SM MSK Anatomy - Lower Limb, Femoral Triangle, Glute, Foot, Gait Flashcards
SM 223a, Lab 2, Lab 3, Lab 4, Lab 5
Which structure is labeled by #12?
Function?
Innervation?
Quadriceps Femoris (one of the 4)
Knee extension, hip flexion (inserts on greater trochanter of femur)
Femoral nerve
What view of the femur is this?
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
Which structure is labeled by #12?
Hamstring
Posterior compartment of the thigh
Which muscle is labeled by #4?
Piriformis
Which vessel is most likely to be damaged by a femoral neck fracture?
What is the consequence?
Medial femoral circumflex artery
This can lead to necrosis of the femoral head
Which structure is labeled by #9?
Hamstring (one of three)
Posterior compartment
Which nerve supplies the big toe compartment of the foot?
What actions does it control?
Medial plantar nerve (branch of the tibial nerve)
Abduction and flexion of the hallux
Which structure is indicated by #2?
What is its primary function?
Piriformis
Lateral rotation of the hip
Which structure is labeled by #10?
What is its function?
What are its attachments?
Tibialis posterior
Foot inversion, plantarflexion
Tibia, fibula, interosseous membrane + sole of the foot (tarsals)
What are the components of the sciatic nerve?
Tibial nerve
Common fibular nerve
Hip extensors are found in the _________ compartment of the thigh, and are supplied by the _________ nerve
Hip extensors are found in the posterior** compartment of the thigh, and are supplied by the **tibial (sciatic) nerve
Which structures are in group A?
Superficial femoral artery, and vein
Femoral nerve
Identify the structures of the lateral compartment of the leg.
What innervates them?
Fibularis longus (5)
Superficial fibular nerve
Which muscles acts to invert the foot?
Tibialis posterior, Tibialis anterior
Which structure is labeled by #5?
Tibial nerve
Which structure is labeled by #1?
Tibia
Which nerve supplies the areas indicated in yellow (#2 and #2a)?
2a is supplied by the saphenous nerve, a branch of the femoral nerve
Femoral nerve
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
D. femoral
Supplies the anterior surface of the thigh. May also block branches fo the obturator nerve.
Which structure labels the anterior cruciate ligament?
Which structure labels the posterior cruciate ligament?
Anterior cruciate ligament = #2
Posterior cruciate libament = #1
Which structure is labeled by #3?
Femoral artery and femoral vein
Fig. 59.7 Adapted from Gilroy et al. Atlas of Anatomy, second edition, Fig. 29.34 B.
Hip adductors are found in the _________ compartment of the thigh, and are supplied by the ________ nerve
Hip adductors are found in the medial** compartment of the thigh, and are supplied by the **obturator nerve
Which areas are supplied by the femoral nerve?
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
Which structure is labeled by #7?
What is its function?
Medial collateral ligament
Stabilizes the knee medially
Where will you find the neurovasculature of the posterior lower leg?
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
Which structure is labeled by #3?
Medial collateral ligament
Lateral compartment of the leg
- Muscles:
- Function:
- Innervation:
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)
Which nerve supplies the little toe compartment of the foot?
What actions does it control?
Lateral plantar nerve (branch of the tibial nerve)
Abduction and flexion of the 5th digit
Which structure is labeled by #3?
Medial malleolus
Which structure is labeled by #8?
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
Which structure is labeled by #10?
Function?
Innervation?
Quadriceps femoris
Hip extension, knee flexion
Sciatic nerve (common fibular division)
Which structure is labeled by #17?
What does it innervate?
Common fibular nerve
Separates into the superficial fibular nerve (lateral compartment of the leg) and deep fibular nerve (anterior compartment of the leg)
Which structure is labeled by #3?
Iliopsoas
Anterior compartment of the thigh
Which vein is labeled by #2?
Where does it join the deep venous system?
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))
Which nerve is labeled by #21?
What does it innervate?
Medial plantar nerve (branch of the tibial nerve)
The lateral plantar does everything else (like the ulnar nerve does in the hand)
Which structure is labeled by #4?
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.
Which structure is labeled by #1?
