Lower Limb Flashcards

1
Q

Ilioinguinal Nerve supply

A

Root of penis
Anterior 1/3rd of scrotum
Small area of thigh below medial end of inguinal lig

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2
Q

Ilioiguinal origin and course

A

L1, lies in NV plane b/w Int oblique + Transversus Abdominis m
Piereces IO and supplies lower fibres
Emerges on front of cord through superficial inguinal ring
Pierces external spermatic fascia

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3
Q

Femoral branch of genitofemoral nerve Origin & supply

A

L1 of L1,2
Supplies skin over femoral triangle

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4
Q

Medial femoral cutaneous nerve supply and origin

A

Off femoral N, supplies medial side of thigh to knee

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5
Q

Intermediate femoral cutaneous nerve origin and supply

A

Branch of femoral
Supplies front of thigh to knee

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6
Q

Lateral femoral cutaneous nerve origin and supply

A

Branch of lumbar plexus
Supplies anteriolateral surface of thigh

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7
Q

4 cutaneous branches of femoral artery (below inguinal lig)

A

Superficial circumflex
Superficial epigastric
Superficial external pudendal
Deep external pudendal

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8
Q

Great saphenous vein course

A

Continuation of medial marginal vein of foot
Passes in front of medial malleolus
Crosses medial surface of tibia
Lies hands breath behind medial border of patella
Spiral forward around thigh to pass through cribiform fascia covering sapheous opening

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9
Q

Superficial inguinal LN = lateral group receives

A

Lymph from buttock, flank and back below waist

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10
Q

Superficial inguinal LN = medial group receives

A

Lymph from umbilicus, anterior abdo wall, ext genitalia, lower anal canal, perineum, uterus around round lig

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11
Q

superficial inguinal LN = Distal group receives

A

Drainage from lower limb

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12
Q

TFL nerve supply

A

Superior gluteal nerve (L4,5,S1)

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13
Q

Action of TFL

A

Assist ITB, stabilise pelvis

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14
Q

Femoral triangle borders

A

Lateral - medial border of sartorius
Medial - medial border of add. Longus
Superior - inguinal lig
Roof - skin, fascia
Floor - iliacus, psoas, pectineus, adductor longus

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14
Q

Contents of femoral triangle

A

Lateral cutaneous nerve of the thigh
Femoral N and branches
Femoral sheath & contents
Femoral A and branches
Femoral Vein
Great saphenous V + tributaries

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15
Q

Sartorius origin and insertion

A

ASIS to medial part of tibia with gracilis & semitendinosus

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16
Q

Sartorius nerve supply

A

Ant div of femoral N L2-4

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17
Q

Iliacus origin and insert

A

Iliac fossa = lesser trochanter

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18
Q

Iliacus nerve supply

A

Femoral N L2,3

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19
Q

Psoas major origin & insertion

A

Lumbar spinal transverse processes => lesser trochanter

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20
Q

Psoas major nerve supply

A

First 3 lumbar nerves (mainly L2)

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21
Q

Pectineus origin and insertion

A

pectineal lines of pubis to vertical line below trochanter

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22
Q

Nerve supply of pectineus

A

Ant div of femoral N (L2,3)
Occasional twig from obturator N

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23
Q

Anterior relations to pectineus

A

Femoral V and canal

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24
Q

Posterior relations of pectineus

A

Add brevis
Anterior div of obturator N

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25
Q

Femoral sheath components

A

Femoral A, vein & canal

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26
Q

Fascia that make femoral sheath

A

Transversalis & iliopsoas fascia

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27
Q

Boundaries of femoral ring

A

Ant = inguinal lig
Posterior = pectineal lig
Medial = lacunar lig
Lateral = femoral V

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28
Q

Profunda femoris origin

A

Off femoral A as it emerges from femoral sheath

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29
Q

Branches of profunda femoris

A

4 perforating arteries
Lateral circumflex femoral A
MEdial circumflex femoral A

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30
Q

Perforating femoral A origin & what do they supply

A

Originate from profunda femoris
Supply adductor & hamstrings

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31
Q

Lateral circumflex A supply

A

Ascending, transverse, descending branch to vastas lateralis, intermedius, and anastomose with cruciates

