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Duke-NUS MS1 > RA9 Lower Limb Anatomy > Flashcards

RA9 Lower Limb Anatomy Flashcards

1
Q

Components of the pelvic girdle

A

Sacrum and hip bones

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2
Q

3 primary bones of the hip bone

A
  • Ilium (superior)
  • Ischium (inferior/posterior)
  • Pubis (anterior/medial)
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3
Q

Articulation site of the left and right hip bone

A

Pubic symphysis

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4
Q

Opening formed by the ischium and pubis

A

Obturator foramen

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5
Q

Separates the 3 primary hip bones before fusion at 15-17 years

A

Triradiate cartilage

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6
Q

A large socket on the lateral face of the hip bone that articulates with the head of the femur to form the hip joint

A

Acetabulum

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7
Q

Ligaments of hip joint (3)

A
  • Iliofemoral ligament: between ilium and femur
  • Pubofemoral ligament: between pubis and femur
  • Ischiofemoral ligament: between ischium and femur
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8
Q

Main parts of the femur (anterior)

A
  • Head
  • Neck
  • Greater and lesser trochanters: joined by intertrochanteric line (anterior) and intertrochanteric crest (posterior)
  • Lateral and medial epicondyles
  • Lateral and medial femoral condyles
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9
Q

Main parts of the femur (posterior)

A
  • Head
  • Neck
  • Greater and lesser trochanters: joined by intertrochanteric line (anterior) and intertrochanteric crest (posterior)
  • Lateral and medial epicondyles
  • Lateral and medial femoral condyles
  • Linea aspera
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10
Q

Knee cap

A

Patella

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11
Q

Ligaments (4) and meniscus (2) of knee

A
  • Anterior cruciate ligament (ACL)
  • Posterior cruciate ligament (PCL)
  • Lateral collateral ligament (LCL)
  • Medial collateral ligament (MCL)
  • Lateral meniscus
  • Medial meniscus
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12
Q
  • Anterior cruciate ligament (ACL): taut in (…)
  • Posterior cruciate ligament (PCL): taut in (…)

extension/flexion

A
  • Anterior cruciate ligament (ACL): taut in extension
  • Posterior cruciate ligament (PCL): taut in flexion
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13
Q

Unhappy triad

A
  • Anterior cruciate ligament (ACL)
  • Posterior cruciate ligament (PCL)
  • Medial meniscus
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14
Q

Where are the flexors and extensors in the lower limb?

A
  • Flexor = posterior side
  • Extensor = anterior side
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15
Q

Compartments of thigh muscles

A
  • Anterior: quadriceps
  • Medial: adductors
  • Posterior: hamstrings
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16
Q

Which nerves comprise the lumbosacral plexus, lumbar plexus, and sacral plexus?

A

Lumbosacral plexus: L1 - S4
Lumbar plexus: L1 - L4
Sacral plexus: L5 - S4

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17
Q

Lumbar plexus
- What does it innervate?
- Important nerves (3)

A
  • Innervates anterior and medial thigh
  • Nerves to iliopsoas
  • Femoral nerve
  • Obturator nerve
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18
Q

Sacral plexus
- What does it innervate?
- Important nerves (7)

A
  • Innervates gluteal region, posterior thigh, legs, foot

Important nerves:
- Superior and inferior gluteal nerves
- Nerve to piriformis
- Sciatic nerve - common fibular and tibial nerve
- Nerve to quadratus femoris
- Nerve to obturator internus

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19
Q

Branching of sciatic nerve

A

Sciatic nerve -> splits posterior to knee -> tibial nerve + common fibular nerve

Tibial nerve -> continues running posteriorly

Common fibular nerve -> runs laterally around head of fibula

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20
Q

Branching of common fibular nerve

A

Common fibular nerve -> runs laterally around head of fibula -> superficial fibular nerve (lateral leg) + deep fibular nerve (anterior leg)

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21
Q

Innervates the iliopsoas

A

Nerve to iliopsoas

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22
Q

Innervates the anterior thigh (quadriceps)

A

Femoral nerve

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23
Q

Innervates the medial thigh (adductors)

A

Obturator nerve

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24
Q

Innervates the gluteal muscles

A

Superior and inferior gluteal nerves

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25
Q

Innervates the lateral rotators of the hip

A
  • Nerve to piriformis
  • Nerve to obturator internus
  • Nerve to quadratus femoris
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26
Q

