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Anatomy Exam 2 > Overview of the Lower Extremity > Flashcards

Overview of the Lower Extremity Flashcards

1
Q

What are the Divisions of the Lower Extremity?

A
  • Gluteal region
  • Thigh (hip to knee)
  • Popliteal fossa (posterior aspect of knee)
  • Leg (knee to ankle)
  • Foot (dorsal and plantar aspects)
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2
Q

Describe the Bones of the lower extremity

A
  • Hip bones (ilium + ischium + pubis),
  • femur,
  • patella,
  • tibia (medial bone of leg),
  • fibula (lateral bone of leg),
  • 7 tarsals
  • 5 metatarsals (proximal part is the base, distal part is the head),
  • 14 phalanges (proximal, middle, distal; the hallux (big toe) has a proximal and distal phalanx only)
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3
Q

What are the 7 tarsals?

A
  • calcaneus
  • talus
  • navicular
  • cuboid
  • medial
  • intermediate
  • lateral cuneiforms
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4
Q

What are the parts of the femur

A
  • Head
  • Neck
  • Shaft (body) with linea aspera (on posterior surface)
  • Medial and lateral femoral condyles (distal)
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5
Q

What are the parts of the tibia

A
  • Medial and lateral tibial condyles (proximal)
  • Shaft (body)
  • Medial malleolus is the distal protuberance on the medial side of the ankle
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6
Q

What are the parts of the fibula

A
  • Head
  • Shaft (body)
  • Lateral malleolus is the distal protuberance on the lateral side of the ankle
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7
Q

What are the Joints and Movements of the Lower Extremity?

A
  • Hip Joint –> Ball and socket synovial joint
  • Knee Joint –> Hinge synovial joint
  • Ankle (Talocrural) Joint –> Hinge synovial joint
  • Subtalar Joint –> Synovial joint
  • Metatarsophalangeal (MTP) Joints –> Synovial joints
  • Interphalangeal (IP) Joints –> Hinge synovial joints
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8
Q

Describe the Hip Joint connection and movement

A
  • Acetabulum of the hip bone articulates with the femoral head
  • Flexion reduces the angle between the thigh and trunk anteriorly
  • Extension increases the angle between the thigh and trunk anteriorly
  • Abduction draws the thigh away from the midline of the body
  • Adduction draws the thigh towards the midline of the body
  • Medial rotation femur rotates medially along its long axis
  • Lateral rotation femur rotates laterally along it long axis
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9
Q

Describe the knee joint connection and movement

A
  • Femoral condyles articulate with the tibial condyles
  • Flexion brings the leg closer to the posterior aspect of the thigh
  • Extension draws the leg away from the posterior aspect of the thigh
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10
Q

Describe the ankle (Talocrural) Joint connection and movement

A
  • Talus articulates with distal tibia and lateral malleolus of the fibula
  • Dorsiflexion brings the foot closer to the anterior aspect of the leg (directs toes superiorly)
  • Plantarflexion draws the foot away from the anterior aspect of the leg (directs toes inferiorly)
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11
Q

Describe the Subtalar Joint connection and movement

A
  • Synovial joint between the talus and the calcaneus
  • Eversion causes the sole of the foot to face laterally
  • Inversion causes the sole of the foot to face medially
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12
Q

Describe how the muscle/tendon units move the foot

A

Muscles will have multiple actions (e.g., dorsiflexion & inversion), depending on where their tendon passes relative to the talocrural and subtalar axes of motion.

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13
Q
  • Synovial joints between the metatarsals and the proximal phalanges
  • Flexion of toes (towards the ground)
  • Extension of toes (away from the ground)
  • Abduction (movement away from the second digit axis)
  • Adduction (movement towards the second digit axis)
A
  • Synovial joints between the metatarsals and the proximal phalanges
  • Flexion of toes (towards the ground)
  • Extension of toes (away from the ground)
  • Abduction (movement away from the second digit axis)
  • Adduction (movement towards the second digit axis)
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14
Q

Describe the Interphalangeal (IP) Joints connection and movement

A
  • Hinge synovial joints between the phalanges
  • Proximal interphalangeal joints (PIPs) are located between the proximal and middle phalanges
  • Distal interphalangeal joints (DIPs) are located between the middle and distal phalanges
  • The hallux has a single IP joint between its proximal and distal phalanges
  • Flexion of toes (towards the ground
  • Extension of toes (away from the ground)
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15
Q

What is the Fascia of the Lower Extremity?

A
  • Superficial fascia

- Deep fascia

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16
Q

Describe the Superficial fascia

A

Contains: fat, cutaneous nerves, superficial veins, lymphatic vessels and lymph nodes

17
Q

Describe the Deep fascia

A
  • Dense connective tissue
  • Invests the lower extremity muscles like an elastic stocking; prevents muscles from bulging during contraction; efficient mechanism to pump blood back to the heart
18
Q

What is the Deep fascia of the thigh called?

