Revision of the Lower Limb Anatomy Flashcards
What is Shenton’s line?
An imaginary curved line drawn along the inferior border of the superior pubic ramus (superior border of the obturator foramen) and along the inferomedial border of the neck of femur. This line should be continuous and smooth.
Name four ligaments at the hip joint
Pubo-femoral
Ilio-femoral
Ischio-femoral
Ligamentum teres (inside joint capsule)
Which artery supplies the head of the femur?
Acetabular branch of the obturator artery
What’s the blood supply to the neck of the femur?
Medial circumflex femoral artery (a branch off profunda femoris)
What are the three main arteries that supply the head and neck of the femur?
Acetabular branch of obturator artery, lateral and medial circumflex arteries (from deep femoral artery)
Name two ligaments of the pelvis
Sacrospinous and sacrotuberous ligaments
Where does gluteus maximus lie in relation to gluteus medium and minimum?
In front of
What is the primary function of gluteus maximus?
Hip extensor and lateral rotator
Where does the iliotibial tract insert?
Anterolateral tubercle of the tibia
What are the insertion points of the gluteus maximus muscle?
3/4 insets into the IT band and 1/4 insets into the gluteal tuberosity of the femur
Where is the tensor fascia latae muscle located?
Lateral anterior thigh above the IT band
What is the nerve supply to the lateral rotators of the hip?
L5-S1
What are the lateral rotators of the hip?
Piriformis, superior gemelli, inferior gemelli, obturator interns and quadratus femoris
What muscles are innervated by the superior gluteal nerve?
Gluteus medius, gluteus minimus and tensor fascia latae
What muscle is innervated by the inferior gluteal nerve?
Gluteus maximus
What muscles does the anterior compartment of the thigh contain?
Quadriceps (+iliopsoas and sartortius)
What is the nerve supply to the anterior compartment of the thigh (quadriceps)?
The femoral nerve L2-L4
What is the function of the anterior compartment of the thigh (quadriceps)?
Flex hip and extend the knee
What muscles does the medial compartment of the thigh contain?
Hip adductors
What is the nerve supply to the medial compartment of the thigh (hip adductors)
The obturator nerve (L2-L4)
Which muscles make up the quadriceps?
Vastus medialis, vastus lateralis, vastus intermedius and rectus femoris
What is the function of the medial compartment of the thigh?
Hip adduction
What muscles does the posterior compartment of the thigh contain?
Hamstrings
What is the nerve supply to the posterior compartment of the thigh (hip adductors)
Tibial branch of the sciatic nerve (L5-S2)
What is the function of the posterior compartment of the thigh?
Hip extension and knee flexion
What is the function of iliopsoas muscle and where is it found?
It consists of iliacus (on the ilium) and psoas major (from lumbar spine into neck of femur). It’s the major flexor of the hip joint
What is the major flexor of the hip joint?
Iliopsoas
What is the function of sartorius and where is it found?
Goes from ASIS to medial knee (long and thin on a diagonall). It works to flex the hip and knee
What is the origin and attachment of the hamstrings?
All originate at the ischial tuberosity and attach distally to the tibia so act to flex the knee joint
What are the hamstring muscles?
Semitendinosus, semimembranosus and biceps femoris (long-head)
Semimembranosus lies above semitendinosus
What are the hip adductors in the medial compartment? (4)
Adductor magnus, adductor longus, adductor braves and gracilis
What is the origin and attachment of the hip adductors in the medial compartment of the thigh?
Attach to the pelvis and distally to the lines asperea
What is the pes anserinus?
Point on the medial knee where sartorius, gracilis and semitendinosus all insert
What are the nerve roots of the lumbar plexus?
L1-L4
Name the nerves of the lumbar plexus in order
Subcostal Iliohypogastric Ilioinguinal Genitofemoral Lateral cutaneous (of thigh)) Femoral Obturator Lumbosacral
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What are the boundaries of the femoral triangle?
Superiorly: inguinal ligament
Lateral: Sartorius
Media: Adductor longus
What are the contents of the femoral triangle?
NAV (lateral to medial)
Femoral nerve, artery, vein as well as deep inguinal lymph nodes
Where does the deep femoral artery pass between?
Pectineus and adductor longus
Where is the great saphenous vein located?
From anterior leg up to the anterior thigh
Where is the small saphenous vein located?
Posteriorly up from the achilles tendon to the popliteal vein
How many bony articulations are there at the knee?
3
What are the three articulations at the knee?
> Lateral femoral and tibial condyles with menisci
Medial femoral and tibial condyles with menisci
Patella and femur
What does the stability of the knee depend upon?
Strength and action of surrounding muscles and their tendons as well as the ligaments that connect the femur and tibia
Describe the medial meniscus of the knee
Meniscus is C-shaped, broader posteriorly than anteriorly. Attached to the ACL ligament anteriorly and the tibial collateral ligament.
To what structures does the medial meniscus attach?
ACL and tibial collateral ligament
Describe the lateral meniscus of the knee
Nearly circular in structure and is smaller and more freely movable. It’s attached to the PCL.
To what structures does the lateral meniscus attach?
PCL
What is the function of the collateral ligaments of the knee?
Stabilise the hinge-like movement of the knee joint
What are the two types of collateral ligament present at the knee?
Fibular colateral ligament and tibial collateral ligament
What are the two cruciate ligaments of the knee?
ACL and PCL
What are the ligaments of the knee?
Cruciate ligaments (ACL and PCL) and collateral ligaments (fibular and tibial)
Which is the strongest cruciate ligament?
PCL
What is the function of the PCL?
Stops the tibia moving backwards on the femur (and prevents external rotation of tibia)
Describe the attachments of the PCL
PCL ligament runs from posterior intercondylar area of the tibia and ascends anteriorly to attach to the medial wall of the femoral intercondylar fossa
What is the function of the ACL?
Stops tibia moving forward on the femur and stabilises knee in extension to prevent hyperextension and excessive internal rotation
Describe the attachments of the ACL
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
What are the boundaries of the popliteal fossa?
Medial superior: semimembranosus/semitendinosus
Lateral superior: biceps femoris
Inferior: two head of gastrocnemius
What nerve runs along the surface of the gastrocnemius?
Sural nerve
What structures pass through the popliteal fossa?
Popliteal artery, popliteal vein, small saphenous vein, common peroneal nerve, tibial nerve and rural nerve
What are the arteries that supply the knee?
Genicular arteries (supplyd by femoral artery mainly)
What is the function of the muscles in the anterior compartment of the leg?
Dorsiflexion, extension of the digits
What is the blood supply to the anterior compartment of the leg?
Anterior tibial artery
What is the nerve supply to the anterior compartment of the leg?
Deep peroneal nerve
What is the function of the muscles in the lateral compartment of the leg?
Eversion of the foot
What is the nerve supply to the lateral compartment of the leg?
Superficial peroneal nerve
What is the blood supply to the lateral compartment of the leg?
Fibular artery
What is the function of the muscles in the posterior compartment of the leg?
Plantarflexion and flexion of digits
What is the nerve supply to the posterior compartment of the leg?
Tibial nerve
What is the blood supply to the posterior compartment of the leg?
Posterior tibial artery
Which compartments of the leg does the common peroneal nerve supply?
Anterior (dorsiflexion) and lateral (eversion)
What type of joint is the ankle?
Hinge (between tibia, fibula and talus)
How many ankle ligaments are there?
3 lateral and 1 medial (strong)
Name the three lateral ligaments of the ankle joint
Anterior talofibular ligament, posterior talofibular ligament, calcaneofibular ligament
What is the medial ligament of the ankle called?
Deltoid ligament