Lower Limb Flashcards
what composes the inominate bone?
ilium, ischium, pubis
(from pelvic girdle)
name the joints in the pelvic girdle
lumbosacral
sacro-iliac
sacro-coccyngeal
pubic symphysis
what is the acetabulum?
a fusion of different inominate bone parts connecting to the femur head
what type of joint is the pubic symphysis?
secondary cartilagenous
what kind of joint is the hip joint?
synovial ball & socket joint (between femur head and acetabulum)
iliofemoral ligament: cover and function
covers superiorly/anteriorly
prevents hyperextension during standing
pubofemoral ligament: covers and function
covers anteriorly/inferiorly
prevents excess abduction
ischiofemoral ligament: covers and function
covers posteriorly
prevents hyperflexion
what are the main nerves of the lumbosacral plexus and what is their corresponding vertebrae?
femoral - L2-4
obturator - L2-4
sciatic - L4-S3
gluteus maximus: origins and insertions
origins - posterior gluteal surface of the ilium, sacrum and coccyx
insert - iliotibial tract, gluteal tuberosity of femur
gluteus maximus: actions and innervation
actions - thigh extension and lateral rotation
innervation – inferior gluteal nerve
gluteus medius: origin and insertion
origin - gluteal surface of ilium
insert - lateral surface of greater trochanter
name the actions and innervation of the gluteus medius, gluteus minimus and tensor fascia lata
actions - lower limb abduction and medial rotation, stabilises pelvis during locomotion
innervation - superior gluteal nerve
gluteus minimus: origin and insertion
origin - ilium
insert - anterior greater trochanter (convergent tendon)
tensor fascia lata: origins and insertions
origins - anterior iliac crest (ASIS)
insert - iliotibial tract (lateral condyle of tibia)
name the deep muscles of the gluteal region
quadratus femoris
piriformis
gemellus superior/inferior
obturator internus
what are the general actions and innervations of the deep gluteal region?
actions - lateral rotation, abduction
innervations - nerve to (insert muscle)
what 2 muscles make up the iliopsoas?
psoar major and iliacus
name the muscles of the anterior compartment of the thigh
iliacus (iliopsoas)
psoas major (iliopsoas)
rectus femoris (quad)
vastus medialis (quad)
vastus lateralis (quad)
vastus intermedius (quad)
saartorius
pectineus
what are the general actions and innervations of the anterior compartment of the thigh?
actions - extend lower limb at knee joint, thigh flexion (only iliospoas + pectineus)
innervation - femoral nerve
where do the quadriceps converge and insert?
insert onto patella as common quadriceps tendon
sartorius: origin, insertion, actions and innervation
origin - anterior superior iliac spine (ASIS)
insert - medial tibia surface
actions - hip flexion/abduction/lateral rotation, knee flexion
innervation - femoral nerve
name the muscles in the medial compartment of the thigh
gracilis
obturator externus
adductor brevis
adductor longus
adductor magnus (adductor part)
what are the general actions and innervation of the muscles in the medial compartment of the thigh?
actions - hip adduction, lateral rotation (obturator externus only), leg flexion (gracilis only)
innervation - obturator nerve
name the muscles in the posterior compartment (hamstring) of the thigh
biceps femoris
semitendinosus
semimembranosus
adductor magnus (hamstring)
what is the general actions and innervations of the muscles in the posterior (hamstring) compartment of the thigh?
actions - hip/thigh extension, leg/knee flexion
innervation - tibial sciatic nerve (short head biceps femoris - fibular sciatic nerve)
what is the linea aspera?
a line along the femur
where is the pes anserinus located and what muscles attach to it?
located below knee at fibular head
attachments - semitendinosus, sartorius, gracilis
what 4 structures does the femoral triangle contain? (from lateral to medial)
nerve, artery, vein, lymphatics
what type of joint is the knee joint and what bones is it formed around?
synovial hinge joint
formed around femur (condyles), tibia (plateaus) and patella
what 3 articulations is the knee composed of?
