MSK Workbooks Lower Limb Flashcards
The Tibia and Fibula are held together by fibrous material called
Membrane
Where are the Tibia and Fibula joined
Proximal and Distal Aspects
The superior or proximal tibia-fibular joint is what type of synovial joint
Plane
The inferior or distal tibia fibular joint is what type of joint
Fibrous Joint
What is the anterior bony prominence feel just below knee
Tibial Tuberosity
Which tendon attaches onto superior tibial tuberosity
Patellar Tendon
What bone makes up medial malleolus
Tibia
What bone makes up lateral malleolus
Fibula
Dorsiflexion is the movement of the ankle
upwards
Plantarflexion is the movement of the ankle
Downwards
The anterior compartment muscles of leg do what
Dorsiflex Ankle and Extend Toes
What are the four anterior compartment muscles
Tibialis Ant
Extensor Digitorum Longus
Extensor Hallucis Longus
FIbularis Tertius
The neuromuscular structures of the leg continue how through popliteal fossa
Distal
What are the two divisions of the sciatic nerve
Tibial Nerve and Common Fibular nerve
What are the two divisions of popliteal artery as it enters leg
Ant Tibial and Pos Tibial
The common fibular nerve divides into
Superficial Fibular and Deep Fibular Nerve
Which branch innervates muscles in anterior compartment of thigh?
Deep Fibular Nerve
The lateral compartment of leg contains which two muscles
- Fibularis Longus
2. Fibularis Brevis
Muscles in the Lateral compartment of the leg do what to the foot
Evert the foot
Muscles in the lateral compartment of the leg do what to the ankle
Plantarflex
Which fibular nerve supplies muscles of lateral compartment
Superficial Fibular nerve
What is foot drop
inability to dorsiflex ankle
A tackle on lateral aspect of leg with footdrop. Which nerve injured
deep fibular nerve
The lesser saphenous vein ascends on
posterior aspect of leg and drains into vein
The greater saphenous vein ascends on the
medial aspect of leg and thigh and drains into femoral vein
The dorsals pedis artery is continuation of which artery
Anterior Tibial Artery
Dorsalis pedis pulse is found
Between 1st and 2nd Metatarsals
Posterior Tibial pulse is palpated behind the
medial malleolus
Posterior Tibial pulse is continuation of
Posterior Tibial Artery
The ankle joint is what type of joint
Hinge Synovial
The ankle is what type of bone
Mortoise
The distal end of tibia and tibia articulate with
superior talus
The malleoli grip the talus tightly during movements of
ankle
The malleolar grip is strongest during
Dorsiflexion of Ankle
The ankle joint is unstable during which movement
Plantarflexion
What ligament of ankle joint is weakest
Lat Anterior Talofibular
What ligament of ankle joint is named deltoid ligament
Medial Lig
During which movements of subtler joint are ankle sprains more common
inversion
Where is the popliteal fossa found
Posterior knee
What is the relation of popliteal artery to popliteal vein
lies medial to it
which muscles form superior boundaries of popliteal fossa
medial - semimembranous and semitendinous
Lateral - Biceps femoris
Content of Popliteal Fossa (6)
- Fat
- Common Fibular Nerve
- Tibial Nerve
- Sural Nerve
- Posterior Femoral Cutaneous Nerve
- Popliteal Lymph Nodes
The popliteal artery is a continuation of
Femoral Artery as it emerges from Adductor Hiatus
Which compartment of the leg is the largest
posterior
Which muscle plantar flexes the ankle and essential for walking
Gastrocnemius
What nerve innervates gastrocnemius
Tibial Nerve s1-s2
What is the strong terminal attachment of gastrocnemius
achilles tendon
what inserts onto posterior calcaneus
achilles tendon
Which four muscles make up deep compartment of leg
- Popliteus
- Flexor Digitorum Longus
- Flexor Hallucis Longus
- Tibialis Pos
Deep compartment of leg muscles pass where?
medially to enter door to the foot
Deep compartment of leg eg muscles pass
posterior to medial malleolus
Deep compartment of leg muscles are covered by
flexor retinaculum
Which muscles flex toes and or ankle
- Popliteus
- Flexor Digitorum Longus
- Flexor Hallucis Longus
- Tibialis Pos
Which nerve and vessel accompany
- Popliteus
- Flexor Digitorum Longus
- Flexor Hallucis Longus
- Tibialis Pos
Tibial Nerve
Tibial Artery
Which nerve innervates all the muscles of posterior leg
Tibial Nerve
Which branch of the popliteal artery supplies the posterior compartment of the leg?