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32
Q

Medial circumflex femoral A supply

A

Ascending branch - to trochanteric anastomosis
Horizontal branch - to cruciate anastomosis

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33
Q

Femoral V tributaries

A

Profunda femoris correspondence
Great saphenous V

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34
Q

Femoral N origin

A

Post div of anterior rami of L2-4

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35
Q

Femoral N supply

A

Supplies extensor compartment of thigh
iliacus
Pectineus
Sartorius
Rectus femoris
N to vastus medialis, lateralis
Saphenous nerve

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36
Q

Quadriceps femoris components & nerve

A

Rectus femoris
Vastus lateralis
Vastus intermedius
Vastus medialis
Femoral N

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37
Q

Rectus femoris origin

A

2 heads from ilium
- reflected head, groove above acetabulum
- straight head from AIIS

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38
Q

Insertion of quadriceps femoris

A

All form quad tendon => patella => patella tendon => tibial tuberosity

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39
Q

Origin vastus lateralis

A

Upper intertrochanteric line
GT
Lateral lip of linea aspera

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40
Q

Origin vastus intermedius

A

Anterior & lateral surfaces of upper 2/3rds of femoral shaft

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41
Q

Origin vastus medialis

A

Intertrochanteric line & medial lip of linea aspera

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42
Q

Adductor canal contents

A

Femoral A, V
Saphenous N
Nerve to vastus medialis

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43
Q

Adductor canal boundaries

A

Gutter shaped groove b/w vastus medialis & adductor muscles
Roof - sartorius
Floor - adductor longus & magnus

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44
Q

Where does the femoral A lie in the adductor canal

A

B/w femoral N and saphenous N

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45
Q

Muscles of medial compartment of thigh

A

Gracilis
Add. Brevis, longus, magnus
Obturator externus

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46
Q

Nerve of medial compartment of thigh

A

Obturator

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47
Q

Artery of medial compartment of thigh

A

Profunda femoris & obturator A

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48
Q

Gracilis origin & insertion

A

Inferior ramus of pubis
Medial surface of tibia behind sartorius

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49
Q

Gracilis nerve supply

A

Ant div of obturator

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50
Q

Adductor longus origin & insertion

A

Body of pubis -> middle 1/3rd of linea aspera

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51
Q

Nerve supply add. Longus

A

Ant div of obturator

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52
Q

Adductor brevis origin & insertion

A

Body and inf ramus of pubic bone (deep to pectineus & longus) ->
Upper part of linea aspera

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53
Q

Nerve of adductor brevis

A

Ant div of obturator N

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54
Q

Adductor magnus origin & insertion

A

Hamstring part - ischial tuberosity => adductor tubercle of femur
Adductor part - ischiopubic ramus => medial supracondylar line, linea aspera, gluteal tuberosity

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55
Q

Nerve supply to add magnus

A

Post div of obturator N
tibial part of sciatic N

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56
Q

Nerve supply obt. Externus

A

Post div of obturator N

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56
Q

Obturator externus origin & insert

A

Obturator membrane & anterior bony margin of obturator foramen => trochanteric fossa

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57
Q

Action of obturator externus

A

Stabilise hip, lower limb & lateral rotation of femur

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58
Q

Anterior div of obturator nerve supplies

A

Hip joint
Add longus, brevis
Gracilis
Subsartorial plexus

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59
Q

Posterior div of obturator externus

A

Supplies obturator externus
Add magnus

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60
Q

Gluteal muscles

A

Glut max, med, min
Piriformis
Sup + inf gemellus
Obturator internus
Quadratus femoris

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61
Q

What forms the greater sciatic foramen

A

Greater sciatic notch, sacrotuberous & sacrospinous lig

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62
Q

Gluteus maximus origin & insert

A

Gluteal surface of ilium, behind post gluteal line, lumbar fascia, lateral mass of sacrum & sacrotuberous lig
=> gluteal tuberosity & ITB

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63
Q

Nerve supply of glut max

A

Inferior gluteal nerve (ONLY muscle supplied by this nerve) L5,S1,S2

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64
Q

Function of glut max

A

Lateral rotator, hip extensor

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65
Q

Gluteus medius origin & insert

A

Arise from gluteal surface of ilium b/w mid & post gluteal lines
Insert into lateral surface of GT

