Lower Limb

Question 1

Nerve root supply to hamstrings

Answer 1

L5, S1, S2

Question 2

Nerve root supply to gastrocnemius and soleus

Answer 2

S1, S2

Question 3

Nerve roots to deep flexor muscles of the thigh

Answer 3

S1, S2

Question 4

Nerve root to tibialis posterior and popliteus

Answer 4

L4, L5

Question 5

Nerve root to intrinsic muscles of the feet

Answer 5

S2, S3

Question 6

Nerve root to plantar cutaneous nerves

Answer 6

L4, L5, S1

Question 7

Roots of the sciatic nerve

Answer 7

L4 - S3

Question 8

What are the cutaneous nerve areas?

Answer 8

Question 9

What parts of the hip are palpable?

Answer 9

Iliac crest

ASIS

PSIS

Ischial spine

Ischial tuberosity

Pubic tubercle

Question 10

Ligaments of the hip joint

Answer 10

Iliofemoral

Pubofemoral

Ischiofemoral

Formed from thickenings of the joint capsule which wrap around the joint from posterior to anterior. This limits extension of the hip and stabilises the trunk

Question 11

Common complication of intracapsular fractures of the femoral neck

Answer 11

Avascular necrosis of the femoral head

Circumflex arteries surround the femoral neck and pass through the fibres of the joint capsule to the femoral head. Intracapsular fractures can disrupt blood supply, meaning that the only blood supplies to the head of the femur is from a small artery in the ligament of the femoral head.

Lack of blood supply causes necrosis.

Question 12

Valgus

Answer 12

Distal part of the bone directed away from the midline

Increase in joint angle

Question 13

Varus

Answer 13

Distal part of bone directed toward the midline

Decrease in joint angel

Question 14

Iliotibial tract

Answer 14

Lateral thickening of fascia lata (deep fascia of the thigh)

Acts as an attachment point for muscles

Asissts in knee extension and staability

Saphenous veins run superficial to the fascia

Question 15

Anterior compartment of the thigh

Answer 15

Produces hip flexion and extension of the knee

Innervated by the femoral nerve (L2-L4)

Blood supplied by femoral artery

Question 16

Medial compartment of the thigh

Answer 16

Produces adduction of the hip

Innervated by the obturator nerve (L2-L4)

Supplied by the obturator artery

Question 17

Posterior compartment

Answer 17

Produces extension of the hip, flexion of the knee, rotation of the leg.

Innervated by the sciatic nerve (L4-S3) - tibial division (L5,S1)

Blood supplied by branches of profunda femorisa

Question 18

Name four structures that drain in inguinal lymph nodes

Answer 18

Lower limb
Perineal region
Penis
Lower anal canal
Lower vagina
Anterior labia majora / scrotal skin

Question 19

Functions of menisci in the knee

Answer 19

Increases contact area

Improves weight bearing

Acts as shock absorbers

Participate in locking mechanism of the knee

Question 20

5 nerves that supply the foot

Answer 20

Deep fibular nerve

Tibial nerve

Superficial fibular nerve

Sural nerve

Saphenous nerve

Question 21

Femoral canal

Answer 21

Fascial compartment that contains lymph cessels and lymph nodes

Question 22

Femoral sheath

Answer 22

Fascia forms a femoral sheath around the femoral vessels

Femoral nerve lies outside the femoral sheath, deep to iliac fascia

Femoral artery, vein and lymphatics are inside the fasia (lymphatics sit in the femoral canal, artery and vein are in the sheath)

Question 23

Lumbar plexus

Answer 23

Lies in the posterior part of psoas major

Composed of anterior rami of L1-L4 nerves

Iliohypogastric L1
Ilioinguinal L1
Genitofemoral L1/L2
Lateral cutanous nerve of the thigh L2/L3
Femoral nerve (L2-L4)
Obturator nerve (L2-L4)
(Lumbosacral trunk)

Question 24

Sacral plexus nerves

Answer 24

Superior gluteal (L4-S1)

Sciatic (L4-S3)

Inferior gluteal (L5-S2)

Nerve to piriformis S1/S2

Nerve to quadratus femoris and inferior gemellus (L4-S1)
Nerve to obturator internus and superior gemellus (L5-S2)

Pudendal (S2-S4)