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ANAT 380 > module 4- lower limb > Flashcards

module 4- lower limb Flashcards

1
Q

where are the lateral rotator muscles located

A

deep to the gluteal muscles

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2
Q

superficial lateral rotator muscles

A

gluteus Medius
gluteus maximus

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3
Q

intermediate lateral rotator muscles

A
  • gluteus Medius
  • lateral rotators
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4
Q

deep lateral rotator muscles

A
  • gluteus minimus
  • lateral rotators
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5
Q

where do the lateral rotator muscles run

A

from the bony pelvis to the greater trochanter and upper posterior femur

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6
Q

what are the lateral rotator muscles

A
  • piriformis
  • obturator internus
  • superior and inferior gemelli
  • quadatrus femoris
  • abturator externus
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7
Q

where does the piriformis attach

A

to the pelvis surface of the lateral part of the sacrum and the femur

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8
Q

where does the piriformis leave

A

the pelvic through the greater sciatic foramen

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9
Q

where does the obturator internus muscle originate

A

obturator membrane of the pelvis

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10
Q

where does the tendon of the obturator interus exit

A

through the lesser sciatic foramen

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11
Q

where does the obturator interus insert

A

on the femur

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12
Q

what is formed with in obturator membrane

A

pudendal canal and carriers structures that supply the perineum

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13
Q

where are the superior and inferior gemelli

A

run above and below the obturator internus

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14
Q

where does the quadratus femoris run

A

from the ischial tuberosity to the femur

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15
Q

where does the obturator externus run

A

from the outer surface of the obturator membrane to the femur

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16
Q

what is better seen from anterior view

A

obturator externus

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17
Q

gemellus pain syndrome

A
  • most common conditions with these muscles
  • they aid in flexion but not their primary function which can make them strained
  • puts pressure on surrounding nerve (posterior femoral cutaneous nerve)
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18
Q

what nerve runs over the gemelli muscles

A
  • posterior femoral cutanous nerve
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19
Q

symptoms of gemellus pain syndrome

A
  • reduced range of motion of hip
  • feeling and sensation to the skin of the posterior thigh from the nerve compression causing numbness in the skin
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20
Q

what are gluteal muscles supplied by

A

branches of the internal iliac artery, primarily the superior and inferior gluteal arteries

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21
Q

what do the vessel go through the supply the guteal muscles

A

greater sciatic foramen, superior and inferior to the pirifiormis muscle and travel along the posterior surface of the ilium, deep to the glute muscles

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22
Q

what do the venous branches of the gluteal muscle drain into

A

internal iliac vein

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23
Q

what is internal iliac artery stenosis (IIAS)

A

consequences of atherosclerosis
- narrowing of the internal iliac arteries reduces blood supply to the structures supplied by branches of the internal iliac artery (superior and inferior gluteal arteries)

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24
Q

symptoms’ of internal iliac artery stenosis

A
  • cramping of muscles in lower back, hip, buttock, thigh further induced by exercise
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25
Q

atherosclerosis

A

buildup of fats, cholesterol, and other substance in an on arterial wall (plaque) which can restrict blood flow

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26
Q

what innervates the gluteal region

A
  • superior gluteal nerve
  • inferior gluteal nerve
  • posterior femoral cutaneous nerve
  • sciatic nerve
  • pudendal nerve
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27
Q

superior gluteal nerve

A

motor innervation too:
- gluteus medius
- gluteus maximus
- gluteus minimus
- tensor fasciae latae

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28
Q

inferior gluteal nerve

A

motor innervation too:
- gluteus maximus

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29
Q

posterior femoral cutaneous nerve

A

sensory innervation:
- skin of the posterior thigh

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30
Q

sciatic nerve

A

muscles that make up the posterior thigh

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31
Q

what is the largest nerve in body

A

sciatic

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32
Q

pudendal nerve

A

motor innervation:
- anal sphincters and the urethral sphincter

sensory innervation:
- perineum
- penis
- scrotum
- labia majora
- clitoris

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33
Q

what is the largest branch of the sacral plexus

A

sciatic nerve (L4,5 and S1,2,3)

