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MSCT > MSCT Week 4: Lower Limb > Flashcards

MSCT Week 4: Lower Limb Flashcards

1
Q

Major Functions of the Lower Limb

2 listed

A
  • Support the body weight
  • Move the body weight
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2
Q

Gluteal Region

A

between the iliac crest and the gluteal fold that defines the lower limit of the buttocks

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3
Q

Each of the two pelvic bones of the gluteal region is formed by?

A

childhood fusion of 3 bones

  • Ilium
  • Ischium
  • Pubis
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4
Q

Anterior Thigh boundaries

A

between the inguinal ligament and the knee joint

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5
Q

Posterior Thigh Boundaries

A

Between the Gluteal Fold and the Knee

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6
Q

Thigh bone is?

A

Femur

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7
Q

Leg Boundaries

A

between the knee and ankle joints

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8
Q

The bones of the leg?

A
  • Tibia
  • Fibula
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9
Q

Bones of the foot

3 listed

A
  • Tarsals
  • metatarsals
  • phalanges
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10
Q

How is muscular energy reduced to maintain a standing position

A

The ligaments of the hip and knee joints and the shapes of the articular surfaces “locks” the joints in position to reduce the muscular energy required to maintain a standing position

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11
Q

Identify Anatomical Parts

A
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12
Q

Identify

A
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13
Q

Identify Movements

A
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14
Q

The Hip Joint Description & Function

2 parts

A
  • a synovial joint between the head of the femur and cup-shaped acetabulum on the lateral surface of the pelvic bone
  • it is a multi-axial ball and socket joint designed for stability and weight bearing
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15
Q

Acetabular Labrum Description & Function

2 listed

A
  • the fibrocartilaginous collar on the rim of the acetabulum on the lateral surface of the pelvic bone
  • it deepens the acetabulum and prevents the femoral head from moving inferiorly
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16
Q

Acetabular labral tears

A
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17
Q

Ligament of the head of the femur Description

A

connective tissue that attaches the head of the femur to the acetabular fossa

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18
Q

The femoral head is supplied by?

A

A branch of the obturator artery supplies femoral head through a branch inside the head of the femur ligament

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19
Q

The synovial membrane around the hip joint attaches to?

A

The articular surfaces of the femur and acetabulum

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20
Q

Identify

A
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21
Q

Identify

A
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22
Q

Fibrous capsule or membrane of the hip joint Description & Function

A
  • surrounds the synovial membrane
  • holds the femoral neck in the acetabulum
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23
Q

How many ligaments around the fibrous capsule of the hip? what are they called?

A

3

  • Iliofemoral ligament
  • Pubofemoral ligament
  • Ischiofemoral ligament
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24
Q

Iliofemoral Ligament location

A

Anterior

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25
Q

Pubofemoral ligament location

A

Anteroinferior

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26
Q

Ischiofemoral ligament Location

A

Posteroinferior

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27
Q

Identify

A
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28
Q

Largest synovial joint in the body

A

The knee

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29
Q

The knee joint is formed by the articulations of?

A
  • The medial and lateral femoral condyles
  • the medial and lateral tibial condyles
  • the patella
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30
Q

The stability of the knee joint relies on?

A
  • Quadriceps
  • hamstrings
  • ligaments
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31
Q

Ligaments of the knee joint

4 listed

A
  • Medial or tibial collateral ligament (MCL or TCL)
  • Lateral or fibular collateral ligament (LCL or FCL)
  • Anterior Cruciate Ligament (ACL)
  • Posterior Cruciate Ligament (PCL)
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32
Q

Medial collateral ligament origin and insertion

A
  • extends from the medial epicondyle of the femur and attaches on the medial aspect of the tibia
  • it is attached to the capsule and medial meniscus
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33
Q

Medial collateral ligament Function

A

prevents lateral displacement of the tibia under the femur

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34
Q

Identify

A
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35
Q

What prevents lateral displacement of the tibia under the femur

A

Medial collateral ligament

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36
Q

Lateral collateral ligament Origin and Insertion

A

extends from the lateral epicondyle of the femur and attaches to the head of the fibula

