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GSSE Anatomy > Lower Limb > Flashcards

Lower Limb Flashcards

1
Q

Superior attachments of fascia lata

A

Inguinal ligament, pubic arch, body of pubic tubercle, Scarpa’s fascia, iliac crest, sacrum, coccyx, sacrotuberous ligament, ischial tuberosity

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2
Q

What is the iliotibial tract

A

Shared aponeurosis of the tensor fasciae latae and gluteus maximums and fibres from fascia lata

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3
Q

Attachments of iliotibial tract

A

Iliac tubercle to the anterolateral tubercle of the tibia (Gerdy’s tubercle)

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4
Q

Inferior attachments of fascia lata

A

Exposed bones around knee, deep fascia of the leg inferior to the knee

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5
Q

What are the compartments of the thigh formed by?

A

Fascia lata and 3 fasciae intermuscular septa that arose from its deep aspect and attach to the lines aspera of the femur

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6
Q

Attachments of lateral intermuscular septum (strongest of the three)

A

From deep iliotibial tract to the lateral lip of the lines aspera and lateral supracondylar line of the femur

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7
Q

Where is the saphenous opening?

A

Inferior to the medial part of the inguinal ligament, approximately 4cm inferolateral to the pubic tubercle

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8
Q

What is the cribriform fascia?

A

Fibrofatty tissue covering the saphenous opening, pierced by numerous openings for efferent lymphatic vessels from the superficial inguinal lymph nodes and the great saphenous vein and its tributaries

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9
Q

What is the falciform margin?

A

The superior, lateral and inferior margins of the saphenous opening that form a sharp crescentic edge

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10
Q

Where does the great saphenous vein enter the femoral vein?

A

After passing through the saphenous opening and cribriform fascia

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11
Q

Differences between superficial and deep veins in the leg

A

Superficial veins run independent of named arteries, deep are deep to the deep fascia and accompany all major arteries.
Deep veins have more valves

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12
Q

Course of the great saphenous vein

A

Ascends anterior to the medial malleolus, passes posterior to the medial confuse of the femur (about a hand’s breadth posterior to the medial border of the patella), traverses the saphenous opening in the fascia lata

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13
Q

What is the origin of gluteus Maximus?

A

External surface of ala of ileum, dorsal surface of sacrum, coccyx and sacrotuberous ligament

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14
Q

What is the insertion of gluteus maximus?

A

Gluteal tuberosity of femur, deep fibres insert into ITB

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15
Q

What is the innervation of gluteus maximus?

A

Inferior gluteal nerve (L5, S1, S2)

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16
Q

What is the action of gluteus maximus?

A
  1. Extends thigh
  2. Assists lateral rotation
  3. Steadies thigh
  4. Assists in raising trunk from a flexed position
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17
Q

What is the origin of gluteus medius?

A

External surface of ileum between ASIS and PSIS

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18
Q

What is the insertion of gluteus medius?

A

Lateral surface of GT or femur

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19
Q

What is the innervation of gluteus medius?

A

Superior gluteal nerve (L5, S1)

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20
Q

What is the action of gluteus medius?

A
  1. abducts thigh
  2. Medial rotation of thigh
  3. Steadies pelvis (injury= trendelenburg gait)
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21
Q

What is the origin of gluteus minimus?

A

Inferior aspect of external surface of ilium

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22
Q

What is the insertion of gluteus minimus?

A

Anterior surface of GT of femur

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23
Q

What is the nerve supply of gluteus minimus?

A

Superior gluteal nerve (L5, S1)

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24
Q

What is the origin of piriformis?

A
  1. Anterior surface of sacrum

2. Sacrotuberous ligament

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25
Q

What is the insertion of piriformis?

A

Superior border of GT

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26
Q

What is the innervation of piriformis?

A

Direct branches from central rami of S1 and S2

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27
Q

What is the action of piriformis? Also of obturator inter us, superior gamellus, inferior gamellus, quadratics femoris

A
  1. Laterally rotates extended thigh
  2. Abduction of flexed thigh
  3. Steadies femoral head in acetabulum
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28
Q

What is the origin of obturator internus?

A
  1. Pelvic surface of obturator membrane

2. Surrounding bone

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29
Q

What is the insertion of obturator internus?