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34
Q

pathway of the sciatic nerve: gluteal region

A
  • after forming from the sacral plexus
  • the sciatic nerve leaves the pelvic via the greater sciatic foramen and emerge below the piriformis muscle
  • sciatic nerve runs deep to the gluteus maximus
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35
Q

pathway of the scaitic nerve: posterior thigh

A
  • passes superficial to the lateral rotator muscles
  • enters the posterior thigh deep the hamstrigns
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36
Q

what does the sciatic nerve innervate in posterior thigh

A
  • biceps femoris
  • semimembranosus
  • semitendiosus
  • hamstrings
  • portion of the adductor magnus
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37
Q

piriformis syndrome (sciatica)

A
  • caused by compression of the sciatic nerve by the piriformis muscle
  • where the nerve emerges over the lateral rotator muscles from under the piriformis
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38
Q

symptoms of sciatica

A
  • pain
  • tingling
  • numbness
  • pain in lower back (where spinal nerve converge to form the sciatic nerve) and down thigh
  • pain can be triggered from sitting for prolonged periods, compressing the sciatic nerve
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39
Q

what is the hip joint

A

strong and stable “ball and socket” joint between the head of the femur and the cup-shaped acetabulum of hip bone

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40
Q

important stabilizing elements of the hip joint

A
  • acetabular labrum
  • ligamentum teres
  • fibrous capsule
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41
Q

acetabular labrum

A
  • the cavity of the acetabulum is deepened by a rim of fibrocartilage, the acetabular labrum
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42
Q

by deepening the acetabulum

A

more than half of the femoral head can fit
- improves the stability of the hip joint

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43
Q

ligamentum teres

A

acts as a secondary stabilizer of the hip joint, supplementing the work of the capsular ligament

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44
Q

fibrous capsule

A
  • is a thick and strong group of ligaments that help hold the head of the femur in the acetabulum
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45
Q

how is the fibrous capsule oriented

A

in a spiral fashion around the hip joint so that they tighten during extension and go slack during flexion

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46
Q

what is the weakest in the posterior inferior region

A

fibrous capsule

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47
Q

what is traumatic posterior hip subluxation

A

occurs when the head of the femur is forced partially out of the acetabulum

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48
Q

most common way to get traumatic posterior hip subluxation

A
  • fall on a flexed and adducted hip
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49
Q

symptoms of traumatic posterior hip subluxation

A
  • painful and limited motion
  • fibrous capsule and ligametum teres can be torn or disrupted
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50
Q

traumatic posterior hip subluxation fibrous capsule

A

typically tears in its posterior regions, since it is weaker than the anterior aspect

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51
Q

traumatic posterior hip subluxation radiographs

A

can reveal a characteristic posterior acetabular lip (labrum) fracture

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52
Q

how are the 3 compartment of the thigh formed by

A

intermuscular septa

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53
Q

intermuscular septa

A

fibrous connective-tissue sheets that partition muscle groups in the lower limb

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54
Q

what muscles make up the anterior compartment of thigh

A
  • quadriceps muscles
  • sartorius muscle
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55
Q

what muscles make up the posterior compartment of the thigh

A
  • hamstrings
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56
Q

medical compartment of thigh what is in it

A

contains primarily adduct msucles
- triangular shaped

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57
Q

where do the adductor muscles originate

A

pubis

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58
Q

where do the adductor muscle interset

A

linea aspera of femur

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59
Q

list the medial compartment of thigh muscles

A
  • pectineus
  • adductor brevis
  • adductor longus
  • gracilis
  • adductor magnus
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60
Q

what is the deepest and largest muscle of the medical compartment of thigh

A

adductor magnus

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61
Q

where does adductor magnus insert

A

along the length of the linea aspera

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62
Q

function of the adductor magnus

A

adduction
extend and medically rotate the thigh at hip

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63
Q

adductor hiatus formation

A
  • adductor magnus attaches on the distal part of the femur a smaller hamstring part attaches on the closer part and forms the adductor hiatus
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64
Q

function of the adductor hiatus

A
  • allows the passage of vessels between the anterior and posterior thigh
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65
Q

adductor magnus strain

A
  • common injuries among soccer, hockey, football players
  • occurs from tearing of muscle that happens when muscle has been forced to stretch or contract beyond its limits
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66
Q

symptoms of adductor magnus strain

A
  • limited movement of the hip
  • weird gate
  • pain with adduction, extension or medial rotation of the thigh
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67
Q

what occurs in athletes as result of adductor magnus strain

A

trigger points

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68
Q

localization pain adductor magnus strain: groin

A

deep aching pain may radiate to the pelvis and groin area, near the origin of the adductor magnus

