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eMRCS questions > Lower limb > Flashcards

Lower limb Flashcards

1
Q

What root is extension of big toe

A

L5

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2
Q

Which tendon lies medial to dorsals pedis

A

Extensor hallicus longus

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3
Q

Origin of triceps heads

A

The long head arises from the infraglenoid tubercle. The fleshy lateral and medial heads are attached to the posterior aspect of the humerus between the insertion of the teres minor and the olecranon fossa.

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4
Q

Ligaments of syndesmosis

A

Antero-inferior tibiofibular ligament
Postero-inferior tibiofibular ligament
Inferior transverse tibiofibular ligament
Interosseous ligament

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5
Q

Where sural nerve ends

A

Posterior to distal fibula

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6
Q

Arteries of leg and foot

A

Femoral
3 branches- profunda
Medial and lateral circumflex

Goes posterior to adductor hiatus to become popliteal

Anterior tibial branches off first
Then divides into posterior tibial and peroneal

Anterior tibial- dorsalis pedis then medial and lateral tarsal

Posterior tibial- medial and lateral plantar

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7
Q

Relations of posterior tibial artery

A

Ant- tibialis post
FDL

Post
Tibial nerve
Gastric and soleus

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8
Q

Which structure lies in between PCL and popliteal artery

A

Oblique popliteal ligament

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9
Q

Content of adductor canal

A

femoral artery, femoral vein (posterior to the artery), nerve to the vastus medialis and the saphenous nerve

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10
Q

Which muscle is the end of the adductor canal in

A

Adductor Magnus

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11
Q

Borders of adductor canal

A

Roof- sartorius
Laterally- vatus medals
Posteriorly- adductor Lingus and Magnus

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12
Q

Structures that pass posterior to lateral mallelous and superficial/deep to peroneal retinaculum

A

Superficial- sural nerve
Short saphenous vein

Deep
Peroneus longus and brevis

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13
Q

How many compartments in lower leg

A

4

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14
Q

Muscles of superficial lower leg

A

Gastrocnemius, Soleus, Plantaris

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15
Q

Which nerve is closely related to posterior tibial artery

A

Tibial nerve

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16
Q

Borders of popliteal fossa

A

Superomedial – semimembranosus.
Superolateral – biceps femoris.
Inferomedial – medial head of the gastrocnemius.
Inferolateral – lateral head of the gastrocnemius and plantaris.

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17
Q

Flexor retinaculum attachments

A

Medial malleolus and medial calcaneus

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18
Q

Innervation of dorsal Muscles of foot

A

EHB
EDB- both deep fibular nerve

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19
Q

Location and function of fibulas tertius

A

Anterior
Eversion and dorsiflexion of the foot.

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20
Q

Attachment of fibulas bravis vs longus

A

Longus- 1st
Brevis- 5th

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21
Q

Tensor fascia lata attachment, innervation and action

A

Attachment- ASIS to lateral condyle of tibia
innervation- superior gluteal
Action- abduct and medially rotate lower limb

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22
Q

Order of attachment of deep gluteal muscles to greater tronchater

A

Piriformis
Superior gemilli
Obturator internus
Inferior gemilli
Quadratus femoris

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23
Q

Nerves that innervates TA and internal oblique

A

Iliohypogastric and ilioinguinal

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24
Q

Sensory function of iliohypogastric, ilioinguinal, genitofemoral

A

IH- Skin of the suprapubic region and posterolateral aspect of gluteal region.

II- Innervates the skin on the superior antero-medial thigh. In males, it also supplies the skin over the root of the penis and anterior scrotum. In females, it supplies the skin over mons pubis and labia majora.

GF- The genital branch innervates the skin of the anterior scrotum (in males) or the skin over mons pubis and labia majora (in females). The femoral branch innervates the skin on the upper anterior thigh.

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25
Q

Roots of sacral plexus

A

S1-S4
Receives some from L4,5

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26
Q

Motor and sensory function of pudendal

A

Motor Functions: Innervates the skeletal muscles in the perineum, the external urethral sphincter, the external anal sphincter, levator ani.

