T2 L14: morphological plan of the lower limb

Question 1

what modifications does bipedalism allow in the lower limb

Answer 1

• locomotion
• weight bearing
• High stresses

Question 2

where are the extensors and flexors located

Answer 2

extensors are anterior

flexors are posterior

medial rotation in development week 6-8 brings posterior compartment anterior

Question 3

lower limb movements

Answer 3

Flexion/Extension

Abduction/Adduction

Lateral/medial rotation

Pronation/supination

Circumduction

no opposition

Question 4

what are the joints of the lower limb and their movements

Answer 4

hip joint:
-flexion,adduction,extension,abducgion, lateral and medial rotation

Ankle joint:

• Plantarflexion- flexion
• dorsiflexion- extension

Knee joint:
-extension, flexion, lateral and medial rotation

joint of the foot:
Eversion, inversion
Supination, pronation
Extension, flexion

Question 5

what are the functional components of the lower limb

Answer 5

Gluteal

Thigh:

• Anterior (Extensors of knee)
• Posterior (Flexors of knee)
• Medial (Adductors of thigh)

Leg:
- Anterior	(Extensors of foot)
- Posterior	(Flexors of foot)
- Lateral 	(Everters of foot)
Foot

Question 6

what are the movements and muscles of the thigh

Answer 6

Flexion:
Rectus femoris
Sartorius
Iliopsoas (Iliacus and psoas major

Abduction:
Gluteus medius
Gluteus minimus

extension :
Gluteus maximus
Hamstrings
Hamstring part of adductor magnus

adduction: 
Adductor longus
Adductor brevis
Adductor part of adductor magnus
Pectineus
Gracilis

Also MEDIAL and LATERAL ROTATION
:
Gluteal muscles, hamstrings, adductors and short rotators

Question 7

what are the nerve supplies

Answer 7

Lumbar plexus :
Anterior rami L1 to L4

sacral plexus :
Anterior rami L4 and L5
(via lumbosacral trunk)
Anterior rami S1 to S4

Femoral nerve
(L2-L4)

Obturator nerve (L2-L4)

Sciatic nerve (L4-S3)

Question 8

describe the femoral nerve

Answer 8

passes through inguinal ligament

from lumbar plexus

forms sapheneous nerve

Motor: Anterior compartment of thigh

Sensory: Skin over anterior thigh, knee, medial side of leg and foot

Question 9

describe the obturator nerve

Answer 9

from lumbar plexus

passes through the obturator foramen

Motor: Medial compartment of thigh
(except pectineus and hamstring part of adductor magnus)

Sensory: Skin over medial thigh

Question 10

describe the sciatic nerve

Answer 10

From sacral plexus

passes through the greater sciatic foramen and popliteal fossa -where it forms the tibial nerve & common fibular nerve (divides into deep and superficial fibular)

tibial nerve goes on to form the sural nerve-sensory to lateral foot

Motor: Posterior compartment of thigh, and leg and foot
(+hamstring part of adductor magnus)

Sensory: Skin over leg and foot (except medial side)

Question 11

what is the blood supply to the lower limb

Answer 11

External iliac artery

Femoral artery
- Profunda femoris artery (to posterior thigh)

Popliteal artery

Anterior and posterior tibial arteries

Question 12

what is the femoral triangle made up off

Answer 12

the sartorius

adductor longus

inguinal ligament

Question 13

what passes through the femoral triangle

Answer 13

femoral nerve and femoral vein and arteries

Question 14

describe the special arrangement of the femoral sheath

Answer 14

Laterally: Femoral nerve-

femoral sheath:

• fem artery
• fem vein
• fem canal-lymphatics

Question 15

clinical significance of the femoral triangle

Answer 15

Clinical – femoral hernia (femoral canal), angioplasty, femoral nerve block, venepuncture

Question 16

what does the femoral artery supply

Answer 16

abductor magnus

Question 17

what does the popliteal artery divide into

Answer 17

at popliteal fossa-

anterior and posterior tibial arteries

Question 18

what does the tibial artery supply

Answer 18

Deep flexors and flexor retinaculum

Question 19

what is the venous drainage of the lower limb

Answer 19

Deep veins follow arteries

Two major superficial veins:

• Great or long saphenous vein
• Small or short saphenous vein
  - Drain dorsal venous arch of foot

Question 20

clinical significance of venous drainage

Answer 20

Clinical – Varicose veins (damage to valves in perforating veins leads to pooling of blood in superficial veins - varicosities)

Question 21

describe the great saphenous vein

Answer 21

Longest vein in body

Drains medial side of arch

Medial side of limb

Drains into femoral vein in femoral triangle

and forms dorsal venous arch

Question 22

describe the short saphenous vein

Answer 22

Drains lateral side of arch

Pierces deep politeal fascia

Drains into popliteal vein

Question 23

describe the lymphatic drainage of the lower limb

Answer 23

Follows general pattern of superficial and deep veins

- Superficial inguinal nodes
Drain skin and superficial fascia of lower limb

- Deep inguinal nodes
Beside femoral vein

Question 24

study the dermatomes of slide 33

Answer 24

how was it