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Anatomy > Lower Limb > Flashcards

Lower Limb Flashcards

1
Q

What are the nerve roots of the lat. fem. cut. n. of thigh?

A

L2 and L3

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2
Q

What are the nerve roots of the femoral nerve?

A

L2, L3, L4

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3
Q

What are the nerve roots of the obturator nerve?

A

L2, L3, L4

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4
Q

What are the nerve roots of the superior gluteal nerve?

A

L4, L5, S1

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5
Q

What are the nerve roots of the inferior gluteal nerve?

A

L5, S1, S2

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6
Q

What are the nerve roots for nerve to obturator internus and superior gemellus?

A

L5, S1, S2

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7
Q

What are the nerve roots for the nerve to the quadratus femoris and inferior gemellus?

A

L4, L5, S1

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8
Q

What are the nerve roots to the posterior cut. n. of thigh?

A

L4, L5, S1

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9
Q

What are the sciatic nerve roots?

A

L4, L5, S1, S2, S3

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10
Q

Where does the lumbosacral plexus or nerve roots come from?

A

the intervertebral foramen of the lumbar and sacral spine

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11
Q

What kind of nerves are the lumbosacral plexus?

A

mixed nerves just like brachial plexus

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12
Q

Where does the lumbosacral trunk arise from?

A

L4 and L5 nerves

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13
Q

What are the three pelvic ligaments?

A

sacroiliac, sacrospinous and sacrotuberous

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14
Q

Which ligament forms the greater sciatic notch into a foramen?

A

the sacrospinous ligament

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15
Q

Where does the sacrospinous ligament attach?

A

the sacrum and the ischial spine (posterior)

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16
Q

What are the ligaments and parts that make up the hip joint?

A

acetabular labrum, transverse acetabular ligament and the ligament of the head of the femur

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17
Q

What is the articular capsule?

A

a bag that holds itself over the bones and produces synovial fluid

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18
Q

What are the ligaments of the hip?

A

iliofemoral, ischialfemoral, pubofemoral

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19
Q

When is hip ligamentum the tightest?

A

When your hip is in extension because the ligaments are anterior

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20
Q

When is the only time the sacroiliac joint moves?

A

during birth

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21
Q

What two joints make up the pelvic girdle?

A

sacroiliac and hip joints

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22
Q

What is three names for the three fused bones?

A

innominate
ox coxae
1/2 pelvis

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23
Q

What is the IT band?

A

iliotibial band

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24
Q

What muscle is associated with the IT band?

A

tensor fascia lata

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25
Q

What are the main veins in the leg?

A

femoral, great saphenous, popliteal, short saphenous

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26
Q

What is in the femoral triangle?

A

the saphenous opening

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27
Q

What borders the femoral triangl?

A

the sartorius, adductor longus and the inguinal ligament

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28
Q

What is in the saphenous opening?

A

the femoral vein, femoral artery and femoral nerve

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29
Q

What does NAVEL stand for?

A 
Nerve
Artery
Vein
Empty space
Lymphs
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30
Q

What are the three muscle groups of the thigh?

A
  1. anterior/quadriceps
  2. medial/adductors
  3. posterior/hamstrings
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31
Q

What do the hamstrings do?

A

thigh/hip extension

leg flexion

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32
Q

What do the quads do?

A

hip flexion

leg extension

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33
Q

What do the adductors do?

A

adduct the thigh

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34
Q

What is the anterior gateway to the lower limb?

A

inguinal ligament

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35
Q

Which muscle does not go under the inguinal ligment?

A

psoas

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36
Q

What muscles make up the quads?

A

rectus femoris
vastus lateralis
vastus medialias
vastus intermedius

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37
Q

Where do the quads go and how?

A

to the patella via the quad tendon

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38
Q

Whats another name for the quad tendon?

A

patellar tendon

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39
Q

If its muscle to bone…

If its bone to bone…

A

muscle to bone = tendon

bone to bone = ligament

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40
Q

What is the only lateral muscle?

A

tensor fascia lata

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41
Q

What is another name for the sartorius muscle?

A

tailors muscle

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42
Q

What movements can the sartorius do?

A

at hip: abduct, laterally rotate and flex

at knee: flex

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43
Q

Where is vastus medialis for the most part?

A

posterior femur

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44
Q

What is vastus intermedius deep to?

A

rectus femoris

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45
Q

What are the three biggest hip flexors?

Name two additional in the thigh?

A

psoas + (- doesn’t cross hip)
iliacus
iliopsoas

thigh: sartorius and rectus femoris

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46
Q

Most of the anterior leg muscles are innervated by the..