A

Medial surface of GT of femur

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30
Q

What is the nerve supply to obturator internus?

A

Nerve to obturator internus (L5, S1)

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31
Q

What is the origin of superior gamellus?

A

Ischial spine

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32
Q

What is the insertion of superior gamellus?

A

Medial surface of GT of femur

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33
Q

What is the nerve supply to superior gamellus?

A

Nerve to obturator internus (L5, S1)

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34
Q

What is the origin or inferior gamellus?

A

Ischial tuberosity

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35
Q

What is the insertion of inferior gamellus?

A

Medial surface of GT of the femur

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36
Q

What is the innervation of inferior gamellus?

A

Nerve to quadratics femoris (L5, S1)

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37
Q

What is the origin of quadratus femoris?

A

Lateral border of ischial tuberosity

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38
Q

What is the insertion of quadratus femoris?

A

Quadratus tubercle on intertrochanteric crest of femur and inferior to this

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39
Q

What is the innervation of quadratus femoris?

A

Nerve to quadratus femoris (L5, S1)

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40
Q

What is the general innnervation of the anterior thigh?

A

Directly/ indirectly by the lumbar plexus, situated in the posterior abdominal wall and formed by the ventral primary rami of L1 to L4

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41
Q

What are the nerve roots of the femoral branch of the genitofemoral nerve?

A

L1, L2

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42
Q

What does the femoral branch of the genitofemoral nerve innervate?

A

Skin over the femoral triangle

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43
Q

What is the course of the femoral branch of the genitofemoral nerve?

A

Lies in hollow femoral sheath of saphenous opening, passes superficially through the sheath’s anterior wall and fascia lata

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44
Q

What is the root of the ilio-inguinal nerve?

A

L1

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45
Q

What does the ilio-inguinal nerve innervate? (3 things)

A
  1. Lowest part of the anterior abdominal wall
  2. Medial branches- external genitalia
  3. Main branch supplies skin under the medial end of the inguinal ligament
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46
Q

What is the root of the lateral cutaneous branch of the subcostal nerve

A

T12

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47
Q

What does the lateral cutaneous branch of subcostal nerve innervate

A

Skin anterior to the GT of the femur

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48
Q

What is the root of the lateral cutaneous branch of the iliohypogastric nerve?

A

L1

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49
Q

What does the lateral cutaneous branch of iliohypogastric nerve innervate?

A

Skin over lateral part of anterior thigh below the iliac crest

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50
Q

What is the root of the medial cutaneous nerve of the thigh?

A

Anterior branch of the femoral nerve (L2, L3)

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51
Q

What does the medial cutaneous nerve of the thigh innervate?

A

Anterior and medial thigh down to the knee

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52
Q

What does the intermediate cutaneous nerve of the thigh innervate?

A

Anterior and medial thigh down to the knee

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53
Q

What is the root of the intermediate cutaneous nerve of the thigh?

A

Anterior branch of the femoral nerve (L2, L3)

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54
Q

What is the root of the saphenous nerve?

A

Femoral nerve L4

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55
Q

What does the saphenous nerve innervate?

A

Skin below knee joint, infrapatellar branch contributes to patella plexus

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56
Q

What is the root of the lateral cutaneous nerve of the thigh?

A

Branch of the lumbar plexus; L2, L3

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57
Q

What does the lateral cutaneous nerve of the thigh innervate?

A

Skin over lateral part of anterior thigh

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58
Q

What is the course of the lateral cutaneous nerve of the thigh?

A

From lateral border of psoas across the iliac fossa, then gets incorporated in fascia lata
It then passes behind or pierces the inguinal ligament where it lies in a fibrous tunnel 1cm medial to the ASIS.
Passes below fascia lata and then branches and each branch pierces the fascia lata individually

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59
Q

What is the origin of pectineus?

A

Pecten pubis on superior ramps of pubis

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60
Q

What is the insertion of pectineus?

A

Pectineal line of femur

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61
Q

What is the innervation of pectineus? (2)

A
  1. Femoral nerve (L2, L3)

2. Branch of obturator nerve

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62
Q

What is the action of pectineus? (2)

A
  1. Adducts thigh

2. Flexes thigh

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63
Q

What is the origin of Adductor Longus?

