Lower Limb Flashcards by Breea Buckley

Primary ossification of the hip bone

3 primary centers:

one for the body of ilium, body of ischium, and body of pubis

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Secondary ossification of the hip bone

5 secondary centers:

Crest of ilium, AIIS, ischial tuberosity, symphysial surface of pubis, and triradiate cartilage

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Sacroiliac joint

Two joints
Anterior synovial joint- Articulating surface: aricular surface of ilium and sacrum
Posterior syndesmosis (made of fibrous connective tissue)- Articulating surface: tuberosity of ilium and tuberosity of sacrum.
Movements: some rotation (nutation and counternutation) as you bend

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Ligaments of the sacroiliac joint

Anterior sacroiliac ligament, Interosseous and posterior sacroiliac ligaments, Sacrospinous ligament, Sacrotuberous ligament

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Anterior sacroiliac ligament

anterior part of fibrous synovial capsule attaches anterior to auricular surfaces of sacrum & ilium

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Interosseous and posterior sacroiliac ligaments

from tuberosity of sacrum to tuberosity of ilium

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Sacrospinous ligament

from posterior surface of sacrum and coccyx to ischial spine

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Sacrotuberous ligament

from posterior surface of sacrum and coccyx to ischial tuberosity

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At the sacroiliac joint weight is transferred…

through posterior and interosseous ligaments

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Excessive anterior rotation (nutation) of the sacrum is prevented by the…

sacrospinous and sacrotuberous ligaments

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Pubic symphysis

Secondary cartilaginous joint - fibrocartilage interpubic disc
Articulating surfaces: 2 symphyseal surfaces of pubic bone with an interpubic disc between
Movements: typically none, but pulls apart during childbirth & during menstruation (hormones cause ligaments to become lax)

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Sacrococcygeal symphysis

Secondary cartilaginous joint with an intervertebal disc
Articulating surfaces: apex of sacrum and base of coccyx
Movements: typically none, slight movement during childbirth (coccyx gets pushed posteriorly)

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Hip joint

Ball & socket synovial joint
Articulating surfaces: head of femur with acetabulum
Movements: flexion, extension, abduction, adduction, circumduction, and rotation

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Acetabular labrum

cartilage extension that goes all the way around the acetabulum

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Transverse acetabular ligament

connects across the acetabular notch

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Ossification of the femur

One primary ossification center for the body

Four secondary centers: head, greater tubercle, lesser tubercle, and distal end

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Intrinsic ligaments of the hip joint

iliofemoral, pubofemoral, ischiofemoral

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Iliofemoral ligament

Located anterior and superior to hip joint. Attaches from AIIS and acetabular rim of ilium to intertrochanteric line.

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Pubofemoral ligament

Located anterior and inferior to hip joint. Attaches from superior ramus of pubic bone to joint capsule and iliofemoral ligament

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Ischiofemoral ligament

Located posterior to hip joint. Attaches from ace tabular rim of ischium to femoral neck.

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Patella

Sesamoid bone (bone that develops within a tendon) that ossifies from one primary ossification center in the quadriceps tendon.

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Compartments of the thigh and their innervations

Medial- obturator nerve.
Anterior- femoral nerve.
Posterior- sciatic nerve.

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Compartments of the leg and their innervations

Anterior- deep fibular nerve.
Posterior (deep and superficial)- tibial nerve.
Lateral- superficial fibular nerve.

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Femoral artery

Continuation of external iliac after it passes the inguinal ligament.
Supplies thigh, leg, foot, superficial perineum, and inferior abdominal wall.

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Branches of femoral artery

Superficial epigastric, superficial circumflex iliac, external pudendal (supplies anterior perineum), unnamed branches supplying anterior thigh, deep artery of thigh

Deep artery of thigh

Supplies posterior, medial, and lateral thigh, hip joint, and surrounding muscles, and knee joint

Branches of deep artery of thigh

Perforating branches, medial femoral circumflex artery, | lateral femoral circumflex artery

If you have an injury that breaks/fractures the neck of the femur...

the medial circumflex branch of the femoral artery can be severed and lead to necrosis of the head of the femur. May have an artery of round ligament of femoral head that can be derived from either obturator or medial circumflex a. However, this a. is small and will not provide enough blood supply to adequately supply the head of the femur.

Perforating branches of deep artery of thigh

Supply posterior, medial, and lateral thigh.

Medial femoral circumflex artery

Supplies hip joint and surrounding muscles. Sends branches to femoral head. Anastomosis with inferior gluteal artery and lateral circumflex femoral artery.

Lateral femoral circumflex artery

Transverse branch supplies hip joint and surrounding muscles. Descending branch supplies lateral thigh and knee; anastomosis with superior lateral genicular artery and descending genicular artery.

