MSK Lower Limb Flashcards
Name the three bones that make up the hip
Ileum, ischium and pubis
name the bones (1-3) and the bony features (A-I)
What is the longest bone in the body?
Femur
Label the bony features of the femur
What does the femoral head articulate with to form the hip joint?
The acetabulum
The two hemi-pelvises articulate in the midline at the _________
pubic symphysis
What are the two superficial veins of the lower limb?
Great and lesser saphenous vein
where do the saphenous veins arise?
dorsal venous arch of the foot
What does the great saphenous vein drain into?
Femoral vein
What does the lesser saphenous vein drain into?
Popliteal vein which then drains into the femoral
Which superficial vein ascends anterior to the medial malleolus of the tibia?
Great saphenous
Which vein ascends posterior to the lateral malleolus?
Lesser saphenous
Which superficial vein empties into the femoral vein?
Great saphenous
Which superficial vein empties into the popliteal vein?
Lesser saphenous
Lymphatic vessels accompanying the great saphenous vein drain into which lymph nodes?
popliteal lymph nodes.
What can cause enlargement of inguinal lymph nodes?
infection to any structure lying inferior to the level of the umbilicus, including the lower limb as well as intra-abdominal/pelvic malignancies
Which dermatome overly the anterior, superior aspect of the thigh?
L2
Which dermatome runs all the way down the back of the lower limb?
S2
Which dermatome overlies the knee?
L3
Which dermatome overlies the big toe?
L5
Which dermatome overlies the little toe?
S1
Which dermatome overlies the medial malleolus?
L4
What is the name of fibrous cartilage surrounding the acetabulum called?
The acetabular labrum
What kind of cartilage is the acetabular labrum made from?
Fibrous
what is the function of the acetabular labrum?
Deepens the joint and acts as a shock absorber
Name the ligaments of the hip labelled below
1- ileofemoral
2- pubofemoral
3-ischiofemoral
Which ligament prevents hyperextension of the hip joint/
Ischiofemoral
Which ligament prevents hyperabduction of the hip joint?
Ischiofemoral
Identify the muscles labelled below
Name the muscles which cause hip extension
- Gluteus maximus
- Hamstrings
- Posterior part of adductor Magnus
Which muscle is the main hip extensor?
Gluteus maximus
Which compartment of the thigh houses the adductor muscles?
Medial compartment
Which nerve supplies the adductor compartment?
Obturator nerve
Name the 5 muscles of hip adduction
- adductor longus
- Adductor brevis
- Adductor magnus
- Gracilis
- Obturator Externus
Which muscles are responsible for hip abduction?
- Gluteus medius
- Gluteus minimus
- Piriformis
Which nerve plexus supplies the adductor compartment?
Sacral plexus
Name the muscles labelled in the diagram
- gluteus medius 2. Gluteus minimus 3. piriformis
Name the 5 muscles involved in internal rotation of the hip
1) Piriformis
2) Obturator Internus
3) Obturator Externus
4) Superior and Inferior Gamelli
5) Quadratus Femoris
Name the labelled muscles
Name the muscles involved in internal/medial rotation
- gluteus minimus
- Gluteus medius
- Tensor Fascia Lata
Which muscles can be found in the anterior compartment of the thigh?
Quadriceps (rectus femurs, vistas laterals, vests intermedialis & Vastus medialis)
Which nerve innervates the anterior compartment of the thigh?
Femoral
Name the muscles labelled on the diagram
- rectus femoris
- Vastus lateralis
- Vastus intermedius
- Vastus medialis
What is the action of rectus femoris on the hip joint?
flexion
what is the action of the anterior compartment of the thigh?
Extension of the knee
Where do the quadriceps insert?
They form a common tendon which passes over the patella, becoming the patella tendon and then inserts into the tibial tuberosity
What is the longest muscle in the body?
Sartorius
Which muscles make up the gooses foot?
Sartorius, semitendinosus and gracilis
What are the three actions of sartorius on the hip joint?
Weak hip flexor, hip abductor, laterally rotates the thigh
What is the action of sartorius on the knee?
Flexes the lower leg at the knee
What is the correct anatomical term for the gooses foot?
Pes ancerenus
Through which bony foramen does the nerve that innervates the medial thigh muscles enter the thigh?
the obturator foramen
Name the labelled muscles/structures
What structures pass through the adductor canal?
Superficial femoral artery, superficial femoral vein , saphenous nerve
What is the medial border of the femoral triangle?
adductor longs muscle
What is the lateral border of the femoral triangle?
Sartorius
Which structure forms the base of the femoral triangle?
The inguinal ligament
Which muscles form the vast proportion of the floor of the femoral triangle
- pectineus and adductor longus medially
2. Iliopsoas laterally
What are the 3 major structures present in the femoral triangle?
1 femoral nerve 2 femoral artery 3 femoral vein
What is contained within the femoral sheath
femoral artery, femoral vein, deep inguinal lymph nodes
Which gender are femoral hernias more common in?
