Lower Limb Flashcards
1
Q
What is the thigh bone that articulates with the acetabulum of hip proximally and the tibia and patella distally?
A
Femur
2
Q
What bone is not really equivalent to anything in the upper bone? It sits in tendon of the quadriceps muscles in anterior thigh?
A
Patella
3
Q
What is the sesmoid bone in the lower extremity?
A
Patella
4
Q
What joint articulates with the acetabulum of the pelvic bone?
A
hip joint
5
Q
What is an acetabulum?
A
cup formed by all the bones of the pelvis
6
Q
Can the hip joint do the same movements as the shoulder?
A
Yes! But hip is not as mobile as shoulder
7
Q
What’s the fovea?
A
fovea capitis for the the ligament of the head of the femur/ligamentum teres femoris. Also has an artery traveling through it
8
Q
On the proximal end of the femur what is found that help with muscle attachments?
A
Greater and Lesser trochanters for muscle attachment e.g. muscles of the posterior abdominal wall etc. (similar to tubercles on the humerus)
9
Q
In the proximal femur, distal to trochanters is what?
A
Shaft of the femur
10
Q
The Distal femur contains what condyles and what do they articulate with? What do we find lateral to the condyles for muscle attachment?
A
medial and lateral condyles (articulate with tibia)
medial and lateral epicondyles for muscle attachment
11
Q
Is patella firmly attached to femur and tibia?
A
NO! that’s why its very mobile
12
Q
What’s the space between the condyles called?
A
intercondylar fossa
13
Q
Do the tibia and fibula have pivoting action (like we saw in the forearm?)
A
NO!
14
Q
Is there a direct connection between femur and fibula?
A
No! Not part of the knee joint. it sits on the side of tibia but it does have a connection to the ankle
15
Q
Do both the tibia and fibula participate in moving the ankle?
A
Yes
16
Q
What are the malleoli of the tibia and fibula?
A
bump outs that you can feel! (so palpation points!)
17
Q
How are the tarsals in the foot arranged?
A
Proximal group: calcaneous, talus
Distal group: cuboid, cuneiforms
18
Q
What’s the only bone that forms a connection with tibia and fibula at the ankle?
A
Talus
19
Q
What tendon attaches to the calcaneus?
A
Calcaneus tendon aka “Achilles tendon”
20
Q
Are there 3 phalanges in toes 2-5?
A
Yes!
21
Q
Are there are only 2 phalanges in the big toe?
A
Yes!
22
Q
Does your big toe have more mobility than your other toes?
A
Yes!
23
Q
What is the knee joint made of?
A
mainly articulation between femur and tibia and also interaction between the patella and femur (so fibula does NOT directly participate in knee joint)
24
Q
Is the knee a modified hinge joint? What action does it?
A
Yes, main actions are = flexion, extension
25
In the flexed knee position, can you pivot your leg on your femur without moving your hip?
Yes (but less stable than extended knee position)
26
Is the knee joint a large weight bearing join in our body? What extra cartilage do we need that protects the joint?
C-shaped MEDIAL and LATERAL MENISCI = fibrocartilage helps to protect, stabilize joint
Ligaments inside joint are cruciate and collateral ligaments
27
What tendon is above the patella that wraps around it?
quadriceps femoris tendon
28
When physician taps below you knee, what ligament is he/she tapping?
Patellar ligament? help with extending the knee
29
What ligaments prevent side to side displacement of tibia on the femur?
1. Fibular (lateral) collateral ligament prevents medial movement
2. Tibial (medial) collateral ligament prevents lateral movement
30
What is the test for cruciate ligaments when person has knee flexed = push it forward and back = and it shouldn't move? If tibia slides past the femur, does this mean that your ACL may be compromised?
DRAWER TEST
YES!
31
What is "blown knee"?
When you take out ALL 3 LIGAMENTS that are attached together = ACL, Medial meniscus, tibial collateral ligament
32
What is the deep fascia of the thigh? Is it underneath the fatty tissue (superficial fascia) and continuous with the leg?
Fascia lata
Yes!
33
On lateral side fascia lata, there's a thickening of the band, what is this called?
Illiotibial (IT) tract (It provides support for the thigh on the lateral side = equivalent of what's provided by 3 muscles on the medial side)
34
Are thigh muscles arranged into 3 compartments? If so, what are they?
Yes! Anterior, medial and posterior compartments
35
What nerve innervates the anterior (extension) compartment thigh muscles?
Femoral nerve (MOTOR)
36
What is the nerve innervating the medial (adduction) compartment of the thigh muscles?
Obturator Nerve
37
What nerve innervates posterior compartment of thigh, whole leg and whole foot?
Sciatic nerve
38
What is the O, I, A and N of the Sartorius?
ASIS goes diagonally across the thigh and inserts on the medial side. It crosses 2 joints (knee and hip joints) so it can move both the knee and hip joints!
A: "Is there gum on my shoe? flexion of knee and hip, external rotation and abduction
N: femoral nerve
39
What is the only quadriceps muscle that crosses 2 joints?
Rectus femoris (on anterior thigh)
40
What is the O, I, N, A of the rectus femoris?
