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Year 2 Anatomy > Lower Limbs > Flashcards

Lower Limbs Flashcards

1
Q

Label this diagram

A
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2
Q

whatv are the 2 main ligaments formed between the sacrum and the ischium.

give a function of them

A

Sacrospinous ligament

Sacrotuberous ligament -

  • connect sacrum to ischial tuberosity.
  • Prevents upwards tilting of the sacrum
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3
Q

what are the two main foramina formed between the ischium and the sacrum.

What forms it and what passes through them

A

Greater sciatic foramen

  • Formed by the greater sciatic notch and the ligaments
  • It transmits sturctures leaving the pelvis to the lower limb. e.g. sciatic nerve

Lesser sciatic foramen

  • Formed by the lesser sciatic notch and the ligaments
  • Transmits structures passing from the pelvis to the perineum
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4
Q

Label this diagram

A
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5
Q

What is the angle of anterversion and when is it larger

A

The angle of anteversion is between the axis of femoral head and transcondylar axis of knee

it’s around 12 degrees

At birth it’s around 30 degress; this leads to intoed foot

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6
Q

what type of joint is the acetabular hip joint and what movemetn does it perform

A

ball and socket synovial joint

Allows all types of movement

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7
Q

what completes the bony acetabular labrum

A

Transverse acetabular ligament

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8
Q

what attaches the head of femur to the acetabulum

A

ligament of the head of the femur

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9
Q

A synovial membrane surrounds the head of the femur, what structure surrounds the synovial membrane.

Give it’s features and how is it related to fractures

A

A capsule surrounds the membrane and the capsule extends down the neck of the femur

It runs more anteriorly than posteriorly

Fractures can either be intracapsular or extracapsular

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10
Q

there are 4 ligaments that reinforce the femoral capsule.

What are they?

A
  • Pubofemoral
  • Ischio-femoral
  • Ilio-femoral
  • Ligament of head of femur
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11
Q

Extensively describe the blood supply to the femoral head

A

It is primarily supploied by 2 branches of the profunda femoris:

  • lateral circumflex artery
  • Medial circumflex artery

It can alsio be supplied by the acetabular branch of the obturator artery

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12
Q

Contrast intracapsular and extracapsular fractures

A

Extra-

  • it’s at intertrochanteric line: less common

Intra:

  • it’s at femoral head OR neck
  • there’s risk of avascular necrosis due to damage to the cirucmflex arteries
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13
Q

label the two muscles seen

A
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14
Q

what proximal (origin) and distal attachments (insertion) of the piriformis.

What does it split?

A

Proximal: Anterior Sacrum

Distal: Medial aspect of greater trochanter

IT splits the greater sciatic foramen into 2 parts

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15
Q

what are the attachments of the obturator internus.

A

Proximal: Internal obturator membrane

Distal: Medial aspect of Greater trochanter

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16
Q

Describe the path of the tendon of the obturator internus

A

it makes a 90 degree turn as it passes through the lesses sicatic foramen

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17
Q

Name as much gateways that allows nerves, vessels and tendons to pass from abdomen to lower limbs

A

Greater sciatic foramen above piriformis

Greater sciatic foramen below piriformis

Lesser sictic foramen

Obturator canal

Gap between inguinal ligament and pelvic bone

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18
Q

label aas much enrve vessels as you can

A
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19
Q

what are the subcompartments of the gluteal compartment

A

Superficial gluteal compartment

  • Gluteus maximus
  • Gluteus medius
  • Gluteus minimus

Deep gluteal compartment (Short external rotators of the hip)

  • Piriformis
  • Obturator internis
  • Superior gamellus
  • Inferior gamellus
  • Quadratus femoris
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20
Q

what are the 3 compartments of the thigh

A

Anterior: Hip flexors and knee extensors

Adductor (Medial): Hip adductors

Posterior: Hip extensors and knee flexors

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21
Q

Name all the muscles of the anterior compartment of the thigh and give innervation

A

Tensor fascia latae- superior gluteal nerve

the rest are innervated by the femoral nerve

Sartorius

Quadriceps femoris

  • Rectus femoris
  • Vastus medialis
  • Vastus intermedius
  • Vastus lateralis

ilio psoas

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22
Q

what are the muscles fo the adductor compartment of thigh and it’s innervation.

any exceptions

A

Mostly innevrated by the obturator nerve.

