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MSK-Derm by Minnie AH Version > SM MSK Anatomy - Lower Limb, Femoral Triangle, Glute, Foot, Gait > Flashcards

SM MSK Anatomy - Lower Limb, Femoral Triangle, Glute, Foot, Gait Flashcards

SM 223a, Lab 2, Lab 3, Lab 4, Lab 5

1
Q

Which structure is labeled by #12?

Function?

Innervation?

A

Quadriceps Femoris (one of the 4)

Knee extension, hip flexion (inserts on greater trochanter of femur)

Femoral nerve

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2
Q

What view of the femur is this?

A

Posterior view

(You can see the intercondylar notch in between the medial and lateral condyles)

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

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3
Q

Which structure is labeled by #12?

A

Hamstring

Posterior compartment of the thigh

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4
Q

Which muscle is labeled by #4?

A

Piriformis

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5
Q

Which vessel is most likely to be damaged by a femoral neck fracture?

What is the consequence?

A

Medial femoral circumflex artery

This can lead to necrosis of the femoral head

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6
Q

Which structure is labeled by #9?

A

Hamstring (one of three)

Posterior compartment

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7
Q

Which nerve supplies the big toe compartment of the foot?

What actions does it control?

A

Medial plantar nerve (branch of the tibial nerve)

Abduction and flexion of the hallux

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8
Q

Which structure is indicated by #2?

What is its primary function?

A

Piriformis

Lateral rotation of the hip

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9
Q

Which structure is labeled by #10?

What is its function?

What are its attachments?

A

Tibialis posterior

Foot inversion, plantarflexion

Tibia, fibula, interosseous membrane + sole of the foot (tarsals)

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10
Q

What are the components of the sciatic nerve?

A

Tibial nerve

Common fibular nerve

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11
Q

Hip extensors are found in the _________ compartment of the thigh, and are supplied by the _________ nerve

A

Hip extensors are found in the posterior** compartment of the thigh, and are supplied by the **tibial (sciatic) nerve

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12
Q

Which structures are in group A?

A

Superficial femoral artery, and vein

Femoral nerve

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13
Q

Identify the structures of the lateral compartment of the leg.

What innervates them?

A

Fibularis longus (5)

Superficial fibular nerve

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14
Q

Which muscles acts to invert the foot?

A

Tibialis posterior, Tibialis anterior

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15
Q

Which structure is labeled by #5?

A

Tibial nerve

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16
Q

Which structure is labeled by #1?

A

Tibia

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17
Q

Which nerve supplies the areas indicated in yellow (#2 and #2a)?

A

2a is supplied by the saphenous nerve, a branch of the femoral nerve

Femoral nerve

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18
Q

A physician would like to block cutaneous nerves in order to remove a small subcutaneous lipoma from the medioanterior surface of the thigh. The branches of which nerve should be blocked?

A. sural

B. tibial

C. musculocutaneous

D. femoral

A

D. femoral

Supplies the anterior surface of the thigh. May also block branches fo the obturator nerve.

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19
Q

Which structure labels the anterior cruciate ligament?

Which structure labels the posterior cruciate ligament?

A

Anterior cruciate ligament = #2

Posterior cruciate libament = #1

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20
Q

Which structure is labeled by #3?

A

Femoral artery and femoral vein

Fig. 59.7 Adapted from Gilroy et al. Atlas of Anatomy, second edition, Fig. 29.34 B.

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21
Q

Hip adductors are found in the _________ compartment of the thigh, and are supplied by the ________ nerve

A

Hip adductors are found in the medial** compartment of the thigh, and are supplied by the **obturator nerve

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22
Q

Which areas are supplied by the femoral nerve?

A

Areas indicated in yellow and labeled #2 and #2a

  • # 2 is supplied by the femoral nerve
  • # 2a is supplied by the saphenous nerve, a branch of the femoral nerve
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23
Q

Which structure is labeled by #7?

What is its function?

A

Medial collateral ligament

Stabilizes the knee medially

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24
Q

Where will you find the neurovasculature of the posterior lower leg?

A

Deep to the soleus, superficial to flexor digitorum longus/tibialis posterior/flexor hallucis longus

aka - between the superficial and deep compartments of the posterior leg

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25
Q

Which structure is labeled by #3?

A

Medial collateral ligament

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26
Q

Lateral compartment of the leg

  • Muscles:
  • Function:
  • Innervation:
A

Lateral compartment of the leg

  • Muscles: Fibularis longus
  • Motion: Eversion of the foot, plantarflexion (flexion) of the foot
  • Innervation: Superficial fibular nerve (comes from sciatic)
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27
Q

Which nerve supplies the little toe compartment of the foot?

What actions does it control?

A

Lateral plantar nerve (branch of the tibial nerve)

Abduction and flexion of the 5th digit

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28
Q

Which structure is labeled by #3?

A

Medial malleolus

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29
Q

Which structure is labeled by #8?

A

Medial epicondyle of the femur

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

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30
Q

Which structure is labeled by #10?

Function?

Innervation?

A

Quadriceps femoris

Hip extension, knee flexion

Sciatic nerve (common fibular division)

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31
Q

Which structure is labeled by #17?

What does it innervate?

A

Common fibular nerve

Separates into the superficial fibular nerve (lateral compartment of the leg) and deep fibular nerve (anterior compartment of the leg)

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32
Q

Which structure is labeled by #3?

A

Iliopsoas

Anterior compartment of the thigh

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33
Q

Which vein is labeled by #2?

Where does it join the deep venous system?

A

Greater saphenous vein

Empties into the femoral vein at the saphenous opening
(in the crease of the hip)

(lesser saphenous vein = back of the leg, dumps into popliteal vein))

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34
Q

Which nerve is labeled by #21?

What does it innervate?

A

Medial plantar nerve (branch of the tibial nerve)

The lateral plantar does everything else (like the ulnar nerve does in the hand)

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35
Q

Which structure is labeled by #4?

A

Lateral malleolus (part of the fibula)

Fig. 56.3 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 27.1 A, 27.1 B.

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36
Q

Which structure is labeled by #1?

A

Part of the iliopsoas

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37
Q

Which actions are controlled by the inferior gluteal nerve?

A

Hip extension, lateral rotation

The inferior gluteal nerve innervates the gluteus maxiumus

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38
Q

Which structure is indicated by #3?

What is its primary function?

A

Quadratus femoris

Lateral rotation of the hip

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39
Q

Which structure is labeled by #2?

A

Popliteal artery

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40
Q

Which nerve is labeled by #3?

What does it innervate?

A

Superficial fibular nerve (part of the sciatic nerve)

Innervates the lateral compartment of the leg

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41
Q

17 labels the plantar aponeurosis that has been removed. The view is immediately deep to this structure

Describe the structure labeled by #11

  • Muscle:
  • Function:
  • Attachments:
  • Innervation:
A
  • Muscle: Flexor digitorum brevis
  • Function: Flex MTP and PIP in toes 2-5
  • Attachments: Calcaneal tuberosity, middle phalanges of toes 2-5
  • Innervation: Medial plantar nerve (Branch of tibial nerve)
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42
Q

Posterior compartment of the leg

  • Motion:
  • Innervation:
A

Posterior compartment of the leg

  • Motion: Flexion aka Plantarflexion
  • Innervation: Tibial nerve (comes from sciatic)
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43
Q

Which number labels the greater trochanter?

Which muscle makes this mark?

A

9

Gluteus medius (and minimus)

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44
Q

Which structure is labeled by #7?

A

Adductor magnus

Lateral compartment

Innervated by obturator nerve

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45
Q

Which structure is labeled by #10?

A

Quadriceps femoris tendon

All of the muscles of quadriceps femoris come together to form the quadriceps tendon

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46
Q

Which structure is labeled by B?

Which movements occur here?

A

Upper ankle (talocrural) joint

Where the tibia/fibular meets the talus

Flexion and extension

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47
Q

Which structure is circled?