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69
Q

localization pain adductor magnus strain: thigh

A

pain is felt at the front and/or back of the thigh along the body of the muscle

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70
Q

localization pain adductor magnus strain: knee

A

pain may radiate to the knee, near the insertion of the adductor magnus

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71
Q

muscles of the posterior compartment

A

hamstrings

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72
Q

where do posterior compartment muscles originate

A

from the ischial tuberosity of the ischium

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73
Q

where do posterior compartment muscles insert

A

on the posterolateral (fibula) and posteromedial (tibia) aspects of the knee

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74
Q

what are the posterior muscles of thigh responsible for

A

extending the hip and flexing the knee

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75
Q

list the posterior thigh compartment muscles

A
  • semitendinosus
  • semimembranosus
  • biceps femoris
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76
Q

what is the femoral triangle

A

area in the upper anterior thigh that contains major neurovasular strucutres

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77
Q

superior border of femoral triangle

A

inguinal ligament

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78
Q

lateral border of femoral triangle

A

satorius muscle

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79
Q

medial border of femoral triangle

A

adductor longus

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80
Q

muscle floor of the femoral triangle

A

iliopsoas and pectineus

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81
Q

roof of femoral triangle

A

fascia lata

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82
Q

fascia lata

A

a thick connective tissue layer that covers and holds the musculature of the thigh

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83
Q

what does the iliac artery do when is passes deep to the inguinal ligament

A

continues as the femoral artery which supplies branches to the hip and thigh

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84
Q

branches that supply the hip region

A
  • deep femoral artery (profunda femoris)
  • circumflex arteries (multiple branches that anastomose around the neck of femur)
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85
Q

what branches of femoral artery supply the thigh

A
  • profunda femoris artery (deep femoral)
  • superficial femoral artery
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86
Q

profunda femoris artery

A
  • main source of blood supply to the thigh and the femoral supplies rest
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87
Q

femoral vein

A

drains the thigh and the rest of the lower limb

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88
Q

saphenous vein

A
  • longest tributary
  • drains the superficial tissues of most of the lower limb
89
Q

where does the great saphenous vein emptie

A

into the femoral vein in the upper thigh

90
Q

what does the femoral triangle contain

A

femoral artery and femoral vein

91
Q

where does the femoral artery and vein go after femoral triangle

A

adductor hiatus

92
Q

adductor (hunters) canal femoral artery and vein

A

they go through it to the posterior knee where they change their name to popliteal artery and vein

93
Q

avascular necrosis of femoral head

A
  • arises when blood supply to the femoral head (circumfelx arteries) is disrupted
  • caused from trauma to joint or bone
94
Q

what happens from avascular necrosis of femoral head

A
  • necrosis or tissue death
95
Q

avascular necrosis of femoral head symptoms

A
  • none in early stages
  • pain can range from mild to severe
  • affected joint may hurt only during weight bearing activities but eventually pain may persist when lying down
  • pain can go to groin, thigh, buttocks
96
Q

location of avascular neurosis of femoral head + structures involved

A
  • femoral head
  • neck
  • circumflex arteries
97
Q

what supplies innervation to hip and thigh

A
  • femoral nerve
  • obturator nerve
  • lateral cutaneous nerve
  • sciatic nerve
98
Q

femoral nerve

A
  • innervates quadriceps muscles
  • skin on anterior thigh
99
Q

where does femoral nerve run

A

along the femoral artery and vein in the femoral triangle

100
Q

obturator nerve

A
  • innervates muscles of the medial compartment (adductors) by motor branches
  • skin of medial thigh via cutaneous branch
101
Q

lateral cutaneous nerve

A
  • supplies skin on the lateral aspect of the thigh above the knee
102
Q

sciatic nerve

A
  • innervate to hamstring muscles
103
Q

obturator nerve entrapment

A
  • can occur from many reasons such as inflammation of the adductor muscels
  • bc it travels between the adductor longus and adductor brevis its susceptible to impingment
104
Q

pain of obturator nerve entrapment

A

can follow the course of the nerve along the medial thigh and can radiate to the groin and/or knee

105
Q

sensory changes of obturator nerve entrapment

A

cutaneous branches of this nerve supply the skin of the medial thigh hence, individuals may experience numbness and paresthesia

