Lower limb Flashcards
what is the movement function of the anterior thigh muscles?
hip flexion and knee extension
what are the muscles of the anterior compartment?
pectineus
sartorius
iliopsoas (iliac + poses major)
quadriceps femoris
Which 4 muscles make up the quadriceps femoris?
rectus femoris
vastus medialis
vastus lateralis
vastus intermedius
Which is the largest component of quadriceps femoris?
vastus lateralis
Which muscle is the main flexor of the thigh?
iliopsoas
innervation of anterior compartment?
peroneal (femoral) nerve for all but psoas major and minor which are anterior rami of lumbar spine
which muscle is the great extensor of the leg?
quadriceps femoris
What is the role of the medial thigh group?
adductors
name the muscles in the medial thigh.
adductor longus adductor brevis adductor magnus gracilis obturator externus
which muscle is the most superiorly placed in the medial compartment?
adductor longus
the largest, most powerful, and most posterior muscle in the adductor group?
adductor magnus
the adductor magnus has a hamstring and an adductor part.. which part has an aponeurotic vs tendinous attachment?
hamstrings part = tendinous
adductor part - fans out widely = aponeurotic attachment
Which is the most medial muscle of the thigh?
gracilis
which superomedial muscle passes directly under the acetabulum and neck of femur?
obturator externus
innervation of medial compartment of thigh?
obturator nerve, except hamstring part of adductor magnus - tibial part of sciatic nerve
the obturator nerve enters the medial compartment after emerging from which canal?
obturator canal
the obturator nerve splits into an anterior and posterior division as it enters the medial compartment…around which muscle does it pass?
adductor brevis
What is the adductor hiatus>
an opening between the distal aponeurotic attachment of the adductor part of the adductor magnus & the distal tendinous attachment of the hamstrings part of the adductor magnus
What is the purpose of the adductor hiatus?
transmits the femoral artery and vein from the adductor canal to the popliteal fossa.
What is the contents of the adductor canal?
femoral artery, femoral vein, saphenous nerve, nerve to vastus medialis
Where is the opening of the adductor hiatus located?
just lateral and superior to the adductor tubercle of the femur
What are the borders of the femoral triangle?
superior - inguinal canal
medial - adductor longus (lateral border)
lateral - sartorius
muscular floor - iliopsoas (laterally) & pectineus (medially)
roof - fascia lata & cribriform fascia
What forms the apex of the femoral triangle?
where the medial border of the sartorius crosses the lateral border of the adductor longus
What is the inguinal ligament?
thickened inferior margin of external oblique aponeurosis
Muscles of the superficial layer of gluteal region?
gluteus maximus
gluteus minimus
gluteus medius
tensor fascia latae
Muscles of the deep gluteal region?
piriformis
obturator internus
superior & inferior gemelli
quadratus femoris
What is the function of the gluteal region?
abductors and rotators of thigh
which muscle in the superficial gluteal region is fusiform?
tensor fascia latae
Which muscle shares a common distal attachment with gluteus maximus? Why does it have a different role?
tensor fascia latae - main role is flexion due to its anterior location
Which muscle is a key landmark of the gluteal region, after which vessels are named superior or inferior?
piriformis, e.g. vessels superior to piriformis are superior gluteal vessels
Which 3 muscles form the triceps coxae?
obturator interns + superior & inferior gemelli
occupies gap between piriformis & quadratus femoris
Which muscle is located inferior to obturator interns & gemelli and is a strong lateral rotator of the thigh?
quadratus femoris
innervation of superficial gluteal muscles?
gluteus maximus = inferior gluteal nerve
rest = superior gluteal nerve
function of gluteus maximus?
extends thigh & assists in its lateral rotation
function of gluteus med., min, and TFL?
abduct and medially rotate thigh; keep pelvis level when ipsilateral limb is weight-bearing
Innervation of deep gluteal muscles?
piriformis = branches of anterior rami of S1, S2
obturator internus + superior gemelli = nerve to obturator internus
quadratus femoris + inferior gemelli = nerve to quadratus femoris
Function of deep gluteal muscles?
steady femoral head in acetabulum
lateral rotate thigh
abduct flexed thigh
How many of the muscles in the posterior thigh compartment are hamstring muscles? Name them.
3 out of 4:
semitendinosus
semimembranosus
long head of biceps femoris
the short head of biceps femoris - different innervation from long head
Which muscle in the posterior compartment protects the sciatic nerve after it descends from the gluteal region?
biceps femoris (long head)
Describe the joining of the 2 heads of the biceps femoris.
In the inferior part of the thigh, the long head becomes tendinous and is joined by the short head.
The rounded common tendon attached to the head of the fibula and is seen/felt as it passes the knee, especially when the knee is flexed against resistance.
