Lower Limb Anatomy (Muscles) Flashcards

1
Q

State the boundaries of FASCIA LATA

Superior:
Inferior:
Medial:
Lateral:
Posterior:

A

Superior: in front of thigh to ASIS, inguinal ligament, pubic tubercle
Inferior: front and sides of knee and capsule
Medial: pubis, pubic arch, ischial tuberosity
Lateral: iliac crest
Posterior: sacrum, coccyx, sacrotuberous ligament

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2
Q

In the thigh region, the medial and lateral ____ ____ divide the region into 3 compartments. Each anterior compartment contains its own set of nerves:

Anterior compartment:
Medial compartment:
Posterior compartment:

A

In the thigh region, the medial and lateral INTERMUSCULAR SEPTUM divide the region into 3 compartments. Each anterior compartment contains its own set of nerves:

Anterior compartment: FEMORAL NERVE
Medial compartment: OBTURATOR NERVE
Posterior compartment: SCIATIC NERVE

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3
Q

Using the 4 quadrants in the gluteal region, explain the choice of quadrant for ____ injections.

A

Upper lateral quadrant is the safest.
- Avoid lower lateral and medial quadrant due to proximity to sciatic nerve
- Sciatic nerve impingement/compression –> foot drop

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4
Q

State the 2 structures that form the FASCIA LATA

A
  1. iliotibial tract - formed from gluteus maximus (superficial fibres) and tensor fascia latae
  2. saphenous opening - contains great saphenous vein which continues from femoral vein
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5
Q

State the function of the iliotibial band/tract

A

Stabilises knee in extension and in partial flexion

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6
Q

State the major muscles of the gluteal region.

A

Larger muscles:
- gluteus maximus
- gluteus medius
- gluteus minimus

Smaller muscles:
- piriformis
- gemellus superior
- gemellus inferior
- obturator internus
- quadratus femoris

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7
Q

Name the blue and yellow muscles.

Recall function of muscles.
Recal innervation of muscles.

State the bursa that lies between tendons of each muscle and greater trochanter of the femur.

A

Blue = gluteus medius
Yellow = gluteus minimus

function:
1. major abductors of hip
- contraction of both muscles on stance side prevents excessive pelvic tilt during swing phase of walking on opposite side
2. medial rotation of hip

innervation: superficial gluteal N (L5-S1)

trochanteric bursa lies between the tendons of gluteus medius and minimus and the greater trochanter of femur

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8
Q

Name the green muscle.

Recall function of muscles.
Recal innervation of muscles.

A

Green = gluteus maximus

function:major extensor of hip(during standing from seated position or during climbing of stairs)

innervation: inferior gluteal nerve (L5-S2)

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9
Q

State the origin and insertion of gluteus maximus, gluteus medius and gluteus minimus.

A

Gluteus maximus:
origin - posterior surface of ilium, dorsal surface of sacrum, side of sacrum, sacrotuberous ligament

insertion - iliotibial tract, gluteal tuberosityof femur

Gluteus medius:
origin - outer surface of ilium between anterior and posterior gluteal lines

insertion - oblique ridge of lateral surface of greater trochanter/ greater trochanter

Gluteus minimus:
origin - outer surface of ilium between anterior and inferior gluteal lines

insertion - ridge on the anterior surface of greater trochanter

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10
Q

State the muscles in the gluteal region that allow lateral rotation of thigh at hip joint.

A
  • piriformis
  • gemellus superior
  • gemellus inferior
  • obturator internus
  • quadratus femoris
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11
Q

State the muscles in this diagram.

A

Green = gluteus maximus
Yellow = piriformis
Blue = gemellus superior
Red = obturator internus
Purple = gemellus inferior
Teal = quadratus femoris

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12
Q

State the origin and insertion of the smaller muscles of the gluteal region.