A

femoral nerve

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47
Q

What movements to the medial/adductor group do?

A

flex, adduct and rotate the hip

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48
Q

What nerve innervates the medial group?

A

obturator

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49
Q

List the medial thigh muscles including the adductors?

A

adductor magnus, longus, brevis
pectineus
gracilis

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50
Q

What lies under pectineus?

A

adductor brevis

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51
Q

What muscles tendon is sometimes used to replace knee tendons?

A

gracilis

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52
Q

What is the adductor hiatus and what runs through it?

A

hole in muscle that allows blood vessels to go through

femoral artery/vein go through adductor hiatus to back of the leg

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53
Q

What do the femoral artery and vein become when they go through the adductor hiatus?

A

popliteal artery and vein

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54
Q

Is there a saphenous artery?

A

NO

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55
Q

From the most superficial to deep list the layers of the adductors/medial group?

A

pectineus, longus, gracilis
brevis
magnus

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56
Q

What is the exception of the innervation rule?

A

biggest and smallest muscles exception:

pectineus –> femoral nerve

adductor magnus has two parts:

1) adductor/oblique - obturator nerve
2) extensor/hamstring/vertical - sciatic nerve

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57
Q

If we are looking at the posterior knee what gives this away?

A

the condyles

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58
Q

What is the path for the femoral artery and vein to get to the popliteal fossa?

A

subsartorial canal

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59
Q

Name the order of the blood supply to the thigh?

A

abdominal aorta
common iliac artery
internal and external iliac arteries
external iliac artery becomes femoral artery and profunda femoris artery

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60
Q

What does evulsion mean?

A

to tear a muscle off the bone

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61
Q

Name a bursa on the posterior thigh and where it is specifically?

A

ischial bursa

between gluteus maximus and the ischial tuberosity

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62
Q

What is the main hip extensor?

A

gluteus maximus

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63
Q

Which muscles are crucial for gait? Why?

A

gluteus medius and minimus

level the ground hip while the other leg is swinging forward when we walk

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64
Q

Which two muscles are leg abductors?

A

gluteus medius and minimus

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65
Q

What is it called if you pinch the SGN?

A

trendelenberg gait - dropping of pelvis on both sides

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66
Q

What is the purpose of the foot on the ground when walking?

A

resists hip adduction to stabilize or level the pelvis

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67
Q

List the lateral rotator muscles?

A 
piriformis
superior gemellus
obturator internus
inferior gemellus
obturator externus
quadratus femoris
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68
Q

Obturator internus bends 90 degrees over what structure?

A

ischium

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69
Q

Where are the superior gluteal nerve and artery? What do they supply?

A

superior to piriformis

gluteus medius, minimus and tensor fascia lata

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70
Q

Where are the inferior gluteal nerve and artery? What do they supply?

A

inferior to piriformis

gluteus maximus

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71
Q

Where does the sciatic nerve appear in the gluteal region?

A

under pirifomris

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72
Q

What is bundle around the sciatic nerve called? And what is inside?

A

epinuerium

two nerves: tibular and fibular portion

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73
Q

What innervates piriformis?

A

nerve to piriformis and ventral rami S1 and S2

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74
Q

What innervates the obturator externus?

A

obturator nerve

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75
Q

List the posterior thigh muscles

A

semimembranosus, semitendenosus, biceps femoris

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76
Q

What two muscles border the popliteal fossa?

A

semimembranosus and biceps femoris

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77
Q

What is the common origin and innervation of the hamstrings?

A

ischial tuebrosity and the sciatic nerve

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78
Q

What are the differences in the moves of the long and short head of biceps femoris?

A

long head: extends hip and flexes knee

short head: flexes knee

79
Q

Which nerve innervates the long head and which nerve innervates the short head?

A

long head: tibial portion of sciatic nerve

short head: common peroneal portion (fibular) of sciatic nerve

80
Q

What muscles make up the tripod/inverted muscles?

A

semitendenosus
gracilis
sartorius

81
Q

What is the tripod/inverted muscles?

A

three different msucles, three different nerves, three different functions but the same insertion (pes anserinis) and all two joint muscles

82
Q

Where is pes anserinis?

A

anterior medial part of tibia

83
Q

What is another name for pes anserinis?

A

Goose’s foot

84
Q

List the knee ligaments?

A

fibular/lateral collateral lig (LCL)
tibial/medial collateral lig (MCL)
patella ligament

85
Q

Where does the LCL attach?

