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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
What does the inferior gluteal nerve innervate? (3)
Gluteus maximus
26
If there is a superior gluteal nerve palsy, what test is positive?
Trendelenberg's test - this tests hip abductors, i.e. gluteus medius and minimus.
27
What are the three major compartments of the thigh?
Anterior, medial and posterior
28
What is the main muscle in the anterior compartment of the thigh? What is its action?
Quadriceps | Knee extension, hip flexion
29
What are the quadriceps innervated by?
Femoral nerve (L2, 3, 4)
30
Where is the adductor canal in relation to the compartments of the thigh?
Behind the anterior compartment
31
Other than quadriceps, what other muscles make up the anterior compartment of the thigh? (2)
Iliopsoas (psoas major and iliacus) | Sartorius
32
Which muscle is the major flexor of the hip joint?
Iliopsoas
33
What action does sartorius do?
Flexes hip AND knee
34
What are the four muscle bellies of quadriceps? | Which is the only one that acts on the hip joint?
Vastus medialis, intermedius, lateralis | Rectus femoris - acts on hip
35
What is the muscle group in the medial compartment of the thigh? What do they do?
Adductors - hip adduction
36
What are the adductors (thigh) innervated by?
Obturator nerve (L2, 3, 4)
37
What are the adductor muscles (thigh)? (4)
``` Adductor magnus (biggest), longus, brevis (smallest) Gracilis ```
38
In general, what do the adductor muscles attach to?
Attach to the pelvis and distally to linea asperea
39
What artery passes through the adductor hiatus?
Femoral artery
40
What is the group of muscles in the posterior compartment of the thigh? What do they do?
Hamstrings | Knee flexion, hip extension
41
What nerve innervates the hamstrings?
Tibial branch of the sciatic (L5, S1, S2)
42
Where do the hamstrings originate? Where do they insert?
Ischial tuberosity, insert onto tibia
43
What are the three hamstrings?
Semitendinosus Semimembranosus Biceps femoris
44
Which is more medial - semitendinosus or semimembranosus?
Semimembranosus
45
What is pes anserinus?
The insertion of sartorius (quadriceps), gracilis (adductor) and semitendinosus (hamstring)
46
What are the nerve roots of the lumbar plexus?
L1-4
47
What nerves make up the lumbar plexus? (7)
``` Subcostal Iliohypogastric Ilioinguinal Genitofemoral Lateral cutaneous of the thigh Obturator Femoral ```
48
What are the only two motor branches of lumbar plexus going into thigh?
Obturator nerve and femoral nerve
49
What is the inguinal ligament? What vessels go under here?
External oblique aponeurosis | Femoral artery, vein and nerve
50
What are the superior, lateral and medial borders of the femoral triangle?
Inguinal ligament superiorly, Sartorius laterally, adductor longus medially
51
Order the femoral vessels and nerve from lateral to medial.
Nerve, artery, vein, deep inguinal nodes and lymphatics
52
What is the first branch of femoral artery?
Profunda femoris
53
Where does profunda femoris pass between?
Pectineus and adductor longus
54
What is the largest joint in the body?
Knee
55
What are the three articulations of the knee?
Lateral femoral and tibial condyles with corresponding meniscus Medial femoral and tibial condyles with corresponding meniscus Patella and femur
56
What are the three bones that make up the knee?
Femur, tibia and patella
57
Why doesn't the knee fit together well? What structures keep them together?
Femur has a rounded condyle, and the tibia is flat. | Menisci, collateral ligaments, cruciate ligaments
58
What does the stability of the knee depend on? (2)
Strength and actions of surrounding muscles and their tendons The ligaments that connect the femur and tibia
59
What are the menisci?
Fibrocartilaginous, wedge-shaped discs - they are shock absorbers.
60
Which is bigger - medial or lateral meniscus?
Medial
61
What shape is the medial meniscus?
C-shaped | Broader posteriorly than anteriorly
62
What is the medial meniscus attached to? (2)
Anteriorly attached to ACL | Firmly adhered to the tibial collateral ligament
63
What shape is the lateral meniscus?
Nearly circular
64
What is the lateral meniscus attached to?
Attached to the PCL
65
Which meniscus is more freely movable?
Lateral
66
What is the purpose of the collateral ligaments?
Collateral ligaments stabilize the hinge-like movement of the knee joint.
67
What are the two collateral ligaments?
Fibular and tibial collateral ligaments
68
Where does the posterior cruciate ligament run from and where to?
Runs from posterior aspect of intercondylar area of tibia and ascends anteriorly to attach to the medial wall of the femoral intercondylar fossa
69
What is the purpose of the PCL? (3)
Stops femur moving posteriorly on the tibia Helps stabilise knee (especially in flexion) Prevents tibia twisting outward (external rotation)
70
Which is torn more frequently - ACL or PCL? Why?
ACL | PCL is stronger
71
Where does the anterior cruciate ligament run from and where to?
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
What is the purpose of the ACL? (3)
Stops femur moving anteriorly/forward on the tibia Stabilise knee in extension (prevents hyperextension) Prevents excessive internal rotation
73
When does ACL tearing often occur?
When the knee is twisted whilst that limb is weight-bearing with the foot fixed on the ground
74
What makes up the borders of the popliteal fossa?
Hamstrings make up superior borders (semimembranosus and semitendinosus medially, biceps femoris on the other) Gastrocnemius make up inferior borders
75
What structures run through the popliteal fossa? (5)
- Popliteal artery (deepest) - Popliteal vein - Common peroneal and tibial nerve (more medial than common peroneal) - Sural nerve - Small saphenous vein
76
What compartment of the leg does the tibial nerve innervate?
Posterior
77
Is the sural nerve sensory or motor? What does it supply?
Sensory | Posterior part of leg
78
What are the branches of the femoral artery that supply the knee? (4)
Superior lateral genicular artery Superior medial genicular artery Inferior lateral genicular artery Inferior medial genicular artery
79
What nerve innervates the anterior compartment of the leg? | What artery?
Deep peroneal nerve | Anterior tibial artery
80
What do the muscles of the anterior compartment of the leg do? (2)
Dorsiflexion | Extension of digits
81
What nerve innervates the lateral compartment of the leg? | What artery?
Superficial peroneal nerve | Fibular artery
82
What do the muscles of the lateral compartment of the leg do?
Eversion
83
What nerve innervates the posterior compartment of the leg? | What artery?
Tibial nerve | Posterior tibial artery
84
What do the muscles of the posterior compartment of the leg do? (2)
Plantarflexion | Flexion of digits
85
The popliteal artery supplies the compartments of the legs. Which branches?
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
What are the two branches of the sciatic nerve?
Tibial and common peroneal nerves
87
What does the tibial nerve innervate? (2)
Superficial post compartment (calf muscles – ankle plantarflexors) Deep post compartment (plantarflexors of foot)
88
What does the common peroneal nerve innervate? (2)
Anterior and lateral compartments | Anterior (dorsiflexion) = deep peroneal, lateral (eversion) = superficial
89
What sign does a common peroneal nerve injury cause?
Foot drop
90
What type of joint is the ankle?
Hinge-type synovial joint
91
What bones form the ankle joint?
Tibia, fibula and talus
92
What ligaments is the ankle reinforced by laterally? (3)
Anterior talofibular ligament Posterior talofibular ligament Calcaneofibular ligament
93
What ligaments is the ankle reinforced by medially?
Deltoid ligament
94
Which ligament is usually sprained in the ankle?
Anterior talofibular ligament

LOCO 2 (28 decks)

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