Lower Limb Flashcards
Name the Superficial Veins of the leg
GREAT SAPHENOUS + SMALL SAPHENOUS VEINS
Great Saphenous Vein
Ascends anterior to medial malleolus of the tibia
Empties into the Femoral Vein
Small Saphenous Vein
Ascends posterior to lateral malleolus of the tibia
Empties into the Popliteal Vein
Do Varicose Veins affects superficial or deep veins of the leg?
Superficial Veins
Name the Deep Veins of the leg
Deep vein of thigh, External Iliac, Femoral, Popliteal, Fibular & Ant/Post Tibial Veins
What is the dermatomal area of Medial Knee?
L3
What is the dermatomal area of the Little Toe?
S1
Where do the lymphatic vessels accompanying Great Saphenous Vein end up?
Superficial Inguinal Nodes
Where do the lymphatic vessels accompanying Small Saphenous Vein end up?
Popliteal Lymph Nodes
What are the 3 main groups of lymph nodes?
Superficial Inguinal, Deep Inguinal and Popliteal
What type of joint is the hip joint?
Ball & socket synovial joint
Name the 2 articulating surfaces of the hip joint
Head of Femur
Acetabulum of pelvis
What is the acetabulum surrounded by?
Ring of cartilage called the Acetabular Labrum
Name the 3 ligaments of the hip joint
ILIOFEMORAL
PUBOFEMORAL
ISHIOFEMORAL
What is the role of the Iliofemoral Ligament?
Prevents increased extension
What is the role of the Pubofemoral Ligament?
Prevents increased abduction
What movements does the Hip Joint allow?
Flexion, Extension, Abduction, Adduction, Circumduction, Medial and Lateral Rotation
Name the HIP FLEXOR muscles of the Hip Joint
ILIACUS
PSOAS MAJOR?MINOR
PECTINEUS
Name the HIP EXTENSOR muscles of the Hip Joint
GLUTEUS MAXIMUS
SEMITENDINOUS
SEMIMEMBRANOUS
BICEPS FEMORIS
(HAMSTRINGS + ADDUCTOR MAGNUS)
Name the HIP ADDUCTOR muscles of the Hip Joint
-Medial Compartment of the Thigh
ADDUCTOR LONGUS ADDUCTOR BREVIS ADDUCTOR MAGNUS PECTINEUS GRACILIS
Which nerve are the Hip Adductor muscles supplied by?
Obturator Nerve
Name the HIP ABDUCTOR muscles of the Hip Joint
GLUTEUS MEDIUS
GLUTEUS MINIMUS
DEEP GLUTEALS
Name the LATERAL ROTATOR muscles of the Hip Joint
BICEPS FEMORIS
GLUTEUS MAXIMUS
DEEP GLUTEALS
Name the MEDIAL ROTATOR muscles of the Hip Joint
GLUTEUS MEDIUS
GLUTEUS MINIMUS
TENSOR FASCIAE LATAE
Name the compartments of the thigh
ANTERIOR (Quads/Extensors of the Knee)
MEDIAL (Adductors of the Hip)
POSTERIOR (Hamstrings/Flexors of the Knee)
Name the muscles in the ANTERIOR compartment of the thigh
QUADRICEPS FEMORIS –> 4 headed muscles; RECTUS FEMORIS, VASTUS LATERALIS, VASTUS MEDIALIS, VASTUS INTERMEDIUS
& SARTORIUS MUSCLE
Which nerve innervates the Quadriceps Femoris muscle?
Femoral Nerve
What do the 4 parts of the quadriceps muscles unite to form?
They unite to form the quadriceps tendon (proximal to patella) which then continues as the patellar ligament
What is the action of the Quadriceps Femorus muscle?
Flexion of Hip + Extension of Knee
Which nerve innervates the Sartorius muscle?
Femoral Nerve
What is the action of the Sartorius muscle?
Flexion, abduction and lateral rotation of the hip
Flexion of knee
Name the muscles in the MEDIAL compartment of the thigh
OBTURATOR EXTERNUS ADDUCTOR BREVIS ADDUCTOR LONGUS ADDUCTOR MAGNUS GRACILIS
Which nerve innervates the medial compartment?
Obturator Nerve
What is the action of the medial compartment?
Adduction of hip
Name the muscles in the POSTERIOR compartment of the thigh and what are the innervation?
