Lower Limb Flashcards

1
Q

action of the gluteal muscles

A

extend, rotate and abduct the thigh

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2
Q

where do the major flexors of the hip arise?

A

posterior abdo wall

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3
Q

anterior compartment of thigh has what action and why?

A

extensor because limb rotates in development. Doesnt apply to hip because didnt rotate. Therefore flexor at hip

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4
Q

which bone is lateral in lower limb?

A

fibula

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5
Q

medial compartment of thigh has what action?

A

adductor

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6
Q

what is the iliotibial tract?

A

fibrous reinforcement of the fascia lata running from pelvis over hip and inserting lateral to knee

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7
Q

name the gluteal muscles. which is most superficial and what is their action?

A

Maximus, medius and minimis. Abduct and medially rotate. Maximus most superficial

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8
Q

name the quadriceps muscles, origins, insertions and their actions

A

Rectus femoris, Vastus Lateralis, V. Medailis & V. Intermedius (deep).
All originate on femur except RF which is from ilium. all blend with patella to become quadriceps ligament and then patella ligament which inserts into Tibial tuberosity
They Extend the knee but RF also flexes hip

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9
Q

where is sartorius and why is it so named?

A

thigh muscle running medially obliquely named after tailors who sat cross legged

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10
Q

where is pectineus?

A

anterior thigh

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11
Q

where is gracilis?

A

medial thigh?

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12
Q

name the adductors and their location. Which is more deep and name one significant aspect of its structure

A

adductor longus and magnus. in medial thigh compartment. Magnus is deepest and has opening for vessels

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13
Q

weakness of VM can causes what?

A

abnormal patella tracking

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14
Q

name the muscles of the hamstring, their origin and insertion. Which is most medial

A

Semimembranosus, semitendinosus and biceps femoris.
Origin is ischial tuberosity. The Semi’s insert and into medial tibia. Biceps (long and short head) insert into lateral head of fibula

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15
Q

why is the hamstring prone to injury? which muscle most common

A

muscles cross 2 joints (hip and knee) so prone to strain when acting on both simultaneously. Biceps most common

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16
Q

action of iliopsoas? where is it

A

hip flexor - anterior thigh

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17
Q

what is in the anterior leg compartment from medial to lateral

A

Tibialis Ant, EHL, EDL

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18
Q

where does Tibialis Anterior Insert? what are its actions?

A

medial cuneiform and base of 1st meta-tarsal. dorsiflexing and inverting the foot

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19
Q

what is fibularis tertius?

A

muscle that splits from EDL to insert into base of 5th toe

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20
Q

muscles of the dorsum of the foot (medial to lateral)? What do they pass beneath

A

Timothy Has A nasty, dirty Toe. Pass beneath extensor retinaculum.
TA, EHL, Anterior Tibila Artery, Nerve (deep fibular), EDL, Fibularis Tertius

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21
Q

muscles of the lateral compartment of leg and their action. Which tendon is more superior in ankle?

A

Fibularis Longus and Brevis. Evert the foot. FB more superior

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22
Q

what is the role of popliteus and where is it

A

unlocks the knee (medial rotation). posterior leg

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23
Q

which leg muscle is always present but completely insignificant

A

plantaris

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24
Q

posterior muscles from superficial to deep? Then medial to lateral

A

Gastrocnemius, Soleus, FDL, tibialis posterior, FDH (the toe flexors are counter-intuitive)

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25
Q

Medial tendons of the ankle (superior to inferior). What do they pass beneath?

A

Tom, Dick And Very Naughty Harry. Pass under flexor retinaculum
TP, FDL, Artery (posterior tibial), Vein (Posterior tibial), Nerve (tibial), FHL

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26
Q

where do gastroc arise and insert?

A

one from each condyle of femur, blend with soleus to become Achilles tendon (inserts into calcaneus)

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27
Q

calf muscles? action?

A

Gastroc ( 2 bellies & superficial) & soleus - plantarflex foot

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28
Q

how does the Line of Gravity run in relation to the Joints

A

BFF (big fucking foot) (behind hip, in Front of knee & ankle)

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29
Q

Large muscles in the gluteal region are supplied by….

A

superior and inferior gluteal nerves

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30
Q

Anterior compartment of thigh is supplied by….

A

femoral nerve

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31
Q

Medial compartment of thigh is supplied by…

A

obturator

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32
Q

Posterior compartment of thigh and leg, and sole of foot are supplied by

A

tibial (except short head of biceps)

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33
Q

which muscle is excluded from tibial nerve supply

A

short head of biceps

34
Q

Anterior and lateral compartments of leg, and dorsum of foot are supplied by….

A

common fibula

35
Q

what is the sensory supply of the femoral nerve

A

anterior and medial thigh, medial leg and foot

36
Q

what is the sensory supply of obturator nerve

A

medial thigh just above knee

37
Q

tibial part of sciartic nerve does what in terms of sensation?

A

posterior leg via sural nerve + heel and sole of foot

38
Q

sensory of common fibula (peroneal)?

A

lateral leg and dorsum of foot

39
Q

where does the sensory supply of lateral and posterior thigh come from?

A

directly from lumbar plexus and sacral plexus respectively - the lateral cutaneous nerve of thigh (lumbar) & posterior cutaneous nerve of thigh (sacral)

40
Q

where is the lumbar plexus located?

