Overview of the Lower Extremity Flashcards
Describe movement of hip joint
-Ball and socket synovial joint
Flexion/Extension
Abduction/Adduction
Medial/Lateral rotation
Describe the movement of the knee joint
-Hinge synovial joint
Flexion/Extension
Medial/Lateral rotation (*some)
Ankle (Talocrural) joint
-Hinge synovial joint
Bones: Talus, distal tibia and lateral malleolus of fibula
Dorsiflexion/plantarflexion
Subtalar Joint
Eversion/Inversion
Bones: Talus and calcaneus
Metatarsophalangeal (MTP) joints
Flexion/extension
Abduction/adduction (away from and towards 2nd digit axis)
Interphalangeal joints (IP) -PIPs and DIPs
Flexion/extension
What does the superficial fascia contain?
- Fat
- Cutaneous nerves
- Superficial veins
- Lymphatics
What does the deep fascia of the lower extremity contain?
- Dense Connective Tissue
2. Elastic stocking
What is the deep fascia above the knee?
Fascia lata
What is the deep fascia below the knee?
Crural fascia
What is the oval shaped window in the fascia lata?
Saphenous opening
location: inferior to the inguinal ligament
contents: great saphenous vein and lymphatics
What is the name of the lateral thickening of fascia lata
iliotibial tract or IT band
The 3 compartments of the lower extremity are separated by what?
3 intermuscular septa arise from fascia lata and attach to linea aspera on posterior side of femur
What are the three compartments of the thigh?
Anterior
Posterior
Medial
What are the three compartments of the leg?
Anterior
Lateral
Posterior (deep and superficial)
What arise from the crural fascia and where do they attach?
2 intermuscular septa arise from crura fascia and attach to the fibula
What create the 3 compartments of the leg?
- intermuscular septa
2. Interosseous membrane (between the tibia and fibula)
What 3 structures does the deep fascia make at the ankle joint?
Deep fascia forms:
- Extensor retinaculum
2, Flexor retinaculum (medial) - Fibular retinaculum (lateral)
Which veins have more valves - Deep or superficial?
Deep veins have more valves
Is the Great Saphenous Vein anterior or posterior to the malleolus?
great saphenous vein is anterior to the medial malleolus
Small saphenous vein
- Arises from lateral side of foot
- Posterior to lateral malleolus
- At popliteal fossa drains into popliteal vein
Perforating veins
connect superficial and deep veins.
Contain valves to only allow blood to flow from the SF to the Deep
Describe lymphatics of the superficial tissues of LE
Drain to the superficial inguinal nodes and then to the external iliac lymph nodes
Describe lymphatics of the deep tissues of LE
Drain to the superior/inferior gluteal to internal iliac nodes
Where do superficial lymph vessels of the lower limb accompanying the Great saphaneous vein drain?
into the superficial inguinal lymph nodes
Where do superficial lymph vessels accompanying the lesser saphaneous vein drain?
into the popliteal lymph nodes -> deep inguinal lymph nodes
Where do deep lymphatic vessels drain?
drain into deep inguinal lymph nodes medial to femoral vein
Where do superficial and deep inguinal lymph nodes drain?
external iliac nodes
What are the 7 Tarsal bones
- Cuneiform
- Cuneiform
- Cuneiform
- Cuboid
- Navicular
- Talus
- Calcaneous
Which nerves comprise the lumbosacral plexus (L1-L4)?
- Iliohypogastric nerve (L1)
- Ilioinguinal nerve (L1)
- Genitofemoral nerve (L1-L2)
- Lateral cutaneous nerve of the thigh (L2-L3)
- Obturator nerve (L2-L4)
- Femoral nerve (L2-L4)
Iliohypogastric: sensory and motor?
sensory: skin of inguinal region and superolateral gluteal region
motor: abdominal muscles
Ilioinguinal nerve: sensory and motor?
sensory: skin of inguinal region, scrotom/labia majora and superomedial thigh
Motor: abdominal muscles
Genitofemoral nerve (L1-L2) sensory and motor?
Femoral branch: sensory to skin of superomedial thigh
Genital branch: sensory to skin of scrotum or labia majora
motor: cremaster muscle
Lateral cutaneous nerve of the thigh (L2-L3) sensory and motor?
sensory: skin of lateral thigh
motor: none
Obturator nerve (L2-L4) sensory and motor?
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
Femoral nerve (L2-L4) sensory and motor?
lateral to psoas major, passes deep to inguinal ligament
sensory: skin of anteromedial thigh, leg, and foot
motor: anterior compartment of thigh
Name the 5 nerves in the Sacral plexus
- Lumbosacral trunk (L-4-L5)
- Superior gluteal nerve
- Inferior gluteal nerve
- Sciatic nerve (L4-S3)
- Pudendal nerve (S2-S4)
Lumbosacral trunk (L4-L5)
descends medial to psoas major joins ventral rami of S1-S4 as they emerge from anterior sacral foramina (and through piriformis)
Superior gluteal nerve. Where does it exit pelvis? Motor innervation?
Exits pelvis via the greater sciatic foramina SUPERIOR to piriformis
Motor:
- gluteus medius
- gluteus minimus
- tensor fascia latae
Inferior gluteal nerve. Where does it exit pelvis? Motor innervation?
Exits pelvis via the greater sciatic foramina INFERIOR to piriformis
Motor:
gluteus maximus
Sciatic nerve (L4-S3)
Exits pelvis via greater sciatic foramina INFERIOR to piriformis
Motor:
- posterior compartment of thigh
- all compartments of leg and foot
Sensory:
skin of food and most of leg
Which two nerves make up the sciatic nerve?
Common fibular (peroneal) nerve and tibial nerve
Pudendal nerve (S2-S4)
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
