T2 L14 Morphological plan lower limb Flashcards
What are the functions of the lower limb?
Locomotion
Weight bearing
High stresses
How is lower limb different to upper limb?
Limbs are closer together
Extensors are anterior
Flexors are posterior
What are the movements of the lower limb?
Flexion / extension Abduction / adduction Lateral / medial rotation Pronation / supination Circumduction
What movement can’t the lower limb do?
Opposition
What movements can occur at the hip joint?
Flexion / extension
Abduction / adduction
Lateral / medial rotation
What movements can occur at the knee joint?
Extension / flexion
Lateral / medial rotation (when flexed)
What movements can occur at the ankle joint?
Dorsiflexion (extension)
Plantarflexion (flexion)
What movements can occur in the foot joints?
Eversion / inversion
Supination / pronation
Extension / flexion
What are the functional compartments of the thigh?
Anterior - extensors of knee
Posterior - flexors of knee
Medial - adductors of thigh
What are the function compartments of the leg?
Anterior - extensors of foot
Posterior - flexors of foot
Lateral - everters of foot
What are the main gluteal muscles?
Gluteus maximus
Gluteus medius
Gluteus minimus
Tensor fasciae latae
What is the origin, insertion, function and innervation of gluteus maximus?
Origin: ilium
Insertion: gluteal tuberosity and iliotibial tract
Function: extension, lateral rotation, support extended knee
Innervation: inferior gluteal nerve
What is the origin, insertion, function and innervation of gluteus medius?
Origin: ilium
Insertion: greater trochanter of femur
Function: abduction and medial rotation
Innervation: superior gluteal nerve
What is the origin, insertion, function and innervation of gluteus minimus?
Origin: ilium
Insertion: greater trochanter femur
Function: abduction and medial rotation
Innervation: superior gluteal nerve
What is the origin, insertion, function and innervation of tensor fasciae latae?
Origin: anterior iliac crest. ASIS
Insertion: iliotibial tract
Function: stabilise knee joint
Innervation: superior gluteal nerve
What are the small muscles of gluteal region?
Piriformis Gemellus superior Obturator internus Gemellus inferior Quadratus femoris
What is the function of the small muscles of gluteal region?
Stabilise hip
Lateral rotation of extended thigh
What is the origin, insertion, function and innervation of piriformis?
Origin: sacrum
Insertion: greater trochanter femur
Function: stabilise hip, lateral rotation extended thigh
Innervation: branches from sacral plexus
Where do the small muscles of gluteal region originate and insert?
Originate from ischium / ischiopubic ramus
Insert onto greater trochanter
Apart from piriformis
What are the muscles in the anterior compartment of the thigh?
Quadriceps
Sartorius
Iliopsoas
What muscles make up the quadriceps?
Rectus femoris
Vastus lateralis
Vastus medialis
Vastus intermedius
What is the origin, insertion, function and innervation of rectus femoris?
Origin: AIIS, femur
Insertion: tibial tuberosity
Function: knee extension, hip flexion
Innervation: femoral nerve
What is the origin, insertion, function and innervation of vastus lateralis?
Origin: AIIS, femur
Insertion: tibial tuberosity
Function: extend knee
Innervation: femoral nerve
What is the origin, insertion, function and innervation of vastus medalis?
Origin: AIIS, femur
Insertion: tibial tuberosity
Function: extend knee
Innervation: femoral nerve
What is the origin, insertion, function and innervation of vastus intermedius?
Origin: AIIS, femur
Insertion: tibial tuberosity
Function: extend knee
Innervation: femoral nerve
What is the origin, insertion, function and innervation of sartorius?
Longest strap muscle in body Origin: ASIS Insertion: medial side tibia Function: flexion at hip and knee Innervation: femoral nerve
What is the origin, insertion, function and innervation of iliopsoas?
Origin: lumbar vertebrae and iliac fossa pelvis
Insertion: lesser trochanter femur
Function: flex thigh at hip joint
Innervation: anterior rami L1-3, femoral nerve
What muscles are in the posterior compartment of the thigh?
Hamstrings
What muscles make up the hamstrings?
Semimembranosus
Semitendinosus
Biceps femoris
What is the origin, insertion, function and innervation of semimembranosus?
Origin: ischial tuberosity
Insertion: medial surface tibia
Function: flexion at knee, extension at hip, medial rotation at hip and knee
Innervation: sciatic nerve
What is the origin, insertion, function and innervation of semitendinosus?
Origin: ischial tuberosity
Insertion: medial surface tibia
Function: flexion at knee, extension at thigh, medial rotation at hip and knee
Innervation: sciatic nerve
What is the origin, insertion, function and innervation of biceps femoris?
