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Appendicular anatomy > Nerves and blood supply of the lower limb > Flashcards

Nerves and blood supply of the lower limb Flashcards

1
Q

What is a plexus

A

a plexus is a network, latin- plecture, means to intertwine- forms peripheral nerves.

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2
Q

what is the lumbar plexus

A

L1-L5 at each level a peripheral spine nerve leaves, this produces neuro material which goes into the plexus, this then exits as a nerve

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3
Q

what is a sacral plexus

A

Sacral plexus- S1-S5

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4
Q

where is the spinal cord from

A

from the cervical region down to L1,2.

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5
Q

what is the cauda equina

A

conus medullaris between L1 and L2, this goes to the cauda equina. This forms peripheral nerve that exit via intervertebral foramen, through the sacrum they exit via anterior sacral foramen- joint sacral plexus

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6
Q

peripheral spinal nerves

A

emerges from spinal cord via a ventral (front) and dorsal (back) root. Dorsal root- carries sensory information to the spinal cord (dorsal root ganglia- contain the sensory cell bodies), ventral root- carries motor information from the anterior horn cells

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7
Q

what are the anterior horn cells

A

to do with motor response

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8
Q

what are dermatomes

A

area of the skin supplied by a single spinal nerve of spinal cord level

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9
Q

what does each spinal nerve do

A

each spinal nerve carries somatic sensory information from specific areas of skin,

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10
Q

outlets from the pelvis- inguinal tunnel

A

femoral nerve- L2,L3,L4

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11
Q

outlets from the pelvis- greater sciatic foramen

A

sciatic nerve, gluteal nerve

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12
Q

outlets from the pelvis- obturator canal

A

obturator nerve

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13
Q

outlets from the pelvis- peripheral nerves

A

peripheral nerves from different origins (L1,L2 etc) join together to form plexus, these join together to share information and form a single nerve

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14
Q

Main branches of the lumbosacral plexus

A

femoral nerve- saphenous nerve, obturator nerve, sciatic nerve- tibial nerve (medial and lateral plantar nerve), common peroneal nerve (deep and superficial), superior and inferior gluteal nerves

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15
Q

what is the lumbar plexus

A

ventral rami of spinal nerves of T12-L4, lies within the posterior part of the psoas major, supplies the abdominal wall and lower extremities

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16
Q

branches of the lumbar plexus- muscle branches

A

femoral nerve L2,L3,L4

Obturator nerve- L2,L3,L4

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17
Q

branches of the lumbar plexus- other nerves

A

iliohypogastric, ilio-inguinal, genitofemoral, lateral cutaneous nerve of thigh

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18
Q

femoral nerve

A

carries information from the anterior rami of L2-L4 and runs through psoas major and under the inguinal ligament lateral to the femoral artery and vein, to enter the femoral triangle on the anteromedial aspect of the thigh- splits into anterior and posterior divisions

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19
Q

femoral nerve- branches into pelvis and distal to the inguinal ligament

A

iliacus, pectineus, inguinal ligament- saphenous nerve- cutaneous, supplying skin of the anteromedial aspect of leg and medial aspect of the foot

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20
Q

anterior divisions of the femoral nerve

A

sartorius, intermediate cutaneous nerve of thigh, medial cutaneous nerve of thigh

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21
Q

posterior division of femoral nerve

A

saphenous nerve and quadriceps

22
Q

obturator nerve

A

originates from ventral rami of L2-L4, runs through psoas major, emerging at medial border; passes down on obturator internus; exits pelvis through the obturator foramen

23
Q

what does the obturator nerve supply

A

adductor group, gracilis, pectineus obturator externus, medial side of thigh, knee and hip joint

24
Q

iliohypogastric nerve

A

originates from L1, innervates- skin over lower abdominal above the pubis and lower back and hip, transverse abdominis, inter and external obliques

25
Q

genitofemoral nerve

A

originates at L1-L2 innervates- anterior thigh inferior to inguinal region

26
Q

ilio-inguinal nerve

A

originates L1, innervates- skin of external genitalia, proximal medial aspect of thigh, transverse abdominis, obliques

27
Q

lateral cutaneous nerve of thigh

A

originates L2-L3- passes under the inguinal ligament medial to the ASIS, innervates- lateral skin of thigh

