Lower Limb Flashcards
What are the six regions of the lower limb?
Gluteal Femoral Knee Leg Ankle Foot
What are the different functions of the acetabulo-femoral joint?
Flexions-extension
Abduction-adduction
Medial-lateral
Circumduction
What are the different ligaments in the acetabulo-femoral joint?
Iliofemoral
Ischiofemoral
Pubofemoral
Ligamentum teres of the femur
What artery supplies the head and neck of the femur?
Medial circumflex femoral artery
What artery runs in the ligamentum teres of the femur?
Acetabular branch of the deep artery of the thigh
What range of movement can the modified synovial hinge joint of the knee perform?
Flexion and extension
Slight rotation
What articulations are present on the knee complex?
Medial tibiofemoral
Lateral tibiofemoral
Patellofemoral
What are the extracapsular ligements of the knee?
Patellar ligament
Lateral (fibular) collateral ligament
Medial (tibial) collateral ligament
What are the intra-articular ligaments of the knee?
Anterior cruciate (ACL) Posterior cruciate (PCL)
What is the menisci?
A cresent shaped fibrocatilage within the knee
How can the medial and lateral collateral ligaments be distinguished?
Medial is much broader
Lateral is more cord like
What is the Q angle?
A line made by connecting the ASIS to the mid-point of the patella
Where do nerves enter/exit the pelvis and perineum via?
Greater and lesser sciatic foramen
Nerves supplying what will pass through the greater sciatic foramen?
Pelvis - sciatic nerve
Nerves supplying what will pass through the lesser sciatic foramen?
Perineum - pudendal nerve
What ligaments make up the gluteal region?
Sacrotuberous and sacrspinous ligaments
What level of the spine does the sciatic nerve originate?
L4-S3
What does the sciatic nerve supply?
Posterior thigh
All leg and foot muscles
Most of the skin via the tibial and fibular branches
What level of the spine does the pudendal nerve orignate from?
S2-4
What level of the spine does the posterior cutaneous nerve of the thigh originate from?
S1-3
What does the posterior cutaneous nerve of the thigh supply?
Skin over posterior thigh, popliteal fossa, lateral perineum and upper medial thigh
What range of motion do the superficial muscles of the gluteal region do?
Extensors, abductors and medial rotators of thigh
What are the superficial muscles of the gluteal region?
Gluteus maximus
Gluteus minimus
Gluteus medius
Tensor fascia latae
What nerve supplies the gluteus maximus?
Inferior gluteal nerve
What nerve supplies the gluteus maximus, gluteus minimus and gluteus medius?
Superior gluteal nerve
What range of motions do the deep muscles of the gluteal region do?
Lateral rotators of the thigh and hip stabilisers
What are the deep muscles of the gluteal region?
Piriformis
Obutrator internus
Gemelli (superior and inferior)
Quadratus femoris
What nerve supplies the deep muscles of the gluteal region?
Sacral plexus
What is the trendelenberg gait?
Reduced function of superior gluteal nerve function resulting in the hip dropping on the contralateral side
What muscle causes trendeleneberg gait?
Weak hip adduction via gluteus medius
Where will the sciatic nerve exit the gluteal region?
Inferior to piriformis
Most lateral to exit the greater sciatic foramen
What are the two portions of the sciatic nerve?
Tibial nerve - larger and medial
Common fibular - smaller and lateral
What are the three compartments of the thigh?
Anterior, medial and posterior
What are the three components of the leg?
Anterior, posterior and lateral
What is compartment syndrome?
Increased pressure caused by swelling of tissue or increased fluid causes compression of muscles and nerves in the compartment
How is compartment syndrome treated?
Fasciotomy
What nerve supplies the anterior compartment of the thigh except from the psoas major?
Femoral nerve (L2,3,4)
What nerve supplies the psoas major?
L1,2,3
What are the muscles of flexion in the anterior compartment of the thigh?
Rectus femoris
Iliopsoas maj and min
Pectineus
Sartorius
What are the muscles of extension in the anterior compartment of the thigh?
Rectus femoris
Vastus lateralis
Vastus medialis
Vastus intermedius
What are the boundaries to the femoral triangle?
Superior = inguinal ligament Medial = lateral border of adductor longus Lateral = medial border of sartorius Floor = ilioposas and pectinus Roof = deep fascia
What are the contents of the femoral triangle?
Femoral Nerve Femoral Artery Femoral Vein Lymphatics Lateral to media = NAVY
In the medial compartment of the thigh, what are the adductor muscles?
Adductor longus Adductor brevis Adductor magnus Gracilis Obturator externus
What nerve supplies the adductors of the medial compartment of the thigh?
Obturator nerve (L2,3,4)
In the posterior compartment of the thigh, what are the extensor muscles of the thigh and flexors of the leg?
Semitendinosus
Semimembranous
Biceps femoris
What nerve supplies the posterior compartment of the thigh?
Tibial division of sciatic nerve (L5,S1,2)
What is the range of motion of the superficial group of muscles in the posterior compartment of the leg?
Plantarflexors of ankle
What are the muscles in the superficial group of the posterior compartment of the leg?
Gastrocnemius
Soleus
Plantaris
What is the range of motion of the deep group of muscles in the posterior compartment of the leg?
Flexors of toes and plantarflexors of ankle
What are the muscles in the deep group of the posterior compartment of the leg?
Popliteus
Flexor hallucis longus
Flexor digitorum longus
Tibialis posterior
What nerve supplies the posterior compartment of the leg?
Tibial nerve
What is the range of motion of the muscles in the anterior compartment of the leg?
Dorsiflexors of ankle and extensors of toes
What are the muscles in the anterior compartment of the leg?
Tibialis anterior
Extensor digitorum longus
Extensor hallucis longus
Fibularis tertius
What nerve supplies the anterior compartment of the leg?
Deep fibular nerve (L4,5)
What are the muscles in the lateral compartment of the leg?
Fibularis longus
Fibularis brevis
What is the range of motion of the muscles in the lateral compartment of the leg?
Evert the foot and weakly plantarflex the ankle
What nerve supplies the lateral component of the leg?
Superficial fibular nerve (L5, S1 and 2)
What causes foot drop?
Deep fibular nerve palsy causing a loss of muscle action in anterior compartment of the leg
Results in reduced or absent dorsiflexion
What are the boundaries of the popliteal fossa?
Superolateraly = biceps femoris Superiomedially = semimembranous Inferiorly = gastrocnemius Roof = popliteal fossa
What is contained within the popliteal fossa?
Fat
Terminal small saphenous vein
Popliteal vessels
Tibial and common fibular nerves
What muscles does the achilles tendon (calcaneal tendon) attach to?
Gastrocnemius and soleus
Attaches to calcneal tuberosity of calcaneus
How can the calcaneal tendon be tested?
Ankle jerk reflex - normal result is plantarflexion
Tests S1 and S2 nerve roots
What do the superficial lymphatics of the leg follow?
Saphenous veins
Drain to superficial inguinal then to external iliac nodes
What do the deep lymphatics of the leg follow?
Deep veins and drain into popliteal lymph nodes
Then to deep inguinal nodes to the external iliac nodes