SEMI-TENDINOUS (tibial of SCIATIC nerve)
SEMI-MEMBRANOUS (tibial of SCIATIC nerve)
Long head of BICEPS FEMORIS (tibial part of SCIATIC nerve)
Short head of BICEPS FEMORIS (fibular part of SCIATIC nerve)
What are the actions of the muscles in the posterior compartment of the thigh?
Extension, lateral +medial rotation of hip
Flexion of knee
Branches of which nerve innervate the Posterior compartment?
Sciatic nerve
What is the main artery of the thigh? When does it change name?
Femoral artery
Name changes when vessel crosses behind inguinal ligament
What is the femoral vein a continuation of?
Popliteal vein
Which 2 veins drain into the femoral vein?
Profunda femoris vein
Great saphenous vein
Which nerve is the largest branch of the lumbar plexus?
Femoral nerve
Which muscles does the femoral nerve supply?
Sartorius, Pectineus, Iliacus + Rectus Femoris
What is the femoral triangle?
Triangular depression below the inguinal ligament
What are the SUPERIOR, LATERAL & MEDIAL borders of the femoral triangle?
Superior - Inguinal ligament
Lateral - Medial border of Sartorius
Medial - Medial border of Adductor Longus
What forms the roof and the base of the femoral triangle?
Roof: Fascia Lata
Base: Pectineus, Iliopsoas & Adductor Longus
What are the contents of the femoral triangle?
Femoral Nerve –> Femoral Artery –> Femoral Vein –> Femoral Canal (contains deep lymph nodes and vessels)
What does the Femoral Sheath contain?
Femoral artery, vein + canal
Lateral - intermediate - medial
What is the Adductor Canal?
A narrow, conical tunnel in the thigh (15cm long) extending from the apex of the femoral triangle to the adductor hiatus of the adductor magnus
What is the anterior, lateral + posterior border of the Adductor Canal?
Anterior- Sartorius
Lateral - Vastus Medialis
Posterior - Adductor Longus + Adductor Magnus
What does the adductor canal contain?
Femoral artery, verin + nerve
Femoral artery & vein exit the canal as the popliteal artery and vein
What are the two main branches of the Lumbar Plexus?
Obturator & Femoral Nerve
What are the levels of the Lumbar Plexus?
T12, L1, L2, L3, L4 (anterior rami of lumbar and thoracic nerves
Which muscle does the Lumbar Plexus emerge through?
Psoas Major
What are the levels of the Femoral Nerve?
L2, L3, L4
What does the femoral nerve innervate?
Anterior compartment of the thigh
What are the levels of the Obturator Nerve?
L2, L3, L4
What does the obturator nerve innervate?
Medial compartment of the thigh (adductors)
Name the 3 main bones of the pelvic girdle
Ilium, ischium & pubis
What goes through the greater sciatic foramen?
Structures entering or leaving the pelvis
What goes through the lesser sciatic foramen?
Structures entering or leaving the perineum
How many layers does the Gluteal region have? What are they?
2- Superficial & Deep
What are the superficial muscles of the Gluteal region?
GLUTEUS MAXIMUS
GLUTEUS MEDIUS
GLUTEUS MINIMUS
TENSOR FASICAE LATAE
What are the deep muscles of the Gluteal region?
PIRIFORMIS
OBTURATOR INTERNUS
SUPERIOR + INFERIOR GEMELLI
QUADRATUS FEMORIS
Where is the sacral plexus?
On the surface of the posterior pelvic wall, anterior to the performs muscle
What are the levels of the Sacral Plexus?
L4, L5, S1, S2, S3 + S4 (anterior rami of spinal nerve)
What are the two main branches of the Sacral Plexus?
Sciatic & Pudendal Nerve
What are the Gluteal Nerves?
There are 2 pairs (Superior and Inferior)
Superior Gluteal Nerve
Root value of L4-S1
Supplies Gluteus Medius, Gluteus Minimus + Tensor Fasciae Latae
Inferior Gluteal Nerve
Root value of L5-S2
Supplies Gluteus Maximus
What is the fascia lata?
Deep fascia of the thigh?
Gluteus Maximus - actions and innervation
Extends and externally rotates hip joint
Innervated by the inferior gluteal nerve
Gluteus Medius/Minimus + Tensor Fasciae Lata - actions and innervation
Abducts, medially and laterally rotates the hip joint
Innervated by superior gluteal nerve
What is the role of the deep muscles of the gluteal region?
