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Gross Anatomy > Lowerr Limb > Flashcards

Lowerr Limb Flashcards

1
Q

Which ligament helps form the lesser sciatic foramen?

A

sacrotuberous

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2
Q

Whats the difference between sciatic notches and foramen?

A

notches are on bones, Foramen formed when ligaments cross over

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3
Q

What runs through the obturator foramen?

A

obturator VAN - specifically the canal (formed from the membrane)

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4
Q

WHat is the femoral region?

A

referred to as the thigh - includes the femur which helps connect the hip and knee

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5
Q

How is body weight transferred throughout the body?

A

From the vertebral column –> through sacroiiliac joint –> to the pelvic girdle –> through the hip joint –> femur–> knee joint –> tibia (fibula does not transfer weight) –> ankle joint –> talus

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6
Q

What are the 3 bones that form the “hip” bone

A

Ilium, Ischium and pubis

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7
Q

The acetabulum is specifically part of which bone?

A

ilium

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8
Q

What is the ischiopubic ramus?

A

Where the ramus of the ischium joins the inferior ramus of the pubis

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9
Q

How to tell right hip from left hip

A
  • acetabulum lateral
  • ASIS in front
  • iscial spine and ischial tuberosity posterior
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10
Q

Head of teh femur articulates with?

A

lunate surface of acetabulum

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11
Q

WHat is the longest and heaviest bone in the body

A

femur

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12
Q

Surgical head of femur vs anatomical neck?

A

surgical neck is more distal and skinner

anatomical is just around the head and widerq

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13
Q

WHat is the fovea?

A

medially placed depression in the head of the femur that houses the ligament of the head of femur - everywhere is is covered with hyaline cartilage

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14
Q

T or F the lesser trochanter is lateral to the greater?

A

false , more medial and smaller

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15
Q

Intertrochanteric line vs Intertrochanteric crest

A

Line - ridge running from grreater to lesser trochanter (anterior surface)
Crest- joints the trochanters posteriorly

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16
Q

What are the 2 large masses at the distal end of teh femur and what do they articulate with?

A

femoral condyles - medial and lateral

articulate with tibial condyles to form the knee joint

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17
Q

Normal angle of inclination

A

average = 126 degrees
angle between head of femur and neck
less in females because wider hips
*advantage is that it places the head of the femur more perpendicualr to the acetablum but places more stress on the neck of the femur

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18
Q

torsion angle

A

same things as angle of declination
between head and neck of femur –> the femoral condyles (superior)
average = 7-12 degrees

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19
Q

Spiral line vs pectineal line

A

pectineal line comes from the lesser trochanter and stops

spiral line comes from the front and becomes the linea aspera

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20
Q

Name the ligaments that reinforces the hip joint

A

Iliofemoral ligament - supports it Anterior and superior (Y shaped)
pubofemoral - inferior and anterior
ischiofemoral - posteriorlly

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21
Q

iliofemoral ligament

A

Y shaped
supports the hip joint anterior and superiorly
AIIS ad acetabular rim –> intertrochanteric line
prevents hyper extension
holds the head of femur in the acetabulum

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22
Q

pubofemoral

A

supports the hip joint anterior and inferior
oturator crest of pubic bone–> merge with joint capsule
tight during extension and abduction
resists excessive abduction

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23
Q

ischiofemoral ligament

A

reinforces the joint posteriorly
weak
ischial part of acetabulum –> neck of femur

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24
Q

ligament of head of femur

A

synovial fold
conducts a blood vessel - acetabular brach of obturator artery
ataches to the transverse acetabular lig and fovea

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25
Q

Transverse acetabular ligament

A

goes across the acetabular notch ( end of lunate surface) to make it a fossa helps hold the head of femur

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26
Q

what is the fascia lata

A

The fascia lata is the deep fascia of the thigh. It encloses the thigh muscles and forms the outer limit of the fascial compartments of thigh, which are internally separated by intermuscular septa. The fascia lata is thickened at its lateral side where it forms the iliotibial tract, a structure that runs to the tibia and serves as a site of muscle attachment.[1]

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27
Q

The fascia lata thickens laterally to form ..