106
Q

motor change obturator nerve entrapment

A
  • impingement can lead to adductor weakness, limited range of motion at hip joint, and pain that worsens with activity
107
Q

what is the point of ligament in the knee joint

A
  • provides stability and support its movements
108
Q

what are the ligaments of the knee

A
  • patellar ligament
  • collateral ligament
  • cruciate ligament
109
Q

patellar ligament

A
  • continuation of the quadriceps tendon
  • keep the patella in proper position
110
Q

what are the 2 collateral ligaments

A

medial collateral ligament
lateral collateral ligament

111
Q

function of collateral ligaments

A

stabilize the hinge motion of the knee, preventing excessive medial or lateral movement

112
Q

medial collateral ligament

A

joins the distal demur to the proximal tibia

113
Q

lateral collateral ligament

A

joins the distal femur to the head of the fibula

114
Q

what are the 2 cruciate ligaments

A
  • anterior cruciate ligament
  • posterior cruciate ligament
115
Q

what are the cruicate ligaments

A

deep ligaments of the knee that prevent the femur and tibia from sliding forwards or backwards

116
Q

anterior cruciate ligament (ACL)

A

prevents anterior disolcation of the tibia on the fixed femur

117
Q

posterior cruciate ligament (PCL)

A

prevents posterior dislocation of the tibia on the fixed femur

118
Q

what are the menisci

A
  • C-shaped
  • fibrocartilaginous pads on the condyles of the tibia
  • deep to the articular surface of the tibia
  • increase stability
  • shock absorbers
119
Q

what are the 2 meniscus

A

medial
lateral

120
Q

medial meniscus tear

A
  • injured or torn from jumping, changing direction quick, rotation of the knee
121
Q

symptoms of medial meniscus tear

A
  • popping sensation
  • pain to localized area
  • swelling + stiffness
  • loss of cushioning makes movements, difficult and painful
122
Q

what are the posterior compartment of the leg responsible for

A
  • plantarflexing foot and ankle
123
Q

muscles of the posterior compartment of leg

A
  • popliteus
  • gastronemius
  • plantaris
124
Q

popliteus

A
  • deepest muscle of posterior compartment
125
Q

origin of popliteus

A

lateral femur

126
Q

insertion of popliteus

A

posterior surface of tibia

127
Q

gastrocnemius origin

A
  • has 2 heads that oringinate on the medial and lateral sides of the femur
128
Q

insertion of gastrocnemius

A

the calcaneus

129
Q

function of the gastronemius

A
  • cross to joints so flexs the leg and foot
130
Q

plantaris origin

A

posterolateral femur

131
Q

insertion of plantaris

132
Q

what is the popliteual fossa

A
  • diamond shaped area of the knee
  • nerve and vessel travel between the thigh and knee found here
133
Q

medial border of the popliteal fossa

A

semimbranosus

134
Q

lateral border of popliteal fossa

A

biceps femoris

135
Q

where is the plantaris in the popliteal fossa

A

lateral inferior

136
Q

inferior lateral border of popliteal border

A

lateral head of gastrocenemius

137
Q

medial inferior border of the popliteal border

A

medial head of gastrocnemius

138
Q

muscles in the popliteal border

A
  • semimbranosus
  • biceps femoris
  • plantaris
  • lateral head of gastrocnemius
  • medial head of gastrocemius
139
Q

medial gastrocnemius strain

A
  • high risk because it crosses 2 joints and injuried alot in sports
140
Q

symptoms of medial gastrocnemius strain

A
  • calf pain
  • possible budge
  • tenderness
  • pain and weakness when flexing the leg at the knee joint
141
Q

what suppleis the knee and leg

A

branches of femoral artery
branches of femoral vein

142
Q

branches off femoral artery that supply the knee and leg

A
  • popliteal artery —> anterior tibial artery
  • posterior tibial artery
  • fibular artery (peroneal artery)
143
Q

popliteal artery

A

continuation of the femoral artery and found in the popliteal fossa

144
Q

anterior tibial artery

A

branch off popliteal artery
- supplies anterior compartment of leg

145
Q

posterior tibial artery

A

supplies posterior compartment of leg

146
Q

fibular artery (peroneal arterty)

A

supplies lateral compartement of leg

147
Q

branches of the femoral vein that drain the knee and leg (order of draining)