A

PIRIFORMIS:
o = pelvic surface of S2-S4
i = apex of greater trochanter

GEMELLUS SUPERIOR:
o = posterior surface of ischial tuberosity
i = medial surface of greater trochanter of femur

OBTURATOR INTERNUS:
o = pelvis surface of obturator membrane and surrounding bones
i = medial surface of greater trochanter of femur

GEMELLUS INFERIOR:
o = upper part of ischial tuberosity, lower part of lesser sciatic notch
i = medial surface of greater trochanter of femur

QUADRATUS FEMORIS:
o = lateral border of ischial tuberosity
i = quadrate tubercle on intertrochanteric crest and area below it

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13
Q

State the innervation of the small muscles of the gluteal region.

A

PIRIFORMIS - ventral rami of S1-S2
GEMELLUS SUPERIOR - nerve to obturator internus (L5-S2)
OBTURATOR INTERNUS - nerve to obturator internus (L5-S1)
GEMELLUS INFERIOR - nerve to quadratus femoris (L4-S1)
QUADRATUS FEMORIS - nerve to quadratus femoris (L5-S1)

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14
Q

Tensor fascia latae continues as the iliotibial tract.

Recall the function of the muscle.
Recall innervation.

Recall origin and insertion.

A

TENSOR FASCIA LATAE

function: abduction of hip (maintains extended position of knee joint through iliotibial tract)

innervation: superior gluteal nerve (L4-S1)
o = outer lip of iliac crest (from ASIS to tubercle of iliac crest)
i = iliotibial tract

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15
Q

Summarise the muscles innervated by
1. superior gluteal N
2. inferior gluteal N

A

SUPERIOR GLUTEAL N:
- gluteus medius
- gluteus minimus
- tensor fascia latae

INFERIOR GLUTEAL N:
- gluteus maximus

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16
Q

State the muscles located in the posterior compartment of the thigh.

A

HAMSTRINGS:
Blue = long head of adductor magnus
Yellow = semimembranosus
Red = semitendinosus
Green = biceps femoris (long head)

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17
Q

State the functions of the hamstring muscles.

Recall the innervation of muscles

A
  1. knee flexion (major) - with gastrocnemius and sartorius
  2. hip extension - with gluteus maximus
  3. restricts range of hip flexion when knee is extended

innervation: sciatic nerve (L5-S2)
- tibial part of sciatic nerve for all muscles except short head of biceps femoris
- common peroneal/fibular part for short head of biceps femoris

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18
Q

State the origin and insertion for each of the hamstring muscles.

A

SEMITENDINOSUS:
o = ischial tuberosity
i = pes anserine on medial aspect of tibia

BICEPS FEMORIS:
o = ischial tuberosity
i = head of fibula

SEMIMEMBRANOSUS:
o = ischial tuberosity
i = posterior aspect of medial condyle

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19
Q

State the 3 functions of muscles in the anterior compartment of thigh.

A
  1. hip flexion
  2. hip adductors
  3. knee extensors
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20
Q

State the common function of all the muscles identified.

State the names of each muscle from 1-5.

A

function: hip flexion

  1. Psoas major (major)
  2. Iliacus (major)
  3. Sartorius
  4. Rectus femoris
  5. Pectineus
21
Q

Strate the origin and insertion of the major hip flexors.

State the innervation of each muscle.

A

recall: major hip flexors include psoas major + iliacus

PSOAS MAJOR:
o = L1-L4 vertebrae
i = lesser trochanter of femur
innervation - L1-L4 ventral rami

ILIACUS:
o = upper 2/3 of floor of iliac fossa, inner lip of iliac crest, upper surface of lateral part of sacrum
i = lesser trochanter of femur
innervation - femoral N (L2-L3)

22
Q

State the common function of all the muscles identified.

State the names of each muscle from 1-5.

A

function: hip adduction

  1. pectineus
  2. adductor brevis
  3. adductor longus
  4. adductor magnus
  5. gracilis
23
Q

State the innervation of these muscles.

State the functions of each muscle.

