Lower limb

Question 1

Pelvic girdle bones

Answer 1

• sacrum

- os coxa

Question 2

Os coxa

Answer 2

• ilium
• ischium
• pubic

Question 3

Lower appendage bones

Answer 3

• femur
• patella
• tibia
• fibula
• talus
• calcaneus
• navicular
• cuboid
• cuneiforms (medial, intermediate, lateral)
• metatarsals
• phalanges

Question 4

Deep fascia of the lower limb

Answer 4

• particularly strong
• prevents outward expansion of muscles (helps with movement of venous blood)
• forms muscle compartments

Question 5

Thigh fascia

Answer 5

• fascia lata

- continuous with Scarpa’s fascia of abdomen

Question 6

Superior attachment of thigh fascia

Answer 6

-inguinal ligament, pubic arch, iliac crest, sacrum, coccyx

Question 7

Inferior attachment of thigh fascia

Answer 7

-bones around knee and deep fascia of the leg

Question 8

Lateral thickening of thigh fascia

Answer 8

• iliotibial tract

- aponeurosis of tensor fasciae latae and gluteus maximus m.

Question 9

Saphenous opening of thigh fascia

Answer 9

-where greater saphenous v. joins the femoral v.

Question 10

Leg fascia

Answer 10

• crural fascia
• attaches to anterior and medial tibia
• thicker proximally
• distally forms the extensor retinacula at the ankle

Question 11

Femoral triangle

Answer 11

• on anterior thigh

- contains femoral artery, vein, nerve, and lymphatics

Question 12

Femoral sheath

Answer 12

• encloses artery, vein, and lymphatics in femoral triangle

- three compartments: one each for a./v./lymphatics

Question 13

Borders of the femoral triangle

Answer 13

• inguinal ligament (superior)
• adductor longus m. (medial)
• sartorius m. (lateral)

Question 14

Contents of popliteal fossa

Answer 14

• popliteal artery (deepest)
• popliteal vein
• tibial nerve
• common peroneal nerve

Question 15

Borders of popliteal fossa

Answer 15

• biceps femoris m. (lateral and superior)
• semimembranosus m. (medial and superior)
• Gastrocnemius m. (inferior, lateral, and medial)

Question 16

Adductor hiatus

Answer 16

• medial thigh
• opening in the aponeurosis of adductor magnus m.
• allows femoral artery and vein to enter the popliteal fossa from the anterior

Question 17

Branches of external iliac artery

Answer 17

• femoral artery (after inguinal ligament)

- popliteal artery (after adductor hiatus)

Question 18

Branches of the femoral artery

Answer 18

-deep femoral artery (aka profunda femoris a.)

Question 19

Branches of deep femoral artery

Answer 19

-medial/lateral circumflex femoral artery

Question 20

Branches of popliteal artery

Answer 20

• anterior tibial artery

- posterior tibial artery

Question 21

Branches of anterior tibial artery

Answer 21

-dorsalis pedis artery (after ankle)

Question 22

Branches of dorsalis pedis artery

Answer 22

• deep palmar artery (turns into deep plantar arch)

- arcuate artery

Question 23

Branches of posterior tibial artery

Answer 23

• peroneal artery
• medial plantar artery
• lateral plantar artery (turns into deep plantar arch with deep palmar artery)

Question 24

Deep veins of the lower limb

Answer 24

• named veins follow like-named arteries
• more variant with more anastomoses than arteries
• more valves than superficial veins (to fight off gravity)

Question 25

Superficial veins of the lower limb

Answer 25

• in subcutaneous fat, many perforating connections to deep veins, with valves (unidrectional flow)
• greater and lesser saphenous veins

Question 26

Greater saphenous vein

Answer 26

-empties into the femoral v. at saphenous opening of fascia lata

Question 27

Lesser saphenous vein

Answer 27

-empties into the popliteal v. in popliteal fossa

Question 28

Deep lymphatic vessels

Answer 28

• accompany deep veins in leg and thigh
• in thigh, end in deep inguinal LN which drain to the external and common iliac LN
• in leg, end in popliteal LN and continue with deep vessels of thigh

Question 29

Superficial lymphatic vessels

Answer 29

1. follow lesser saphenous vein (end in popliteal LN in popliteal fossa)
2. follow greater saphenous vein (end in superficial inguinal lymph nodes)
   - superficial inguinal lymph nodes join the external iliac LN

Question 30

Lumbar plexus

Answer 30

• iliohypogastric n.
• ilioinguinal n.
• genitofemoral n.
• lateral femoral cutaneous n.
• obturator n. (L2-4)
• femoral n. (L2-4)

Question 31

Sacral plexus

Answer 31

• superior gluteal n.
• inferior gluteal n.
• sciatic n.
• posterior femoral cutaneous n.
• pudendal n.

Question 32

Sciatic nerve branches

Answer 32

• Tibial nerve (L4-S3)

- common peroneal n. (L4-S2)

Question 33

Tibial nerve branches

Answer 33

• sural nerve

- medial/lateral plantar nerves

Question 34

Common peroneal nerve branches

Answer 34

• deep peroneal nerve

- superficial peroneal nerve

Question 35

Sciatic nerve

Answer 35

• “pierces” the piriformis m. (only for 12% of people)
• usually below the piriformis m.
• very rarely above the piriformis m.
• important for intramuscular injections

Question 36

Intragluteal injections anatomical structures

Answer 36

• ASIS (anterior superior iliac spine)
• iliac crest
• PSIS
• greater trochanter
• sciatic nerve
• superior gluteal nerve

Question 37

Dermatomes

Answer 37

• inguinal lig. (L1)
• lateral thigh (L2)
• lower medial thigh (L3)
• medial hallux (L4)
• medial digit 2 (L5)
• Digit 5 (S1)
• posterior thigh (S2)
• gluteal fold (S3)

Question 38

Dermatome dot locations

Answer 38

• L1= on inguinal ligament
• L2= middle, lateral most side
• L3= upper, medial side of thigh
• L4= big toe
• L5= second toe
• S1= pinky toe
• S2= posterior thigh just above popliteal area