Lower Limb Flashcards by JOSH WOHL

Extensor digitorum brevis

Origin: Calcaneus (7)
Insertion: with 3 tendons to dorsal 
                aponeurosis (8).
Function: dorsiflexion of these digits
Innervation: Deep peroneal nerve (S1-S2).

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Extensor Hallucis brevis

Origin: Calcaneus
Insertion: Dorsal aponeurosis of 1st digit
Function: Dorsiflexion of 1st digit
Innervation: Deep peroneal nerve (S1-S2

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Plantar Aponeurosis

Consist of longitudinal and transverse fibers.
It maintains the longitudinal arch of the foot
and protects the vessels and nerves there

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Abductor Hallucis

Origin: Tuber Calcanei (6), plantar aponeurosis (7).
Insertion: medial sesomoid bone (8) and base
of proximal phalanx of 1st toe (9).
Innervation: Medial plantar Nerve (L5-S1).

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Flexor Hallucis Brevis

Origin: medial cuneiform bone (11)
It has 2 heads. A medial head (12) which
extends to medial sesamoid bone (13) and
Its lateral head (15) extend to lateral sesamoid
bone (16) and inserted on proximal phalanx
of 1st toe.
Innervation: Medial Plantar Nerve (L5-S1

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Flexor digitorum Brevis

Origin: calcaneus
Insertion: middle phalax of 2nd-4th digits
Innervation: Medial Plantar N (L5-S1).

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Lumbriclas (4 ones)

Tiny muscles originating from tendon (2)
of the flexor digitorum longus (medial side).
Insertion: Dorsal aponeurosis of 2nd-5th digit.
Function: plantar flexion of these digits
Innervation: Medial Plantar N to 1, and
Lat Plantar N to 2, 3 and 4 (S2 and S3)

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Quadratus Plantae

Origin: by 2 heads from calcaneus
Insertion: lateral border of the tendon of the
Flexor digitorum longus.
Innervation: Lateral Plantar N. (S1-S2).

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Lumbar Plexus

Arises from L1-L4
Lies within the psoas major muscle
Mostly anterior structures

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Sacral Plexus

Arises from spinal nerve L4-S4
Lies caudal to the lumbar plexus-(above)
Mostly posterior structures

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femoral nerve

Cutaneous branches-goes to thigh, leg, and foot (ex. Saphenous nerve)
Motor branches-anterior thigh muscles (quads, sartorius, and iliopsoas)

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obturator nerve

Sensory-skin and medial thigh, hip, knee joint

Motor-adductor muscles

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Lateral femoral cutaneous

Sensory-skin of lateral thigh

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Genitofemoral

Sensory-scrotum, labia major, anterior thigh

Motor-cremaster muscle

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Sciatic nerve roots

L4-S3

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Sciatic nerve is composed of

common peroneal and tibial nerves

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what makes up the lumbosacral trunk

L4 and L5

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common peroneal

Cutaneous-Anterior and lateral leg, dorsum foot

Motor-Lateral compartment, tibialis anterior, toe extensors

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tibial nerve

Cutaneous-Posterior leg and sole of foot

Motor-Posterior leg, foot

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Superior gluteal nerve

Gluteus medius and minimus, tensor fasciae latae

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Inferior gluteal nerve

Motor-gluteus maximus

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Posterior femoral cutaneous nerve

Sensory-inferior buttocks, posterior thigh, popliteal fossa

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Pudendal nerve

Sensory-external genitalia and anus

Motor-muscles of perineum

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common iliac branches into…..

internal and external iliac

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internal iliac supplies

pelvic organs

external iliac supplies

lower limbs

external iliac artery becomes

femoral artery once passes the inguinal ligament

femoral artery

Branches into Deep femoral - Adductors, hamstrings, quadriceps - Branches into Medial/lateral femoral circumflex which supply the head and neck of femur

femoral artery becomes

popliteal artery

popliteal branches into

geniculars and splits into anterior tibial (Anterior leg muscles, further branches to feet) and posterior tibial (Flexor muscles, plantar arch, branches to toes)

great saphenous vein empties into

femoral vein

small saphenous vein empties into

popliteal

dorsal artery of the foot or Dorsalis Pedis artery

When the Anterior tibial artery passes beneath the superior extensor retinaculum

Together, the lateral tarsal and dorsalis pedis make up.. the and give rise to....

- arcuate artery | - Metatarsal (15) and dorsal digital (16) arteries.

Posterior tibial artery(2) in the plantar region | gives rise to the

medial and lateral plantar arteries

Lateral plantar artery makes most part of the.... | which give rise to....

-plantar arch -plantar metatarsal arteries and proper plantar digital arteries

collateral circulation

- when there is a narrowing of an artery, neovascularization occurs - works for older people because it has had time to set up unlike a young person

Claudication

muscular pain caused by compromised vasculature caused by smoking/uncontrolled diabetes typically in the lower extremity

DVT

-thrombus formation in legs or thighs -can be found in (Tibial veins, soleal/gastrocnemius veins, popliteal vein, femoral vein, deep femoral vein, common femoral vein, iliac veins.) -600,000 cases per year

What percent of DVT develop a PE?

- approximately 1/3 | - 15% death rate

Nonfatal vs fatal VTE rate

nonfatal-20/100,000 | fatal-50/100,000

Virchow's triad

- Alterations in blood flow - Venous Stasis - Alterations in blood constituents-Hypercoagulability - Vascular endothelium damage-Injury

Risk factors of VTE

- after sx - previous DVT - varicose veins - immobilization

signs of DVT

- Asymptomatic - Pain/tenderness - Erythema - Acute swelling - Pallor - Cyanosis

signs of PE

- Dyspnea & Tachypnea - Diaphoresis - Cough - Hypotension - CXR

Gold standard for VTE diagnosis is

venography

a close second to the gold standard for VTE diagnosis is

duplex ultrasound - Comfortable - Inexpensive - No risk - Good sensitivity and specificity for distal - Less sensitive for proximal DVT

Deep leg veins include

- iliac - femoral - tibial - popliteal

Superficial leg veins include

- great saphenous | - lesser saphenous

superficial femoral vein

-this term should not be used -this is actually a DEEP vein simply "femoral" vein

anterior group of hip muscles include

- iliopsoas | - tensor fascia latae

posterior group of hip muscles include

- glutues maximus - glutues medius - glutues minimus - piriformus

anterior group of thigh muscles include

- quadriceps/rectus femoris | - sartorius

medial group of thigh muscles include

- pectineus - adductor longus - adductor brevis - gracilus - adductor magnus

posterior group of thigh muscle include

- biceps femorus - semitendinosus - semimembranosus

achilles tendon is made up of

2 heads of gastrocnemeus, soleus, as well as the plantarus muscle

anterior muscles of leg include

Tibialis anterior Extensor digitorum longus Extensor hallueis longus

posterior muscles of the leg include

superficial-gastrocnemeus and soleus | deep-tibialis posterior, flexor digitorum longus, flexor hallucis longus

lateral muscles of the leg include

- peroneus longus | - peroneus brevis

retinaculum

guides the 4 tendons of the extensor digitorum

quadricep tendon attaches to

patellar ligament

obturator and femoral nerve branch

L2/L3/L4

subcostal nerve branch

T12

ilioinguinal nerve branch

genitofamoral nerve branch

L1/L2

iliohypogastric nerve branch

T12-L1

lateral cutaneuous nerve branch of thigh

L2/L3