Stabilise and externally rotates the hip joint
Sciatic nerve
Largest nerve in the body emerging inferior to performs, branching into TIBIAL portion + COMMON FIBULAR portion ~ doesn’t supply any muscles in the gluteal region, innervates the posterior thigh (HAMSTRINGS)
What type of joint is the knee joint?
Compound, synovial hinge joint
What are the actions of the knee joint?
Flexion, extension, lateral and medial rotation
What are the articular surfaces of the knee joint?
Medial + lateral condyles of femur, tibia and posterior surface of patella
Which bone is not involved in the knee joint articulations?
Fibula
Name the 2 collateral ligaments of the knee
Lateral Collateral Ligament
Medial Collateral Ligament
What are the 2 cruciate ligaments of the knee?
Anterior Cruciate Ligament
Posterior Cruciate Ligament
What does the Anterior Cruciate Ligament prevent?
Prevents the femur sliding posteriorly
Prevents rotation of the knee
What does the Posterior Cruciate Ligament prevent?
Prevents the femur sliding anteriorly
Which of the 2 cruciate ligaments has poor blood supply + is prone to injury and poor repair?
Anterior Cruciate Ligament
Name the menisci of the knee
Medial and Lateral
What is the role of the menisci of the knee?
Deepen the articular surface of the tibia, increasing stability of the joint
Disperse body weight
Reduce friction during movement
What does the medial meniscus adhere to?
Deep surface of the tibial/medial collateral ligament
What does the lateral meniscus adhere to?
Nothing- no extra attachments and is much smaller
What movements occur at the knee joint and which muscles are responsible for them?
Flexion - HAMSTRINGS, GRACILIS, SARTORIUS, POPLITEUS
Extension - QUADRICEPS FEMORIS
Lateral rotation - BICEPS FEMORIS
Medial rotation - SEMI-MEMBRANOUS, SEMI-TENDINOSUS, GRACILIS, SARTORIUS + POPLITEUS
What is the bursa around the knee?
Suprapatellar bursa
What are the compartments of the lower leg?
Anterior
Lateral
Posterior
How many muscles are in the Anterior compartment of the lower leg? What are they called?
4 muscles:
TIBIALIS ANTERIOR
EXTENSOR DIGITORUM LONGUS
EXTENSOR HALLUCIS LONGUS
FIBULARIS TERTIUS
What are the actions of the muscles in the anterior compartment of the lower leg?
Dorsiflex + invert the foot at the ankle
EDL + EHL ALSO extend the toes
Which nerve innervates the muscles in the anterior compartment of the lower leg?
Deep Fibular Nerve
What is the blood supply to the muscles in the anterior compartment of the lower leg?
Anterior Tibial Artery
What are the 2 branches of the Sciatic Nerve?
Common Fibular Nerve
Tibial Nerve
Which terminal branch of the popliteal artery supplies the anterior leg?
Anterior Tibial Artery
Which artery runs midway between the malleoli?
Dorsalis Pedis Artery
What type of joint is the ankle joint?
Synovial hinge joint
What are the articulating surfaces of the ankle joint?
Distal end of the tibia + fibula of the leg
Superior part of the talks bone
What is strong during dorsiflexion of the ankle?
Malleoli grip
What is unstable during plantar flexion of the ankle?
Ankle joint
What are the ligaments of the ankle called?
Medial and lateral ligaments
When is an ankle sprain most common?
Torn fibres of ankle ligament is most common on inversion of the subtler joint
What are the main movements of the ankle joint?
Dorsiflexion (ANT COMPARTMENT OF LEG)
Plantarflexion (POST COMPARTMENT OF LEG)
What are the names + types of TIBIO-FIBULAR joints?
Superior/Proximal Tibio-fibular - synovial plane joint
Inferior/Distal Tibio-fibular - compound fibrous joint
What is the popliteal fossa?
Fat filled diamond shaped area posterior to the knee joint
What are the borders of the popliteal fossa?
Superiomedial - SEMI-MEMBRANOUS
Superiolateral - BICEPS FEMORIS
Inferiomedial - MEDIAL HEAD OF GASTROCNEMIUS
Inferiolateral - LATERAL HEAD OF GASTROCNEMIUS
What are the contents of the popliteal fossa?