O: Anterior inferior iliac spine and superior margin of acetabulum
I: patella and tibial tuberosity via patellar ligament
A: extends knees and flexes thigh at hip
N: femoral
41
Are all quadriceps muscles knee extensors?
Yes!
42
What is the O, I, A, and N of the vastus lateralis?
O: greater trochanter, intertrochanteric line, linea aspera
I: patella and tibial tuberosity via patellar ligament
A: extends and stabilizes knee
N: femoral
43
What's action of the Gracilis in medial thigh?
thigh adduction
44
Why is the adductor canal of the medial compartment of the thigh important?
Blood supply passes through here
45
The adductor magnus is so big that its innervated by what 2 nerves?
obturator (1/2), sciatic (1/2)
46
Why is the adductor canal (near the adductor magnus) of the medial compartment of the thigh important?
Blood supply passes through here
47
Biceps femoris is on what side of the thigh?
Posterior compartment! It is a hamstring muscle
48
What is the O, I, A and N of the vastus medialis?
O: linea aspera, intertrochanteric and medial supracondylar lines
I: patella and tibial tuberosity via patellar ligament
N: femoral nerve
A: extends knee
49
What is the O, I, A and N of the vastus intermedius?
O: ASIS
I: winds around medial aspect of knee and inserts into medial aspect of proximal tibia
N: femoral nerve
A: flexes, abducts and laterally rotates thigh (flexes knee as in soccer kick, helps make cross-legged position)
50
As vessels cross the femoral ligament, do they change names?
Yes!
51
Does the main source of blood supply comes from the external iliac?
Yes! These are where the main vessels supplying blood the lower limb are
52
What is the order of nerves, blood supply and lymphatics in the femoral triangle?
NAVEL from lateral to medial
| Femoral nerve and femoral sheath, femoral artery, vein and lymphatics
53
The artery is closes to the _______ of the femoral triangle?
lateral part of the femoral triangle
54
What travels through the popliteal fossa?
femoral vessels that went through adductor canal go down wrap around the medial area of thigh and then go through popliteal fossa, sciatic nerve also (remember the sciatic nerve branches above the popliteal fossa into tibial and common fibular nerves)
55
The sciatic nerve branches into what two nerves?
tibial and common fibular nerves
56
What's the O, I, A, N of the adductor magnus?
O: ischial and pubic rami and ischial tuberosity
I: linea aspera and adductor tubercle of femur
A: ANTERIOR part: adducts, medially rotates, flexes thigh, POSTERIOR part: synergist of hamstrings to extend thigh
N: obturator, sciatic nerves
57
What's the O, I, A, N of the adductor longus?
O:pubis near pubic symphysis
I: linea aspera
A: adducts, flexes, and medially rotates thigh
N: obturator nerve
58
What's the O, I, A, N of the adductor brevis?
O: body and inferior pubic ramus
I: linea aspera above adductor longus
A: adducts, flexes, medially rotates thigh
N: obturator nerve
59
What's the O, I, A, N of the pectineus?
O: pubis (and superior ramus)
I: from lesser trochanter inferior to linea aspera on posterior aspect of femur
A: adducts, flexes and medially rotates thigh
N: femoral, sometimes obturator
60
What's the O, I, A, N of the gracilis?
O: inferior ramus and body of pubis and adjacent ischial ramus
I: medial surface of tibia just inferior to its medial condyle
A: adducts thigh, flexes and medially rotates leg, especially during walking
N: obturator nerve
61
What does eversion of the foot mean in relation to the midline?
moving foot away from midline
62
What are the 3 muscles of the hamstring group in the posterior compartment of the thigh?
Biceps femoris
Semitendinosus
Semimembranosus
63
What is the O, I, A, N of the biceps femoris?
O: ischial tuberosity (long head), linea aspera, lateral supracondylar line, distal femur (short head)
I: common tendon passes downward and laterally (forming lateral border of popliteal fossa) to insert into head of fibula and lateral condyle of tibia
A: extends thigh and flexes knee (laterally rotates leg, especially when knee is flexed)
N: sciatic nerve - tibial nerve to long head, common fibular nerve to short head (L5-S2)
64
What is the O, I, A, N of the semitendinosus?
O: ischial tuberosity in common with long head of biceps femoris
I: medial aspect of upper tibial shaft
A: extends thigh and flexes knee (with semimembraneous medially rotates leg)
N: sciatic nerve - tibial nerve portion
65
What is the O, I, A, N of the semimembranosus?
O: ischial tuberosity
I: medial condyle of tibia via oblique popliteal ligament to lateral condyle of femur
A: extends thigh and flexes knee (medially rotates leg)
N: sciatic nerve - tibial nerve portion
66
What are the boundaries of the femoral triangle?
Lateral - Sartorius
Medial - Adductor longus
Superior - inguinal ligament
67
What are the boundaries of the popliteal fossa?
Biceps femoris - lateral
Semitendinosus/semimembranosus - medial
2 heads of gastrocnemius and plantaris - inferior
68
What does the popliteal fossa contain?
popliteal artery and vein, continuation of femoral vessels into thigh, tibial and common fibular nerves (branches of sciatic nerve)
69
Are the muscles of the legs arranged into 3 compartments?