A

within psoas major

41
Q

range of lumbar plexus?

A

L1-4

42
Q

which nerves emerge on quadratus lumborum

A

iliohypogastric & ilioinguinal (L1)

43
Q

nerves of lateral border of lumbar plexus? (3)

A

iliohypogastric & ilioinguinal (L1).
Lateral cutaneous nerve of thigh (L2-3).
Femoral (L2-4)

44
Q

nerve of anterior border?

A

genitofemoral (L1-2)

45
Q

nerve of medial border?

A

Obturator (L2-4)

46
Q

what is the saphenous nerve and what does it supply?

A

branch of femoral nerve. supplies medial leg

47
Q

describe course of femoral nerve

A

emerges from lateral border of psoas (L2-4 posterior division of plexus)> under inguinal ligament> 2.5cm later divides into terminal branches

48
Q

describe motor and sensory supply of femoral nerve

A

motor: quads, sartorius and pectineus.
Sensory: Anteromedial thigh, medial knee, leg and ankle

49
Q

what is interesting about pectineus

A

transitional muscle b/w anterior and medial compartment. so adducts and flexes hip. Nerve supply from both

50
Q

describe course of obturator nerve

A

emerge from medial border of psoas (L2-4 anterior division of plexus)> lateral wall of pelvis > obturator canal > medial compartment of thigh

51
Q

motor and sensory supply of obturator

A

motor: adductor (except hamstring part of adductor magnus), some of pectineus.
Sensory: small medial bit above knee

52
Q

spinal range of sciatic nerve

A

L4-S3 (anterior + posterior divisions)

53
Q

course of sciatic nerve

A

Exits via GSF> emerges beneath piriformis > posteroir to hip joint > descends in posterior thigh under biceps > divides into common fibula and tibial 2/3s down thigh (variations)

54
Q

motor and sensory of sciatic

A

motor: hammys (except SHOB).
Sensory: nothing

55
Q

path of tibial

A

desecends popliteal fossa on tibialis posterior> posterior to medial malleolus > sole of foot> divides to medial and lateral plantar nerves

56
Q

motor and sensory of tibial

A

motor: Posterior leg and sole of foot.
Sensory: Posterior leg (sural) and sole of foot

57
Q

path of Common Fibulae

A

once diverges from sciatic medial to lateral head of biceps> superficial to gastroc > wraps around neck of fibula > divides into terminal branches (deep and superficial) on fibularis longus

58
Q

spinal segments of common fibular

A

L4-S2

59
Q

what does common fibular supply.

A

NO MOTOR.

Sensory: upper lateral leg (via lateral sural cutaneous)

60
Q

supply of Deep fibular

A

motor: whole anterior compartment of leg & EDB (digits 2-4).
Sensory: 1st toe cleft (little triangle b/w first two toes)

61
Q

supply of superficial fibular

A

Motor: lateral leg
Sensory: lower lateral leg and dorsum of foot

62
Q

referred pain from ovary can be via which nerve and to where can the pain be referred?

A

obturator - little medial bit just above knee

63
Q

what is compartment syndrome? what causes it and what are clinical signs?

A

increased pressure in one of the muscular compartments. Can be caused by oedema or muscle swelling.
Signs (5 Ps): Pale,, Pulseless, Pain, Pins & needles and Paralysed.

64
Q

what are the main superficial veins of lower limb and what is their relative position

A

Great Saphenous (anterior) & short Saphenous (posterior)

65
Q

what marks external iliac artery to femoral artery

A

inguinal ligament

66
Q

what marks femoral to popliteal artery

A

adductor hiatus

67
Q

branch of femoral artery?

A

profunda femoris

68
Q

branches of popliteal artery?

A

genicular anastamosis (goes round knee joint), anterior tibial and posterior tibial

69
Q

what marks popliteal to posterior tibial artery?

A

inferior border of popliteus

70
Q

what does the anterior tibial artery become

A

dorsalis pedis

71
Q

what does the posterior tibial artery become and when?

A

medial + lateral plantar arteries (Origin under Flexor Retinaculum) & Fibular (peroneal) artery (just below knee)

72
Q

describe the arches of the foot

A

2 longitudinal (medial and lateral) & 1 transverse

73
Q

what creates the tarsal tunnel? what are its contents?

A

flexor R. contents are TDAVNH

74
Q

span of flexor R?

A

medial malleolus to medial calcaneus

75
Q

span of extensor and lateral retinaculum

A

extensor has 2. The superior is on anterior border of tib and fib. Inferior is Y shaped going from medial mal and medial plantar to lateral calcaneous.

76
Q

for main structures of the dorsum of foot?

A

EDB, extensor hoods, dorsalis pedis & deep fibular nerve

77
Q

EDB in relation to EDL

A

deep

78
Q

describe the layers of the sole?

A

plantar aponeurosis then 4 layers (short, long, short, short)

79
Q

where in regards to the sole layers are the neurovascular structures. describe the innervation of toes

A

b/w layers 1 & 2.

Lateral plantar nerve does lat 1.5 toes and nearly all intrinsic muscles. Medial plantar nerve does medial 3.5 toes

80
Q

which digit is abduction/adduction around?

A

2nd

81
Q

invertors of foot?

A

tibialis ant and post

82
Q

evertors of foot?

A

fibularis, longus and brevis