Lower Limbs Flashcards
What’s the discount code for Brainscape Pro?
MCPHS91BS
What are the three major long bones of the lower limb?
Femur, Tibia, Fibula
Which ligament is found in the Intercondylar Notch that connects the Femur to the Tibia?
Cruciate ligaments (ACL and PCL)
What type of cartilage is found in the condyles?
Hyalin cartilige
The anterior femur is smooth or rough?
Smooth. Back is rough for insertion of muscles!
What boney structure on the femur does the Glut Max attach to?
Gluteal Tuberosity
What is the VAN for the Anterior Compartment of the Thigh?
Femoral Nerve, Femoral Artery, Femoral Vein
Which nerve innervates the Anterior Compartment of the Thigh?
Femoral Nerve
What is the arterial and venous blood supply for the Anterior Compartment of the Thigh?
Femoral Artery and Femoral Vein
What are the three compartments of the Thigh?
Anterior, Medial, Posterior
What are the five muscles in the Anterior Compartment of the Thigh?
Rectus Femoris, Vastus Lateralis, Vastus Intermedius, Vastus Medias (Quadricep Femoris), Sartorius (RVVVS)
What is the name of the group of muscles found in the Anterior Compartment of the Thigh?
Quadricep Femoris and Sartorius
What are the four muscles making up the Quadricep Femoris of the Anterior Compartment of the Thigh?
Rectus Femoris, Vastus Lateralis, Vastus Intermedius, Vastus Medias (RVVV)
Which compartment are the three vastus muscles in?
Anterior Compartment of Thigh
What is the action of the Vastus Muscles on the leg?
Extend leg at knee joint
What action does the Rectus Femoris and Sartorious of the Anterior Thigh have?
Flex femur at hipjoint, extends leg at knee joint
What are the actions of the Rectus Femoris and Sartorious muscles? (Hint: same actions)
Flexes femur at hip joint and extend leg at knee joint
What is the VAN for the Posterior Compartment of the Thigh?
Tibial Division of Sciatic Nerve and Common Fibular Division of Sciatic Nerve, Perforating Branches of Deep Femoral Artery, Perforating Branches of Deep Femoral Vein
What is the artery and nerve for the Posterior Compartment of the Thigh?
Deep Femoral Artery, Tibial Division of Sciatic Nerve and Common Fibular Division of Sciatic Nerve
What is the nerve(s) for the Posterior Compartment of the Thigh?
Tibial Division of Sciatic Nerve and Common Fibular Division of Sciatic Nerve (only for Bicep Short Head)
What is the artery for the Posterior Compartment of the Thigh?
Perforating Branches of the Deep Femoral Artery
What is the name of the group for the three muscles in the Posterior Compartment of the Thigh?
Hamstrings
Which nerve innervates the Biceps Short Head (in Posterior Thigh)?
Common Fibular Division of the Sciatic Nerve
Which nerve innervates the Long Hamstrings (in Posterior Thigh)?
Tibial Division of Sciatic Nerve for Long Hamstrings
What three muscles make up the hamstrings?
Biceps Femoris Long Head, Semitendinosus, Semimembranusus
Which compartment are the Hamstrings in?
Posterior Compartment of the Thigh
How many “heads” are on the Biceps Femoris?
Two. Long head and Short head. In Posterior Thigh.
What is the action of the Hamstrings on the thigh and leg?
Flexes Leg at knee joint and Extends Thigh at Hip Joint. In Posterior Thigh.
What is the action of the Short Head of the Bicep Femoris?
Attaches to Fibula to Flex kneejoint
What are the six muscles of the Medial Compartment of the Thigh?
Graclis, Pectineus, Adductor Longus, Adductor Brevis, Adductor Magnus, Obturator Externus (GPAAAO)
Which compartment are the three Adductors in?
Medial Thigh
Which nerve innervates all muscles in the Medial Thigh except the Pectineus?
Obturator Nerve (femoral nerve for pectineus)
What is the arterial and venous blood supply for the Medial Compartment of the Thigh?