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37
Q

Lateral collateral ligament Function

A

Prevents medial displacement of the tibia under the femur

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38
Q

Cruciate ligaments description and properties

3 listed

A
  • cross each other in the intercondylar region of the knee
  • they are inside the capsule but outside the synovial membrane
  • they connect the tibia and femur and restrict anterior to posterior movement of the knee joint
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39
Q

Anterior Cruciate Ligament Origin and Insertion

A

it extends from the lateral femoral condyle to the anterior tibia

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40
Q

Anterior Cruciate Ligament Function

A
  • Keeps the tibia from moving anteriorly on the fixed femur
  • it resists hyperextension and is weaker than the PCL
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41
Q

Posterior Cruciate Ligament Origin and Insertion

A

it extends from the medial femoral condyle to the posterior tibia

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42
Q

Posterior Cruciate Ligament Function

A
  • keeps the tibia from moving posteriorly on the fixed femur
  • Tension on it is greatest when the knee is flexed
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43
Q

Identify

A
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44
Q

Identify

A
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45
Q

Medial and Lateral Menisci description and function

A

C-shaped fibrocartilage between the articulating condyles that help make the surfaces more congruent and serve as shock absorbers

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46
Q

Most common menisci injury

A

The medial meniscus is more frequently injured than the lateral due to its attachment to the MCL

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47
Q

Synovial membrane of the knee joint description & function

2 listed

A
  • attaches to the margins of the articular surfaces and menisci
  • it forms pouches or bursa that provide low-friction movement for tendons such as the (Suprapatellar bursa and subpopliteal recess)
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48
Q

Fibrous capsule of the knee Description & Function

3 listed

A
  • encloses the articular cavity
  • it is partly formed and reinforced by muscle tendons
  • the upper end of the popliteal muscle is enclosed by the fibrous membrane
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49
Q

Patellar Ligament Description

A
  • The patellar Ligament is the continuation of the quadriceps tendon
  • it connects the patella to the tibia
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50
Q

Identify

A
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51
Q

Most commonly injured structures in the knee

A

Called the Unhappy Triad of O’Donahue

  • MCL
  • Medial Meniscus
  • ACL

Resultant from a blow to the lateral aspect of the knee with the foot planted on the ground

The injury is often accompanied by an audible snap and immediate pain and swelling

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52
Q

Unhappy Triad of O’Donahue

A
  • Called the Unhappy Triad of O’Donahue
  • MCL
  • Medial Meniscus
  • ACL
  • Resultant from a blow to the lateral aspect of the knee with the foot planted on the ground
  • The injury is often accompanied by an audible snap and immediate pain and swelling
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53
Q

The Ankle Joint Description

A
  • Is a synovial hinge joint between the talus, tibia and fibula.
  • the distal ends of the fibula are anchored together by medial (deltoid) and lateral ligaments to create a deep socket for the upper body of the talus
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54
Q

Lateral Ligament of the ankle description

A

Composed of 3 ligaments

is the most commonly sprained by foot inversion

  • Posterior talofibular ligament
  • Anterior talofibular ligament
  • Calcaneofibular ligament
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55
Q

Most common sprain of the ankle

A

Anterior talofibular ligament due to foot inversion

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56
Q

Medial Deltoid Ligament of the ankle inferior attachment sites

A

is divided into four parts based on the inferior points of attachment

  • posterior tibitalar
  • tibiocalcanela
  • tibionavicular
  • anterior tibiotalar parts
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57
Q

Sprain of the Medial Deltoid Ligament of the ankle usually occurs how?

A

most often occurs by foot eversion

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58
Q

Identify

A
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59
Q

Identify

A
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60
Q

Lachman Test Procedure, Structure Tested and Positive Result

A
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61
Q

Anterior Drawer Test Procedure, Structure Tested and Positive Result

A
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62
Q

Posterior Drawer Test Procedure, Structure Tested and Positive Result

A
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63
Q

Valgus Stress Test Procedure, Structure Tested and Positive Result

A
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64
Q

Varus Stress Test Procedure, Structure Tested and Positive Result

A
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65
Q

McMurray Test Procedure, Structure Tested and Positive Result

A
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66
Q

Patellar Apprehension and Patellofemoral Grind Test Procedure, Structure Tested and Positive Result

A
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67
Q

Valgus

A

when the foot is more lateral (knock-kneed)

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68
Q

Varus

A

When the foot is more medial (bow-legged)

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69
Q

The muscles in the gluteal region do what?