A

Body of Pubis (inferior Ramus to Pubic crest)

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64
Q

What is the insertion of adductor longus?

A

Middle third of linea aspera

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65
Q

What is the innervation of adductor longus?

A

Anterior branch of obturator nerve (L2, L3, L4)

66
Q

What is the action of adductor longus?

A

Adducts thigh

67
Q

What is the origin of adductor brevis? (2)

A
  1. Body of Pubis

2. Inferior Ramus of Pubis

68
Q

What is the insertion of adductor brevis? (2)

A
  1. Pectineal (spiral) Line

2. Proximal part of linea aspera

69
Q

What is the innervation of adductor brevis?

A

Obturator nerve (L2. L3, L4)

70
Q

What is the action of adductor brevis? (2)

A
  1. Adducts thigh

2. Partially flexes thigh

71
Q

What is the origin of adductor magnus? (2)

A
  1. Adductor- ischiopubic ramus

2. Hamstring- Ischial tuberosity

72
Q

What is the origin of adductor magnus? (4)

A
  1. Adductor- Gluteal tuberosity
  2. Adductor- Medial line aspera
  3. Adductor- Medial supracondylar line
  4. Hamstring- Adductor tubercle of femur
73
Q

What is the innervation of adductor magnus? (2)

A
  1. Adductor- Obturator nerve (L2, L3, L4)

2. Hamstring- tibial portion of sciatic nerve

74
Q

What is the action of adductor magnus? (3)

A
  1. Adducts thigh
  2. Adductor- flexes thigh
  3. Hamstring- extends thigh
75
Q

What is the origin of gracilis? (2)

A
  1. Body of pubis

2. Inferior ramus of pubis

76
Q

What is the insertion of gracilis?

A

Superior part of the medial surface of the tibia

77
Q

What is the innervation of gracilis?

A

Obturator nerve (L2, L3)

78
Q

What is the action of gracilis? (3)

A
  1. Adducts thigh
  2. Flexes leg
  3. Medial rotation of thigh
79
Q

What is the origin of obturator externus? (2)

A
  1. Obturator Foramen’s margins

2. Obturator membrane

80
Q

What is the insertion of obturator externus?

A

Greater trochanter of femur

81
Q

What is the innervation of obturator externus?

A

Obturator nerve (L3, L4)

82
Q

What is the action of obturator externus? (2)

A
  1. Lateral rotation of thigh

2. Steadies head of femur in acetabulum

83
Q

What is the course of the obturator artery?

A

Enters medial compartment of thigh through obturator canal along with the obturator nerve

84
Q

What does the obturator artery supply?

A

Medial compartment and hip joint

85
Q

What is the origin of the obturator artery?

A

Originates as a branch of the internal iliac artery in the pelvic cavity

86
Q

What is the importance of the obturator artery in ortho?

A

A branch of its posterior division forms the Artery to head of Femur

87
Q

What is the origin of rectus femoris? (2)

A
  1. Straight head- Anterior Inferior Iliac Spine

2. Reflected head- outer surgace of ilium above acetabulum

88
Q

What is the insertion of rectus femoris? (2)

A
  1. Reflected head- merges with posterior aspect of straight head
  2. Fused bellies- becomes tendonous and fuses with aponeurosis that becomes patella tendon
89
Q

What is the innervation of rectus femoris?

A

Femoral nerve (posterior divisions of L2, L3, L4)

90
Q

What is the action of rectus femoris? (2)

A
  1. Steadies hip joint

2. Helps iliopsoas in flexing thigh

91
Q

What is the origin of vastus lateralis? (4)

A
  1. Halfway up intertrochanteric line
  2. GT
  3. Gluteal tuberosity
  4. Lateral lip of linea aspera
92
Q

What is the insertion of vastus lateralis?

A

Extensive aponeurosis on deep aspect of muscle belly

93
Q

What is the innervation of vastus lateralis?

A

Femoral nerve (posterior divisions of L2, L3, L4)

94
Q

What is the action of vastus lateralis?

