Part 1: Lower Limb, Gluteal Region, Hip Joint

Question 1

The muscles of the lower extremity act to (3):

Answer 1

• initiate limb movement
• support body weight
• counter the effects of gravity

Question 2

The lower extremity is comprised of four major regions from proximal to distal:

Answer 2

• gluteal region
• thigh
• leg
• ankle
• foot

Question 3

During the 6th to 8th weeks of development, what occurs to the upper limbs?

Answer 3

• rotate laterally resulting in the elbows pointing posteriorly and the thumbs laterally placed.

Question 4

During the 6th to 8th weeks of development, what occurs to the lower limbs?

Answer 4

• rotate medially resulting in the knees pointing anteriorly and the great toes medially placed.

Question 5

In general, anterior compartment muscles of the lower limb are:

Answer 5

• extensors;
  
  • dorsal muscle mass innervated by posterior division nerve fibers
  • due to limb rotation

Question 6

In general, posterior compartment muscles of the lower limb are:

Answer 6

• flexors;
  
  • ventral muscle mass innervated by anterior division nerve fibers
  • due to limb rotation

Question 7

Lumbosacral plexus composition:

Answer 7

• ventral rami of spinal nerves L2-S3
• ventral rami divide into anterior and posterior divisions, which then unite to form collateral and terminal nerves

Question 8

The union of the lumbar plexus and the sacral plexus in the lumbosacral trunk is completed by:

Answer 8

• lumbosacral trunk

Question 9

In general, posterior division nerve fibers in the lumbrosacral plexus innervate:

Answer 9

• anterior compartment muscles

Question 10

In general, anterior division nerve fibers in the lumbrosacral plexus innervate:

Answer 10

• posterior compartment muscles

Question 11

Major terminal nerves of the lumbrosacral plexus:

Answer 11

• femoral
• obturator
• tibial
• common fibular

Question 12

Femoral nerve rami, division and compartment:

Answer 12

• L2-L4
• Posterior
• Anterior Thigh

Question 13

Obturator nerve rami, division and compartment:

Answer 13

• L2-L4
• Anterior
• Medial Thigh

Question 14

Tibial nerve rami, division and compartment:

Answer 14

• L4-S3
• Anterior
• Posterior thigh, leg, sole of the foot

Question 15

Common fibullar nerve rami, division and compartment:

Answer 15

• L4-S2
• Posterior
• Anterior leg: deep fibular
• Lateral leg: superior fibular

Question 16

Function of muscles innervated by femoral nerve:

Answer 16

• knee extension
• hip flexion

Question 17

Function of muscles innervated by obturator nerve:

Answer 17

• hip adduction

Question 18

Function of muscles innervated by tibial nerve:

Answer 18

• hip extension
• knee and digit flexion
• ankle plantar flexion

Question 19

Function of muscles innervated by common fibular nerve:

Answer 19

• Ankle Dorsiflexion
• Digit Extension

Question 20

Proximodistal Motor Innervation in the lower limb:

Answer 20

• Superior Rami Levels Innervate more Proximal Muscles
• Inferior Rami Levels Innervate more Distal Muscles

Question 21

Dorsiflexion versus plantar flexion:

Answer 21

Question 22

Ventral dermatomes of lower limb (diagram):

Answer 22

WEB OF GREAT TOE AND 2ND DIGIT IS EXCLUSIVELY L5

Question 23

Drosal dermatomes of lower limb (diagram):

Answer 23

Question 24

Arteries of the lower limb by region: Hip, Thigh, Knee, Leg, Foot:

Answer 24

• Hip: internal iliac and femoral
• Thigh: deep femoral
• Knee: popliteal
• Leg: anterior and posterior tibial
• Foot: plantar arches

Question 25

Veins of the lower limb:

Answer 25

* great saphenous (medial) * lesser saphenous (posterior calf)

Question 26

Types of veins in the lower limb:

Answer 26

* superficial veins (in superficial fascia) * deep veins (between muscles) * perforating veins (connect the above)

Question 27

Muscular venous pump system:

Answer 27

* **_Muscle contraction:_** compressed deep veins forces blood superiorly. * **_Muscle relaxation:_** blood of the superficial veins passes through perforating veins to reach deep veins.

Question 28

Perforating veins in the lower limb:

Answer 28

* connect superficial and deep veins. * have one-way valves that prevent blood flow from deep into superficial veins.

Question 29

What lower limb vein is frequently used as a graft in heart by-pass surgery?

Answer 29

great saphenous

Question 30

Varicose veins are due to:

Answer 30

* malfunction of the one way valves in perforating veins. * high pressure blood in deep veins leaks into the superficial veins, which then expand.

Question 31

Deep vein thrombosis (DVT):

Answer 31

* a blood clot thrombus forms inside a deep vein, commonly in the calf or thigh, that fully or partially blocks flow of blood in that vein. * May lead to pulmonary embolism is the clot detaches and travels to the pulmonary artery.

Question 32

IVC filter:

Answer 32

* filter placed in the inferior vena cava that breaks up blood clots to prevent pulmonary embolisms

Question 33

Lymphatic system of leg:

Answer 33

* Superficial lymphatics drain into superficial inguinal or popliteal nodes, which in turn drain into the deep inguinal nodes. * Deep inguinal nodes drain into the external iliac nodes.

Question 34

Label all:

Answer 34

Question 35

Label all:

Answer 35

Question 36

Label all:

Answer 36

* Left; top to bottom: * greater sciatic foramen * sacrospinous ligament * lesser sciatic foramen * sacrotuberous ligament * Right; top to bottom: * obturator canal * obturator membrane

Question 37

Label:

Answer 37

Sacroiliac ligament

Question 38

Label:

Answer 38

sacroiliac ligament