A

Medial collateral ligament of the ankle

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48
Q

Which muscles insert into the IT band?

A

Gluteus maximus, tensor fasciae latae

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49
Q

Which structure is labeled by #5?

A

Calcaneus

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50
Q

What kind of bone is labeled by #1?

A

Distal phalanx of the foot

(This is the 5th distal phalanx)

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51
Q

Which structure is labeled by #3?

A

Iliofemoral ligament

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52
Q

Which structure is labeled by #1?

A

Adductor magnus

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53
Q

Which structure is labeled by #16?

What does it innervate?

A

Tibial nerve

Posterior compartment of the leg

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54
Q

Describe the structure labeled by #8

  • Muscle:
  • Function:
  • Attachments:
  • Innervation:
A
  • Muscle: Quadratus femoris
  • Function: Extension, external rotation of the femur
  • Attachments: Ishcial tuberosity, femur (Intertrochanteric crest)
  • Innervation: Sacral plexus (L5, S1)
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55
Q

Which structure is labeled by #18?

A

Gastrocnemius

Innervated by tibial nerve

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56
Q

What kind of bone is labeled by #8?

A

Proximal phalanx of the foot

(This is the 1st proximal phalanx)

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57
Q

Which structures are labeled by #12?

A

Tendons of extensor digitorum longus

(Extensor digiotorum longus = #7)

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58
Q

Which structure is labeled by #1?

A

Iliotibial tract

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59
Q

Describe the hip flexors

  • Primary muscles:
  • Nerve:
A

Hip flexors

  • Primary muscles: Iliopsoas
  • Nerve: Femoral
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60
Q

Which muscles are important for lateral balance of the trunk during walking or running?

A

Gluteus medius

(Abduction to pull the trunk back over the leg)

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61
Q

Which structure is labeled by #1?

A

Lesser trochanter of the femur

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

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62
Q

Which structure is labeled by #15

A

gastrocnemius

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63
Q

Which structure is labeled by #4?

A

Posterior tibial artery

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64
Q

A patient has lost feeling between their hallux and 2nd toe.

Which nerve is damaged?

Which other functions should you test?

A

Deep fibular nerve

Innervates the anterior compartment of the leg, becomes cutaneous between the hallux and 2nd toe

Test toe and ankle extension (dorsiflexion); More proximal injuries to the ulnar nerve will cause weakness with these movements

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65
Q

Which structure is labeled by #11?

A

Extensor digitorum longus

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66
Q

Which structure is labeled by #6?

A

Ischial tuberosity

Origin of the hamstrings

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67
Q

Which structure is labeled by #14?

A

Tibialis posterior

(Also #11)

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68
Q

Describe gluteus maximus

  • Function:
  • Attachments:
  • Innervation:
A

Gluteus maximus

  • Function: Thigh extension, external rotation, abduction (superior fibers), adduction (inferior fibors)
  • Attachments: Sacrum, ilium, thoracolumbar fascia, iliotibial tract, femur (gluteal tuberosity)
  • Innervation: Inferior gluteal nerve (L5 to S2)
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69
Q

Describe the highlighted muscle

  • Collectively:
  • Function:
A
  • Collectively: Iliopsoas muscle
  • Function: Hip flexion
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70
Q

If a patient cannot flex their hip, which nerve is most likely injured?

A

Femoral nerve

Innervates the anterior compartment of the thigh; necessary for hip flexion and knee extension

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71
Q

Which structure is labeled by #11?

A

Adductor magnus

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72
Q

Which structure is labeled by #2?

A

Femoral artery

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73
Q

Which actions are controlled by the obturator nerve?

A

Hip adduction

Obturator innervates the medial compartment of the thigh (where the hip adductors live)

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74
Q

Which artery is labeled by C?

A

Lateral circumflex artery (goes to the anterior side)

Medial circumflex artery goes to the posterior side

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75
Q

Which structure is labeled by #2?

A

Part of the hamstrings

Posterior compartment

Sciatic nerve

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76
Q

Which structure is labeled by #13?

A

Tibia

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77
Q

Which structures are in group C?

A

Deep femoral artery and vein

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78
Q

Which structure is circled?

A

Lateral collateral ligament of the ankle

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79
Q

Which vessel is labeled by #9?

Where does it come from?

What does it supply?

A

lateral plantar artery

  • Branch of the posterior tibial artery
  • Lateral sole of the foot and toes
  • Contributes to the plantar arch (18), which anastomosis wtih the dorsalis pedis
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80
Q

The foot plantarflexes and extends (dorsiflexes) at the ___________ joint and inverts and everts at the ____________ joints

A

The foot plantarflexes and extends (dorsiflexes) at the upper ankle** joint and inverts and everts at the **lower ankle and transverse tarsal joints

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81
Q

A 61-year-old male presents with symptoms of intermittent claudication in his left leg (pain/cramping in muscles due to blockage or narrowing of their arterial supply). Coronal maximum-intensity projection from a high-resolution magnetic resonance angiogram demonstrates a complete occlusion (large white arrow) with a large collateral (arrowhead) of the _____________ artery. His right leg is normal

A. Common femoral

B. Deep femoral

C. Superficial femoral

D. Popliteal

E. Lateral femoral circumflex

A

C. Superficial femoral

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82
Q

Which structure is labeled by #6?

A

gastrocnemius

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83
Q

Which structure is labeled by #15?

A

Flexor digitorum longus

(Also #12)

Deep layer of posterior compartment

Flexor hallucis longus and flexor digitorum longus cross each other at the heel

Part of the Tom, Dick aNd Harry

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84
Q

Which structure is labeled by #7?

Function?

Innervation?

A

Quadricpes Femoris (part of)

Hip flexion, knee extension

Femoral nerve

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85
Q

Which structure is labeled by F?

A

metatarsal

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86
Q

What actions are controlled by the superior gluteal nerve?

A

Hip abduction, lateral balance

Innervates gluteus medius

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87
Q

Which compartment of the leg is supplied by the deep fibular nerve?

What actions does this nerve control?

A

Anterior compartment

  • Ankle extension (dorsiflexion)
  • Toe extension (dorsiflexion)
  • Ankle inversion
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88
Q

Which structure is labeled by #9?

A

Extensor digitorum longus

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89
Q

Which strucutre is labeled by #6?

A

Hamstring

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90
Q

Which structure is labeled by E?

A

Shaft of the femur

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91
Q

Which structure is labeled by #5?

A

gastrocnemius

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92
Q

Which structure is labeled by #2?

A

Patella

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93
Q

Which structure is labeled by #1?

Which vessels can you see through this structure?

A

Saphenous opening

Inside we can see the femoral artery and femoral vein

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94
Q

Which nerve is labeled by #5?

What does it innervate?

Where does it come from?

A

Sural nurve

Provides sensory information in the calf region

Made up of branches from the tibial nerve and common fibular nerve (Which come from the sciatic nerve)

=> Sciatic nerve pain can radiate to the calf

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95
Q

Which structure is labeled by #4?

A

Adductor longus

Medial compartment

Innervated by the obturator nerve

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96
Q

Which structure is labled by #2?

(Flexor digitorum brevis has been reflected)

A

Flexor digitorum longus

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97
Q

Which joint is indicated by the red line? (#3)

A

Lower ankle aka subtalar joint

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98
Q

If a patient cannot extend (dorsiflex) their ankle, which nerve is most likely injured?

A

Deep fibular nerve

Innervates the anterior compartment of the leg

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99
Q

Which nerve supplies the interossei of the foot?

What actions does it control?

A

Lateral plantar nerve (branch of the tibial nerve)

  • Abduction of the toes
  • Adductionof the toes
  • Flex the MCP joints
  • Extend the IP joints
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100
Q

The structures outlined in purple are collectively called the…

A

Tarsals

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101
Q

A twenty five year old man receives a gunshot wound to the calf. The emergency room physician is concerned about damage to the vessels of the leg. The examiner pictured below is testing for patency of which vessel?

