Morphology of lower limb Flashcards

1
Q

Comparison to upper limb

A

Lower climb are closer

Extensors are anterior, flexors posterior

  • Due to medial rotation during development (6-8)
  • Allows better propulsion whilst walking and running.
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2
Q

Pelvis

A

Anterior superior/Inferior iliac spine (ASIS, AIIS)

Pubis

Ischipubic ramus
Ischial tuberosity

Obturator canal

Greater sciatic foramen

  • Greater sciatic notch
  • Sacrotuberus ligament
  • Sacrospinous ligament

Acetabulum
- Articulates with femur head

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3
Q

Femur

A

Head and neck
- Neck allows femur to be slightly adducting=stability

Greater and lesser trochanter (posterior)

Gluteal tuberosity- posterolateral
- Gluteus maximus inserts

Linea aspera (posterior)
- Insertion for adductor muscles

Lateral and medial epicondyle

Condyles

Adductor tubercle
- Above medial epicondyle

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4
Q

Tibia and fibula

A

Tibia

  • Condyles- articulates with condyles of the femur to form knee
  • Tibial tuberosity- quadriceps insertion
  • Medial malleolus

Fibula
- Lateral malleolus

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5
Q

Foot skeleton

A

7 tarsals

5 metatarasals

14 phalanges

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6
Q

Lower limb movements

A

All movements except opposition

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7
Q

Hip joint

A

Ball and socket

  • Extension/ flexion
  • Lat and med rotation
  • Add/abduction
  • Circumduction
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8
Q

Knee joint

A

Hinge joint

  • Flex and extend
  • Small lat and med rotation when flexed at knee
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9
Q

Ankle joint

A

Dorsiflexion (extension)

Plantarflexion (flexion)

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10
Q

Foot joints

A

Movements

  • Eversion, inversion
  • Adduct and abduct
  • Flex extend
  • Supination and pronation
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11
Q

Gluteus maximus

  • Origin and insertion
  • Action
  • Innervation
A

Origin
- Ilium

Insertion

  • Gluteal tuberosity
  • Iliotibial tract (supports and stabilises knee joint whilst standing)

Action

  • Extension
  • Lateral roation
  • Supports knee when extended

Innervation
- Inferior gluteal nerve

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12
Q

Gluteus minimus + medius

  • Origin and insertion
  • Action
  • Innervation
A

Origin
- Ilium, anterior to maximum

Insertion
- Greater trochanter

Action

  • Med. rotate
  • Abduction

Innervation
- Superior gluteal nerve

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13
Q

Tensor fasciae latae

A

Stabilises knee joint by inserting into iliotibial tract

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14
Q

Small muscles of the gluteal region

  • Origin and insertion
  • Action
  • Innervation
A

Muscles
- Piriformis [sciatic nerve underneath, as well as superior and inferior gluteal nerve)

Origin (piriformis)

  • Sacrum
  • Ischium/ ischopubic ramus

Insertion
- Greater trochanter (cuffs the hip joint)

Action
- Lat. rotation of extended thigh

Innervation
- Branches of sacral plexus

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15
Q

Quadriceps

  • 4 muscles
  • Origin and insertion
  • Action
  • Innervation
A

4 muscles

  • Rectus femoris (from AIIS )
  • Vastus lateralis
  • Vastus medialis
  • Vastus intermedius (being RF)

Origin

  • RF from AIIS
  • Vasti from femur

Action

  • Extension of knee
  • RF= Flexion at hip

Insertion
- Tibial tuberosity via quadriceps tendon, carries on as patella ligament

Innervation
- Femoral nerve

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16
Q

Sartorius

A

Longest strap muscles in the body.