Sensory Functions: Innervates the penis and the clitoris and most of the skin of the perineum.

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27
Q

Branches of femoral nerve and supply

A

Anterior- pectinous, sartorius, sensory of thigh
Posterior- vastus, saphenous

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28
Q

Root of femoral nerve and motor supply

A

L2,3,4

Illacus
Pectineus
Sartorius
Quads

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29
Q

Sensory supply of obturator nerve

A

MID part of medial thigh

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30
Q

Branches of obturator nerve and roots

A

L2,3,4

Anterior (to AB)- between AB and AL
Adductor longus, brevis, gracili

Posterior (to AB) descends between AB and Magnus
Adductor Magnus
Obturator externes

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31
Q

Roots of sciatic nerve

A

L4-S3

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32
Q

Branches of tibial nerve

A

Medial calcaneal branches: These arise within the tarsal tunnel, and innervate the skin over the heel.

Medial plantar nerve: Innervates the plantar surface of the medial three and a half digits, and the associated sole area.

Lateral plantar nerve: Innervates the plantar surface of the lateral one and a half digits, and the associated sole area.

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33
Q

Function of popliteus

A

“unlocks” the knee by laterally rotating the femur on the tibia.

Flexes fully extended knee

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34
Q

Root of tibial

A

L4-S3
Same as sciatic

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35
Q

Root of common fibular

A

L4-S2

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36
Q

Branch of deep fibular

A

Lateral branch – innervates two of the intrinsic muscles of the foot (extensor digitorum brevis and extensor hallucis brevis).

Medial branch – innervates the skin of the webbed space between the 1st and 2nd toes.

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37
Q

Branches of obturator artery and supply

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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38
Q

Branches of popliteal artery

A

Ant Tibial (deep fibular nerve)- from dorsalis pedis

Tibioperoneal trunk- post tibial (accompanies tibial nerve) and peroneal
Post tibial- forms Medial and lateral plantar- deep plantar arch

39
Q

Veins draining into femoral vein

A

Long saphenous
Profunda femoris vein

40
Q

Route of small saphenous and drainage

A

Post to lateral malleolus
Post
At the level of the knee, the short saphenous vein passes between the two heads of the gastrocnemius muscle and empties into the popliteal vein

41
Q

Normal angle between femoral neck and shaft

42
Q

Where obturator interns and externes insert

A

Medial greater trochanter

43
Q

What does the dorsalis pedis artery pass under

A

Inferior extensor retinaculum

44
Q

What crosses doralis pedis

45
Q

What does the femoral artery pass under, that if retracted can improve access

46
Q

What structure runs under long saphenous vein close to origin and may be damaged in ligation

A

Deep external pudendal artery

47
Q

At what level does the sciatic nerve usually bifurcate into the tibial and common peroneal nerves?

A

Superior aspect of popliteal fossa

48
Q

Sings for lateral cutaneous nerve of thigh entrapment

A

Tinel sign at inguinal lig

Runs under

49
Q

Innervation of foot muscles

A

Medial- FHB, FDB, Abd H, 1st lumbrical
Lateral- Abd DM, 2-4th lumbricals, QP, Add H(deep), FDM(superficial), palmar and dorsal interossei

EHB, EDB- deep fibular

50
Q

Psoas major attachment and innveration

A

Originates from the transverse processes and vertebral bodies of T12 – L5.
Lesser trochanter

Innervation L1-3

51
Q

Illiacus major attachment and innveration

A

Femoral nerve

Originates from the surface of the iliac fossa and anterior inferior iliac spine, inserting into the lesser trochanter of the femur.

52
Q

QL attachment and innervation

A

Originates from the iliac crest and iliolumbar ligament. The fibres travel superomedially, inserting onto the transverse processes of L1 – L4 and the inferior border of the 12th rib.

Anterior rami of T12 – L4 nerves.

