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Anatomy > Lower limb > Flashcards

Lower limb Flashcards

1
Q

Where can the femoral artery be felt?

A

Middle inguinal point

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2
Q

What kind of joint is the hip joint?

A

Ball and socket synovial

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3
Q

What fractures of the femur are common in the elderly and how do they present?

A

Neck of femur fracture. Presented by shortened and externally rotated leg.

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4
Q

What are the bones of the lower limb - minus the foot?

A 
Hip bone
Femur
Patella
Tibia
Fibula
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5
Q

How are the tibia and fibula joined?

A

Interosseous ligament

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6
Q

What is the clinical significance of the medial malleolus of the tibia?

A

Great saphenous vein can be quickly accessed anterior to it

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7
Q

What bones are found in the foot?

A

Distal, middle and proximal phalanges
tarsals - medial, intermediate and lateral cunieform, cuboid, navicular, talus and calcaneus
Metatarsals

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8
Q

What are the muscle compartments of the thigh?

A

Anterior, medial and posterior

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9
Q

What are the muscle compartments of the leg?

A

Anterior, lateral deep and superficial posterior

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10
Q

What are the symptoms of compartment syndrome?

A

Pain, palor, pulseless and paraesthesia

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11
Q

What is the treatment for compartment syndrome?

A

Fasciotomy

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12
Q

Anterior compartment of the thigh

A

Supplied by the femoral artery and femoral nerve.

Composed of the sartorius, ilipsoas and quadriceps muscles

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13
Q

What does the anterior compartment of the thigh do?

A

Knee extension and hip flexion

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14
Q

What muscles make up the quadriceps?

A

Rectus femoris
vastus medius
vastus intermedius
vastus lateralis

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15
Q

Medial compartment of the thigh

A

Supplied by the obturator nerve and profunda femoris/ obturator artery. Composed of the obturator externus, gracilis, adductor magnus, adductor brevis and adductor longus

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16
Q

Posterior compartment of the thigh

A

Supplied by the sciatic nerve and profunda femoris artery.

Made up of the biceps femoris - long and short head, semimembranosus and semitendinosus

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17
Q

What does the medial compartment of the thigh do?

A

Adduction of thigh

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18
Q

What does the posterior compartment of the thigh do?

A

Flexion of knee and extension of hip

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19
Q

Where should an intramuscular injection be given?

A

Upper lateral quadrant of the gluteal region to avoid damaging the sciatic nerve

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20
Q

What are the muscles of the gluteal region?

A

Gluteus maximus
Gluteus minimus
Gluteus medius

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21
Q

Gluteus maximus

A

Thick extensor, assists with lateral rotation. Innervated by inferior gluteal nerve. Located superficially to the gluteus minimus and inferior to the gluteus medius

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22
Q

Gluteus medius

A

abducts and medially rotates lower limb. Innervated by the superior gluteal nerve. Found superior to the gluteus maximus and minimus

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23
Q

Gluteus minimus

A

abducts and medially rotates the lower limb. Innervated by the superior gluteus nerve. Found deep to the gluteus maximus

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24
Q

Trendelenburg gait

A

When there is damage to the superior gluteal nerve, causing weakness of the abductor muscles - gluteus medius and minimus. The opposite side to the side affected drops when walking.

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25
Q

Duchenne’s gait

A

Pelvic tilt

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26
Q

Anterior compartment of the leg

A

Supplied by the deep fibular nerve and anterior tibial artery. Composed of:
extensor hallucis longus, extensor digitorum longus, tibialis anterior and fibularis tertius

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27
Q

What does the anterior compartment of the leg do?

A

Dorsiflexion of foot and inversion of foot at ankle joint

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28
Q

What happens when there is damage to the common fibular/ peroneal nerve?

A

Foot drop as the muscles of the anterior compartment are paralysed because the deep fibular nerve arises from the peroneal nerve.

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29
Q

Saphenous nerve?

A

Supplies a medial portion of the leg

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30
Q

Lateral compartment of the leg

A

Supplied by the superficial fibular nerve and fibular artery. Composed of the fibularis longus and brevis

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31
Q

What does the lateral compartment of the leg do?

A

Eversion of the foot

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32
Q

Superficial posterior compartment of the leg

A

Supplied by the tibial nerve and posterior tibial artery. Composed of the gastrocnemius, soleus and plantaris

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33
Q

What does the superficial posterior compartment of the leg do?

A

Plantarflexion at ankle joint

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34
Q

Deep posterior compartment of the leg

A

Supplied by the tibial nerve and posterior tibial artery. Composed of the flexor digitorum longus, flexor hallucis longus, tibialis posterior and popliteus

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35
Q

Role of popliteus

A

laterally rotates the femur, unlocking knee joint, allowing flexion

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36
Q

Role of flexor hallucis longus

A

flexes big toes

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37
Q

Role of flexor digitorum longus

A

flexes lateral 4 toes

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38
Q

Role of tibialis posterior

A

Inverts and plantar flexes the foot

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39
Q

Sciatica

A

Pain in the buttocks or legs that is caused by the sciatic nerve becoming compressed or irritated.