Part of the iliopsoas
Which actions are controlled by the inferior gluteal nerve?
Hip extension, lateral rotation
The inferior gluteal nerve innervates the gluteus maxiumus
Which structure is indicated by #3?
What is its primary function?
Quadratus femoris
Lateral rotation of the hip
Which structure is labeled by #2?
Popliteal artery
Which nerve is labeled by #3?
What does it innervate?
Superficial fibular nerve (part of the sciatic nerve)
Innervates the lateral compartment of the leg
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:
- 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)
Posterior compartment of the leg
- Motion:
- Innervation:
Posterior compartment of the leg
- Motion: Flexion aka Plantarflexion
- Innervation: Tibial nerve (comes from sciatic)
Which number labels the greater trochanter?
Which muscle makes this mark?
9
Gluteus medius (and minimus)
Which structure is labeled by #7?
Adductor magnus
Lateral compartment
Innervated by obturator nerve
Which structure is labeled by #10?
Quadriceps femoris tendon
All of the muscles of quadriceps femoris come together to form the quadriceps tendon
Which structure is labeled by B?
Which movements occur here?
Upper ankle (talocrural) joint
Where the tibia/fibular meets the talus
Flexion and extension
Which structure is circled?
Medial collateral ligament of the ankle
Which muscles insert into the IT band?
Gluteus maximus, tensor fasciae latae
Which structure is labeled by #5?
Calcaneus
What kind of bone is labeled by #1?
Distal phalanx of the foot
(This is the 5th distal phalanx)
Which structure is labeled by #3?
Iliofemoral ligament
Which structure is labeled by #1?
Adductor magnus
Which structure is labeled by #16?
What does it innervate?
Tibial nerve
Posterior compartment of the leg
Describe the structure labeled by #8
- Muscle:
- Function:
- Attachments:
- Innervation:
- Muscle: Quadratus femoris
- Function: Extension, external rotation of the femur
- Attachments: Ishcial tuberosity, femur (Intertrochanteric crest)
- Innervation: Sacral plexus (L5, S1)
Which structure is labeled by #18?
Gastrocnemius
Innervated by tibial nerve
What kind of bone is labeled by #8?
Proximal phalanx of the foot
(This is the 1st proximal phalanx)
Which structures are labeled by #12?
Tendons of extensor digitorum longus
(Extensor digiotorum longus = #7)
Which structure is labeled by #1?
Iliotibial tract
Describe the hip flexors
- Primary muscles:
- Nerve:
Hip flexors
- Primary muscles: Iliopsoas
- Nerve: Femoral
Which muscles are important for lateral balance of the trunk during walking or running?
Gluteus medius
(Abduction to pull the trunk back over the leg)
Which structure is labeled by #1?
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
Which structure is labeled by #15
gastrocnemius
Which structure is labeled by #4?
Posterior tibial artery
A patient has lost feeling between their hallux and 2nd toe.
Which nerve is damaged?
Which other functions should you test?
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
Which structure is labeled by #11?
Extensor digitorum longus
Which structure is labeled by #6?
Ischial tuberosity
Origin of the hamstrings
Which structure is labeled by #14?
Tibialis posterior
(Also #11)
Describe gluteus maximus
- Function:
- Attachments:
- Innervation:
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)
Describe the highlighted muscle
- Collectively:
- Function:
- Collectively: Iliopsoas muscle
- Function: Hip flexion
If a patient cannot flex their hip, which nerve is most likely injured?
Femoral nerve
Innervates the anterior compartment of the thigh; necessary for hip flexion and knee extension
Which structure is labeled by #11?
Adductor magnus
Which structure is labeled by #2?
Femoral artery
Which actions are controlled by the obturator nerve?
Hip adduction
Obturator innervates the medial compartment of the thigh (where the hip adductors live)
Which artery is labeled by C?
Lateral circumflex artery (goes to the anterior side)
Medial circumflex artery goes to the posterior side
Which structure is labeled by #2?
Part of the hamstrings
Posterior compartment
Sciatic nerve
Which structure is labeled by #13?
Tibia
Which structures are in group C?
