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LOCO 2 > Review of Anatomy of Lower Limb > Flashcards

Review of Anatomy of Lower Limb Flashcards

1
Q

How is the lower limb divided (for descriptive purposes)?

A

Hip (between the pelvis and thigh, includes pelvic girdle and hip joint)
Thigh (between hip and knee)
Lower leg (between knee and ankle)
Foot (portion distal to ankle)

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2
Q

What are the bones of the hip? (4)

A

Pelvis (ischium, ilium, pubis) and proximal femur

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3
Q

What are the joints of the hip? (3)

A

Sarcoiliac, pubic symphysis, hip

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4
Q

Are hip dislocations generally anterior or posterior? Why?

A

Posterior - iliofemoral ligament is one of the strongest ligaments in the body, and it is anterior to the hip joint.

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5
Q

What is Shenton’s line? What does it mean if it is disrupted?

A

Smooth, continuous arch drawn underneath superior pubic ramus and along infero-medial border of neck of femur.
Femur is fractured.

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6
Q

What are the three major ligaments of the hip?

A

Pubofemoral
Iliofemoral
Ischiofemoral

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7
Q

What ligament is there within the hip itself?

What does it do?

A

Ligamentum teres

From acetabulum to head of femur to keep it in socket.

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8
Q

What two main arteries supply the hip (NOT the branches)?

A

Deep artery of thigh/profunda femoris** - main one

Obturator - less important in adults

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9
Q

What branches does the profunda femoris give off? What do they supply?

A

Lateral and medial circumflex arteries - supply head and neck of femur

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10
Q

What branch does the obturator artery give off?

A

Artery to head of femur

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11
Q

Which artery is involved in avascular necrosis of the femur?

A

Medial circumflex artery

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12
Q

What does profunda femoris come off? Where does that stem from?

A

External iliac -> femoral -> profunda femoris

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13
Q

Where does the sacrospinous ligament travel from/to?

A

From sacrum to ischial spine.

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14
Q

Where does the sacrotuberous ligament travel from/to?

A

From sacrum to ischial tuberosity

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15
Q

What foramina do the sacrospinous and sacrotuberous ligament create?

A

Greater and lesser sciatic foramen

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16
Q

What passes through the greater sciatic foramen? (5)

A 
Sciatic nerve
Pudendal nerve
Superior gluteal bundle
Inferior gluteal bundle
Piriformis
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17
Q

What action does piriformis do?

A

Lateral rotation

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18
Q

What actions does gluteus maximus do? (2)

A

Hip extension

Lateral rotation

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19
Q

What do gluteus medius and minimus do?

A

Abduction

Contract to keep pelvis in place when you lift the other leg up

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20
Q

What are the nerve roots for the lateral rotators?

A

L5, S1, S2

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21
Q

When doing intramuscular injections into gluteus maximus, care needs to be taken to avoid what nerves?

A

Sciatic nerve (and superior and inferior gluteal nerves).

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22
Q

What does 3/4 of glut max insert to?

What about the other 1/4?

A

Iliotibial band of the fascia lata

Gluteal tuberosity of femur

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23
Q

What are the lateral rotators? (5)

A 
Piriformis
Superior gemellus
Obturator internus
Inferior gemellus
Quadratus femoris
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24
Q

What does the superior gluteal nerve innervate? (3)

A

Gluteus medius
Gluteus minimus
Tensor fascia latae

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25
Q

What does the inferior gluteal nerve innervate? (3)

A

Gluteus maximus

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26
Q

If there is a superior gluteal nerve palsy, what test is positive?

A

Trendelenberg’s test - this tests hip abductors, i.e. gluteus medius and minimus.

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27
Q

What are the three major compartments of the thigh?

A

Anterior, medial and posterior

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28
Q

What is the main muscle in the anterior compartment of the thigh? What is its action?

A

Quadriceps

Knee extension, hip flexion

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29
Q

What are the quadriceps innervated by?

A

Femoral nerve (L2, 3, 4)

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30
Q

Where is the adductor canal in relation to the compartments of the thigh?