Innervates the posterior thigh (hamstrings)

A

Tibial nerve (from sciatic nerve)

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27
Q

The 2 muscles that make up the iliopsoas

A
  • Psoas major
  • Iliacus
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28
Q

Iliopsoas
- Insertion
- Action
- Innervation

A
  • Insertion: lesser trochanter
  • Action: hip flexion
  • Innervation: nerve to iliopsoas
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29
Q

Anterior thigh muscles (5)
(quadriceps)

A
  • Sartorius
  • Rectus femoris
  • Vastus lateralis
  • Vastus medialis
  • Vastus intermedius
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30
Q

Insertion of anterior thigh muscles

A
  • Sartorius: proximal tibia
  • Rectus femoris: tibial tuberosity
  • Vastus lateralis: tibial tuberosity
  • Vastus medialis: tibial tuberosity
  • Vastus intermedius: tibial tuberosity
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31
Q

Action of anterior thigh muscles

A
  • Sartorius: hip and knee flexion
  • Rectus femoris: knee extension
  • Vastus lateralis: knee extension
  • Vastus medialis: knee extension
  • Vastus intermedius: knee extension
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32
Q

Innervation of anterior thigh muscles

A

Femoral nerve

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33
Q

Medial thigh muscles (5)
(adductors)

A
  • Adductor longus
  • Adductor brevis
  • Adductor magnus
  • Pectineus
  • Gracilis

Adductor hiatus: space through which femoral artery passes through

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34
Q

Space through which the femoral artery passes through

A

Adductor hiatus

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35
Q

Insertion of medial thigh muscles

A
  • Adductor longus: linea aspera of femur
  • Adductor brevis: linea aspera, lesser trochanter
  • Adductor magnus: linea aspera
  • Pectineus: linea aspera
  • Gracilis: proximal tibia
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36
Q

Action of medial thigh muscles

A

Thigh adduction

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37
Q

Innervation of medial thigh muscles

A

Obturator nerve

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38
Q

Gluteal muscles (3)

A
  • Gluteus maximus
  • Gluteus medius
  • Gluteus minimus
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39
Q

Insertion of gluteal muscles

A
  • Gluteus maximus: IT tract and femur
  • Gluteus medius: greater trochanter
  • Gluteus minimus: greater trochanter
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40
Q

Action of gluteal muscles

A
  • Gluteus maximus: thigh extension
  • Gluteus medius: thigh abduction
  • Gluteus minimus: thigh abduction
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41
Q

Innervation of gluteal muscles

A
  • Gluteus maximus: inferior gluteal
  • Gluteus medius: superior gluteal
  • Gluteus minimus: superior gluteal
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42
Q

Lateral rotator muscles of hip (5)

A
  • Piriformis
  • Superior gemellus
  • Obturator internus
  • Inferior gemellus
  • Quadratus femoris
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43
Q

Insertion of lateral rotator muscles of hip

A
  • Piriformis: greater trochanter
  • Superior gemellus: greater trochanter
  • Obturator internus: greater trochanter
  • Inferior gemellus: greater trochanter
  • Quadratus femoris: intertrochanteric crest
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44
Q

Action of lateral rotator muscles of hip

A

Lateral rotation

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45
Q

Innervation of lateral rotator muscles of hip

A
  • Piriformis: nerve to piriformis
  • Superior gemellus: nerve to obturator internus
  • Obturator internus: nerve to obturator internus
  • Inferior gemellus: nerve to quadratus femoris
  • Quadratus femoris: nerve to quadratus femoris
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46
Q

Where does the sciatic nerve emerge?

A

The sciatic nerve emerges inferior to the piriformis

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47
Q

Posterior thigh muscles (3)
(hamstrings)

A
  • Biceps femoris
  • Semitendinosus
  • Semimembranosus
48
Q

Insertion of posterior thigh muscles

A
  • Biceps femoris: proximal fibula
  • Semitendinosus: proximal tibia
  • Semimebranosus: proximal tibia
49
Q

Action of posterior thigh muscles

A
  • Biceps femoris: knee flexion, hip extension (long head)
  • Semitendinosus: knee flexion, hip extension
  • Semimbranosus: knee flexion, hip extension
50
Q