A

PECTINEUS
- innervation = obturator N (anterior division), femoral N
- function = hip adduction

ADDUCTOR BREVIS
- innervation = obturator N (anterior and posterior division)
- function = hip adduction

ADDUCTOR LONGUS
- innervation = obturator N (anterior division)
- function = hip adduction, medial rotation of thigh

ADDUCTOR MAGNUS
- innervation = obturator N (anterior and posterior division)
- function = hip adduction, weak medial rotation of thigh, weak hip extension

GRACILIS
- innervation = obturator N
- function = hip adduction, knee flexion, hip rotation

24
Q

State the common function of the muscles.

Name the muscles from 1-5.

State the innervation of the muscles.

A

function: knee extension

collectively, 1-4 = quadriceps femoris
1. vastus medialis (superficial)
2. rectus femoris (superficial)
3. vastus lateralis (superficial)
4. vastus intermedius (deep to rectus femoris)

innervation -femoral nerve (L2-L4)

25
Q

Summarise the muscles used for each action of the hip.

State the corresponding innervation and nerve root of each action.

  1. Hip Flexion
  2. Hip Extension
  3. Hip Abduction
  4. Hip Adduction
  5. Hip Medial Rotation
  6. Hip Lateral Rotation
A

Hip Flexion - femoral nerve, ventral rami - L2-L3
1. psoas major
2. iliacus
3. pectineus
4. sartorius
5. rectus femoris

Hip Extension - inferior gluteal nerve - L4-5
1. gluteus maximus (major)
2. hamstrings - biceps femoris, semimembranosus, semitendinosus
3. adductor magnus

Hip Abduction - superior gluteal nerve - L4-L5
1. gluteus medius
2. gluteus minimus
3. tensor fascia latae
4. gastrocnemius

Hip Adduction - obturator nerve - L2-L3
1. pectineus
2. adductor brevis
3. adductor magnus
4. adductor longus
5. gracilis

Hip Medial Rotation - superficial gluteal nerve - L2-L3
1. gluteus medius (anterior fibres)
2. gluteus minimus (anterior fibres)
3. tensor fascia latae

Hip Lateral Rotation - L4-L5
1. piriformis
2. obturator internus
3. gemellus superior
4. gemellus inferior
5. quadratus femoris

26
Q

State the nerve roots of obturator nerve and femoral nerve.

A

obturator nerve - L2-L4
femoral nerve - L2-L4

27
Q

State the nerves in each compartment (anterior, lateral, posterior) of the leg

A

anterior compartment - deep peroneal N
lateral compartment - superficial peroneal N
posterior compartment - tibial N

28
Q

State the functions of the muscles located in each compartment

A

Anterior compartment - dorsiflexors/extensors of foot

Lateral compartment - fibularis longus + fibularis brevis

Posterior compartment - plantarflexors/flexors of foot

29
Q

Name the muscles located in the anterior compartment of the leg.

A
30
Q

ANTERIOR COMPARTMENT OF LEG

State the innervation of the muscles.
State the action of each muscle.

A

recap: TDH-F = tibialis anterior, extensor digitorum longus, extensor hallucis longus, fibularis tertius

innervation: deep fibular (peroneal) nerve

TOM - TIBIALIS ANTERIOR
- function = ankle dorsiflexion (major), foot inversion(at subtalar joints)

DICK - EXTENSOR DIGITORUM LONGUS
- function = ankle dorsiflexion (major), extension of lateral 4 toes (at MP, PIP and DIP joints)

HARRY - EXTENSOR HALLUCIS LONGUS
- function = ankle dorsiflexion (major) , extension of great toe

F - FIBULARIS TERTIUS
- function = ankle dorsiflexion, eversion of foot*

EXTENSOR DIGITORUM BREVIS
- function = extension of great toe to fourth toe when foot is dorsiflexed

31
Q

ANTERIOR COMPARTMENT OF LEG

State the origin and insertion of each muscle.

