MSK Etc. Flashcards
Femoral triangle contents
Floor: iliopsoas m. Roof: fascia lata N, A, V, empty space w/ lymph (deep inguinal). Base: inguinal l. Lateral wall: sartorius m. Medial wall: adductor longus m.
Femoral sheath
Encloses femoral vessels and femoral canal to allow for gliding during movement. Does not contain the femoral n.
Femoral canal
Contains lymph nodes and fat. Allows veins to expand during high venous return. Proximal opening is termed the femoral ring.
Superficial inguinal lymph nodes
Contains proximal and distal groups Distal LNs are alongside the great saphenous v.
Deep inguinal lymph nodes drain into:
External iliac lymph nodes
Femoral n.
Largest branch of lumbar plexus. Forms within psoas major m.
Supplies: iliacus m., sartorius m., quadriceps ms, pectineous m.
Terminal branch is saphenous n.
Cutaneous innervation of the femoral n.
Gives anterior cutaneous n., lateral cutaneous n., and saphenous n.
Anterior does anterior side. Saphenous n. anterior and medial portion of leg and medial foot. Lateral cutaneous n. does lateral part of thigh.
Meralgia parathetica
Compression of the lateral femoral n. as it passes under inguinal l. and causes pain along lateral thigh.
Saphenous n. passes along with:
Great saphenous v.
Adductor canal
Extends from apex of femoral triangle. Contains femoral vessels and saphenous n. Saphenous branch of the descending genicular a. exits on medial side of the canal.
Ends at adductor hiatus.
Descending genicular a. gives what branches?
Articular branch.
Saphenous branch.
Comes off medially.
Medial circumflex femoral a.
Main supply to femoral head and neck.
Reaches posterior thigh.
Lateral circumflex femoral a.
Supplies lateral thigh muscles and femoral head.
Has 3 branches.
Cruciate anastomosis (4)
Inferior gluteal a.
Medial and lateral circumflex femoral as.
1st perforating branch.
Nerve roots to know (5)
Femoral n. L2-L4 Obturator n. L2-L4 Sciatic n. L4-S3 ---> Tibial n. L4-S3 ---> Common fibular n. L4-S2
Patellar reflex
Tests L2-L4 femoral n. Decrease in this reflex is called Westphal’s sign.
Calcaneal tendon reflex
Tests S1-S2.
Pes anserinus
Common insertion for sartorius m., gracilis m., and semitendinosis m. Inserts on medial part of tibia.
Quads action
Rectus femoris m. extends leg and flexes thigh due to origin of AIIS. Vasti all extend leg only as they originate on femoral body.
Gracilis m. is the only:
Action:
Adductor to cross knee joint.
Adducts thigh and flexes and medially rotates leg.
Greater sciatic foramen
All exit. Gluteal neurovascular bundles. Piriformis m. Sciatic n. Posterior femoral cutaneous n. P, I, N structures
Lesser sciatic foramen
P, I, N enters.
Obturator internus m. exits.
Superior and middle cluneal ns.
Lateral branches of dorsal rami.
Supplies superior 2/3 of thigh and sacrum.
Inferior cluneal n.
Gluteal branches of posterior femoral cutaneous n.
Supplies inferior 1/3 of thigh.
Superior gluteal n.
Leaves superior to piriformis m. w/ superior gluteal a. and runs between gluteus medius m. and gluteus minimus m. Supplies all gluteus medius m., gluteus minimus m., and tensor fascia lata m.
Inferior gluteal n.
Leaves inferiorly to piriformis m. w/ inferior gluteal a.
Supplies gluteus maximus m.
N. to quadratus femoris m. supplies:
Quadratus femoris m. and inferior gemellus m.
N. to superior gemellus m. supplies:
Superior gemellus m. and obturator internus m.
Branches from internal iliac a.
Superior gluteal a.
Inferior gluteal a.
Internal pudendal a.
Positive Trendelenburg’s sign (Duchenne’s limp)
Injury to superior gluteal n. Steadying action of gluteus medius m. and gluteus minimus m. does not work.
Triceps coxae
Superior and inferior gemellus ms, and obturator internus m.
Medial rotators of the thigh (3)
Tensor fascia latae m.
Gluteus medius m.
Gluteus minimus m.
Lateral rotators of the thigh
All other gluteal ms.
Boundaries of the popliteal fossa
SM: semi ms.
SL: biceps femoris m.
IM: medial head of gastrocnemius m.
IL: lateral head of gastrocnemius m.
Poplital fossa contents superficial to deep
Nerves
Popliteal v. and lymph nodes.
Popliteal a. and branches.
Sural n. is formed by:
Medial sural cutaneous n. from the tibial n.
Sural communicating branch from common fibular n.
Runs with small saphenous v.
Sural n. cutaneously supplies:
Distal posterior aspect of leg and lateral aspect of ankle and foot.
Crural fascia of the leg
3 septa: anterior, posterior, and transverse.
Anterior separates anterior and lateral compartments.
Posterior separates lateral and posterior superficial.
Transverse separates deep and superficial posterior.
Action of popliteus m,
Unlocks knee by laterally rotating femur.
Sustentaculum tali
Shelf-like projection that supports talus and provides groove for FHL m.
Trauma to common fibular n. results in:
Foot drop
Posterior dislocation of femoral head results in:
A flex, internally rotated, and adducted hip.
Ligaments of the knee
Lateral collateral l. (fibular)
Medial collateral l. (tibial)
ACL
PCL
Unhappy triad
ACL, TCL, and medial meniscus.
Lachman’s test
Dx injury of ACL.
Apley grind test (McMurray)
Dx injury to meniscus.
Dorsal foot muscles
Extensor hallicus brevis m.
Extensor digitorum m.
Innervation: deep fibular n.
Posterior drawer test
Dx injury to PCL.
SLAP tear
Superior labrum anterior posterior tear.
Repetitive movements of the shoulder.
Hill-Sachs deformity
From repetitive dislocation of the shoulder.
Sail sign
Displacement of fat pad.
In adults, accompanied by a radial fx. In children, supracondylar fx.
Colle’s fx
FOOSH with wrist extended.
Smith’s fx
FOOSH with wrist flexed.
Anterior talofibular l.
Always tears first.
Positive anterior drawer test due to injury upon inversion.