A
  • fibular vein–>posterior tibial vein–> anterior tibial vein–> popliteal vein–> femoral vein
  • small saphenous vein–>great saphenous vein–>popliteal vein–> femoral vein
148
Q

fibular vein

A

drains lateral compartment of leg

149
Q

posterior tibial vein

A

drains the fibular vein and posterior compartment of leg

150
Q

anterior tibial vein

A

drains the anterior compartment of leg

151
Q

small saphenous vein

A

drains from lower leg into popliteal vein
- (short or lesser saphenous vein)

152
Q

great saphenous vein

A

drains the superifical tissue of most of the lower limb

153
Q

popliteal vein

A

found in popliteal fossa and drains into the femoral vein

154
Q

deep vein thrombosis

A

involves the formation of a blood clot in a deep vein
- from decreased blood flow increased tendency to clot, injury to blood vessel

155
Q

risk factors of deep vein thrombosis

A
  • age
  • obesity
  • trauma
  • lack of movement
  • use of birth control
156
Q

symptoms of deep vein thrombosis

A
  • pain that starts in calf
  • cramp or soreness
  • red vein or discolored on skin
  • warm and swollen
157
Q

what innervate the knee and leg

A
  • sciatic nerve splits to form tibial and common peroneal nerves at the distal thigh
158
Q

common peroneal (fibular nerve)

A

innervates the muscles of lateral and anterior compartments of the leg

159
Q

tibial nerve

A

descends posteriorly through popliteal fossa and innervates the muscles of the posterior leg

160
Q

branchs of the common peroneal (fibualr) nerve

A

superficial fibular nerve
deep fibular nerve

161
Q

superifical fibular nerve

A

innervates muscles of the latereal compartment of leg

162
Q

deep fibular nerve

A

innervates muscles of the anterior compartment of the leg

163
Q

contents of the popliteal fossa

A
  • popliteal artery
  • popliteal vein
  • tibial nerve
  • common peroneal nerve
164
Q

common peroneal nerve dysfunction

A

occurs when there is damage to the peroneaal (fibular) nerve leading to loss of movement or sensation in the foot and leg
- truama or injury to the knee
- impairment to the foot (drop foot, impaired gait)

165
Q

what nerve could be affect from medial gastrocneumius strain

A

posterior tibial artery , tibial nerve

166
Q

functions of bones in the foot

A

faciliate movement of the foot while bearing the weight of the body

167
Q

list the tarsal bones

A
  • calcaneus
  • talus
  • cuboid
  • navicular
  • intermediate, lateral, medial cuneiforms
168
Q

this larger bone, the _____ is part of the ankle joint

169
Q

the ____ bone is a good landmark because of its long rectangular shape

170
Q

this bone, the ____ articulates with the first metatarsal

A

medial cuniform

171
Q

the ____ articulates with the second metatarsal

A

intermediate cuniform

172
Q

the ______ articulates with the third metatarsal

A

lateral cuneiform

173
Q

this square shaped bone, the ____ is almost as thick as it is wide

174
Q

the _____ forms the heel of the foot

175
Q

stress facture

A

is a small crack in a bone or serve bruising within a bone
- it is NOT a complete break
- caused by overuse and repetitive activity

176
Q

where do stress fractures occur

A

in bones with weight bearing functions
- second and third metatarsal bones of the foot recieve the greatest impact of force as you push ass when walking/running
-

177
Q

symtpom of stress fracture

A

pain that worsens with weight bearing activity, and dimishes during rest
- swelling
- difficulty walking and performing low impact activities (climbing stairs)
- can be difficult to see on x-ray due to their size

178
Q

what is the ankle joint

A

is a synovial joint located in the lower limb

179
Q

what makes the ankle joint

A

bones of the leg (tibia and fibula) articualting with the foot (talus)
- tibia and fibula together form a joint in which the talus sits

180
Q

what does the ankle joint do

A

hinge joint permitting dorsiflexion and plantarflexion of the foot
- strengthened by tendons and ligament

181
Q

what do ligament of the foot and ankle do

182
Q

ligaments of the foot

A
  • deltoid
  • spring
  • plantar fascia
183
Q

what does the deltoid ligament do

A

help stabilize the ankle during plantar flexion, external rotation and pronation of the foot to prevent overstrtching of muscles

