Lower Limb Flashcards
What are the borders of the femoral triangle?
Superior - inguinal ligament
Lateral - sartorius
Medial - adductor longus
What are the contents of the femoral triangle from lateral to medial?
Nerve, artery, vein, empty space, lymph nodes (NAVEL)
What structures does the femoral canal contain?
Lymphatic vessels
Lymph nodes
The saphenous opening is present in which structure?
Fascia lata
What is Trendelenburg sign?
When standing on one leg - the pelvis drops on the side that the leg is raised. This is due to weakness of the gluteaus medius and minimus on the side of the raised leg
Name the structure within the head of the femur where the ligamentum teres attaches
Fovea
Damage to which artery would cause avascular necrosis of the femoral head?
Medial femoral circumflex
What is the action of iliopsoas?
Flexion of the hip
Name the quadracepts muscles
Vastus lateralis
Vastus intermedius
Vastus medialis
Rectus femoris
Which quadraceps muscle is involved in hip flexion?
Rectus femoris
Which nerve supplies the adductors of the thigh?
Obturator nerve (L2-4)
Name the 3 hamstring muscles from lateral to medial
Biceps femoris
Semitendinosus
Semimembranosus
What is the innervation of the short head of biceps femoris?
Common fibular nerve
What are the borders of the adductor canal?
Anteromedial - sartorius
Lateral - vastus medialis
Posterior - adduct longus and magnus
Which muscle creates the adductor hiatus?
Adductor magnus
Where is the lumbar plexus located?
Psoas major muscle
Which anterior rami form the sacral plexus?
L1-4
Which nerve roots form the iliohypogastric nerve?
L1
With contributions from T12
What are the motor functions of the iliohypogastric nerve?
Innervates IO and TA
What are the sensory functions of the iliohypogastric nerve?
Innervates the skin of the posterolateral gluteal and pubic regions
Which nerve root forms the ilioinguinal nerve?
L1
What are the motor functions of the ilioinguinal nerve?
Innervates IO and TA
What are the sensory functions of the ilioinguinal nerve?
Innervates the skin of the superior anteromedial thigh, root of penis, anterior scrotum, mons pubis and labia majora
What is the motor function of the genitofemoral nerve?
Genital branch innervates the cremasteric muscle
What are the sensory functions of the genitofemoral nerve?
Genital branch - skin of anterior scrotum, mons pubis and labia majora
Femoral branch - skin on upper anterior thigh
Which nerve in the lumbar plexus is purely sensory?
Lateral cutaneous nerve of the thigh
Which nerve roots form the genitofemoral nerve?
L1-2
Which nerve roots form the lateral cutaneous nerve?
L2-3
What are the sensory functions of the lateral cutaneous nerve?
Innervates the anterior and lateral thigh
Which nerve roots form the obturator nerve?
L2-4
What are the motor and sensory functions of the obturator nerve?
Innervates the muscles and skin of the medial thigh
Which nerve roots form the femoral nerve?
L2-4
What are the motor and sensory functions of the femoral nerve?
Innervates the muscles of the anterior thigh and the skin of the anterior thigh and medial leg
Where is the sacral plexus located?
Posterior pelvic wall, anterior to piriformis
Which nerve roots make up the sacral plexus?
Anterior rami of S1-4
Which nerve roots make up the superior gluteal nerve?
L4-S1
What are the motor functions of the superior gluteal nerve?
Innervates gluteus minimus, gluteus medius and tensor fascia lata
Which nerve roots make up the inferior gluteal nerve?
L5-S2
What are the motor functions of the inferior gluteal nerve?
Innervates gluteus maximus
Which nerve roots make up the sciatic nerve?
L4-S3
What are the motor functions of the sciatic nerve?
Innervates the muscles of the posterior thigh, leg and sole of foot and the anterior and lateral compartments of the lower leg
What are the sensory functions of the sciatic nerve?
Innervates the skin of the posterolateral lower leg, lateral foot and foot
Which nerve roots form the posterior femoral cutaneous nerve?
S1-3
What are the sensory functions of the posterior femoral cutaneous nerve?
Innervates the skin of the perineum, posterior thigh and lower leg
Which nerve roots form the pudendal nerve?
S2-4
What are the motor functions of the pudendal nerve?
Innervates the skeletal muscles of the perineum, external urethral and anal sphincters and levator ani
What are the sensory functions of the pudendal nerve?
Innervates the penis, clitoris and skin of the perineum
Name the 3 other branches of the sacral plexus
Nerve to piriformis
Nerve to obturator internus
Nerve to quadratus femoris
What structure connexts the apex of the patella to the tibial tuberosity?
Patellar ligament
Which tendon travels behind the medial malleous to the foot?
Tibialis posterior
Name the contents of the popliteal fossa from medial to lateral
Popliteal artery
Popliteal vein
Tibial nerve
Common fibular nerve
What are the borders of the popliteal fossa?
Superomedial - semimembranosus
Superolateral - biceps femoris
Inferomedial - medial head of gastrocneumius
Inferolateral - lateral head of gastrocneumius and plantaris
What structures are the most superficial in the popliteal fossa?
Tibial and common fibular nerves
What is the deepest structure in the popliteal fossa?
Popliteal artery
A Baker’s cyst is a benign swelling of which structure?
Semimembranosus bursa
Which superficial vein drains into the popliteal vein within the popliteal fossa?
Small saphenous vein
What is the function of the anterior lower leg muscles?
Dorsiflexion and invertion
Which nerve supplies the muscles in the anterior compartment of the lower leg?
