Morphological plan of the lower limb Flashcards
Describe the function of the lower limb in bipedal organisms
Locomotion
Weight bearing
Stresses
Describe the movement of the lower limb during development
Medial rotation
Where are the extensors in the lower limb?
Anterior
Where are the flexors in the lower limb?
Posterior
What is the importance of the flexors and extensors?
Good propulsion
What happens to the lower limb in weeks 6-8 of development?
Brings the posterior compartment anterior
Describe the skeleton in the lower limb
Pelvis Femur Fibia and tibia Tarsal bones (x7) Metatarsals (x5) Phalanges (x14)
Name some important landmarks on the pelvis
Anterior superior iliac spine Anterior inferior iliac spine Pubis Ischiopubic ramus Obturator foramen Ischial tuberosity Greater sciatic foramen Greater sciatic notch Acetabulum
Name some ligaments on the pelvis
Sacrotuberous ligament
Sacrospinous ligament
List the landmarks on the anterior of the femur
Head Neck Intertrochanteric line Adductor tubercle Medial epicondyle Lateral epicondyle
List the landmarks on the posterior of the femur
Greater trochanter Intertrochanteric crest Lesser trochanter Gluteal tuberosity Linea aspera Lateral and medial condyles
List the landmarks on the fibula
Lateral condyle
Lateral malleolus
List the landmarks on the tibia
Medial condyle
Tibial tuberosity
Medial malleolus
List the bones in the foot
Tarsals
Metatarsals
Phalanges
List the limb movements in the lower limb
Flexion/extension Abduction/adduction Lateral/medial rotation Pronation/supination Circumduction
What movement isnt present in the lower limb?
Opposition
Name the joints in the lower limb
Hip joint
Ankle joint
Knee joint
Joints of the foot
What movements does the ankle joint facilitate?
Dorsiflexion (or extension)
Plantarflexion (or extension)
What movements do the joints of the foot facilitate?
Eversion, inversion
Supination, pronation
Extension, flexion
List the functional compartments of the lower limb
Gluteal
Thigh
Leg
Foot
Name the 3 major gluteal muscles
Gluteus maximus
Gluteus medius
Gluteus minimus
What movement does gluteus maximus facilitate?
Extensor + lateral rotator
What movements does gluteus medius do?
Abductor + medial rotator
What movements does gluteus minimus facilitate?
Abductor + medial rotator
What does gluteus maximus also support and how?
Extended knee via the iliotibial tract
What are the gluteal muscles important for?
Locomotion
Give the origin of gluteus maximus
Ilium
Give the insertion of gluteus maximus
Gluteal tuberosity
Iliotibial tract
Which nerve supplies gluteus maximus?
Inferior gluteal nerve
Where do gluteus medius and minimus originate?
Ileum
Where do gluteus medius and minimus insert?
Greater trochanter of the femur
What are gluteus medius and minimis innervated by?
Superior gluteal nerve
What are the small muscles of the gluteal region equivalent to?
Rotator cuff
What is the function of the small muscles of the gluteal region?
Stabilize the hip
Lateral rotation of the extended thigh
Where do the small muscles of the gluteal region originate?
Sacrum (piriformis) and ischium/ischipubic ramus
Where do the small muscles of the gluteal region insert?
Greater trochanter of the femur
What are the small muscles of the gluteal region innervated by?
Sacral plexus
List the muscles found in the anterior compartment of the thigh
Quadriceps Rectus femoris Vastus lateralis Vastus medialis Vastus intermedius Sartorius
Where do the muscles in the anterior compartment of the thigh originate?
Anterior inferior iliac spine and femur
Where do the muscles in the anterior compartment of the thigh insert?
Tibial tuberosity
What are the muscles in the anterior compartment of the thigh innervated by?
Femoral nerve
Where does sartorius originate?
Anterior superior iliac spine
Where does sartorius insert?
Tibia
What muscles are found in the posterior compartment of the thigh?
Hamstrings
Biceps femoris
Semimembranosus
Semitendinosus
Where do muscles in the posterior compartment of the thigh originate?
Ischial tuberosity
Where do muscles in the posterior compartment of the thigh insert?
