Lower Limb Flashcards
Which nerve is largely responsible for plantarflexion of the foot at the ankle, and flexion of the toes? Which nerve and its two muscles are the exceptions?
Tibial nerve Fibularis longus and brevis, superficial fibular nerve
Which muscles and nerves are largely involved in inversion of the foot? Generally speaking, muscles that attach where also aid in inversion?
Tibialis anterior (deep fibular) Tibialis posterior (tibial nerve) Muscles that attach on the medial aspect of foot (near hallucis)
Which nerve supplies the entirety of the anterior compartment of the leg?
Deep fibular
Which nerve supplies the lateral compartment of the leg?
Superficial fibular (peroneal)
Which nerve supplies the anterior compartment of the leg?
Deep fibular (peroneal)
Loss of the Achilles tendon reflex relates primarily to a deficit of which nerve root?
an S1 deficit.
If the ______ nerve were injured, eversion of the foot and plantar flexion would be lost in addition to dorsiflexion and inversion.
common fibular (peroneal) #4 Gray
What actions of the foot and ankle would be lost with an injury to the superficial fibular nerve? Because of which muscles?
Eversion, due to the fibularis longus and brevis.
An injury to which nerve would result in foot drop with normal eversion?
Deep fibular
Describe the borders of the femoral triangle (floor, roof, superior, medial, lateral, and apex)
-Floor: iliopsoas (laterally), and pectineus (medially). -Roof: Fascia lata, and cribiform fascia. -Superiorly by the inguinal ligament (thickened inferior margin of external oblique aponeurosis) that forms the base of the femoral triangle. -Medially by the lateral border of the adductor longus. -Laterally by the sartorius -the apex of the femoral triangle is where the medial border of the sartorius crosses the lateral border of the adductor longus.
Name the contents of the femoral triangle (lateral to medial)
-Femoral nerve and its (terminal) branches. -Femoral sheath and its contents: • Femoral artery and several of its branches. • Femoral vein and its proximal tributaries (e.g., the great saphenous and profunda femoris veins). • Deep inguinal lymph nodes and associated lymphatic vessels.
Which muscles make up the pes anserinus and where does it insert?
-Gracilis, semitendinosus, and sartorius. -Inserts into the superior part of the medial surface of the tibia.
To which two bony landmarks does the inguinal ligament attach? What is the space it creates beneath it called?
-ASIS and pubic tubercle. -Retro-inguinal space
What is the innervation for adductor magnus?
Adductor part: Obturator nerve Hamstring part: Tibial part of SCIATIC NERVE
What is the most anterior of the adductor muscles?
Adductor longus
What unique feature is useful in identifying the adductor brevis muscle in dissections and cross-sections?
As the obturator nerve emerges from the obturator canal to enter the medial compartment of the thigh, it splits into an anterior and a posterior division. The two divisions pass anterior and posterior to the adductor brevis.
1.) What are the boundaries of the adductor canal (anterior, posterior, medial, lateral, and roof)? 2.) What does it provide passage to? 3.) What are the contents of the adductor canal (4)? p.556 Moore
1.) Anteriorly and laterally – Vastus medialis. Posteriorly – Adductors longus and magnus. Medially (and roof) – Sartorius 2.) Provides INTERmuscular passage for the femoral vessels to the popliteal fossa (where they become the popliteal vessels). 3.) Femoral artery and vein, saphenous nerve, nerve to vastus medialis.
The femoral sheath does not enclose the ______ because it passes through the __________ compartment.
-femoral nerve -muscular compartment.
The muscular and vascular lacunae/compartments in the retro-inguinal space are partitioned by what structure?
Iliopectineal arch
Which is anterior and posterior – Intertrochanteric line, intertrochanteric crest.
Intertrochanteric line = Anterior Intertrochanteric crest = Posterior
What muscles insert on the greater trochanter of the femur (5)?
Obturator internus, gemelli, piriformis, gluteus minimus, Gluteus medius. *NOT GLUTEUS MAXIMUS* #20 Grays
1.) Where is the apex of the femoral triangle? 2.) What structure begins at this location? 3.) What structures lie deep to the apex of the triangle?
1.) The apex of the femoral triangle occurs at the junction of the adductor longus and sartorius muscles. 2.) The subsartorial (Hunter) canal begins at this location. 3.) Immediately deep to this anatomic point lie the femoral artery, femoral vein, deep femoral artery, and deep femoral vein, often overlying one another in that sequence. #21 Grays
What structures pass beneath the superior extensor retinaculum (5)? (medial to lateral)
- Tibialis anterior 2. Extensor hallucis longus 3. Anterior tibial vessels and nerve 4. Extensor digitorum longus 5.) Peroneus tertius p.590 Moore
What structures are enclosed by the stem of the ‘Y’ formed by the inferior extensor retinaculum (2)?
Peroneus tertius and EHL tendons.
What structures does the medial compartment of the sole contain (4)?
1.) ABductor hallucis 2.) Flexor hallucis brevis 3.) Flexor hallucis longus tendon, 4.) The medial plantar nerve and vessels. p.610 Moore
What structures does the central compartment of the sole contain (6)?
1.) FDB 2.) Tendons of FHL and FDL (and the muscles of FDL) 3-4.) QP and lumbricals 5.) AdH 6.) Lateral plantar nerve and vessels. p.610 Moore
What structures does the lateral compartment of the sole contain (2)?
1.) ABductor digiti minimi brevis 2.) Flexor digiti minimi p.610 Moore
How would one palpate the EDB? (location, and position of foot/toes)
-Lateral part of dorsum of foot, anterior to malleolus. -When TOES ARE EXTENDED, the small fleshy belly can be felt. p.614 Moore
1.) What is the primary function of the plantar muscles? 2.) When are they most active?
1.) To resist forces that tend to reduce the longitudinal arch as weight is received at the heel (posterior end of arch), and then transferred to the ball of the foot and great toe (anterior end of arch). 2.) Most active when stabilizing the foot for propulsion (push-off), a time when forces tend to flatten the foot’s transverse arch.
Describe the action and pennate of bipennate for the interossei of the foot.
-Plantar interossei ADduct (PAD) and arise from a single metatarsal as unipennate muscles. -Dorsal interossei ABduct (DAB) and arise from two metatarsals as bipennate muscles. p.611 Moore
Which tarsals articulate with which cuneiforms?
Navicular – Articulates with all three cuneiforms posteriorly. Cuboid – Lateral cuneiform laterally