They are:

  • Adductor longus
  • Adductor brevis
  • Adductor magnus
  • Gracilis
  • Obturator externus

EXCEPTION

Pectineus- femoral nerve

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23
Q

what are posterior thigh compartments muscles and give it’s innevration

A

All supplied by the sciatic nerve

they are the hamstrings which are:

  • Semimembranous
  • Semitendinosus
  • Biceps femoris
  • Hamstring component of the adductor magnus*- supplied by sciatic nerve
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24
Q

What forms the lumbar plexus and sacral plexus

A

Lumbar plexus:

  • Ventral ramis of L1-L4

Sacral plexus formed by:

  • Lumbosacral trunk (L4,5)- a branch of lumbar plexus
  • Ventral rami of S1-S4
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25
Q

Describe how the femoral nerve arises and it’s motor and snesory innevratio/vbranches

A

From posterior divisions of L2-L4

Innervates all anterior thigh muscles EXCEPT tensor fascia latae

Also innervates pectineus muscle (adductor compartment)

Sensory cutaneous branches are:

  • Saphenous nerve- anteromedial knee, medial leg and foot
  • Medial and intermediate femoral cutaneous nerve
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26
Q

How does the obturator nerve arise and give it’s innervation

A

Arises from Anterior divisions of L2-L4

Innervates all aductor compartment muscle EXCEPT:

  • pectineus
  • Hamstring half of adductor magnus
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27
Q

Sciatic nerve (L4- S3) what are it’s main branches and what does it innervate?

A

Composed of two nerves:

  1. Tibial - the rest of the hamstring muscles
  2. Common peroneal- short head of bicep femoris

Innervates all hamstring muscles (posterior compartment of thigh)

it also innervates everything from knee downwards

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28
Q

where is the safe area for gluteal injections

A

Superolateral quadrant- avoid damage to impprtant structures

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29
Q

Name all the nerves of the gluteal compartment and give the muscles they innervate.

These nerves are derived from the sacral plexus

A

The superior gluteal nerve (L4-S1)

  • Gluteus medius, minimus and tensor fascia lata

The inferior gluteal nerve (L5-S2)

  • Gluteus maximus

The nerve to piriformis (S1,S2)

The nerve to obturator internus (L5-S2)

  • Obturator internus and superior gamellus

The nerve to the quadratus femoris (L4-S1

  • Quadratus femoris and Inferior gamellus
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30
Q

list all the cutaneous innervation of the thigh

A

Saphenous Nerve- anteromedial knee, medial leg and foot

lioinguinal nerves (L1)

Genitofemoral nerve (L1,2)

Lateral cutanenous nerve

  • Medial femoral cutaneous nerve: Medial part of anterior thigh*
  • Intermediate femoral cutaneous nerve: Middle part of anterior thigh*
  • Posterior cutaneous nerve of thigh*
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31
Q

Give the origins of the muscles of the anterior compartment of the thigh.

A

iliacus- iliac fossa

Sartorius- ASIS

Tensor fascia latae- ASIS

Rectus femoris- Anterior inferior iliac spine

3 Vastus muscles- Anterior femur

All these attachments at the anterior ilium

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32
Q

Give the origins of the superficial gluteal muscles

A

they all originate from the posterior ilium

Gluteus maximus - blue on diagram

Minimus- yellow

Medius- purple

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33
Q

what are the orgins of the deep gluteal msucles

A

Piriformis: Anterior sacrum

Obturator internus: Obturator membrane

Superior and inferior gamelli: Ischium

Quadratus femoris: Ischium

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34
Q

what are the origins of the adductor compartment of the thigh

A

All of them originate from the pubis or ischiopubis ramus.