A

**TIBIALIS ANTERIOR **
o = upper 2/3 lateral surface of tibia, interosseous membrane, distal part of lateral condyle of tibia
i = medial cuneiform, adjoining part of base of 1st metatarsal

EXTENSOR DIGITORUM LONGUS
o = lateral condyle of tibia, upper 3/4 medial surface of fibula
i = bases of middle and distal phalanges of lateral four toes

EXTENSOR HALLUCIS LONGUS
o = middle 2/4 of medial surface of shaft of fibula
i = base of distal phalanx of greater toe

FIBULARIS TERTIUS
o = lower 1/4 medial surface of fibula, adjacent part of interosseous membrane
i = medial part of base of 5th metatarsal bone

32
Q

Name the muscles 1-2 in the lateral compartment of the leg.

State the functions of the muscles
State the innervation of the muscles

A

1 = fibularis longus muscle
2 = fibularis brevis muscle

functions:
1. ankle eversion
2. ankle plantarflexion (weak)
3. supports lateral longitudinal arch of foot

innervation = superficial fibular (peroneal) nerve

33
Q

LATERAL COMPARTMENT OF LEG

State the origin and insertion of each muscle.

A

FIBULARIS LONGUS
o = head of fibula, upper 2/3 lateral surface of shaft of fibula
i = medial cuneiform, base of 1st metatarsal

FIBULARIS BREVIS
o = lower 2/3 lateral surface of shaft of fibula
i = lateral side of base of 5th metatarsal

34
Q

State the superficial and deep muscles of the posterior compartment of the leg.

State the innervation of the compartment

A

Superficial
- gastrocnemius
- soleus
- plantaris

Deep
- popliteus
- flexor digitorum longus
- flexor hallucis longus
- tibialis posterior

Innervation = tibial nerve

35
Q

Name the muscles 1-3 in the posterior compartment of the leg.

State the functions of each muscle.

A

1 = gastrocnemius - knee flexion, foot plantarflexion (when knee extended)
2 = soleus - foot plantarflexion (when knee flexed)
3 = plantaris - foot plantarflexion, knee flexion (minor)

36
Q

Name the muscles in the posterior compartment of the leg.

State the functions of each muscle.

A

(1) popliteus - knee unlocking (rotates femur laterally during flexion of knee)
(2) = flexor digitorum longus - plantarflexion of lateral 4 toes, ankle plantarflexion, maintains longitudinal arches of foot
(3) = flexor hallucis longus - plantarflexion of great toe, maintains medial longitudinal arches of foot
(4) = tibialis posterior - foot inversion, ankle plantarflexion

37
Q

POSTERIOR COMPARTMENT OF LEG

State the origin and insertion of the superficial muscles.

A

GASTROCNEMIUS
o = (medial head) posterosuperior surface of medial femoral condyle behind adductor tubercle + adjoining part of popliteal surface of femur, (lateral head) lateral surface of lateral femoral condyle
i = middle 1/3 of posterior surface of calcaneum

SOLEUS
o = posterior head of fibula, tendinosus arch connecting tibia and fibula, soleal line, medial border of tibia
i = middle 1/3 of posterior surface of calcaneum

PLANTARIS
o = lower part of lateral supracondylar line of femur
i = middle 1/3 of posterior surface of calcaneum medial to tendocalcaneus

38
Q

POSTERIOR COMPARTMENT OF LEG

State the origin and insertion of the deep muscles.

A

POPLITEUS
o = popliteal groove on lateral surface of lateral femoral condyle, lateral meniscus, arcuate popliteal ligament
i = medial 2/3 of triangular area above soleal line

FLEXOR DIGITORUM LONGUS
o = upper 2/3 of medial part of posterosurface of tibia below soleal line
i = bases of distal phalanges of lateral four toes

FLEXOR HALLUCIS LONGUS
o = lower 3/4 of posterosurface of fibula behind medial crest, adjoining interosseous membrane
i = base of plantar surface of distal phalanx of great toe

TIBIALIS POSTERIOR
o = upper 2/3 of lateral part of posterosurface of tibia
i = all tarsal bones except talus, 2nd-4th metatarsals

39
Q

Name the contents 1-6 of the tarsal tunnel. State the muscle that superficially binds the content.