A

Posterior tibial artery

The posterior tibial artery passes posterior to the medial malleolus of the tibia. This is where the posterior tibial artery passes through the tarsal tunnel

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102
Q

Which structures stabilize the knee medially?

A
  • Medial (aka tibial) collateral ligament
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103
Q

Which structure is labeled by #8?

A

Quadriceps femoris

Fig. 59.7 Adapted from Gilroy et al. Atlas of Anatomy, second edition, Fig. 29.34 B.

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104
Q

Loss of sensation in the toes may indicate damage to which nerve?

A

Fibular nerve (superficial branch)

The fibular nerve supplies the areas in blue, labeled #4 or #4a

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105
Q

Which structure is labeled by #2?

A

Head of the fibula

Fig. 56.3 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 27.1 A, 27.1 B.

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106
Q

Which structure is labeled by #4?

A

Calcaneus

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107
Q

What is the function of the anterior cruciate ligament?

A

Prevents the tibia from sliding anteriorly relative to the femur

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108
Q

What is the purpose of the calcaneal tendon

A

Calcaneal tendon = Achilles tendon

Attaches the gastrocnemius (medial and lateral heads) and the soleus to the calcaneus

This allows these muscles to felx (plantarflex) the foot)

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109
Q

What kind of bone is labeled by #7?

A

Metatarsal

(This is the 1st metatarsal)

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110
Q

What is the most common type of ankle sprain?

A

Injury to the lateral collateral ligament of the ankle

Caused by hyperinversion

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111
Q

Which structure is labeled by #1?

A

Patella

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112
Q

Which strucutre is labeled by #7?

A

Hamstring

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113
Q

Which structure is labeled by #5?

What is its function?

A

Posterior cruciate ligament

Prevents the tibia from sliding too far backward

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114
Q

Describe the hip adductors

  • Primary muscles:
  • Nerve:
A

Hip adductors

  • Primary muscles: Adductor group
    • Adductor longus
    • Adductor magnus
  • Nerve: Obturator
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115
Q

Describe the posterior compartment of the leg

  • Muscles:
  • Actions:
  • Nerve:
  • Skeletal landmarks (attachments):
A

Posterior leg

  • Muscles:
    • Superficial: Gastrocnemius, Soleus
    • Deep: Flexor digitorum longus,Flexor hallucis longus, Tibialis posterior
      • “Tom, Dick and Harry”
  • Actions:
    • Superficial: Plantarflexion of the ankle
    • Deep: Plantarflexion of the foot and toes, inversion of the foot
  • Nerve:
    • Tibial nerve (comes from sciatic)
  • Skeletal landmarks (attachments):
    • Heel of calcaneus, medial malleolus of tibia
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116
Q

Which muscles make up the deep posterior leg?

What are their functions?

A

Flexor digitorum longus

Tibialis posterior

Flexor hallucis longus

Plantarflex the foot, flex the toes

Tibialis posterior inverts the foot at the ankle

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117
Q

Which view of the lower leg is this?

A

Posterior view

Fig. 56.3 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 27.1 A, 27.1 B.

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118
Q

Which nerve is labeled by #3?

What does it innervate?

A

Superficial fibular nerve

Innervates the lateral compartment of the leg

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119
Q

Which structure is labeled by #4?

A

Medial meniscus

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120
Q

Which structure is labeled by #17

A

Tendon of tibialis anterior

(#6 = tibialis anterior)

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121
Q

Which nerve runs with the lesser saphenous vein?

A

Sural nerve

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122
Q

Which structure is labeled by #4?

A

Greater trochanter of the femur

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

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123
Q

What causes IT band syndrome?

A

Friction between the iliotibial band and the greater trochanter and/or the lateral condyle of the femur

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124
Q

The exercise depicted below (moving from position 1 to position 2) primarily involves contraction of the _________ muscles.

Which nerve supplies these muscles?

A

The exercise depicted below (moving from position 1 to position 2) primarily involves contraction of the hip adductor muscles.

Supplied by the obturator nerve

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125
Q

Which structure is labeled by #7?

A

Lateral condyle of the femur

(Articulates with lateral condyle of the tibia)

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

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126
Q

Which structure is labeled by #26?

A

Fibular artery

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127
Q

A 75 year old woman fell and landed on her hip. The given X-ray reveals fragmentation of her proximal femur. Which of the following muscles is pulling on the detached piece of femur displacing it?

A. Gluteus maximus

B. Ilopsoas

C. Rectus femoris

D. Gluteus medius

E. Adductor magnus

A

D. Gluteus medius

Greater trochanter is fractured; the gluteus medius inserts here

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128
Q

What kind of bone is labeled by #9?

A

Distal phalanx of the foot

(This is the 1st distal phalanx)

The hallux does not have a middle phalanx

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129
Q

Which joint is indicated in red?

A

Upper ankle joint

Articulaton between tibia, fibula, and talus

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130
Q

Which structure is labeled #4?

A

Calcaneus

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131
Q

List the pathway of the vein on the tibial side of the lower limb, from its most proximal point to its entry into the deep venous system

A
  • Greater saphenous vein
    • Passes in front of the medial malleolus
    • Goes up the entire leg on the medial side
    • Through saphenous opening
  • Femoral vein (part of the deep venous system)
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132
Q

If a patient cannot adduct their hip, which nerve is most likely injured?

A

Obturator nerve

Innervates the medial compartment of the thigh, where the adductors live

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133
Q

Describe the medial rotators of the hip

  • Primary muscles:
  • Nerve:
A

Medial rotators of the hip

  • Primary muscles: Gluteus medius,
  • Nerve: Superior gluteal
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134
Q

Which structure is labeled by #2?

A

Iliofemoral ligament

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135
Q

Which areas are supplied by the fibular nerve?

A

Areas indicated in blue and labeled #4 or #4a

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136
Q

Anterior compartment of the leg

  • Motion:
  • Innervation:
A

Anterior compartment of the leg

  • Motion: Extension aka Dorsiflexion
  • Innervation: Deep fibular nerve (comes from sciatic nerve)
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137
Q

Which number labels the ischial tuberosity?

Which muscle makes this mark?

A

26

Hamstrings (except short head of biceps femoris)

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138
Q

Which structure is labeled by #6?

A

Medial meniscus of the knee

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139
Q

Which structure is labeled by #7?

A

Extensor digitorum longus

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140
Q

Which structure is labeled by #11?

A

Tibialis posterior

(Also #14)

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141
Q

Which structure is labeled #2?

A

Fibula

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142
Q

Which structure is labeled by #1?

A

Gluteus maximus

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143
Q

Which structure is labeled by #7?

A

Soleus

gastrocnemius (5, 6)

soleus (7)

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144
Q

If a patient cannot flex their knee, which nerve is most likely injured?

A

Tibial nerve

Innervates the posterior thigh and posterior leg

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145
Q

Which blood vessels supply the dorsum of the foot?

A

deep plantar artery (15)

These are branches from the anterior tibial artery

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146
Q

Which structure is labeled by #5?

A

Lesser trochanter of the femur

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147
Q

Which structure is labeled by #14?

A

Tibial tuberosity

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148
Q

Which structure is labeled by #6?

A

Sural nerve

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149
Q

Which structure is labeled by #4?

A

Extensor digitorum longus

Anterior compartment extends = dorsiflexes

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150
Q

Which artery is labeled by D?

A

Superficial femoral artery

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151
Q

List the muscles in the anterior compartment of the leg

What is their innervation?

Which artery supplies them?

A
  • Tibialis anterior (4, 14)
  • Extensor digitorum longus (5, 10)

Deep fibular nerve

Anterior tibial artery

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152
Q

Which structure is labeled by #7?

A

Common iliac vein

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153
Q

Which nerve is labeled by #2?

What does it innervate?