Pos Tibial Artery
What acts as a spring when pushing off in normal walking gait
Deep Fascial f Foot
Which movements of ankle are achieved at mortise joint of ankle
Dorsiflexion and Plantarflexion
Which movements of ankle occur at subtler joint
eversion and inversion
What type of joint is talonavicular joint
Ball and Socket/Synovial
The foot bones are arranged in which arches
Transverse and Longitudinal
Which ligament helps to maintain median longitudinal arch in foot
Plantar Calcaneo-Navicular
What are the passive factors of the foot which maintains integrity of foot
- Shape of United Bones
- Plantar Calcaneovaciular Ligament or Spring ligament
- Long Plantar Ligament
- Short Plantar
What are the dynamic factors of foot which maintains integrity of foot
- Intrinsic Muscles of Foot
- Long Flexor Tendons
- Tendon of TIbialis Ant and Fibularis Longus
What is the other name for high arches
Pes Cajus
what is the other name for flat feet
Pes Planes
What are the two terminal branches of tibial nerve which innervates intrinsic muscles of foot
Medial Plantar and Lateral Plantar Nerves
What are the two terminal branches of posterior tibial artery which supplies foot
Medial Plantar Artery and Lateral Plantar Artery
What is the longest bone in the body?
Femur
Where is the Femur found
Thigh
The femoral head articulates with
acetabulum of hip to form hip joint
The two hemi-pelvises articulate in midline at…
pubic symphysis
The two superficial veins in the lower limb are
the great staph vein and lesser staph vein
The great saph vein and lesser staph vein begin as
main tributaries from dorsal venous arch of foot ascending superiorly with great staph vein draining into femoral vein at medial aspect of thigh
Where does the great staph vein drain into
femoral vein at medial thigh
Which superficial vein ascends anterior to medial malleolus of tibia
great saph
which vein ascends posterior to lat malleolus
small saph
which superficial vein empties into femoral vein
great saph
which superficial vein empties into popliteal vein
small saph
What prevents pooling of blood in legs
Valves
What happens if valves in leg dilate and become torturous
varicose vein
Thrombophelebitis is related to what condition
Varicose Vein
The deep veins of lower leg ascend with
respective major arteries
What is it called when thrombus becomes dislodged
An embolus
The lymphatics in lower leg drain into which 3 groups of nodes
- Superficial Inguinal
- Deep Inguinal
- Popliteal
Lymphatic vessels accompanying the great saph vein drain into where
superficial inguinal nodes
The lymphatics accompanying the small saphenous vein drain into
popliteal lymph nodes
enlargement of inguinal lymph nodes can be caused by
infection to any structure lying inferior to umbilicus
Dermatomes of Lower limb sensory supply comes from
lumbar and sacral plexus
Which dermatomes supplied by Sacral Plexus
Any of the S Dermatomes in Lower Limb
Which dermatome runs behind knee
S2
The anterior of the knee is commonly supplied by which dermatome
L3
The big toe is commonly supplied by which dermatome
L5
The little toe is supplied by which dermatome
S1
The hip joint is what type of joint
Ball and Socket Synovial
What is the acetabular labrum?
Fibrocartilage Collar
What are the 3 Main Ligaments of the Hip Joint
Ileofemoral, Ischiofemoral and Pubofemoral
Which ligament prevents hyperextension of hip
Ileofemoral Ligament
Which ligament prevents hyper abduction of hip
Pubofemoral Ligament
Which muscles arise from inner pelvis
Psoas Major and Iliacus
Iliacus and Psoas major attach onto
greater trochanter of femur
At which point does iliac and posts major become iliopsoas muscle
At greater trochanter of femur
Where does Pectineus arise from
Pubis
Which muscle attaches distally onto femur
Pectineus
The Iliacus, Psoas Major and Pectineus are supplied by branches from
Lumbar Plexus
Which 3 muscles are extensor of hip
- Gluteus Maximus
- Hamstrings
- Posterior Adductor Magnus
Which muscle is main extensor of hip
Glutei Maximus
Which 3 muscles that are hip extensors are supplied by branches from sacral plexus (l4-s3)
- Gluteus Maximus
- Hamstrings
- Posterior Adductor Magnus
Sacral Plexus runs from where to where
L4-S3
The Hip Adductor muscles are found where
Medial Thigh
Adduction of Hip is movement of straightened leg where
Inwards crossing axis of other leg
Hip Adductors are mostly supplied by
Obturator Nerve
What are the names of the Hip Adductor Muscles
Pectineus Femur Adductor Longus Adductor Brevis Adductor Magnus Gracialis Vastus Medialis
The Sacral Plexus innervates which Hip Adductor muscles
Pectineus Femur Adductor Longus Adductor Brevis Adductor Magnus Gracialis Vastus Medialis
Which muscle carries out Hip Abduction
Deep Gluteal Muscles via attachment to greater trochanter of femur
Which muscles are abductors of hip (3)
Gluteus Medius and Minimis, Piriformis and Tensor Fascia Latae
What is the most superficial and largest muscle of gluteal region
Gluteus Maximus
Which muscles of hip are essential for normal walking Gait
Hip Abductors
- Gluteus Medius and Minimis
- Piriformis
- Tensor Fasciae Latae
When you raise on leg off ground what happens to abductors on opposite of pelvis
They contract to provide stability
The hip abductor compartment is supplied by branches of
Lumbosacral Plexus
Turning the inside of the foot to face forward requires what movement of hip
Internal Rotation of Hip
Turning the inside of the foot to face backward requires what movement of hip
external rotation of hip
Muscles involved in external rotate of hip cross joint on which side
Posterior.