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40
Q

What sensation does the femoral nerve supply?

A

Anterior thigh and medial leg

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41
Q

What sensation does the lateral femoral cutaneous nerve supply?

A

Lateral thigh

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42
Q

What sensation does the sciatic nerve supply

A

All of the posterior thigh and leg, anterior leg and foot - except medial part of leg

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43
Q

Myotome for hip flexion

A

L2

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44
Q

Myotome for knee extension

A

L3

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45
Q

Myotome for ankle dorsiflexion

A

L4

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46
Q

Myotome for great toes extension

A

L5

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47
Q

Myotome for ankle plantar flexion/ eversion/ hip extension

A

S1

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48
Q

Arterial supply of the lower limb

A

Abdominal aorta > common iliac > external iliac > femoral > popliteal > anterior tibial > fibular and posterior tibial arteries. Anterior tibial becomes dorsalis pedis artery in foot. Posterior tibial artery enters through tarsal tunnel and splits into lateral and medial plantar arteries

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49
Q

Deep veins of the lower limb

A

Veins from dorsal arch form anterior tibial vein.
On plantar foot medial and lateral plantar veins arise and combine to form the posterior tibial and fibular veins > popliteal vein > femoral vein > external iliac > common iliac > inferior vena cava

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50
Q

Superficial veins of the lower limb

A

great saphenous vein from dorsal venous arch - into femoral vein
small saphenous from dorsal venous arch - empties into popliteal vein

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51
Q

What forms the femoral triangle?

A

Iliopsoas, sartorius, adductor longus, pectineus and inguinal ligament

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52
Q

What is found in the femoral triangle?

A

Femoral nerve, femoral artery, femoral vein

53
Q

Valgus

A

Abnormal abduction

54
Q

Varus

A

Abnormal adduction

55
Q

Coxa valgus

A

Increase in the femoral neck shaft angle

56
Q

Coxa varus

A

Decrease in the femoral neck shaft angle

57
Q

Genu valgus

A

Knock knee, condition where the knees angle in and touch each other when the legs are straightened. Lower leg angled outwards.

58
Q

Genu varus

A

Outward bowing at the knee

59
Q

Another name for the hip bone?

A

Innominate bone

60
Q

When do the 3 hip bones fuse?

A

During puberty

61
Q

Ligaments of the hip?

A 
Transverse acetabular 
Ligamentum teres - 
Iliofemoral
Pubofemoral
Ischiofemoral
62
Q

What is important about the ligamentum teres?

A

Contains the ligamentum teres artery that supplies blood to the femoral head during childhood, less so in adulthood, which is why there is still risk of AVN if there is a femoral neck fracture.

63
Q

What does the iliofemoral ligament do?

A

limits extension

64
Q

What does the pubofemoral ligament do?

A

Limits abduction

65
Q

What does the ischiofemoral ligament do?

A

Limits extension

66
Q

Legg-calve pethes disease

A

A childhood condition that occurs when blood supply to the femoral head is interrupted temporarily and the bone begins to die. The bone gradually breaks apart and can lose its shape.

67
Q

Symptoms of Legg-calve Pethes disease

A

A limp and pain, shortening of the leg

68
Q

Clinical presentation of neck of femur fractrure

A

Laterally rotated and shortened

69
Q

Clinical presentation of shaft of femur fracture

A

Shortened leg only

70
Q

What are the ligaments involved in the knee joint?

A

Anterior cruciate and posterior cruciate
Lateral and medial collateral
Patellar

71
Q

What do the collateral ligaments fo?

A

Act to stabilise the hinge joint

72
Q

What does the ACL do?

A

Prevents anterior dislocation of the tibia onto the femur

73
Q

What does the PCL do?

A

Prevents posterior dislocation of the tibia onto the femur

74
Q

What is the unhappy triad

A

Damage to one of the medial meniscus, medial collateral ligament and anterior cruciate ligament causes damage to the rest.

75
Q

What is the most common knee pathology

A

Injury to the collateral ligaments caused by side ward force.

76
Q

How to assess collateral ligament damage?

A

Pain on medial rotation = medial ligament damaged and pain on lateral rotation = lateral ligament damaged

77
Q

How can the ACL or PCL be torn?

A

Hyperextension of the knee or force to the back of the knee - ACL or front - PCL.

78
Q

How to test damage to the cruciate ligaments?

A

Anterior/ posterior drawer test. Involves pulling the tibia forwards or backwards. If it moves the ligament has been damaged.

79
Q

What are the 2 joints of the tibia and fibular?

A

Distal and proximal tibiofibular joints

80
Q

What are the ligaments of the proximal tibiofibular joint?

A

Anterior and posterior superior tibiofibular ligaments
lateral collateral ligament of knee
biceps femoris

81
Q

What are the supporting structures of the distal tibiofibular joints?

A

Interosseous membrane
anterior and posterior inferior tibiofibular ligaments
Inferior transverse tibiofibular ligament

82
Q

What type of joint is the ankle joint?