Fat, Popliteal artery, Popliteal vein, Tibial nerve, Common fibular nerve, Popliteal lymph nodes and vessels
Where does the femoral artery become the popliteal artery?
Adductor hiatus
How many muscles are in the Posterior compartment of the lower leg? What are they called?
7 muscles;
SUPERFICIAL GROUP - GASTROCNEMIUS, PLANTARIS, SOLEUS
DEEP GROUP - POLITEUS, TIBIALIS POSTERIOR, FLEXOR DIGITORUM LONGUS, FLEXOR HALLICUS LONGUS
Gastrocnemius muscle (action + innervation)
Most superficial muscle; 2 headed muscles (lateral and medial) which PLANTARFLEXES at ankle joint + FLEXES at knee
Innervated by the TIBIAL NERVE
Plantaris muscle (action + innervation)
Small muscle with long tendon
PLANTARFLEXES at ankle joint + FLEXES at knee
Innervated by the TIBIAL NERVE
Soleus muscles (action + innervation)
Deep to gastrocnemius; large and flat
PLANTARFLEXES at ankle joint
Innervated by TIBIAL NERVE
What do the superficial group of muscles of the lower leg insert into?
Calcaneal tendon
Popliteus (action + innervation)
LATERALLY ROTATES femur (unlocks knee for flexion)
Innervated by TIBIAL NERVE
Tibialis Posterior (action + innervation)
Lies between FDL + FHL
INVERTS + PLANTARFLEXES foot
Innervated bu TIBIAL NERVE
Flexor Digitorum Longus (action + innervation)
FLEXES lateral 4 toes
Innervation by TIBIAL NERVE
Flexor Hallicus Longus (action + innervation)
FLEXES great toe
Innervated by TIBIAL NERVE
How many intrinsic muscles of the foot are there? What are their action and innervation?
2- EXTENSOR DIGITORUM BREVIS (aids EDL in extending medial 4 toes) + EXTENSOR HALLICUS BREVIS (aids EHL in extending big toe)
Innervated by Deep Fibular Nerve
How many muscles are in the Lateral compartment of the lower leg? What are they called?
2 - FIBULARIS LONGUS (longer + more superficial) + FIBULARIS BREVIS (shorter + deeper)
Both evert and plantar flex the foot at the ankle
Innervated by Superficial Fibular Nerve
What are the two roles of the foot?
Supports the body weight and plays a role in locomotion
What are the bones of the foot?
Calcaneus, Talus, Navicular, Cuboid, Cuneiforms (lateral, intermediate and medial)
What is the name of the deep fascia of the foot?
Planta fascia/aponeurosis
What is the subtalar joint?
Joint of the foot at the meeting point of the talus + calcaneus allowing eversion and inversion
How many layers of muscles on the foot are there?
4
Layer 1 of muscles of the foot
3 muscles
ABDUCTOR HALLUCIS (abducts and flexes big toes/ medial plantar nerve innervation)
FLEXOR DIGITORUM BREVIS (flexes digits at PIP/ medial plantar nerve innervation)
ABDUCTOR DIGITI MINIMI (abducts and flexes little toe/ lateral plantar nerve innervation)
Layer 2 of muscles of the foot
2 muscles + tendon of FDL
QUADRATUS PLANTAE (flexes lateral 4 digits/ lateral plantar nerve innervation)
LUMBRICALS x4 which are each medial to FDL tendon (flexes at MCP joint and extends at IP joint/most medial is innervated by medial plantar nerve and other 3 are innervated by lateral plantar nerve)
Layer 3 of muscles of the foot
3 muscles
FLEXOR HALLICUS BREVIS (flexes big toe/ innervated by medial plantar nerve)
ADDUCTOR HALLUCIS (adducts big toe/ innervated by deep branch of lateral plantar nerve)
FLEXOR DIGITI MINIMI BREVIS (flexes little toe/ innervated by superficial branch of lateral plantar nerve)
Layer 4 of muscles of the foot
PLANTAR INTEROSSEI (3) –> ADDUCT DIGITS 3-5
DORSAL INTEROSSEI (4) –> ABDUCT DIGITS 2-4 + flex MSP
Remember PAD + DAB
Both innervated by lateral plantar nerve
What is the role of the arches of the foot?
Distribute body weight and act as shock absorbers
How are the arches of the foot maintained?
Passive factors
Dynamic factors