  • Pectineus
  • Adductor longus
  • Adductor brevis
  • Adductor magnus
  • Gracilis

EXCEPTION: obturator externus- obturator membrane

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35
Q

what are the origins of the posterior compartment of the thigh

A

All 3 hamstring muscles and hamstring componetn of adductor magnus all orginate from the ischial tuberosity

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36
Q

Gluteus maximus

give insertion, innervation and function

A

Insertion:

  • Deep fibres: Gluteal tuberosity
  • Superficial fibres: Iliotibial tract

Function

  • Hip Extension
  • Some lateral rotation and abduction

Innervation:

  • Inferior gluteal nerve
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37
Q

Gluteus medius and minimus

Give insertion, function and innervation

A

insertion: Greater trochanter

Function: Hip abduction

Innervation: Superior gluteal nerve

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38
Q

How do you perform the Trendelenburg test and what does it tests for?

A

tests for a weak or paralysed hip abductors.

Tell them to raise a good leg and if the hip drops towards the side of th egood leg then it’s a positive Trendelenburg test.

They have a weakness or paralysis of the gluteus medius and minimus

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39
Q

outline the short external rotators of the hip. Give me their insertion

A
  • Piriformis
  • Obturator internus
  • Superior gamellus
  • Inferior gamellus
  • Quadratus femoris

INSERT at the greater trochanter

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40
Q

what are the two layers of fascia of the thigh

A

Superficial fascia- similar to other fascia in the body.

Deep fascia

  • Area of the thigh called the fascia lata
  • Extends like a stocking beneath the skin
  • Lateral thickened area is the iliotibial tract
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41
Q

Tensor fascia latae

give origin, insertion, innervation and function

A

Proximal- ASIS

Distal

  • Iliotibial tract –Attaches to the lateral condyle of the tibia

Function

  • Stabilise the knee in extension

Innervation?

Superior gluteal nerve

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42
Q

Sartorius

give origin, insertion and function

A

Proximal- ASIS

Distal

  • Pes anserinus ligament* on medial tibia inferior to the tibial tuberosity

Function

  • Hip and knee flexion
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43
Q

Rectus femoris

Give origin, insertion and function

A

Proximal- AIIS

  • Distal*
  • Quadriceps femoris tendon
  • Function*
  • Hip flexion and knee extension
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44
Q

the 3 VASTUS muscles.

Give the origin, insertion and function

A

Proximal

  • Medial, anterior and lateral femoral shaft respectively
  • Lateralis has other proximal attachments*

Distal

  • Quadriceps femoris tendon

Function

  • Knee extension
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45
Q

3 Addcutor muscles (longus, magnus and brevis)

give origin, insertion and function

A

Proximal

  • Pubis and ischiopubic ramus

Distal

  • Femoral shaft

Function

  • Adduction and medial rotation of hip joint
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46
Q

Gracilis (adductor compartment of thigh)

Give origin, insertion and function

A

Proximal

  • Pubis

Distal

  • Medial-proximal tibial shaft (PES anserinus)

Function

  • Hip adduction and knee flexion
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47
Q

The Hamstring muscles.

give orignin, insertion and function

A

Proximal

  • Ischial tuberosity

Distal

  • Biceps femoris: Fibula
  • Semi-M and semi-T: Tibia
  • Adductor magnus*: Hamstring part attaches to adductor tubercle

Functions

  • Knee flexion and thigh extension
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48
Q

what are the borders of the femoral triangle

A

Base of the triangle (superior border of triangle)

  • Inguinal ligament

Medial border:

  • Adductor longus

Lateral border:

  • Sartorius

Apex of the triangle (inferior end)

  • Continuous with the adductor canal
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49
Q

what are the contents of the femoral triangle

A

Within the femoral sheath

  • Femoral artery
  • Femoral vein
  • Lymphatics

Outside of the femoral sheath

  • Femoral nerve
  • Psoas major tendon*
  • Pectineus*
  • Lateral femoral cutaneous nerve*
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50
Q

describe the borders of the adductor canal

A

Anterior

  • Sartorius- curves around medially

Posterior

  • Adductor longus and magnus

Laterally

  • Vastus medialis
51
Q

what are the contents of the adductor canal

A

Femoral artery

Femoral vein

Saphenous nerve

  • The other branches of the femoral nerve have left to supply the anterior compartment

Nerve to the vastus medialis*

52
Q

where does the adductor canal end?

how does the vessels of the canal change

A

Adductor hiatus of adductor magnus

The femoral artery becomes the popliteal artery

The femoral vein becomes the popiliteal vein

53
Q

give the arrangement of the femoral artery, vein and nerve in the base of the femoral triangle

A

NAV

54
Q

What are the branches of the femoral artery in the femoral triangle and describe it’s course in the thigh

A

Profunda femoris

  • the superficial circumflex iliac artery*
  • the superficial epigastric artery*
  • the superficial external pudendal artery*
  • the deep external pudendal artery*

After giving off the profunda femoris, the femoral artery continue in the adductor canal as the superficial femoral artery.

