lower limbs Flashcards
what ligament runs down the head of the head of the fibula?
lateral co-lateral ligament
where is the origin of popliteus muscle?
lateral epicondyle, inserts above the soleus line
causes medial rotation to unlock the condyle of the knee to allow flexion
what are the two articulations of the knee>
tibiofemoral
patellofemoral
(allowing tendon of the quadriceps to be inserted over the knee, increasing the effeciency)
what is the blood suply to the knee?
Genicular anastomoses
- branches of the femoral and popiteal arteries.
what other injury is associated with medial collateral ligament damage?
medial meniscus tear - because the medial meniscus is fixed to the medical collateral ligament.
what are the four bersae found in the knee?
Suprapatella bursa
prepatella bursa
infrapatella bursa
semimembranousus bursa
where is the supra-patella bursa found?
between the quadriceps femoris and the femur
where is the prepatella bursa located?
between the apex of the patella and the skin
where is the infrapatella bursa located?
superficial = between patella ligament and teh skin
deep = between the tibia and the patella ligament
where is the semimembranosus bursa located?
posterior to the knee
between the semimembranosus muscel and teh medial head of gastrocnemius
what muscel allows extension of the knee?
quadriceps femoris, which inserts to the tibial tuberosity.
what muscel allows for flexion of the knee?
hamstrings, gracilis, satorius and popiteus
what muscle allows for lateral rotation at the knee?
biceps femoris
what muscle allows for medial rotation of the knee?
semimembranosus
semitendinous
gracillis
sartorius
popliteus
what examination can be used to assess for a antior cruciate ligament tear?
anterior drawer test
what muscle inserts to the fibular head?
biceps femoris
what nerve inovates the proximal tibiofibular joint?
the common fibular nerve
what artery supplies the proximal tibiofibular joint?
Inferior genicular artery
what type of joint is the proximal tibiofibular joint?
plane synovial joint
what type of joint is the distal tibiofibular joint?
fibrous joint
what are three structures that support the tibiofibular joint?
interosseous membrane
anterior and posterior inferior tibiofibular ligaments
inferior transverse tibiofibular ligament
what is the nerve supply to the distal tibiofibular joint?
deep peroneal and tibial nerves
what is a complication of a proximal tibiofibular joint dislocation?
injury to the common fibular nerve (teh nerve winds around the neck of the fibular)
what is the name given to the bracket shaped joint of the ankle?
the mortise
where does the medial ligament of the ankle originate to and then attach? what is its function?
originates to the medial malleolus
forms four ligaments attaching to the talus,calcaneus and the navicular bones.
function = resist over-eversion
what are the three ligaments that form the lateral ligament in the ankle?
- Anterior talofibular
- Posterior talofibular
- Calcaneofibular
what muscels allow for plantarflexion of the ankle?
what nerve is responsible?
posterior compartment of the leg
- gastrocnemius
- soleus
- plantaris
- posterior tibialis
Tibial
what muscels allow for dorsiflexion of the ankle?
muscels of the anterior compartment of the leg
- tibialis anterior
- extension hallucis longus
- extensor digitorum longus
what arteries supply the ankle joint?
malleolar branches of the anterior tibial, posterior tibial and fibular arteries
what artery is at risk with deep lacerations to the anterior aspect of the lower limb?
Anterior tibial artery
what artery is the anterior tibial artery a branch of?
popliteal artery
what muscel is responsible for extending the big toe ?
extensor hallucis longus
what movement is the tibialis anterior tendon responsible for?
dorsiflexion
what inury is Lachmans test for?
ACL
what two nerves form the Sural nerve?
The common fibular
tibial nerve
what is the sensory inovation of the sural nerve?
The posterio-lateral aspect of the lower limb
what nerve routes form the femoral nerve?
L2-L4
what two muscles form iliopsoas?
Psoas Major and iliacus (psoas major is medial)
what is the action of Iliopsoas?
flexion at the hip joint
where does Psoas major originate from?
the lumbar vertebrae
where does iliacus originate from ?
iliac fossa of the pelvis
where does the iliopsoas insert?
lesser trocanter of the femus
what are the four muscles of the quadriceps?
