Lower Limb Flashcards
action of the gluteal muscles
extend, rotate and abduct the thigh
where do the major flexors of the hip arise?
posterior abdo wall
anterior compartment of thigh has what action and why?
extensor because limb rotates in development. Doesnt apply to hip because didnt rotate. Therefore flexor at hip
which bone is lateral in lower limb?
fibula
medial compartment of thigh has what action?
adductor
what is the iliotibial tract?
fibrous reinforcement of the fascia lata running from pelvis over hip and inserting lateral to knee
name the gluteal muscles. which is most superficial and what is their action?
Maximus, medius and minimis. Abduct and medially rotate. Maximus most superficial
name the quadriceps muscles, origins, insertions and their actions
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 tuberosityThey Extend the knee but RF also flexes hip
where is sartorius and why is it so named?
thigh muscle running medially obliquely named after tailors who sat cross legged
where is pectineus?
anterior thigh
where is gracilis?
medial thigh?
name the adductors and their location. Which is more deep and name one significant aspect of its structure
adductor longus and magnus. in medial thigh compartment. Magnus is deepest and has opening for vessels
weakness of VM can causes what?
abnormal patella tracking
name the muscles of the hamstring, their origin and insertion. Which is most medial
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
why is the hamstring prone to injury? which muscle most common
muscles cross 2 joints (hip and knee) so prone to strain when acting on both simultaneously. Biceps most common
action of iliopsoas? where is it
hip flexor - anterior thigh
what is in the anterior leg compartment from medial to lateral
Tibialis Ant, EHL, EDL
where does Tibialis Anterior Insert? what are its actions?
medial cuneiform and base of 1st meta-tarsal. dorsiflexing and inverting the foot
what is fibularis tertius?
muscle that splits from EDL to insert into base of 5th toe
muscles of the dorsum of the foot (medial to lateral)? What do they pass beneath
Timothy Has A nasty, dirty Toe. Pass beneath extensor retinaculum. TA, EHL, Anterior Tibila Artery, Nerve (deep fibular), EDL, Fibularis Tertius
muscles of the lateral compartment of leg and their action. Which tendon is more superior in ankle?
Fibularis Longus and Brevis. Evert the foot. FB more superior
what is the role of popliteus and where is it
unlocks the knee (medial rotation). posterior leg
which leg muscle is always present but completely insignificant
plantaris
posterior muscles from superficial to deep? Then medial to lateral
Gastrocnemius, Soleus, FDL, tibialis posterior, FDH (the toe flexors are counter-intuitive)
Medial tendons of the ankle (superior to inferior). What do they pass beneath?
Tom, Dick And Very Naughty Harry. Pass under flexor retinaculumTP, FDL, Artery (posterior tibial), Vein (Posterior tibial), Nerve (tibial), FHL
where do gastroc arise and insert?
one from each condyle of femur, blend with soleus to become Achilles tendon (inserts into calcaneus)
calf muscles? action?
Gastroc ( 2 bellies & superficial) & soleus - plantarflex foot
how does the Line of Gravity run in relation to the Joints
BFF (big fucking foot) (behind hip, in Front of knee & ankle)
Large muscles in the gluteal region are supplied by….
superior and inferior gluteal nerves
Anterior compartment of thigh is supplied by….
femoral nerve
Medial compartment of thigh is supplied by…
obturator
Posterior compartment of thigh and leg, and sole of foot are supplied by
tibial (except short head of biceps)
which muscle is excluded from tibial nerve supply
short head of biceps
Anterior and lateral compartments of leg, and dorsum of foot are supplied by….
common fibula
what is the sensory supply of the femoral nerve
anterior and medial thigh, medial leg and foot
what is the sensory supply of obturator nerve
medial thigh just above knee
tibial part of sciartic nerve does what in terms of sensation?
posterior leg via sural nerve + heel and sole of foot
sensory of common fibula (peroneal)?
lateral leg and dorsum of foot
where does the sensory supply of lateral and posterior thigh come from?
directly from lumbar plexus and sacral plexus respectively - the lateral cutaneous nerve of thigh (lumbar) & posterior cutaneous nerve of thigh (sacral)
where is the lumbar plexus located?
within psoas major
range of lumbar plexus?