A

Fascia lata

19
Q

What is the Deep fascia of the leg called?

A

Crural fascia

20
Q

Describe the attachment of the Fascia lata

A

-Firmly attached to pubis, inguinal ligament, iliac crest, sacrum, coccyx, and ischial tuberosity

21
Q

Oval shaped window in the fascia lata is the _______

A

-Saphenous opening: it is located just inferior to the inguinal ligament –> the great saphenous vein and associated lymphatic vessels pass through this opening

22
Q

Lateral thickening of fascia lata is the ___________

A

Iliotibial tract (or band)

23
Q

What septa arise from the fascia lata?

A
  • 3 intermuscular septa arise from the fascia lata and attach to the linea aspera of the femur
  • These septa divide the thigh into 3 compartments: anterior, posterior, and medial
24
Q

What septa arise from the Crural fascia?

A
  • Continuous with fascia lata
  • 2 intermuscular septa arise from the crural fascia and attach to the fibula
  • These septa (along with the interosseous membrane between the tibia and fibula) divide the leg into 3 compartments: anterior, posterior, and lateral
  • Another septum separates the posterior compartment into superficial and deep layers
  • Near the ankle joint, the deep fascia forms extensor, flexor, and fibular retinacula; these bands keep tendons in place around the ankle joint
25
Q

What are the Veins of the Lower Extremity?

A
  • Superficial and deep veins in the lower extremity
  • Perforating veins

-These veins all have valves, but the valves are more numerous in the deep veins

26
Q

What are the superficial veins?

A
  • Great saphenous vein

- Small saphenous vein

27
Q

Describe the location of the Great saphenous vein?

A
  • Arises from dorsal aspect of the foot
  • Passes anterior to the medial malleolus
  • Ascends along the medial aspect of the leg and thigh
  • Enters the saphenous opening in the fascia lata
  • Drains into the femoral vein
  • Receives numerous tributaries as it ascends, and anastomoses with the small saphenous vein
28
Q

Describe the saphenous cut down procedure

A
  • The great saphenous vein can be accessed anterior to the medial malleolus to administer medications, fluids, etc.
  • The procedure is effective even in infants, obese and dehydrated patients (with collapsed veins).
29
Q

What is the Great saphenous vein used for surgically? Why is THAT vein used?

A

-Can be used in coronary bypass surgery

  • (a) the vein is superficial and easily accessible;
  • (b) the wall of the great saphenous vein contains a high percentage of muscular and elastic fibers; and
  • (c) the vein is long, with long distances between tributaries (easy to harvest usable lengths)
30
Q

Describe the Small saphenous vein

A
  • Arises from lateral side of foot
  • Passes posterior to the lateral malleolus of the ankle
  • Enters popliteal fossa and drains into popliteal vein
31
Q

Describe the Perforating veins

A
  • Connect the superficial and deep veins

- Contain valves that allow blood to flow only from sf deep veins

32
Q

Describe the Musculovenous pump

A
  • When muscles contract, blood in the deep veins is propelled to the femoral and then external iliac veins (musculovenous pump)
  • Valves in deep veins prevent reflux of blood inferiorly
  • Valves in the perforating veins prevent reflux of blood from the deep to superficial veins
33
Q

When do Varicose veins occur?

A
  • When valves in the perforating veins become incompetent, allowing large amounts of blood to reflux from the deep to the superficial veins.
  • The superficial veins become distended as they receive this large volume of blood.
34
Q

Describe Lymphatics of the Lower Extremity (Gluteal Region)

A
  • Lymph from superficial tissues of the gluteal region –> superficial inguinal lymph nodes –> external iliac lymph nodes
  • Lymph from deep tissues of the gluteal region –> superior and inferior gluteal lymph nodes –> internal iliac lymph nodes
35
Q

Describe SUPERFICIAL Lymphatics of the Lower Extremity (Thigh, Leg, and Foot)

A
  • Superficial lymphatic vessels accompanying the great saphenous vein drain into the superficial inguinal lymph nodes
  • Superficial lymphatic vessels accompanying the small saphenous vein drain into the popliteal lymph nodes –> deep inguinal lymph nodes
  • Both superficial and deep inguinal lymph nodes drain into the external iliac nodes
36
Q

Describe DEEP Lymphatics of the Lower Extremity (Thigh, Leg, and Foot)

A
  • Deep lymphatic vessels accompany the deep veins (e.g., popliteal, femoral) and drain into deep inguinal lymph nodes located medial to the femoral vein
  • Both superficial and deep inguinal lymph nodes drain into the external iliac nodes
37
Q

What are the Dermatomes of the Lower Extremity?

A

-You are responsible for knowing the dermatome map shown in C and D; however, there is a great deal of overlap between adjacent spinal nerve territories. In addition, please note that other maps (e.g., E, F) may be used by some clinicians.

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Anatomy Exam 2 (10 decks)

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