Organization of the lower limb Flashcards
why is the joint at the hip more secure but LESS mobile than the upper ilmb
it is more stable because the acetabulum captures the head of the femur to a greater degree than does the glenoid cavity
but this decreases the hip joints mobility
what does the capsule of the hip joint do?
helps with stability
limites extension and abduction
DOES LITTLE to inhibit flexion
what type of joint is the knee joint
modified hinge joint
what allows for climbing and running?
modified hinge joint at knee coupled with flexion at the hip
what is the role of the fibula. what does it NOT do?
mainly provides muscle attachment site
assists in forming mortise for ankle joint
DOES NOT add to stability or strength
what does the ankle joint allow for?
hinge joint
needed to jump and run
what is the purpose of the multiple jointed feet?
allows for spring needed for cushioned landing and for negotiating uneven surfaces
what are the layers of the superficial fascia?
fatty layer
membranous layer
what is in the space between the fatty layer and the membranous layer of superficial fascia?
superficial inguinal lymph nodes
subcutaneous blood vessels and nerves
what is deep fascia attached to superiorly and inferiorly?
most of the inferior aspect of the bony pelvis and is attached below to bony prominences at the knee and ankle
what is fascia lata
most superior portion of deep fascia
surrounds the thigh and a portion of the gluteal region
what is the gluteal aponeurosis
thickened portion of the fascia lata which extends inferiorly from the posterior portion of the iliac crest and forms and incomplete intermuscular septum between the gluteus maximus and medus muscles
iliotibial tract
lateral thickening of the fascia lata which serves as a tendon for the tensor fascia kata and gluteus maximus muscles
what does the iliotibial tract attach to
to the tibia
head of the fibula and blends with the capsule of the knee joint
where is the saphenous vein opening?
it is a circular opening in the superior anteromedial portion of the fascia lata below the inguinal ligament
presents a falciform margin (sickle shaped)
is underlain with fascia cribrosa and transmits the great saphenous v
part of superior fascia lata
what is crural fascia?
fascia that is an extension of fascia lata below the knee
anterior and posterior intermuscular septa of crural fascia are what and do what?
inward extensions of crural fascia to the fibula
delineate anterior and lateral crural compartments
what does the transverse intermuscular septa of the crural fascia do?
attaches between the tibia and fibula posteriorly
delineates superficial and deep posterior compartments
what does the retinacula of the ankle do?
prevents tendon bowstringing
where are the superior and inferior extensor retinacula
anterior surface
looks like a Z
where are the superior and inferior fibular retinacula
lateral surface of ankle
where is the flexor retinaculum
posteriormedial surface of ankle
what is the fascia of the dorsum of the foot continuous with?
extensor retinaculum
what is the plantar aponeurosis
its a thickened central component of the plantar fascia
what is the major function of muscles located in the anterior femoral compartment?
quads and sartorius
flex thigh and/or extend the leg
what supplies blood and innervation to the anterior femoral compartment
femoral artery and n
what is found in the femoral triangle?
femoral vein and artery and nerve
deep inguinal lymph nodes
what covers the femoral triangle?
fascia lata
what are the boundaries of the femoral triangle
inguinal ligament
sartorius
adductor longus
what is the main action of muscles in the medial femoral compartment
flex
adduct
rotate the thigh
what supplies blood and innervates the medial femoral compartment ?
branches of the obturator artery and nerve distribute within this compartment
what is the adductor canal?
canal connecting the femoral triangle with the popliteal fossa
what is the adductor canal bounded by? and what is found inside it?
sartorius
adductor musculature
vastus medialis
found inside is the femoral artery, vein, saphenous nerve and nerve to the vastus medialis
what is the main action of the superficial compartment muscles of the gluteal compartment
these muscles mimic the deltoid muscle
abducts
flexes andmedially rotates thigh
extends andlaterally rotates the thigh
what do the deep compartment muscles of the gluteal compartment do?
abduct and laterally rotate the thigh
what nerve passes through the gluteal compartment?
sciatic
what branches of arteries and nerves distribute to the gluteal compartment ?
superior and inferior gluteal artery and nerve
what is the main action of muscles located within the posterior femoral compartment?
flex the leg
extend the thigh
what arterial supply and innervation supplies the posterior femoral compartment?