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66
Q

Glut medius nerve supply

A

Sup gluteal N L4,5,S1

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67
Q

Function of gluteal medius

A

Abduct hip joint, anterior fibres medially rotate

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68
Q

Gluteus minimus origin and insert

A

Gluteal surface of ilium, b/w middle & inferior gluteal lines
Insert edge to edge with glut medius on lateral surface of GT

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69
Q

Nerve supply of glut min

A

Sup gluteal N L4,5,S1

70
Q

Piriformis origin & insert

A

Middle 3 pieces of sacrum => through greater sciatic foramen onto superior aspect of GT

71
Q

Piriformis nerve supply

A

Anterior rami S1,2

72
Q

Function of piriformis

A

Stabilise hip, lateral rotate thigh and abduct of flexed thigh

73
Q

Obturator internus origin & insert

A

Internal surface of lateral wall of pelvis
=> medial surface of GT above trochanteric fossa

74
Q

Nerve supply to obturator internus

A

Nerve to obturator internus L5,S1,2

75
Q

Gemelli origin & insertion

A

Superior from spine of ischium
Inferior from ischial tuberosity
Insert into medial surface of GT

76
Q

Nerve supply of superior gemelli

A

Nerve to obturator internus

77
Q

Nerve supply ot inferior gemelli

A

Nerve to quadratus femoris

78
Q

Quadratus femoris origin & insertion

A

Arise from ischial tuberosity => quadrate tubercle of femur

79
Q

Nerve supply of quadratus femoris

A

N to quadratus femoris, l4,5,s1

80
Q

Function of quadratus femoris

A

Stabilise hip joint, lateral rotator of extended thigh & abductor of the flexed thigh

81
Q

Greater sciatic foramen components

A

Superior gluteal N and vessels
Piriformis
Sciatic N
Inferior gluteal N and vessels
Femoral cutaneous N
Internal pudendal nerve
Pudendal nerve
Nerve to obturator internus
Nerve to quadratus femoris

82
Q

What is the main source of blood to head of femur

A

Via trochanteric anastomosis
Descending branch of sup gluteal A
Ascending branch of lateral circumflex femoral A
Ascending branch of medial circumflex femoral A
Inferior gluteal A

83
Q

Cuatneous supply of posterior compartment of thigh

A

Posterior femoral cutaneous N

84
Q

Muscles of posterior compartment of thigh

A

Semimembranosus
Semitendinosus
Biceps femoris

85
Q

Nerve supply of posterior aspect of thigh

A

All by tibial component of sciatic N (L5,S1) except SH of biceps (common peroneal N part of sciatic N)

86
Q

Origin & insertion of semimembranosus

A

Ischial tuberosity => medial condyle of tibia, deep to MCL (separated by bursa)

87
Q

Origin & insert of semitendinosus

A

Arise from medial part of ischial tuberosity => behind gracilis into upper part of tibial surface

88
Q

Biceps femoris origin & insertions

A

LH from ischial tuberosity
SH from linea aspera and upper part of lateral supracondylar line of femur
Insert into head of fibula

89
Q

Blood supply of posterior compartment of thigh

A

Profunda femoris A and perforating branches
Upper part = inferior gluteal A
Lower part = popliteal A

90
Q

Popliteal fossa boundaries

A

Upper diamond = biceps femoris (lat), semimembranosus & semitendinosus (medial)
Lower diamond = gastrocnemius medial, lateral heads
Roof = fascia lata, pierced by small saphenous V & post femoral cut nerve
Floor = popliteal surface of femur, capsule of knee joint, oblique popliteal lig & popliteus m

91
Q

Contents of popliteal fossa

A

Popliteal A (deep)
Popliteal V
Tibial N
Common peroneal N (lateral)
Popliteal LN

92
Q

Common peroneal nerve branches

A

Sural communicating nerve
Lateral (sural) cutaneous nerve of the calf
Superior genicular nerve
Inferior genicular nerve
Recurrent genicular nerve

93
Q

Tibial nerve major branch

A

Sural nerve

94
Q

Sural nerve origin & supplies ..