2 tibiofemoral
1 patellofemoral
explain why the knee is more stable when extended
flat surfaces are in contact making it more congruent
what are knee menisci?
c-shaped wedges of fibrocartilage (medial and lateral)
what are the functions of knee menisci?
improves articular surface fit
accomodates shape change during movement
shock absorption
assist locking mechanism
joint nutrition and lubrication
how do knee menisci receive nourishment?
outer 1/3 - vascularised
inner 2/3 - synovial fluid
where does the anterior cruciate ligament (ACL) run and what is its function?
attaches from anterior intercondylar region of tibia to lateral femoral condyle
prevents hyperextension
where does the posterior cruciate ligament (PCL) attach and what is its function?
attaches from posterior intercondylar region of tibia to medial femoral condyle
prevents hyperflexion
where does the fibular collateral ligament extend from?
lateral epicondyle of femur to lateral fibula
where does the tibial collateral ligament extend to?
medial epicondyle of femur to medial tibia
what is the function of collateral ligaments?
prevents rotation during knee extension (stability)
what is the normal Q angle of the femur?
15 degrees
explain the conditions caused by abnormal allignment of the femur
genu varum (bow leg) - Q angle below 13 degrees (hyperadduction)
genu valgum (knock knee) - Q angle above 17 degrees (hyperabduction)
name the 7 tarsal bones and state whether they are proximal or distal
calcaneus (P)
talus (P)
navicular (P)
cuboid (D)
lateral cruciform (D)
intermediate cruciform (D)
medial cruciform (D)
what does the true ankle joint involve and allow?
talocrural joint involving fibula, tibia and talus
allows dorsiflexion (extension) and plantarflexion (flexion)
what does the subtalar joint involve and allow?
talocalcaneal joint involving talus and calcaneus
allows inversion and eversion
what 2 ligaments are in the ankle joint and how many parts are there on each?
medial (deltoid) ligament (4)
lateral ligament (3)
what are the 3 muscular compartment groups of retinacula in the ankle?
flexor
extensor (superior/inferior)
fibular (superior/inferior)
name the muscles in the posterior compartment of the leg
gastrocnemius (lateral/medial head)
soleus
plantaris
popliteus
flexor digitorum longus
flexor halucis longus
tibialis posterior
what are the general actions and innervation of the muscles in the posterior compartment of the leg?
actions - foot plantarflexion and inversion
innervation - tibial nerve
what is the anatomical name of the achilles tendon?
calcaneal tendon
what causes tarsal tunnel syndrome?
compression of tibial nerve
explain the mneumonic used to remember the order of occurence of ankle tendons/structures
(from anterior to posterior)
Tom, Dick and very nervous Harry
T - tibialis posterior (tendon)
D - digitorum longus (flexor tendon)
A - tibial artery
V - tibial vein
N - tibial nerve
H - hallucis longus (flexor tendon)
name the 3 ankle extensors and whether they allow for inversion or eversion at the subtalar joint
tibialis anterior (I)
extensor hallucis longus (I)
extensor digitorum longus (E)
what are the 2 lateral group muscles in the ankle and what do they allow?
fibularis longus/brevis
allow eversion and plantarflexion
name the 3 foot arches
medial longitudinal
lateral longitudinal
transverse
what structures give dynamic support to the foot arch?
tibialis posterior/anterior
flexor hallucis longus
fibularis longus
intrinsic plantar muscles
name the structures giving passive support to the foot arch
plantar aponeurosis
long/short plantar ligament
plantar calcaneonavicular ligament
what is the deepest structure in the popliteal fossa?
popliteal artery
explain the branching of the sciatic nerve
sciatic -> tibial and common fibular
tibial -> medial/lateral plantar
common fibular -> deep/superficial fibular
name the arterial branches in the lower limb from superficial to deep
aorta
common iliac
external/internal iliac
femoral
popliteal
posterior/anterior tibial
fibular/dorsalis pedis
medial/lateral plantar
explain the venous drainage system of the lower limb
deep veins and flanked arteries (2 veins, 1 artery)
superficial veins drain into deep veins
name the main veins of the lower leg and where they drain
lesser saphenous -> popliteal
greater saphenous -> femoral
what is the function of perforating veins?
connecting the 2 systems of venous drainage
what happens when blood backs up in deep veins?
perforating veins back up and become varicose veins
name the muscles in the anterior compartment of the leg
tibialis anterior
extensor digitorum longus
extensor hallucis longus
fibularis tertius
what are the general actions and innervation of the muscles in the anterior compartment of the leg?
actions - foot dorsiflexion and eversion
innervation - deep fibular nerve
