Lower Limb Flashcards
Flexors of the Hip (3-5)
Iliosoas
Sartorius
Rectus femoris
(pectineus and tensor fascia lata)
Extensors of the Hip (4)
Biceps femoris (LH only)
Semitendinosus
Semimembranosus
Gluteus maximus
Abductors of the Hip (3)
Gluteus Medius
Gluteus Minimus
Deep gluteal muscles (piriformis)
Adductors of the Hip (5)?
Adductor Longus Adductor Brevis Adductor Magnus Gracilis Pectineus
Lateral rotators of the hip? 3
Gluteus Maximus
Biceps femoris
(Deep gluteals)
Medial rotators of the hip? 4
Semitendinosus
Semimembranosus
Gluteus medius
Gluteus minimis
Anterior Compartment of thigh - Name 7 muscles?
Rectus femoris
Vastus medialis
Vastus lateralis
Vastus intermedius
Iliosoas
Sartorius
Pectineus
Anterior Compartment of thigh innervation? Roots?
Femoral nerve (L2-L4)
Medial Compartment of thigh - Name 5 muscles?
Adductor Longus Adductor Brevis Adductor Magnus Gracilis Obturator externus
Whats the innervation of the Medial Compartment of thigh? Roots?
Obturator nerve (L2-L4) (except for adductor magnus which has two innervations. Adductor part is obturator nerve and the hamstring part is L4-S3 Tibial branch of sciatic)
Posterior Compartment of thigh - Name 3 muscles?
Biceps femoris
Semitendinosus
Semimembranosus
Whats the innervation of the Posterior Compartment of thigh? Roots?
Tibial part of Sciatic nerve (L4-S3)
Except for the Biceps femoris short head which is innervated by the common fibular part of the sciatic nerve
Where do the hamstrings attach?
Ischial tuberosity
What’s Avulsion?
A fraction where the bony attachment comes away
e.g. Hamstrings attach to ischial tuberosity which can snap off
What is the innervation of Biceps femoris?
SCIATIC NERVE. Long head innervated by the tibial part of the sciatic nerve, whereas the short head is innervated by the common fibular part of the sciatic nerve.
What muscles lie in the anterior compartment of the leg? 4
Tibialis anterior,
Extensor digitorum longus,
Extensor hallucis longus
Fibularis tertius.
What nerve innervates the anterior compartment of the leg?
Deep fibular nerve
What causes footdrop?
How does this present?
When the deep fibular nerve does not work. Unopposed plantar flexion
What gait characteristic does footdrop cause?
Eversion flick
What does the calcaneal reflex test?
Spinal roots S1-S2.
What sort of people are most likely to suffer from a calcaneal tendon tear?
People with calcaneal tendonitis
What action is most likely to cause a calcaneal tendon tear?
Strong plantarflexion against resistance. Afterwards the foot will be dorsiflexed and a lump will appear in the calf region
What muscle unlocks the knee?
What motion is it?
Popliteus
Laterally rotates the femur on the tibia or
Medially rotates the tibia on the femur
What nerve innervates the unlocking of the knee?
Tibial nerve.
Popliteus is a muscle of the posterior compartment of the leg
Which Quad muscle stabilises the knee cap with its horizontal fibers?
Vastas medialis
Prevents lateral movement of patella
(feels tired after first run)
Who are Tom, Dick and A Very Nervous Harry
Tibialis posterior Flexor Digitorum Longus artery (tibial) vein (posterior tibial) nerve (tibial) Flexor Hallucis Longus
Where does the great saphenous vein... Start? Navigate related to a malleolus? What part of the leg does it travel up? What does it pass through? What does it drain into?
Dorsal vein of the big toe (GSV=Great/Big toe)
–Navigates anterior to medial malleolus—
Then up anterior medial leg
Entering the saphenous opening ( opening in the fascia lata)
Joins the common femoral vein in the region of the femoral triangle (sapheno-femoral junction)
Where does the small saphenous vein... Start? Navigate related to a malleolus? What part of the leg does it travel up? What does it drain into?
Dorsal vein of 5th digit (SSV=Small toe)
Navigates posteriorly around lateral malleolus
Travels up the posterior leg
Drains into popliteal vein
What muscles are found in the lateral compartment of the leg?
Fibularis/Peroneal Longus
Fibularis/Peroneal Brevis
What actions do the muscles in the lateral compartment of the leg do?
Innervation
EVERSION
Superficial fibular nerve
Where does the common fibular nerve bifurcate?
Small space through fibularis longus (near head and neck of fibula)
What muscles are found in the posterior compartment of the leg? 7
Gastrocnemias
Soleus
Plantaris
Popliteus
Tibialis Posterior
Flexor digitorum longus
Flexor Hallucis Longus
What nerve innervates the muscles found in the posterior compartment of the leg?