A

Common fibular nerve

  • Lateral leg via superficial fibular nerve (26)
  • Anterior leg via deep fibular nerve (24)
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154
Q

Which areas are supplied by the tibial nerve?

A

Areas indicated in purple and labled #5 or #5a

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155
Q

Which structure is labeled by #4?

A

Greater trochanter of the femur

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156
Q

Which structure is labeled by #2?

What is its function?

What is its innervation?

A

Gluteus medius

​Hip abduction

Superior gluteal nerve

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157
Q

Which structure is labeled by #1?

A

Iliotibial tract

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158
Q

Which structure is labeled by #3?

A

Medial malleolus (of the tibia)

Fig. 56.3 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 27.1 A, 27.1 B.

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159
Q

Which structure is labeled by #11?

A

Gastrocnemius (medial head)

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160
Q

Which structure is labeled by #3?

A

Flexor digitorum longus

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161
Q

Which structure is labeled by #3?

A

Patelar ligament

162
Q

Which structure is labeled by #5?

A

Deep fibular nerve

(Also #1 - both branches are the deep fibular nerve)

163
Q

Which nerve is labeled by #2?

Which compartment does it innervate?

A

Femoral nerve

Innervates the anterior compartment of the thigh

164
Q

Which bones make up the upper ankle joint?

Describe teh movement at this joint

A

Tibia, fibula, talus

Hinge joint

Flexion and extension only

(Inversion and eversion occur at the subtalar (aka lower ankle) joint)

165
Q

Which structure is labeled by #6?

A

Flexor hallucis longus

The only muscle of the deep posterior leg that descends posterior to the posterior tibial artery and tibial nerve

166
Q

Which movement shows eversion?

Which shows inversion?

Which ligament is stretched in each motion?

A
  • A = inversion
    • Stretches the lateral (fibular) collateral ligament
  • B = eversion
    • Stretches the medial (deltoid or tibular) collateral ligament
167
Q

Which nerve supplies the areas indicated in purple (#5 or #5a)?

A

Tibial nerve

168
Q

What kind of bone is labeled by #3?

A

Proximal phalanx of the foot

(This is the 5th proximal phalanx)

169
Q

Which structure is labeled by #2?

A

Tibial tuberosity

Attachment of patellar ligament

170
Q

Which structure is labeled by #2?

A

Anterior tibeal artery

(Also #7)

171
Q

Which structures are labeled by #3?

What do they supply?

A

Inferior gluteal artery, vein, and nerve

Supplies the gluteus maximus

172
Q

Describe the lateral rotators of the hip

  • Primary muscles:
  • Nerve:
A

Lateral rotators of the hip

  • Primary muscles: Gluteus maximus,
  • Nerve: Inferior gluteal (Gluteus maximus),
173
Q

Which structure is labeled by H?

A

Navicular

(boat shaped, aritculates with the talus)

174
Q

Which structure is labeled by #5?

A

Lateral malleolus (part of the fibula)

Fig. 56.3 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 27.1 A, 27.1 B.

175
Q

Describe structure #5

  • Muscle:
  • Function:
  • Attachments:
  • Innervation:
A
  • Muscle: Piriformis
  • Function: External rotation, abduction, extension of thigh, stabilize hip joint
  • Attachments: Sacrum, greater trochanter of femur
  • Innervation: Sacral plexus (S1, S2)
176
Q

Which structure is labeled by #7?

A

Medial condyle of the femur

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

177
Q

Which structure is labeled by #11?

(Where the artery and vein are emerging)

A

Adductor hiatus

The popliteal artery and vein are emerging through it

The femoral artery and vein become the popliteal when they cross through the adductor hiatus

178
Q

Which structure is labeled by #9?

What is its function?

A

Quadriceps femoris tendon

Connects quadriceps femoris to the patella

179
Q

What is the function of the posterior cruciate ligament?

A

Prevents the tibia from sliding posteriorly relative to the femur

180
Q

Which structure is labeled by #2?

A

Ilium (body of the ilium)

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

181
Q

What is this gait called?

Damage or weakness in which structures might cause this?

A

Trendelenbrg gait

Caused by any of the following on the side of the hip that is raised

  • Gluteus medius or minimus weakness
  • Superior gluteal nerve damage

Results in the person leaning toward the side of the weakness or damage

182
Q

Which structure is labeled by #3?

What is its function

A

Plantar aponeurosis

Thick layer of fascia deep to the skin of the sole of the foot; supports the longitudinal arch of the foot

Inflammation -> plantar fasciitis

183
Q

Which structure is labeled by #11?

Function?

Innervation?

A

Hamstring

Hip extension, knee flexion

sciatic nerve

184
Q

Which structure is labeled by #12?

A

Patellar ligament

Attaches patella to tibial tuberosity

185
Q

What kind of bone is labeled by #2?

A

Middle phalanx of the foot

(This is the 5th middle phalanx)

186
Q

Which structures form the ball and socket part of the hip joint?

A

Acetabulum of the pelvis

Femoral head

187
Q

Which structure is labeled by #2?

A

Sciatic nerve

188
Q

If a patient cannot flex their knee, which nerve is most likely injured?

A

Tibial nerve

Innervates the posterior thigh and posterior leg

189
Q

Which structure is labeled by #2?

What is its function?

A

Anterior cruciate ligament

Prevents the tibia from sliding anteriorly relative to the femur

190
Q

Which structure is labeled by #7?

A

Pubis (medial portion of the pubis)

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

191
Q

Which structure is labeled by #3?

A

Hamstring (Short head)

192
Q

Identify the ischial tuberoisty

193
Q

Which structure is labeled by #14?

A

Tibial tuberosity

194
Q

Which structure is labeled by C?

Which muscles attach to it?

A

Lesser trochanter of the femur

Iliopsoas

195
Q

What are the functions of the cruciate ligaments?

A

The cruciate ligaments act to prevent anterior-posterior sliding of the tibia on the femur.

  • ACL – prevents tibia from sliding forward
  • PCL – prevents the tibia from sliding backward
196
Q

The bones of the knee joint (Tibia, fibula, femur) do not fit snugly together. Which pieces of cartilage improve this fit?

A

The medial meniscus and lateral meniscus

197
Q

Describe the hip extensors

  • Primary muscles:
  • Nerve:
A

Hip extensors

  • Hamstrings - Sciatic nerve
    • Tibeal portion, except short head of biceps femoris (common fibular nerve)
  • Gluteus maximus - Inferior gluteal nerve
198
Q

Which artery is labeled by E?

A

Popliteal artery

199
Q

Which structure is labeled by #1?

A

Lateral condyle of the tibia

Fig. 56.3 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 27.1 A, 27.1 B.

200
Q

Which structure is labeled by #5?

A

Lateral epicondyle of the femur

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

201
Q

Which structures are labeled by #4?

What do they supply?

A

Superior gluteal vein, artery, and nerve

Supply gluteus medius and gluteus minimus

202
Q

Which structure is labeled by #5?

A

Medial epicondyle of the femur

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

203
Q

During a softball game a ball hits a player on the lateral side of the knee. She presents with the inability to dorsiflex her foot. What nerve is damaged?

A

Deep fibular nerve -> inability to dorsiflex the foot

However, if she is hit in the lateral knee, the common fibular nerve is likely injured; it has not yet split into its superficial and deep branches. Eversion of the foot is likely absent as well.

204
Q

Which areas are supplied by the obturator nerve?

A

Areas indicated in orange and labeled #3

205
Q

Describe the muscle shown in this picture

  • Muscle + Attachments
  • Function:
  • Innervation:
A
  • Muscle: Hamstrings
  • Function: Extend hip, flex knee
  • Innervation: Sciatic nerve
    • Tibial tract for all except the short head of biceps femoris
206
Q

Which structure is labeled by #8?

A

Lateral epicondyle of the femur

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

207
Q

Which structure is labeled by #3?

208
Q

Which structure is labeled by#5?

A

Tibial nerve

Runs alongside the tibeal artery

209
Q

Which structures is labeled by #7?