A

Behind the anterior compartment

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31
Q

Other than quadriceps, what other muscles make up the anterior compartment of the thigh? (2)

A

Iliopsoas (psoas major and iliacus)

Sartorius

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32
Q

Which muscle is the major flexor of the hip joint?

A

Iliopsoas

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33
Q

What action does sartorius do?

A

Flexes hip AND knee

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34
Q

What are the four muscle bellies of quadriceps?

Which is the only one that acts on the hip joint?

A

Vastus medialis, intermedius, lateralis

Rectus femoris - acts on hip

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35
Q

What is the muscle group in the medial compartment of the thigh? What do they do?

A

Adductors - hip adduction

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36
Q

What are the adductors (thigh) innervated by?

A

Obturator nerve (L2, 3, 4)

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37
Q

What are the adductor muscles (thigh)? (4)

A 
Adductor magnus (biggest), longus, brevis (smallest)
Gracilis
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38
Q

In general, what do the adductor muscles attach to?

A

Attach to the pelvis and distally to linea asperea

39
Q

What artery passes through the adductor hiatus?

A

Femoral artery

40
Q

What is the group of muscles in the posterior compartment of the thigh? What do they do?

A

Hamstrings

Knee flexion, hip extension

41
Q

What nerve innervates the hamstrings?

A

Tibial branch of the sciatic (L5, S1, S2)

42
Q

Where do the hamstrings originate? Where do they insert?

A

Ischial tuberosity, insert onto tibia

43
Q

What are the three hamstrings?

A

Semitendinosus
Semimembranosus
Biceps femoris

44
Q

Which is more medial - semitendinosus or semimembranosus?

A

Semimembranosus

45
Q

What is pes anserinus?

A

The insertion of sartorius (quadriceps), gracilis (adductor) and semitendinosus (hamstring)

46
Q

What are the nerve roots of the lumbar plexus?

A

L1-4

47
Q

What nerves make up the lumbar plexus? (7)

A 
Subcostal
Iliohypogastric
Ilioinguinal
Genitofemoral
Lateral cutaneous of the thigh
Obturator
Femoral
48
Q

What are the only two motor branches of lumbar plexus going into thigh?

A

Obturator nerve and femoral nerve

49
Q

What is the inguinal ligament? What vessels go under here?

A

External oblique aponeurosis

Femoral artery, vein and nerve

50
Q

What are the superior, lateral and medial borders of the femoral triangle?

A

Inguinal ligament superiorly, Sartorius laterally, adductor longus medially

51
Q

Order the femoral vessels and nerve from lateral to medial.

A

Nerve, artery, vein, deep inguinal nodes and lymphatics

52
Q

What is the first branch of femoral artery?

A

Profunda femoris

53
Q

Where does profunda femoris pass between?

A

Pectineus and adductor longus

54
Q

What is the largest joint in the body?

A

Knee

55
Q

What are the three articulations of the knee?

A

Lateral femoral and tibial condyles with corresponding meniscus
Medial femoral and tibial condyles with corresponding meniscus
Patella and femur

56
Q

What are the three bones that make up the knee?

A

Femur, tibia and patella

57
Q

Why doesn’t the knee fit together well? What structures keep them together?

A

Femur has a rounded condyle, and the tibia is flat.

Menisci, collateral ligaments, cruciate ligaments

58
Q

What does the stability of the knee depend on? (2)

A

Strength and actions of surrounding muscles and their tendons
The ligaments that connect the femur and tibia

59
Q

What are the menisci?

A

Fibrocartilaginous, wedge-shaped discs - they are shock absorbers.

60
Q

Which is bigger - medial or lateral meniscus?

A

Medial

61
Q

What shape is the medial meniscus?

A

C-shaped

Broader posteriorly than anteriorly

62
Q

What is the medial meniscus attached to? (2)

A

Anteriorly attached to ACL

Firmly adhered to the tibial collateral ligament

63
Q

What shape is the lateral meniscus?

A

Nearly circular

64
Q

What is the lateral meniscus attached to?

A

Attached to the PCL

65
Q

Which meniscus is more freely movable?

A

Lateral

66
Q

What is the purpose of the collateral ligaments?