Female
Where does the femoral artery begin?
inguinal ligament (it is a continuation of the external iliac)
The femoral artery enters the thigh midway between which 2 bony surface markings?
anterior superior iliac spine
and pubic symphysis
What is the deep branch of the femoral artery called?
Profunda femoris
Which vein is the femoral vein a continuation of?
Popliteal
What does the femoral vein become as it crosses the inguinal ligament
femoral vein becomes the external iliac
Which two veins drain into the femoral vein in the femoral triangle?
Profunda femoris vein and greater saphenous vein
Which two veins drain into the femoral vein in the femoral triangle?
Profunda femoris vein and greater saphenous vein
As the neurovascular structures of the anterior thigh pass distally towards the apex of the femoral triangle, they begin to pass deep through the musculature called in a fascial sheath called the …
Adductor canal
Which muscle has the opening named the adductor canal?
Adductor Magnus
Name the two main motor nerves of the lumbar plexus supplying the lower limb
- obturator 2. femoral
Name one main sensory nerve of the lumbar plexus supplying the lower limb
- lateral cutaneous
What is the nerve root value of the motor nerves coming from the lumbar plexus?
L2,3,4
What is the nerve root value of the sensory nerve coming off the lumbar plexus?
L2, 3
name all of the branches of the lumbar plexus
Name the features of the pelvis
Note- lesser sciatic foramen is sometimes called the obturator foramen
Which sciatic foramen is the route for structures entering or leaving the pelvis?
Greater sciatic foramen
Which sciatic foramen is a route for structures entering or leaving the perineum?
Lesser sciatic foramen
Name the muscles and the innervation
What are the actions of gluteus maximus muscle?
Abduction and adduction of thigh and extension of the thigh and lateral rotation
What is the action of gluteus medius, gluteus minimus and tensor fasciae latae?
They are internal rotators and abductors of hip joint.
What is the deep fascia of the thigh called?
Fascia lata
What is the thickening of facia latae called?
Iliotibial tract
Name the muscles that attach to the ileo-tibial tract
tensor fascia lata and gluteus maximus.
What is the function of the ileotibial tract?
provides stabilisation to the lateral aspect of the knee joint.
The sacral plexus lies on which muscle?
Piriformis
The sacral plexus is formed by the union of the ventral rami of which spinal nerves
L 4, L5 and S 1 to S4
What are the two main branches of the sacral plexus
sciatic and puedental
Which branch of the sacral plexus is the main branch to the lower limb?
Sciatic
List the muscles supplied by the superior gluteal nerve?
- Gluteus minimus
- Gluteus medius
- tensor fascia latae
The inferior gluteal muscle supplies only one muscle in the gluteal region.
Gluteus maximus
What are the root values of the sciatic nerve?
L 4 to S 3
describe the course of the sciatic nerve
It passes through the greater sciatic foramen, inferior to the piriformis muscle, passing behind the deep abductors of the hip joint between the ischial tuberosity and greater trochanter of the femur to enter the posterior compartment of the thigh.
Where in the lower limb does the sciatic nerve divide
popliteal fossa
what does the sciatic nerve divide into at the popliteal fossa
tibial and common fibular (sometimes called peroneal)
name the muscle coloured in green
Piriformis
Name the three muscles that make up the hamstrings
- semimembranosus
- semitendinosus
- biceps femoris
Name the labelled muscles
- semimembranosus
- semitendinosus
- biceps femoris
What is the action of the hamstring muscles on the hip and knee joint?
Hip joint extension
Knee joint flexion
Which nerve innervates the posterior compartment of the thigh?
sciatic
Which branch of the femoral artery contributes to the posterior muscle compartment blood supply?
Profunda femorus
Name the features of bones below
Bones
- patella
- fibula
- tibia
- femur
Articular Surfaces
a. Medial Femoral Condyle
b. Lateral Femoral Condyle
c. Lateral Tibial Condyle
d. Medial Tibial Condyle
e. Tibial Tuberosity
Which is the most important muscle which helps to stabilize the knee joint?
Quadriceps & hamstrings
Name the ligaments of the knee
The anterior cruciate ligament (ACL) prevents the femur from sliding (anterior or posterior?) on the tibia.
Anterior
The posterior cruciate ligament (PCL) prevents anterior or posterior displacement of the tibia?
Posterior
Name the muscle
Popliteus
Name the features of the knee meniscus
- Medial meniscus
- Lateral meniscus
- Anterior cruciate
- Posterior cruciate
What are the main functions of the menisci?
Shock absorber and deepen the joint
Which meniscus firmly adheres to the deep surface of the medial collateral ligament?
The medial meniscus
What type of bone is the patella
Sesamoid
Which movement of the knee causes the patella to move?
Flexion
Name the different bursae (4 on the diagram)
Which bursa communicates with the articular cavity of the knee joint?
SUPRAPATELLAR
What is housemaid’s knee (pre-patellar bursitis)?
Inflammation of the prepatellar bursa
Which muscles cause knee flexion
hamstrings and biceps femoris and to a lesser extent the gastrocnemius and popliteus.
Which muscles cause knee extension?
quadriceps femoris muscle group (rectus femoris, vastus lateralis, vastus medius, and vastus intermedius)