What does it supply?

A

Sciatic nerve

Supplies the back of the thigh and all of the leg

  • Tibial tract
    • Most of the posterior thigh, except the short head of biceps femoris
    • Posterior leg (deep and superficial compartments
  • Fibular tract
    • Short head of biceps femoris
    • Anterior leg (deep fibular nerve)
    • Lateral leg (superficial fibular nerve)
210
Q

Identify the pubis

211
Q

Describe the structure labeled by #10

  • Muscle:
  • Function:
  • Attachments:
  • Innervation:
A
  • Muscle: Adductor longus
  • Function: Adduct the femur, stabilize the hip joint
  • Attachments: Pubis, femur
  • Innervation: Obturator (L2-L4)
212
Q

What are the primary ligaments of the ankle?

A
  • Lateral (fibular) collateral
    • Injured during hyperinversion
  • Medial (deltoid or tibial) collateral
    • Injured during hypereversion
213
Q

Which actions are controlled by the superficial fibular nerve?

A

Ankle flexion

Ankle eversion

The superficial fibular nerve innervates the lateral compartment of the leg

214
Q

Label the boundaries of the femoral triangle

  • A:
  • B:
  • C:

Label the structures within the femoral triangle

  • 1:
  • 2:
  • 3:
A

Label the boundaries of the femoral triangle

  • A: Inguinal ligament
  • B: Sartorius
  • C: Adductor longus

Label the structures within the femoral triangle

  • 1: Femoral nerve (most lateral structure)
  • 2: Femoral artery
  • 3: Femoral vein (most medial structure)
215
Q

Which vessel is labeled by #3?

Where does it join the deep venous system?

A

Great saphenous vein

Empties into the femoral vein at the saphenous opening (#1)

216
Q

If a patient cannot invert their ankle, which nerves might be injured?

A

Tibial nerve and/or deep fibular nerve

Both participate in ankle inversion

217
Q

Which strucutre is labeled by #3?

218
Q

Which actions are controlled by the tibial nerve?

A
  • Hip extension
  • Knee flexion
  • Ankle, toe flexion
    • Plantarflexion
  • Ankle inversion
  • Toe adduction and abduction

Tibial nerve innervates the posterior thigh and leg

219
Q

Which structure is labeled by #5?

A

Deep femoral artery

Fig. 59.7 Adapted from Gilroy et al. Atlas of Anatomy, second edition, Fig. 29.34 B.

220
Q

Hip flexors are found in the _________ compartment of the thigh, and are supplied by the ________ nerve

A

Hip flexors are found in the anterior** compartment of the thigh, and are supplied by the **femoral nerve

221
Q

Which structures comprise the rotator cuff of the hip?

A
  • Hip extensors
    • Gluteus maximus
  • Lateral rotators
    • Piriformis
    • Quadratus femoris
  • Hip Abductors
    • Gluteus medis
222
Q

Where is the fibular nerve most likely to be injured?

What deficits will result?

A

As it winds around the fibula

At this point, it is the common fibular nerve; both superficial and deep branches will be affected

  • Loss of superficial fibular nerve -> loss of lateral leg muscle function (fibularis longus and fibularis brevis)
    • -> loss of foot eversion
  • Loss of deep fibular nerve -> loss of anterior leg muscle function (extensor digitorum longus, extensor hallucis longus, and tibialis anterior)
    • -> Loss of foot and ankle extension (dorsiflexion)
  • > Foot drop/slapping gait
223
Q

Which structure is labeled by #2?

A

Part of the iliopsoas

224
Q

Which structure is labeled by #2

225
Q

Which structure is labeled by #4?

A

Lesser trochanter of the femur

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

226
Q

What features of the hip joint limit its range of motion in comparison to the shoulder joint?

A
  • Deep socket of the acetabulum
  • Tight articulation between the femoral head and the acetabulum
    • There is more overlap between the femoral head and the acetabulum than between the head of the humerus and the glenoid
  • Thick, strong intrinsick ligaments
    • Iliofemoral and ischiofemoral
227
Q

Which structure is labeled by #4?

A

Common fibular nerve

228
Q

Cardiac catheterization is the insertion of a catheter into a chamber or vessel of the heart. The femoral artery is often utilized for this purpose. The pulses of the femoral artery will be felt…

A. Medial to the femoral nerve

B. Medial to the femoral vein

C. Medial to the femoral canal

A

A. Medial to the femoral nerve

Pulses are felt in arteries

The femoral artery (2) is between the femoral nerve (1) and the femoral vein (3)

229
Q

Which compartment of the leg is supplied by the superficial fibular nerve?

What actions does this nerve control?

A

Lateral compartment

Ankle eversion

230
Q

Which view of the lower leg is this?

A

Anterior view

Fig. 56.3 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 27.1 A, 27.1 B.

231
Q

Which nerve supplies the areas indicated in blue (#4 and #4a)?

A

Fibular nerve

232
Q

Which nerve is labeled by #1?

What does it innervate?

A

Saphenous nerve

Provides sensory innervation to the skin along the saphenous vein (Surface of the medial leg, medial malleolus, part of the sole of the foot)

233
Q

Which number labels the lesser trochanter?

Which muscle makes this mark?

A

20

Iliopsoas

234
Q

List the pathway of the vein on the fibular side of the lower limb, from its most proximal point to its entry into the deep venous system

A
  • Lesser saphenous vein
    • Through popliteal fossa
  • Popliteal vein (part of the deep venous system)
235
Q

Which structure is labeled by #6?

A

Lateral condyle of the femur

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

236
Q

Which strucutre is labeled by #2?

237
Q

Which structure is labeled by #6?

238
Q

Which structure is indicated by #1?

What is its primary function?

A

Gluteus maximus

Hip extension

239
Q

Which structure is labeled by #3?

A

Lateral head of gastrocnemius

240
Q

Which structure is labeled by #3?

A

Tibialis posterior

In the lower leg, it sits between flexor digitorum longus and flexor hallucis longus

However, flexor digitorum longus crosses both tibialis posterior and flexor hallucis longus as it descends behind the medial malleolus (but anterior to the tibial nerve and posterior tibial artery)

241
Q

Which structure is labeled by #4?

242
Q

The nerves on the dorsal side of the foot are branches of the ____________ nerves

A

The nerves on the dorsal side of the foot are branches of the superficial and deep fibular nerves

243
Q

Which structure is labeled by #11?

244
Q

Which nerve is labeled by #16?

What does it innervate?

A

Deep fibular nerve

  • Anterior compartment of the leg
  • Becomes cutaneous between the hallux and 2nd toe => sensory innervation
    • Testing sensation between the hallux and 2nd toe can test the integrity of the deep fibular nerve
245
Q

Which structure is labeled by #4?

A

Tensor fasciae latae

246
Q

The saphenous nerve is a terminal branch of the ______ nerve

A

The saphenous nerve is a terminal branch of the femoral nerve

247
Q

Loss of sensation in the medial thigh and medial leg may idicate damage to which nerve?

A

2 = femoral nerve

Femoral nerve

(Yellow, #2 and #2a)

248
Q

Which vein is labeled by #4?

Where does it join the deep venous system?

A

Lesser saphenous vein

Empties into the popliteal vein at the popliteal fossa

249
Q

Which structure is labeled by #12?

What is its function?

Attachments?

Innervation?

A

Flexor digitorum longus (Also #15)

Flex (plantarflex) the foot and toes

Tibia, distal phalanges (Analagous to flexor digitorum profundus of hand)

Tibial nerve

250
Q

If a patient cannot abduct their hip, which nerve is most likely injured?

A

Superior gluteal nerve

Innervates gluteus medius, necessary for hip abduction

251
Q

Which structure is labeled by #8?

A

Adductor longus

252
Q

What is the difference between the patellar tendon and the patellar ligament?