branches of the deep femoral artery and vein
sciatic nerve (traverses the entire length)
what is the popliteal fossa bounded by?
semimembranosus semitendinosus biceps femoris gastrocnemius fascia lata
what does the popliteal fossa contain?
popliteal a and its branches
popliteal v
bifurcation of sciatic nerve into its common fibular and tibial branches
what do the muscles of superficial compartment of the posterior crural compartment do?
flex the leg
plantar flex the foot
includes:
gastrocnemius
soleus
plantaris
what is the main action of the deep compartment muscles of the posterior crural compartment ?
plantar flex
invert the foot
what innervates the posterior crural compartment?
tibial nerve and tibial artery
what do the muscles of the lateral crural compartment do? what innervates this compartment
plantar flex and evert the foot
branches of the superficial fibular n. and fibular a.
what do the muscles of the anterior crural compartment do?
dorsi flex and invert the foot
extends toes
assists in eversion of the foot
what is the innervation of the anterior crural compartment
deep fibular n.
anterior tibial a.
what are the four compartments of the foot?
what innervates and supplies blood to this
medial
lateral
central
interosseous
posterior tibial a (bifurcates to form lateral and medial plantar aa.)
tibial n (bifurcates to form the lateral and medial plantar nn.
what is the major artery of the lower limb?
femoral a
when does the femoral a become the popliteal
upon escaping the adductor canal
when does the popliteal a bifurcate to become anterior and posterior tibial arteries ?
upon exiting the popliteal fossa
what does the posterior tibial a provide circulation for?
posterior and lateral compartment (via fibular a.) of the leg and plantar surface of the foot
where are the major anastomoses in the lower limb located?
hip
knee
ankle
foot
where does the great saphenous vein begin?
begins on the medial side of the dorsum of the foot
where does the great saphenous vein ascend
medially along the leg and thigh
ANTERIOR to the medial malleolus at the ankle
POSTERIOR to the medial condyle of the femur at the knee
parallels the corse of the saphenous nerve in the leg
when does the saphenous vein empty into the femoral vein?
after passing through the saphenous vein opening of the fascia lata
where does the lesser saphenous vein begin
on the lateral side of the dorsum of the foot
what is the path of the lesser saphenous vein
ascends behind the lateral malleolus and along the midline of the calf paralleling the course of the sural n.
pierces the crural fascia to join the popliteal vein
what is a problem that can happen with superficial veins?
because they have valves, due to increased back flow and subsequent valvular incompetency these can form varicosities
ALSO these veins are used in coronary by=pass surgery
what is the cord levels of femoral nerve
L2 3 4
where does the femoral nerve enter the leg?
deep to the inguinal ligament and enters the femoral triangle
what does the femoral nerve innervate?
anterior femoral musculature and skin of the anterior thigh, medial leg and medial foot
what are the cord levels of the obturator n
L2 3 4
where does the obturator nerve enter the thigh
via the obturator canal
sends a posterior branch behind the obturator muscle and an anterior branch in front of this muscle
what does the obturator nerve provide innervation for?
motor innervation to the adductor muscles of the thigh
cutaneous innervation to the medial surface of the thigh
what are the cord levels of the sciatic nerve
L4, 5
S 1 2 3
where does the sciatic nerve exit the pelvis? and where does it run thereafter and split into?
via the greater sciatic foramen
courses through the posterior thigh to bifurcate in the popliteal fossa into tibial and common fibular nn.
what does the sciate n innervate
all of the posterior thigh, leg, and plantar musculature
specific cutaneous areas
cutaneous innervation of the lower limb is accomplished by branches of what?
branches of the lumbar and sacral plexuses (VENTRAL rami of spinal nerves L1-L2)
and DORSAL rami of spinal nerves L1-L3 and S1-S3
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dermatomes of the lower limb invovle what spinal cord levels?
L1-S2
spiral around the limb from lateral to medial in “barber pole” fashion
where is the L4 dermatome
located anterior to the greater trochanter
overlays the patella, medial malleolus and great toe
where is S1 and S2 dermatomes
both descend the middle of the posterior thigh and leg
S1 overlays the lateral malleolus
S2 is located on the medial plantar surface of the heel
where are L4,5 and S1
cross the dorsum and plantar surface of the foot from medial to lateral