A

lateral femur to lateral fibula

86
Q

What is the purpose of the LCL?

A

keeps knee from sliding sideways

87
Q

Where does the MCL attach?

A

medial femur to medial tibia

88
Q

What is the purpose of the MCL?

A

prevent medial movement of tibula or femur

89
Q

What does the quadriceps tendon attach to?

A

the patella (seisamoid bone)

90
Q

How can you test the LCL?

A

push on the side of the leg, prevents the knee from bending like book

91
Q

How does the femur articulate with the tibia?

A

the femoral condyles articulate with the tibial plateau covered in hyaline cartilage

92
Q

What is the articularis genu muscle? Attachments and function?

A

hooks up to vastus intermedialis and inserts on the suprapatellar bursa and joint capsule

it pulls/tightens the bursa and capsule during knee extension

93
Q

What is the bursa on the knee called?

A

the prepatellar bursa

94
Q

Where is the prepatellar bursa?

A

just under skin on top of the patella

95
Q

What is housemaids knee?

A

inflammation (bursitis) of the prepatellar bursa

96
Q

Name the cruciate ligaments

A

the anterior cruciate ligament (ACL)

posterior cruciate ligament (PCL)

97
Q

Where does the ACL attach?

A

the anterior tibia plateau to the lateral femoral condyle

98
Q

Where does the PCL attach?

A

the posterior tibia plateau to the inside of the medial femoral condyle

99
Q

Do the ACL and PCL have blood supply?

A

No, avascular - bathed in synovial fluid

100
Q

What is the function of the ACL?`

A

prevents anterior movement of the tibia

and posterior movement of the femur

101
Q

What is the function of the PCL?

A

prevents posterior movement of the tibia

and anterior movement of the femur

102
Q

the ACL tightens during ______

the PCL tightens during ______

A

ACL - knee extensions

PCL - knee flexion

103
Q

Name the other ligaments of the posterior knee

A

oblique popliteal ligament (removed with capsule)
arcuate popliteal ligament (fibula to popliteal fossa)
meniscofemoral ligament

104
Q

What makes up the tibial plateau?

A

menisci and ligaments

105
Q

What are the differences between the medial and lateral menisci?

A

medial is less filled in

lateral is thicker/more filled in but small that medial

106
Q

What is the purpose of the transverse ligament of the knee?

A

prevents the menisci from moving forward during extension

107
Q

Where are the coronary ligaments of the knee? and what are their function?

A

all around the outside of the knee to hold the meniscus to the tibia

108
Q

Is there space between the MCL and MM?

A

no they hook together

109
Q

Once you damage the hyaline cartilage of the knee does it grow back?

A

no now you have fibrocartilage

110
Q

What are the tests you can do on cruciate ligament laxity?

A

the anterior drawer test - anterior cruciate test
pull on leg from the back towards you
the head of tibia will pop out anteriorly if the ACL is torn

posterior drawer test - posterior cruciate test
push drawer back in

111
Q

What does the popliteus do?

A

unlocks the knee
when the foot is on the ground it causes the femur to rotate laterally to unlock
when foot is off the ground it will rotate femur medially

112
Q

What happens if your popliteus is not functioning?

A

you have to do funky hip movements to unlock the knee

113
Q

What is the terrible triad injury?

A

damage the MM, MCL and the ACL

114
Q

If you have a positive anterior drawer test what does this mean?

A

you have loosened or torn your ACL

115
Q

Where does the short saphenous vein and the sural nerve travel?

A

between the gastrocs

116
Q

What is the triceps surae?

A

the three big muscles in posterior leg

medial and lateral gastrocs and the soleus

117
Q

What is the densest bone in the body?

A

calcaneus

118
Q

What borders the popliteal fossa?

A

gastrocs, semitendenosus and biceps femoris

119
Q

What are the three connections of the fibula to tibia?

A

1) superior tibiofibular joint
2) interosseous membrane
3) inferior tibiofibular joint

120
Q

Why is fascia clinically important?

A

compartment syndrome

121
Q

What fascia do we have in the shank?

A

superficially - fascia lata

deep - crural fascia

122
Q

Where does compartment syndrome typically happen?

A

in the front of the shank because excess blood flow in confined space

123
Q

What is supination of the foot?

A

plantar flexion and inversion

124
Q

What is pronation of the foot?

A

dorsiflexion and eversion

125
Q

What is genu valgum?

A

also known as knock knee

pronation - eversion of foot when walking

126
Q

What is genu varum?