28
Q

what is meralgia paresthetica

A

it is a condition characterized by tingling, numbness and burning pain in the outer part of your thigh. The condition is caused by compression of the lateral femoral cutaneous nerve

29
Q

what is the sacral plexus

A

it arises from ventral rami of S1-S4, contribution from lumbar plexus (L4-L5), lies anterior to the piriformis muscle and posterior pelvic wall, exits via the greater sciatic notch

30
Q

branches of the sacral plexus

A

sciatic nerve, superior/ inferior gluteal nerve, quadratus femoris and gemellus inf, obturator internus and gemellus sup, piriformis

31
Q

sciatic nerve

A

largest nerve in the body- L4-S3, consists of 2 nerve bundles- tibial nerve and common peroneal nerve, leaves pelvis via greater sciatic notch, exits just inferior to piriformis

32
Q

sciatic nerve innervates

A

hamstrings, adductor magnus

33
Q

sciatic nerve route

A

passess vertically down the back of the thigh, lying on adductor magnus, covered by long head bicep femoris. it divides into common peroneal (wraps around the head of fibula) and tibial nerve (straight through knee joint) between hip and popliteal fossa

34
Q

superior gluteal nerve

A

fibres from L4,L5,S1, innervates- gluteus med and min, and TFL

35
Q

inferior gluteal nerve

A

fibres from L5,S1,S2, innervates gluteus maximus

36
Q

tibial nerve

A

fibres from L4-S3, innervates popliteus, plantaris, gastrocnemius, soleus, tibialis posterior, FHL, FDL, it gives a branch to the sural nerve

37
Q

what does the tibial nerve split into

A

medial and lateral plantar nerves

38
Q

what is the sural nervw

A

sensory nerve that supplies the skin over the lateral side of the lower third of leg, derives from branches from both tibial and common peroneal nerve

39
Q

lateral plantar nerve innervates

A

remaining deep muscles, lumbricals (2,3,4), interossei, adductor digiti minimis, adductor hallucis, sensory cutaneous- 5th toe and lateral half of 4th toe

40
Q

medial plantar nerve innervates

A

FDB, FHB, 1st Lumbrical, sensory cutaneous- skin medial to big toe, skin between 1st and 4th toes

41
Q

common peroneal nerve

A

fibres from L4-S2, wraps around neck of fibula, splits into deep and superficial peroneal nerves

42
Q

superficial peroneal nerve

A

peroneus longus/ peroneus brevis- lateral compartment, skin over lateral leg , splits into medial and lateral branches

43
Q

deep peroneal nerve

A

innervates dorsiflexors, tibialis anterior, EHL, EDL, peroneus tertius, ankle joint

44
Q

deep peroneal nerve lateral branch

A

EDB/ 2nd dorsal interossei, tarsal and MTP joint

45
Q

deep peroneal nerve medial branch

A

1st dorsal interossei, 1st tarsal and MTP joint, skin between big and second toe

46
Q

femoral artery

A

this is a major artery supplying the lower limb which is the contribution of the external iliac artery, the artery continues down the thigh in the femoral canal, continuous in the adductor hiatus and then becomes the popliteal artery posterior to knee

47
Q

what does the external iliac artery become the femoral. artery

A

as the vessel passes under the inguinal ligament and enters the femoral triangle

48
Q

popliteal artery

A

this is the major artery that supplies the leg and foot and enters the posterior compartment of the leg from the popliteal fossa. in the posterior compartment the popliteal artery divides into the anterior tibial artery and posterior tibial artery

49
Q

where can the popliteal artery be palpated

A

in the popliteal fossa

50
Q

lower limb arterial supply

A

popliteal artery splits into- posterior and anterior tibial arteries, and dorsal pedis

51
Q

anterior and posterior tibial artery

A

anterior- anterior aspect ankle between EHL and 1st tendon of EDL
posterior- enters the foot through the tarsal tunnel on the medial side of the ankle and posterior medial malleolus

52
Q

what is the dorsalis pedis

A

this is the continuation of the anterior tibial artery as it crosses the ankle joint. the pulse could be palpated on the dorsal aspect of the foot palpitating the vessel against the tarsal bone between the tendons of FHL and FDL to second toe

Appendicular anatomy (20 decks)

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