Overview of the Lower Extremity

Question 1

Describe movement of hip joint

Answer 1

-Ball and socket synovial joint

Flexion/Extension
Abduction/Adduction
Medial/Lateral rotation

Question 2

Describe the movement of the knee joint

Answer 2

-Hinge synovial joint

Flexion/Extension
Medial/Lateral rotation (*some)

Question 3

Ankle (Talocrural) joint

Answer 3

-Hinge synovial joint

Bones: Talus, distal tibia and lateral malleolus of fibula

Dorsiflexion/plantarflexion

Question 4

Subtalar Joint

Answer 4

Eversion/Inversion

Bones: Talus and calcaneus

Question 5

Metatarsophalangeal (MTP) joints

Answer 5

Flexion/extension

Abduction/adduction (away from and towards 2nd digit axis)

Question 6

Interphalangeal joints (IP)
-PIPs and DIPs

Answer 6

Flexion/extension

Question 7

What does the superficial fascia contain?

Answer 7

1. Fat
2. Cutaneous nerves
3. Superficial veins
4. Lymphatics

Question 8

What does the deep fascia of the lower extremity contain?

Answer 8

1. Dense Connective Tissue

2. Elastic stocking

Question 9

What is the deep fascia above the knee?

Answer 9

Fascia lata

Question 10

What is the deep fascia below the knee?

Answer 10

Crural fascia

Question 11

What is the oval shaped window in the fascia lata?

Answer 11

Saphenous opening

location: inferior to the inguinal ligament
contents: great saphenous vein and lymphatics

Question 12

What is the name of the lateral thickening of fascia lata

Answer 12

iliotibial tract or IT band

Question 13

The 3 compartments of the lower extremity are separated by what?

Answer 13

3 intermuscular septa arise from fascia lata and attach to linea aspera on posterior side of femur

Question 14

What are the three compartments of the thigh?

Answer 14

Anterior
Posterior
Medial

Question 15

What are the three compartments of the leg?

Answer 15

Anterior
Lateral
Posterior (deep and superficial)

Question 16

What arise from the crural fascia and where do they attach?

Answer 16

2 intermuscular septa arise from crura fascia and attach to the fibula

Question 17

What create the 3 compartments of the leg?

Answer 17

1. intermuscular septa

2. Interosseous membrane (between the tibia and fibula)

Question 18

What 3 structures does the deep fascia make at the ankle joint?

Answer 18

Deep fascia forms:

1. Extensor retinaculum
   2, Flexor retinaculum (medial)
2. Fibular retinaculum (lateral)

Question 19

Which veins have more valves - Deep or superficial?

Answer 19

Deep veins have more valves

Question 20

Is the Great Saphenous Vein anterior or posterior to the malleolus?

Answer 20

great saphenous vein is anterior to the medial malleolus

Question 21

Small saphenous vein

Answer 21

1. Arises from lateral side of foot
2. Posterior to lateral malleolus
3. At popliteal fossa drains into popliteal vein

Question 22

Perforating veins

Answer 22

connect superficial and deep veins.

Contain valves to only allow blood to flow from the SF to the Deep

Question 23

Describe lymphatics of the superficial tissues of LE

Answer 23

Drain to the superficial inguinal nodes and then to the external iliac lymph nodes

Question 24

Describe lymphatics of the deep tissues of LE

Answer 24

Drain to the superior/inferior gluteal to internal iliac nodes

Question 25

Where do superficial lymph vessels of the lower limb accompanying the Great saphaneous vein drain?

Answer 25

into the superficial inguinal lymph nodes

Question 26

Where do superficial lymph vessels accompanying the lesser saphaneous vein drain?

Answer 26

into the popliteal lymph nodes -> deep inguinal lymph nodes

Question 27

Where do deep lymphatic vessels drain?

Answer 27

drain into deep inguinal lymph nodes medial to femoral vein

Question 28

Where do superficial and deep inguinal lymph nodes drain?

Answer 28

external iliac nodes

Question 29

What are the 7 Tarsal bones

Answer 29

1. Cuneiform 2. Cuneiform 3. Cuneiform 4. Cuboid 5. Navicular 6. Talus 7. Calcaneous

Question 30

Which nerves comprise the lumbosacral plexus (L1-L4)?

Answer 30

1. Iliohypogastric nerve (L1) 2. Ilioinguinal nerve (L1) 3. Genitofemoral nerve (L1-L2) 4. Lateral cutaneous nerve of the thigh (L2-L3) 5. Obturator nerve (L2-L4) 6. Femoral nerve (L2-L4)

Question 31

Iliohypogastric: sensory and motor?

Answer 31

sensory: skin of inguinal region and superolateral gluteal region motor: abdominal muscles

Question 32

Ilioinguinal nerve: sensory and motor?

Answer 32

sensory: skin of inguinal region, scrotom/labia majora and superomedial thigh Motor: abdominal muscles

Question 33

Genitofemoral nerve (L1-L2) sensory and motor?

Answer 33

Femoral branch: sensory to skin of superomedial thigh Genital branch: sensory to skin of scrotum or labia majora motor: cremaster muscle

Question 34

Lateral cutaneous nerve of the thigh (L2-L3) sensory and motor?

Answer 34

sensory: skin of lateral thigh motor: none

Question 35

``` Obturator nerve (L2-L4) sensory and motor? ```

Answer 35

**medial to psoas major, courses along lateral wall of the pelvis and exits via the obturator canal** sensory: skin of medial thigh motor: medial compartment of thigh

Question 36

Femoral nerve (L2-L4) sensory and motor?

Answer 36

**lateral to psoas major, passes deep to inguinal ligament** sensory: skin of anteromedial thigh, leg, and foot motor: anterior compartment of thigh

Question 37

Name the 5 nerves in the Sacral plexus

Answer 37

1. Lumbosacral trunk (L-4-L5) 2. Superior gluteal nerve 3. Inferior gluteal nerve 4. Sciatic nerve (L4-S3) 5. Pudendal nerve (S2-S4)

Question 38

Lumbosacral trunk (L4-L5)

Answer 38

descends medial to psoas major joins ventral rami of S1-S4 as they emerge from anterior sacral foramina (and through piriformis)

Question 39

Superior gluteal nerve. Where does it exit pelvis? Motor innervation?

Answer 39

Exits pelvis via the greater sciatic foramina SUPERIOR to piriformis Motor: 1. gluteus medius 2. gluteus minimus 3. tensor fascia latae

Question 40

Inferior gluteal nerve. Where does it exit pelvis? Motor innervation?

Answer 40

Exits pelvis via the greater sciatic foramina INFERIOR to piriformis Motor: gluteus maximus

Question 41

Sciatic nerve (L4-S3)

Answer 41

Exits pelvis via greater sciatic foramina INFERIOR to piriformis Motor: 1. posterior compartment of thigh 2. all compartments of leg and foot Sensory: skin of food and most of leg

Question 42

Which two nerves make up the sciatic nerve?

Answer 42

Common fibular (peroneal) nerve and tibial nerve

Question 43

Pudendal nerve (S2-S4)

Answer 43

Exits pelvis via the greater sciatic foramen INFERIOR to piriformis around ischial spine in through the lesser sciatic foramen, pudendal (Alcock) canal Motor: muscles of the urogenital triangle and anal triangle Sensory: skin of the urogenital triangle and anal triangle