Superficial veins that drain into femoral vein

superficial epigastric, superficial circumflex iliac, great saphenous

Great saphenous vein

Drains superficial dorsum and medial surface of foot, superficial thigh, and superficial medial and anterior leg. Tributary: dorsal venous arch of foot (medially)

Small saphenous vein

Drains into popliteal vein. Drains superficial plantar and lateral surfaces of foot and superficial posterior leg. Tributaries: dorsal venous arch of foot (laterally) & plantar venous network

Cutaneous sensory from gluteal region

Superior buttock: superior clunial nerves = posterior rami of L1-L3. Middle buttock: middle clunial nerves = posterior rami of S1-S3. Inferior buttock: inferior clunial nerves = branches of posterior cutaneous nerve of the thigh (anterior rami of S1-S3)

Cutaneous sensory from anal region

Inferior rectal nerve & anococcygeal nerves

Inferior rectal nerve

Perianal skin, motor to external anal sphincter, branch of pudendal nerve, anterior rami of S3-S4 spinal nerves

Anococcygeal nerves

Perianal skin, anterior rami of S4-Co1 spinal nerves. Come off of sacrococcygeal plexus

Cutaneous sensory from the skin of the inguinal region

Lateral cutaneous branch of iliohypogastric & ilioinguinal (L1)

Cutaneous sensory from the skin of the lateral thigh

Lateral cutaneous nerve of the thigh (L2-L3)

Cutaneous sensory from the skin of the posterior thigh

Posterior cutaneous nerve of the thigh (S1-S3)

Cutaneous sensory from the skin of the lateral leg

Lateral sural nerve (S1)- branch of common fibular nerve

Cutaneous sensory from the skin of the posterior leg and lateral foot

Medial sural nerve (S1-S2)- branch of tibial nerve

Cutaneous sensory from the skin of the upper anterolateral thigh

Lateral cutaneous branch of subcostal n. (T12)

Cutaneous sensory from the skin of the upper anterior thigh

Genitofemoral n. (L1-L2)

Cutaneous sensory from the skin of the anterior thigh

Anterior cutaneous branches of femoral nerve (L2-L4)

Cutaneous sensory from the skin of the upper medial thigh

Ilioinguinal n. (L1)

Cutaneous sensory from the skin of the medial thigh

Cutaneous branch of obturator n. (L2-L4)

Cutaneous sensory from the skin of the anterior/medial leg and medial foot

Saphenous n. (L3-L4) - branch of femoral nerve

Cutaneous sensory from the skin of the dorsum of foot

Superficial fibular nerve (L4-S1)

Cutaneous sensory from the skin of the 1st interdigital cleft

Deep fibular nerve (L5) "flip-flop n."

Dermatome of gluteal region

posterior rami of L1-Co

Dermatome of inferior buttock & anal region

anterior rami of S1-Co

Dermatome of inguinal region & superior anterior thigh

Dermatome of external genitalia

L1, and S2-S4 (posterior genitalia)

Dermatome of medial thigh

L1-L3

Dermatome of anterior thigh

L2-L4

Dermatome of lateral thigh

L2-L5

Dermatome of posterior thigh

S1-S2

Dermatome of medial leg

L3-L4

Dermatome of anterior leg

L4-L5

Dermatome of lateral leg

L5-S1

Dermatome of posterior leg

L5-S2

Dermatome of lateral foot & digit 5

Dermatome of medial foot

L4 & S2

Dermatome of dorsum of foot

L4-S1

Dermatome of sole of foot

L4-S2

Dermatome of heel

L5-S2

Dermatome of medial half of digit 1

Dermatome of digits 2-4 & lateral half of digit 1

Femoral triangle is bounded by

Inguinal ligament superiorly, medially by adductor longus muscle, laterally by sartorius muscle, and posteriorly by iliopsoas and pectineus

Contents of femoral triangle

femoral nerve & femoral sheath containing the femoral artery, femoral vein, & deep inguinal lymph nodes & lymphatic vessels

Spinal cord level of femoral nerve

L2-L4

Muscles innervated by the femoral nerve

Iliacus, pectineus, sartorius, and quadriceps femoris group (rectus femoris, vastus medialis, vastus lateralis, vastus intermedius)

Femoral nerve provides cutaneous sensory to...

the skin of the anterior thigh

Saphenous nerve

Branch of femoral nerve. Cutaneous sensory to the skin of anterior/medial leg and medial foot.

Spinal cord level of obturator nerve

L2-L4

Muscles innervated by the obturator nerve

Gracilis, obturator externus, adductor longus, adductor brevis, and adductor part of adductor magnus

Obturator nerve provides cutaneous sensory to the...

skin of medial thigh

Structures within the adductor canal

femoral artery & vein, saphenous n. (branch of femoral), n. to vastus medialis (branch of femoral)

Location of adductor canal

from apex of femoral triangle to adductor hiatus

Muscles surrounding adductor canal

Anterior and lateral = sartorius m. Anterior and medial = vastus medialis m. Posterior = adductor longus & magnus muscles