A

Part of quadriceps- extends leg at knee joint

95
Q

What is the origin of vastus medialis? (5)

A
  1. Mid-point of intertrochanteric line
  2. Lesser trochanter
  3. Spiral line
  4. Medial lip of linea aspera
  5. Upper half of medial supracondylar line
96
Q

What is the insertion of vastus medialis?

A

Extensive aponeurosis on deep aspect of muscle belly

97
Q

What is the innervation of vastus medialis?

A

Femoral nerve (posterior divisions of L2, L3, L4)

98
Q

What is the action of vastus medialis? (2)

A
  1. Part of quadriceps- extends leg at knee joint

2. Lower fibres run horizontally and fix patella preventing its lateral displacement

99
Q

What is the origin of vastus intermedius?

A

Anterior and lateral surfaces of shaft of femur

100
Q

What is the insertion of vastus intermedius?

A

Extensive aponeurosis on deep aspect of muscle belly

101
Q

What is the innervation of vastus intermedius?

A

Femoral nerve (posterior divisions of L2, L3, L4)

102
Q

What is the action of vastus intermedius?

A

Part of quadriceps- extends leg at knee joint

103
Q

What goes through the greater sciatic foramen?

A

Sciatic nerve, superior and inferior gluteal nerves and vessels, pudendal nerve (also passes back through the lesser), posterior femoral cutaneous nerve, nerves to obturator internus and quadratus femoris

104
Q

What goes through the lesser sciatic foramen?

A

Tendon of obturator internus, pudendal nerve, internal pudendal vessels, nerve to obturator internus

105
Q

What movements occur at the subtalar joint?

A

Inversion and ever soon

106
Q

What is the ligament of Humphrey?

A

Meniscofemoral ligament that passes ANTERIOR to the PCL

107
Q

What is the ligament of Wrisberg?

A

Meniscofemoral ligament that passes POSTERIOR to the PCL

108
Q

Where do the meniscofemoral ligaments originate from?

A

The posterior horn of the lateral meniscus

109
Q

What is the anterolateral border of the subsartorial (Hunter’s) canal?

A

Vastus medialis

110
Q

What’s the posteromedial border of the subsartorial (Hunter’s) canal?

A

Adductor Longus, adductor magnus

111
Q

What is the anteromedial (roof) of the subsartorial (Hunter’s) canal?

112
Q

What are the contents of the subsartorial (Hunter’s) canal?

A

Femoral artery, femoral vein, saphenous nerve, nerve to vastus medialis

113
Q

What are the contents of the first layer of the foot?

A

Flexor digitorum brevis, Abductor hallucis, Abductor digit minimi

114
Q

What are the contents of the second layer of the foot?

A

Tendon of flexor hallucis longus, tendon of flexor digitorum longus, flexor accessorius (quadratus plantae)

115
Q

What are the contents of the third layer of the foot?

A

Flexor hallucis brevis, adductor hallucis, flexor digiti minimi brevis

116
Q

What are the contents of the fourth layer of the foot?

A

Interossei, tendons of tibialis posterior and peroneus longus lying deeply against the under surface of the tarsus

117
Q

Where do the nerves and arteries of the sole of the foot lie?

A

Between the first and second layers- the artery is more marginal than the nerve

118
Q

What is the clinical significance of the lateral femoral cutaneous nerve?

A

It can get compressed as it passes through the inguinal ligament or where it pierces the fascia lata causing pain in the lateral side of the thigh (meralgia paraesthetica)

119
Q

What is the course of the genitofemoral nerve prior to entering the leg?

A

It lies on psoas and then the external iliac as it passes into the femoral sheath

120
Q

What is the root of the ilioinguinal nerve?

A

It is a branch of the ilihypogastric (L1)

121
Q

What does the ilioinguinal nerve supply?

A

It supplies the the lower fibres of internal oblique
Skin at the root of the penis
Anterior 1/3 of the scrotum
Small area of skin at the medial end of the inguinal ligament

122
Q

What is the nerve supply of the hip joint?

A

Femoral nerve via nerve to rectus femoris
Sciatic via the nerve to quadratus femoris
Obturator nerve from its anterior division

123
Q

Which ligament prevents hyperextension of the hip?

A

The iliofemoral ligament

124
Q

Is the anterior tibial vein a tributary of the great saphenous vein?