Deep femoral artery and vein
Which structure is circled?
Lateral collateral ligament of the ankle
Which vessel is labeled by #9?
Where does it come from?
What does it supply?
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
The foot plantarflexes and extends (dorsiflexes) at the ___________ joint and inverts and everts at the ____________ joints
The foot plantarflexes and extends (dorsiflexes) at the upper ankle** joint and inverts and everts at the **lower ankle and transverse tarsal joints
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
C. Superficial femoral
Which structure is labeled by #6?
gastrocnemius
Which structure is labeled by #15?
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
Which structure is labeled by #7?
Function?
Innervation?
Quadricpes Femoris (part of)
Hip flexion, knee extension
Femoral nerve
Which structure is labeled by F?
metatarsal
What actions are controlled by the superior gluteal nerve?
Hip abduction, lateral balance
Innervates gluteus medius
Which compartment of the leg is supplied by the deep fibular nerve?
What actions does this nerve control?
Anterior compartment
- Ankle extension (dorsiflexion)
- Toe extension (dorsiflexion)
- Ankle inversion
Which structure is labeled by #9?
Extensor digitorum longus
Which strucutre is labeled by #6?
Hamstring
Which structure is labeled by E?
Shaft of the femur
Which structure is labeled by #5?
gastrocnemius
Which structure is labeled by #2?
Patella
Which structure is labeled by #1?
Which vessels can you see through this structure?
Saphenous opening
Inside we can see the femoral artery and femoral vein
Which nerve is labeled by #5?
What does it innervate?
Where does it come from?
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
Which structure is labeled by #4?
Adductor longus
Medial compartment
Innervated by the obturator nerve
Which structure is labled by #2?
(Flexor digitorum brevis has been reflected)
Flexor digitorum longus
Which joint is indicated by the red line? (#3)
Lower ankle aka subtalar joint
If a patient cannot extend (dorsiflex) their ankle, which nerve is most likely injured?
Deep fibular nerve
Innervates the anterior compartment of the leg
Which nerve supplies the interossei of the foot?
What actions does it control?
Lateral plantar nerve (branch of the tibial nerve)
- Abduction of the toes
- Adductionof the toes
- Flex the MCP joints
- Extend the IP joints
The structures outlined in purple are collectively called the…
Tarsals
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?
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
Which structures stabilize the knee medially?
- Medial (aka tibial) collateral ligament
Which structure is labeled by #8?
Quadriceps femoris
Fig. 59.7 Adapted from Gilroy et al. Atlas of Anatomy, second edition, Fig. 29.34 B.
Loss of sensation in the toes may indicate damage to which nerve?
Fibular nerve (superficial branch)
The fibular nerve supplies the areas in blue, labeled #4 or #4a
Which structure is labeled by #2?
Head of the fibula
Fig. 56.3 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 27.1 A, 27.1 B.
Which structure is labeled by #4?
Calcaneus
What is the function of the anterior cruciate ligament?
Prevents the tibia from sliding anteriorly relative to the femur
What is the purpose of the calcaneal tendon
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)
What kind of bone is labeled by #7?
Metatarsal
(This is the 1st metatarsal)
What is the most common type of ankle sprain?
Injury to the lateral collateral ligament of the ankle
Caused by hyperinversion
Which structure is labeled by #1?
Patella
Which strucutre is labeled by #7?
Hamstring
Which structure is labeled by #5?
What is its function?
Posterior cruciate ligament
Prevents the tibia from sliding too far backward
Describe the hip adductors
- Primary muscles:
- Nerve:
Hip adductors
- Primary muscles: Adductor group
- Adductor longus
- Adductor magnus
- Nerve: Obturator
Describe the posterior compartment of the leg
- Muscles:
- Actions:
- Nerve:
- Skeletal landmarks (attachments):
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
Which muscles make up the deep posterior leg?
What are their functions?
Flexor digitorum longus
Tibialis posterior
Flexor hallucis longus
Plantarflex the foot, flex the toes
Tibialis posterior inverts the foot at the ankle
Which view of the lower leg is this?
