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MSK lectures > Overview of the lower limb 01/10/18 > Flashcards

Overview of the lower limb 01/10/18 Flashcards

1
Q

Where does the lower limb begin?

A

Extends from the pelvis

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2
Q

What are the 3 functions of the lower limb?

A

Support body weight
Locomotion
Maintain balance

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3
Q

What are the six regions of the lower limb?

A 
Gluteal
Femoral
Knee
Leg
Ankle
Foot
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4
Q

What is the proper name of the Hip joint?

A

Acetabulo-femoral joint

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5
Q

What type of joint is the hip joint?

A

Ball and Socket

Synovial

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6
Q

What 4 movements is the hip joint able to do?

A

Flexion-extension
Abduction-adduction
Medial-lateral rotation
Circumduction

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7
Q

Where are synovial joints found?

A

Within strong joint capsules

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8
Q

What formation are the ligaments of the hip in?

A

Spiral formation

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9
Q

What are the three ligaments of the hip joint?

A

Iliofemoral
Ischiofemoral
Pubofemoral

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10
Q

Why are the hip ligaments arranged in this (spiral) formation?

A

So that when the hip moves the joint compacts and stabilizes

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11
Q

What is the primary blood supply to the head of the femur?

A

The medial circumflex femoral artery

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12
Q

What arteries are damaged in femoral neck fractures?

A

Intracapsular retinacular arteries

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13
Q

What kind of joint is the knee joint?

A

Modified synovial hinge joint

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14
Q

What are the 2 functions of the knee joint?

A

Flexion/extension

Slight rotation

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15
Q

What are the 3 articulations of the knee complex?

A

Medial Tibiofemoral
Lateral Tibiofemoral
Patellofemoral

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16
Q

What are the 3 extracapsular ligaments of the knee?

A

Patellar
Lateral (fibular) collateral
Medial (tibial) collateral

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17
Q

What are the 2 intra-articular ligaments of the knee?

A 
Anterior cruciate (ACL)
Posterior cruciate (PCL)
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18
Q

What is the difference between the patellar ligament and the patellar tendon?

A

They are the same thing

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19
Q

What are the characteristics of the lateral collateral ligament and why?

A

Thin and cord like as there are lots of other structures around it for support

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20
Q

What are the characteristics of the medial collateral ligament and why?

A

Thick
More robust than LCL
Withstands more force

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21
Q

What are the menisci?

A

Crescent shaped fibrocartilage

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22
Q

What is the function of the ACL?

A

Prevents the anterior movement of the tibia on the femur

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23
Q

What is the function of the PCL?

A

Prevents the posterior movement of the tibia on the femur

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24
Q

How do the ACL and PCL interact?

A

They cross over

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25
Q

What is the Q angle?

A

The angle between the following two lines:

The Asis and the mid-point of the patella

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26
Q

Which gender is likely to have a greater Q angle?

A

Females as they have wider hips for child bearing

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27
Q

How do nerves enter/exit the pelvis and perineum?

A

Through the greater and lesser sciatic foramen

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28
Q

Which ligaments separates the greater and lesser sciatic foramen?

A

Sacrospinous and sacrotuberous

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29
Q

What region is through the greater sciatic foramen?

A

Gluteal

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30
Q

What region is through the lesser sciatic foramen?

A

Perineum

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31
Q

For injections, what is the gluteal region divided into and what is the best region?

A

Quadrants

ULQ

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32
Q

What are the 3 nerves that enter the pelvis via the gluteal region?

A

Sciatic
Pudenal
Posterior cutaneous nerve of the thigh

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33
Q

Where does the sciatic nerve originate from?

A

L4-S3

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34
Q

What is the largest nerve in the body?

A

Sciatic

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35
Q

Where does the sciatic nerve supply?

A

Posterior thigh
All leg and foot muscles
Most of the skin via tibial and fibular branches

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36
Q

Where does the Pudenal nerve originate?

A

S2-S4 (keeps the gut off the floor)

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37
Q

What is the principle nerve to the perineum?

A

Pudenal

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38
Q

Where does the posterior cutaneous nerve of the thigh originate?

A

S1-S3

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39
Q

Where does the posterior cutaneous nerve of the thigh supply?

A

Skin over posterior thigh
Popliteal fossa
Lateral perineum
Upper medial thigh

40
Q

What are the 4 superficial muscles of the gluteal region?

A

Gluteus maximus
Gluteus medius
Gluteus minimus
Tensor fascia latae

41
Q

What are the 3 functions of the superficial thigh muscles?

A

Extension
Abduction
Medial rotation

42
Q

What does the inferior gluteal nerve supply?

A

Gluteus maximus

43
Q

What supplies all other superficial gluteal muscles?

A

Superior gluteal nerve

44
Q

What are the 4 deep muscles of the gluteal region?

A

Piriformis
Obturator internus
Gemelli (superior and inferior)
Quadratus femoris

45
Q

What are the 2 functions of the deep muscle group?

A

Lateral rotation of thigh

Hip stabilisers

46
Q

What supplies the deep gluteal muscles?

A

Nerves from the sacral plexus

47
Q

What does a tight piriformis cause?

A

Sciatica

48
Q

What is a Trendelenberg gait and what causes it?

A

An abnormal walk caused by reduced function of the superior gluteal nerve and weak hip abduction by the gluteus medius

49
Q

Which hip drops in trendelenberg gait?

A

The contralateral hip

50
Q

Where does the sciatic nerve exit the gluteal region?

A

Inferior to the piriformis

51
Q

What artery supplies the sciatic nerve?