A
  • Abduct
  • extend
  • laterally rotate

the femur relative to the pelvic bone

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70
Q

Deep Muscles of the Gluteal Region

4 listed

A

are lateral rotators of the femur at the hip joint

  • Piriformis
  • obturator internus
  • the gemelli (twins)
  • quadratus femoris
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71
Q

Superficial Muscles of the Gluteal Region

A

Abduct (gluteus minimus and medius)

extend the hip (gluteus maximus)

the tensor fasciae latae muscle stabilizes the knee in extension by acting on the iliotibial tract (a band of deep fascia that passes down the lateral side of the thigh to attach to the proximal end of the tibia)

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72
Q

Iliotibial tract

A

(a band of deep fascia that passes down the lateral side of the thigh to attach to the proximal end of the tibia)

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73
Q

Identify

A
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74
Q

Identify

A
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75
Q

Nerves enter the gluteal region from?

A
  • The pelvis through the greater sciatic foramen
  • most are in the plane between the superficial and deep muscles
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76
Q

Superior Gluteal Nerve innervates and location

A
  • gluteus medius
  • gluteus minimus
  • tensor fascia latae

Passes superior to the piriformis muscle

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77
Q

The nerve to the quadratus femoris also supplies?

A

Gamellus Inferior

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78
Q

The nerve to the obturator internus supplies and location & roots

A
  • Gemellus superior & the obturator internus
  • passes through the lesser sciatic foramen to innervate
  • L5-S2 Spinal Nerves
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79
Q

The posterior femoral cutaneous nerve of the thigh innervates

A

innervates the skin of the gluteal region, the posterior thigh, and posterior leg

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80
Q

The inferior gluteal nerve innervates

A

gluteus maximus muscle

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81
Q

The piriformis muscle is innervated by branches of?

A

L5, S1 and S2 spinal nerves

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82
Q

The Pudendal Nerve is the nerve of the?

A

Perineum

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83
Q

Pudenal nerve roots

A

S2-S4

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84
Q

Inferior gluteal nerve roots

A
  • L5
  • S1
  • S2
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85
Q

Obturator internus nerve roots

A
  • L5
  • S1
  • S2
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86
Q

Quadratus Femoris nerve roots

A
  • L4
  • L5
  • S1
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87
Q

Superior Gluteal Nerve Roots

A
  • L4
  • L5
  • S1
88
Q

Trendelenburg sign/gait

A

an abnormal gait (as with walking) caused by weakness of the abductor muscles of the lower limb (gluteus medius and gluteus minimus

people with injury of the superior gluteal nerve have weakness of abducting the thigh at the hip

89
Q

people with an injury of this nerve have weakness of abducting the thigh at the hip

A

Superior Gluteal Nerve

90
Q

the upper end of the popliteal muscle is enclosed by?

A

The Fibrous Capsule of the Knee

91
Q

Identify

A
92
Q

Describe the Trendelenburg Sign

A
93
Q

The Superior and Inferior Gluteal Arteries supply?

A

The gluteal region

94
Q

The Superior and Inferior Gluteal Arteries originate from

A

from the internal iliac artery which is a terminal branch of the aorta

95
Q

Identify

A
96
Q

How many compartments does the thigh have?

A

3

Anterior compartment

Medial compartment

Posterior compartment

97
Q

The compartments of the thigh are separated by?

A

intermuscular fascial septa

98
Q

Anterior compartment of the thigh functional contents and muscle action

A
  • Femoral Nerve
  • Branches of the femoral artery
  • Extension of the Leg
99
Q

Medial Compartment of the Thigh Functional Contents & muscle Action

A
  • Obturator Nerve
  • Branches of the deep femoral artery and obturator artery
  • Adduction of the thigh
  • Gracilis also flexes the knee
100
Q

Posterior Compartment of the Thigh Functional Contents

A
  • Tibial division of sciatic nerve (common fibular division of sciatic nerve to short head of biceps femoris)
  • Perforating branches of deep femoral artery
  • Flexion of the leg
  • Extension of the thigh
101
Q