125
Q

How many tarsal bones are there in the foot?

126
Q

Where does the medial circumflex artery sometimes branch from other than the profunda femoris artery?

A

The femoral artery

127
Q

What area of sensation does the sural nerve supply?

A

The lateral border of the foot

128
Q

Which nerves combine to form the sural nerve?

A
  1. Medial cutaneous branch from the tibial nerve

2. Lateral cutaneous branch from the common perineal nerve

129
Q

Which projects more anteriorly the medial or lateral condole of the femur and why?

A

The lateral to help prevent lateral dislocation of the patella

130
Q

What are the borders of the femoral ring? Mnemonic SLIP

A

Septa of femoral sheath
Lacunar ligament
Inguinal ligament
Pectineal ligament

131
Q

What is the floor of the femoral triangle?

A

Adductor longus, pectineus and a wee bit of iliopsoas

132
Q

Are the collateral ligaments extracapsular?

133
Q

Which bone of the foot contains a groove for the fibularis longus tendon?

A

The cuboid

134
Q

What is the spring ligament?

A

AKA plantar calcaneonavicular ligament passes between the sustentaculum tali of the calcaneus and the plantar surface of the navicular

135
Q

What is the deltoid ligament made up of?

A

Anterior tibiotalar ligament

Tibiocalcaneal ligament

Posterior tibiotalar ligament

Tibionavicular ligament

136
Q

What inserts at the base of the 5th metatarsal?

A

Peroneus brevis

137
Q

What are the muscle attachments to the linea aspera from medial to lateral?

A

vastus medialis, adductor longus, adductor brevis, adductor magnus, short head of biceps, vastus lateralis.

138
Q

Which nerve pierces psoas anteriorly?

A

Genitofemoral nerve

139
Q

Which muscles cause dorsiflexion at the ankle joint?

A

Tib ant and peroneus tertius

140
Q

Which muscles cause inversion at the ankle joint?

A

Tib ant and tib post

141
Q

Which muscles cause plantarflexion at the ankle joint?

A

Tib post and peroneus longus and brevis

142
Q

Which muscles cause eversion at the ankle joint?

A

Peroneus tertius, peroneus longus and peroneus brevis

143
Q

Which muscle helps to limit flexion of the hip when the knee is extended?

A

Semimebranosus

144
Q

What part of quads has fleshy fibres extending more distally, lateralis or medialis?

A

Vastus medialis

145
Q

Is quads power increased by hip extension?

146
Q

What does the soleus muscle contain?

A

A rich plexus of veins

147
Q

Are the suprerior and inferior tibio-fibular joints both synovial?

A

No- the proximal is, but the distal is a fibrous joint

148
Q

What is unusual about the flexor digitorum longus?

A

Bipennate and arises from both bones in the leg

149
Q

What is the innervation of gastroc?

A

Tibial nerve

150
Q

Where is the tibial nerve derived from?

A

The ventral rami of L4-S3

151
Q

Which nerve supplies skin of the medial mall

A

Femoral (L2-L4)

152
Q

What are the attachments of the deltoid ligament?

A

Medial mall, sustentaculum tali, talar neck, body of talus, spring ligament, navicular

153
Q

What structures are in the anterior compartment of the leg?

A

Tibialis anterior, EDL, EHL, peroneus tertius, anterior tibial artery and vein, deep peroneal nerve

154
Q

What structures are in the lateral compartment of the leg?

A

Peroneus longus and brevis, superficial peroneal nerve

155
Q

What structures are in the superficial posterior compartment of the leg?

A

Soleus, gastrocnemius, plantaris tendon

156
Q

What structures are in the deep posterior compartment of the leg?

A

FDL, tibialis posterior, FHL, posterior tibial artery and vein, peroneal artery and vein

157
Q

What is the first branch of the popliteal artery?

A

Anterior tibial artery

158
Q

What is the terminal branch of the anterior tibial artery

A

Dorsalis pedis

159
Q

What is the terminal branch of the peroneal artery?

A

Calcaneal branches

160
Q

What are the terminal branches of the posterior tibial artery?

A

Medial abs lateral plantar arteries

GSSE Anatomy (11 decks)

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