Lower limb Flashcards
Lumbar plexus made up of ventral rami from what spinal levels?
L2-S4
5 key nerves of lumbosacral plexus? (flexor + extensor)
Extensors: Femoral (knee) + obturator (hip)
Flexors: Sciatic –> tibial (knee, plantar flexors), fibular (dorsiflexors)
*also superior/inferior gluteal nerves
2 main fascia of lower limb
Fascia lata (thigh) Crural fascia (deep fascia of shank)
Arterial supply of lower limb
Abdominal aorta –> common iliac –> internal iliac (pelvis) + external iliac (leg) –> under inguinal ligament –> deep artery of thigh –> through adductor hiatus –> popliteal arterial –> bifucates into anterior tibia –> dorsal pedal & posterior tibial –> medial plantar & fibular
what are the 4 gluteal compartments?
Iliopsoas
Gluteals
Deep rotators (lateral rotation, incld piriformis)
Hip adductors
Role of iliopsoas muscles? Which 2 muscles? Innervation
1) Psoas
2) Iliacus
Function: hip flexion
Nerve: femoral
Role of gluteal muscles? Which muscles? innervation?
Gluteus maximus –> hip extension, lat rotation; inferior gluteal nerve
Glut med/min/tensor fascia lata –> Hip abduction, medial rotation; superior gluteal nerve
___ is important for landmarking the sciatic nerve
Piriformis (doesn’t INNERVATE this though)
Fibular nerve AKA
Peroneal
3 compartments of thigh + innervation
Medial (adductors) - obturator
Posterior (flexors) - Sciatic (tibial)
Anterior (extensors - femoral
4 compartments of leg + innervation
Anterior (extensors) = deep peroneal
Posterior (flexors) deep/superficial - sciatic
Lateral (abductors) - superficial peroneal N
Muscles of anterior compartment of thigh
Quadriceps femoris: rectus femoris, vastus intermedius/medialis/lateralis
Sartorius
Quadriceps femoris attached to patella via what?
Patellar tendon (patella connected to tibial tuberosity by patellar LIGAMENT which is actually continuous with the tendon)
Which muscles of the anterior compartment of the thigh are dual joint?
Sartorius + rectus femoris (knee extension + hip flexion)
Muscles of medial compartment of thigh
Adductor longus, gracilis
Deeper: adductor brevis + adductor magnus
(Main innervation = obturator; main function = hip adduction, flexion + medial rotation)
Important gateway for structures to move from anterior thigh into posterior leg
Adductor hiatis (in adductor magnus)
Muscles of posterior compartment of thigh
Hamstrings:
Biceps femoris (long + short heads) - lateral
Semitendinosis + semimembranosus (medial)
(Innervation: sciatic nerve - tibial)
Muscle of anterior compartment of the leg
Tibialis anterior Extensor digitorum longus Extensor hallucis longus N = deep fibular (peroneal) Ankle dorsiflexion/digit extension
Muscles/nerves of lateral compartment of the leg
Fibularis longus
Fibularis brevis
N = superficial fibular (peroneal)
Ankle eversion
Which muscle helps maintain plantar arch by crossing beneath foot and inserting at 1st metatarsal
Fibularis longus
Fibularis longus/brevis travel behind ___ and are held in place by ____
Lateral malleolus
Peroneal retinaculum
Muscles of the superior posterior compartment of the leg
Innervation?
Gastrocnemius (lateral/medial heads)
Soleus (deep)
N = tibial
The triceps surae is what? How does it attach to the calcaneus?
Gastrocs + soleus
Attaches via Achilles’ (calcaneal) tendon
Muscles of deep posterior compartment
Innervation?
Tib post
flexor digitorum longus
flexor hallucinus longus
N = tibial nerve
Muscles of deep posterior compartment of leg travel around ___ to get to foot under what?
Order of structures inside?
Medial malleolus
Flexor retinaculum
“Tom Dick and Not Harry”
TP, FDL, Posterior Tib A, Post. Tib N, FHL (ant ti post)
Socket of the hipbone (where head of femur fits)
What deepens this?
Acetabulum
Acetabular labrum
3 important ligaments of hip joint
Iliofemoral
Pubofemoral
Ischiofemoral
When walking, which muscle contracts on swing leg? Which on the supported leg?
Quadratus Lumborum (unsupported leg) Gluteus medius (supported leg)
What is the “unhappy triad” knee injury?
Damage to ACL + medial meniscus + MCL
Force to lateral femur
Cruciate ligaments are in the ____ but outside the ___
In the joint capsule
outside the synovial membrane
PCL injury would happen why?
Hyperextension of knee or blow to tibial tuberosity
Structures on the __ side of the knee are more secure/attached, on the __ side more forgiving
Medial = attached Lateral = mobile
Define meniscus
Fibrocartilage shock absorbers that deepen + stabilize articulating surfaces
Medial meniscus is __ mobile and __ injury prone. Why?
Less mobile
More injuries
Because connected to MCL
Pes Anserine
“Goose Foot”
Insertion of sartorius, gracilis, semitendinosis (on medial side of tibia)
Medial palpable tuberosity on foot = what bone?
Navicular
Main ankle joint
Talocrural joint (talus + tib/fib (mortise))
What joint allows foot to invert/evert?
Subtalar joint (talus, calcaneus, navicular
2 ligaments of ankle that are injured in high ankle sprain?
Ant/Post tibiofibular ligament (stabilize inferior tibiofibular joint)
Talocrural joint:
- 3 stabilizing lateral ligaments
- 1 main medial ligament
Lateral: anterior/posterior talofibular + calcaneofibular
Medial = deltoid ligament
What might be damaged in an inversion sprain?
Anterior talofibular ligament
Calcaneofibular ligament