Posterior view
Fig. 56.3 Adapted from Gilroy et al. Atlas of Anatomy, 2nd edition, Figs. 27.1 A, 27.1 B.
Which nerve is labeled by #3?
What does it innervate?
Superficial fibular nerve
Innervates the lateral compartment of the leg
Which structure is labeled by #4?
Medial meniscus
Which structure is labeled by #17
Tendon of tibialis anterior
(#6 = tibialis anterior)
Which nerve runs with the lesser saphenous vein?
Sural nerve
Which structure is labeled by #4?
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
What causes IT band syndrome?
Friction between the iliotibial band and the greater trochanter and/or the lateral condyle of the femur
The exercise depicted below (moving from position 1 to position 2) primarily involves contraction of the _________ muscles.
Which nerve supplies these muscles?
The exercise depicted below (moving from position 1 to position 2) primarily involves contraction of the hip adductor muscles.
Supplied by the obturator nerve
Which structure is labeled by #7?
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
Which structure is labeled by #26?
Fibular artery
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
D. Gluteus medius
Greater trochanter is fractured; the gluteus medius inserts here
What kind of bone is labeled by #9?
Distal phalanx of the foot
(This is the 1st distal phalanx)
The hallux does not have a middle phalanx
Which joint is indicated in red?
Upper ankle joint
Articulaton between tibia, fibula, and talus
Which structure is labeled #4?
Calcaneus
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
- 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)
If a patient cannot adduct their hip, which nerve is most likely injured?
Obturator nerve
Innervates the medial compartment of the thigh, where the adductors live
Describe the medial rotators of the hip
- Primary muscles:
- Nerve:
Medial rotators of the hip
- Primary muscles: Gluteus medius,
- Nerve: Superior gluteal
Which structure is labeled by #2?
Iliofemoral ligament
Which areas are supplied by the fibular nerve?
Areas indicated in blue and labeled #4 or #4a
Anterior compartment of the leg
- Motion:
- Innervation:
Anterior compartment of the leg
- Motion: Extension aka Dorsiflexion
- Innervation: Deep fibular nerve (comes from sciatic nerve)
Which number labels the ischial tuberosity?
Which muscle makes this mark?
26
Hamstrings (except short head of biceps femoris)
Which structure is labeled by #6?
Medial meniscus of the knee
Which structure is labeled by #7?
Extensor digitorum longus
Which structure is labeled by #11?
Tibialis posterior
(Also #14)
Which structure is labeled #2?
Fibula
Which structure is labeled by #1?
Gluteus maximus
Which structure is labeled by #7?
Soleus
gastrocnemius (5, 6)
soleus (7)
If a patient cannot flex their knee, which nerve is most likely injured?
Tibial nerve
Innervates the posterior thigh and posterior leg
Which blood vessels supply the dorsum of the foot?
deep plantar artery (15)
These are branches from the anterior tibial artery
Which structure is labeled by #5?
Lesser trochanter of the femur
Which structure is labeled by #14?
Tibial tuberosity
Which structure is labeled by #6?
Sural nerve
Which structure is labeled by #4?
Extensor digitorum longus
Anterior compartment extends = dorsiflexes
Which artery is labeled by D?
Superficial femoral artery
List the muscles in the anterior compartment of the leg
What is their innervation?
Which artery supplies them?
- Tibialis anterior (4, 14)
- Extensor digitorum longus (5, 10)
Deep fibular nerve
Anterior tibial artery
Which structure is labeled by #7?
Common iliac vein
Which nerve is labeled by #2?
What does it innervate?
Common fibular nerve
- Lateral leg via superficial fibular nerve (26)
- Anterior leg via deep fibular nerve (24)
Which areas are supplied by the tibial nerve?
Areas indicated in purple and labled #5 or #5a
Which structure is labeled by #4?
Greater trochanter of the femur
Which structure is labeled by #2?
What is its function?
What is its innervation?
Gluteus medius
Hip abduction
Superior gluteal nerve
Which structure is labeled by #1?
Iliotibial tract
Which structure is labeled by #3?
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.
Which structure is labeled by #11?
Gastrocnemius (medial head)
Which structure is labeled by #3?
Flexor digitorum longus