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ACE Unit 1 > TBL 7 - Anterior & Medial Thigh and Anterior & Lateral Leg > Flashcards

TBL 7 - Anterior & Medial Thigh and Anterior & Lateral Leg Flashcards

1
Q

What mesoderm layer forms chondroblasts and osteoblasts of the hip bones and bones of the lower limb?

A

Parietal layer of lateral plate mesoderm

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2
Q

What is the difference in morphogenesis between the upper and lower limbs?

A

The upper limb rotates 90 degrees laterally, the lower limb rotates 90 degrees medially.

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3
Q

Bones that make up the hip joint

A

Acetabulum composed of the ilium, pubis, and ischium along with the head of femur

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4
Q

What three ligaments hold the hip joint together and what do they do? Which one is strongest and which one is weakest? How do they hold the joint together to enable extension and flexion

A

Iliofemoral - strongest - prevents hyperextension
Ischiofemoral - weakest - most hip dislocations are posterior
Pubofemoral - prevents overabduction
They spiral around. They tighten during extension (less mobility) and unwind during flexion (more mobility)

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5
Q

What are avulsion fractures of the hip bone?

A

Small piece of bone with some ligament or tendon is torn away. Occurs at apophyses (no secondary ossification centers) and occurs where muscles are attached (ASIS, AIIS, ischial tuberosities, ischiopubic rami)

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6
Q

How do spiral fractures and comminuted fractures of the femur differ?

A

Spiral is where there is foreshortening as the fragments override
Comminuted is where the bone is broken into several pieces. Way worse

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7
Q

Bones that make up the knee joint

A

articulation of the femoral and tibial condyles

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8
Q

What causes Osgood-Schlatter disease and what are its symptoms?

A

It is where the epiphysial plate at the tibial tuberosity is disrupted resulting in inflammation at the tuberosity. Common in young athletes who get chronic recurring pain.

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9
Q

How does angle of inclination change with age and what is the effect?

A

The angle becomes more acute which increases the strain on the neck of the femur resulting in more fractures

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10
Q

Most stable position of knee is

A

Erect, extended position. Contact of articular surfaces is maximized and ligaments are taut

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11
Q

Lateral collateral ligament attachments and what separates it from the lateral meniscus

A

lateral epicondyle of femur to fibular head. The popliteus muscle

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12
Q

Medial collateral ligament attachments

A

medial epicondyle of femur to superomedial surface of tibia. Also connected to medial meniscus. Stronger than LCL

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13
Q

posterior cruciate ligament

A

posterior intercondylar area of tibia to the anterior medial condyle of the femur. Prevents anterior displacement and hyper flexion of leg and is stronger than the ACL

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14
Q

anterior cruciate ligament

A

anterior intercondylar area of tibia to the posterior lateral condyle of the femur. Prevents posterior displacement and hyperextension of leg.

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15
Q

How can twisting of the flexed knee create the “unhappy triad” injury?

A

MCL is torn and with it goes the medial meniscus since they are connected. The ACL is taut during flexion and is vulnerable to being torn once the medial meniscus is torn

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16
Q

What are the anterior and posterior drawer signs?

A

Anterior drawer sign is where the tibia slides anterior of the femur when the ACL is ruptured.
Posterior drawer sign is where the tibia slides posterior to femur when PCL is ruptured

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17
Q

What is the articular cartilage and what function does the meniscus perform?

A

Articular cartilage is hyaline cartilage with no perichondrium. The meniscus projects into the synovial cavity and provides shock absorption and load distribution for the knee

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18
Q

What characterizes all joints of the upper and lower limbs

A

Synovial cavities, synovial membranes (cuboidal epithelium that produces synovial fluid for lubrication), and articular cartilage

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19
Q

What is the pathogenesis of osteoarthritis, the most common form of arthritis?

A

ECM degradation and chondrocyte metabolism. Decreases glycosaminoglycan content and increased water content. Disease of the articular cartilage

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20
Q

What forms the great saphenous vein and what forms the small saphenous vein and describe their course up the leg.