A

Patellar tendon: Attatches quadriceps femoris to the patella

Patellar ligament: Attaches the patella to the tibia (at the tibial tuberosity)

253
Q

Which structure is labeled by #10?

A

Popliteal artery and vein

254
Q

Which structure is labeled by #5?

A

Ischial tuberosity

Origin of the hamstrings

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

255
Q

Damage to which nerve would result in pain or sensory loss on the medial side of the lower leg?

A

Saphenous nerve

Cuteneous branch of the femoral nerve

Note: This would not result in any motor deficit

256
Q

Describe the hip abductors

  • Primary muscles:
  • Nerve:
A

Hip abductors

  • Primary muscles: Gluteus medius,
  • Nerve: Superior gluteal
257
Q

Describe the muscle labeled by #4

  • Muscle:
  • Function:
  • Attachments:
  • Innervation:
A
  • Muscle: Tibialis anterior
  • Function: Foot dorsiflexion (extension) and inversion
  • Attachments: Tibia, medial foot
  • Innervation: Deep fibular nerve
258
Q

Which structure is labeled by #1?

A

Head of the tibia

Fig. 56.3 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 27.1 A, 27.1 B.

259
Q

Which structure is labeled #1?

260
Q

If a patient cannot climb stairs, which nerve is most likely injured?

A

Inferior gluteal nerve

Innervates gluteus maximus; necessary for hip extension and lateral rotation

261
Q

Which structure is indicated by #5?

What is its primary function?

A

Gluteus medius

Hip abduction

262
Q

Which structure is labeled by A?

A

Acetabulum

(Head of the femur is right there too)

263
Q

Which structure is labeled by I?

264
Q

Identify the ischium

265
Q

Which structure is labeled by #1?

A

Iliotibial tract

266
Q

Which structure is labeled by #10

A

Tibialis anterior

Dorsiflexion (=extension) of the foot

267
Q

Which structure is labeled by #2?

A

Lateral meniscus

268
Q

Which structure is labeled by #3?

A

Tibialis anterior

Innervated by deep fibular nerve

Drosiflexion of the foot

269
Q

Which structure is labeled by #2?

A

Neck of the femur

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

270
Q

Which structure is labeled by #10?

Which nerve runs alongside it?

A

Posterior tibial artery

Tibial nerve

271
Q

What is the purpose of most of the muscles and ligaments of the foot?

A

Support the longitudinal and transverse arches

272
Q

Which structure is labeled by #2?

A

Medial condyle of the tibia

Fig. 56.3 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 27.1 A, 27.1 B.

273
Q

What view of the femur is this?

A

Anterior view

(Patellar surface is at the bottom between the medial and lateral condyles)

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

274
Q

Which structure is labeled by B?

A

Great saphenous vein

(In the superficial fascia)

275
Q

Describe the structure labeled by #4

  • Muscle:
  • Function:
  • Attachments:
  • Innervation:
A
  • Muscle: Fibularis longus
  • Function: Evert the foot, plantarflex (flex) the foot
  • Attachments: Fibula, Medial cuneiform, 1st metatarsal
    • ​Forms a sling underneath the foot
  • Innervation: Superficial fibular nerve
276
Q

Which structure is labeled by #7?

What innervates it?

A

Gastrocnemius

Tibial nerve

277
Q

Which structure is labeled by #6?

A

Internal iliac vein

278
Q

Which structure is labeled by #9?

A

Quadriceps femoris

innervated by femoral nerve

279
Q

Which structure is labeled by G?

A

Lateral epicondyle

280
Q

Which nerve runs with the greater saphenous vein?

A

Saphenous nerve

281
Q

Which artery is labeled by B?

A

Common femoral artery

282
Q

Which structure is labeled #3?

283
Q

Which structure is labeled by #3?

A

Tibial tuberosity

Fig. 56.3 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 27.1 A, 27.1 B.

284
Q

Which structure is labeled by #9?

A

Medial malleolus of the tibia

285
Q

What actions are controlled by the deep fibular nerve?

A
  • Ankle and toe extension
    • Dorsiflexion
  • Ankle inversion
286
Q

Which structure is labeled by #7?

What does it innervate?

A

Saphenous nerve

Skin of the medial leg

Fig. 59.7 Adapted from Gilroy et al. Atlas of Anatomy, second edition, Fig. 29.34 B.

287
Q

A girl falls off a bicycle and gets a cut immediately posterior to the medial malleolus. Which of the following structures might be damaged?

A) Tendon of the tibialis anterior muscle

B) Tendon of the fibularis (peroneus) longus muscle

C) Superficial fibular (peroneal) nerve

D) Sural nerve

E) Tibial nerve

A

E) Tibial nerve

288
Q

Which structure is labeled by #1?

A

Femoral nerve

289
Q

Which nerve is labeled by #8?

What does it innervate?

A

Lateral plantar nerve

Adductor hallucis, lateral lumbricals, interossei, quadratus plantae

(Analogous to the ulnar nerve - it innervates all of the intrinsic muscles of the foot except the most medial)

290
Q

Which structure is labeled by #2?

A

Femoral nerve

(Innervates the anterior compartment of the thigh)

Fig. 59.7 Adapted from Gilroy et al. Atlas of Anatomy, second edition, Fig. 29.34 B.

291
Q

If a patient cannot evert their ankle and has weakness with plantarflexion (flexion), which nerve is most likely injured?

A

Superficial fibular nerve

Innervates the lateral compartment of the leg

Note: the tibeal nerve also participates in ankle flexion (plantarflexion), but does not participate in ankle eversion

292
Q

Which structure is labeled by #4

293
Q

Which structure is labeled by C?

What movements occur here?

A

Lower ankle (subtalar) joint

Eversion and inversion

294
Q

Which view of the foot is this?

A

Plantar (inferior) view

295
Q

Which structure is labeled by #6?

A

Head of the fibula

Fig. 56.3 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 27.1 A, 27.1 B.

296
Q

Which structure is labeled by #7?

A

Iliotibeal tract/IT Band

297
Q

A physician asks a patient to stand on his tiptoes so she can evaluate lower limb function.

What nerve is she evaluating?

Which muscles?

A

Tibial nerve - innervates the posterior compartment of the leg

  • Triceps surae
    • Gastrocnemius
    • Soleus
  • Flexor digitorum longus
  • Tibialis posterior
  • Flexor hallucis longus
298
Q

Which structure is labeled by H?

A

Medial epicondyle

299
Q

Which vein is labeled by #2?

Where does it join the deep venous system?

A

Great saphenous vein

Empties into the femoral vein at the saphenous opening (in the crease of the hip)

300
Q

The sural nerve is a terminal branch of the ________ nerve

A

The sural nerve is a terminal branch of the tibial and fibular nerves

301
Q

After an auto accident a woman presents with a foot that is dorsiflexed and everted. Knee extension is normal, but she cannot stand on her toes. She has little sensation on the distolateral part of her calf. What nerve is damaged?

A) Common fibular

B) Deep fibular

C) Femoral

D) Superficial fibular

E) Tibial

302
Q

Describe the posterior compartment of the thigh

  • Muscles:
  • Actions:
  • Nerve:
  • Skeletal landmarks (attachments):
A

Posterior compartment of the thigh

  • Muscles: Hamstrings
  • Actions: Hip extension, knee flexion
  • Nerve: Sciatic (tibeal), fibular for short head of biceps femoris
  • Skeletal landmarks (attachments): Ischial tuberosity
303
Q

What kind of bone is labeled by #4?

A

Metatarsal

(This is the 5th metatarsal)

304
Q

Which structure is labeled by #4?

(The part of the bone)

A

Head of the fibula

305
Q

Which structure is labeled by #13?

A

Flexor hallucis longus

(Also #16)

306
Q

Which structure is labeled by #8?

A

Calcaneal tendon

Achille’s tendon

307
Q

The tendon of what muscle inserts at the location labeled above?

