Overview of LE Flashcards
What are the bones of the lower extremity
Os Coxae femur patella tibia fibula 7 tarsals 5 metatarsals 14 phalanges (toe has proximal and distal only )
What are the regions of the Tibia
medial and lateral tibial condyles
shaft
medial malleolus of the tibia
What are the regions of the fibula
head
shaft
lateral malleolus
What bone bears most of the weight in the leg
Tibia
What kind of joint is the hip joint
Acetabulum and head of femur have a ball and socket synovial joint
What does the talus articulate with
distal tibia and lateral malleolus of the fibula
What kind of joint is the knee joint
femoral and tibial condyles have a hinge joint (SOME medial and lateral rotation)
What kind of joint is the Talocrural(ankle) joint
hinge joint
What kind of joint is the subtler joint
talus and calcaneus have a synovial joint capable of inversion and eversion
What are metatarsophalangeal joints
synovial joints between metatarsals and phalanges
What movements are the MTP joints capable of
Flexion (toes towards the ground)
Extension (toes away from ground
Abduction (move away from 2nd digit)
Adduction (move towards 2nd digit)
What are interphalangeal joints
Hinge synovial joints between phalanges Can be PIP (proximal to middle phalange) or DIP (middle to distal phalange)
What movements are the IP joints capable of
Flexion (toes away from the ground)
Extension (toes towards the ground)
What is found in the superficial fascia of the LE
cutaneous nerves, SF veins, lymph, fat
What is found in the deep fascia of the LE
dense connective tissue, similar to elastic stocking
What are the regions of the deep fascia in the LE
Thigh: Fascia lata
Leg: crural fascia
What is the fascia lata attached to
Inguinal ligament, pubis, iliac crest, sacrum, coccyx, ischia tuberosity
What opening in the fascia lata is inferior to the inguinal ligament
Saphenous opening
great saphenous vein and associated vessels pass through
What is the lateral thickening of the fascia lata
Iliotibial tract (which is attached to tensor fascia latae)
What intermuscular septa arise from fascia lata
3, which attach to linea aspera diving thigh into anterior, medial, and posterior compartments
What intermuscular fascia arise from the crural fascia
2, which attach to fibula (along with interosseous membrane) which divide leg into anterior, lateral, and posterior compartments
Another fascia divides posterior into SF and deep
What does the crural fascia become distally, near the ankle joint
It thickens to become extensor, flexor, and fibular retinacula
Where does the great saphenous vein run
dorsal aspect of foot, anterior to medial malleolus
ascend along medial leg and thigh
enter saphenous opening in fascia lata
drain into femoral vein
What is the saphenous cut down procedure
Access to saphenous vein anterior to medial malleolus to administer fluids and meds quickly in obese, infants, and dehydrated patients (collapsed veins)
What are great saphenous grafts used for
Coronary bypass surgery (CABG)
it is accessible,
walls have muscular and elastic fibers, there are long distances between tributaries
What is the path of the Small saphenous vein
arises from lateral foot
posterior to lateral malleolus
enter popliteal fossa
drain into popliteal vein
What are the major Deep veins of the LE
popliteal vein
deep vein of the thigh
femoral vein
What are perforating veins
Veins connecting superficial to deep veins, containing valves to make sure blood only flows SF to deep
How do we prevent blood from pooling in the legs
- Musculovenous pump: when muscles contract, blood un deep veins is propelled to femoral and external iliac veins
- Valves in the deep veins prevent reflux of blood inferiorly
What are varicose veins
When valves in the perforating veins malfunction leading to back flow of blood from deep to superficial, distending SF veins
Where does the SF gluteal region drain lymph
SF glutes–>SF inguinal nodes–>external iliac–>common iliac–>lumbar nodes–>chyle cistern–>thoracic duct
Where does the deep gluteal region drain lymph
deep gluteal–>superior/inferior gluteal nodes–>internal iliac nodes–>common iliac nodes–>lumbar nodes–>chyle cistern–>thoracic duct
Where do SF thigh/leg/foot with great saphenous vein drain lymph
Drain into SF inguinal nodes–>external iliac nodes–>common iliac etc.
Where do SF thigh/leg/foot with small saphenous vein drain lymph
popliteal nodes–>deep inguinal nodes–>external iliac nodes–>common iliac nodes etc.
What makes up the Lumbar plexus
Iliohypogastric (L1) Ilioinguinal (L1) Genitofemoral (L1-L2) Lateral cutaneous of thigh (L2-L3) Obturator (L2-L4) Femoral (L2-L4)
What makes up the Sacral plexus
Lumbosacral trunk (L4-L5) Superior gluteal Inferior gluteal Sciatic (L4-S3) Pudendal (S2-S4)
What is the course of the sciatic nerve
Exits greater sciatic foramen, inferior to piriformis
Enters gluteal region (does not innervate glutes)
What is the course of the pudendal nerve
Exits greater sciatic foramen inferior to piriformis
Goes around ischial spine
Enters lesser sciatic foramen
Enters pudendal canal
What is the course of the obturator nerve
Emerge medial to posts major
exit obturator canal
What is the course of the femoral nerve
Emerge lateral to psoas major
