Module 3: Unit 4 — ANATOMY LE CARDS Flashcards
What is the innervation of Poas major?
Femoral nerve made of L2-L4 nerve segments
What are the actions and innervation of the muscles in the anterior thigh compartment of the leg?
With the exception of what muscle?
Flexion of the hip and extension of the knee *not all muscles but most!
Innervation: Femoral nerve (L2-L4 segments)
Exception is the pectineus because 2/3 of the time the femoral nerve innervates it and 1/3 of the time obturator nerve innervates it
What muscles insert at the PES ANSERINUS? 3 muscles
Sartorius, gracilis, semitendinosus
What are the actions of the sartorius muscle?
Flexion of the hip, abduction of the hip, externally (lateral) rotate the hip (Crossing leg over opposite knee)
When knee is flexed it helps with internal rotation of tibia
What are the actions of the sartorius muscle?
Flexion of the hip, abduction of the hip, externally (lateral) rotate the hip (Crossing leg over opposite knee)
When knee is flexed it helps with internal rotation of tibia
What is the primary hip flexor? And what two muscles form this?
What is the action of this muscle?
Iliopsoas = Iliacus and Psoas Major
Flexion of the hip
Name the quadriceps muscles; O: and shared I:
What is the only quadricep muscle that crosses the hip and the knee?
Rectus femoris - *The only quadriceps muscle that crosses the hip and the knee
O: AIIS
A: Flexion of hip, Extension of knee
Vastus Lateralis - O: greater trochanter and upper lateral surface of linea aspera
Vastus Medialis -O: Intertrocanteric line and medial lip of linea aspera
Vastus Intermedius - upper two thirds of the anterior and lateral surfaces of the femur
I: patella via the quadriceps tendon
What muscles make up the medial compartment? What action and innervation associate with this region.
- Adductor longus
- Adductor brevis
- Adductor magnus (rule breaker! Because its N: by obturator nerve and sciatic nerve tibial division)
- Gracilis (O:pubis symphisis, I: MPATS = PES ANS.)
A: adduction
N: obturator nerve (L2-L4)
What muscle is deep to the pectineus, and where does it get its name from? What is the action of this muscle?
Obturator Externus, got its name because its attaching originating on the external surface of the obturator foramen and obturator fascia
A: laterally rotate the hip
I: posterior aspect of femur
What muscle is primary extensor of the hip? And what are all of its actions, O:, I:
Gluteus Maximus
A: hip extensor, lateral rotator, abductor, adductor
Upper fibers insert into IT band and the IT band inserts on the proximal lateral tibial shaft. Lower fibers insert into the gluteal tuberosity.
What three muscles contribute to balancing the pelvis? What test involves these muscles?
Gluteus medius
Gluteus minimus
TFL
Trendelenburgs gait/sign = when you lift one foot off the ground (Like marching) and the hip falls. It’s the inability to hold the pelvis horizontal when ambulating and when walking.
——> can indicate damage to the muscle or to the nerve
—> when the hip drop is on one side, it is the opposite side nerve or muscles that are affected.
Name the O: and I: of the piriformis aaand the origin of the nerve that N: the piriformis.
O: anterior aspect of lateral sacrum
I: greater trochanter
N: nerve to the piriformis WHICH comes from the sacral plexus which is made up of the L4-S4
A: lateral rotation
Name the N: of the piriformis, quadratus femoris,
Obturator internus, obturator externus, gemellus superior, gemellus inferior and the A: of all muscles.
Piriformis N: nerve to piriformis (sacral plexus)
Quadratus femoris N: nerve to QF (sacral plexus)
Obturator internus N: nerve to OI (sacral plexus)
Obturator externus N: posterior branch of obturator nerve
Gemellus superior N: nerve to obturator internus (sacral plexus)
Gemellus inferior N: nerve to Quadratus femoris (sacral plexus
A: all muscles laterally rotate the hip
What nerve innervates the posterior compartment of the thigh and what are the actions of those muscles?
N: Sciatic nerve tibial division
A: Extension of hip, flexion of knee
What muscle of the posterior thigh attaches to the medial meniscus?
Semimembranosus
Name the I: and N: of the biceps femoris long head.
What is the A: and N: of the bicep femoris short head?
I: Lateral head of the fibula
N: Scatic nerve tibial division
BF short head - A: flexion and lateral rotation of knee
N: Sciatic nerve common fibular division
Where is the adductor hiatus? And what does it do?
Gap located on the inferior portion of the adductor magnus is the adductor hiatus
This opening allows for the femoral nerve and vein to pass through on their way to the leg. Once it passes through it becomes the popliteal artery
What are the actions of the muscles in the posterior compartment of the leg?
A: little bit of knee flexion, MAINLY plantar flexion and flexion of the digits
Name the O: of the gastrocnemius
Medial and lateral head originates on the distal femur crossing the knee. Assists in knee flexion
The plantaris muscle I: where?
*goes lateral to medial
O:
I: medial to the calcaneus tendon
What is another name for the Achilles tendon?