  1. Gluteus medius
  2. Gluteus maximus
  3. Iliopsoas
  4. Rectus femoris
A

a. Gluteus medius (and minimus)

308
Q

Which structure is labeled by #1?

A

Greater trochanter of the femur

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

309
Q

Which structure is labeled by A?

310
Q

Which actions are controlled by the femoral nerve?

A

Hip flexion, knee extension

Femoral nerve innervates the anterior compartment of the thigh (quadricpes femoris and iliopsoas)

311
Q

Which structure is labeled by #5?

A

Adductor magnus

312
Q

What view of the foot is this?

A

Dorsal (superior) view

313
Q

Which structures are labeled by #6?

What are their more distal destinations?

A

Femoral artery, femoral vein, saphenous nerve

Femoral artery and femoral vein will pass through adductor hiatus on their way to the posterior leg/popliteal fossa

Saphenous nerve will travel with the great saphenous vein to innervate the skin of the medial leg

Fig. 59.7 Adapted from Gilroy et al. Atlas of Anatomy, second edition, Fig. 29.34 B.

314
Q

Which structure is labeled by #4?

A

Common fibular nerve

315
Q

Describe the structure outlined in blue (middle outlined structure)

  • Muscle:
  • Function:
  • Attachments:
  • Innervation
A
  • Muscle: Adductor longus
  • Function: Adduct the thigh
  • Attachments: Pubis, femur
  • Innervation: Obturator nerve

Other superficial adductors in this picture:
Yellow = pectineus
Green = gracilis

316
Q

Which muscle is labeled by #1?

A

Gluteus medius

Adduct the hip

317
Q

Which structure is labeled by #3?

A

Saphenous vein

318
Q

List the muscles of the medial compartment of the thigh.

Which nerve supplies this compartment?

A
  • Adductor longus
  • Adductor magnus

Supplied by the obturator nerve

319
Q

Which strucutre is labeled by #4?

A

Medial malleolus

320
Q

The tibial tuberosity has its own secondary ossification center and it may separate to varying degrees from the tibial shaft in a physically active adolescent (Osgood-Schlatter’s disease). Which muscle inserts on the tibial tuberosity causing the pull of the epiphysis away from the tibial shaft?

A. Adductor magnus

B. Iliopsoas

C. Quadriceps femoris

D. Sartorius

E. Gracilis

A

C. Quadriceps femoris

321
Q

Which structure is labeled by D?

Which muscles attach to it?

A

Ischial tuberosity

Hamstrings

322
Q

Which artery is labeled by A?

A

Deep femoral artery

323
Q

Which structure is labeled by #4?

A

Ischium (body of the ischium)

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

324
Q

What type of gait deviation might you see in someone with a common fibular nerve injury?

A

Foot drop

The muscles of the anterior (dorsiflexor) compartment will not work, so they cannot hold the foot up; it will slap to the ground

Eversion will also be lost

325
Q

Describe the lateral compartment of the leg

  • Muscles:
  • Actions:
  • Nerve:
  • Skeletal landmarks (attachments):
A

Lateral leg

  • Muscles: Fibularis longus
  • Actions: Eversion of the foot, some plantarflexion
  • Nerve: Superficial fibular nerve (comes from sciatic)
  • Skeletal landmarks (attachments):
    • Head of fibula, lateral malleolus
326
Q

Which structure is labeled by D?

327
Q

Which structure is labeled by #4?

A

Medial malleolus (part of the tibia)

Fig. 56.3 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 27.1 A, 27.1 B.

328
Q

List the labeled structures

      1. SKIP
  2. 5.
A
  1. Gluteus Medius
  2. Piriformis
    1. Quadratus Femoris
  4. Adductor Longus
329
Q

Describe the anterior compartment of the leg

  • Muscles:
  • Actions:
  • Nerve:
  • Skeletal landmarks (attachments):
A

Anterior leg

  • Muscles:
    • Tibialis anterior, extensor digitorum longus
  • Actions:
    • Extension (dorsiflexion) of the ankle, inversion of the ankle
  • Nerve:
    • Deep fibular nerve (comes from sciatic)
  • Skeletal landmarks (attachments):
    • Lateral malleolus, medial malleolus of tibia
330
Q

Which structure is labeled by #7?

A

Fibularis longus

Eversion and plantar flexion

Superficial fibular nerve

(Also #5)

331
Q

Which nerve is labeled by #8?

What does it innervate

A

Tibial nerve

Innervates the posterior compartment of the leg
(superficial and deep)

332
Q

Which structure is labeled by #3?

A

Greater trochanter of the femur

333
Q

Describe the highlighted muscle

  • What function do all of these muscles share?
A

Quadriceps femoris

  • All: Knee extension
  • Some hip flexion
334
Q

Which structure is labeled by #8?

What is its function?

A

Patellar ligament

Attaches the patella to the tibial tuberosity

335
Q

Which structure is labeled by #1?

A

Inguinal ligament

Fig. 59.7 Adapted from Gilroy et al. Atlas of Anatomy, second edition, Fig. 29.34 B.

336
Q

Which structure is labeled by #8?

A

Quadriceps femoris

Innervated by femoral nerve

337
Q

Which structure is labeled by #29?

Which nerve follows this artery?

A

Anterior tibial artery

Deep fibular nerve

338
Q

Which structure is labeled by #3?

A

Lateral meniscus of the knee

339
Q

Which structure is labeled by #5?

A

Fibularis longus

340
Q

Which structure is labeled by #4?

A

Obturator nerve

Innervates the medial compartment of the thigh (adductors)

Fig. 59.7 Adapted from Gilroy et al. Atlas of Anatomy, second edition, Fig. 29.34 B.

341
Q

Which structure is labeled by #16?

A

Flexor hallucis longus

(Also #13)

Note: Flexor hallucis longus and flexor digitorum longus cross each other at the heel

342
Q

Which vessel is labeled by #20?

Where does it come from?

What does it supply?

A

Medial plantar artery

Branch of the posterior tibial artery

Medial sole of the foot and toes

343
Q

Which structure is labeled by #1?

What is its function?

A

Posterior cruciate ligament

Prevents the tibia from sliding posteriorly relative to the femur

344
Q

Which structure is labeled by #11?

A

Flexor hallucis longus

345
Q

Which structure is labeled by #1?

A

Adductor magnus

346
Q

Which structure is labeled by #6?

347
Q

Which bones make up the lower ankle (subtalar) joint?

Describe the movement at this joint

A

Talus, calcaneus

Inversion and eversion

(Flexion and extension take place at the upper ankle joint)

348
Q

Which nerve supplies the area indicated in orange (#3)?

A

Obturator nerve

349
Q

Which structure is labled by #9?

(Flexor digitorum brevis has been reflected)

A

Flexor hallucis longus

350
Q

Which structure is labeled by #1?

A

1st proximal phalanx

351
Q

Which structure is labeled by #16?

352
Q

Describe the muscle labeled by #5

  • Muscle:
  • Function:
  • Attachments:
  • Innervation:
A
  • Muscle: Extensor digitorum longus
  • Function: Dorsiflexion (extension) of the foot and toes 2-5
  • Attachments: Tibia, toes 2-5
  • Innervation: Deep fibular nerve
353
Q

A woman has bloody stools and is unable to completely empty her rectum. Physical exam shows weakness in her ability to flex the knee against resistance and a neoplasm of the posterior rectum. Knee extension and hip adduction are normal. The cancer has compressed which nerve causing the muscle weakness?

A

Sciatic nerve

Innervates the hamstrings, which are the primary flexors of the knee

354
Q

Which structure is labeled by #2?

A

Saphenous nerve

355
Q

Which structure is labeled by #2?

A

Head of the femur

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

356
Q

Which structure is labeled by #1?

A

Deep fibular nerve

(Also #5 both branches are the deep fibular nerve)

357
Q

Inflammation in which structure results in plantar fasciitis?

A

Plantar Aponeurosis

358
Q

Which structure is labeled by #4?

