MSK -Lower Limb Flashcards
What is in the femoral triangle?
NAVY
Nerve - femoral
Artery - femoral
Vein - femoral
Y fronts (shows its lateral to medial)
Also femoral canal
What is in the femoral canal and why is there space?
Lymph nodes
Connective tissue
Space for distension on increase venous return e.g. with exercise
What is the femoral sheath covering?
Femoral artery and vein
What is the role of the fascia lata? What is the thickening at the upper part and the lateral longitudinal reinforcement?
- Band of thick connective tissue that encircles thigh - keeps muscles bound tightly together
- Tensor fascia lata is a muscle between it’s layers
- Iliotibial tract is a longitudinal reinforcement of the fascia lata
What is the order of the thigh adductors from lateral to medial?
Brevis
Longus
Magnus
Gracilis
What is the chief flexor of the thigh and what muscles is it made up of? Which two other muscles flex at the hip?
Iliopsoas
Iliacus
Posts major
Also pectineus
Sartorius
Why can sartorius muscle do both hip and knee flexion?
As it crosses the anterior aspect of the hip but the posterior aspect of the knee
What are the 7 anterior superficial thigh muscles?
Sartorius Pectineus Iliacus Psoas major Rectus femoris Vastus medialis Vastus lateralis
What are the quadriceps made up of?
Rectus femoris
Vastus medialis
Vastus lateralis
Vastus intermedialis
What are the 5 muscles of the medial thigh?
Obturator Externus Adductor Brevis Adductor Longus Adductor Magnus Adductor Gracilis
Which is the only quadricep to flex the hip and extend the knee and why?
Rectus femoris as only one that originates from the hip so crosses the hip and the knee. The other 3 vastus originate from the femur.
Which 4 muscles attach to the quadriceps femoris tendon that attaches to the patella?
The quadriceps
What are the roles of the 3 vastus muscles?
They extend at the knee and stabilise patella
How do the quadriceps extend at the knee if they insert above it?
Cross the knee via the quadriceps tendon –> patella –> patella ligament/tendon –> tibia
Which nerves supply most of anterior muscles of thigh, medial muscles, posterior muscles?
- Femoral
- Obturator
- Sciactic
Which muscle of the medial compartment of the thigh is the exception and not innervated by the obturator nerve?
Adductor Magnus - the hamstring portion of it is innervated by the sciatic nerve
What do the muscles in the post compartment of the thigh all do except one part?
All extend the hip and flex the knee apart from the short head of the biceps femoris which originates on the line aspera of the femur so doesn’t have action at the hip.
Where do all the hip extensors originate - apart from the short head of the biceps femoris?
On the ischial tuberosity
What are the borders of the femoral triangle?
Superior - inguinal ligament
Lateral - medial portion of the sartorius muscle
- Medial - medial border of adductor longus muscle
- Base is pectinius
- Roof is fascia lata
What are four signs of osteoarthritis on X-ray?
Reduced joint space
Sclerosis
Osteophytes
Cysts
What is sclerosis see on Xray in osteoarthritis? What are osteophytes?
Increased bone formation at joints
Bony spurs
What is the trendleburg test for OA of hip?
Dropped hip on walking
What is a clinical sign of NOF fracture? Why?
Shortened, abducted and externally rotated hip. Shortened due to impaction of bone, laterally rotated due to iliopsoas being attached to lesser trochanter and externally rotating distal fragment. Abducted due to the gluteus medius and minimum attaching to the greater trochanter abducting the distal fragment
What is the worry with a NOF (4)? Is intra or extra capsular fracture more prone to this?
The head of femur relies on the blood supply from the medial circumflex artery of the femoral artery - avascular necrosis. Intracapsular more prone to avascular necrosis.
Can damage sciatic nerve, femoral artery, can get compartment syndrome due to build up of pressure around the bones