Innervation of posterior thigh muscles

A

Tibial nerve

51
Q

Anterior, medial, and posterior thigh compartments
- Action
- Innervation

A

Anterior thigh (quadriceps)
- Knee extension
- Femoral nerve

Medial thigh:
- Adduction
- Obturator nerve

Posterior thigh (hamstrings):
- Knee flexion, hip extension
- Tibial nerve

52
Q

Arteries of gluteal region

A

Common iliac artery -> internal iliac artery -> superior and inferior gluteal artery

53
Q

Arteries of the lower limb

A

Common iliac artery (anterior) -> external iliac artery -> femoral artery -> goes posterior through adductor hiatus -> popliteal artery

Popliteal artery (posterior) -> goes anterior through interosseus membrane -> anterior tibial artery -> dorsalis pedis artery

Popliteal artery (posterior) -> posterior tibial artery (medial) -> lateral + medial plantar artery

Popliteal artery (posterior) -> fibular artery

54
Q

Femoral triangle
- Borders?
- Contains?

A

Borders:
- Inguinal ligament
- Sartorius
- Adductor longus

Contains:
- Femoral nerve
- Femoral artery
- Femoral vein

55
Q

Superficial veins of lower limb

A
  • Great saphenous vein: anterior to medial malleolus, empties into femoral vein
  • Small saphenous vein: posterior to lateral malleolus, empties into politeal fossa
56
Q

2 bones of the leg

A
  • Tibia (medial)
  • Fibula (lateral)
57
Q

The tibia and fibula are connected by the (…)

A

The tibia and fibula are connected by the interosseous membrane

58
Q

Main parts of the tibia

A
  • Medial tibial condyle
  • Lateral tibial condyle
  • Tibial tuberosity
  • Medial malleolus
59
Q

Main parts of the fibula

A
  • Head
  • Neck
  • Lateral malleolus
60
Q

3 main parts of the foot

A
  1. Tarsals (7)
    - Talus (ankle bone)
    - Calcaneus (heel bone)
    - Cuboid
    - Navicular
    - Medial cuneiform
    - Intermediate cuneiform
    - Lateral cuneiform
  2. Metatarsals (5)
  3. Phalanges (3 for each toe, except big toe only has 2)
61
Q

Tarsal bones (7)

A

Tiger Cubs Need MILC
- Talus (ankle bone)
- Calcaneus (heel bone)
- Navicular
- Medial cuneiforms
- Intermediate cuneiform
- Lateral cuneiform
- Cuboid

62
Q

Joints of foot

A
  • Tarsometatarsal joints (TMT)
  • Metatarsophalangeal joints (MTP)
  • Interphalangeal joints (IP)
  • Tibiotalar joint (ankle joint)
  • Subtalar/talocalcaneal joint
63
Q

Movement at ankle (tibiotalar) joint

A
  • Dorsiflexion: lift foot and toes up
  • Plantarflexion: point foot and toes down
64
Q

Movement at subtalar joint

A
  • Eversion: bring sole lateral
  • Inversion: bring sole medial
65
Q

Which digit is the axis around which abduction and adduction of the toes occur?

A

2nd digit

66
Q

Compartments of leg muscles

A
  • Anterior
  • Lateral
  • Posterior
67
Q

Anterior leg muscles (4)

A
  • Tibialis anterior
  • Extensor digitorum longus
  • Extensor hallucis longus
  • Fibularis tertius
68
Q

Insertion of anterior leg muscles

A
  • Tibialis anterior: medial cuneiform, metatarsal 1
  • Extensor digitorum longus: middle and distal phalanges 2-5
  • Extensor hallucis longus: dital phalanx 1
  • Fibularis tertius: base of metatarsal 5
69
Q

Action of anterior leg muscles

A
  • Tibialis anterior: ankle dorsiflexion, inversion
  • Extensor digitorum longus: toe (2-5) extension
  • Extensor hallucis longus: hallux extension
  • Fibularis tertius: eversion
70
Q

Innervation of anterior leg muscles

A

Deep fibular nerve

71
Q

Dorsal foot muscles (2)

A
  • Extensor hallucis brevis
  • Extensor digitorum brevis
72
Q

Insertion of dorsal foot muscles

A
  • Extensor hallucis brevis: proximal phalanx 1
  • Extensor digitorum brevis: middle phalanx 2-5
73
Q

