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Anatomy 1 > Sept 16 - Lower Extremity > Flashcards

Sept 16 - Lower Extremity Flashcards

1
Q

Name the functions of the lower extremity

A

Responsible for stability (posture) and locomotion
They work concentrically: jumping (hip extension), climbing stairs (hip extension), rising from sitting to standing (hip extension), skating (hip abduction/extension/lateral rotation).
Muscles of the lower limb have an anti-gravity function (they work eccentrically): descending stairs, lowering from a standing to sitting position

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2
Q

Name the 3 regions of the lower extremity and their extremities

A 
Pelvic region (between iliac crest and gluteal fold)
Thigh (between hip and knee)
Lower leg (region below the knee)
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3
Q

Describe the pelvic girdle

A

Strong, stable, weight bearing joint
Bones firmly united to form a basin
Structured for bipedal movement (upright walking)
Bone form a complete ring that is virtually immovable
Comprised of three bones that fuse together
Where the upper body meets the lower body

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4
Q

Name the three bones of the pelvic girdle

A

Ilium
Ischium
Pubis

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5
Q

Describe the ilium

A

Large fan shaped bone that makes up the proximal portion of the innominate bone (hands on hips)
Protects the lower abdominal contents
Provides a surface area for attachment of large powerful muscles
Absorbs force

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6
Q

Describe the ishium

A

The bone that makes the posterior and inferior aspect of the innominate bone (what you sit on)

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7
Q

Describe the pubis

A

Makes up the anterior/inferior aspect of the innominate bone

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8
Q

What is innominate fusion? Why is it important?

A

The fusion of the three bones of the hips. It is best observed as “Y” shaped markings inside the socket of the hip joint (acetabulum). It’s important because it’s the socket and it’s comprised of sections of all three hip bones

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9
Q

What is the iliac crest?

A

Where you put your hands on your hips

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10
Q

what is the tuberosity of the ischium?

A

What you sit on

It’s the most prominent

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11
Q

What is the anterior iliac spine?

A

It’s where your hands fall off your hips

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12
Q

What is the importance of the obturator foramen?

A

It allows neurovascular structures to exit into the leg

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13
Q

What is the importance of the acetabulum?

A

It’s the socket for the ball and socket of the hip joint; it’s designed to move whereas the pelvis is designed to be stable

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14
Q

Name the three hip joints

A

The right sacroiliac joint
The left sacroiliac joint
The symphisis pubis

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15
Q

Describe the sacroiliac joint

A

The joint between the auricular surface of the ilium and the auricular surface of the sacrum. It is partly synovial (anterior) and partly fibrous (posterior)
Allows for some flexion/extension

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16
Q

What is the importance of the sacroiliac joint?

A

Important for walking and in full forward flexion

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17
Q

Name the three ligaments that support the SI joint

A

Sacroiliac ligaments (anterior/posterior)
Sacrospinous ligaments
Sacrotuberous ligament

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18
Q

What is the importance of the greater sciatic foramen?

A

The sciatic nerve is the largest nerve in the human body and it comes out the greater sciatic foramen

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19
Q

Describe the symphysis pubis

A

It is the point where the two pubic bodies joint anteriorly. It is joined by two very strong ligaments superiorly and inferiorly. It has a dense fibrocartilagenous disc in between which allows minimal movement. It softens and loosens in late pregnancy

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20
Q

Describe the hip joint

A

Best example of a ball and socket joint. Articulation between the head of the femur and the acetabulum of the innominate bone (about two-thirds of the femoral surface interact. It is one of the most secure joints, yet very mobile joints. It is a synovial multi-axial joint

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21
Q

Describe the acetabulum

A

It has an incomplete ring on the lateral surface of the innominate bone. It is closed in by the transverse acetabular ligament

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22
Q

Describe the acetabular fossa

A

Deepest part of the acetabulum. Does not articulate with the femur

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23
Q

Describe the lunate surface

A

Horseshoe shaped articular (hyaline) cartilage. Articulates with the head of the femur

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24
Q

Describe the importance of the acetabular labrum

A

Helps with shock absorption. Helps reinforce contact. Creates space for circulation of synovial fluid

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25
Q

What is the difference between a synovial joint and a fibro-cartilage joint?

