Lower limb 2: Proximal neurovasculature, knee & leg

Question 1

Which spinal nerve roots form the sacral plexus?

Answer 1

L4 - S4

Question 2

What are the nerve roots of the pudendal nerve?

Answer 2

S2 - S4

Question 3

The lumbar plexus emerges from where?

Answer 3

Psoas major

Question 4

List the 5 major branches of the lumbar plexus.

Answer 4

Ilioinguinal nerve

Lateral femoral cutaneous nerve

Femoral nerve

Obturator nerve

Lumbosacral trunk

Question 5

Describe how the lateral femoral cutaneous nerve enters the thigh.

Answer 5

Enters the anterior thigh close to the ASIS

Question 6

What is Meralgia Paraesthetica?

Answer 6

Compression of the lateral femoral cutaneous nerve

Question 7

Describe the anatomical position of the lateral femoral cutaneous nerve in relation to the inguinal ligament, ASIS, and sartorius.

Answer 7

The LFCN passes posterior to the inguinal ligament, medial to the ASIS, and superficial to the sartorius

Question 8

The superior and inferior gluteal arteries are a branch of what?

Answer 8

Internal iliac artery

Question 9

The external iliac artery becomes which artery after passing under the inguinal ligament?

Answer 9

Common femoral artery

Question 10

The common femoral artery branches into what?

Answer 10

Superficial and deep femoral arteries

Question 11

Starting from medial and moving lateral, what is the order of the vasculature in the femoral triangle?

Answer 11

Lymphatics
Vein
Artery
Nerve

Question 12

What are the borders of the femoral triangle?

Answer 12

Inguinal ligament (superior)
Sartorius (lateral)
Adductor longus (medial)

Question 13

Which side of the heart can be accessed with cannula insertion into the femoral artery?

Answer 13

Left side via aortic arch

Question 14

Which side of the heart can be accessed with cannula insertion into the femoral vein?

Answer 14

Right side via IVC

Question 14

What are the attachment points of the inguinal ligament?

Answer 14

ASIS and pubic tubercle

Question 15

The superficial inguinal nodes can be divided into which 2 groups?

Answer 15

Horizontal
Vertical

Question 16

What is the anatomical location of the menisci?

Answer 16

Superior surface of the tibial condyles

Question 17

The menisci are made of what?

Answer 17

Fibrocartilage

Question 18

List 4 functions of the menisci.

Answer 18

Increase contact area

Weight-bearing

Act as shock absorbers

Participate in the locking mechanism

Question 19

The patella bone attaches to what superiorly and inferiorly?

Answer 19

Quadriceps tendon

Patella ligament

Question 20

What is the function of the ACL?

Answer 20

Prevents anterior movement of the tibia on a fixed position femur

Question 21

What is the function of the PCL?

Answer 21

Prevents posterior movement of the tibia on a fixed position femur

Question 22

Which 2 examinations can be used to check the integrity of the ACL and PCL?

Answer 22

Lachman test
Drawer test

Question 23

The ACL attaches to which condyle?

Answer 23

Lateral femoral condyle

Question 24

The PCL attaches to which condyle?

Answer 24

Medial femoral condyle

Question 25

Which examination is used to check for damage to the ACL?

Answer 25

Lachman test

Question 26

Which ligaments resist valgus and varus forces at the knee?

Answer 26

Medial and lateral collateral ligaments

Question 27

Which ligament resists tibial abduction?

Answer 27

Medial collateral ligament

Question 28

Which ligament resists tibial adduction?

Answer 28

Lateral collateral ligament

Question 29

What are the 3 anterior bursa of the knee?

Answer 29

Prepatellar bursa Infrapatellar bursa Suprapatellar bursa

Question 30

What is meant by 'close-packing' of the knee joint?

Answer 30

On full extension of the knee, the femur rotates medially on the tibia, which tenses the ligaments of the knee

Question 31

Which muscle unlocks a fully extended knee and how?

Answer 31

Popliteus - by laterally rotating the femur on the tibia

Question 32

Give the function, innervation, and blood supply of the anterior leg compartment.

Answer 32

Foot and digit dorsiflexors and foot invertors Deep fibular nerve (L4 - S1) Anterior tibial artery

Question 33

Give the function, innervation, and blood supply of the lateral leg compartment.

Answer 33

Foot evertors Superficial fibular nerve (L5, S1) Fibular artery

Question 34

Give the function, innervation, and blood supply of the posterior leg compartment.

Answer 34

Foot and digit plantarflexors and foot invertors Tibial nerve (L4 - S2) Posterior tibial artery

Question 35

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

Answer 35

Tibialis anterior Extensor digitorum longus Extensor hallucis longus Fibularis tertius

Question 36

What are the 2 main muscles of the lateral leg compartment?

Answer 36

Fibularis longus Fibularis brevis

Question 37

What are the 7 main muscles of the posterior leg compartment?

Answer 37

Gastrocnemius Plantaris Soleus Tibialis posterior Flexor digitorum longus Flexor hallucis longus Popliteal

Question 38

What are the 4 structures within the popliteal fossa?

Answer 38

Popliteal artery Popliteal vein Tibial nerve Common fibular nerve

Question 39

What does the sciatic nerve divide into?

Answer 39

Tibial nerve Common fibular nerve

Question 40

Knee joint swelling will extend into which bursa?

Answer 40

Suprapatellar bursa

Question 41

Where is the common fibular nerve at risk of compression?

Answer 41

As it winds around the neck of the fibula

Question 42

Loss of function to which muscle would cause foot drop?

Answer 42

Tibialis anterior

Question 43

Loss of function to which 2 muscles would cause an inability to point toes towards the ceiling?

Answer 43

Extensor digitorum longus Extensor hallucis longus

Question 44

On excessive inversion of the foot, the 5th metatarsal tuberosity can be avulsed by which muscle?

Answer 44

Fibularis brevis