Action of dorsal foot muscles

A
  • Extensor hallucis brevis: hallux extension
  • Extensor digitorum brevis: toe extension
74
Q

Innervation of dorsal foot muscles

A

Deep fibular nerve

75
Q

Lateral leg muscles (2)

A
  • Fibularis longus (superficial)
  • Fibularis brevis (deep)
76
Q

Insertion of lateral leg muscles

A
  • Fibularis longus: medial cuneiform, metatarsal 1
  • Fibularis brevis: base of metatarsal 5
77
Q

Action of lateral leg muscles

A
  • Fibularis longus: eversion, plantarflexion
  • Fibularis brevis: eversion, plantarflexion
78
Q

Innervation of lateral leg muscles

A

Superficial fibular

79
Q

Posterior leg muscles (superficial and intermediate; 4)

A
  • Gastrocnemius (superficial)
  • Soleus (intermediate)
  • Plantaris (superficial)
  • Popliteus (intermediate)
80
Q

Insertion of posterior leg muscles (superficial and intermediate)

A
  • Gastrocnemius: calcaneus
  • Soleus: calcaneus
  • Plantaris: calcaneus
  • Popliteus: tibia
81
Q

Action of posterior leg muscles (superficial and intermediate)

A
  • Gastrocnemius: plantarflexion
  • Soleus: plantarflexion
  • Plantaris: plantarflexion
  • Popliteus: internally rotate tibia on femur
82
Q

Innervation of posterior leg muscles (superficial and intermediate)

A

Tibial nerve

83
Q

What is another name for the Achilles tendon?

A

Calcaneal tendon

84
Q

What muscles come together to form the calcanal (Achilles) tendon?

A
  • Two heads of gastrocnemius
  • Soleus (triceps surae)
85
Q

Posterior leg muscles (deep; 3)

A
  • Tibialis posterior
  • Flexor digitorum longus
  • Flexor hallucis longus
86
Q

Insertion of posterior leg muscles (deep)

A
  • Tibialis posterior: medial cuneiform, navicular
  • Flexor digitorum longus: distal phalanges 2-5
  • Flexor digitorum brevis: distal phalanx 1
87
Q

Action of posterior leg muscles (deep)

A
  • Tibialis posterior: plantarflexion, inversion
  • Flexor digitorum longus: toe flexion
  • Flexor hallucis longus: hallux flexion
88
Q

Innervation of posterior leg muscles (deep)

A

Tibial nerve

89
Q

Contents of medial ankle

A

Tom Dick And Very Nervous Harry:
- Tibialis posterior
- Flexor digitorum longus
- Posterior tibial artery
- Posterior tibial vein
- Tibial nerve
- Flexor hallucis longus

90
Q

Anterior, lateral, and posterior leg compartments
- Action
- Innvervation

A

Anterior leg:
- Dorsiflexion, toe extension, inversion
- Deep fibular nerve

Lateral leg:
- Eversion
- Superficial fibular nerve

Posterior leg:
- Plantarflexion, inversion
- Tibial nerve

91
Q

Branching of tibial nerve

A

Tibial nerve (posterior) -> lateral plantar nerve + medial plantar nerve -> innervates intrinsic plantar foot muscles

92
Q

Intrinsic foot muscles layer 1 (3)

A
  • Flexor digitorum brevis
  • Abductor hallucis
  • Abductor digiti minimi
93
Q

Origin of intrinsic foot muscles layer 1

A

Calcaneus

94
Q

Insertion of intrinsic foot muscles layer 1

A
  • Flexor digitorum brevis: middle phalanges 2-5
  • Abductor hallucis: proximal phalanx 1
  • Abductor digiti minimi: proximal phalanx 5
95
Q

Action of intrinsic foot muscles layer 1

A
  • Flexor digitorum brevis: toe flexion
  • Abductor hallucis: hallux abduction
  • Abductor digiti minimi: digit 5 abduction
96
Q

Innervation of intrinsic foot muscles layer 1

A
  • Flexor digitorum brevis: medial plantar nerve
  • Abductor hallus: medial plantar nerve
  • Abductor digiti minimi: lateral plantar nerve
97
Q

Intrinsic foot muscles layer 2 (3)