Vastus lateralis
Vastus intermedius
Vastus medialis
rectus femoris
where does the rectus femoris originate from?
ASIS + ilium of the pelvis
attaches to the patella
crosses the knee.
what is the natural load to failure the ACL
2000 newtons
What is used as a graft for a ACL repair?
semitendinosus or patella tendon
when does the external iliac artery become the femoral artery?
when it crosses the inguinal ligament.
and enters the femoral triangle
where does the profunda femoris artery arise from the femoral?
in the femoral triangle
what three braches come off the profundo artery in the thigh?
- perforating branches - supply muscles in the medial and posterior thigh
- lateral femoral circumflex artery - wraps around the anterior lateral side of the femur
- medial femoral circumflex artery - supplies the neck and head of the femur
what artery is damaged in a NOF?
medial femoral circumflex artery
at what point does the femoral artery become the popliteal artery?
when it passes through the adductor hiatus
what does the popliteal artery divide into?
the peroneal (fibular) artery
posterior tibial arteries
what forms the lateral borders of the popliteal fossa
gastrocnemius
what is the nerve routes of the sciatic nerve?
L4 to S3
what muscels insert onto the Greater trocanter?
Piriformis
Gluteus medius
Gluteus Minimus
Obturator internus
Obturator externus
Vastus lateralis
Gemelli
what bursa is affected in housemaid knee?
pre patella bursa
what bursa is affected in clergyman’s knee?
superficial infrapatella bursa
what are the two joints to the calcaneus?
superiorly - talus
anteriorly - cuboid
where does the Achilles tendon insert?
calcaneal tuberosity
where is the most common place to fracture your talus?
neck
what injury causes a talar neck fracture?
high energy forcible dorsiflexion
this can lead to AVN
with excessive inversion of the foot what muscle can lead to an avulse fracture?
fibularis brevis
what is the first branch of the lumbar plexus?
Iliohypogastric nerve
what are the roots of the iliohypogastric nerve?
T12 to L1
what muscles are inovated by the first branch of the lumbar plexus?
internal obliques
transverse abdominis
The pneumonic of the lumbar plexus is I I Get Leftovers On Fridays. what does it stand for?
I - Iliohypogastric
I - Ilioinguinal
G - Genitofemoral
L - Lateral cutaneous
O - Obturator
F - Femoral
what nerves make up the sacral plexus ?
L4 - S4
what are the functions of the superior gluteal nerve?
innervates the gluteus minimus, gluteal medius and tensor fascia lata
a pneumonic to remember the sciatic plexus is Some Irish Sailor Pesters Polly - what does this stand for?
S - superior gluteal
I - Inferior gluteal
S - Sciatic
P - posterior cutaneous
P -Pudendal
what nerves Innovates gluteus maximus
Inferior Gluteal nerve
L5 S1 S2
what nerve innovates the short head of the biceps femoris)?
Common fibular, branch of sciatic
what branch of the sacral plexus gives sensory function to the penis/Clitoris?
The pudendal nerve
what passes through the Hunter Canal?
superficial femoral artery
femoral vein
saphenous nerve
nerve to vastus medialis
what muscles make up the anterior compartment of the leg?
Tibialis anterior
extensor hallucis longus
extensor digitorum longus
peroneus tertius
what are the borders of the femoral triangle?
superior - inguinal ligament.
lateral - medial border of sartorius
medial-medial border of adductor longus
where does gluteus maximus insert on the femur?
Gluteal Tuberosity
where is the linea aspera found?
running down the posterior aspect of the femur
is teh deltoid ligament medial or lateral?
medial
injured in eversion injury
Injury of what ligament can cause flat foot deformity?
The calcaneonavicular ligament (spring)
what structures pass behind the lateral malleolus ?
sural nerve
short saphenous vein
peroneus longus tendon
peroneus brevis tendon
what structure is most likely to be damaged in a femoral condyle fracture ?
popliteal artery fracture
as head of gastronemius will contract to pull the fracture posteriorly, damanging the politeal atery
