lower limbs living anatomy pp Flashcards
what is the normal anteversion angle for different ages
what influences anteversion
W sitting promotes it
tailor sitting prevents it (crossed legs)
what is the blood supply of the hip joint *
there is a trochanteric anastomosis:
medial femoral circumflex a
lateral ‘’
superior and inferior gluteal a - from internal iliac
acetabular branch to head (in ligament of head) from obturator a (ant division of internal iliac)
identify these features of the femoral artery angiogram *
1 external iliac
2 common femoral
3 superficial femoral
4 profunda femoris
5 lateral circumflex femoral
6 perforating artery
identify these features of the popliteal artery angiogram *
- A popliteal artery
- B anterior tibial a
- C tibiofibular trunk
- D Fibular a
- E posterior tibial
•
•Red arrow – growth plate in tibia
feel the popliteal arterial pulse *
flex the knee to relax the hamstrings
palpate the artery against the posterior tibia at the inferior part of the popliteal fossa
landmarks for safe injection in gluteal region *
where do you do self administered injections *
below the greater trochanter
describe tredelenburg gait *
if R hip abductors are paralysed - L hip hip will drop when lift left food because of lack of lifting support
the pelvis will drop on the non-affected side
for the trendelenburg test - subject stands upright on both feet, examiner stands behind and notes level of iliac crests - a drop indicated weakness of abductors on opposite sides
how does compartment syndrome heal *
fibrosis and contracture
symptoms of ischemic limb - ie from compartment syndrome *
- Pain, greater than expected
- Pallor of the limb, patchy
- The limb is cool
- Pulses absent
- Movement, passive extension is very painful
cross section of compartments of the thigh *
cross section of compartments and fascia of leg *
what spinal levels is the tibial nerve from *
l4 5 s1 2 3
what spinal levels is the common peroneus nerve from *
l4 5 s1 2
effect of femoral nerve injury *
l2 3 4
motor - quadriceps paralysis = weakness of knee, difficulty with stairs
sensory - anterior and medial thigh loss, medial side of leg and medial border of foot (not big toe)
effect of obturator nerve injury *
l2 3 4
motor - paralysis of adductors of thigh (except hamstring part of adductor magnus) - cross legging effected
insignificant sensory loss on medial side of thigh
also supply pelvis - pain on medial side of thigh could be from ovarian tumours
effect of common peroneal nerve injury *
sciatic is l4-s3
motor - foot extensors and evertors paralysed, foot drop and inverted (because tibialis posterior is still functioning) - peroneal muscles, tibialis anterior and EDL and EHL are affected
sensory loss in anterior and lateral side of leg and dorsum of foot
effect of tibial nerve injury *
sciatic is l4-s3
motor - hamstrings and muscles of back of leg and sole of foot - foot in dorsiflexed and everted - gastrocnemius, soleus, tibialis posterior, FHL and FDL and all intrinsic foot flexors, interossei and lumbricles are affected
sensory - loss in sole of foot
effect of whole sciatic nerve injury (
motor - hamstrings and all muscle below knee paralysed
foot in plantar flexed (foot drop) - because of its own weight
sensory - loss below knee except narrow area on medial side of leg and foot - saphenous nerve area, not the big toe
what is sciatica *
pain radiating from lower back into buttock, posterior/lateral thigh and into leg
cause - herniated intervertebral disc - L4/5 or L5/S1 - compression of L5/S1 part of sciatic nerve
effect of ACL and PCL damage *
ACL - walking upstairs limited
PCL - walkimg downstairs limited
what are the movements at the ankle joint *
what is the support for the arches *
passive - plantar aponeurosis, plantar calcaneonavicular lig (spring lig), long plantar lig (calcaneo-cuboid-metatarsal), short plantar lig (calcaneocuboid)
dynamic support - intrinsic muscles - tibialis anterior and posterior, FHL, peroneus longus
what is involved in inversion of the foot and how do you test it *
what is involved in eversion of the foot and how do you test it *
upper limb - what is involved in the scapulothoracic joint *
latissimus dorsi
rhomboids
trapezius
serratus anterior
what is the antebrachial vein - upper limb *
in anterior forearm between basilic and cephalic veins
branch from any of the veins
describe the clinical significance of the ‘crows foot’
femoral nerve passes through the semimembrinosis and tendinosis - if irritated refers pain to medial side of our feet