A
  • Quadratus plantae
  • Lumbrical 1
  • Lumbricals 2-4
98
Q

Origin and insertion of intrinsic foot muscles layer 2

A
  • Quadratus plantae: calcaneus -> flexor digitorum longus
  • Lumbrical 1: flexor digitorum longus -> extensor hood 2
  • Lumbricals 2-4: flexor digitoum longus -> extensor hoods 3-5
99
Q

Action of intrinsic foot muscles layer 2

A
  • Quadratus plantae: assists flexor digitorum longus in toe flexion
  • Lumbrical 1: MTP flexion, IP extension
  • Lumbricals 2-4: MTP flexion, IP extension

MTP = metatarsophalangeal
IP = interphalangeal

100
Q

Intrinsic foot muscles layer 3 (3)

A
  • Flexor digiti minimi brevis
  • Flexor hallucis brevis
  • Adductor hallucis (transverse and oblique heads)
101
Q

Insertion of intrinsic foot muscles layer 3

A
  • Flexor digiti minimi brevis: proximal phalanx 5
  • Flexor hallucis brevis: proximal phalanx 1
  • Adductor hallucis: proximal phalanx 1
102
Q

Action of intrinsic foot muscles layer 3

A
  • Flexor digiti minimi brevis: MTP 5 flexion
  • Flexor hallucis brevis: MTP 1 flexion
  • Adductor hallucis: adduct hallux
103
Q

Innervation of intrinsic foot muscles layer 3

A
  • Flexor digiti minimi brevis: lateral plantar nerve
  • Flexor hallucis brevis: medial plantar nerve
  • Adductor hallucis: lateral plantar nerve
104
Q

Intrinsic foot muscles layer 4 (2)

A
  • Plantar interossei
  • Dorsal interossei
105
Q

Insertion of intrinsic foot muscles layer 4

A
  • Plantar interossei: proximal phalanges 3-5
  • Dorsal interossei: proximal phalanges 2-4
106
Q

Action of intrinsic foot muscles layer 4

A
  • Plantar interossei: toe adduction (PAD)
  • Dorsal interossei: toe abduction (DAB)
107
Q

Innervation of intrinsic foot muscles layer 4

A

Lateral plantar nerve

108
Q

Patient has an injury to the left hip joint and exhibits weakness of the gluteus medius resulting in the Trendelenburg gait. When asked to stand on one leg, what is the most likely finding?

A. When standing on the left leg, the pelvis will tilt to the left because of weak hip abduction.
B. When standing on the left leg, the pelvis will tilt to the right because of weak hip abduction.
C. When standing on the right leg, the pelvis will remain level because there is no weakness.
D. When standing on the right leg, the pelvis will tilt to the left because of weak hip abduction.

A

B. When standing on the left leg, the pelvis will tilt to the right because of weak hip abduction.

109
Q

A man is unable to dorsiflex his ankle - clinical case of foot drop. Upon examination, you see something that tells you the cause. What did you see?

A. A stab wound scar over his femoral triangle.
B. A stab wound scar over his vastus medialis muscle.
C. A laceration scar over his proximal fibula.
D. A 10 degree valgus deformity of his tibia shaft due to a malunited fracture.

A

C. A laceration scar over his proximal fibula.

An injury to the proximal fibula will lead to an injury of the deep fibular nerve, which innervates the anterior part of the leg. Thus, leads to foot drop.

110
Q

Which of the following muscles are flexors of the thigh?
A. Psoas
B. Pectineus
C. Rectus femoris
D. Vastus lateralis

A

A, B, and C

A: Psoas: part of iliopsoas
B: Pectineus: originates on pubis, so can flex hip/thigh
C: Rectus femoris: originates on ilium, so can flex hip/thigh

111
Q

Boundaries of popliteal fossa

A
  • Biceps femoris and semimembranous superiorly
  • Gastrocnemius inferiorly
112
Q

Which muscle passes through the greater sciatic foramen?

A

Piriformis

(piriformis peers through the hole)

113
Q

What does the femoral triangle contain?

A

Femoral nerve, artery, vein, and lymphatic vessels

114
Q

“Unlocking” of the knee joint to permit flexion is caused by the action of which muscle?

A

Popliteus
- Contraction causes lateral rotation of the femur on the tibia, unlocking the knee

115
Q

The anterior cruciate ligamnet resists (…) of the tibia

A

The anterior cruciate ligament resists anterior translation of the tibia

Duke-NUS MS1 (12 decks)

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