Muscles involved in external rotate of hip attach onto or around where
greater trochanter
Which muscles are involved in external hip rotation
- Piriformis
- Obturator Internus
- Obturator Externa
- Sup and inf Gamelli
- Quadratus Femoris
Muscles involved in internal rotation of hip cross joint where
anterior
which muscles are medial rotators of hip
- Glute Medius
- Glute Minimis
- Tensor Fascia Lata
Muscles of thigh are organised into what three compartments
Anterior
Medial
Posterior
Which muscle forms main bulk of ant thigh
Quad Femoris
What are the four heads of Quad Femoris
- Rectus Femoris
- Vastus Lateralis
- Vastus Intermedius
- Vastus Medius
Which nerve innervates anterior thigh muscles
Femoral Nerve
Femoral Nerve innervates which anterior thigh muscles
- Rectus Femoris
- Vastus Lateralis
- Vastus Intermedius
- Vastus Medius
What is the action of rectus femurs on hip
Flexion
Where does the quadriceps tendon form
Proximal to Patella
Distal to patella what does the quad tendon continue as
Patellar tendon
Where does patellar tendon insert
Anterior Tibia
To which part of Tibia does Patellar ligament attach
Tibial Tuberosity
Quadriceps actions
Flex Hip
Extend Knee
What is the longest muscle in body
Sartorius
Most superficial muscle in anterior thigh
Sartorius
Where does Sartorius run from and to
Prox Anterior Superior Iliac Spine to Pes Anserinus on Medial Tibia
Which three other muscles run from Prox Anterior Superior Iliac Spine to Pes Anserinus on Medial Tibia
- Sartorius
- Gracialis
- Semitendinous Muscle
3 Actions of Sartorius on Hip
- Weak flexion
- Abduct
- Lateral rotate thigh
Action of Sartorius at knee
Medially Rotate
Which action does Sartorius perform at Hip and Knee
Flexion
How do the muscles in medial compartment of thigh act on hip
Adduct
Which nerve innervates medially thigh muscles
Obturator S2-4
Through which bony foramen does nerve that innervates medial thigh enter thigh
Obturator
Medial Thigh Muscles (3)
- Pectineus
- Adductor Magnus
- Adductor Canal
What structures pass through adductor canal
Femoral Artery and Vein and Saph Nerve
Which fossa does Femoral Artery, Vein and Saph Nerve enter after passing through adductor canal
Popliteal Fossa
Medial Boundary of Femoral Triangle
Adductor Longus Muscle
Lateral Boundary of Femoral Triangle
Sartorius Muscle
Which structure forms base of femoral triangle
Inguinal Ligament
Which muscles form vast proportion of floor of femoral triangle
Pectineus
Iliposoas
Which three major structures present in femoral triangle
- Femoral Nerve
- Femoral Artery
- Femoral Vein
The femoral sheath is made up of what type of tissue
Connective
Lateral femoral sheath compartment
Femoral Artery
intermediate femoral sheath compartment
Femoral Vein
medial femoral sheath compartment
Femoral Canal
Cloquet node is found where
Femoral Sheath/Canal
Femoral Hernias are more common in
Females
What is the main artery of lower limb
Femoral
Where does femoral artery begin
inguinal ligament as continuation of ext iliac artery
Femoral artery enters thigh midway between which 2 bony surface markings
Ant Superior Iliac Spine
Pubic Symphysis
What is the deep artery in lower leg
Profunda Femoris
The femoral vein is continuation of which vein
Popliteal
the femoral vein passes where before entering femoral triangle
proximally
The femoral vein becomes which vein as it enters femoral triangle
Ext Iliac Vein as it passes under inguinal ligament
which two important veins drain into femoral triangle
Profunda Femoris and Great Saph Vein
What is the largest branch nerve of lumbar plexus
Femoral
What allows anterior femoral artery to become posterior popliteal artery
Adductor Canal
Lumbar Plexus roots
L1 to L4
Where does lumbar plexus emerge through
Psoas Major Muscle
Which nerves make up lumbar plexus
Lat Cutaneous nerve of thigh
Femoral Nerve
Obturator Nerve
What are two main motor nerves of lumbar plexus supplying lower limb
Obturator
Femoral
What is the one main sensory nerve of lumbar plexus
