Musculoskeletal (Lower limbs) ANATOMY Flashcards
What are the 3 main long bones in the lower limb?
- Femur (proximal).
- Fibula (distal and lateral).
- Tibia (distal and medial).
What nerve innervates the muscles in the anterior compartment of the thigh?
The femoral nerve, L2-4.
What is the action of the majority of the muscles in the anterior compartment of the thigh?
Extension of the leg at the knee.
What is the origin of psoas major?
Transverse processes of T12-L5 vertebrae.
What is the origin of iliacus?
The iliac fossa and the pelvis.
Where does iliopsoas insert?
The lesser trochanter of the femur.
What is the innervation to psoas major?
Anterior rami of L1-3.
What is the innervation to iliacus?
Femoral nerve L2-4.
What is the action of iliopsoas?
Flexes the lower limb at the hip.
What muscles make up quadriceps femoris?
- Vastus medialis.
- Vastus intermedius.
- Vastus lateralis.
- Rectus femoris.
What is the lower part of quadriceps femoris related to?
The suprapatellar bursa.
What attaches the patella to the tibia?
The patella ligament.
What is the action of the vasti muscles?
Extension at the knee.
What is the action of rectus femoris?
Extension at the knee and flexion at the hip.
What is the innervation of quadriceps femoris?
Femoral nerve, L2-4.
What is the origin of sartorious?
ASIS.
What is the action of sartorious?
Flexion, abduction and lateral rotation at the hip. Flexion at the knee.
What is the innervation to sartorious?
Femoral nerve, L2-4.
How can you test the action of quadriceps femoris?
Ask the patient to extend their legs against resistance whilst lying in a supine position.
What nerve innervates the muscles in the medial compartment of the thigh?
Obturator, L2-4.
What is the action of the majority of the muscles in the medial compartment of the thigh?
Hip adductors.
Name the 5 muscles found in the medial compartment of the thigh.
- Gracilis.
- Obturator externus.
- Adductor brevis.
- Adductor longus.
- Adductor magnus.
Where do adductor brevis, adductor longus and adductor magnus originate and insert?
Origin: pubis.
Insertion: medial femur.
What is the action of adductor brevis, adductor longus and adductor magnus.
Adduction of the thigh.
What is the innervation of adductor brevis, adductor longus and adductor magnus.
Obtruator nerve, L2-4.
What forms the superior border of the femoral triangle?
The inguinal ligament.
What muscle forms the medial border of the femoral triangle?
Adductor longus.
What muscle forms the lateral border of the femoral triangle?
Sartorious.
What are the contents of the femoral triangle?
Femoral nerve, femoral artery, femoral vein and lymph nodes. NAV lateral to medial.
What is the femoral canal and what does it contain?
A potential space medial to the femoral vein. It contains lymph nodes.
Define hernia.
The protrusion of an organ through the wall of the cavity containing it.
What is a femoral hernia?
Protrusion of bowel into the femoral canal. This manifests as a bulge in the thigh.
What is the subsartorial canal?
A passageway for vessels extending from the femoral triangle to the popliteal fossa at the back of the knee.
What is the saphenous opening?
An opening in the fascia lacta pierced by the great saphenous vein.
What is the surface marking for the saphenous opening?
4cm below and lateral to the pubic tubercle.
What are the contents of the femoral sheath?
Femoral artery, veins and lymphatics.
What is the surface marking for the femoral artery?
2cm below the mid-inguinal point.
Where is the femoral artery pulsation palpable?
Below the mid-inguinal point.
Name the arteries in between the aorta and the femoral artery?
Aorta -> common iliac arteries -> external iliac arteries -> femoral artery.
Name the 2 main branches of the femoral artery.
- Profunda femoris artery.
- Superficial femoral artery.
Which veins join to become the common femoral vein?
The superficial femoral vein and the profunda femoris vein.
Name all the major veins blood flows through from the femoral vein to the heart?
Femoral vein -> external iliac vein -> common iliac vein -> IVC -> heart.
If you do a femoral puncture to take blood from the femoral vein, do you introduce the needle lateral or medial to the femoral arterial pulsation?
Medial. NAV therefore vein is medial to artery.
What is the motor supply of the femoral nerve?
Anterior thigh compartment muscles.
