
Q

Innervation of the lumbrical of the foot

A

o Medial lumbrical – medial plantar nerve.
o Lateral three lumbricals – lateral plantar nerve

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9
Q

Innervation of the interossei of the foot

A

Lateral plantar nerve

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10
Q

What is medial plantar nerve entrapment

A

The medial plantar nerve can become compressed and irritated as it passes deep to the abductor hallucis muscle.
This can cause aching, numbness and paraesthesia on the medial side of the sole of the foot. The muscle can become compressed during repetitive eversion of the foot, which may occur in some sports such as gymnastics.

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11
Q

Name a nerve that is from the common fibular and the tibial nerve

A

Sural nerve

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12
Q

Which of the four muscles of the posterior thigh is innervated by the common fibular nerve?

A

Short head of the biceps femoris

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13
Q

First web space innervation

A

This innervates the webbed space of skin between the great toe (hallux) and the second toe.

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14
Q

Nerve roots of the lower limb nerves (Lumbar plexus)

A

Iliohypogastric: T12 - L1
Ilioinguinal - L1
Genitofemoral - L1-L2
Lateral cutaneous: L2-L3
Femoral: L2-L4
Obturator: L2-L4

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15
Q

Nerve roots of the lower limb nerves (Sacral plexus)

A

Superior Gluteal nerve: L4,L5 and S1
Inferior gluteal nerve: L5 - S2
Sciatic: L4 - S3
Posterior femoral cutaneous: S1, S2, S3
Pudendal: S2-S4

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16
Q

Nerves of the sciatic nerve

A

Tibial nerve: L4-S3
Common fibular: L4 - S2
Deep fibular: L4-S1
Superficial fibular: L4 - S1

TCDs haha

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17
Q

What are the branches of the obturator artery

A

Anterior branch – This supplies the pectineus, obturator externus, adductor muscles and gracilis.
Posterior branch – This supplies some of the deep gluteal muscles.

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18
Q

Where do the posterior tibial and fibular nerve arise from

A

The tibioperoneal trunk, This is the popliteal artery after the anterior tibial has left it

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19
Q

Which group of nodes form a line directly below the inguinal ligament?

A

Superficial inguinal nodes

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20
Q

Avulsion fracture of the 5th metatarsal

A

Fibularis brevis. It is the most common type of inversion injury

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21
Q

To which bony landmark of the proximal femur do the gluteal muscles attach?

A

Greater trochanter

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22
Q

Which action of fibularis longus is NOT shared by fibularis brevis?

A

Plantarflexion

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23
Tarsal tunnel contents
Tibialis posterior tendon Flexor digitorum longus tendon Posterior tibial artery and vein Tibial nerve Flexor hallucis longus tendon The mnemonic Tom, Dick, and a Very Nervous Harry can be used to aid recall of these structures
24
Where on the femur does the adductor magnus attach?
Adductor tubercle
25
What classification is the subtalar joint of the foot?
Plane synovial joint
26
Where does the ACL attach on the tibia
Intercondylar eminence
27
What is the position of the sciatic nerve in relation to the glute max
Ant
28
Which muscle of the posterior thigh produces lateral rotation at the hip and knee?
Biceps femoris
29
In which direction does the femur move (relative to the tibia) to unlock the knee?
The popliteus laterally rotates the femur on the tibia – ‘unlocking’ the knee joint so that flexion can occur.
30
Which muscle is associated with dual nerve supply
Pectinius can receive a nerve supply from both the obturator and femoral nerves
31
Which ligament is injured with forced eversions of the foot
The lateral ligament is injured with forced inversions of the foot since it is much weaker than the medial ligaments and is the ligament that resists inversion at the talocrural joint.
32
Plantar tendon reflex innervation
The plantar reflex is a myotatic, deep tendon reflex involving spinal roots L4 – S2 and is routinely tested in a neurological examination.
33
Which muscle is often implicated in greater trochanteric pain syndrome
The gluteus medius inserts into the greater trochanter of the femur and its tendon is often implicated in Greater Trochanteric Pain Syndrome.
34
Which muscle lies in between the superior and inferior Gemelli
Obturator internus
35
A patient presents to ED with a stab wound to the buttock. Injury to the nerve to obturator internus is suspected. Which of the following muscles would be affected?
Superior gemellus
36
Which of the following best describes the action of piriformis on the hip joint?
Lateral rotation and abduction
37
What is the innervation of the tensor fascia lata
The tensor fascia is innervated by the superior gluteal nerve, like gluteus medius and minimus, but is located more anterolaterally than the other gluteal muscles.
38
What is the main function of the empty space in the femoral triangle?
Allow the femoral vein to distend when the venous return is high
39
A Baker’s cyst is a benign swelling of which structure?
Semimembranous bursa
40
Which structure attaches to the apex of the patella?
Patellar ligament
41
Which of the following attaches to the base of the patella?
Quad tendon
42
Which muscle flexes at the knee and plantarflexes at the ankle
Gastrocnemius
43
The knee is laterally rotated using which of the following muscles?
Biceps femoris
44
Which myotome is most strongly associated with knee extension?
L3 myotome
45
Listed below are the muscles of the anterior leg. Which attaches to the base of the 1st metatarsal?
Tib ant
46
A patient presents to ED following a fall from height. Which of the following fractures is most likely?
The calcaneus is often fractured as a result of axial loading, typically from a fall from a height.
47
FACT
Diathrodal joint is another term for synovial joint
48
Which fractures are associated with posterior dislocation of the hip
Acetabular fractures
49
What is the prominent ridge behind the femoral shaft called?
Linea Aspera
50
What function of the knee allows enhanced flexion
Posterior rollback of the femur on the tibia
51
What forms the floor of the popliteal fossa
Joint capsule
52
What tendon is used for minimally invasive ACL repair
Semitendanous as it has a high load to failure ration
53
Sural nerve
Runs behind the lateral malleolus and supplies the posterolateral aspect of the right leg and the lateral aspect of the right foot
54
Mnemonic for muscle attachment on greater trochanter is POGO:
Piriformis Obturator internus Gemelli, gluteus medius, gluteus minimus Obturator externus
55
What is the anatomical relations of the femoral artery in the adductor canal
Femoral artery is anterior to the vein in the adductor canal
56
What is a bakers cyst
Bakers cyst: swelling of the semimembranosus bursa
57
What is tarsal tunnel syndrome
Tarsal tunnel syndrome refers to entrapment and compression of the tibial nerve as it passes through the tarsal tunnel. Patients may experience altered sensation in the sensory distribution of the tibial nerve – the sole of the foot.
58
What fascia of the abdomen becomes fascia lata
The deep layer of the superficial fascia of the abdominal wall (Scarpa’s fascia) blends with the fascia lata just below the inguinal ligament.
59
What are the actions of the muscles of the gluteal region
Maximus is the extendor The superficial ones like mini and medium are medial rotators and abductors The deep ones like piriformis, obturator internus and quad femoris and gemilli are lateral rotators and abductors
60
What is the difference between psoas major innervation and iliacus innervation
The psoas major is innervated by anterior rami of L1-3, while the iliacus is innervated by the femoral nerve.
61
Why do femoral shaft fractures cause torrential bleeding?
Due to the perforating branches of the profunda femoris
62
What are the muscles that attach to the line aspera

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