At the hiatus (knee) it becomes the popilteal artery

55
Q

where can you palpate the femoral artery

A

Halfway between ASIS and pubic symphysis.

Lies on psoas tendon and easily palpable

56
Q

What are the branches of the profunda femoris and why are they important clincially

A

Lateral femoral circumflex

Medial femoral circumflex

Clinical Importance:

  • Avascular necrosis of the femoral head can occur if there’s an intracpasular fracture

there are other branching perforating arteries

57
Q

describe the venous drainage of the thigh

A

Superficial: Popliteal vein becomes the femoral vein at the knee

Deep: The superficial femoral vein receives the venae comitantes of the profunda femoris artery

The saphenofemoral junction occurs in the femoral triangle

58
Q

describe the lymph drainage of the lower limb

A

All the lymph drains into Inguinal lymph nodes

Lymph closely follow veins.

Popliteal lymph drains the distal limb

Superficial inguinal nodes drains into deep inguinal which drains into external iliac nodes

59
Q

What passes throught he greater scitic foramen gateway

A

Above piriformis:

  • Superior Gluteal artery, vein and nerve

Below piriformis:

  • Inferior gluteal artery, vein and nerve
  • Internal pudendal artery and vein and pudendal nerve
  • Sciatic nerve
  • Nerves to Obturator Internus and Quadratus Femoris
  • Posterior femoral cutaneous nerve
60
Q

what are the contents of the lesser scitaic formaen and obturator foramen

A

Lesser sciatic foramina:

  • Pudendal Nerve and Pudendal Vessels (going into the perineum)
  • Tendon of obturator internus

Obturator Foramen

  • Connects medial compartment of lower limb to pelvis
  • Contains obturator nerve and vessels
61
Q

how do you measure true and apparent leg length in a pt

A

Lie patient supine and ensure the ASIS’s are at the same level and the hip is squared

True leg: Measure distance between medial malleolus and ipsilateral ASIS (fixed)

Apparent leg: Measure distance between medial malleolus and xiphisternum (non-fixed)

62
Q

Describe the embryology of the lower limb development

A
  • in early development, upper and lower limb buds extend laterally
  • internal rotation of lower limb below the hip = permanent pronation
  • structures that would have been anterior become posterior (and vice-versa)
  • flexors become become posterior and extensors anterior
63
Q

what are the consquences of the permanent pronation of lower limb in early development

A

In adults:

  • anterior dermatomes have twisted, oblique fields, as opposed to the straighter fields in the upper limb
  • extensor muscles are anterior and flexors are posterior
  • in upper limb thumb is lateral and in lower limb homologous digit large toe is medial
64
Q

Draw out the lumbar plexus and state 2 important nerves coming out with their corresponding nerve root

A

Femoral nerve- (L2, 3,4) and derived from the posterior divisions

Obturator nerve - (L2,3,4) ansd derived from the anterior divisions

65
Q

what are the other nerves of the lumbar plexus

A

Iliohypogastric (L1)

Ilioinguinal (L1)

GenitoFemoral (L1, L2)

Lateral femoral cutaneous nerve (L2, L3)

66
Q

Draw out the lumbosacral plexus and state the important nerves and their nerve roots.