A

IT band

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28
Q

IT band is an aponeurosis of which 2 muscles?

A

Glut max and tensor fascia lata

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29
Q

IT band extends from

A

iliac tubercle (external surface above the ASIS) –> anterolateral tibial tubercle (GERDY’S tubercle) on the lateral condyle of tibia

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30
Q

What are cluneal nerves?

A

superficial gluteal nerves that supply the skin - superior middle and inferior
superior cluneal nerves - posterior rami of L1 L2 L3
Medial cluneal nerves - posterior rami of S1 S2 S3
inferior cluneal nerve - off the posterior cutaneous nerve of thigh ( S1 - S3)

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31
Q

T or F pudendal nerve does not supply any muscles in gluteal region?

A

True - exits through the lesser sciatic foramen to supply the perineum

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32
Q

What is the largest nerve in the body

A

Sciatic nerve - artery to sciatic nerve from he inferior gluteal artery

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33
Q

Sciatic nerve splits into ..

A

tibial nerve and common fibular

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34
Q

T or False the sciatic nerve innervates muscles of the gluteal region

A

FALSE - innervates posterior thigh muscles, leg and foot muscles

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35
Q

SUperior gluteal nerve

A

leaves through the greater sciatic foramen superior to piriformis
innervates gluteus mediu, gluteus minimus and TFL
L4-S1

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36
Q

Inferior gluteal nerve

A

leaves through greater sciatic foramen inferior to piriformis
Innervates glut max
L5 - S2

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37
Q

Nerve to quadratus femoris

A

leaves through greater sciatic foramen deep to sciatic nerve
innervates the hip joint, inferior gemellus and quadratus femoris
L4 L5-S1

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38
Q

Pudendal nerve

A

enters gluteal region through the greater sciatic foramen inferior to piriformis and then enters the perineum through lesser sciatic foramen
supplies no structures in the gluteal region
supplies perineum
S2-S4

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39
Q

Nerve to obturator internus

A

greater sciatic foramen
enter lesser sciatic foramen and pass to obturator interus
supplies superior gemellus and obturator internus
L5-S2

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40
Q

T or F - all deep nerves of the gluteal region leave the pelvis through the greater sciatic foramen?

A

TRUE

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41
Q

which nerve is the only nerve thAt emerges superior to the piriformis?

A

superior gluteal
(inferior gluteal, sciatic, posterior cutaneus of thigh, nerve to quadratus femoris, pudendal and nerve to OI ARE ALL INFERIOR)

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42
Q

T or F: Arteries of the gluteal region arise directly or indirectly frmo the internal iliac artery?

A

T

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43
Q

What are tibial plateaus?

A

grooves on the top of medial and lateral tibial condyles

44
Q

Where is the tibial tuberositty and what is its importance

A

anterior surface of tibia - where the patellar lig attaches from the hamstrings

45
Q

Where is Gerdy tubercle

A

lateral edge of lateral condyle of tibia (where the IT band inserts)

46
Q

intercondylar fossa of femur

A

fossa between the condyles and is seen posteriorly

47
Q

soleal or popliteal line

A

seen posterior - lines up with head of fibula

48
Q

ALl quad muscles have a common insertion into

A

the quadricep tendon which inserts onto the patella, then becomes the patellar lig as it inserts onto the tibial tuberosity

49
Q

Adductor magnus origin and insertion

A

O:
Adductor part: inferior ramus of pubic, ramus of ischium
Hamstring part: ischial tuberosity

I:
Adductor part: gluteal tuberosity, linea aspera, medial supracondylar line
Hanstring part: adductor tubercle of femur

50
Q

WHat does the tendon of adductor magnus create?