Obturator Artery and Obturator Vein
Which nerve innervates the Pectineus Muscle even tho it’s in the Medial Thigh?
Femoral Nerve
The Femoral Nerve innervates what single muscle in the Medial Compartment of the Thigh?
Pectineus
Which muscle in the Medial Thigh does the Obturator Nerve not innervate?
Pectineus. Femoral Nerve does.
Which is the action of the adductor muscles in the medial thigh?
Adducts femur at hipjoint
What is the action of the Obturator Externus in the Medial Compartment of the thigh?
Laterally rotates femur at hipjoint
What is the action of the Gracilis in the Medial Compartment of the thigh?
Adduction of femur at hip joint, slight flexion of knee
What is the action of the Pectineus in the Medial Compartment of the thigh?
Adducts femur at hip joint
The External Iliac Artery splits after the Inguinal Ligament to become what two arteries?
Femoral Art and Deep Femoral Artery (aka Profunda Femoris Art)
The Femoral Artery supplies the _____ Thigh while the Deep Femoral Artery supplies the _____ Thigh.
Anterior; Posterior
Obturator Artery supplies the ____ Thigh, the Femoral Artery supplies the _____ Thigh, and the Deep Femoral Artery supplies the _____ Thigh.
Medial, Anterior, Posterior
Obturator Nerve supplies the ____ Thigh, the Femoral Nerve supplies the _____ Thigh, and the Tibial Division of Sciatic Nerve supplies the _____ Compartment of the Thigh.
Medial (except Petineus musc), Anterior, Posterior
What is the artery and nerve for the Anterior Compartment of the Thigh?
Femoral Artery, Femoral Nerve
What is the VAN for the Medial Compartment of the Thigh?
Obturator Nerve (except Pectineus musc is Femoral Nerve), Obturator Artery, Obturator Vein
What is the artery and nerve for the Medial Compartment of the Thigh?
Obturator Artery, Obturator Nerve (except Pectineus muscle)
Where is the Femoral Triangle?
Anterior and medial on the thigh
What are the borders of the Femoral Triangle?
Inguinal Ligament (sup border), Sartorius musc (lat border), Adductor longus musc (medial border).
What runs through Femoral Triangle lateral to medial?
NAVEL. Fem Nerve, Fem Art, Fem Vein, Empty Space next to femoral vein (inside is femoral sheath that contains fem VAN), Lymphnode
The Adductor Canal starts where?
Inferior End (aka apex) of the Femoral Triangle
Where is the Adductor Hiatus?
Inferior end of the of Adductor Canal
The Adductor Canal starts at the inferior end of the _____ ______ and ends at the _____ _____
Femoral Triangle; Adductor Hiatus
The Adductor Canal is a passageway between what two parts of the lower limb?
Anterior Thigh and Posterior Leg
What does the Adductor Canal contain?
Femoral Artery, Femoral Vein, and Saphenous Nerve
When the Femoral Art and Femoral Vein exit the Adductor Canal what are they called?
Popliteal Artery and Popliteal Vein
Where is the Popliteal Fossa?
Posterior knee. AKA kneepit
What is in the Popliteal Fossa?
Tibial Nerve, Common Fibular Nerve, Popliteal Artery, Popliteal Vein, Small Saphenous Vein
The Adductor Hiatus ends on the posterior thigh and goes into the….?
Popliteal Fossa
What is the path of triangles/canals/fossas?
Femoral Triangle->Adductor Canal->Popliteal Fossa (Femoral art and vein goes through these only. Not nerve.) Canal goes from Ant Thigh to Posterior Thigh and into Popliteal Fossa.
The posterior Femur has what two lips/ridges on it and is how you know it’s the posterior side?
Lateral and Medial Lip/Ridge
What is the name of the heel bone?
Calcaneous
Why does the Calcaneous Tuberosity stick out?
Calcaneal Tendon
The Iliopsoas goes under which ligament?
Inguinal
What is the strongest hip flexor in the body?
