Lower Limb Flashcards
what types of muscles are found in the anterior compartment of the lower limb and then the posterior compartments
In the lower limb, the anterior compartments (thigh and leg) contain extensor muscles.
The posterior compartments (thigh and leg) contain flexor muscles.
describe the venous drainage of the lower limb
anterior thigh part 1
slide 6 and 7
Venous blood from superficial structures of the lower limb will drain into the following:
Dorsal venous arch (located on the dorsum of the foot)
Short saphenous vein (located on the posterior aspect of the leg – see next slide)
Great saphenous vein (located on the medial aspect of the leg and medial thigh)
The great saphenous vein drains into the femoral vein within the femoral triangle.
briefly describe the arterial supply of the lower limb
anterior thigh part 1
slide 8
The principal artery within the lower limb is the femoral artery – a continuation of the external iliac artery.
The femoral artery gives off the profunda femoris artery as a branch. This vessel is also known at the deep artery of the thigh.
The femoral artery enters the adductor hiatus and on passing through this opening the vessel becomes the popliteal artery.
name the Quadriceps group of muscles
Rectus femoris m.
Vastus medialis m.
Vastus intermedius m. (next slide) Vastus lateralis m.
what forms the base, medial border, lateral border and apex of the femoral triangle
The base of the femoral triangle is formed by the inguinal ligament.
The medial border is formed by the lateral border of the adductor longus m.
The lateral border is formed by the medial border of the sartorius m.
The apex is located where the sartorius and adductor longus mm. overlap.
what forms the floor of the femoral triangle
Pectineus muscle
Iliopsoas muscle (ilacus m. located within the iliac fossa and psoas major muscle located on the posterior abdominal wall join together). This muscle is a powerful flexor of the lower limb at the hip joint.
describe the contents of the femoral triangle
The following structures are located within the femoral triangle, from medial to lateral:
Femoral vein Femoral artery Femoral nerve
Both the femoral vein and femoral artery are enclosed within the femoral sheath (a tube of fascia).
Note that the femoral nerve is not enclosed within the femoral sheath.
what structures are located in the femoral sheath
The femoral sheath is sub- divided into 3 compartments:
Lateral compartment: contains the femoral a.
Intermediate compartment: contains the femoral v.
Medial compartment: contains the femoral canal
describe the boundaries of the sub-sartorial canal
The boundaries of the sub-sartorial canal are:
Anteromedially:
sartorius m.
Anterolaterally: vastus medialis m.
Posteriorly: adductor longus m. and adductor magnus m.
• Name the structures that travel within the sub-sartorial canal
Femoral artery
Femoral vein
Saphenous nerve (a cutaneous branch of the femoral nerve) Nerve to vastus medialis
what type of movement occurs at the ankle joint
The following movements take place at the ankle joint: dorsiflexion (extension of the foot at the ankle joint) and plantarflexion (flexion of the foot at the ankle joint).
what movements take place at the sub-tala joint
Anterior and Lateral Compartments of the Leg. Dorsum of Foot. lecture
slide 4
inversion and eversion
Note that both of these movements take place at the sub-talar joint and not at the ankle joint
function of tibialis anterior m
inversion
works w. tibialis posterior
function of extensor digitorum longus m
extend (bring towards you) all toes except great toe
function of extensor hallucis longus m
extend great toe
combined function of
tibialis anterior m
extensor digitorum longus m
extensor hallucis longus m
extend for at ankle joint
dorsiflexion
combined function of fibularis longus m and fibularis brevis m
evert foot
what nerve may be damaged if there is a fraction of the neck of the fibula
common fibular nerve
what two nerves does the common fibular nerve split in to
superficial fibular nerve
deep fibular nerve
what muscles does the superficial fibular nerve innervate
fibularis longus and brevis muscles
what muscles does the deep fibular nerve innervate
tibialis anterior
extensor digitorum longus
extensor hallucis longus
then in the foot:
extensor digitorum brevis
extensor hallucis brevis
what artery provides arterial supply to the muscles in the anterior compartment of the leg
anterior tibial artery
what artery supplies the lateral compartment of the leg
fibular artery
name the terminal branches of the popliteal artery
anterior tibial artery
posterior tibial artery
name the three ligaments of the hip joint
Iliofemoral ligament: this y-shaped ligament prevents hyperextension of the hip joint
Ischiofemoral ligament
Pubofemoral ligament
function of illiofemoral ligament
this y-shaped ligament prevents hyperextension of the hip joint
describe the arterial supply of the hip joint
The hip joint receives arterial supply from:
Medial and lateral circumflex femoral arteries – both of these vessels arise as branches of the profunda femoris artery.
