Pre-practical Lower Limb Flashcards
What are the components of the hip joint?
- Acetabulum
- Acetabular labrum
- Ligament of head of femur (intracapsular)
- Femoral head
What does the ligament of the head of the demur enclose?
It encloses a branch of the oburator artery, which comprises a small proportion of the hip joint blood.
What are the extracapsular ligaments of the hip joint?
- Iliofemoral
- Pubofemoral
- Ischiofemoral
What is the function of the iliofemoral ligament?
Prevents hyperextension of the hip joint
What is the function of the pubofemoral ligament?
Prevents excessive abduction and extension
What is the function of the ischiofemoral ligament?
Prevents excessive extension
How are the extrcapsular ligaments of the hip joint orientated?
These ligaments have a uniquespiral orientation; this causes them to become tighter when the joint is extended, which adds stability to the joint.
What are the circumflex arteries branches of?
The profunda femoris artery
What is responsible for the majority of the blood supply to the hip joint?
Medial circumflex artery
What can damage to the medial circumflex artery result in?
Avascular necrosis of the femoral head
What is Hilton’s law?
Any major nerve supplying muscles that act on a joint will send a branches to also supply the joint
What nerves innervate the hip joint?
- Femoral nerve
- Obturator nerve
- Superior gluteal nerve
- Nerve to quadratus femoris
What ligaments are found in the gluteal region?
- Sacroiliac
- Sacrotuberous
- Sacrospinous
What are the actions of gluteus maximus?
- Extension of thigh at hip
- Abduction of thigh at jip
- External rotation of thigh at hip
- Stabilise the knee in extension of the thigh via the iliotibial band
What is the innervation of gluteus maximus?
Inferior gluteal nerve L5-S2
What is the blood supply to gluteus maximus?
Inferior gluteal nerve
What are the actions of gluteus medius and minimus?
- Abduction of the hip
- Internal rotation of the thigh
- Support the body on one limb in conjunction with tenor fascia lata
What is the innervation of gluteus medius and minimus?
Superior gluteal nerve L4-S1
What is the blood supply to gluteus medius and gluteus minimus?
Superior gluteal region
What are the actions of tensor fasciae lata?
Assiste with flexion and abduction of the thigh
What is the innervation of tensor fasciae lata?
Superior gluteal nerve L4-S1
What is the blood supply to tensor fasciae lata?
Superior gluteal nerve
Where can the sciatic nerve be located?
Sciatic nerve halfway between:
- Sacrum & greater trochanter
- Ischial tuberosity & lesser trochanter
- Natal cleft & lateral edge of thigh
- Inferior border of piriformis
What is Trendelenburg sign?
- Dipping gait of contralateral side when standing on one leg
- Compromised gluteus medius/ superior gluteus nerve
What muscles make up the hamstrings?
- Biceps femoris
- Semimembranosus
- Semitendinosus
Where do the hamstrings originate?
Ischial tuberosity
What nerve innervates the adductor compartment?
Obturator nerve
What are the contents of the femoral triangle?
- Lymphatics
- Femoral vein
- Femoral artery
- Femoral nerve
What are the boundaries of the femoral triangle?
- Roof= inguinal ligament
- Medial= adductor longus
- Lateral= sartorius
What are the boundaries of the adductor canal?
- Anterior= sartorius
- Lateral= vastus medialis
- Posterior= adductor longus and adductor magnus
What are the contents of the adductor canal?
- Femoral artery
- Femoral vein
- Saphenous nerve
Where is the femoral pulse felt?
Midway between the pubis symphysis and anterior superior iliac spine (midinguinal point)
How do femoral hernias occur?
Part of the bowel pushes into the femoral canal
How do femoral hernias present?
Manifests as a lump or bulge in the area of the femoral triangle posterior and inferior to inguinal ligament
Who do femoral hernias occur in commonly?
Females
What bones are present at the knee joint?
- Femur
- Tibia
- Patella
What ligaments are present at the knee?