L4 and L5 from lumbar plexus joins the sacral plexus

A

Sciatic nerve (L4-S3): divided into tibial and coomon peroneal nerve

Superior gluteal nerve- (L4, L5, S1)

Inferior gluteal nerve ( L5, S1, S2)

Posterior cutaneous nerve of the thigh ( S1, S2, S3)

Pudendal nerve ( S2-S4)

Nerve to piriformis (S1, S2)

Nerve to obturator internus ( L5-S2)

67
Q

What are the key landmarks of transitons in the leg

A

From Thigh to Leg: via the Popliteal fossa

From leg to foot :

  • Plantar: Tarsal tunnel- posteriomedial to ankle
  • Dorsal: Structures enter directly into the ankle
68
Q

What forms the Tarsal tunnel and what structures pass through it

A

Formed by the Flexor Retinaculum behind the Medial Malleolus

Structures are: Tom, Dick And Very Naughty Harry

  • Tibialis posterior
  • Flexor Digitorum longus
  • Posterior Tibial Artery
  • Posterior Tibial Vein
  • Tibial Nerve
  • Flexor Hallucis Longus

They are arranged from anterior to posterior

69
Q

what forms the floor of the popliteal fossa

A

posterior femur: linea aspera widens

70
Q

what are the keyt landmarks on the proximal tibia

A

Anterior:

  • Tibial Tuberosity
  • Pes Anserinus (SGT)

Posterior:

  • Soleal line
71
Q

is the fibula a weightbearing bone? Explain

A

No- not involved in Knee joint

It’s superior medial surface articulates with th etibia to from proximal tibio-fibular joint

72
Q

what type of joint is the knee joint and what movement can it allow

A

Hinge type (largest synovial joint in body.

Normally flexion and extension, but allows some gliding, rolling and rotation

73
Q

what are the cruciate ligaments of the knee joints and give their respective attahcments

A

ACL:

  • Superior: Lateral Wall of Femoral Intercondylar Fossa
  • Inferior: Anterior Tibial Intercondylar region

PCL:

  • Superior: Medial Wall of Femoral Intercondylar Fossa
  • Inferior: Posterior Tibial Intercondylar region

PMAL; acronym

these cruciate ligaments are extrasynovial but intraarticular

74
Q

what are the tests for assessing ACL/PCL integrity

A

Anterior/ posterior drawer test (knee at 80 degrees)

Lachman’s test (ACL)- knee at 30 degress

You trying to see if there’s excessive tibia displacement on the fixed femur

A postive sag sign on inspection shows a PCL rupture

75
Q

which menisci (shock absorber) is more susceptible to injury and why?

A

medial

This is because it is also attached to the Tibial collateral ligaments to form a joint capsule

76
Q

what forms the fibrous membrane of the knee joint

A

Extensions of tendons of the muscles

it encloses the articular cavity and intercondylar regions

77
Q

what is thew function of a bursae and how can it get inflamme

A

Minimise friction between bone and skin; it can get inflammed due to too much friction, infection or inflammatory diseases

78
Q

Name the burase of the knee joints

A
  • Pre-patellar
  • Suprapatellar
  • Infrapatellar
  • Popliteus
  • Subpopliteal bursae
79
Q

How does the knee joint save energy when fully extended

A

Femoral condyles are flatter/broader anterior

Medial rotation of the femur on the tibia which tightens the ligaments

Body centre gravity is anterior to the knee joint

80
Q

what are the contents of the popliteal fossa

A

Popliteal artery/vein

Short saphenous vein (which changes to popliteal vein)

The 2 branches of the sciativ nerve

Popliteal lymph nodes

81
Q

What are the boudnaries of the popliteal fossa

A

Floor: Knee capsule and Femur/Tibia

Roof: Deep fascia

Superio-Medial: Semi- Membranosis

Superior lateral: long head of biceps femoris

82
Q

Label this foot

A
83
Q

There are sesamid bones in the foot; where exactly are they located?

A

Can only be seen on plantar surface of foot

Located within the Flexor Hallucis brevis (FHB)

These are located on the Ball fo the foot (Head of 1st Metatarsal)

84
Q

What tpyr of joint is the ankle joint? and whatmovement does it permit

A

Hinge-like synovial joint

Allow Dorsi and Plantar flexion

85
Q

what forms the “mortice” face for the ankle joint

A

Roof- Inferior surface of Distal Tibia

Medial Side- Medial Malleolus of Tibia

Lateral Side: Lateral Malleolus of Fibula.

86
Q

Ligaments in the ankle provide stabilisation of it. There are medial and lateral ligaments.