Tibial nerve
What actions do the muscles found in the posterior compartment of the leg do?
Plantarflexion
Eversion
What separates the superficial muscles in the posterior compartment to the deep muscles? Bonus points for number of muscles and names
Separated by a band of fasica
3 - Superficial
Gastrocnemius
Soleus
Plantaris
4- Deep
Popliteus
(Tom dick and Harry)
TP, FDL, FHL
What 2 ways (movement/force) can cause the ACL to tear?
Hyperextension of the knee joint,
Large force to the back of the knee with the joint partly flexed
What event can cause the PCL to tear?
Dashboard injury
When the knee is flexed, and a large force is applied to the shins, pushing the tibia posteriorly
e.g. hitting the dashboard in a car accident
What bursa becomes inflammed in Housemaids knee?
Suprapatella bursa
What bursa becomes inflammed in Clergyman’s knee?
Infrapatella bursa
What bursa becomes inflammed in a Baker’s cyst?
Its the synovial fluid from the joint that expands out into the popliteal fossa
What are the two functions of menisci?
To deepen the articular surface (increasing stability)
To act as shock absorbers.
Which of the menisci is larger/more C shaped?
Medial meniscus
What is the name of the gooses foot?
What side of the leg is it found?
Pes anserinus Medial side (goose, MEALdial side)
What muscles are involved in the gooses foot?
Pes anserinus aka the SGS (Special Goose Service) (anterior to posterior)
Sartorius
Gracilis
Semitendinosus
What nerve is affected if you see a Trendelenburg sign/gait?
Superior gluteal nerve
What is a Trendelenburg test?
If there is a left positive what does it mean?
Get the patient to stand on each leg seperately. The hips should stay horizontally aligned. If there is a hip drop (e.g. on the left) then there is a problem with medius and minimis (on the right)
Borders of the popliteal fossa?
Superomedial border: Semimembranosus.
Superolateral border: Biceps femoris.
Inferomedial border: Medial head of the gastrocnemius.
Inferolateral border: Lateral head of the gastrocnemius and plantaris
What are the contents of popliteal fossa? (medial to anterior)
AVN
Popliteal Artery
popliteal Vein
Tibial nerve and Common fibular nerve
Along the tendon of which muscle does the common fibular nerve run?
Biceps femoris
What superficial vein drains into the popliteal vein within the popliteal fossa?
Small saphenous vein
Damage to the tibial nerve in the popliteal fossa will appear clinically?
Weakened plantarflexion (appear dosiflexed)
What is the sural nerve a branch of?
Tibial nerve.
It follows the small saphenous vein down the posterior leg and behind the lateral malleolus
What does the sural nerve innervate? Muscle? Skin?
Innervates the skin in the posterolateral aspect of the leg.
Tough. What is the route of the common fibular nerve distal to the knee?
Around the head of the femur
Which branch of the common fibular nerve gives sensory innervation between the 1st and 2nd digits?
Deep fibular nerve.
Flip-flops deep down on the beach
What is the saphenous nerve a branch of?
Femoral nerve
Lateral cutaneous nerve of the thigh innervate?
Skin on lateral thigh
Whats the floor of the femoral triangle?
IPA make you hit the floor
Iliosoas
Pectineus
Adductor longus
Whats the roof of the femoral triangle?
Fascia lata
Borders of the femoral triangle?
Inguinal ligament
Adductor longus
Sartorius
Deep gluteal muscles have what action?
Lateral rotation
Patella fractures can be…?
Displaced or undisplaced
Which ankle ligaments are weaker?
Lateral (think what ankle sprain is easier)
Anterior talofibular ligament is the lateral ligament most at risk of irreversible damage.
Name the bones in the transverse arch?
Cuboid and cuneiform bones
Whats a bunion?
Hallux Valgus
medial deviation of the first metatarsal bone and lateral deviation of the hallux
In terms of gait - what is the difference between walking and running?
Walking has a phase where there is double support. Both legs touch the ground, whereas in running there is a phase where both legs are off the ground
What are the 5 stages of “stance phase” (gait)
- Initial contact
- Loading response
- Mid-stance
- Terminal stance
- Pre-swing
What are the 3 stages of the “swing stage”
- Initial swing
- Mid swing
- Terminal swing
Gait: What is cadence?
Cadence
Gait: What is Stride?
RIGHT Initial contact to RIC. StRide = Right
Gait: What is Step?
LEFT Initial contact to LIC
Eccentric muscles?
Lengthening muscles
Concentric muscles?
Shortening muscles
Hemiplegic
Usually stroke victims. Muscle in leg are extended so as the walk they swing their leg around in a semi circle
Diplegic
Paralysis of both legs. Body is flexed forward to give momentum to drive the body forward
Trendelenberg
Dysfunction of gluteus medius and minimus. Results in trunk compensating
Ataxic / Cerebellar / Broad-based
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