Calcaneal tendon
Together the gastrocnemius and soleus form what?
Triceps surae
All posterior leg muscles are N: by what nerve
Tibial nerve
What are the three deep muscles of the posterior leg from lateral to medial?
WHERE TO THEY ORIGINATE AND INSERT?
In what order do they pass through the tarsal tunnel?
- Flexor hallucis longus,
O: Inferior two-thirds of the posterior fibula
I: Inferior surface fo the distal phalanx of digit 1 - Tibialis posterior,
O: posterior surface of tibia, and superior two-thirds of the medial surface of the fibula
I: tuberosity on navicular bone and slips to cuneiforms, cuboid, and metatarsals 2-4 - Flexor digitorum longus
O: Posterior surface of the tibia
I: inferior surfaces of the distal phalanges of digits 2-5
ORDER OF passing through tunnel - Tom, Dick, Harry
T first, D second, H last (most posterior)
O: and I: of the quadratus plantae
O: Medial and lateral sides of the calcaneus
I: the two portions join and end in the flat tendon band at the tendon of the flexor digitorum longus
What are the actions of the muscles of the left lateral compartment of the lower leg
A: eversion and plantar flexion
Where does the fibularis longus insert? And what is its action?
I: Base of metatarsal 1
A: eversion of foot, assists in plantar flexion
Where does the fibularis brevis insert? What is its action
I: base of 5th metatarsal
A: weak eversion
What are the actions of the muscles in the anterior compartment of the leg?
Dorsiflexion and extension of digits
Where does the tibialis anterior insert?
Base of metatarsal 1 and cuneiform
Where does the fibularis tertius insert?
Dorsal surface of the base of metatarsal 5
What are the foot arches referred to as?
Medial longitudinal arch, lateral longitudinal arch, and transverse arch (on top of foot)
In the thigh: lumbar plexus (T12, L1-L4)
Name the divisions of the anterior compartment, medial compartment, and posterior compartment.
AC - femoral nerve (L2-4)
MC - Obturator nerve (L2-4)
PC - sciatic nerve tibial division (L4-S3)
In the sacral plexus (L4-S4)
Name the nerves and their divisions within the anterior compartment, lateral compartment, and posterior compartment of the leg
AC - Deep fibular nerve (L4-S2)
LC - superficial fibular nerve (L4-S1)
PC - Tibial nerve (L4- S3)
In the gluteal region: sacral plexus (L4-S4)
Name the divisions for the superior gluteal nerve and inferior gluteal nerve
SGN - L4-S1
IGN - L5-S2
What is the division of the tibial nerve?
NOTE; same as sciatic nerve
L4-S3
What is the division for the common fibular nerve?
L4-S2
What is Hilton’s law?
Nerves supplying muscles that cross a joint innervate the joint and the skin overlying the muscle
Draw out dermatonal segment nerve innervations on slide 41*
What makes up the femoral triangle?
What structures run through the femoral triangle?
Borders: inguinal ligament, medial border of sartorius, medial border of adductor longus
Femoral artery, nerve, vein, and lymphatics
Where or at what point does the femoral artery terminate?
Adductor hiatus
What is the profunda femoris? What are the branches of the profunda femoris?
Deep femoral artery = largest branch
Medial femoral circumflex - wraps around femoral head, forms cruciate anastomosis with lateral femoral circumflex, inferior gluteal artery
Lateral femoral circumflex - wraps around lateral side of femoral head/neck, supplies vastus lateralis
Perforating branches
When the femoral artery goes through the adductor hiatus is becomes _____________?
Popliteal artery
What are the tiny branches coming off the popliteal artery called?
Genicular arteries - “Genuflect show some respect get down on one kneeeee”
^ forms an anastomosis around the knee
The popliteal artery splits into what? And what does this supply?
Posterior tibial artery supples posterior and lateral compartments of leg
Anterior tibial artery runs with the deep fibular nerve and supply the anterior compartment
What are the division of veins in the LE?
Superficial veins
— Great saphenous (longest vein in the body, medial aspect of leg and thigh, ends when passing through saphenous hiatus)
— Small saphenous (passes around lateral malleolus, drains lateral foot, lateral leg, ends as a tributary to popliteal vein)
Name the deep veins of the LE.
Plantar digital
Posterior tibial and fibular
Anterior tibial
Popliteal
Femoral profunda femoris
*ALL OF THE DEEP VIENS SHARE THE SAME NAME OF THE ARTERY THAT THEY TRAVEL WITH
Name the common vascular conditions associated with veins.
Atherosclerosis
Arteriosclerosis
Peripheral artery disease
Varicose veins
Deep vein thrombosis (slow return of veins blood and forms clots, can then become embolism)
Which joint connects the pelvis to the femur?
A. Patellofemoral joint
B. Sacroiliac joint
C. Femoroacetabular joint
C
What type of joint is the knee joint?
Hinge
The ankle joint primarily allows which type of movement?
A. Rotation
B. Flexion and extension
C abduction and adduction
D. Plantarflexion and Dorsiflexion
D
Which joint allows for the greatest ROM in the lower extremity?