Anterior compartment of the thigh muscles

A

Quadriceps femoris

  • Rectus Femoris
  • Vastus Lateralis
  • Vastus Medialis
  • Vastus intermedius

Sartorius

Psoas Major

Ilicus (iliopsoas)

102
Q

Rectus femoris function

A
  • flexes the thigh at the hip joint
  • extends the leg
103
Q

Vastus Lateralis Function

A

Extend the leg

104
Q

Vastus Medialis Function

A

Extend the leg

105
Q

Vastus intermedius Function

A

Extend the leg

106
Q

Sartorius Function

A
  • Flexes the thigh
  • Flexes the leg
  • laterally rotate the thigh
  • medially rotate the leg
107
Q

Psoas major Function

A

Flex the thigh

108
Q

Iliacus AKA

A

Iliopsoas

109
Q

Iliacus Function

A

Flex the thigh

110
Q

Muscles of the medial compartment of the thigh

A
  • Gracilis (not shown)
  • Pectineus (not shown
  • Adductor Longus
  • Adductor Brevis
  • Adductor Magnus
  • Obturator Externus
111
Q

Gracilis Function

A
  • Adduct the thigh
  • medially rotate the thigh
  • flex the knee
112
Q

Pectineus Function

A
  • Adduct the thigh
  • medially rotate the thigh
113
Q

Adductor Longus Function

A
  • Adduct the thigh
  • medially rotate the thigh
114
Q

Adductor Brevis Function

A
  • Adduct the thigh
  • medially rotate the thigh
115
Q

Adductor Magnus Function

A
  • Adduct the thigh
  • medially rotate the thigh
116
Q

Obturator Externus Function

A
  • Laterally Rotates the thigh
117
Q

Posterior compartment muscles

A

Hamstrings

  • Biceps femoris
  • Semitendinosus
  • Semimembranosus
118
Q

The posterior compartment muscles mainly

A

Extend the thigh at the hip and flex the leg at the knee and rotate both joints

119
Q

Biceps Femoris heads

A

Has 2 heads long and short

the long head crosses the hip and knee joints

the short head does not

120
Q

Biceps Femoris Function

A
  • Flex the leg at the knee joint
  • extend the leg at the hip joint
121
Q

Semitendinosus Function

A
  • flex the knee
  • extend the hip
122
Q

Semimembranosus Function

A
  • flex the knee
  • extend the hip
123
Q

Pes Anserinus AKA

A

Goose’s Foot

124
Q

Pes Anserinus is what?

A

is the common insertion of the tendons of the sartorius, gracilis and semitendinosus muscles of the proximal tibia

125
Q

The common insertion of the sartorius, gracilis and semitendinosus muscles

A

Pes Anserinus

126
Q

Identify

A
127
Q

Identify

A
128
Q

Identify

A
129
Q

The compartments of the leg are separated by?

A

Interosseous membrane and intermuscular fascial septa

130
Q

The Anterior Compartment of the leg grossly contains

A
  • 4 muscles
  • deep fibular nerve
  • Anterior Tibial Artery
  • Dorsiflexion and inversion of Foot
  • Extension of toes
131
Q

The Lateral Compartment of the Leg contains

A
  • 2 muscles
  • Superficial Fibular Nerve
  • Fibular Artery
  • Eversion and plantar flexion of foot
132
Q

The posterior compartment of the leg contains & action

A
  • 3 superficial muscles
  • 4 deep muscles
  • Tibial nerve
  • Posterior tibial artery
  • Plantar flexion
  • inversion of foot
  • flexion of toes
133
Q

Identify

A
134
Q

Muscles of the anterior compartment of the leg

A
  • Tibialis Anterior
  • Extensor hallucis longus
  • Extensor digitorum longus
  • fibularis tertius
135
Q

Anterior compartment of the leg muscles action All have in common

2 listed

A
  • dorsiflex the foot
  • extend the toes
136
Q

is the most commonly sprained by foot inversion

A

Lateral ligaments of the ankle

  • Posterior talofibular ligament
  • Anterior Talofibular ligament
  • Calcaneofibular Ligament
137
Q

