Lower limb 2 (proximal neurovasculature, knee and leg) Flashcards
Where does the sacral plexus sit?
On the postero-lateral pelvic wall, anterior to piriformis muscle
What spinal nerves contribute to the sacral plexus?
L4, L5, S1, S2, S3 and S4
What are the major branches of the sacral plexus? (Hint: some irish sailor pesters polly)
Superior gluteal n, Inferior gluteal n, sciatic n, pudendal n, posterior cutaneous n of thigh, lumbosacral trunk (L4 and L5)
Where does the lumbar plexus sit?
It is located in the lumbar region, within the substance of the psoas major muscle and anterior to the transverse processes of the lumbar vertebrae.
What spinal nerves contribute to the lumbar plexus?
T12, L1, L2, L3 and L4
What are the major branches of the lumbar plexus?
Subcostal n, iliohypogastric n, ilioinguinal n, lateral cutaneous n of thigh (LCNT), femoral n, genitofemoral n, obturator n, lumbosacral trunk
What muscles does the ilioinguinal n supply?
After innervating the muscles of the anterior abdominal wall, it passes through the superficial inguinal ring to innervate the skin of the genitalia and middle thigh.
What is Meralgia Paraesthetica (CALVIN KLEIN SYNDROME)?
When the lateral cutaneous n of the thigh enters the anterior thigh, close to the ASIS and so can get compressed. Can occur by wearing tight clothes or by running.
At what level does the aorta bifurcate?
L4
What can happen as a result of pelvic fractures?
Laceration of vessels
At what point does the femoral artery enter the femoral triangle?
At the midinguinal point plus/minus 1.5cm
Where does the femoral vein sit in relation to the femoral artery?
1cm medial to the pulsating femoral artery.
What is the adductor canal and where does it run?
The adductor (subsartorial) canal runs deep to sartorius in the middle 1/3rd of the medial thigh to the adductor hiatus. Contains superficial femoral artery, femoral vein and saphenous nerve
What does the saphenous n innervate?
knee and skin of medial leg and foot
What is compartment syndrome?
Compartment syndrome is a painful condition that occurs when pressure within the muscles builds to dangerous levels. This pressure can decrease blood flow, which prevents nourishment and oxygen from reaching nerve and muscle cells.
Where do the horizontal group of the superficial inguinal nodes sit in relation to the inguinal ligaments?
Sit below the inguinal ligament
Where do the vertical group of the superficial inguinal nodes sit in relation to the great saphenous vein?
Follow the proximal part of the great saphenous vein
Where do the deep inguinal nodes sit?
Located in femoral canal and medial to femoral vein; Cloquet’s node sits in femoral canal
What do the inguinal lymph nodes drain?
Lower limb Perineal region Penis Lower anal canal Lower vagina Anterior labia majora / scrotal skin
What can be confused with a lymph node and hernia in the inner thigh?
Saphena varix - can cause groin region swelling
What is the name of the fibrous joint between the tibia and fibula?
Interosseous membrane
What type of joint is the knee?
Synovial hinge joint
What movements can the knee joint bring?
Flexion-extension
Rotation (medial and lateral)
Translocation (sliding)
Where is the knee joint palpable?
Knee joint line is palpable anteriorly and sits ~2cm distal to the skin crease behind the joint
