Superficial And Osseous Lower Limb Flashcards
Gluteal Region
Boundary?
Composed of?
- transition between the trunk, superiorly, and the free lower limb, inferiorly
- posterior rounded buttock and the lateral hip region
- bounded by iliac crests, superiorly-the gluteal folds, inferiorly-the intergluteal fold (natal fold), medially-greater trochanter, laterally-ASIS to greater trochanter, anteriorly
What composes the gluteal region?
-gluteal muscles and fat comprise the majority
Thigh region
- inferior from the gluteal, abdominal, and perineal regions, superiorly
- to the knee region, posteriorly
- and ischiopubic ramus, medially
Knee region
- includes the prominences of the distal femur, proximal tibia, and proximal fibula-as well as their joints, between them
- posterior knee includes the popliteal fossa, the fat-filled hollow transmitting neurovascular structures
Leg region
-located inferior from the knee, through the narrow distal portion of the leg
Ankle region
-flared portion between leg and foot, including medial and lateral malleoli
Foot region
-includes most of the tarsus, as well as the metatarsus and phalanges
Subcutaneous tissue location?
-lies deep from lower extremity skin, and superficial from lower extremity deep fascia
Subcutaneous tissue consists of?
-loose connective tissue that contains variable amounts of fat, cutaneous nerves, superficial veins, superficial lymph vessels and nodes
Subcutaneous tissue at the knee
-loses some of its fat and blends with the deep Fascia-although, fat resumes distal from the knee
Subcutaneous tissue function?
-insulation, storage of fat, transmittal of vessels/nerves to and from the the skin
Superficial veins location
-located superficial from deep fascia (while deep veins are located deep from deep fascia)
Superficial vein valves
-both superficial and deep veins have valves (deep veins have more) (inferior veins have more)
Musculovenous pump
-multiple valves partition the blood into shorter segments within the vein, fighting gravity and promoting the musculovenous pump
Great saphenous vein tributaries?
-medial portion of the foot’s dorsal venous arch, and dorsal vein of the great toe
Great saphenous vein path
- ascend anterior to the medial malleolus
- passes relatively posterior along the medical knee region (hand width from the medial margin of the patella)
- anastomoses freely with veins b/t it and the small saphenous vein
- transverse the cribriform fascia of subcutaneous tissue that covers the saphenous opening of the Fascia late, then terminates into the femoral vein
how many valves does the great saphenous vein have?
- 10 to 12
- more numerous in the leg than in the thigh
Small saphenous vein tributaries
-formed from the lateral portion of the foot’s dorsal venous arch, and dorsal vein of the little toe
Small saphenous vein path
- ascends posterior to the lateral malleolus
- passes along the lateral border of the Achilles’ tendon
- ascends b/t the heads of the gastrocnemius
- crosses deep fascia, and empties to the popliteal vein
Perforating veins of the great and small saphenous veins
- veins that shunt blood from superficial veins, across deep fascia, to deep veins
- have valves (only allow flow from superficial to deep)
- compress with muscle contraction
Musculovenous pump
- as a muscle contracts within a covering of deep fascia, pressure within the compartment builds
- outward pressure compresses and squeezes the deep veins, making their blood flow out, with their valves assuring that flow is toward the heart.
- when muscle relaxes and pressure decreases, blood flows back in and the process repeats
Superficial Lymphatics
-most lymph drains superficial lymph vessels that follow superficial veins to superficial inguinal nodes
Superficial inguinal nodes
-2 subgroups
- vertical group=around the great saphenous
- horizontal group=inferior from the inguinal ligament
Dermatomes
-individual spinal nerves, retain the segmental pattern (but distorted due to limb lengthening and medial rotation (pronation) during fetal development
Cutaneous nerve distributions
- area of skin served by a cutaneous nerve after having mixed within the lumbar or sacral plexus
- rather than dermatomes stripes. These are patch-like geographic areas across the limb-each being served by a different cutaneous nerve
Lateral superior thigh skin
What is it called when it is impinged?
-inebriated by the lateral femoral cutaneous nerve
Meralgia Paresthetica–impinged as it passes deep from the inguinal ligament (obesity or thigh clothing) and can cause pain of that cutaneous nerve distribution
Pelvic Girdle
- bony ring, composed of sacrum, right and left hip bones, joined anteriorly at the pubic symphysis and posteriorly at the sacroiliac joints
- attaches the free lower limb with the axial skeleton
Hip bone/ Pelvic bone
-3 bones?
- ilium, pubis, and ischium
- converge at the acetabulum, initially separated by cartilage, called the triradite cartilage, fuse b/t ages of 16-25
Ilium
Body?
Ala?
- largest and most superior
- body forms the superior part of the acetabulum
- ala is a broad wing-like posterolateral portion, for wide fleshy attachment of muscles
Anterior superior and anterior inferior iliac spines (ASIS and AIIS)
-attachment sites of ligaments and tendons of the lower limb
Iliac crest
-attachment site for thin sheet-like muscles and deep fascia, coursing from ASIS to PSIS
Tubercle of the iliac crest (iliac tubercle)
- thickening of the crest 5-6cm posterior from the ASIS
- origin of the iliotibial tract
posterior superior iliac spine
-attachment to skin, forming skin dimple- a surface landmark for the posterior extent of the iliac crest
Posterior inferior iliac spine
-superior extent of the greater sciatic notch
Fovea of femur
-attachment of the Ligament of the Head of the Femur
Patella
- largest sesamoid bone in the body
- base where quadriceps tendon attaches
- apex where patella ligament attaches
- posterior surface has a smaller medial facet and larger lateral facet (that articulate with the femoral trochlea
Tibia
- second largest bone in the body
- transmits weight of everything superior from it, onto the Talus
Fibula
- not weight bearing
- serves as muscle attachment and helps form the ankle joint
Superficial Lymphatics
- majority of lymph drains along Lymphatics that follow superficial veins, to superficial nodes
- eventually drain along external iliac and common iliac (deep) nodes
