Overview of LE Flashcards
What kind of joint is the knee joint and what kind of movement does it allow for?
mostly hinge joint, flexion, extension and some rotation
Where is the medial malleolus located?
distal end of the tibia
What kind of joint is the hip joint and what kind of movement does it allow?
highly mobile synovial joint. Allows for flexion, extension, abduction, adduction, medial rotation and lateral rotation
Where is the talocural joint located? what kind of movement does it allow?
located between talus, distal tibia and lateral malleolus of the fibula. It is a hinge synovial joint that allows for dorsiflexion and plantar flexion
Where is the subtalar joint located? What kind of movement does it allow?
metatarsophalangeal joints. Synovial joint between talus and calcaneus. Allows for eversion and inversion
MTP joints
synovial joints located between metatarsals and proximal phalanges. Allows for flexion of toes, extension of toes, abduction and adduction
Interphalangeal joints
hinge synovial joints between the phalanges. Allows for flexion and extension
What are the 2 fascia layers of the LE?
superficial fascia, deep fascia
What is found in the superficial fascia of the LE?
fat, cutaneous nerves, superficial veins, lymphatic vessels, lymph nodes
Fascia lata
deep fascia of the thigh, firmly attached to pubis, inguinal ligament, iliac crest, sacrum, coccyx and ischial tuberosity
IT band
iliotibial tract, lateral thickening of fascia lata
What is the saphenous opening?
oval opening in the fascia lata, inferior to the inguinal ligament, the great saphenous vein and associated lymphatics pass through here
What separates the thigh into the anterior, posterior and medial compartments?
The intermuscular septa of the fascia lata, attach to the linea aspera
crural fascia
deep fascia of the leg, continuous with fascia lata
What separates the leg into anterior, posterior and lateral compartments?
2 intermuscular septa and the interosseous membrane between the tibia and fibula
What does the deep fascia form near the ankle joint?
extensor, flexor and fibular retinacula which help keep the tendons in place
What can the great saphenous vein be used for?
saphenous cut down procedure- used to give meds and fluids to pts with difficult veins
CABG- vein be harvest and used as graft
Where is the great saphenous vein?
arises from dorsal aspect of foot, passes anterior to medial malleolus and ascends along the medial aspect of the leg and thigh, enter saphenous opening in fascia lata
Where is the small saphenous vein located?
arises on lateral side of foot, ascends posterior leg and enters popliteal fossa and drains into popliteal vein
What are the superficial veins of the LE?
great saphenous vein, small saphenous vein
What are the deep veins of the LE?
femoral vein, deep vein of the thigh, popliteal vein
What are perforating veins?
connect the superficial and deep veins, have valves that only allow blood to travel from the superficial veins to the deep
musculovenous pump
When muscles contract, blood in the deep veins is propelled to the femoral and the iliac veins, presses valves open, pushing blood up
What causes varicose veins?
incompetent perforating veins, which allow large amounts of blood to reflux from the deep to the superficial veins. The superficial veins become distended as they receive large volume of blood
Where does lymph from the superficial gluteal region drain?
into the superficial gluteal lymph nodes>
external iliac lymph nodes
Where does lymph from the deep tissue in the gluteal region drain?
into the superior and inferior gluteal lymph nodes>
internal iliac lymph nodes
Where do superficial lymphatic vessels accompanying the great saphenous vein drain into?
superficial inguinal lymph nodes >
external iliac lymph nodes
Where do superficial lymphatic vessels accompanying the small saphenous vein drain into?
popliteal lymph nodes >
deep inguinal lymph nodes >
external iliac lymph nodes
Where do deep lymphatic vessels accompanying the deep veins drain?
into the deep inguinal lymph nodes >
external iliac lymph nodes
What are the spinal levels for the ventral rami of the lumbar plexus?
L1-L4
Iliohypogastric nerve spinal level? Sensory and motor function?
L1
sensory: skin of inguinal region and superolateral gluteal region
motor: abdominal muscles
Ilioinguinal nerve spinal level? Sensory and motor function?
L1
Sensory: skin of inguinal region, scrotum/labia majora and superomedial thigh
motor: abdominal muscles
What are the nerves of the lumbar sacral plexus?
iliohypogastric, ilioinguinal, genitofemoral, lateral cutaneous nerve of the thigh, obturator, femoral
Genitofemoral nerve spinal level? Sensory and motor function?
L1-L2
femoral branch: sensory to skin of superomedial thigh
genital branch: sensory to skin of scrotum/labia majora. Motor to cremaster muscle
Lateral cutaneous nerve of the thigh spinal level? Sensory and motor function?
L2-L3
sensory to skin of lateral thigh
Obturator nerve spinal level? Sensory and motor function?
L2-L4
emerges medial to psoas major, courses along lateral wall of the pelvis and exits via obturator canal
motor: medial compartment of thigh
sensory: skin of medial thigh
Femoral nerve spinal level? Sensory and motor function?
L2-L4
emerges lateral to psoas major, passes deep to inguinal ligament
motor: anterior comportment of thigh
sensory: skin of anteromedial thigh, leg and foot
What are the spinal levels for ventral rami of the sacral plexus?
L4-S4
What are the nerves of the sacral plexus?
lumbosacral trunk, superior gluteal, inferior gluteal, sciatic, and pudendal
spinal levels for lumbosacral trunk?
L4-L5 + S1-S4
Superior gluteal nerve
exits pelvis via greater sciatic foramen superior to piriformis
motor: to gluteus medius, gluteus minimus and tensor fascia latae
inferior gluteal nerve
exits pelvis via greater sciatic foramen inferior to piriformis
motor: to gluteus maximus
sciatic nerve spinal level? Sensory and motor function?
L4-S3
largest nerve in the body
motor: posterior compartment of thigh, all compartments of leg and foot
sensory: skin and most of leg
** sciatic nerve is a combination of common fibular nerve and tibial nerve
pudendal nerve spinal level? Sensory and motor function?
S2-S4
exits pelvis via greater sciatic foramen inferior to piriformis goes around ischial spine and enters perineum via the lesser sciatic foramen. enters the pudendal canal on the lateral wall of the ischioanal fossa
motor: muscles of the UG and anal triangles
sensory: skin of the UG and anal triagnles