Origin
- ASIS, runs obliquly

Insertion
- Tibia on medial side

Action (allows crossing of legs)

  • Flex thigh at hip joint
  • Flex leg at knee
17
Q

Hamstrings

  • 3 muscles
  • Origin and insertion
  • Action
  • Innervation
A

3 muscles

  • Biceps femoris [long, from ischial tuberosity and short head, from femur]
  • Semimembranosus (below s.tendinosus)
  • Semitendinosus

Origin
- Ischial tuberosity

Insertion

  • Tibia (semis)
  • Fibular (biceps)

Action

  • Extend at hip
  • Flex at knee
  • Med. rotation (semis)
  • Lat. rotation (biceps)

Innervation
- Sciatic nerve

18
Q

Medial muscles

  • Muscles [5]
  • Origin and insertion
  • Action
  • Innervation
A

Muscles

  • Superficial: adductor longus, pectine, gracilis
  • Middle: adductor brevis
  • Deep: adductor magus

Origin

  • Magus: hamstring part= ischium, adductor part= ischipubic ramus
  • The rest= Pubic and ischium

Insertion

  • Magus: H= adductor tubercle, A= linea aspera
  • Adductors

actions

  • Adduction
  • Medial rotation
  • Extension

Innervation

  • Femoral
  • XC hamstring magus = sciatic
19
Q

Flexors of thigh

A

Recutus femoris

Sartorius

Iliopsoas–> main flexor of thigh at hip (inserts into lesser trochanter)

20
Q

Extension of thigh

A

G. maximus

Hamstrings

Hamstring of a. Magnus

21
Q

Abduction

A

Gluteus medius and minimus

22
Q

Nervous supply of thigh

- Plexi and terminal branch

A

Lumbar plexus

  • L1-4
  • Includes: obturator nerve (L2-4), femoral nerve (L2-4)

Sacral plexus

  • L4-S4
  • Includes: sciatic nerve [L4-S3]
23
Q

Femoral nerve

A

L2-4, from lumbar plexus

Branches at femoral traingle
- Saphenous nerve (longest cutaneous in the body), sits under sartorius muscle

Motor

  • Anterior thigh
  • Branches to iliac and pectineus

Sensory

  • Anterior thigh
  • Anteromedial knee
  • Medial leg and foot
24
Q

Arterial supply to thigh

A

External iliac–> femoral

Femoral

  • Profunda femoris–> to hamstrings
  • Through adductor hiatus
  • Continues popliteal artery

Popliteal- into anterior and posterior tibial arteries.

25
Q

Obturator nerve

A

L2-4, from lumbar plexus
- Runs through obturator foramen.

Motor
- medial thigh

Sensory
- Skin on medial thigh

26
Q

Sciatic nerve

A

L4-S3
- Longest in body

Through g. sciatic foramen, enters popliteal fossa

Branches

  • Tibial nerve (continues as sural)
  • Common fibular nerve (into superficial and deep fibular)

Motor

  • Posterior thigh + hamstring of a.magnus
  • Leg and foot

Sensory
- Skin on leg and foot XC medial side (saphenous nerve)

27
Q

Femoral triangle

A

Contents: surrounded by femoral sheath (XC nerve)

  • Femoral artery and vein
  • Femoral nerve
  • Femoral canal (lymphatics)

Borders

  • Inguinal ligament (superior)
  • Sartorius (lateral)
  • Adductor longus (medial)
  • Floor: adductor longus, iliopsoas, pectine
28
Q

Femoral hernia

A

Contents of abdomen into femoral canal

29
Q

Popliteal fossa

A

Content
- Popliteal artery and vein–> next to tibial nerve

Artery divides into anterior and posterior tibial arteries

30
Q

Tibial arteries

A

Anterior and posterior, from popliteal

- Within deep flexors

31
Q

Deep veins of lower limb

A

Follow name of arteries

- i.e femoral, popliteal

32
Q

Superficial veins of lower limb

A

Great/ long saphenous
Small/ short saphenous
- Both drain the dorsal venous arch

Varciose veins
- Dysfunction valves (perforating) causes pooling in these veins

33
Q

Great/ long saphenous vein

A

Longest cutaneous in body

  • Pierces through fascia lata into femoral traingle
  • Drains medial leg into femoral vein
34
Q

Small/ short saphenous

A

Drains lateral leg

- Drains into popliteal vein

35
Q

Lymphatic drainage

A

All drain into inguinal nodes
- Deep- next to femoral, drains into external iliac nodes
- Superficial- near greater saphenous vein
Drains into external iliac nodes