A

1 = Tibialis posterior
2 = Flexor Digitorum Longus
3 = Tibial vein
4 = Tibial artery
5 = Tibial nerve
6 = Flexor Hallucis Longus

the flexor digitorum binds superficially from middle malleolus to medial tubercle of calcaneus

40
Q

DORSUM OF FOOT

Name the contents 1-6.

A

1 = superficial fibular nerve
2 = deep fibular nerve
3 = fibularis tertius
4 = extensor digitorum brevis
5 = dorsal pedis artery
6 = dorsal venous arch

41
Q

DORSUM OF FOOT

State the functions and innervation of extensor digitorum brevis and extensor hallucis brevis.

A

extensor digitorum brevis - extension of 2nd-4th toe
extensor hallucis brevis - extension of great toe

innervation = deep fibular nerve (L5-S1)

42
Q

SOLE OF FOOT

State the components 1-3. Explain the significance of component 1

A

1 = plantar aponeurosis
2 = lateral plantar fascia
3 = medial plantar fascia

plantar aponeurosis
- central thickened part of deep fascia
- extends from medial tubercle of calcaneus to deep transverse metatarsal ligament

43
Q

SOLE OF FOOT

Name the coloured muscles of the most superficial layer of sole of foot.
Name the vessels 1-2 in the second layer of sole of foot.

A

Blue = Abductor digiti minimi
Green = Flexor digitorum brevis
Yellow = Abductor hallucis

1 = Medial plantar nerve
2 = Medial plantar artery

44
Q

SOLE OF FOOT

State the function and innervation of each muscle in the most superficial layer of foot.

A

ABDUCTOR DIGITI MINIMI
- function = abduction and flexion of little toe at MTP joint
- innervation = lateral plantar nerve (S2-S3)

FLEXOR DIGITORUM BREVIS
- function = flexion of second-fifth (little) toe
- innervation = medial plantar nerve (S1-S3)

ABDUCTOR HALLUCIS
- function = abduction of great toe at MTP joint
- innervation = medial plantar nerve (S1-S3)

45
Q

SOLE OF FOOT

Name the coloured muscles in the second layer (deeper) of muscles.

A

Yellow = Lumbricals
Green = Quadratus plantae/Flexor digitorum accessorius

46
Q

SOLE OF FOOT

State the function and innervation of each muscle in the 2nd layer of muscles of foot.

A

LUMBRICALS
- function = flexion of second-little toe at MTP joint (minor)
- innervation = lateral plantar nerve (S1-S3)

QUADRATUS PLANTAE/FLEXOR DIGITORUM ACCESSORIUS
- function = plantarflexion at MTP joint of second-little toe, dorsiflexion at IP joint of second-little toe
- innervation = lateral plantar nerve (S2-S3)

47
Q

SOLE OF FOOT

Name the coloured muscles in the sole of foot and classify based on layer of muscle (superficial or deep)

A

3rd layer of muscles:
Blue = Flexor digiti minimi brevis
Red = Adductor hallucis
Yellow = Flexor hallucis brevis

4th layer (depest layer of muscles)
Purple = dorsal interossei
Green = plantar interossei

48
Q

SOLE OF FOOT

State the function and innervation of each muscle in the 3rd and 4th layer of muscles of foot.

A

3RD LAYER OF MUSCLES:
1. FLEXOR DIGITI MINIMI BREVIS
- function - flexion of PP at MTP joint of little toe
- innervation - lateral plantar nerve (S2-S3)

  1. ADDUCTOR HALLUCIS
    - function - adduction of greeat toe at MTP joint
    - innervation - lateral plantar nerve (S2-S3)
  2. FLEXOR HALLUCIS BREVIS
    - function - flexion of great toe at MTP joint
    - innervation - medial plantar nerve (S1-S3)

4TH LAYER OF MUSCLES:
1. DORSAL INTEROSSEI
- function - abduction of second-little toe at MTP joint, flexion of second-little toe at MTP joint with extension of IP joint
- innervation - lateral plantar nerve (S2-S3)

  1. PLANTAR INTEROSSEI
    - function - adduction of third-little toe at MTP joint, flexion of toes at MTP joint with extension of IP joint