A

Tibial N
Supplies the posterior aspect of the calf

95
Q

Where does the popliteal A lie in relation to the tibial N in the popliteal fossa

A

It lies medial to tibial N in the fossa

96
Q

What are the terminating branches of the popliteal A

A

Anterior tibial A
Posterior tibial A
Peroneal A

97
Q

Muscular branches of Popliteal A

A

2 large sural A
5 genicular A

98
Q

What are the genicular A that branch from popliteal A

A

Middle genicular - cruciates!!
Superior lateral genicular A
Superior medial genicular A
Inferior lateral genicular A
Inferior medial genicular A

99
Q

What supplies the cruciate ligament (blood)

A

Middle genicular A

100
Q

Action of popliteus

A

Unlocks the fully extended knee
Laterally rotates the femur

101
Q
A
102
Q

Which femoral condyle is wider?

A

Lateral

103
Q

Which meniscus is bigger

A

Medial

104
Q

Is the popliteus tendon in or out of the synovial membrane

A

Outside the memebrane

105
Q

Which muscles are in the extensor compartment of the leg

A

Tib Ant
EHL EDL
peroneus tertius

106
Q

Which nerve supplies the extensor compartment of the leg

A

Deep peroneal N

107
Q

What tendons lie deep to the extensor retinaculum (of the foot)

A

Tib Ant
EHL
EDL
Peroneus tertius

108
Q

Tib ant origin & insertion

A

Upper 2/3rd extensor surface of tibia & from interosseous membrane
Insert - medial cuneiform & adjacent 1st metatarsal

109
Q

Nerve supply of tib Ant

A

Deep peroneal N and recurrent genicular nerves (L4)

110
Q

Origin & insert EHL

A

Middle 1/2 of fibular, insert into terminal phalanx of big toe

111
Q

Nerve supply of EHL

A

Deep peroneal N

112
Q

EDL origin and insert

A

Arise from upper 3/4 of fibular
Inset into lateral 4 toes

113
Q

Nerve supply EDL

A

Deep peroneal N

114
Q

Peroneus tertius origin & insert

A

Lower 1/3rd of fibular
Insert into dorsum of base of 5th MT bone

115
Q

Deep peroneal nerve supplies…

A

Ant tib, EHL, eDL, Peroneus tertisu
Small area of 1st web space

116
Q

What supplies the skin (nerve) of the dorsum of hte foot

A

Superficial peroneal N

117
Q

Extensor digitorum brevis origin & insert

A

Upper surface of calcaneus
Dorsal extensor expansions

118
Q

Nerve supply EDB

A

Deep peroneal nerve S1,2

119
Q

Dorsalis pedis A origin

A

Anterior tibial A

120
Q

Branches of dorsalis pedis A

A

Lateral tarsal A
Arcuate A
1st dorsal metatarsal A

121
Q

Lateral compartment of the leg muscles

A

Peroneus longus & brevis

122
Q

Lateral compartment of the leg artery

A

Peroneal A

123
Q

Lateral compartment of the leg nerve

A

Superficial peroneal N

124
Q

What drains the lateral compartment of the leg

A

Small saphenous vein

125
Q

Peroneus longus origin & insertion

A

Upper 2/3rd of peroneal surface of fibula & intermuscular septum
Into lateral surface of medial cuneiform & 1st metatarsal

126
Q

Peroneus brevis origin & insert

A

Head & lower 2/3rd of fibular
Insert into tubercle on 5th MTP

127
Q

Posterior compartment of the leg muscles

A

Deep = popliteus, FDL, FHL, tib post
Superficial - gastroc, soleus, plantaris

128
Q

What nerve supplies skin to the calf

A

Upper half = posterior femoral cutaneous N
Lower = sural & sural communicating N
Medial = saphenous N

129
Q

What accompanies the sural nerve (vein)

A

Short saphenous V

130
Q

What is the nerve of post compartment Of leg

A

Tibial N

131
Q

What is the artery of post compartment of leg

A

Post tibial A

132
Q

Gastrocnemius origin & insertion

A

Lat head = lateral femoral condyle
Med head = medial condyle + popliteal surface of shaft of femur
Blends with soleus to insert into achilles tendon * middle 1/3rd post calcaneus

133
Q

Plantaris origin & insertion

A

Lateral supracondylar line of femur
Fuses with achilles

134
Q

Soleus origin & insert

A

Upper 1/4 back of fibula to soleal line of tibia & middle 1/3rd of post border of tibia