Iliopsoas
What “tract” is made of an extra thick fascia?
Iliotibial Tract
What is the start, wrap, and attachment of the Iliotibial Tract (aka band)?
Start on ilium, wraps around tensor fascia latae, and attaches to anterior-lat tibia
Which is the “tailor muscle”? action?
Sartorius (flexion thigh at hipjoimt, flexion leg at kneejoint, external rotation of thigh)
Where does the Sartorius start, cross, and do?
Starts on ASIS, crosses medially to kneejoint, anterior to hip joint, attaches to medial surface of tibia. Flexion of hip and flexor of knee. “tailor muscle”
What is the Patella made of?
Bone
What does the Patellar Ligament go from and to?
From Patella bone to Tibial Tuberosity.
What is the action of the Gracilis?
Adduction of hip joint, slight flexion of knee. on medial thigh.
The muscles in the medial thigh go from where to where?
From Pubis to Femur (except for Sartorius, Gracilis, Semitendinousis)
What makes up the Pes Anserinus? Where is Pes Anserinus?
One muscle from each thigh compartment at a common tendon of insertion. Gracilis, Sartorius, Semitendinosus. On Medial Side of Tibia.
What does Pes Anseurinus translate to?
ped=foot. anserinus=geese. “foot of goose.”
The Medial Epicondyle is so big because which muscle attaches to it?
Adductor Magnus
Where are the three attachments of the Adductor Magnus?
Three attachments. High on Femur to low on Femur then to Adductor Tubercle.
Where and what is the Adductor Minimus?
On top end of Adductor Magnus. Same muscle.
What does the Adductor Magnus hold together?
Helps to hold knees together like horse back riding. Adduction of femur at hipjoint
Which artery and vein supplies everything below knee?
Popliteal Art and Popliteal Vein. Become all the Vessels to the three compartment of leg.
What are the attachments of the Biceps Femoris?
Long head off Ischial Tuberosity, Short Head off Femur. Short head and Long head both attache to Fibular Head. On lateral side.
What is the most superficial muscle of the posterior leg?
Gastronemicus
What does to Gastronemicus attach to?
Femur above knee and Achilles Tendon to Calcaneous.
What does the Gastronemicus do when it contracts?
Flexes kneejoint and plantarflexion at anklejoint
The Sciatic Nerve becomes what two branches?
Common Fibular Nerve and Tibular Nerve.
The Saphenous Nerve is from which nerve?
Femoral Nerve
What branch of the Femoral Nerve that goes into the leg?
Saphenous nerve for cutaneous innervation
What branch of the Femoral Nerve enters the Adductor Canal?
Saphenous Nerve. Femoral Nerve does NOT enter Adductor Canal!!!!!
The Semitendinousis is first a ____ but then becomes a ____
Muscle, Tendon
Which very meaty muscle at Popliteal Fossa, on medial side, makes a “bed” for semitendinosus tendon?
Semimembranousis
The Short Saphenous Vein runs up and down the leg like a….
Seemed Stocking
The Common Fibular Nerve comes from which thigh nerve and goes to which Leg Compartments?
Comes from Sciatic Nerve in Posterior Thigh, goes to Anterior and Lateral Leg Compartments
The Tibial Nerve is from which nerve and in which thigh and leg compartments?
From Sciatic Nerve in the Posterior Compartment of Thigh and Leg (and to plantar foot)
Does the Great Saphenous Vein have valves?
Yes
What major heart operation can the Great Saphenous Vein be used for? What’s important to remember?
CABG but must remember to turn it around so valves point the right way.
Which muscles sandwich the Superficial Fibular Nerve? Where does the SFN go to on the foot?
Between Fibularis Longus and Brevis, Lateral Leg to dorsum of foot.
Where does the Short Saphenous Vein start and go to?
Starts on little toe and goes up to popliteal vein.
What are the three compartments of the leg (not the thigh)?
Anterior, Posterior, Lateral
What is the VAN for the Anterior Compartment of the Leg?