Yes: Anterior, Posterior, Lateral
70
What's the action and innervation of the posterior leg muscles?
```
Superficial muscles (gastrocnemius, soleus, plantaris) do plantarflexion
Deep muscles (popliteus, flexor halluces longus, flexor digitorum longus, tibialis posterior) invert foot, flex toes,
tibial nerve
```
71
What action does the lateral leg muscles do? Innervation?
eversion of foot
(muscles: fibularis longus and brevis)
common fibular (superficial fibular branch),
72
What action do the anterior leg muscles of the foot do? Innervation?
dorsiflexion, inverts foot, extends toes
(muscles: tibialis anterior, extensor hallucis longus, extensor digitorum longus, fibularis tertius)
Common fibular (deep fibular branch)
73
What's the O, I, A, N for tibialis anterior?
O: lateral condyle and upper 2/3 of tibial shaft, interosseous membrane
I: by tendon into inferior surface of medial cuneiform and first metatarsal bone
A: prime mover of dorsiflexion (also inverts foot, helps support medial longitudinal arch of foot)
N: deep fibular nerve (L4,L5)
74
What's the O, I, A, N for extensor digitorum longus?
O: lateral condyle of tibia, proximal 3/4 of fibula, interosseous membrane
I: middle and distal phalanges of toes 2-5 via extensor expansion
A: prime mover of toe extension (acts mainly at metatarsophalangeal joints), dorsiflexes foot
N: deep fibular nerve (L5, S1)
75
What's the O, I, A, N for the fibularis (peroneus) tertius?
O:distal anterior surface of fibula and interosseous membrane
I: tendon inserts on dorsum of 5th metatarsal
A: extends great toe (dorsiflexes foot)
N: deep fibular nerve
76
What's the O, I, A, N for the extensor hallucis longus?
O: head and upper portion of lateral fibula
I: long tendon that curves under foot to first metatarsal and medial cuneiform
A: plantar flexes and everts foot (may help keep foot flat on ground)
N: superficial fibular nerve
77
What's the O, I, A, N for fibularis (peroneus longus)?
O: head and upper portion of lateral fibula
I: tendon running behind lateral malleolus to insert on proximal end of 5th metatarsal
A: plantar flexes and everts foot
N: superficial fibular nerve
78
What is the Tom, Dick and Harry mnemonic stand for?
Tendons of foot
79
What are the Anterior Thigh muscles?
1. Sartorius
2-5: Quads: rectus femoris + vastus lateralis, intermedius, and medialis
N: Femoral nerve
ACTION: Extend knee, flex hip
80
What are the Medial Thigh muscles?
```
Gracilis
Pectineus - femoral nerve
ADductor group: adductor longus, brevis and magnus (*Adductor magnus = sciatic nerve)
N: Obturator nerve except pectineus
ACTION: ADduct thigh, medial rotation
```
81
What are the Posterior Thigh muscles?
Hamstrings: Biceps femoris, semitendinosus, semimembranosus
N: Sciatic nerve
ACTION: Flex knee, extend hip
82
Where does Psoas major and iliacus muscles from posterior abdominal wall attach?
Lesser Trochanter of femur to FLEX HIP JOINT
83
What are the posterior abdominal wall muscles that help to move lower limb?
Psoas Major, Iliacus
84
What is the biggest nerve travelling underneath piriformis?
Sciatic nerve (innervates POSTERIOR compartment of thigh)
85
What are the 2 branches of sciatic nerve?
Tibial nerve, common fibular nerve (innervates leg, foot)
86
How are the leg muscles organized?
3 compartments:
| POSTERIOR (has MOST leg muscles)- SUPERFICIAL and DEEP, lateral and anterior
87
What is the calf muscle?
Gastrocnemius
88
What are the Posterior leg muscles?
SUPERFICIAL (do PLANTARFLEXION = points ankle down): Gastrocnemius, Soleus, Plantaris
DEEP (Inverts foot = draws ankle TO MIDLINE, FLEXES TOES): Popliteus, Flexor Hallucis longus, Flexor Digitorum longus, Tibialis posterior
89
What are the Posterior leg muscles?
SUPERFICIAL (do PLANTARFLEXION = points ankle down): Gastrocnemius, Soleus, Plantaris
DEEP (Inverts foot = draws ankle TO MIDLINE, FLEXES TOES): Popliteus, Flexor Hallucis longus, Flexor Digitorum longus, Tibialis posterior
Innervation: TIBIAL nerve
90
What are the LATERAL leg muscles?
ACTION = Eversion of foot (turn ankle AWAY from midline): Fibularis longus, fibularis brevis
Innervation: Superficial Fibular branch of Common Fibular
91
What are ANTERIOR leg muscles?
ACTION = DORSIflexion (flexing foot up), invert foot (TO midline), EXTEND TOES
Tibialis anterior, extensor halluces longus, extensor digitorum longus, fibularis tertius
Innervation: Deep Fibular branch of Common Fibular