The hamstrings muscles shares 4 things…?
- common proximal attachment (ischial tuberosity deep to gluteus maximus)
- distal attachment to the bones of leg
- span & act on 2 joints producing extension at hip and flexion at knee
- common innervation by tibial division of sciatic nerve
Innervation of posterior compartment of thigh?
tibial division of sciatic nerve (hamstrings)
common fibular division of sciatic nerve (short head biceps femoris)
Function of the semi-muscles?
extend thigh
flex leg & rotate medially when knee flexed
when thigh + leg are flexed, these muscles can extend trunk
Function of biceps femoris (both heads)?
flexes leg & rotates laterally when knee is flexed;
extends thigh
injury to which nerve results in trendelenburg gait?
superior gluteal nerve
popliteal region boundaries?
supero-laterally = biceps femoris
supero-medially = semi-membranosus
infero-laterally & infers-medially = lateral & medial heads of gastrocnemius
posteriorly = skin + popliteal fascia
what is the contents of the popliteal fossa?
- termination of the small saphenous vein
- popliteal arteries & veins & their branches
- tibial and common fibular nerves
- posterior cutaneous nerve of thigh (terminal branches)
- popliteal lymph & lymphatic vessels
Which group of arteries branching from the popliteal supplies the capsule and ligaments of the knee joint?
genicular arteries: superior lateral, superior medial, middle, inferior lateral and inferior medial genicular arteries
When is the periarticular vehicular anastomosis essential?
during full knee flexion
Which other arteries are essential to forming the anastomosis?
the descending genicular artery,
descending branch of lateral femoral circumflex artery,
anterior tibial recurrent artery
Where is the anterior compartment of the leg located?
anterior to the interosseous membrane, between the lateral surface of the shaft of the tibia and the medial surface of the shaft of the fibula
What is formed inferior to the compartment? And what is its purpose?
two band-like thickenings of fascia form retinacula - binds the tendons of the compartment muscles before and after they cross the ankle joint
Describe the superior extensor retinaculum.
a strong, broad band of deep fascia passing from fibula to tibia, proximal to the malleoli.
Describe the inferior extensor retinaculum.
A Y-shaped band of deep fascia, attaches laterally to antero-superior surface of calcaneus.
Forms a strong loop around the tendons of the fibularis tertius and extensor digitorum longus muscles.
What are the muscles of the anterior compartment fo the leg?
Tibialis anterior
Extensor digitorum longus
Extensor hallucis longus
Fibularis tertius
What is the role of the muscles of the anterior leg compartment?
dorsiflexors of the ankle joint
(elevate the forefoot and depress the heel)
long extensors also attach to dorsal aspect of digits and so extend the toes
the innervation of the anterior compartment of leg?
deep fibular nerve
What clinical condition is a sign of a nerve injury to the nerve supplying the anterior compartment?
foot drop
the lateral compartment of the leg is also known as … compartment?
evertor compartment
the lateral compartment ends inferiorly at what?
the superior fibular retinaculum - spans the distal tip of the fibula and the calcaneus
What is foot evertion? What is another role of the muscles of the lateral compartment?
elevating the lateral margin of the foot
plantar flexion at the ankle
Name the muscles of the lateral leg compartment.
fibularis longus
fibularis brevis
nerve of the lateral leg compartment? what does it continue on to supply after these muscles?
superficial fibular nerve
continues as cutaneous nerve, supplying skin ono distal part of anterior surface of leg and nearly all of the dorsal of the foot.
The posterior compartment fo the leg is divided into superficial and deep sub-compartments by what?
the transverse inter muscular septum
Which nerve and blood vessels supply the posterior compartment of the leg? And in which sub-compartment do they run?
tibial nerve
posterior tibial and fibular vessels
supply both parts but run in the deep sub-compartment (anterior) to the transverse inter muscular septum
What does the end of the transverse inter muscular septum form?
ends as reinforcing fibres from the medial malleolus and calcaneus meet and form the flexor retinaculum
Which is smaller: the superficial or deep sub-compartment of the posterior leg?
deep - more susceptible to compartment syndrome
superficial - the least confined compartment area
What do the muscles of the posterior compartment produce?
plantarflexion at the ankle
inversion at subtalar & transverse joints
flexion of the toes
Name the muscles of the superficial sub-compartment.
gastrocnemius
soleus
plantaris
Which muscle is continuously active during standing?
soleus
planters is insignificant by itself but works along with which muscle?
gastrocnemius
which muscles make up the triceps surae?
gastrocnemius + soleus share a common tendon (calcaneal tendon) which attaches to calcaneus
triceps surae tugs on calcaneal tuberosity, elevating the heel and depressing the forefoot
