Overview - upper and lower limb Flashcards
Femoral head fits into?
Acetabulum
Anatomical neck of the femur is?
Just inferior to the femoral head
Surgical neck of the femur is?
Region of the femoral neck that breaks the most
Relation of anatomical and surgical neck in the femur?
In the femur, these are the same
Muscles attach where on the femur?
Greater and lesser trochanter
Shenton’s line is?
Line from superior pubic rami to medial border of femoral neck
Change to Shenton’s line indicates?
Damage to the neck of the femur e.g. fracture
Three ligaments of the hip joint? Anterior or posterior?
Iliofemoral - anterior
Pubofemoral - anterior
Ischiofemoral - posterior
Strongest ligament of the hip joint?
Anterior iliofemoral ligament
Hip joint is stable or not very stable?
Very very stable
Appearance of the iliofemoral ligamnet?
Y-shaped ligament
Most common dislocation at the hip and why?
Posterior dislocation - the iliofemoral is strongest ligament and this is anterior
Change in shape of the ligaments to the hip joint upon movement of the leg is?
Relaxed when the hip is flexed
When leg moves backwards and extends, ligaments twist and turn
When is the femoral head inserted deeper into the acetabulum?
When the ligaments of the hip twist upon leg extension
Ligamentum teres is where?
Inside the acetabulum
Ligamentum teres function is?
Helps to strengthen the joining of the head of the femur into the acetabulum
What runs within the ligamentum teres?
Artery
Main blood supply to the hip joint is?
Circumflex arteries - medial and lateral
Circumflex arteries originate from?
Femoral artery
Artery to the head of the femur provides blood supply to the hip in whom?
Children
Artery to the head of the femur originates from?
Obturator artery
Necrosis of head of the femur can be caused by?
Fracture to the neck of the femur
When does the external iliac artery become the femoral artery?
When it passes under the inguinal ligament
What branch does the external iliac artery give off?
Inferior epigastric artery
Inferior epigastric artery goes in which direction?
Superiorly
What are the three branches given off by the femoral artery?
Profunda femoris
Lateral circumflex
Medial circumflex
What does the femoral artery become and where?
Popliteal artery when it passes over the popliteus muscle
Popliteal artery is long or short?
Short
Popliteal artery bifrucates into which two arteries?
Anterior tibial
Posterior tibial
Posterior tibial becomes which two arteries at teh posterior leg?
Continues as the posterior tibial artery
Gives off the fibular artery
Two ligaments forming the greater and lesser sciatic foramen are?
Sacrospinous
Sacrotuberous ligaments
How can you differentiate between the sacrospinous and sacrotuberous ligaments?
Sacrospinous ligament comes across and divides like the SPINE of the SCAPULA
Greater and lesser sciatic foramen - relation to each other?
Greater sciatic foramen is superior and lesser sciatic foramen is inferior
Muscle passing through greater sciatic foramen is?
Piriformis
Four nerves through greater sciatic foramen is?
Sciatic nerve
Pudendal nerve
Inferior gluteal nerve
Superior gluteal nerve
Which nerve through the greater sciatic foramen then passes back out through the lesser sciatic foramen?
Pudendal nerve
Where should IM injection be given in the bum and why?
Upper outer gluteal quadrant - avoid the sciatic nerve
What does the gluteus maximus insert into distally?
3/4 - iliotibial tract
1/4 - gluteal tuberosity of the femur
Iliotibial tract inserts into what?
Anterolateral tubercle of the tibia
Function of gluteus maximus is? x2
Hip extension
Lateral rotation
Function of piriformis?
Aids gluteus maximus in lateral rotation
Nervous innervation to the lateral rotators?
L5, S1, S2
Six muscles that function for lateral rotation of the hip?
Gluteus maximus Piriformis Superior gemellus Inferior gemellus Obturator internus Quadratus femoris
Superior gluteal nerve innervates? x2
Gluteus medius
Gluteus minimis
Tensor fascia latae
Inferior gluteal nerve innervates?
Gluteus maximus
Trendelenberg test involves which nerve?
Superior gluteal
Function of gluteus minimus and medius?
Abduction of the hip
Results of the trendelenberg test?
If there is damage then the hip will drop on the unaffected side
Drooping on one side - other side damage to superior gluteal nerve
Three compartments of the thigh are?
Anterior
Posterior
Medial
Muscles and function of anterior compartment of thigh?
Quads + iliopsoas + sartorius
Knee extension
Hip flexion
Nervous innervation to the anterior compartment of the thigh?
Femoral nerve
Muscles and function of posterior compartment of thigh
Hamstrings
Knee flexion
Hip extension
Nervous innervation of medial compartment of thigh?
Obturator nerve
Muscles and function of medial compartment of thigh?
Hip adductors and gracilis
Adduction of hip
Nervous innervation of posterior compartment of thigh?
Sciatic nerve
Nerve roots of femoral nerve?
L2, L3, L4
Nerve roots of sciatic nerve?
L5, S1, S2
Nerve roots of obturator nerve?