What is its function?

A

Lateral collateral ligament

Stabilizes the knee laterally

359
Q

Describe the medial compartment of the thigh

  • Muscles:
  • Actions:
  • Nerve:
    *
A

Medial compartment of the thigh

  • Muscles:
    • ​Adductor longus
    • Adductor magnus
  • Actions: Hip adduction
  • Nerve: Obturator
    *
360
Q

Which structure is labeled by B?

Which muscles attach to it?

A

Greater trochanter of the femur

Gluteus medius and gluteus minimus

361
Q

Which bone is labeled by #9?

A

Ischial tuberosity

Attachment of the hamstrings

362
Q

Which structure is labeled by #10?

A

Lateral malleolus

On the fibula

363
Q

Which structure is labeled by #8?

A

Iliotibial tract

364
Q

Which muscle is labeled by #2?

A

Gluteus maximus

365
Q

Which structure is labeled by #5?

Function?

Innervation?

A

Tensor fasciae latae

Hip abduction, internal rotation, flexion

Superior gluteal nerve

366
Q

Identify the ilium

367
Q

Which structure is labeled by D?

A

Sciatic nerve

368
Q

Which muscles flex the foot?

What is their innervation?

A

Flexion = plantarlexion

gastrocnemius + soleus

They are in the posterior compartment of the leg, so they are innervated by the tibial nerve

369
Q

Which structure is labeled by #7?

A

Anterior tibeal artery

(Also #2)

370
Q

Which nerve supplies the muscles of the foot?

A

Tibial nerve branches

  • Medial plantar nerve
  • Lateral plantar nerve

Remember: Tibial nerve = part of sciatic nerve

371
Q

Damage to which nerve would result in pain or sensory loss on the lateral side of the lower leg and foot?

A

Sural nerve

Cuteneous branch of the tibial and fibular nerves

Note: This would not result in any motor deficit

372
Q

Describe the fate of the common femoral artery

A

Common femoral artery ->

  • -> Superficial femoral artery
    • Descends in the thigh between the anterior and medial compartments
    • Travels through the adductor hiatus
    • -Becomes the popliteal artery
      • Anterior tibial artery
      • Posterior tibial artery
        • Fibular artery
  • -> Deep femoral artery
    • -> Lateral circumflex artery + Medial circumflex artery
      • Both of these wrap around the back of the femoral neck to form an anastomosis
    • The rest goes on to supply the hip joint, thigh, and femur
373
Q

Which motions will be difficult for a patient with nerve damage to their inferior gluteal nerve?

A

Going up stairs

Standing from sitting

Other motions that involve extension of the hip

374
Q

Which strucutre is labeled by #1?

A

Adductor magnus

375
Q

Describe the highlighted muscle

  • Muscle:
  • Function:
  • Attachments:
  • Innervation:
A
  • Muscle: Tensor fasciae latae
  • Function: Abduct, flex, internally rotate the femur
  • Attachments: Iliac spine, Iliotibial tract (Aka IT band)
  • Innervation: Superior gluteal nerve
    • Even though it technically belongs to the anterior compartment of the thigh
376
Q

Which structure is labeled by #1?

A

Tibial nerve

377
Q

Describe structure #2

  • Muscle:
  • Function:
  • Attachments:
  • Innervation:
A
  • Muscle: Gluteus medius
  • Function: Hip abduction
  • Attachments: Ilium, greater trochanter of femur
  • Innervation: Superior gluteal nerve (L4-S1)
378
Q

Which vein empties into the femoral vein?

Which vein empties into the popliteal vein?

A

The greater saphenous vein (#2) empties into the femoral vein at the saphenous opening (in the crease of the hip)

The lesser saphenous vein (#4) empties into the popliteal vein at the popliteal fossa (behind the knee)

379
Q

Which structure is labeled by #6?

A

Tibialis anterior

Dorsiflexion

Deep fibular nerve

380
Q

Which compartment of the leg is supplied by the tibial nerve?

What actions does this nerve control?

A

Posterior compartment

  • Ankle flexion (plantarflexion)
  • Toe flexion (plantarflexion)
381
Q

Which structure is labeled by #1?

What is its function?

A

Anterior cruciate ligament

Prevents the tibia from sliding too far forward

382
Q

A patient presents with extreme pain due to arterial insufficiency in the posterior compartment of the thigh. This compartment receives its blood supply mainly from the perforating arteries. An arteriogram confirms partial obstruction of the artery that gives rise to these perforating arteries. What artery is occluded in the arteriogram?

A

Deep femoral artery

383
Q

Which structure is labeled by #9?

Function?

Innervation?

A

Long head of biceps femoris (part of the hamstring)

Hip extension, knee flexion

Sciatic nerve (tibial division)

384
Q

Which structure is labeled by #1?

A

Flexor digitorum longus

Passes posterior to the medial malleolus, but anterior to the poster tibial artery and tibial nerve

385
Q

Describe the anterior compartment of the thigh

  • Muscles:
  • Actions:
  • Nerve:
  • Skeletal landmarks (attachments):
A

Anterior compartment of the thigh

  • Muscles:
    • Quadriceps femoris
    • Iliopsoas
  • Actions: Hip flexion, knee extension
  • Nerve: Femoral
  • Skeletal landmarks (attachments):
    • Patella
    • Lesser trochanter
    • Tibeal tuberosity
386
Q

What artery supplies the femoral head?

A

Medial and lateral femoral circumflex artery

(Branch from the deep femoral artery)

387
Q

Which structure is labeled by #6?

A

Medial condyle of the femur

(Articulates wiwht the medial condyle of the tibia)

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

388
Q

Which structure is labeled by #4?

A

Lesser trochanter of the femur

389
Q

Which structure is labeled by #4?

A

Lateral malleolus

Part of the fibula

390
Q

Which structure is labeled by #5?

A

Fibularis longus

(#7 = tendon of fibularus longus)

391
Q

Which structure is labeled by #5?

A

Quadriceps femoris

392
Q

Sensory loss on the lateral side of the leg in foot is due to damage of which nerve?

What other deficits might be present?

A

Superficial fibular nerve

Eversion of the foot will be lost

393
Q

Which structure is labeled by #40?

A

Tibial nerve

Innervates the superficial and deep posterior compartments of the leg

394
Q

Which nerve supplies the sole of the foot?

A

Tibial nerve

(Branches into medial plantar and lateral plantar nerves

395
Q

Which structure is labeled by #4?

Function?

Innervation?

Attachments?

A

Gluteus maximus

Hip extension

Inferior gluteal nerve

Dorsal surface of the sacrum, gluteal surface of the ilium, thoracolumbar fascia, iliotibial tract, gluteal tuberosity of the femur

396
Q

Which nerve is labeled by #1?

What does it innervate?

It is a branch from which larger nerve?

A

Saphenous nerve

Sensory nerve that provides innervation to the skin around the saphenous vein (medial aspect of the lower leg, medial malleolus, and a small portion of the arch of the foot)

It comes from the femoral nerve

397
Q

Which structure is labeled by #18?

A

Medial malleolus

Part of the tibia

398
Q

Describe gluteus medius

  • Function:
  • Attachments:
  • Innervation:
A

Gluteus medius

  • Function: Hip abduction
  • Attachments: Ilium, greater trochanter of the femur
  • Innervation: Superior gluteal nerve
399
Q

Which structure is labeled by #9?

A

Fibular artery

Branch of the popliteal artery (6)

400
Q

Which structures stabilize the knee laterally?

A

Lateral (aka fibular) collateral ligament

Iliotibial tract

401
Q

Which structure is labeled by #3?

A

Neck of the femur

Fig. 56.2 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 26.4 A, 26.4 B

402
Q

How is the ACL most commonly injured?

A

Usually noncontact injuries

Lateral twisting of the femur on a planted foot carres the femur backward relative to the tibia, stretching the ACL

MSK-Derm by Minnie AH Version (47 decks)

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