Musculoskeletal Anatomy - Lower Limb Flashcards
what are the two superficial veins draining the lower leg?
great saphenous vein
small saphenous vein
which superficial vein of the lower leg ascends anteriorly to the medial malleolus?
great saphenous vein
which superficial vein of the lower leg ascends posteriorly to the lateral malleolus?
small saphenous vein
where does the great saphenous vein drain, and into which vein?
it drains into the femoral vein in the inguinal region
where does the small saphenous vein drain, and into which vein?
it drains into the popliteal vein in the popliteal fossa
which superficial vein of the lower leg presents more commonly with varicose veins?
great saphenous vein
what are the major groups of lymph nodes in the leg, and which veins are they associated with?
superficial inguinal nodes - great saphenous vein
deep inguinal nodes - femoral vein
popliteal nodes - small saphenous vein/popliteal vein
what is the dermatome of the knee?
L3
what is the dermatome of the big toe?
L5
what is the dermatome of the little toe?
S1
which artery is damaged in avascular necrosis of the hip?
medial circumflex femoral artery
what are the boundaries of the femoral triangle?
inguinal ligament
sartorius muscle
adductor longus muscle
what are the contents of the femoral triangle, lateral to medial?
femoral nerve
femoral artery
femoral vein
inguinal lymph nodes
name the main flexors of the hip
iliacus/psoas major pectineus sartorius rectus femoris tensor fascia latae
name the main extensors of the hip and their innervation
gluteus maximus
semitendinosus
semimembranosus
biceps femoris
what is the cutaneous innervation of the sole of the foot?
medial plantar nerve lateral plantar nerve saphenous nerve sural nerve medial calcaneal nerve (branch of tibial)
name the main abductors of the hip and their innervation
tensor fascia lata
gluteus medius
gluteus minimus
name the main adductors of the hip
adductor brevis adductor longus adductor magnus gracilis pectineus
name the main internal rotators of the hip
tensor fascia lata
anterior fibres of gluteus medius
name the main external rotators of the hip
piriformis obturator internus obturator externus gemelli (sup and inf) quadratus femoris
what is Shenton’s line, and what is its purpose?
line formed by superior pubic ramus and neck of femur
disruption in the line can indicate a neck of femur fracture
what is the blood supply to the femoral head?
medial and lateral femoral circumflex arteries
obturator artery branch (via ligamentum teres of head of femur)
intramedullary blood supply
what structure passes through the ligament of head of femur (ligamentum teres) and what is its significance?
branch of obturator artery - supplies head of femur
the medial and lateral femoral circumflex arteries arise from which artery?
profunda femoris artery
what is the surgical management of intracapsular and extracapsular hip fractures?
intracapsular - replacement (unless young/undisplaced, in which case fix)
extracapsular - intramedullary nail fixation
what is the main factor contributing to the difference in surgical management of intracapsular and extracapsular hip fractures?
whether the blood supply to the head of femur is compromised as a result of the fracture
what is the purpose of the patella?
extension of the knee, acting as a lever for the quadriceps femoris
what is the main extensor of the knee joint?
quadriceps femoris
what are the main flexors of the knee joint?
semitendinosus semimembranosus biceps femoris sartorius gracilis popliteus (unlocks knee)
what is the purpose of the popliteus muscle?
it unlocks knee before flexion
what is the purpose of the menisci?
transmit load
shock absorption
proprioception
stability
what type of joint are the ankle joint and subtalar joint?
ankle joint - hinge
subtalar joint - plane
during which joint movement is the ankle joint the most stable?
during dorsiflexion
which joints in the foot are responsible for inversion and eversion?
subtalar joint
transverse tarsal joint
what is the transverse tarsal joint made up of?
talo-navicular joint
calcaneo-cuboidal joint
which muscles are responsible for inversion of the foot?
tibialis anterior
tibialis posterior
which muscles are responsible for eversion of the foot?
fibularis longus
fibularis brevis
what are the contributors to the arch form in the foot?
- long and short plantar ligaments
- plantar aponeurosis
- spring ligament (calcaneonavicular)
- intrinsic foot tendons
- shape of the bones
what is a common cause of acquired flat feet?
posterior tibial muscle dysfunction
what are the functions of the arches in the foot?
distribute weight
shock absorption
springboard for walking/jumping/running
what are tarsal coalitions and where are they most commonly found?
tarsal bones becoming stuck to eachother
commonest are calcaneonavicular and talocalcaneal
what are the most frequently found accessory bones in the foot?
accessory navicular
os trigonum
os peroneum
what is the Apical Ectodermal Ridge?
it’s an area of ectoderm at the end of each limb bud which promotes the differentiation and proliferation of mesenchymal cells into blood vessels, cartilage, muscle, bone
by which week of embryological development do fingers and toes separate from eachother?
week 8 of development
once hand and foot plates are formed in the embryo, what rotation occurs in each?
upper limb buds - rotate laterally
lower limb buds - rotate medially
what’s the structure responsible for limb development in the embryo?
apical ectodermal ridge
during bone development in the embryo, what do the primary and secondary ossification centres form respectively?
primary ossification centre - diaphysis/shaft
secondary ossification centre - epiphysis
what are the genes responsible for bone formation?
HOX genes
what type of cells make up limb buds in the embryo?
ectoderm
mesenchyme
what is syndactily?
fusion of fingers, either through webbing (cutaneous syndactily) or with fused bones (osseous syndactily)
what causes syndactily?
digital rays don’t develop in the hand plate in utero
what is the commonest type of clubfoot seen in babies, and what does it look like?
talipes equinovarus - foot inverted medially and downwards
how common is talipes equinovarus?
1 in 1000 babies