describe innervation of the hip joint
The hip joint receives innervation from the sciatic, obturator and femoral nerves.
innervation of piriformis m
innervated by nerve to piriformus
innervation of superior gemellus m
nerve to obturator internus
innervation of inferior gemellus m
nerve to quadrates femoris
innervation of quadrates femoris m
innervated by nerve to quadratus femoris
innervation of gluteus Maximus
inferior gluteal nerve
innervation of gluteus medius
superior gluteal nerve
innervation of gluteus minimus
superior gluteal nerve
movement produced by gluteus Maximus m
extensor of lower limbs at hip joint
movement produced by gluteus medius m
abduction of lower limb at hip joint
movement produced by gluteus minimus m
abduction of lower limb at hip
what is the Clinical Relevance: Gluteus Medius and Gluteus Minimus Muscles
Both the gluteus medius and gluteus minimus muscles will keep the pelvis level when the lower limb at the same side of the body is weight-bearing, thereby preventing pelvic drop (image B).
Image C shows pelvic drop following paralysis of the gluteus medius and gluteus minimus mm.
movement produced by the piriformis m
lateral rotation of the lower limb
movement produced by the Superior gemellus m., Obturator internus m., Inferior gemellus m., Quadratus femoris m.
work with piriform to produce lateral rotation of the lower limb at the hip joint
biceps femoris
origin, insertion, innervation and actions
ACTION:
- assist gluteus with extension of ll at hip
- flexion of ll at knee
- allows for small amount of lateral rotation when there is flexion at the knee
ORIGIN:
- Long head: ischial tuberosity
- short head: lines aspera
INSERTION:
- head of fibula
INNERVATION:
- sciatic nerve
semitendinosus
origin, insertion, innervation and actions
ACTION:
- assist gluteus with extension of ll at hip
- flexion of ll at knee
- allow small amount of medial rotation when there is flexion at the knee
ORIGIN:
- ischial tuberosity
INSERTION:
- upper anterior aspect of proximal tibia
INNERVATION:
- sciatic nerve
semimembranosus
origin, insertion, innervation and actions
ACTION:
- assist gluteus with extension of ll at hip
- flexion of ll at knee
- allow small amount of medial rotation when there is flexion at the knee
ORIGIN:
- ischial tuberosity
INSERTION:
- proximal tibia - higher up than semitendinosus
INNERVATION:
- sciatic nerve
Boundaries and contents of popliteal fossa
upper lateral boundary:
- biceps femoris m
upper medial boundary:
- semitendinosus and semimembrenosus
gastrocnemius m = lower lateral and medial boundaries
Roof:
- skin and fascia
Floor:
- popliteal muscle
CONTENTS:
- popliteal artery and vein
- tibial nerve
- common fibular nerve
innervation and ac ton of gastrocnemius
tibial n
flex ll at knee
flex foot at ankle (plantarflex)
innervation and action of soleus
tibial n
tendon joins calcaneal tendon so therefore plantarfelxion
innervation and action of tibias posterior
tibial n
invert foot
innervation and action of flexor hallucis longus
tibial n
flex great toe
innervation and action of flexor digitorum longus
tibial n
flex all digits of foot except big toe
innervation and action of popliteus
tibial n
unlocks the knee joint
boundaries and contents of tarsal tunnel
The floor is a concave surface formed by the medial aspect of the tibia, talus and calcaneus.
It is converted into a tunnel by the flexor retinaculum, which spans obliquely between the medial malleolus and the medial tubercle of the calcaneus to form the roof.
Contents:
The tarsal tunnel acts as a passageway for tendons, nerves and vessels to travel between the posterior leg and the foot. Its contents (anterior to posterior) are:
Tibialis posterior tendon Flexor digitorum longus tendon Posterior tibial artery and vein Tibial nerve Flexor hallucis longus tendon The mnemonic Tom, Dick and a Very Nervous Harry can be used to aid recall of these structures.
