Superficial and Osseous Lower Limb Flashcards
The subcutaneous tissue lies deep from lower extremity ____ and superficial from lower extremity ___ ___
skin; deep fascia
Subcutaneous fascia consists of ____ connective tissue that contains variable amounts of fat, cutaneous nerves, superficial veins, superficial lymph vessels and nodes
loose
At the ____, the subcutaneous tissue loses some of its fat and blend with the deep fascia - although, fat resumes distally
knee
What are the functions of the subcutaneous tissue?
insulation, storage of fat
True or false? Superficial veins are located superficial from deep fascia
true
True or false? Only deep veins have valves
false; both superficial and deep have valves but deep veins do have more
note: inferior veins in general have more valves
Describe the valves found in veins
cup-like endothelial flap - that when full, occludes the lumen of the vein, making flow unidirectional (toward the heart)
Multiple valves partition the blood not shorter segments within the vein, fighting gravity and promoting the “____ ____”
musculovenous pump
The following describes what vein:
Formed by its tributaries, the medial portion of the foot’s dorsal venous arch, and dorsal vein of the great toe
great saphenous vein
Describe the route of the great saphenous vein
it ascends anterior to the medial malleolus and passes relatively posterior from the medial femoral condyle
The great saphenous vein anastomoses freely with veins between it and the ___ ____ vein
small saphenous
The great saphenous vein traverses the saphenous opening of the fascia late, emptying to the ____ vein
femoral
How many valves does the great saphenous vein have?
10-12, more numerous in leg than in the thigh
The small saphenous vein is formed from what?
the lateral portion of the foot’s dorsal venous arch, and vein of the little toe
Describe the rout of the small saphenous vein
it ascends posterior to the lateral malleolus and passes along the lateral border of the achilles tendon
The small saphenous vein ascends between the heads of ___
gastrocnemius
What vein does the saphenous vein empty into?
popliteal
Great and small saphenous veins have numerous perforating veins. Describe what these veins do.
shunt blood from superficial veins, across deep fascia, to deep veins
The perforating veins from the great and small saphenous veins have valves which only allow flow from ___ to ____
superficial; deep
Perforating veins compress with ___ ____, further preventing blood flowing from the deep to superficial veins
muscle contraction
note: this process is part of the “musculovenous pump”
Most lymph drains via ___ lymph nodes that follow ___ veins to ____ inguinal nodes around the great saphenous and horizontal group inferior from the inguinal ligament
superficial; superficial; superficial
Some lymph vessels follow the small saphenous to ___ nodes
popliteal
There are also deep lymph vessels, following the deep inguinal nodes. True or false?
true
Dermatomes retain the segmental pattern but is distorted due to limb ___ and ___ rotation during fetal development
lengthening; medial
In regards to cutaneous nerve distributions, the lateral superior thigh skin is innervated by what nerve?
lateral femoral cutaneous nerve
What is Meralgia Paresthetica?
the lateral femoral cutaneous nerve gets impinged as it passes deep from the inguinal ligament, often due to obesity, or tight clothing and can cause pain
How are cutaneous nerve distributions different from dermatomes?
cutaneous nerve distributions are patch-like geographic areas across the limb - each being served by a different cutaneous nerve
The larges, longest, heaviest bone in the body is the ___
femur
The head of the femur has a fovea for the attachment of what ligament?
ligament o the head of the femur aka ligamentum teres femoris
What part of the femur is the narrowest?
the neck
note: common fracture site
The neck of the femur is angled ____ from the trochanters, relatively perpindicular from the acetabulum to allow greater freedom of movement
superomedially
The shaft of the femur is angled ____ from the trochanters so that the distal end is positioned near our center of gravity
inferomedially
the angle created by the neck of the femur versus the shaft is called what?
the angle of inclination
Where is the apex of the angle of inclination located? What does this create?
trochanters; leverage for hip abductors and rotators inserting on or near the greater trochanter
What is a disadvantage of the angle of inclination in the femur?
it puts great stress on the bone near the apex and predisposes to fracture, especially in old age when this angle is its greatest
What type of movement do the torsion angle (or angle of declination) and the angle of inclination allow?
rotary movements between the obliquely-oriented head and acetabulum to be translated to the direct flexion-extension, abduction-adduction, etc.
This bone is the second largest bone in the body and transmits the weight of all superior from it onto the talus
tibia
Proximally, the tibia has wide medial and lateral condyles. The articular surfaces of these condyles - which, along with the intercondylar eminence, comprise the ___ ___
tibial plateau
Between the two articular surfaces of the medial and lateral condyles of the tibia is the intercondylar eminence, which is mainly composed of what?
medial and lateral intercondylar tubercles (attachment sites for menisci and cruciate ligaments)
Gerdy’s tubercle is located where? What is it an attachment site for?
anterolaterally at the lateral condyle of the tibia; iliotibial band
The anterior border is subcutaneous throughout its length, as is the medial surface. These are commonly referred to as what?
shin bones
What is the tibial tuberosity the attachment site for?
patellar ligament
This bone is not weight-bearing but serves as muscle attachment and helps form the ankle joint
fibula
The fibula lies posterolateral from the tibia and is firmly attached to it by the ____ ____
tibiofibular syndesmosis
note: this includes the interosseous membrane along the shaft, as well as additional ligaments more distally
fibers of the interosseous membrane in the tibiofibular syndesmosis are angled to resists ____ pull upon the fibula
inferior
Proximally is the fibular head. This has an apex, attachment for the ___ ____ and ____ ____ ligament
biceps femoris; lateral collateral
What structure is located on the distal fibula?
lateral malleolus
The body of the talus rests atop the ____
calcaneous
The head of the talus is anterior to the body and neck of the talus and articulates with which bone?
navicular
What is the largest and strongest bone of the foot?
calcaneus
The posterior part of the calcaneus has a large calcaneal ____, the medial portion does what?
tuberosity; transmits weight toward the ground
Medially, on the calcaneus, is a shelf-like projection to help support the talus called the _____ _____
sustenaculum tali
What are the midfoot bones?
navicular, cuboid, and cuniforms
What are the forefoot bones?
metatarsals and phalanges