Lateral compartment muscles of the leg

A
  • Fibularis Longus
  • Fibularis Brevis
138
Q

Lateral compartment muscles action all have in common

A

everts foot

139
Q

Posterior compartment superficial and deep muscles of the leg

A

Superficialis muscles

  • Gastrocnemius
  • Soleus
  • Plantaris

Deep Muscles

  • Tibialis posterior
  • Flexor Digitorum longus
  • Flexor hallucis longus
  • popliteus
140
Q

Identify

A
141
Q

Identify

A
142
Q

Identify

A
143
Q

Identify

A
144
Q

Compartment Syndrome Description

A

occurs when increased pressure within a fascial compartment compromises the blood supply, innervation and function of the tissues within that space

145
Q

Symptoms of Compartment Syndrome

A
  • pain
  • numbness
  • swelling
146
Q

Compartment syndrome properties

5 listed

A
  • may be acute, following trauma
  • may be chronic, seen most often in athletes
  • most common in the anterior leg but can occur in other compartments of leg, forearm, hand, foot
  • Acute compartment syndrome (ACS) following injury is a surgical emergency
  • ACS is relieved by cutting the skin and fascia (fasciotomy)
147
Q

Identify

A
148
Q

Acute Compartment syndrome is treated with

A
149
Q

Lumbosacral plexus is formed by?

A

the anterior (ventral) rami of L1-L4 Spinal nerves

150
Q

The femoral nerve is formed by?

A

The ventral rami of L2-L4

151
Q

Femoral Nerve Motor to?

A
  • Motor to the anterior compartment of the thigh and the pectineus
152
Q

The saphenous nerve travels through

A

the adductor canal (opening in the aponeurosis of the adductor magnus)

153
Q

An aponeurosis is?

A

A flat tendon

154
Q

Obturator nerve is formed by?

A

L2-L4 Ventral Rami of spinal nerves

155
Q

Obturator nerve Motor Functions

A
  • motor to the medial compartment of the thigh and the Adductor Magnus
  • innervates part of pectineus along with femoral nerve
156
Q

The Sacral plexus is formed by?

A

Ventral Rami of L4-S5 Spinal nerves

157
Q

The sciatic nerve tibial division

A

has a tibial division that supplies the posterior compartment of the thigh, except the short head of the biceps femoris

158
Q

The Biceps Femoris Short head is innervated by?

A

The common Fibular Division of the Sciatic nerve

159
Q

Sciatic nerve divisions

A
  • Tibial division
  • Common Fibular (peroneal) nerves
160
Q

Common Fibular (peroneal) nerves location

A

proximal to the popliteal fossa (the space behind the knee)

161
Q

The tibial nerve innervates

A

the posterior compartment of the leg and is sensory to overlying skin and the plantar surface of the foot (and the 5th toe)

162
Q

The common fibular nerve splits into

A
  • The superficial fibular nerve
  • The deep fibular nerve
163
Q

The superficial fibular nerve innervates?

A

The lateral compartment of the leg and is sensory to overlying skin of the leg and foot

164
Q

The deep fibular nerve innervates?

A

the anterior compartment of the leg and overlying skin of leg and between the great and 2nd toe

165
Q

Identify

A
166
Q

Describe the major branches of the lumbosacral plexus

A
167
Q

Four major routes by which nerves and vessels pass into the lower limb

A
  • Obturator Canal
  • Greater Sciatic Formation
  • Lesser Sciatic Foramen
  • Inferior to inguinal ligament
168
Q

The Obturator Canal is

A

an opening in the obturator foramen through which the obturator nerve passes

169
Q

The Greater Sciatic Foramen main channels

A
  • Below the piriformis muscle
  • Above the Piriformis muscle
170
Q

The Sciatic Nerve Below the piriformis muscle

5 listed

A
  • Sciatic nerve
  • inferior gluteal nerve
  • pudendal nerve
  • posterior femoral cutaneous nerve
  • nerves to obturator internus and quadratus femoris
171
Q

The greater Sciatic Foramen Above the piriformis muscle

A

Between the gluteus medius and minimus

  • Superior gluteal nerve
172
Q

Lesser Sciatic Foramen nerves that pass

A

Pudendal nerve passes from the gluteal region into perineum

173
Q

Inferior to inguinal ligament nerves that pass

3 listed

A
  • Femoral nerve
  • femoral branch of genitofemoral nerve
  • the lateral cutaneous nerve of thigh
174
Q