184
Q

where is the deltoid ligament

A

runs between the tibia and talus

185
Q

what does the spring ligament do

A

(calcaneonavicular) stabilizes the medial longitudinal arch and the talus

186
Q

where is the spring ligament

A

runs between the navicular and calcaneus bone

187
Q

what is the longest ligament in the foot

A

planatar fascia

188
Q

what does the plantar fascia do

A

thick fascia helps support the medial longitudinal arch of the foot

189
Q

deltoid ligament sprain

A

caused by sudden rotation o the ankle

190
Q

symptoms of deltoid ligament sprain

A
  • pain of medial ankle
  • swelling
  • bruising
  • damage to ligament and surrounding structures
  • difficulty walking
  • bearing weight
191
Q

what can the muscles in the foot be divided into

A

extrinsic and intrinsic muscles

192
Q

intrinsic muscles of the foot location

A
  • sole of the foot
193
Q

function of the intrinsic muscles of foot

A

stabilize the arches of the foot
- individually control movement of the digitis

194
Q

where are extrinsic muscles/location

A

arise from the anterior, posterior, and lateral, compartment of the leg

195
Q

function of extrinsic muscles

A
  • eversion
  • inversion
  • plantar flexion
  • dorsiflexion
196
Q

tibialis posterior muscles

A

is an important extrinsic muscle attaching onto the navicular in the foot

197
Q

posterior tibial tendonitis

A
  • very important tendon of the leg functioning to support the medial longitudinal arch of the foot during walking
198
Q

what can cause posterior tibial tendonitis

A
  • acute injury
  • fall
  • overuse
    can tear it or become inflamed
199
Q

what usually happens with posterior tibial tendontitis

A

the medial longitudinal arch may slowly fall (collapse) over time

200
Q

symptoms of posterior tibial tendinitis’s

A
  • pain around foot and ankle
  • swollen, warm, red
  • prone to rolling medially (ankle) and toes and foot rotate laterally
201
Q

what 2 main arteries supply the ankle and foot

A
  • dorsalis pedis artery
  • posterior tibial artery
202
Q

where does the dorsalis pedis artery come from and supply

A
  • branch of the anterior tibial artery
  • supplies the dorsum of the foot
203
Q

what does the posterior tibial artery supply

A

plantar surface of the foot

204
Q

what is the dorsal surface of the foot drained by

A

dorsal venous arch

205
Q

what does the dorsal venous arch drain into

A

small saphenous vein laterally and the great saphenous vein medially

206
Q

what does the dorsal venous arch drain

A

distal surfaces of the foot, such as the toes, via smaller branches

207
Q

varicose veins

A
  • are twisted, enlarges veins caused by weak or damaged valves in the veins
  • can cause backflow and pooling of blood in the vein
  • causing them to stretch or twist
208
Q

early stages of varicose veins

A
  • simply a cosmetic concern
209
Q

lateral stages of varicose veins

A

can cause uncomfortable symptoms such as aching pain and discomfort due to the pooling of the blood
- possible permanent damage to the veins

210
Q

innervation to the ankle and foot

A

tibial nerve
deep fibular nerve
superficial fibular nerve

211
Q

where does the tibial nerve travel

A

descends in the posterior compartment of the leg supplying the muscles and enters the foot

212
Q

what does the tibial nerve innervate

A

intrinsic muscles of the plantar surface of foot

213
Q

where does the deep fibular nerve travel

A

descends into the anterior compartment of the leg

214
Q

what does the deep fibular nerve suuply

A

muscles and part of the skin on the dorsum of foot

215
Q

where does the superficial fibular nerve travel

A

descends in the lateral compartment of the leg

216
Q

what does the superficial fibular nerve supply

A

muscles and the skin of the lower anterior leg and most skin on the dorsum of the foot

217
Q

tibial nerve dysfunction

A

occurs when there is damage to the tibial nerve, which supplies muscles of the leg
- loss of movement or sensation in the foot
- caused from trauma, continuous pressure on the nerve for a long period of tome, pressure on the nerve from nearby structures and overuse

218
Q

symptoms of tibial nerve dysfunction

A

changes in sensation to the skin on the sole of the foot (burning, numbness, tingling)
- pain in sole of foot and toes
- changes in motor innervation can manifest as weakness of muscles that plantarflex the foot at the ankle joint

ANAT 380 (9 decks)

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