Lat Cutaneous Nerve
Nerve root value of Obturator and Femoral Nerves in Lumbar Plexus
L2-4
Nerve root value of lateral cutaneous nerve in lumbar plexus
L2-3
The pelvic girdle is joined anteriorly by
Pubic Symphysis
The pelvic girdle is joined posteriorly by
Sacroiliac joints
which sciatic foramen is route for structures entering or leaving pelvis
Greater Sciatic Foramen
Which sciatic foramen is a route for structures entering or leaving perineum
Lesser Sciatic Foramen
Innervation of Gluteus Maximis
L5, S1,S2
Innervation of Gluteus Medius
L4,5,S1
Innervation of Gluteus Minimis
L4,5,S1
Innervation of Tensor Fascia Lata
L4,5
What action do deep muscles of hip do on hip
External rotate, lat rotate and abduct
All the gluteus muscles and tensor fasciae latae nerve supply
sacral plexus
Action of gluteus medius, gluteus minimus and tensor fasciae latae
abduct and medially rotate hip
The deep fascia of thigh is called
Fascia Lata
Deep fascia of thigh extends from
Front of thigh
what is thickened laterally to form iliotibial tract
fascia lata
which two muscles attach to iliiotibial tract
tensor fascia lata and gluteus maximus
what provides stabilisation to lateral knee joint
ilitotibial tract
The sacral plexus lies on which muscle
piriformis
Sacral plexus formed by union of which ventral rami of spinal nerves
L4, L5, S1 to S4
The sacral plexus supplies
posterior aspect of lower limb plus perineum
Two main branches of sacral plexus
Main branch to lower limb sciatic nerve
Main branch to perineum: pudental nerve
Superior Gluteal nerve root value
L4-S1
Inferior Gluteal nerve root value
L5-S2
Muscles supplied by superior gluteal nerve
Gluteus Medius and Maximis
Tensor Fasciae Latae
Piriformis
Which muscle does inferior gluteal nerve supply
Gluteus Maximus
What is the largest nerve in body
Sciatic
Sciatic nerve root values
L4-S3
Sciatic nerve passes through where
Greater Sciatic Foramen inferior to Piriformis behind deep abductors of Hip between Ischial Tuberosity and Greater Trochanter of Femur to posterior enter thigh
Sciatic nerve divides at popliteal fossa into
Tibial Nerve
Common Fibular Nerve
which vertebrae is most common place for sciatica
L5
Which muscle of hamstrings is most lateral
Biceps Femoris
Posterior compartment of thigh muscles
Semimembranous
Semitendinous
Biceps femoris long head
short head of biceps femoris
Semimembranous
Semitendinous
Biceps femoris long head
short head of biceps femoris
all together are termed
Hamstrings
Action of hamstring on hip
Extend Thigh
Action of hamstring on knee
Flex Leg
which nerve innervates posterior thigh
Sciatic L3-S3
which branch of femoral artery contributes to posterior muscle compartment blood supply
Profunda Femoris
What type of joint is knee
Synovial Hinge
What is the most important muscle for knee stabilisation
Quads
Ligaments of Knee
ACL
PCL
Fib Collateral Ligament
Medial Menisci
The fibular or lateral collateral ligament extends from
Lat Epicondyle of femur to lateral head of fibula
The tendon of which muscle passes deep to LDL separating it from lat meniscus
Popliteus
The tibial or medial collateral ligament extends from
medial epicondyle of femur to medial tibia with attachment to superior epicondyle of tibia
At it’s midpoint the MCL is attached onto
medial meniscus of knee
The anterior cruciate ligament prevents femur from sliding
posterior on tibia
the posterior cruciate ligament prevents femur from sliding
anterior on tibia
What type of cartilage are knee menisci
fibrocartilage
Menisci of knee sit directly on
articular surfaces of tibia
Which meniscus firmly attaches to deep surface of tibia or MCL
Medial Menisci
What is the largest sesamoid bone in body
Patella
The patella is an anchor point for which tendon
Quad Femorus Tendon Superior
Patella Inferiorly
which movement of knee causes patella to move
Flexion
Which knee bursa communicates with articular cavity of knee joint
Suprapatellar Bursa
What is housemaid’s knee?
Inflammation of Bursa in Knee