A

Synovial hinge joint between the tibia and fibular with the talus of the foot.

83
Q

Ligaments of the ankle joint?

A

Medial ligament

Lateral ligament

84
Q

What makes up the lateral ligament of the ankle?

A

Anterior talofibular
Posterior talofibular
Calcaneofibular

85
Q

Subtalar joint

A

articulation between the talus and calcaneus. It is a synovial plane joint

86
Q

The ligaments of the subtalar joint

A

Posterior, medial and lateral talocalcaneal ligaments

Interosseous talocalcaneal ligament

87
Q

Calcaneal fracture

A

Crush type injury, the talus is driven into the calcaneus. There will be pain on inversion and eversion

88
Q

What spinal nerves are in the lumbar plexus?

A

L1-L4

89
Q

Where do spinal nerves leave the spinal cord?

A

Intervertebral foramina

90
Q

What are the main nerve branches of the lumbar plexus?

A 
Iliohypogastric nerve
Ilioinguinal nerve
Genitofemoral nerve
Lateral cutaneous nerve of the thigh
Obturator nerve
Femoral nerve
91
Q

Where is the lumbar plexus

A

Within the psoas major and anterior to transverse vertebral processes

92
Q

Iliohypogastric nerve root

A

L1

93
Q

Iliohypogastric nerve sensory function

A

posterolateral gluteal skin in pubic region

94
Q

Motor function of iliohypogastric nerve

A

internal oblique and transversus abdominis

95
Q

ilioinguinal nerve root

A

L1

96
Q

Motor function of ilioinguinal nerve

A

Internal oblique and transversus abdominis

97
Q

Sensory function of ilioinguinal nerve

A

Skin of upper middle thigh and over the genitals

98
Q

Genitofemoral nerve root

A

L1 and L2

99
Q

Motor function of genitofemoral nerve

A

Cremasteric muscle

100
Q

Sensory function of genitofemoral nerve

A

Upper anterior thigh and genital area

101
Q

Lateral cutaneous nerve of thigh root

A

L2 and L3

102
Q

Motor function of Lateral cutaneous thigh nerve

A

none

103
Q

Sensory function of lateral cutaneous thigh nerve

A

Anterior and lateral thigh down to knee

104
Q

Obturator nerve root

A

L2,3,4

105
Q

Motor function of obturator nerve

A

Obturator externus, pectineus, adduction longus, brevis and magnus and gracilis

106
Q

Sensory function of obturator nerve

A

Skin over medial thigh

107
Q

Femoral nerve root

A

L2,3,4

108
Q

Motor function of femoral nerve

A

Quadriceps femoris muscles, iliacus, pectineus and sartorius

109
Q

Sensory function of femoral nerve

A

Skin on anterior thigh and medial leg

110
Q

What spinal nerves are in the sacral plexus?

A

S1-4

111
Q

How does the lumbarsacral trunk form?

A

The anterior spinal nerves of S1-4 join with the 4th and 5th lumbar roots

112
Q

What are the major nerves of the sacral plexus?

A 
Superior gluteal nerve
Inferior gluteal nerve
Sciatic nerve
Posterior femoral cutaneous
Pudendal nerve
113
Q

What are the main destinations of the sacral plexus branches?

A

Leave pelvis via greater sciatic foramen or remain in the pelvis

114
Q

Superior gluteal nerve root

A

L4,5 and S1 leaves via the greater sciatic foramen

115
Q

Motor function of superior gluteal nerve

A

Gluteus minimus, medius and tensor fascia lata

116
Q

Sensory function of superior gluteal nerve

A

None

117
Q

Inferior gluteal nerve root

A

L5, S1 and 2 leaves via greater sciatic foramen

118
Q

Motor function of inferior gluteal nerve

A

Gluteus maximus

119
Q

Sensory function of inferior gluteal nerve

A

None

120
Q

Sciatic nerve root

A

L4,5, S1,2,3

121
Q

Motor functions of sciatic nerve

A

Posterior compartment of leg and thigh and hamstring component of adductor magnus and sole of foot
Supplies the common fibular nerve and so innervates all muscles of anterior and lateral compartments of leg and extensor digitorum brevis

122
Q

Sensory function of sciatic nerve

A

Posterolateral and medial surfaces of foot, sole of foot. Through common fibular - skin on anterolateral of leg and dorsal aspect of foot

123
Q

Posterior femoral cutaneous nerve root

A

S1-3

124
Q

Motor functions of posterior cutaneous femoral nerve

A

None

125
Q

Sensory function of posterior cutaneous femoral nerve

A

Skin on posterior of thigh and leg and perineum

126
Q

Pudendal nerve root?

A

S2-4

127
Q

Motor function of pudendal nerve

A

perineum skeletal muscles, sphincters ,levator ani

128
Q

Sensory functions of pudendal nerve

A

Penis and clitoris and perineum

129
Q

What is an inguinal hernia

A

When part of the intestine protrudes through a weak spot in the abdominal muscles, resulting in a painful bulge

Anatomy (16 decks)

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