A

A synovial joint provides movement, has fluid and a bag. A fibro-cartilage joint does not

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26
Q

Describe the hip capsule

A

Tight, strong and extensive. It extends from just beyond the outer edge of the acetabulum over femur to attach to level area around intertrochanteric line. It’s reinforced by 3 strong thick ligaments which all resist excessive abduction

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27
Q

Name the three ligaments of the hip capsule

A

Iliofemoral ligament
Ischiofemoral ligament
Pubofemoral ligament

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28
Q

Name the six hip movements

A

Hip extension/flexion
Hip abduction/adduction
Internal rotation/external rotation

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29
Q

What muscles are involved in hip extension. When do you use hip extension?

A

Primarily gluteus maximus, but also hamstrings adductor magnus. Hip extension is used for walking, stairs, skating, running

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30
Q

What muscles are involved in hip flexion. When do you use hip flexion?

A

Primarily ilio psoas and rectus femoris, but also TFL, pectineus and adductor longus & brevis. Hip flexion is used every time kick, climb stairs, run on spot

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31
Q

What muscles are involved in hip abduction?

A

Primarily gluteus medius and minimus, but also tensor fascia lata (TFL) and ilio tibial band (ITB)

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32
Q

What muscles are involved in hip adduction?

A

Pectineus, adductor magnus, gracilis and adductor longus & brevis

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33
Q

What muscles are involved in internal rotation of the hips? When do you use internal rotation?

A

Gluteus medius and minimus. When you bring your knees together and separate your ankles

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34
Q

What muscles are involved in external rotation of the hips? When do you use external rotation

A

Gluteus maximus and piriformis. When you cross your legs

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35
Q

Name the four muscles of the gluteal region

A 
Gluteus maximus (most superficial)
Gluteus medius (deep to gluteus maximus)
Gluteus minimus (deep to gluteus medius)
Piriformis (most deep)
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36
Q

Name the five “little brother” muscles that make up the piriformis

A 
Obturator internus
Obturator externus
Superior gemelli
Inferior gemelli
Quadratus femoris
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37
Q

Describe the gluteus maximus. What are it’s functions?

A

Largest muscle of the gluteal region. It is a powerful hip extensor. It is also involved in lateral rotation of the extended hip and a composite motion (push-off in skating)

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38
Q

What nerve innervates the gluteus maximus?

A

The inferior gluteal nerve (L5-S2) (because of how far down the nerve it extends, it is not innervated by the superior gluteal nerve)

39
Q

What are the function of the gluteus medius and minimus

A

Critical stabilizer of the pelvis during single leg support such as walking and running. Maintains horizontal pelvic alignment during single leg stance phase. Responsible for internal hip rotation and abduction of hip

40
Q

What happens if the gluteus medius and minimus are unable to stabilize the pelvis?

A

It results in “waddling” or Trendenlenburg gait pattern

41
Q

What nerve innervates the gluteus medius and minimus?

A

The superior gluteal nerve L4, L5 and S1

42
Q

Describe the Trendenlenburg test

A

If someone stands on a single leg, the pelvis should remain parallel to the ground. Injury can cause the hip to fall during this test (indicator of pathologies, osteoarthritis or lack of mobility, as seen in obese people)

43
Q

Describe the piriformis

A

Deep to gluteal muscles. It exits the pelvis to gluteal region via the greater sciatic foramen; the sciatic nerve is position just inferior to the piriformis muscle

44
Q

What is the function of the piriformis?

A

Lateral hip rotation

45
Q

What nerve innervates the piriformis?

A

Nerve to piriformis S1 and S2

46
Q

Describe the iliopsoas

A

This muscle is 2 seperate muscles at its proximal end, the psoas major and iliacus, which join distally and have a common attachment on the femor. It attaches to the lesser trochanter.

47
Q

What are the functions of iliopsoas?

A

Flexion of the thigh/hip joint. Very involved in cycling

48
Q

What nerve innervates iliopsoas?

A

The psoas is innervated by ventral rami L1-L3

The iliacus is innervated by femoral nerve

49
Q

Describe the sartorius

A

Superficial, strap like muscle
Runs from lateral hip to medial knee
Longest muscle in the body (longest fibre - 20cm)
Commonly referred to at “Tailor Sit Muscle”
Helps separate the anterior compartment and the medial compartment

50
Q

What is the function of the sartorius

A

Knee and hip flexion (N.B. when we need both at the same time

51
Q

What nerve innervates the sartorius?