Deep fibular nerve (L4-S2)
What are the attachments of tibialis anterior?
Proximal - lateral surface of tibia
Distal - medial cuneiform, base of 1st metatarsal
What are the attachments of extensor digitorum longus?
Proximal - lateral condyle of tibia and medial surface of fibula
Distal - 2nd-5th toes
What are the attachments of extensor hallucis longus?
Proximal - medial surface of fibular shaft
Distal - base of the 1st distal phalanx
Which muscle in the anterior lower leg is not present in all individuals?
Fibularis tertius
What sign is seen in the gait of someone with foot drop?
Eversion flick - flick the foot outwards when walking to overcome the footdrop
Which anterior lower leg muscle produces eversion at the subtalar joint?
Fibularis tertius
Which artery supplies the anterior compartment of the lower leg?
Anterior tibial artery
Which muscle is responsible for inversion of the foot?
Tibialis anterior
What is the function of the muscles in the lateral compartment of the lower leg?
Eversion of the foot
What are the attachments of fibularis longus?
Proximal - superior and lateral surface of the fibula, lateral tibial condyle
Distal - medial cuneiform, base of 1st metatarsal
What is the nerve supply to the lateral compartment of the lower leg?
Superficial fibular nerve
What are the attachments of fibularis brevis?
Proximal - inferolateral surface of fibular shaft
Distal - tubercle on the 5th metatarsal
Which two tendons pass posterior to the lateral malleolus?
Fibularis longus and brevis
How can the common fibular nerve be located?
In the space between the proximal attachments of fibularis longus to the tibia and fibula
What is the function of the muscles in the posterior lower leg?
Plantarflexion
Inversion of the foot
Which nerve supplies the posterior compartment of the lower leg?
Tibial nerve
Which artery supplies the posterior compartment of the lower leg?
Posterior tibial artery
Which three muscles insert into the calcaneus via the calcaneal tendon?
Gastrocneumius
Soleus
Plantaris
What are the attachements of gastrocneumius?
Proximal - femoral condyles
Distal - calcaneus
What is the function of gastrocneumius?
Plantarflexion
Knee flexion
What are the attachements of soleus?
Proximal - soleal line of tibia, proximal fibula
Distal - calcaneus
Which muscle in the superficial posterior compartment of the leg is not present in all individuals?
Plantaris
Which muscle in the posterior compartment of the lower leg forms the base of the popliteal fossa?
Popliteus
What is the function of popliteus?
Lateral flexion of the femur relative to the tibia
What are the attachments of flexor digitorum longus?
Proximal - medial surface of the tibia
Distal - plantar surface of the lateral 4 digits
What are the attachments of flexor hallucis longus?
Proximal - posterior surface of the fibula
Distal - plantar surface of the phalanx of the great toe
Which muscle is the deepest muscle in the posterior compartment of the lower leg?
Tibialis posterior
Which nerve roots does the calcaneal reflex assess?
S1-2
Which talar bone is at high risk of avascular necrosis?
Talus
A strain of which muscle can lead to an avulsion fracture of the 5th metatarsal?
Fibularis brevis
Which nerve roots are involved in Babinski sign?
L4-S2
Which artery is the largest contributor to the blood supply of the femoral head and neck?
Medial circumflex femoral artery
Which myotome is associated with knee extension?
L3
Damage to which artery can result in avascular necrosis of the femoral head?
Medial circumflex femoral artery
Which nerves are implicated in referred pain from the hip to knee and knee to hip?
Sciatic nerve
Femoral nerve
Obturator nerve
Name the fibrocartilaginous structure which stablises the hip joint
Acetabular labrum
Which nerve is most likely to be damaged in a posterior hip dislocation?
Sciatic nerve
Which type of hip dislocation is most common?
Posterior
Which anastomosis supplies the knee joint?
Genicular
Which ligament acts to prevent over-eversion of the foot?
Medial (deltoid) ligament
Which ligaments prevent over-inversion of the foot?
Anterior talofibular
Posterior talofibular
Calcaneofibular
Which joint is responsible for inversion and eversion of the foot?
Subtalar joint
Which ligament joins the talus and calcaneus together?
Interosseous talocalcaneal ligament
Which ligament lies within the sinus tarsi?
Interosseous talocalcaneal ligament
Where is the tarsal tunnel located?
Posteromedial aspect of the ankle
Where does the flexor retinaculum in the foot span from?
Medial malleolus to the medial tubercle of the calcaneus
Which structures pass through the tarsal tunnel from anterior to posterior? (Tom, Dick and a Very Nervous Harry)
Tibialis posterior tendon
flexor
Digitorum longus tendon
Posterior tibial artery and vein
Tibial nerve
Flexor Hallucis longus tendon
Where would the sensory disturbance be present in Tarsal Tunnel Syndrome?
Sole of foot
Where would the motor disturbance be present in Tarsal Tunnel Syndrome?
Wasting of the intrinsic foot muscles
Name the two extrinsic muscles in the dorsum of the foot
Extensor digitorum brevis
Extensor hallucis brevis
Which nerve supplies the intrinsic muscles of the dorsum of the foot?
Deep fibular nerve
Which nerve supplies the intrinsic muscles of the sole of the foot?
Medial and lateral plantar nerve which are branches of the tibial nerve
What is the action of quadratus plantae?
Flexion of lateral four toes
What is the function of the lumbricals in the foot?
Flexion of MTP
Extension of IPJs
Which nerve supplies the interossei?
Lateral plantar nerve
Which muscle is likely to cause an avulsion fracture of the 5th metatarsal?
Fibularis brevis