Deep Fibular Nerve, Anterior Tibial Artery, Anterior Tibial Vein
What is the action of the Anterior Compartment of the Leg?
Dorsiflexion of foot at ankle joint and extension of toes pulls up on toes
Common Fibular Nerve aka
Peroneal Nerve
What is the VAN of the Posterior Compartment of the Leg?
Tibial Nerve, Posterior Tibial Artery, Posterior Tibial Vein
What is the action of the Superficial Posterior Compartment of the Leg?
Plantar Flexion of foot at ankle joint (GSP mm)
What is the VAN of the Lateral Compartment of the Leg?
Superficial Fibular Nerve, Perforating Branches of Fibular Artery, Perforating Branches of Fibular Vein
What is the action of the Lateral Compartment of the Leg?
Eversion of foot (tilt foot so pink toe is up and big toe is down)
Which artery can you take the pulse at on the foot?
Dorsalis Pedis Art
What are the two surfaces of the foot?
Dorsum (top), Plantar (bottom)
What are the two VANS for the Plantar Foot?
Medial Plantar VAN and Lateral Plantar VAN (from Tibial N and Post Tibial Art/Vein)
What is the VAN for the Dorsum of the foot? (Hint: Two nerves)
Dorsalis Pedis Artery, Dorsalis Pedias Vein, and Superficial and Deep Fibular Nerves
The Knee Joint is what kind of joint?
Hinge Joint
What are the main two movements of the Knee Joint? What is the other movement that it can only do a tiny bit of?
Flex and Extend with a TINY BIT of rotation from popliteus muscle unlocking knee.
Which muscle causes the tiny amount of rotation of the knee joint?
Popliteus muscle unlocking knee
What sort of tissue is the Meniscus?
Fibrocartilidge
What bones are the meniscus between? What is the ONLY bone the menisci attach to?
Femur and Tibia. Only attach to Tibia (not Femur!)
What does the meniscus form?
Forms pocket for condyle of femur to fit in and keep condyle in place.
What do the menisci attach to?
Eminences of Tibia and also Medial Collateral Ligament (NOT Lateral Collateral Ligament)
How many meniscuses are there and what is their shape?
Two. Medial Meniscus C shape, Lateral Meniscus O shape
What are the three main ligaments attaching the Femur to the Tibia/Fibula?
Patellar Ligament, Lateral Collateral Ligament, Medial Collateral Ligament
What does the Lateral Collateral Ligament connect?
Femur to Fibula on lateral side. From Lateral Epicondyle of Femur to Head of Fibula. Gives strength in lateral direction.
What does the Medial Collateral Ligament connect? Another “special” connection?
Medial Epicondyle of Femur to Tibia on medial side. Attaches to Medial Meniscus.
What does the Patellar Ligament connect?
Patella to the Tibial Tuberosity
ended at page 4 of knee lecture on 4/13/16 at 10:30pm. pick up on page 4 tomorrow. also need to add muscles to of the different compartments of the leg. already have thigh.
ended at page 4 of knee lecture on 4/13/16 at 10:30pm. pick up on page 4 tomorrow. also need to add muscles to of the different compartments of the leg. already have thigh.
Inversion of foot by which two muscles? Which nerves?
Tibialis Ant (Deep Fibular Nerve) and Tibialis Post (Tibial Nerve)
Divisions of the sciatic nerve and muscles those divisions innervate in thigh and leg
Tibial Division Posterior Thigh: biceps long head, semitendinousis, semimembranousis Common Fibular Division Thigh: bicep short head Leg Posterior Tibial : GSP FFTP Leg Sup Fibular (Lateral Leg): Fibularis Longus and Brevis Leg Deep Fibular (Anterior Leg): Tibialis Anterior, Extensor Hallicus Longus, Extensor Digitorum Longus
What shape is the plantaris muscle?
Triangular
Deep femoral art branches go which way?
Medially deep
Do you really think that the tiny obturator artery can take care of the Medial Thigh by itself?