A

Collateral ligaments stabilize the hinge-like movement of the knee joint.

67
Q

What are the two collateral ligaments?

A

Fibular and tibial collateral ligaments

68
Q

Where does the posterior cruciate ligament run from and where to?

A

Runs from posterior aspect of intercondylar area of tibia and ascends anteriorly to attach to the medial wall of the femoral intercondylar fossa

69
Q

What is the purpose of the PCL? (3)

A

Stops femur moving posteriorly on the tibia
Helps stabilise knee (especially in flexion)
Prevents tibia twisting outward (external rotation)

70
Q

Which is torn more frequently - ACL or PCL? Why?

A

ACL

PCL is stronger

71
Q

Where does the anterior cruciate ligament run from and where to?

A

Runs from facet on the anterior part of the intercondylar area of tibia and ascends posteriorly to attach to the back of the lateral wall of the intercondylar fossa of the femur

72
Q

What is the purpose of the ACL? (3)

A

Stops femur moving anteriorly/forward on the tibia
Stabilise knee in extension (prevents hyperextension)
Prevents excessive internal rotation

73
Q

When does ACL tearing often occur?

A

When the knee is twisted whilst that limb is weight-bearing with the foot fixed on the ground

74
Q

What makes up the borders of the popliteal fossa?

A

Hamstrings make up superior borders (semimembranosus and semitendinosus medially, biceps femoris on the other)
Gastrocnemius make up inferior borders

75
Q

What structures run through the popliteal fossa? (5)

A
  • Popliteal artery (deepest)
  • Popliteal vein
  • Common peroneal and tibial nerve (more medial than common peroneal)
  • Sural nerve
  • Small saphenous vein
76
Q

What compartment of the leg does the tibial nerve innervate?

A

Posterior

77
Q

Is the sural nerve sensory or motor? What does it supply?

A

Sensory

Posterior part of leg

78
Q

What are the branches of the femoral artery that supply the knee? (4)

A

Superior lateral genicular artery
Superior medial genicular artery
Inferior lateral genicular artery
Inferior medial genicular artery

79
Q

What nerve innervates the anterior compartment of the leg?

What artery?

A

Deep peroneal nerve

Anterior tibial artery

80
Q

What do the muscles of the anterior compartment of the leg do? (2)

A

Dorsiflexion

Extension of digits

81
Q

What nerve innervates the lateral compartment of the leg?

What artery?

A

Superficial peroneal nerve

Fibular artery

82
Q

What do the muscles of the lateral compartment of the leg do?

A

Eversion

83
Q

What nerve innervates the posterior compartment of the leg?

What artery?

A

Tibial nerve

Posterior tibial artery

84
Q

What do the muscles of the posterior compartment of the leg do? (2)

A

Plantarflexion

Flexion of digits

85
Q

The popliteal artery supplies the compartments of the legs. Which branches?

A

Anterior – anterior tibial (dorsalis pedis is a branch of this)
Lateral – perforating branches of deep penoneal (fibular)
Posterior – posterior tibial (this has medial and lateral plantar as branches)

86
Q

What are the two branches of the sciatic nerve?

A

Tibial and common peroneal nerves

87
Q

What does the tibial nerve innervate? (2)

A

Superficial post compartment (calf muscles – ankle plantarflexors)
Deep post compartment (plantarflexors of foot)

88
Q

What does the common peroneal nerve innervate? (2)

A

Anterior and lateral compartments

Anterior (dorsiflexion) = deep peroneal, lateral (eversion) = superficial

89
Q

What sign does a common peroneal nerve injury cause?

A

Foot drop

90
Q

What type of joint is the ankle?

A

Hinge-type synovial joint

91
Q

What bones form the ankle joint?

A

Tibia, fibula and talus

92
Q

What ligaments is the ankle reinforced by laterally? (3)

A

Anterior talofibular ligament
Posterior talofibular ligament
Calcaneofibular ligament

93
Q

What ligaments is the ankle reinforced by medially?

A

Deltoid ligament

94
Q

Which ligament is usually sprained in the ankle?

A

Anterior talofibular ligament

LOCO 2 (28 decks)

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