Lower Limb

Question 1

How is the ischial tuberosity subdivided?

Answer 1

Transverse line divides it in to an upper and lower area and upper area is further divided in to medial and lateral by an oblique line. Inferior part is further divided in to medial and lateral by a ridge of bone.

Question 2

What is the lateral superior part of the ischial tuberosity for the attachment of?

Answer 2

Combined origin of the semitendinosus muscle and the long head of the biceps femoris muscle

Question 3

What is the medial superior part of the ischial tuberosity for the attachment of?

Answer 3

Semimembranosus

Question 4

What is the lateral inferior part of the ischial tuberosity the attachment for?

Answer 4

Adductor magnus muscle

Question 5

What is the medial inferior part of the ischial tuberosity the attachment for?

Answer 5

Nothing, it is covered by connective tissue and bursa. When sitting, it supports the body weight.

Question 6

Apart from muscles, what else attaches to the ischial tuberosity?

Answer 6

The sacrotuberous ligament

Question 7

What muscles are part of the medial compartment of the thigh?

Answer 7

Adductor longus
Adductor brevis
Adductor magnus
Pectineus
Gracilis

Question 8

What is the nonarticular part of the head of the femur?

Answer 8

Fovea (nonarticular pit) for attachment of the ligament of the head of the femur

Question 9

Where is the intertrochanteric line?

Answer 9

On the anterior surface of the upper margin of the shaft of the femur between a tubercle on the anterior surface of the base of the greater trochanter and just anterior to the base of the lesser trochanter

Question 10

What is the intertrochanteric line continuous with?

Answer 10

The spiral line (pectineal line), which curves medially under the lesser trochanter and around the shaft of the femur to merge with the medial margin of the linea aspera on the posterior surface of the femur.

Question 11

Where is the intertrochanteric crest?

Answer 11

On the posterior surface of the femur. Descends medially from the posterior margin of the greater trochanter to the base of the lesser trochanter

Question 12

What is located on the intertrochanteric crest?

Answer 12

quadrate tubercle on its upper half for the attachment of the quadratus femoris muscle

Question 13

What two ridges form the linea aspera?

Answer 13

Spiral line medially and the gluteal tuberosity laterally

Question 14

How are the attachments of the muscles on the greater trochanter arranged?

Answer 14

When looking from medial to lateral, oval depression for obturator externus is most inferior, then attachment of obturator internus then attachment for piriformis superiorly. Anterior to these areas is the attachment for gluteus medius

Question 15

What is attached to the gluteal tuberosity?

Answer 15

Gluteus maximus

Question 16

What are the articular surfaces of the hip joint?

Answer 16

Head of the femur and the lunate surface of the acetabulum

Question 17

What does the ligament of the head of the femur carry?

Answer 17

A small branch of the obturator artery

Question 18

What converts the acetabular notch in to the acetabular foramen?

Answer 18

Transverse acetabular ligament

Question 19

What three ligaments reinforce the external surface of the fibrous membrane of the hip joint and stabilise it?

Answer 19

Iliofemoral
Pubofemoral
Ischiofemoral

Question 20

What passes through the gap between the inguinal ligament and the pelvic bone?

Answer 20

Psoas major, iliacus, pectineus muscles
Femoral artery and femoral vein
Femoral nerve
Lymphatics

Question 21

What is the arrangement of vessels in the femoral triangle?

Answer 21

From lateral to medial:
Femoral nerve (outside of femoral sheath)
Femoral artery
Femoral vein
Lymphatics (in femoral canal)

Question 22

What does the femoral nerve innervate?

Answer 22

Muscles in the anterior compartment of the thigh
Iliacus and pectineus
Skin over the anterior thigh, anteromedial side of the knee, medial side of the leg and medial foot
(L2-L4)

Question 23

What does the obturator nerve innervate?

Answer 23

All muscles in the medial compartment of the thigh except the hamstring part of adductor magnus and the pectineus
Obturator externus
Skin on medial side of upper thigh
(L2-L4)

Question 24

What does the superior gluteal nerve supply and what are its nerve roots?

Answer 24

Gluteus medius, gluteus minimus and tensor fascia latae

Nerve root is anterior rami of L4-S1

Question 25

What does the inferior gluteal nerve supply and what are its nerve roots?

Answer 25

Gluteus maximus

L5-S2

Question 26

What is the cutaneous nerve supply of the ilioinguinal nerve in the thigh?

Answer 26

Medial side of the upper thigh and adjacent regions of the perineum (L1)

Question 27

What is the cutaneous supply of the femoral branch of the genitofemoral nerve?

Answer 27

Upper central part of the anterior thigh

L1, L2

Question 28

What are the nerve roots of the nerve to quadratus femoris?

Answer 28

L4-S1

Supplies quadratus femoris and gemellus inferior

Question 29

What are the nerve roots of the nerve to obturator internus?

Answer 29

L5-S2

Supplies obturator internus and gemellus superior

Question 30

What are the nerve roots of the posterior cutaneous nerve of the thigh?

Answer 30

S1-S3

Question 31

What are the nerve roots of the perforating cutaneous nerve and what does it supply?

Answer 31

S2 and S3
Supplies skin over the medial aspect of the gluteal fold overlapping with the posterior cutaneous nerve of the thigh
(it also penetrates the sacrotuberous ligament to leave the pelvic cavity)

Question 32

What does the obturator artery supply?

Answer 32

Gives branch called acetabular branch which continues as the artery to the ligament of the head of the femur
Supplies medial compartment of the thigh

Question 33

Describe the venous drainage of the lower limb

Answer 33

Great saphenous vein originates from medial dorsal arch and ascends on the anterior leg, lateral knee and anteromedial thigh to drain in to the femoral vein in the femoral triangle
Small saphenous vein begins at lateral dorsal venous arch and ascends on the posterior leg to drain in to the popliteal vein
Anterior and posterior tibial veins ascend and join to form the popliteal vein which becomes the femoral vein

Question 34

What muscles insert on the iliotibial tract?

Answer 34

Tensor fascia latae and gluteus maximus

Question 35

What is the function of the iliotibial tract and its associated muscles?

Answer 35

Hold leg in extension when other muscles have extended the leg at the knee joint
Stabilise the hip joint by preventing lateral displacement of the proximal end of the femur

Question 36

What is the prominent aperture in the fascia lata just inferior to the medial end of the inguinal ligament?

Answer 36

Saphenous opening to allow the great saphenous vein to travel deep to drain in to the femoral vein in the femoral triangle

Question 37

What are the borders of the femoral triangle?

Answer 37

Laterally is the medial border of sartorius
Superior is the inguinal ligament
Medially is the medial border of adductor longus muscle
The floor is formed medially by the pectineus and adductor longus muscle and laterally by iliopsoas

Question 38

What is the femoral sheath continuous with superiorly?

Answer 38

Transversalis fascia

Question 39

What is the origin and insertion of piriformis?

Answer 39

Origin - Anterior surface of sacrum between anterior sacral foramina
Insertion - Medial side of the superior border of greater trochanter of femur

Question 40

What is the action of the deep muscles of the gluteal region?

Answer 40

Laterally rotates the hip joint and abducts the hip when the femur is flexed
(Quadratus femoris only laterally rotates)