A

The femoral nerve

52
Q

What does the Tailor Sit FABER stand for?

A

Flexion, Abduction, External Rotation, flexion of the knee

Can’t do any of these movements without the sartorius

53
Q

Name the 4 compartments of the thigh muscles, how many muscles are in each compartment, and their function

A

Medial (5; Hip adduction)
Anterior (4; Knee extension and hip flexion)
Posterior (3; Knee flexion and hip extension)
Lateral (2; Hip abduction)

54
Q

Describe the muscles of the medial thigh compartment. What nerve innervates them?

A

There are 5 muscles that all cross the hip joint. Only one crosses the knee joint; the gracilus. They are innervated by the obturator nerve (L2-L4). They power hip adduction

55
Q

Describe the muscles of the anterior thigh compartment. What innervates them? Where does their circulation comprise of?

A

Large, powerful, antigravity muscles. Essential for daily living: walking, running, jumping, sitting up or down, climbing or descending stairs, sporting activities. They are innervated by the femoral nerve L2-L4. Circulation is via the femoral artery and vein. They are also known as the quadriceps or “quads” and they all insert into the tibial tuberosity via the quadriceps tendon - patella - patellar tendon/ligament

56
Q

Name the four muscles of the quadriceps

A

Rectus femoris
Vastus medialis
Vastus intermedius
Vastus lateralis

57
Q

Describe the rectus femoris

A

Straight superficial portion that crosses both hip and knee joints
Powers hip flexion and knee extension
It crosses the knee and the hip

58
Q

Describe the vasti muscles

A

They surround the shaft of the femur and wrap around the thigh from the back
They power knee extension

59
Q

Name the muscles of the medial thigh compartment

A 
Adductor brevis
Adductor longus
Adductor magnus
Gracilis
Pectineus
60
Q

Describe the patellofemoral joint

A

aka PFJ aka knee cap
Articulation between the trochlea of the femur and the posterior surface of the patella. Considered the centrepiece of the extensor mechanism. Common site of dysfunction. Well defined structure with many variables involved in function

61
Q

Name the three muscles of the posterior thigh compartment

A

Biceps femoris
Semi-membranosus
Semi-tendinosus

62
Q

Describe the muscles of the posterior thigh compartment. What innervates them?

A

3 muscles, 2 joints. Cross both the hip and the knee. Common origin: ischial tuberosity of the innominate bone. They are involved in rotation of the flexed knee (modified hinge joint). They are all innervated by the sciatic nerve

63
Q

Name the muscles of the lateral thigh compartment

A

Tensor fasciae latae

Ilotibial band

64
Q

What is the role of the patella?

A

It provides/reinforces the strength of the quads and moves the tendon away from the centre of the knee joint

65
Q

Describe the knee joint

A

It’s where the femur meets the tibia. There are 4 ligaments and 2 meniscus (medial and lateral). It’s the largest and most complex joint in the human body. Modified hinge type synovial joint that allows flexion/extension and some rotation. Lacks bony stability; stability is dependant on soft tissue structures (ie. muscles, tendons, ligaments, etc.)

66
Q

Name the 4 ligaments of the knee joint

A

The anterior and posterior crucuate ligaments, and the medial and lateral collateral ligaments

67
Q

Describe the movements of the knee joint

A

Flexion/extension (approx 135˚)

Medial/lateral rotaion when flexed (approx 45˚ of rotation when knee is flexed 90˚)

68
Q

Describe the lateral collateral ligament

A

Cord like (nearer to the back of the joint)
From lateral epicondyle of the femur to fibular head
Easily palpated (can roll with finger)
Resists varus force
aka LCL

69
Q

Describe the medial collateral ligament

A 
Fan shaped
Attaches to the medial femoral epicondyle proximally and medial surface of the tibia distally. Also attaches to the medial meniscus
Resists valgus force
Stronger than LCL
aka MCL
70
Q

Describe the cruciate ligaments

A

They are contained in the thin, vascularized envelope formed by synovial lining. They have poor blood supply and an inadequate ability to heal

71
Q

What is the function of the cruciate ligaments

A

First degree of restraint - tibial translation (help control it)
Second degree of restraint - internal/external rotation and varus/valgus angulation (help control it)

72
Q

What does valgus stress cause?