Tibia or fibula
What are the muscles in the posterior compartment of the thigh innervated by?
Sciatic nerve
What movements do the muscles in the posterior compartment of the thigh facilitate?
Flex knee
Extend hip
Medial rotation
Lateral rotation
List the muscles in the medial compartment of the thigh
Pectineus Adductor longus Adductor brevis Adductor magnus Gracilis
Where do muscles in the medial compartment of the thigh originate?
Pubis and ischium
Where do muscles in the medial compartment of the thigh insert?
Linea aspera
Which nerve innervates the muscles in the medial compartment of the thigh except pectineus and hamstring part of adductor magnus?
Obturator nerve
What two parts form adductor magnus?
Adductor part
Hamstring part
Give the origin and insertion of the adductor part of adductor magnus
Ischiopubic ramus to linea aspera
Give the origin and insertion of the hamstring part of adductor magnus
Ischium to adductor tubercle
What movements does the medial compartment of the thigh facilitate?
Adduction
Medial rotation
Extension
Which muscles facilitate flexion of the thigh?
Rectus femoris
Sartorius
Iliopsoas (iliacus and psoas major)
Which muscles facilitate abduction of the thigh?
Gluteus medius
Gluteus minimus
Which muscles facilitate extension of the thigh?
Gluteus maximus
Hamstrings
Hamstrings part of adductor magnus
Which muscles facilitate adduction of the thigh?
adductor longus Adductor brevis Adductor part of adductor magnus Pectineus Gracilis
Which muscles facilitate medial and lateral rotation of the thigh?
Gluteal muscles
Hamstrings
Adductors
Short rotators
What nerve roots form the lumbar plexus?
Anterior rami of L1 to L4
What nerve roots form the sacral plexus?
Anterior rami of L4 and L5 via lumbosacral trunk
Anterior rami of S1 to S4
Which nerve roots form the femoral nerve?
L2-L4
Which nerve roots form the sciatic nerve?
L4-S3
Which nerve roots form the obturator nerve?
L2-L4
Where does the femoral nerve originate?
From lumbar plexus
What does the femoral nerve do?
Motor - Anterior compartment of the thigh
Sensory - skin over anterior thigh, knee, medial side of leg and foot
Where does the obturator nerve come from?
Lumbar plexus
What does the obturator nerve do?
Motor - Medial compartment of the thigh (except hamstring part of adductor magnus and pectineus)
Sensory - Skin over medial thigh
Where does the sciatic nerve come from?
Sacral plexus
What does the sacral nerve do?
Motor: Posterior compartment of thigh, and leg and foot
(+hamstring part of adductor magnus)
Sensory: Skin over leg and foot (except medial side)
Describe the blood supply of the lower limb
External iliac artery crosses inguinal ligament to become the femoral artery which gives off a profunda femoris artery to the posterior thigh. The femoral artery continues as the popliteal artery which divides into anterior and posterior tibial arteries.
What passes through the femoral triangle?
Femoral artery
Femoral vein
Lymphatics
Where do the lymphatics pass?
Femoral canal
What surrounds the femoral artery and vein?
Femoral sheath
What is the femoral triangle bordered by?
Inguinal ligament
Sartorius
Adductor longus
What is the clinical significance of the femoral triangle?
Femoral hernia
Angioplasty
Femoral nerve block
Venepuncture
Which muscle overlies the femoral artery?
Adductor magnus
Describe the venous drainage of the lower limb
Deep veins follow arteries
Two major superficial veins:
- Great or long saphenous vein
- Small or short saphenous vein
- Drain dorsal venous arch of foot
What is the clinical significance of the veins in the legs?
Varicose veins - damage to the valves in perforating veins leads to pooling of blood in superficial veins - varicosities
Describe the great saphenous vein
Longest vein in body
Drains medial side of arch
Medial side of limb
Drains into femoral vein in femoral triangle
Describe the short saphenous vein
Drains lateral side of arch
Pierces deep politeal fascia
Drains into popliteal vein
Name the two lymph nodes in the leg
Superficial inguinal nodes
Deep inguinal nodes
What do the superficial inguinal nodes drain?
Drain skin and superficial fascia of lower limb
What do the deep inguinal nodes drain?
Beside femoral vein