Origin: ischial tuberosity, linea aspera of femur
Insertion: proximal end fibula
Function: flexion at knee, extension of thigh, lateral rotation of hip and knee
Innervation: sciatic nerve
What muscles are in the medial compartment of thigh?
Adductor longus Adductor brevis Adductor magnus Pectineus Gracilis
What is the origin, insertion, function and innervation of adductor longus?
Origin: pubis
Insertion: linea aspera femur
Function: adduction thigh
Innervation: obturator nerve
What is the origin, insertion, function and innervation of adductor brevis?
Origin: body pubis, inferior pubic rami
Insertion: linea aspera on posterior surface femur
Function: adducts thigh
Innervation: obturator nerve
What is the origin, insertion, function and innervation of adductor part of adductor magnus?
Origin: ischiopubic ramus
Insertion: linea aspera
Function: adduct thigh, flex thigh
Innervation: obturator nerve
What is the origin, insertion, function and innervation of hamstring part of adductor Magnus?
Origin: ischial tuberosity
Insertion: adductor tubercle
Function: adduct thigh, extend thigh
Innervation: sciatic nerve
What is the origin, insertion, function and innervation of pectineus?
Origin: pectineal line on anterior surface pelvis
Insertion: pectineal line on posterior side femur
Function: adduction and flexion at hip
Innervation: femoral nerve
What is the origin, insertion, function and innervation of gracilis?
Origin: inferior rami pubis, body of pubis
Insertion: medial surface tibia
Function: adducts thigh at hip, flexes leg at thigh
Innervation: obturator nerve
What muscles flex the thigh?
Rectus femoris
Sartorius
Iliopsoas
What muscles abduct thigh?
Gluteus medius
Gluteus minimus
What muscles extend thigh?
Gluteus maximus
Hamstrings
Hamstring part adductor magnus
What muscles adduct thigh?
Adductor longus Adductor brevis Adductor part of adductor magnus Pectineus Gracilis
What muscles medially and laterally rotate thigh?
Gluteal muscles
Hamstrings
Adductors
Short rotators
Where does the nerve supply to the lower limb come from?
Lumbar and sacral plexus
Where does the obturator nerve come from and what does it pass through?
From lumbar plexus of L2-L4
Passes through obturator foramen
What does obturator nerve supply?
Motor to medial compartment of thigh except pectineus and hamstring part of adductor magnus
Sensory to skin over medial thigh
Where does sciatic nerve come from and where does it go?
From sacral plexus L4 to S3
Passes through greater sciatic foramen to emerge inferior to piriformis
What does sciatic nerve supply?
Motor to posterior compartment of thigh, leg, foot and hamstring part of adductor magnus
Sensory to skin over leg and foot, except for medial side
Where does the sciatic nerve terminate?
At apex of popliteal fossa into tibial nerve and common fibular nerve
What branches off tibial nerve and what does it supply?
Sural nerve branch for sensory supply to lateral foot
What does the common fibular nerve divide into?
Superficial fibular
Deep fibular
Where does the femoral nerve come from and pass?
From lumbar plexus L2 to L4
Passes through inguinal ligament
What does the femoral nerve supply?
Motor to anterior compartment of thigh
Sensory to skin over anterior thigh, knee, medial side of leg and foot
What branches off the femoral nerve and what does it supply?
Saphenous nerve for sensory supply to medial leg / foot
What muscle does saphenous nerve sit under?
Sartorius muscle
Describe the blood supply to lower limb
External iliac artery passes through inguinal ligament to become femoral artery
Passes through adductor hiatus to become popliteal artery which divides into anterior and posterior tibial arteries
What is the femoral triangle?
Area in anterior thigh where many large neurovascular structures pass
What are the borders of the femoral triangle?
Superiorly - inguinal ligament
Laterally - medial border sartorius muscle
Medially - medial border adductor longus
Anteriorly - fascia lata
Posteriorly - pectineus, iliopsoas, adductor longus
What is contained in the femoral sheath?
Femoral artery
Femoral vein
Femoral canal containing lymphatics
What is not contained in femoral sheath?
Femoral nerve
What are some clinical applications of the femoral triangle?
Femoral hernia through inguinal canal
Angioplasty
Femoral nerve block
Venepuncture
Describe the venous drainage of the lower limb
Deep veins follow arteries
2 major superficial veins:
- great / long saphenous vein
- small / short saphenous vein
Describe the great saphenous vein
Longest vein in body
Drains medial side of dorsal venous arch
Drains medial side limb
Drains into femoral vein in femoral triangle
Describe the small saphenous vein
Drains lateral side of dorsal venous arch
Pierces deep popliteal fossa to drain into popliteal vein
Describe the lymphatics of the lower limb
Follows general pattern of superficial and deep veins
Superficial inguinal nodes - drain skin and superficial fascia of lower limb
Deep inguinal nodes found beside femoral vein