A

It tears the medial collateral ligament which attaches to the medial meniscus and blows apart the ACL

73
Q

Describe the anterior cruciate ligament

A

It attaches to the anterior portion of the intercondylar eminence. It runs in a posterior/superior direction. It runs towards the external aspect of the joint ie. the lateral femoral condyle, but note the medial surface of the lateral femoral condyle
aka ACL
APEX = Anterior, Posterior/superior, EXternal aspect

74
Q

Describe the posterior cruciate ligament

A

Attaches to the posterior aspect of the intercondylar eminence. It runs in an anterior direction toward the front of the knee joint. It runs towards the internal aspect of the knee, ie. the medial femoral condyle, but the lateral surface of the medial femoral condyle
aka PCL
PAIN = Posterior, Anterior, INternal aspect

75
Q

Describe the medial meniscus

A

C shaped, attached to the joint capsule and medial collateral ligament (MCL)

76
Q

Describe the lateral meniscus

A

O shaped, connected to popliteus muscle

77
Q

Describe the meniscuses

A

Both are disc-like structures with a high outer edge. They are connected anteriorly by the transverse of the knee.

78
Q

What is the function of the meniscuses

A

They deepen the tibial surface to increase stability. They spread out the load bearing force on the joint (shock absorption). They help control of rotational and gliding motion at the tibio-femoral joint. They help circulate the synovial fluid thru the joint

79
Q

Describe the bones of the foot

A

They are analogus to the bones of the hand but modified for weight bearing and locomotion. There are 7 tarsal bones, 5 metatarsals and 14 phalanges

80
Q

Name the two joints of the ankle

A

Two synovial joints: talocrural ankle joint (permits plantar and dorsi flexion) and subtalar joint (permits inversion and eversion)

81
Q

Describe the subtalar joint

A

The joint between the superior aspect of the calcaneus and the inferior aspect of the talus. It is stable in dorsi flexion and unstable in plantar flexion. It has strong ligaments and weak muscles

82
Q

Describe the talocrural joint

A

It’s the true ankle joint between the distal end of the leg bones and the talus. It is referred to as a brick and mortar joint because of it’s bony configuration. The tibia and fibula forma mortise in which the dome of the talus fits. It is more stable with eversion than with inversion

83
Q

Describe the lateral ligaments of the ankle

A

There are three ligaments on the lateral side of the ankle joint and they are named to describe their location relative to each other as well as the bones to which they attach

84
Q

Name the lateral ligaments of the ankle

A

Posterior and anterior talofibular ligaments, and the calcaneofibular ligaments

85
Q

Describe the medial ligaments of the ankle

A

The deltoid ligament is very strong medial ligament that extends from the medial malleolus of the tibia and attaches on the talus, calcaneus and navicular bones

86
Q

Name the three muscular compartments of the lower leg, as well as their respective funtions

A

Anterior (dorsiflexors/toe extensors)
Lateral (Everters)
Posterior (Plantarflexors/toe flexors)

87
Q

Name the four muscles of the anterior compartment of the lower leg

A

Tibialis anterior
Extensor Hallucis longus
Extensor digitorum longus
Peroneus tertius

88
Q

What innervates the anterior muscle compartment of the lower leg

A

The deep peroneal nerve (L4-S1)

89
Q

Name the two muscles of the lateral compartment of the lower leg

A

Fibularis (peroneus) longus

Fibularis (peroneus) brevis

90
Q

What innervates the muscles of the lateral compartment of the lower leg?

A

The superficial peroneal nerve (L5-S2)

91
Q

Name the three superficial muscles of the posterior compartment of the lower leg

A

Plantaris
Gastronemius
Soleus

92
Q

What innervates the superficial muscles of the posterior compartment of the lower leg

A

The tibial nerve (S1-S2)

93
Q

Name the three deep muscles of the posterior compartment of the lower leg

A

Flexor hallicus longus
Flexor digitorum longus
Tibialis posterior muscle

Anatomy 1 (9 decks)

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