53
Q

Long saphenous vein stripped, now parasetheisa above ankle

A

Saphenous nerve injury

54
Q

Order of popliteal fossa content

A

Nerve
Vein
Artwey

55
Q

Profunda artery femoral branch surface anatomy

A

3cm below inguinal ligament

56
Q

Popliteal artery continues into what

A

Peronteal tibial trunk

57
Q

Attachments of ACL

A

Medial wall of lateral femoral condyle to intercondylar eminence of tibia

58
Q

Attachments of PCL

A

Medial femoral condyle to intercondylar eminence of tibia

59
Q

Main tendon for medial arch

60
Q

Which muscles attach to linea aspera

A

Adductor longus and briefs

Biceps originate here

61
Q

Floor of femoral triangle

A

Pectineus
Ilipsoas
Adductor loungus

62
Q

Superficial to deep of lateral knee joint

A

Skin
LCL
Popliteus tendon- runs between
Lateral meniscus

63
Q

Knee flexion for lachman test

64
Q

Movement of femur to aid knee flexion

A

Internal rotation - popliteus
Posterior roll back

65
Q

Which bone articulate with tibia distally

66
Q

Which bones articulator with calcaneus

A

Cuboid, navicular, talus

67
Q

What articulates with talus

A

Tibia, fibular, navicular, calcaneus

No muscles

68
Q

Sciatic nerve relative to biceps and where does it bifurcate

A

Deep to long head
Crosses posterior surface of OI, S/I gemellus and QF

Splits at apex of popliteal fossa

69
Q

What is the medial calcanea a branch of

70
Q

Main cutaneous branch from tibial in popliteal fossa

A

Medial sural cutaneous nerve

71
Q

Roots of lateral femoral cutaneous

72
Q

What each metatarsal articulates with

A

First with medial cuneiform

Second- 3 cuneiforms

3rd- lateral

4th - lateral and cuboid

5th- cuboid only

73
Q

Ligaments supporting medial arch

A

Short plantar- calcaneocuboid

Plantar calcaneonavicular

Interosseous - talocalcaneal

Deltoid

Long plantar

74
Q

Fracture associated with posterior hip dislocation

A

Acetabulum

75
Q

Gluteus maximus attachment

A

Gluteal tuberosity of femur

76
Q

Arteries supplying trochanteric anastomosis

A

Medial and lateral circumflex femoral

Superior gluteal

77
Q

What does femoral sheath contain and what forms it

A

Contains femoral vessels and canal

Continuation of TF

78
Q

Which joint is a modified synovial joint

79
Q

What is the saphenous nerve found between at ankle

A

Medial malleolus and TA

80
Q

Postion of content in adductor canal

A

Artery anterior
Vein posterior

81
Q

Gluteus medius attachment

A

Lateral aspect of greater trochanter

82
Q

Which bone articulates on the anterior surface of the talus

83
Q

Structure most likely damaged anterior to medial malleolus

84
Q

EDL compared to TA

A

EDL is lateral

85
Q

Most common patella dislocation

A

Lateral - due to quads

86
Q

Diathrodal joint

A

Synovial joint

87
Q

Hip joint when most tight and most relaxed

A

Tight in extensions
Relaxed in flexion

88
Q

Iliofemoral ligament function

A

Strongest ligament

Prevents overextension of hip

AIIS to intertronchanteric line of femur

89
Q

Bursa of knee

A

Anterior
Supra- patellar
Pre
Subcut Infra
Deep infra

Lateral
Iliotibial
Lateral Coll

Medial
Pes anserinus
MCL

Posterior
Semimembranous
Popliteus
Lateral gastroc
Medial gastroc

90
Q

Ligaments of hip joint attachments

A

Intracapsular
Ligament of femur

Extracapsular
Iliofemoral- AIIS to IT
Pubofemoral- superior pubic rami to IT
Ischiofemoral- body of ischium to greater trochanter-posterior

91
Q

Ligament and muscle strength of hip joint

A

Ant- ligaments strongest, muscles weakest

Post- ligaments weakest, muscles strongest

92
Q

Muscles causing medial and lateral rotation of the hip

A

Lateral rotation – biceps femoris, gluteus maximus, piriformis, assisted by the obturators, gemilli and quadratus femoris.

Medial rotation – anterior fibres of gluteus medius and minimus, tensor fascia latae

eMRCS questions (45 decks)

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