No!!!!!! Medial compartment is also supplied by deep femoral perforating branches!
Where does soleus attach to?
Tibia on soleal line
What are the three muscles of the Anterior Leg?
Tibialis Anterior, Extensor Hallicus Longus, Extensor Digitorum Longus (T.Eh.Ed)
What is the artery and nerve for the Anterior Leg?
Deep Fibular Nerve (DFN), Anterior Tibial Artery (ATA)
What is the action of the muscles in the Anterior Leg?
Inversion of foot, Dorsiflexion, Extends digits
What are the two muscles of the Lateral Leg?
Fibularis Longus, Fibularis Brevis
What is the artery and nerve for the Lateral Leg?
Fibular Artery, Superficial Fibular Nerve
What is the action of the Lateral Leg?
Eversion of foot
What are the seven muscles of the Posterior Leg?
Sups: Gastronemicus, Soleus, Plantaris, Deeps: Flexor Hallicus Longus, Flexor Digitorum Longus, Tibialis Posterior, Popliteus (GSP, FFTP)
What is the artery and nerve for the Posterior Leg?
Posterior Tibial Artery, Tibial Nerve
What three muscles of the Superficial Posterior Leg?
Gastronemicus, Soleus, Plantarus
What is the action of the muscles of the Posterior Superficial Leg?
Flexion of ankle
What are the four muscles of the Deep Posterior Leg?
Popliteus, Tibialis Posterior, Flexor Digitorum Longus, Flexor Hallicus Longus (PTFF)
What are the two layers of the Posterior Leg? How many muscles in each?
Superficial 3 and Deep 4
What is the action of the muscles of the Deep Posterior Leg?
Ankle Plantarflexion and toe flexion
What is the nerve and artery for both the Superficial and Deep Posterior Leg?
Tibial Nerve, Posterior Tibial Artery
Which three muscles make up the Achilles/Calcaneal Tendon?
Gastrocnemius, Soleus, Plantaris (GSP)
What is the action of the Achilles/Calcaneal Tendon?
Plantar Flexion of foot at ankle
Where do the two muscles making the Achilles/Calcaneal Tendon connect?
Calcaneal Tuberosity on the Calcaneus (heel bone).
What are the two main branches of the Sciatic Nerve?
Tibial Nerve and Common Fibular Nerve
Which branch of the Femoral Nerve enters the Adductor Canal with the Femoral Art and Vein but exits before the adductor hiatus?
Saphenous Nerve
Who are Tom Dick AN Harry?
Tibialis Posterior(Tom), Flexor Digitorum Longus(Dick), Posterior Tibial Artery(A), Tibial Nerve(N), Flexor Hallicus Longus(H). Contents of Deep Posterior Compartment.
What does Tom Dick AN Harry make up?
Deep Posterior Leg
Tom Dick AN Harry all pass behind what major landmark?
Medial Malleolus then under arch of foot
What branch of the Femoral Nerve extends into the leg?
Saphenous Nerve, which does medial cutaneous on tibia
Quadricepts make which tendon?
Quadricep Tendon to Patella
What is the action of the Deep Posterior Compartment of the Leg?
Flexion of the toes (Tom Dick AN Harry)
The Interossei muscles of the foot do what actions depending on where they are?
On top of foot do ABDUCTION. On bottom of foot ADDUCTION.
The Anterior Tibial Artery becomes what artery on the top of the foot?
Past true ankle joint becomes Dorsalis Pedis Artery where take pulse on top of foot.
Does the Dorsalis Pedis supply the toes?
Yes
Mneumonic for three muscles and vessels passing behind the Medial Malleolus?
Tom=Tendon of tibialis post Dick=Flexor Digitorum Longus (flexes toes) AN=Post Tib Art; Tibial Nerve Harry=Flexor Hallicus Longus
What is the action and VAN of the Abductor Hallicus?
Pull great toe away from center. Medial Plantar art and nerve.
What is the function of the Abductor Digiti Minimi?
Pull little toe away from center
Which muscle do you use to write with your big toe?