L2, L3, L4
The three hip adductors are? (biggest to smallest)
Adductor Magnus, Longus, Brevis
MLB
Structure located deep to the inguinal ligament is?
Femoral VAN
What passes through the obturator foramen?
Obturator nerve
Main hip flexors are?
Iliopsoas
What are the four quadricep muscles?
Vastus medialis
Vastus lateralis
Vastus intermedialis
Rectus femoris
Which is the only quadricep that crosses the hip and has a role at the hip?
Rectus femoris
Where do the other three quadricep muscles have a function?
Knee
Two attachment points of hamstrings are?
Ischial tuberosity
Tibia
Three hamstring muscles are?
Semitendinosus
Semimembranosus
Biceps femoris (long head)
Three components of the pes anserinus are?
Insertion of the three muscles:
Sartorius
Gracilis
Semiteninosus
Borders of the femoral triangle are?
Inguinal ligament
Sartorius
Adductor longus
What is common through the femoral triangle?
Hernias in women
Two superficial veins of the leg?
Great saphenous vein
Small saphenous vein
Three bones of the knee are?
Patella
Femur
Tibia
Larger meniscus is lateral or medial?
Medial
Posterior cruciate ligament attached to lateral or medial meniscus?
Lateral
Anterior cruciate ligament attached to lateral or medial meniscus?
Medial
ACL and PCL - which is stronger?
PCL
Lateral and medial meniscus - which is more movable?
Lateral - smaller and more movable
Two collateral ligaments of the knee are?
Lateral/fibular collateral
Medial/tibial collateral
The menisci of the knee are superior or inferior to the patella bone?
Inferior
Main function of the PCL?
Stops the TIBIA moving back on the FEMUR
Two additional functions of the PCL?
Stabilise the knee in flexion
Prevents external rotation of the tibia
Main function of the ACL?
Stops the TIBIA moving forward on the FEMUR
Two additional functions of the ACL?
Stabilise the knee in knee extension
Preventions hyperextension and excessive internal rotation
Three components of the unhappy triad are?
Medial meniscus
ACL
Medial collateral
Deepest structure in the popliteal fossa is?
Popliteal artery
Function of anterior compartment of leg? x2
Dorsiflexion
Extension of digits
Innervation of anterior compartment of leg?
Deep peroneal nerve
Artery of anterior compartment of leg?
Anterior tibial artery
Function of posterior compartment of leg? x2
Plantarflexion
Flexion of digits
Innervation of posterior compartment of leg?
Tibial nerve
Artery of posterior compartment of leg?
Posterior tibial artery
Function of lateral compartment of leg?
Eversion
Innervation of lateral compartment of leg?
Superficial peroneal nerve
Artery of lateral compartment of leg?
Fibular artery
Three bones of the ankle?
Tibia
Fibula
Talus
Heel bone is?
Calcaneus
Blood supply to the head and neck of the femur is which artery?
Medial circumflex
Avascular necrosis to the head of the femur occurs with damage to which artery in an adult?
Medial circumflex
Presentation of the leg when the neck of the femur is fractured?
Shorter and lateral rotation
Presentation of the leg when the hip is dislocated?
Shorter and external rotation
Nerve most likely to be damaged in hip dislocation is?
Sciatic nerve
Rectus femoris could cause avulsion fracture of which boney prominence?
AAIS
Fracture of the tibia can cause damage to which nerve?
Common fibular nerve
HLA associated with ankylosing spondylitis is?
HLA-B27
Bow legs - genu varum or valgum?
Genu varum
Genu varum involves which bones in Blounts disease?
Just the tibia
Genu varum involves which bones in Rickets?
Tibia AND the femur
Muscles and nerve causing flexion of the hip?
Iliopsoas and rectus femoris and sartorius
Femoral nerve
Muscles and nerve causing extension of the hip?
Gluteus maximus and hamstrings (semitendinosus, semimembranosus and biceps femoris)
Sciatic nerve
Muscles and nerve causing abduction of the hip?
Gluteus medius and gluteus minimis
Superior gluteal nerve
Muscles and nerve causing adduction of the hip?
Adductors longus, brevis and magnus
Obturator nerve
Muscles and nerve causing lateral rotation of the hip?
Gluteus maximus and piriformis
Inferior gluteal nerve
Muscles and nerve causing medial rotation of the hip?
Gluteus medius, minimus and three hamstrings
Muscles and nerve causing flexion of the knee?
Three hamstrings - semimemb, tend and biceps femoris
Sciatic nerve
Muscles and nerve causing extension of the knee?
Four quadriceps - vastus lateralis, medialis, intermedius and rectus femoris
Femoral nerve
Muscles and nerve causing lateral rotation of the knee?
Semimemb, tend, gracilis, sartorius and popliteus
Sciatic nerve
Muscles and nerve causing medial rotation of the knee?
Biceps femoris
Sciatic nerve
Nerve root of femoral nerve?
L2, L3, L4
Nerve root of sciatic nerve?
S1, S2, S3
Nerve root of obturator nerve?
L2, L3, L4