A. Knee joint
B. Hip joint
C. Ankle joint
B
The subtalar joint is responsible for which type of movement?
A. Abduction and adduction
B. Flexion and extension
C. Eversion and inversion
C
What is the primary function of the patella in the knee joint?
A. Lever for knee extension
B. Stability
C. Protection
D. Chock absorption
A
Which of the following structures helps stabilzize the hip joint?
A. Acetabulum labrum
B. Synovial membrane
C. Menisci
D. Bursa
A
Which of the following connects the tibia and fibular distally?
A. Hip joint
B. Knee joint
C. Syndesmosis joint
D. Talocrurual joint
C
Which vessel is a continuation of the external iliac artery as it passes under the inguinal ligament?
Femoral artery
Which muscle is responsible for the abduction of the thigh?
A. Adductor magnus
B. Iliopsoas
C. Gluteus medius
C
The popliteal artery is a continuation of which artery?
Femoral artery
Which of the following structures does not pass through the greater sciatic foramen?
A. Sciatic nerve
B. Superior gluteal nerve
C. Inferior gluteal nerve
D. Femoral artery
D
The quadratus plantae is found in which layer of intrinsic foot muscles?
A. 1
B. 2
C. 4
D. 3
B
Which structure does not participate in the medial longitudinal arch?
A. Tibialis anterior
B. Fibularis tertius
C. Fibularis longus
D. Quadratus plantae
B
A pts right hip drops while walking (Trendelenburg Gait/sign). Which nerve is most likely affected?
A. R inferior gluteal
B. R superior gluteal
C. L superior gluteal
D. L inferior gluteal
C
The lateral border of the femoral triangle is formed by ______
Sartorius
Name the layer, nerve, and action of the abductor hallucis.
Layer - 1st layer
Nerve - medial plantar nerve
Action - Abducts big toe
Name the layer, nerve, and action of the abductor digit minimi.
Layer - 1st layer
Nerve - Lateral planar nerve
Action - Abducts 5th digit
Name the layer, nerve, and action of the flexor digitorum brevis.
Layer - 1st
Nerve - medial plantar
Action - flexes the lateral 4 digits
Name the layer, nerve, and action of the quadratus plantae
Layer - 2nd
Nerve - lateral plantar
Action - assists in flexor digitorum longus flexing the toes
Name the layer, nerve, and action of the lumbricals
Layer - 2nd
Nerve - 1st lumbricals (medial plantar nerve) 2nd-4th lumbricals (lateral plantar nerve)
Action - flexion of metatarsal phalangeal joints
Name the layer, nerve, and action of the flexor hallucis brevis
Layer - 3rd
Nerve - medial plantar nerve
Action - flexes big toe
Name the layer, nerve, and action of the adductor hallucis
Layer - 3rd
Nerve - lateral plantar nerve
Action - adducts the big toe
Name the layer, nerve, and action of the flexor digiti minimi brevis
Layer - 3rd
Nerve- lateral nerve
Action - flexes 5th digit
Name the layer, nerve, and action of the opponents digiti minimi
Layer - 3rd
Nerve - lateral plantar nerve
Action - opposes the 5th digit
Division of sacral plexus
L4-S3 (sciatic nerve)
Tibial nerve (L4-S3)
Common Fibular Nerve (L4-S2)
Division of the lumbar plexus
T12-L4
Branches of profunda femoris include:
Medial femoral circumflex
Lateral femoral circumflex
What do they supply blood to?
Medial femoral circumflex - Iliacus
Lateral femoral circumflex - vastus lateralis, vastus intermedius, rectus femoris, TFL, TVI
The medial circumflex femoral artery innervates what muscle?
Iliacus
The lateral circumflex femoral artery innervates what muscles?
TVI (tensor vastus intermedius)
Rectus femoris
Vastus lateralis
Vastus intermedius
TFL
The obturator artery innervates what muscles?
Pectineus
Gracilis
Adductor longus
Adductor brevis
Adductor magnus
Obturator externus
The femoral artery innervates what muscles?
Vastus medialis
Articularis genu
The deep femoral (profunda femoris) artery innervates what muscles?
Adductor magnus (hamstring head)
Biceps femoris (long head)
Biceps femoris (short head)
Semitendinosus
Semimembranosus
The fibular artery innervates what muscles?
Fibularis longus
Fibularis brevis
Flexor hallucis longus
What muscles are innervated by the anterior tibial artery?
Tibialis anterior
Extensor hallucis longus
Extensor Digitorum longus
Fibularis tertius
The quadratus femoris and Gemellus inferior are innervated by what artery and nerve?
Artery - Inferior gluteal artery
Nerve - Nerve to the quadratus femoris (sacral plexus)
The gemellus superior and obturator internus are innervated by what nerve and artery?
Nerve - Nerve to the Obturator internus
Artery - Inferior gluteal artery
Name the insertions for the piriformis, obturator internus, obturator externus, gemellus superior, and gemellus inferior.
ALL GREATER TROCHANTER
