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Jonathan's Locomotor > Lower Limb Neurovasculature > Flashcards

Lower Limb Neurovasculature Flashcards

1
Q

Which spinal segments make up the lumbar plexus

A

L1 to L4

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2
Q

What are the first two branches of the lumbar plexus? Which spinal do they come from?

A

iliohypogastric and ilioinguinal

L1

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3
Q

Where do iliohypgastric and ilioinguinal nerves travel? What do they supply?

A

they slip into the neurovascular plane between abdominal muscles, supplying the abdo wall

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4
Q

What is the motor supply of iliohypogastric and ilioinguinal nerves

A

the lower most fibres of IOM and TA, which is the roof of inguinal canal

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5
Q

Why do pregnancy women sometimes feel pins and needles down the lateral side of the thigh?

A

The increased body size can cause compression of lateral cutaneous nerve just adjacent to the ASIS, causing sensory abnormalities

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6
Q

Which lumbar segments give rise to lateral cutaneous nerve of the thigh?

A

L2 and L3

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7
Q

Which lumbar segments give rise to genitofemoral nerve?

A

L1 - femoral branch

L2 - genital branch

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8
Q

Which nerve supplies the spermatic cord?

A

genital branch of the genitofemoral nerve

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9
Q

What does the femoral branch of the genitofemoral nerve supply?

A

the skin over the femoral triangle

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10
Q

T/F Femoral nerve is from the posterior division of the ventral rami

A

True, posterior division supplies the extensors

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11
Q

T/F Femoral nerve supplies the psoas as it is a muscle of the anterior compartment

A

False, psoas gets segmental supply from the nerves within

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12
Q

Which muscles does the femoral nerve supply?

A

quads, sartorius, lateral compartment of the pectineus

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13
Q

What is the sensory terminal branches of femoral nerve?

A

intermediate and medial cutaneous nerves of the thigh

saphenous nerve

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14
Q

What does the saphenous nerve supply?

A

the sensory component medially along the knee, leg and ankle, right down to the first metatarsal

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15
Q

T/F Femoral nerve supplies all of the sensory component for anterior and medial part of the thigh

A

False, femoral branch of genitofemoral supplies the supero-medial thigh, and obturator supplies a patch of the medial side just above the knee

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16
Q

Which compartment does the obturator supply?

A

medial compartment of the thigh

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17
Q

T/F Obturator nerve divides into the anterior and posterior divisions before giving suppy to gracilis

A

False, it supplies the gracilis, then split into anterior and posterior divisions

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18
Q

Which muscles does the anterior division of obturator travel between

A

adductor longus and adductor brevis

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19
Q

Which muscles does the posterior division of obturator travel between

A

adductor brevis and adductor magnus

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20
Q

What is the sensory supply of the obturator nerve?

A

pelvic peritoneum

medial side of thigh just above the knee

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21
Q

Which nerve roots make up the sacral plexus

A

ventral nerves of S1-4, plus L5, and the leftover of L4

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22
Q

Which muscle is a useful landmark for the sacral plexus

A

piriformis

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23
Q

Which muscles does 1) superior gluteal nerve 2) inferior gluteal nerve supply?

A

1) gluteus medius and minimus

2) gluteus maximus

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24
Q

Is posterior cutaneous nerve of the thigh a branch of the sciatic?

A

No

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25
Q

T/F Sciatic nerve has both anterior and posterior division fibres

A

True, anterior and posterior of L4, L5, S1-S3

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26
Q

When does sciatic nerve divide into its terminal branches

A

at the apex of the popliteal fossa, 2/3 way down the thigh

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27
Q

T/F Posterior dislocation of the hip joint will damage the sciatic nerve

A

True

28
Q

What are the sensory branches of the femoral nerve?

A

medial and intermediate cutaneous branches

saphenous branch

29
Q

T/F the terminal branches of sciatic nerve arises from the same segment and division of the sacral plexus

A

False, tibial nerves gets the anterior division of L4,L5, S1-3

Common fibular gets posterior division of L4,L5, S1, S2

30
Q

Describe the course of descend of the tibial nerve in the leg

A

from the popliteal fossa, it slips beneath and soleal arch, between the superficial and deep posterior compartments

31
Q

T/F The tibial nerve is posterior to the lateral malleolus

A

False, it is posterior to the medial malleolus

32
Q

What is the sensory branch off the tibial nerve?