A

Adductor hiatus

51
Q

WHat is the adductor canal?

A

bounded anterior by the adductor longus and magnus; medially by the sartorius
starts at the apex of the femoral triangle
provides intermuscluar passage for the femoral atery and vein, saphenous nerve and nerve to vastus medialis **and delivering femoral vessels to the popliteal fossa to become popliteal vessels

52
Q

Femoral artery is a continuation of which artery?

A

External iliac

53
Q

Once the femoral artery goes through the adductor hiatus it becomes …

A

popliteal artery

54
Q

WHat is the largest bracnh of femoral artery

A

profunda femoris artery

55
Q

Deep artery of the thigh is the same thing as profunda femoris*
this artery gives off perforating fibers that supply …

A

adductor magnus
hamstring
and vastus lateralis

56
Q

Circumflex femoral arteries typically branch from

A

profundus femoris artery - but can directly come from femoral

57
Q

which artery supplies most of the blood to the head and neck of femur?

A

medial circumflex femoral artery - from the posterior retinacular arteries

58
Q

Obturator artery usually arises frommm

A

internal iliac

59
Q

Obturator artery supplies

A

obturator externus, pectineus, adductors of thigh and gracilis
Also has a branch that supplies the head of femur -actebaluar branch

60
Q

Obturator nerve supplies

A

adductor longus and brevis
gracilis
pectineus
posterior fibers = obturator externus and adductor magnus

61
Q

SUperficial vein on the lateral side of leg

A

small saphenous

62
Q

Deep vein on medial side of leg

A

Great saphenous

63
Q

WHat is the terminal cutaneous branch of the femoral nerve

A

saphenous nerve

64
Q

When the femoral artery and vein go through the adductor hiatus, what happens to sphenous nerve?

A

it becomes superficial by piercing through the sartorious and gracilis

65
Q

What is pes anserinus?

A

insertion of sartorius, gracilis and semitendinosus

anteromedial surface of medial condyle of tibia

66
Q

Explain NAVEL

A

in the femoral triangle
from lateral to medial
NERVE; ARTERY; VEIN; Empty space; LYMPHATICs

67
Q

The femoral sheath is a inferior prolongation of

A

transversalis and iliopsoas fascia

68
Q

T or F: the femoral sheath does not enclose the femoral nerve

A

true

69
Q

purpose of the femoral sheath

A

allows the femoral artery and vein to glide deep to the inguinal ligament during hip movement

70
Q

compartments of the femoral sheath

A

lateral: femoral artery
intermediate: femoral vein
medial: femoral canal – ends at the saphenous opening ( where the great saphenous vein comes to form the femoral vein)
* allows the vein to expand for blood flow
* contains loose connective tissue, lymphatics and lymph nodes

71
Q

Which ligament helps form the greater sciatic foramen?

A

sacrospinous

72
Q

Muscles of anterior thigh, medial thigh and posterior thigh

A

anterior: iliopsoas, sartorius, rectus femoris, vastus lateralis, vastus intermedius and vastus medialis
medial: adductor longus and brevis, adductor magnus, gracilis, obturator externus
posterior: biceps femoris, semitendinosus, semiembranosus

73
Q

What nerve supplies the anterior medial and posterior compartments

A

anterior: femoral
medial: obturator (exception: pectineus some femoral); hamstring part=tibial)
posterior: tibial (exception: short head = common fibular)

74
Q

articularis genu

A

derivative of vastus intermedius attachs superiorly to the inferior part of anterior aspect of femur and inferiorly to the synovial membrane of the knee (suprapatellar bursa). Pulls the bursa superior during knee extension

75
Q

WHat is the most anterior muscle in the medial compartment

A

adductor longus

76
Q

What is the only adductor muscle to cross and act both at the knee and the hip

A

gracilis
O: body and inferior ramus of pubis
I: superior part of medial surface of tibia
Inn: obturator
A: adducts hip; flex knee and help medially rotate it

77
Q

Significance of adductor hiatus

A

where the femoral artery and vein become popliteal

78
Q

Insertion of gluteus medius

A

lateral surface of greater trochanter

79
Q

quadratus femoris

A 
O:lateral border of ischial tuberosity
I: quadrate tubercle on intertrochanteric crest of femur and area inferior to it 
Inn: nerve to quadratus femoris
A: laterally rotates hip
pulls femoral head into acetabulum
80
Q

When does glut max function best?