A

also known as bow legged

supination - inversion of foot when walking

127
Q

Why don’t we lose blood supply to our leg when we kneel?

A

because there are genicular anastomoses

artery to artery

128
Q

How do you isolate the soleus?

A

plantar flexing with bent knee

129
Q

What does down the hatch represent?

A

the muscle bellies from medial to lateral in the posterior leg

flexor digitorum longus, tibialis posterior, flexor hallucis longus

130
Q

What does tom, dick and harry stand for?

A

the muscle tendons of the deep posterior leg muscles from medial to lateral

tibialis posterior, flexor digitorum longus and flexor hallucis longus

travel posterior to the medial malleolus

131
Q

Which arteries, veins or nerves travel with the tendons of the posterior leg?

A

the tibial nerve and posterior tibial nerve and artery

132
Q

What is the gateway to the foot?

A

posterior to the medial malleolus

133
Q

Which tendon of the leg goes under the foot at 90 degrees?

A

fibularis longus

134
Q

What holds the tendons of the fibularis’ in place?

A

the superior and inferior fibular retinaculum on the lateral side of the foot

135
Q

Which muscle causes the most trouble with compartment syndrome?

A

tibialis anterior

136
Q

What is the purpose of the extensor retinaculum?

A

to hold the tendons of the anterior leg muscles in place

137
Q

What type of joints are the hip and knee?

A

hip is ball and socket

knee is hinge

138
Q

What type of joint is the ankle joint?

A

hinge joint

139
Q

Which bones does the cuboid articulate with?

A

the 4th and 5th metatarsals

140
Q

What is the name of the joint made by the talus and calcaneus?

A

the subtalar joint

141
Q

What are the movements at the subtalar joint?

A

inversion and eversion

sliding of talus on calcaneous

142
Q

What movements does the ankle joint perform?

A

dorsiflexion and plantar flexion

143
Q

Which bones make up the ankle joint?

A

tibia
fibula
talus

144
Q

The lateral ligament consists of which three ligaments and they all have a common attachment of?

A
  1. anterior talofibular
  2. posterior talofibular
  3. calcenofibular

all from the lateral malleolus

145
Q

What is another name of the medial ligament?

A

deltoid ligament

146
Q

What are the deltoid ligaments?

A
  1. Anterior tibiotalar
  2. Posterior tibiotalar
  3. Tibiotalar
  4. Tibionavicular
147
Q

Where does the tibiocalcaneal ligament attach?

A

medial malleolus to the sustentaculum tali of calcaneous

148
Q

Where does the tibionavicular ligament attach?

A

the medial navicular and the spring ligament

149
Q

What are the arches of the foot?

A

medial longitudinal
lateral longitudinal
transverse arch

150
Q

What is the key stone bone and of which arch is it part of?

A

the talus in the medial longitudinal arch

151
Q

Which bones make up the medial longitudinal arch?

A 
calcaneus
talus
navicular
3 cuneiforms
3 medial metatarsals and phalanges
152
Q

Which bones make up the lateral longitudinal arch?

A

calcaneus
cuboid
2 lateral metatarsals and phalanges

153
Q

Which bones make up the transverse arch?

A

3 cuneiforms
cuboid
bases of metatarsals

154
Q

What contributes to arch support?

A

shape of bones

supporting ligaments

intrinsic/extrinsic muscles and tendons

plantar aponeurosis

155
Q

What are the three supporting ligaments of the foot?

A

long plantar ligament
short plantar ligament
spring ligament

156
Q

What is another name for the spring ligament?

A

calcaneonavicular ligament

157
Q

Where does the spring ligament attach?

A

sustentaculum tali to the navicular bone

158
Q

Name the tendons that run in the plantar base of the foot?

A

Tibialis posterior
Fibularis longus
flexor hallucis longus
flexor digitorum longus

159
Q

What is the plantar aponeurosis? Describe its shape and attachments and functions.

A

thickening of deep fascia

goes from the calcaneal tuberosity and diverges into digital bands connected by the superficial transverse metatarsal ligaments and attaches to bones and ligaments

supports the longitudinal arch

160
Q

What is the name of the retinaculum that makes the tarsal tunnel?

A

flexor retinaculum

161
Q

Which tendon hooks under the sustentaculum tali?

A

flexor hallucis longus

162
Q

List all the extrinsic muscles of the foot?

A 
fibularis longus
fibularis brevis
flexor hallucis longus
flexor digitorum longus
tibialis posterior
163
Q

Which muscles/tendons are in layer 1 of the foot?