A

sural nerve, supplying the skin over the posterior compartment

33
Q

What does the tibial nerve divide into at the foot

A

Medial and lateral plantar nerves for the sole

34
Q

Describe the course of the common fibular nerve from the popliteal fossa

A

travels medial to biceps, to the lateral side of the knee and winds around the fibula. Then it turns medially and sink into the substance of tibialis anterior

35
Q

What is the sensory branch off the common fibular at the leg region?

A

the communicating sural nerve

36
Q

T/F Common fibular nerve is deep to the lateral head of gastrocnemius

A

False, it is superficial. Its superficial location makes it prone to injury

37
Q

What can happen if we fracture the head of fibula

A

lose motor and sensory supply by the common fibular nerve, and you get a foot drop

38
Q

What does the deep fibular nerve supply?

A

motor for the anterior compartment and EDB

sensory to the triangle between 1st and 2nd toes

39
Q

T/F Deep fibular nerve travels along the interosseous membrane

A

True

40
Q

What does the superficial fibular nerve supply?

A

motor to lateral compartment and sensory to lower lateral leg and dorsum of foot

41
Q

The superficial fibular nerve initially runs deep in the lateral compartment. When does it become superficial?

A

After supplying fibularis longus and brevis

42
Q

What is the major branch of femoral artery

A

profunda femoris

43
Q

How does profunda femoris travel?

A

It travels with adductor magnus, sending off perforating branches

44
Q

T/F Femoral artery and profunda femoris both enter the posterior compartment of the thigh

A

False, femoral artery does, at the adductor hiatus. Profunda femoris stays in the anterior compartment

45
Q

The ascending branch of profunda femoris supplies the head of the femur. What are the names of the two branches?

A

medial circumflex

lateral circumflex

46
Q

What are the branches of popliteal artery?

A

geniculate branch around the knee

Splits into anterior and posterior tibial at the inferior border of popliteus

47
Q

What the femoral sheath contain?

A

femoral artery, femoral vein

femoral nerve is NOT included

48
Q

T/F femoral vein lies medial to the femoral artery in the femoral sheath

A

True, so it can expand into the femoral canal

49
Q

Where is the femoral ring?

A

at the top of the femoral canal

50
Q

what is directly posterior to the femoral ring?

A

pectineus

51
Q

Why does strangulation often occur to the herniated content through the femoral ring?

A

Because the boundary of the femoral ring is especially rigid

52
Q

Which major neurovascular structures can be found in the popliteus?

A

popliteal artery, popliteal vein, tibial nerve

53
Q

T/F Popliteal vein is the most superficial structure in the popliteal neurovascular bundle

A

False, tibial nerve is

54
Q

Which nerve does the anterior tibial artery travel with?

A

deep fibular nerve, along the interosseous membrane

55
Q

Which branch comes off the posterior tibial artery?

A

fibular artery, going to the evertor compartment

56
Q

Which artery becomes the dorsalis pedis artery after crossing the extensor retinaculum

A

anterior tibial artery

57
Q

Does posterior tibial artery travel medially or laterally at the ankle?

A

medially

58
Q

How does compartment haematoma lead to increased compartmental pressure?

A

initial bleeding + the oedema from ischaemia

59
Q

What are the five P’s of compartment syndrome

A 
pain
pale 
pulseless
parasthetic 
paralysed
60
Q

T/F Deep veins often run in pairs (vena commitantes)

A

True

61
Q

Which veins does the dorsal venous arch drain into?

A

medially, into the great saphenous vein

laterally, into short saphenous vein

62
Q

T/F the drainage pathway between dorsal venous arch and great saphenous vein is posterior to the medial malleolus

A

False, it is anterior to the medial malleolus

63
Q

From an anterior view, when does the great saphenous vein disappear from view

A

at the level of the knee

64
Q

How does great saphenous vein drain into deep venous structure?

A

at the superior thigh, through the saphenous opening in the fascia lata and join with the femoral vein

65
Q

how does short saphenous drain into deep venous structure

A

at the superior leg, pierce the fascia to join up with anterior and posterior tibial veins, and eventually join the popliteal vein

66
Q

What happens to the superficial veins when there is defect in the communicating valves

A

veins are engorged, tortuous and full of blood

67
Q

Why do you get brown pigmentation and varicose ulcers with defects in communicating valves?

A

Due to increased capillary pressure, squeezing blood into soft tissue

Jonathan's Locomotor (16 decks)

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