Which joints does the femoral nerve supply?
The hip and knee.
What are the problems produced by weak quadriceps?
Difficulty walking downstairs.
In what muscle is the obturator nerve formed?
Psoas major.
Define referred pain.
Pain arising from one area but it’s felt elsewhere.
Give an example of referred pain in the leg.
Medial thigh pain can be felt due to inflammation of the ovary irritating the obturator nerve.
What is the femoral artery a continuation of?
The external iliac artery.
When does the external iliac artery become the femoral artery?
When it crosses under the inguinal ligament into the femoral triangle.
What artery does the obturator arise from?
The internal iliac artery.
Name the 3 glutei muscles.
- Gluteus maximus.
- Gluteus medius.
- Gluteus minimus.
Where does gluteus maximus insert?
The iliotibial tract and the gluteal tuberosity of the femur.
What is the action of gluteus maximus?
Extension of the thigh.
What is the innervation of gluteus maximus?
Inferior gluteal nerve.
What is the action of gluteus medialis and minimus?
Abduction of the lower limb.
What is the innervation of gluteus medialis and minimus?
Superior gluteal nerve.
When do you abduct the hip joint?
When walking.
What is the usual function of the abductors of the hip joint?
They hold the pelvis level when you take one foot off the ground.
Where do gluteal vessels and nerves emerge from?
The greater sciatic foramen.
What are the nerve roots of the sciatic nerve?
L4-S3.
What does the sciatic nerve innervate?
The muscles of the posterior thigh and the hamstring part of adductor magnus.
What does the sciatic nerve bifurcate into?
The tibial and common peroneal (common fibular) nerves.
What 3 muscles make up the hamstrings?
- Biceps femoris (lateral).
- Semimembranous (medial).
- Semitendinous.
What is the action of the muscles in the posterior compartment of the thigh?
Extension at the hip and flexion at the knee.
When do the extensors of the hip joint act?
When climbing the stairs.
What is the innervation of the muscles in the posterior compartment of the thigh?
Sciatic nerve L4-S3.
Where does the biceps femoris tendon insert?
The head of the fibula.
What muscle forms the superiomedial border of the politeal fossa?
Semimembranosus muscle.
What muscle forms the superiolateral border of the politeal fossa?
Biceps femoris.
What muscle forms the inferiormedial border of the politeal fossa?
Medial head of the gastrocnemius.
What muscle forms the inferiorlateral border of the politeal fossa?
Lateral head of the gastrocnemius and plantaris.
What forms the roof of the popliteal fossa?
Fascia.
What are the contents of the popliteal fossa?
- Popliteal artery.
- Popliteal vein.
- Tibial nerve.
- Common peroneal nerve.
How are the arteries, veins and nerves arranged in the popliteal fossa?
Usually NAV from lateral to medial. The nerve is always most superficial and the artery is always deepest.
How can you examine the hamstrings in the living?
Active flexion of the knee.
Name 4 muscles that insert on to the medial condyle of the tibia.
- Semitendinosus.
- Semimembranosus.
- Sartorious.
- Gracilis.
How does the popliteal artery reach the popliteal fossa?
As the femoral artery through the adductor canal.
What superficial vein drains into the popliteal vein?
The great saphenous vein.
What is the surface marking of the sciatic nerve?
Lower medial quadrant of the buttock.
What is the effect of a complete transection of the sciatic nerve?
Loss of hamstring function and of muscles below the knee.
What is the origin of the long head of the biceps (biceps femoris, NOT to be confused with biceps brachi), semitendinosus and semimembranosus?
The ischial tuberosity.
What is the origin of the short head of the biceps?
Linea aspera.
Where does biceps femoris tendon insert?
The head of the fibula.
Which of the hamstrings muscles lies most lateral?
The biceps femoris.
How can you identify semitendinosus?
It has a very long tendon attaching to the medial condyle of the tibia.
Define myotome.
A group of muscles supplied by the same spinal nerve root.
What is the dermatome of the big toe?
L5.
What is the dermatome of the little toe?
S1.
What is the dermatome of the patella?
L3.
What is the myotome for leg adductors?
L2.
What is the myotome for the quadriceps?
L3.
What is the spinal reflex for the ankle?
S1/2.