Lower Limb Flashcards
What provides cutaneous sensory to the lateral thigh? Intermediate and medial cutaneous?
Lateral: ventral rami of L2,3
Inter/Medial: femoral nerve
What is the origin, insertion, and what muscles are in the ITB?
O: Iliac crest
I: lateral condyle of tibia
Muscles: TFL and Gluteus maximus
What nerves cause the patellar ligament reflex?
L2,3,4
What four muscles make up the Quadriceps Tendon?
- rectus femoris
- vastus medialis
- vastus lateralis
- vastus intermedius
What makes up the boundaries of the femoral triangle?
- Superior: inguinal ligament
- Medial: lateral border of adductor
- Lateral: medial border of sartorius
- Floor: adductor longus, pectineus, psoas major, iliacus
What are the root values of the femoral nerve?
Posterior Division, Ventral Rami of L2,3,4
What are the branches of the femoral nerve?
Femoral
A. Anterior- ant. medial cutaneous, ant. intermediate cutaneous, branch to sartorius
B. Posterior- saphenous nerve, supply to quadratus femoris
Posterior division of femoral nerve supplies two joints. What are they?
Hip and knee.
What are the three branches of the deep femoral artery?
- Medial Circumflex
- Lateral Circumflex
- Four Perforating Arteries (Deep Femoral ends as 4th Perforating)
Why are the 4 perforating arteries important?
They are the only blood supply to the back of the thigh.
What are the branches of the femoral artery?
- Superficial External Iliac
- Superficial External Pudendal
- Superficial Epigastric
- Deep External Pudendal
What do the three compartments of the femoral sheath contain?
- Femoral Artery
- Femoral Vein
- Femoral Canal
This is a common site of herniation
What is in the Adductor Canal (aka, subsartorial canal or hunter’s canal)?
Femoral Artery and Vein, Nerve to vastus medialis and saphenous nerve
What lies in front and behind of adductor brevis?
Front: anterior division of obturator
Behind: posterior division of obturator
Adductor Magnus has how many parts?
- Hamstring Part: ischial tuberosity to adductor tubercle and medial supracondylar line.
- Adductor Part: attached at inferior ischial ramus and inserts at linea aspera and medial supracondylar line
What innervates the adductor magnus?
Adductor part- posterior division of obturator nerve
Hamstring part- tibial part of sciatic nerve
What innervates the obturator externus?
posterior division of obturator nerve.
What are the three adductor muscles?
- Brevis
- Longus
- Magnus
What are the root values of the obturator nerve?
anterior division, ventral rami L2,3,4
What type of joint is the hip socket?
ball and socket synovial joint
Where does the Iliofemoral Ligament attach?
AIIS and acetabular rim and the intertrochanteric line
What are the four ligaments that cover the hip socket?
- pubofemoral
- ishciofemoral
- ligament of the head of the femur
- transverse acetabular
What nerves cross the hip joint?
- Femoral
- Superior Gluteal
- Nerve to Quadratus Femoris
- Obturator
- Sciatic
What muscles abduct?
Gluts medius and minimus. Also assisted by piriformis.
What muscles medial rotate?
Anterior fibers of:
- gluteus medius
- gluteus minimus
- tensor fascia lata
What muscles laterally rotate?
- Gluteus maximus (most powerful)
- Gluteus medius/minimus (posterior fibers)
- Gemelli
- Quadratus femoris
- Piriformis
- Obturator Externus/Internus
What type of joint is the knee?
modified hinge, synovial
What does the ACL do?
prevents hyperextension and prevents posterior displacement of femur on tibia.
What does the PCL do?
prevents hyperflexion and prevents anterior displacement of femur on tibia.
How does the popliteus aid in flexion?
It laterally rotates the tibia so that the joint is “unlocked”.
What type of joint is the ankle?
Hinge, synovial
What muscles help to dorsiflex the foot?
- tibialis anterior
- extensor hallucis longis
- extensor digitorum
- peroneus tertius
what muscles help to plantarflex the foot?
- gastrocnemius
- soleus
- tibialis posterior
- flexor hallucis longus
- flexor digitorum longus
What is “Tom Dick And a Very Nervous Harry?”
T= Tibialis posterior
D= Flexor digitorum longus
A, V, N= Posterior tibial artery, vein, nerve
H= Flexor hallucis longus
When does the popliteal artery appear?
After femoral artery has passed through the adductor hiatus.
What muscles does the tibial nerve supply?
- Popliteus
- Gastroc
- Soleus
- Plantaris
- Tibialis Posterior
- Flexor Digitorum longus
- Flexor Hallucis longus
What muscles are in the extensor compartment of the leg?
- Tibilias anterior
- Extensor hallucis longus
- Extensor digitorum longus
- Peroneus tertius
What are the roots of the common peroneal? What does it divide into?
Ventral rami of L4-S2.
Divides to become superficial and deep peroneal nerves.
What nerve is damaged when you fracture the neck of your fibula? What happens?
Common peroneal nerve is damaged. Causes foot drop, inverted foot and sensory loss to dorsum of foot.
What innvervates most of the muscles no the front of the lower leg?
The deep peroneal nerve. Deep peroneal also innervates extensor hallucis/digitorum brevis and gives sensory to the 1st and 2nd toes.
What are the terminal branches for the anterior tibial artery?
first dorsal metatarsal and deep plantar arteries.
What muscles does the superficial peroneus (fibular) nerve innervate?
Peroneal longus and brevis.