A

abductor hallucis
abductor digit minimi
flexor digitorum brevis

164
Q

Which muscles/tendons are in layer 2 of the foot?

A

quadratus plantae
lumbricals

flexor hallucis longus tendon
flexor digitorum longus tendon

165
Q

How many lumbricals are there?

A

4

166
Q

Which muscles/tendons are in layer 3 of the foot?

A

flexor hallucis brevis
adductor hallucis
flexor digit minimi

167
Q

Which muscles/tendons are in layer 4 of the foot?

A

dorsal interossei
plantar interossei

fibularis longus tendon
tibialis posterior tendon

168
Q

Describe the pathway the anterior tibial artery takes after it divides from the peroneal artery?

A

passes between the tibia and fibia to the anterior leg where it is between tibialis anterior and extensor digitorum longus

once it passes under the extensor retinaculum it becomes the dorsal pedis artery that is now between extensor digitorum longus and extensory hallucis longus

it now forms the arcuate, metatarsal and digital arteries

169
Q

Describe the pathway the posterior tibial artery takes after it divides from the peroneal artery?

A

passes along the surface of the deep posterior leg muscles
passes posterior to the medial malleolus and divides into the medial and lateral plantar arteries
the medial and lateral plantar arteries form the deep plantar arch, metatarsal and digital arteries

170
Q

Where are pulse points for the foot?

A

the posterior tibial artery - by the medial malleolus and calcaneus

the dorsal pedis artery - between the extensor hallucis longus and extensor digitorum longus tendons

171
Q

What is the farthest area away from the heart that you can take a pulse?

A

the dorsalis pedis artery

172
Q

Where is the small saphenous vein compared to the great saphenous vein in the ankle?

A

small saphenous is posterior to the lateral malleolus and the great saphenous is anterior to the medial malleolus

173
Q

Where does the small saphenous vein travel in the leg compared to the great saphenous?

A

small - posterior leg

great - medial leg

174
Q

Where do the small saphenous and great saphenous vein come from?

A

the dorsal venous arch

175
Q

When does the tibial nerve divide into the medial and lateral plantar nerves?

A

after it travels posterior to the medial malleolus

176
Q

Which tendons does the medial plantar nerve travel between?

A

the flexor digitorum brevis and abductor hallucis

177
Q

Which foot muscles does the medial plantar nerve innervate?

A

abductor hallucis
flexor digitorum brevis
flexor hallucis brevis
1st lumbrical

178
Q

Which part of the foot does the medial plantar nerve supply sensory information to?

A

medial posterior side and the medial 4.5 toes

179
Q

Which part of the foot does the lateral plantar nerve supply sensory information to?

A

the lateral side and the lateral 1.5 digits

180
Q

Which muscles in the foot does the deep fibular nerve innervate and which sensory areas?

A

extensor digitorum brevis
extensor hallucis brevis

and the webbing between the 1st and 2nd toe

181
Q

Which muscle does the deep fibular nerve travel under in the leg?

A

tibialis anterior

182
Q

Which artery does the deep fibular nerve travel with in the foot?

A

dorsalis pedis artery

183
Q

Which nerve innervates the skin of the top of the foot?

A

superficial fibular nerve

184
Q

Which nerve innervates the skin of the lateral side of the top of the foot?

A

the sural nerve

185
Q

Which nerve innervates the skin of the heel?

A

medial calcaneal nerves

186
Q

Which nerve innervates the skin of the medial ankle?

A

the saphenous nerve

187
Q

What is tarsal tunnel syndrome?

A

the compression of the structure in the tarsal tunnel

188
Q

What passes through the tarsal tunnel?

A 
tibialis posterior
flexor digitorum longus
flexor hallucis longus
tibial nerve 
posterior tibial artery and vein
189
Q

What causes tarsal tunnel?

A

varicose veins
swollen tendons
injury causing swelling
conditions such as diabetes and arthritis

190
Q

What are the symptoms of tarsal tunnel?

A

tingling, pain, numbness along the bottom of the foot - lateral and medial plantar nerves from the tibial nerve

weakness in toe flexion, adduction and abduction - medial and lateral plantar nerves innervate all the muscles of the bottom of the foot

191
Q

What happens if you pinch the superior gluteal nerve?

A

lose functions of medius and minimus and therefore would present with trendelenburg gait

grounded leg cannot resist adduction and therefore you lose the stabilization of pelvic level

192
Q

What are the two heads of the rectus femoris?

A

straight and reflected

193
Q

Do the ligaments of the hip go over or under the capsule?

A

over top

Anatomy (7 decks)

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