Identify

A
175
Q

Identify

A
176
Q

Identify

A
177
Q

Identify

A
178
Q

Identify

A
179
Q

Sensory Endpoint of Obturator

A

medial thigh above knee

180
Q

Sensory Endpoint of Femoral

A

Medial Malleolus

181
Q

Sensory Endpoint of Tibial

A

lateral malleolus (sural nerve)

182
Q

Sensory Endpoint of Superficial fibular

A

Dorsum of the foot

183
Q

Sensory Endpoint of Deep Fibular

A

Between the first two toes

184
Q

Deep Fibular Nerve

  • Common entrapment regions
  • Muscle Weakness
  • Sensory loss
A
185
Q

Superficial Fibular Nerve

  • Common entrapment regions
  • Muscle Weakness
  • Sensory loss
A
186
Q

Tibial Nerve

  • Common entrapment regions
  • Muscle Weakness
  • Sensory loss
A
187
Q

Femoral Nerve

  • Common entrapment regions
  • Muscle Weakness
  • Sensory loss
A
188
Q

Obturator Nerve

  • Common entrapment regions
  • Muscle Weakness
  • Sensory loss
A
189
Q

Femoral artery

A
  • the major artery supplying the lower limb originating from the external iliac artery when it passes under the inguinal ligament to enter the femoral triangle in the anterior thigh
  • It supplies most of the thigh and all of the leg and foot
190
Q

Borders of the femoral triangle

A
  • inguinal ligament superiorly
  • sartorius muscle laterally
  • adductor longus muscle medially
191
Q

The femoral nerve, artery, vein, and lymphatics pass from the abdomen into the lower limb under the?

A

Inguinal ligament and in the femoral triangle

192
Q

Femoral Sheath

A

The femoral vein, artery and lymphatics are enclosed by fascia called the femoral sheath

193
Q

Femoral pulse

A

The femoral pulse can be palpated in the femoral triangle just inferior to the inguinal ligament and midway between the anterior superior iliac spine and the pubic symphysis

194
Q

The superior and inferior gluteal arteries supply

A

the gluteal region

195
Q

The obturator arteries supplies

A

the medial compartment of the thigh

196
Q
A
197
Q

Collateral circulation to the hip joint

A

anastamoses between

198
Q

Identify

A
199
Q

Collateral circulation of the knee

A

anastomoses between

200
Q

Identify

A
201
Q

Identify

A
202
Q

Identify

A
203
Q

Identify

A
204
Q

Tensor Fascia Lata

A

the tensor fasciae lata muscle stabilizes the knee in extension by acting on the iliotibial tract (a band of deep fascia that passes down the lateral side of the thigh to attach to the proximal end of the tibia)

205
Q

Anterior Compartment of the thigh Muscle Actions

A
206
Q

Posterior Compartment of the thigh Muscle Actions

A
207
Q

Medial Compartment of the thigh Muscle Actions

A
208
Q

Muscles of the Anterior Compartment of the thigh

A

Sartorius

Vastus medialis

Iliopsoas

Rectus femoris

vastus lateralis

vastus intermedius (not shown)

pectineus

iliacus

209
Q

Muscles of the medial compartment of the thigh

4 listed

A
  • Adductor Longus
  • Adductor Brevis
  • Adductor Magnus
  • Gracilis
210
Q

Muscles of the Posterior Compartment of the Thigh

A
211
Q

Superficial muscles of the posterior leg

A
212
Q

Tension on it is greatest on the PCL when

A

The knee is flexed

213
Q

Hyperextension of the knee is resisted by?

A

The ACL

214
Q

Femoral Nerve Sensory Branches

2 listed

A

Sensory branches are the anterior cutaneous nerve of the thigh and the saphenous nerve which goes through the adductor canal opening in the aponeurosis of the adductor magnus to the medial leg and malleoulus

215
Q

Obturator Nerve Sensory Functions

A

Sensory branch (a cutaneous branch) to the skin above the medial side of the knee

216
Q

The Biceps Femoris Long head is innervated by?

A

Tibial Division of the Sciatic Nerve

MSCT (30 decks)

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