A

Artery to the sciatic nerve

52
Q

Does the sciatic nerve supply the gluteal region/

A

No

53
Q

What are the two portions of the sciatic nerve?

A

Tibial/Medial

Common fibular/Lateral

54
Q

What are compartments surrounded/divided by?

A

An intermuscular septum

55
Q

What invaginates to form an intermuscular septum?

A

Deep Fascia

56
Q

What are the three compartments of the thigh?

A

Anterior
Medial
Posterior

57
Q

What are the three compartments of the leg?

A

Anterior
Posterior
Lateral

58
Q

What is true about muscles in the same compartment?

A

They generally have similar actions

They generally have the same nerve supply

59
Q

What is compartment syndrome?

A

The fascia creates an enclosed space
When increased pressure occurs (i.e a bleed or swelling) it can affect the functions of muscles and nerves in the compartment

60
Q

What is the emergency treatment for compartment syndrome?

A

Fasciotomy

61
Q

What are the 2 functional groups of muscles in the anterior compartment of the thigh?

A

Flexors of thigh

Extensors of leg

62
Q

What are the 4 flexors of the thigh?

A

Pectineus
Iliopsoas
Sartorius
Rectus femoris

63
Q

What are the 4 extensors of the leg?

A

Rectus femoris
Vastus lateralis
Vastus medialis
Vastus intermedius

64
Q

What supplies everything in the anterior compartment of the thigh apart from the psoas major?

A

The femoral nerve (L2,3,4)

65
Q

What supplies the psoas major/

A

L1,2,3

66
Q

What are the 5 boundaries of the femoral triangle?

A 
Superior - inguinal ligament
Medial - Lateral border of adductor longus
Lateral - Medial border of sartorius
Floor - Iliopsoas and pectineus 
Roof - Deep fascia
67
Q

What are the contents of the femoral triangle?

A

Femoral Nerve
Femoral Artery
Femoral Vein
Lymphatics

68
Q

What is the function of the muscles in the medial thigh compartment/

A

Adduction of the thigh

69
Q

What are the 5 adductors of the thigh?

A 
Adductor longus
Adductor brevis
Adductor magnus
Gracilis
Obturator externus
70
Q

What supplies all of the adductors of the thigh?

A

Obturator nerve (L2,3,4) except the hamstring - tibial nerve

71
Q

What is the function of the muscles in the posterior compartment of the thigh?

A

Extension of thigh

Flexion of leg

72
Q

What are extensors of the thigh and flexors of the leg?

A

Semitendinosus
Semimebranosus
Biceps femoris

73
Q

What supplies the extensors of the thigh and flexors of the leg?

A

Tibial division of sciatic nerve

74
Q

What supplies the short head of biceps femoris?

A

The common fibular division of sciatic

75
Q

What is the function of the Superficial muscles in the posterior compartment of the leg?

A

Plantarflexors of the ankle

76
Q

What is the function of the Deep muscles in the posterior compartment of the leg?

A

Flexors of toes

Plantarflexors of ankle

77
Q

What are the 3 superficial muscles of the posterior leg compartment?

A

Gastrocnemius
Soleus
Plantaris

78
Q

What are the 4 deep muscles of the posterior compartment of the leg?

A

Popliteus
Flexor hallucis longus
Flexor digitorum longus
Tibilas posterior

79
Q

What supplies all the muscles of the posterior leg compartment?

A

The tibial nerve

80
Q

What is the function of the muscles in the anterior compartment of the leg?

A

Dorsiflexors of ankle and extensors of toes

81
Q

What are the 4 muscles in the anterior compartment of the leg?

A

Tibialis anterior
Entensor digitorum longus
Extensor hallucis longus
Fibularis tertius

82
Q

What nerve supplies all of the muscles in the anterior compartment of the leg?

A

Deep fibular nerve

83
Q

What is the function of the muscles in the lateral compartment of the leg?

A

Evert the foot and weakly plantarflex ankle

84
Q

What are the muscles in the lateral compartment of the leg?

A

Fibularis longus

Fibularis brevis

85
Q

What nerve supplies the lateral compartment of the leg?

A

Superficial fibular nerve (L5,S1,S2)

86
Q

What does deep fibular nerve palsy cause?

A

Loss of muscle action in anterior leg compartment

Reduced or absent dorsiflexion

87
Q

What are the 4 boundaries of the popliteal fossa?

A

Superolateral - Biceps femoris
Superomedial - semimembranosus
Inferior - Gastrocnemius
Roof - Popliteal fascia

88
Q

What are the contents of the popliteal fossa?

A

Lots of fat
Terminal small saphenous vein
Popliteal vessels
Tibial and common fibular nerves

89
Q

What is the thickest and strongest tendon in the body?

A

Calcaneal/Achilles tendon

90
Q

How long is the achilles tendon?

A

15cm

91
Q

What two tendons come together to form the achilles tendon/

A

Gastrocnemius

Soleus

92
Q

Where does the achilles tendon attach?

A

Calcaneal tuberosity of the calcaneus

93
Q

What does the ankle jerk reflex test?

A

S1,S2 nerve roots

94
Q

What veins do the superficial lymphatics follow?

A

Saphenous veins

95
Q

Where do the superficial lymphatics drain to?

A

Superficial inguinal nodes then external iliac nodes

96
Q

What veins do deep lymphatics follow?

A

Deep veins

97
Q

Where do the deep lymphatics drain to?

A

Popliteal lymph nodes then deep inguinal nodes, then external iliac nodes

MSK lectures (50 decks)

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