L1-4
which nerves emerge on quadratus lumborum
iliohypogastric & ilioinguinal (L1)
nerves of lateral border of lumbar plexus? (3)
iliohypogastric & ilioinguinal (L1).Lateral cutaneous nerve of thigh (L2-3).Femoral (L2-4)
nerve of anterior border?
genitofemoral (L1-2)
nerve of medial border?
Obturator (L2-4)
what is the saphenous nerve and what does it supply?
branch of femoral nerve. supplies medial leg
describe course of femoral nerve
emerges from lateral border of psoas (L2-4 posterior division of plexus)> under inguinal ligament> 2.5cm later divides into terminal branches
describe motor and sensory supply of femoral nerve
motor: quads, sartorius and pectineus.Sensory: Anteromedial thigh, medial knee, leg and ankle
what is interesting about pectineus
transitional muscle b/w anterior and medial compartment. so adducts and flexes hip. Nerve supply from both
describe course of obturator nerve
emerge from medial border of psoas (L2-4 anterior division of plexus)> lateral wall of pelvis > obturator canal > medial compartment of thigh
motor and sensory supply of obturator
motor: adductor (except hamstring part of adductor magnus), some of pectineus.Sensory: small medial bit above knee
spinal range of sciatic nerve
L4-S3 (anterior + posterior divisions)
course of sciatic nerve
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)
motor and sensory of sciatic
motor: hammys (except SHOB).Sensory: nothing
path of tibial
desecends popliteal fossa on tibialis posterior> posterior to medial malleolus > sole of foot> divides to medial and lateral plantar nerves
motor and sensory of tibial
motor: Posterior leg and sole of foot.Sensory: Posterior leg (sural) and sole of foot
path of Common Fibulae
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
spinal segments of common fibular
L4-S2
what does common fibular supply.
NO MOTOR.Sensory: upper lateral leg (via lateral sural cutaneous)
supply of Deep fibular
motor: whole anterior compartment of leg & EDB (digits 2-4).Sensory: 1st toe cleft (little triangle b/w first two toes)
supply of superficial fibular
Motor: lateral legSensory: lower lateral leg and dorsum of foot
referred pain from ovary can be via which nerve and to where can the pain be referred?
obturator - little medial bit just above knee
what is compartment syndrome? what causes it and what are clinical signs?
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.
what are the main superficial veins of lower limb and what is their relative position
Great Saphenous (anterior) & short Saphenous (posterior)
what marks external iliac artery to femoral artery
inguinal ligament
what marks femoral to popliteal artery
adductor hiatus
branch of femoral artery?
profunda femoris
branches of popliteal artery?
genicular anastamosis (goes round knee joint), anterior tibial and posterior tibial
what marks popliteal to posterior tibial artery?
inferior border of popliteus
what does the anterior tibial artery become
dorsalis pedis
what does the posterior tibial artery become and when?
medial + lateral plantar arteries (Origin under Flexor Retinaculum) & Fibular (peroneal) artery (just below knee)
describe the arches of the foot
2 longitudinal (medial and lateral) & 1 transverse
what creates the tarsal tunnel? what are its contents?
flexor R. contents are TDAVNH
span of flexor R?
medial malleolus to medial calcaneus
span of extensor and lateral retinaculum
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.
for main structures of the dorsum of foot?
EDB, extensor hoods, dorsalis pedis & deep fibular nerve
EDB in relation to EDL
deep
describe the layers of the sole?
plantar aponeurosis then 4 layers (short, long, short, short)
where in regards to the sole layers are the neurovascular structures. describe the innervation of toes
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
which digit is abduction/adduction around?
2nd
invertors of foot?
tibialis ant and post
evertors of foot?
fibularis, longus and brevis