A

between flexed and standing position (rising from a chair and walking uphill)

81
Q

Common origin for hamstrings

A

ischial tuberosity

82
Q

When will you get the most hip extension? With knee flexed or extended?

A

extension: because hamstrings works to extend the hip and also flex the knee

83
Q

Borders of popliteal fossa

A

superolaterally: biceps femoris
superomedially: semimembranosus
inferlaterally and infermedially: heads of gastroc
roof: popliteal fascia
floor: posterior capsule fascia covering the popliteus

84
Q

contents of popliteal fossa

A 
popliteal artery and vein
termination of the small saphenous vein
tibial and common fibular nerves
posterior cutaneous nerve of the thigh
lymph
fat
85
Q

popliteal artery splits into

A

anterior and posterior tibial arteries

86
Q

deepest structure in the fossa

A

artery

87
Q

most superficial structure

A

tibial nerve

88
Q

describe sural nerve

A

medial sural cutaneous nerve from the tibial
sural communicating branch of common fibular
*supplies skin on the posterior and lateral aspects of the leg and lateral side of foot

89
Q

Where is the common fibular nerve most vulnerable to injury?

A

When wraping around the neck of fibula

90
Q

What forms the compartments of the leg?

A

intermuscular septa, interosseuous membrance and 2 leg bones

91
Q

Anterior compartment of leg

A 
tibilas anterior
EDL
EHL
fibularis tertius 
*supplied by deep fibular
*vasculature = anterior tibial artery
92
Q

Where does the deep fibular nerve arise from?

A

between the fibularis longus and neck of the fibula

93
Q

Where can you find anterior tibial artery

A

between tibilas anterior and extensor digitorum longus - ends at the ankle and becomes dorsalis pedis

94
Q

Superficial fibular nerve supplies which compartment of the leg?

A

lateral

*fibularis longus and brevis

95
Q

Shin splits are repetitve microtrauma to which muscle?

A

TA - inflammation of muscle reduces blood flow to the muscles and it becomes painful and tender to pressure

96
Q

Injury to common fibular nerve?

A 
paralysis of all anterior muscles of leg plus lateral compartment
(loss of dorsiflexion causes foot drop)
*waddle gait
*swing gait
*high step
97
Q

This nerve can be damaged from wearing tight shoes

A

deep fibular - deep the the extensor retinaculum
pain radiating to 1st dorsal webspace
*usually called ski boot syndrome

98
Q

WHat seperats the posterior muscles into superficaly and deep?

A

transverse intermusclar septum

99
Q

posterior compartment

A

superficial: gastroc, soleus and plantaris
deep: popliteus, FDL, FHL, TP

100
Q

When is the gastroc most efficient

A

when the knee is extended

101
Q

Which tendon in the leg is usually removed for grafting without causing disability

A

plantaris

102
Q

Actions of popliteus

A

weakly flexes the knee and unlocks it by laterally rotating femur on fixed tibia
*may also medially rotate tibia of unplanted limb

103
Q

Which muscle gives the final thrust in order to continue to preswing during gait?

A

flexor hallucis longus
* immediately after the triceps surae has delivered the thrust of plantarflexion to the ball of footm FHL gives flexion of big toe for preswing

104
Q

Main role of Tibilas posteior

A

support the medial longitudinal arch during weight bearing

105
Q

WHICH nerve divides into medial and lateral plantar nerves

A

tibial

Gross Anatomy (4 decks)

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