Give the component of the Medial Ligaments. Label them

A

This is also called the Deltoid ligament.

made up fo 4 components:

  • Tibiocalcaneal
  • Tibionavicular
  • Anterior tibiotalar
  • Posterior tibiotalar
87
Q

What are the 3 components of the lateral ankle ligaments

A

Anterior talofibular- MAIN ONE

Posterior talofibular

Calcaneofibular

88
Q

which ankle ligament do we commonly sprain and what do pts present with?

A

The ankle lateral ligaments due to over inversion of the foor

pt present with:

  • Pain on outside of ankle
  • Swelling
  • Ecchymosis
89
Q

what joint allows foot inversion and eversion

A

Subtalar joint- between posterior calceneal facet and inferior surface of talus.

However, the clinical joint complex is called the talocalcaneonavicular complex.

This allows gliding and rotation

90
Q

what type of joint is the PTF and DTF (tibiofibular)

A

Proximal- synovial

Distal- fibrous

91
Q

Give the origin, insertion and function of the gastrocenimus

A

Origin:

  • Medial head- superior to medial femoral condyle
  • lateral head- superior to lateral femoral condyle

Insertion- Achilles tendon

Function:

  • Plantar flexion
  • Knee flexion
92
Q

whats the origin, insertion and function of the plantaris?

A

Proximal

  • Inferior part of lateral supracondylar line of femur

Distal

  • Calcaneal tendon

Function: plantar flexion and knee flexion

93
Q

what is the orgin, insertion and function of the Soleus

A

Proximal

  • Soleal line and medial border of tibia
  • Posterior fibular head

Distal

  • Calcaneal tendon

Function: Only Plantar Flexion

94
Q

What is the origin, insertion and fucntion of the Popliteus (Deep muscle group of Posterior leg)

A

Proximal

  • Lateral femoral condyl

Distal

  • Posterior surface of tibia

Function

  • Unlocks the knee joint
  • Stabilses the knee joint and limit lateral rotation of the tibio-femoral joint
95
Q

what is the origin, insertion and function of the Tibialis Posterior

A

Proximal

  • Posterior interosseous membrane
  • Tibia/Fibula

Distal

  • Navicular Tuberosity
  • Medial Cuneiform

Function

  • Plantarflexion, Foot Inversion
  • Also support of Medial Arch
96
Q

what is the origin, insertion and function of the Flexor Hallucis Longus

A

Proximal

  • Posterior interosseous membrane
  • Fibula

Distal

  • Plantar surface of Base of 1st Distal Phalanx

Function:

  • Flexes the big toe
97
Q

what is the origin, insertion and function of the Flexor Digtorum Longus

A

Proximal

  • Medial Tibia

Distal

  • Plantar surfaces of Base of Distal Phalanx of Lateral 4 Toes

Fucntion:

  • Flexion of Lateral 4 Toes
98
Q

wbhat innevrates all the muscles of the posterior leg ,muscles?

A

Tibial nerve

99
Q

what are the muscles in the lateral componet of the leg. What innervates them

what are their functions:

A
  • Fibularis longus
  • Fibularis brevis

Innervation: Superficial peroneal nerve- a bramch of the Common Peroneal nerve

Function

plantar flexion and eversion

100
Q

What are the origins and insertion and function of the Fibularis longus

A

Proximal

  • Upper lateral surface/Head of fibula

Distal

  • Base of 1st Metatarsal
  • Medial cuneiform

Function:

Foot Eversion, Plantarflexion, Support arches of foot

101
Q

What are the origins and insertion and function of the Fibularis Brevis

A

Proximal

  • Lower 2/3 of lateral surface of fibula

Distal

  • Base of 5th Metatarsal

Function;

Foot Eversion

102
Q

what are the muscles iof the anterior compartment of the leg and what innervates them

A
  • Tibialis Anterior
  • Extensor Hallucis Longus
  • Extensor Digitorum Longus
  • Peroneus Tertius

Innervation: Deep Peroneal Nerve- branch of common peroneal nerve

103
Q

What are the origins and insertion and function of Tibialis Anterior

A

Proximal

  • Lateral Tibia
  • Anterior interosseous membrane

Distal

  • Medial Cuneiform
  • Base of 1st Metatarsal

Function:

Dorsiflexion, Foot Inversion, Support of medial arch of foot

104
Q

What are the origins and insertion and function of Extensor Hallucis Longus

A

Proximal

  • Medial Fibula
  • Anterior Interosseous Membrane

Distal

  • Dorsal surface of 1st Distal Phalanx

Function;

Extension of Great Toe, Dorsiflexion

105
Q

What are the origins and insertion and function of Extensor Digitorum Longus

A

Proximal

  • Medial Fibula
  • Lateral Tibial Condyle

Distal

  • Dorsal surface of Distal & Middle Phalanges of Lateral 4 Toes via Dorsal Digital Expansions

Function:

Extension of Lateral 4 Toes, Dorsiflexion

106
Q

What are the origins and insertion and function of Fibularis Tertius

A

Proximal

  • Distal, Medial Fibula

Distal

  • Dorsal surface of Base of 5th Metatarsal

function:

  • Dorsiflexion, Eversion of Foot
107
Q

what are the functions of the arches of the foot.

Give the name of the 3 arches

A

Absorb and distribute downward forces when standing/ diffferent surface types. Tendons and muscles support arches

Names are:

  • Medial Longitudinal arch
  • Lateral Longitudinal arch
  • Transverse arch
108
Q

draw out the vascualture of the leg

A
109
Q

what are the deep and superifcial veins fo the leg

A

Deep- follow arteris via venae comitantes except femoral and popliteal veins (on thier own)

Superficial

  • Great and small saphenous veins
  • Interconnect with deep system using perforating veins
110
Q

describe the path of the GREAT Saphenous vein

A

Starts and the MEDIAL side of dorsal venous arch

Then ascends anterioly to medial malleolus on the medial leg, knee and thigh

Connect with the femoral vein just inferior to the inguinal ligament at the Sapheno-femoral junction; 3-4cm below inguinal crease and medial to femoral artery pulse site

111
Q

Describe the path of the SMALL saphenous vein

A

Starts at the lateral side of dorsal venous arch

it ascends POSTERIOR to the lateral malleolus

it penetrates deep fascia and drain into popliteal vein (just below the knee)

112
Q

Describe the foot muscle innervation

A

Tibial nerve innervates all of them EXCEPT Extensor digitorum brevis

EDB innervated by a branch of the deep peroneal nerve.

The Tibial nerve branch into:

  • Medial and Lateral Plantar nerve
113
Q

what is this nerve\?

how does it arise and what does it innervate

A

Sural nerve

Formed by a branch of Tibial nerve and Common Peroneal nerve

It innervates:

  • Skin of lower posterior leg
  • Skin of lateral foot/little toe
114
Q

why is the sural nerve useful clincially

A

harvested for nerve repair

115
Q

when is the common peroneal nerve suscpetible to injury and what’s the presentation of it’s palsy

A

Suscpetible when there’s a:

  • Fibular fracture
  • Knee joint dislocation

This is becuase is descends around the neck of the fibula

Presentation : foot drop

116
Q

Outline all the motor segmental supply of the movements of the lower limbs

A

Hip Flexion

  • L2,L3

Hip Extension

  • L4, L5

Knee Extension

  • L3, L4

Knee Flexion

  • L5, S1

Ankle Dorsiflexion

  • L4, L5

Ankle Plantarflexion

  • S1, S2
117
Q

Describe the dermatomal supply of the lower limb

A

L3 to the Knee

L4 to the Floor

L5 – Great Toe

S1 – Lateral Dorsum of Foot/Sole

S2 – Most of the Posterior Leg/Thigh

118
Q

what type of joints are:

Tarsometatrasal joints

MTP

Interphalangeal

A

TMJ- Plane synovial joints

MTP- eliippsoid synovial joint

Interphalangeal- hinge synovial

119
Q

Draw out the arterial distribution of the lower limbs

A
120
Q

what connects the superficial veins to the deep veins. what happesn when they are compromised?

A

Perforating veins

When the valves are dysfunctional, it can lead to varicose veins

121
Q

where does the saphenous nerve innervate

A

Sensory only;

Innervates skin of snterior kne, medial leg and foot. NOT THE BIG TOE

122
Q

LABEL THIS DIAGRAM

A
123
Q

LABEL THIS DIARGAM (Cutaneous 2)

A

Year 2 Anatomy (9 decks)

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