Insert into achilles tendon (1/3rd post calcaneus)

135
Q

Nerve supply to gastroc

A

Tibial N

136
Q

Nerve supply to soleus

A

Tibial N

137
Q

FDL origin & insert

A

Post surface of tibia below soleal line
Divides into 4 tendons
Perforated FDB to insert into base of distal phalanx

138
Q

Nerve supply FDL

A

Tibial N

139
Q

Action of FDL

A

Plantar flex lateral 4 toes, and ankle

140
Q

FHL origin & insert

A

Arise from flexor surface of fibula & interosseous membrane
Insert into central tendon to base of distal phalanx of great toe

141
Q

What crosses the FHL in the sole

A

FDL tendon

142
Q

Nerv e to FHL

A

Tibial N

143
Q

Fx of FHL

A

Flex great toe, ‘take off’

144
Q

Tibialis posterior origin & insert

A

Interosseous membrane & adjoining surfaces of tibia and fibula
Insert into tuberosity of navicular

145
Q

Nerve of tib post

A

TibialN L4

146
Q

Fx tibial post

A

Invert & adduct forefoot, contributes to maintaining the longitudinal arch

147
Q

Tibial N branches int he foot

A

Medial & lateral plantar nerves
Medial calcanean nerves

148
Q

Post tibial A branches

A

Medial & lateral plantar A
Peroneal A
Circumflex fibular A
Nutrient A to the tibia

149
Q

What supplies skin on sole of foot

A

Medial & lateral plantar N *tibial N

150
Q

What are the layers of the foot

A
  1. Abductor hallucis, FBD, Abductor digiti minimi
  2. lumbricals, FHL tendon, FDL tendon, flexor acessorius
  3. Abductor hallucis brevis, flexor digitiminimi brevis, flexor hallucis brevis
  4. interosseous muscles
151
Q

components of layer 1 of sole

A

abductor hallucis
abductor digiti minimi
flexor digitorum brevis

152
Q

components of 2nd layer of sole

A

lumbricals
FHL tendon
FDL tendon
Flexor Accessorius

153
Q

components of 3rd layer of sole

A

abductor hallucis brevis
Flexor digiti minimi brevis
flexor hallucis brevis

154
Q

nerve supply to interosseous muscles of foot

A

lateral plantar nerve

155
Q

what gives rise to deep plantar arch artery in foot

A

lateral plantar A

156
Q

medial ligament of ankle

A

deltoid ligament

157
Q

components of lateral ligament of ankle

A

anterior & posterior talofibular lig
calcaneofibular lig
post tibiofibular lig

158
Q

what makes up the longitudinal arch medially

A

calcaneus
talus
navicular
3 cuneiforms
metatarsal heads

159
Q

what makes up the longitudinal arch laterally

A

calcaneus
cuboid
lateral 2 metatarsal bones

160
Q

what makes up the transverse arch

A

bases of 5 metatarsal bones
cuboid
cuneiforms

161
Q

ligamentous aspect of medial longitudinal Arch

A

plantar aponeurosis
spring ligament
FHL
FDL

162
Q

spring ligament origin & insert

A

sustentaculum tali => head of navicular bone

163
Q

longitudinal arch of foot LATERAL ligament

A

plantar aponeurosis and ligaments
peroneus longus

164
Q

important ligament in transverse arch

A

peroneus longus

165
Q

What attaches to iliac crest

A

Lat dorsi
Quadratus lumborum
internal oblique
Transversus abdominis

166
Q

What attaches to pubic crest

A

Rectus abdominis
Pyramidalis

167
Q

Body of pubis muscle attachments

A

Adductor longus
Gracilis
Adductor brevis
Adductor magnus & obturator externus

168
Q

What divides the greater & lesser sciatic notch

A

Spine of ischium & sacrospinus ligament

169
Q

What originates from ischial tuberosity

A

Semimembranosus
Semitendinosus
LH of biceps

170
Q

What attaches to greater trochanter

A

Piriformis
Obturator internus
Gemelli
Glut med, min

171
Q

What attaches to Lesser trochanter

A

Iliopsoas

172
Q

Which aspect of patella is BROAD

A

Lateral surface

173
Q
A