- Anterior cruciate ligament
- Posterior cruciate ligament
- Medial collateral ligament
- Lateral collateral ligament
What is Drawer test?
- Excessive anterior displacement of the tibia suggests that the ACL is injured.
- Excessive posterior displacement of tibia the suggests that the PCL is injured.
What bursa are present around the knee?
- Semimembranosus bursa
- Subsartorial bursa
- Deep infrapatellar bursa
- Subcutaneous infrapatellar bursa
- Subcutaneous prepatellar bursa
- Suprapatellar bursa
What is a fabella?
- A sesamoid bone located inside the gastrocnemius lateral head tendon on the posterior side of the knee, in about 25% of people.
- It is a variant of normal anatomy
What are the boundaries of the popliteal fossa?
- Superiolateral= biceps femoris
- Superomeadial= semimembranosus
- Inferolateral= Lateral head of gastrocnemius
- Inferomedial= Medial head of gastrocnemius
What are the contents of the popliteal fossa from superficial to deep?
- Tibial nerve
- Politeal vein
- Popliteal artery
Where does the common peroneal nerve cross the fibula?
Surgical neck
What muscle can entrap the common peroneal nerve?
Fibularis longus
What muscles make up the superficial posterior leg?
- Gastrocnemius
- Soleus
- Plantaris
What muscles make up the deep posterior leg?
-Popliteus
-Tibialis posterior
-Flexor digitorum longus
-Flexor hallucis longus
-
Where does the calf neurovascular plane lie?
Between the superficial and deep muscle groups
What does the post tibial artery give off?
Fibular artery
What muscles are in the anterior leg compartment?
- Tibialis anterior
- Extensor digitorum longus
- Extensor hallucis longus
What is the innervation of the anterior leg compartment?
Deep fibular nerve
What muscles are in the lateral leg compartment?
- Fibularis longus
- Fibularies brevis
- Fibularis tertius
What is the innervation of the lateral compartment of the leg?
Superficial fibular nerve
What structures pass posterior the medial malleolus?
- Tibialis posterior
- Flexor digitroum longus
- Posterior tibial artery
- Posterior tibial vein
- Tibial nerve
- Flexor hallucis longus
Describe the medial ligament of the malleolus?
- The medial ligament (or deltoid ligament)is attached to the medial malleolus.
- Itconsists of four separate ligaments, which fan out from the malleolus, attaching to the talus, calcaneus and navicular bones. -The primary action of the medial ligament is to resist over-eversion of the foot
What ligaments make up the deltoid ligament?
- Anterior tbiotalar
- Posterior tibiotalar
- Tibionavicular
- Tibiocalcaneal
Describe the lateral ligament of the malleolus.
- The lateral ligament originates from the lateral malleolus.
- It resists over-inversion of thefoot.It is comprised of three distinct ligaments.
What ligaments make up the lateral ligament?
- Posterior talodibular
- Anterior talofibular
- Calcaneofibular
What ligaments are present in the foot?
- Plantarcalcaneonavicular ligament
- Long plantar ligament
- Short plantar ligament
- Plantar fascia
What type of joint is the superior tibial fibular joint?
Synovial plane
What type of joint is the inferior tibial fibula joint?
Syndesmosis
How many layers of muscles are there in the foot?
4
How many neurovascular planes are there in the foot/
2
What arches are there in the foot?
- Lateral longitudinal arch
- Transverse arch
- Medial longitudinal arch
What structures maintain the arches of the foot?
- Tibialis anterior
- Peroneus longus
- Plantar aponeurosis
- Flexor digitorum brevis
- Ligaments
What is the lympathic drainage of the lower limb?
Inguinal nodes
Major dermatomal landmarks?
- L1-2= groin
- L4= knee
- L5= sole of foot
- S1= baby toe
- S1-2= back of leg and thigh
What is the cutaneous innervation of the sole of the foot?
- First 3.5 toes= medial plantar nerve
- Last 1.5 toes= lateral plantar nerve
- Heel= medial calcaneal branches
- Lateral aspect= sural nerve
- Medial aspect= saphenous nerve