Adductor Hallicus
Which toe side and arch does the Great Saphenous Vein come off from?
Great toe side of dorsal arch.
Which toe side does the Short Saphenous Vein come off from?
Short toe side of dorsal arch.
Spinal roots S1 and S2 innervate which side of the foot?
Lateral side of foot
Which spinal roots innervate the lateral side of foot?
S1, S2
Which spinal roots innervate the medial side of the foot?
L4, L5
Which side of the foot do the spinal roots L4, L5 innervate?
Medial side of foot
What type of joint is the Femoropatellar Joint?
Synovial joint.
What cells makes synovial fluid?
Synoviocytes which make synovial fluid.
What is a Baker’s Cyst?
Bursa that can become full of fluid
What are the layers of the contents of the Popliteal Fossa from superficial to deep?
from superficial to deep: fat, popliteal vein, popliteal art against bone
What causes a Baker’s Cyst?
Friction of muscle rubbing over bursa which protects a joint that muscle runs over from friction. Can also protect a boney surface such as the glut max going over greater trochanter and the greater trochanter bursa protecting greater trochanter/side glut max with less friction at that spot.
What does a Bursa do?
Reduces friction where muscle rubbing over joint or boney surface
What is the Terrible Triad?
Happens often in football injuries with impact to lateral leg which damages knee structures. Tear of the ACL, MCL, and the medial meniscus. Heals poorly as cartilidge has no blood supply.
Which ligament attaches the meniscus to the tibia?
Coronary Ligament
What is a Bucket Handle tear?
Happens on lateral or medial meniscus tearing away and a floating piece of meniscus synovial joint. Body will feel it and induce a spinal reflex that will cause knee to not bear weight/buckle/collapse/give out.
Where do synoviocytes get source of fluid to make synovial fluid?
Capillaries.
What is the drawback to having capillaries provide fluid for the meniscus?
Can allow bleeding into joint which can make joint swollen. Body makes more synovial fluid to keep femur and tibia from rubbing against meniscus and each other together but this causes discomfort, tightness, reduced range of motion in knee joint due to extra synovial fluid.
Describe the thickness of the meniscus from the edge and as it goes in
Edge of meniscus is very very thin and gets thicker as goes in
Where does the Anterior Cruciate Ligament start and go?
From lateral intercondylar space of femur to medial eminence of tibia on anterior side post criciate does opposite
Where does the Posterior Cruciate Ligament start and go to?
From medial intercondylar space of femur to lateral eminence of tibia on posterior side
The ACL and PCL are named for where they start or finish?
Finish. Either on Anterior or Posterior Tibia.
What is the Anterior Drawer Test?
When ACL no longer attached to femur so can pull tibia anteriorally more than normal How to fix? build a new one!
What is the Posterior Drawer Test?
PCL no longer attached to femur and can push tibia posteriorally more than normal.
The Popliteal artery becomes what three arteries and to which compartments?
Post Tibil Art (Post Leg), Ant Tibial Art (Ant Leg), Fibular Art (Lateral Leg).
The Tibial Nerve innervates which leg compartment?
Posterior leg
The Tibial Nerve is paired with which artery in the leg?
Post Tibial Art (post leg)
The Superficial Fibular Nerve innervates which compartment of the leg?
Lateral Leg
The Superficial Fibular Nerve is paired with which artery?
Fibular Artery (Lateral Leg)
The Deep Fibular Nerve innervates which leg compartment?
Anterior Leg
The Deep Fibular Nerve is paired with which artery?
Anterior Tibial Artery (Ant Leg)
The Anterior Leg has which nerve and artery?
Deep Fibular Nerve, Anterior Tibial Artery
The Lateral Leg has which nerve and artery?
Superficial Fibular Nerve, Fibular Artery
The Posterior Leg has which nerve and artery?
Tibial Nerve, Posterior Tibial Artery
Which side of the Femur is the Trochanteric Line?
Anterior
Which side of the Femur is the Trochanteric Crest?
Posterior