A

Great - dorsal vein of big toe and dorsal venous arch. anterior to medial malleolus, posterior to medial condyle of femur and into femoral vein
Small - dorsal vein of little toe and dorsal venous arch. posterior to lateral malleolus, lateral border of calcanea tendon and into the popliteal vein

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21
Q

where do the lymphatic vessels drain in the leg

A

The one following the great saphenous vein drains into the inguinal lymph nodes and the small drains into the popliteal lymph nodes

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22
Q

Which nerves innervate which part of the cutaneous thigh

A

Femoral = anterior
Obturator = medial
Lateral cutaneous nerve of thigh = lateral
Posterior cutaneous nerve of thigh = posterior

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23
Q

Which nerves innervate which part of leg

A

Saphenous = anteromedial leg and medial of ankle
common fibular = inferolateral leg
Superficial fibular = lateral side of ankle

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24
Q

Why does the great saphenous vein or its tributaries often become varicose? Why can a deep vein thrombus in the lower limb be fatal?

A

The valves in the veins become dilated or rotated and therefore ineffective. The clot in the lower limb can travel to the small capillaries in the lungs and cause a pulmonary thromboembolism

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25
When is a saphenous cutdown required and where can sensory loss occur after the procedure?
Used to insert a cannula for prolonged administration of blood, plasma expanders, electrolytes, or drugs. Sensory loss can occur on medial border of foot
26
Iliopsoas muscle
formed by union of posts major and iliacus. Distal attachment is the lesser trochanter of the femur
27
What muscles flex the thigh
Iliopsoas (chief) and sartorius and gracilis help
28
Sartorius
ASIS to superomedial tibia
29
What muscles flex the knee
Sartorius helps
30
Four quadricep muscles and its tendon
Rectus femoris - ASIS - flex thigh and extend knee rest extend leg vastus medialis (intertrochanteric line and medial lip of linea aspera) vastus intermedius (anterior and lateral surface of shaft of femur) vastus lateralis (greater trochanter and lateral lip of linea aspera Tendon continues as patellar ligament attaching to the tibial tuberosity
31
Function of patella
Bony surface that withstands compression on quadriceps tendon and the friction when knee is flexed and extended. Also provides leverage for quadriceps by moving tendon more anteriorly and farther from joint axis
32
What is the kicking a soccer ball muscle?
Rectus femoris
33
What does the supra patellar bursa do?
It is continuous with the synovial cavity of the knee joint and is between the femur and quadriceps tendon to cushion it
34
How is suprapatellar bursitis related to popliteal (Baker) cysts?
suprapatellar bursitis is caused by infection and could result in leakage of synovial fluid which is what the popliteal cysts consist of
35
Adductor longus and adductor portion of adductor magnus attachments and what else adducts
Longus - body of pubis Magnus - ischiopubic ramus Distal - linea aspera Gracilis
36
What attaches to the ischial tuberosity?
hamstring portion of adductor magnus
37
Gracilis
Ischiopublic ramus to superomedial tibia
38
Where is the gracilis muscle used for transplantation and why is lower limb function not noticeably compromised?
The muscle with nerves and blood vessels can replace hand muscles or external anal sphincter. It is a synergist so it is not essential to lower limb function
39
Hip pointer
contusion of iliac crest
40
Charley horses
cramping on thigh muscle due to ischemia or contusion that forms a hematoma. Usually tears of the rectus femoris. Direct trauma is usually the cause
41
Groin pulls
Tearing of proximal attachments of anteromedial thigh muscles
42
Boundaries of femoral triangle
Superior = inguinal ligament (ASIS to body of pubis) Lateral - Sartorius Medial - Adductor longus
43
Origin and course of femoral nerve
Spinal cord L2-L4, lateral aspect of femoral triangle, innervates anterior thigh muscles, saphenous nerve is terminal cutaneous branch
44
What lesions might cause diminution or loss of the patellar tendon reflex?
Lesions that disrupts innervation of quadriceps, like those affecting the femoral nerve
45
Origin and course of obturator nerve
Spinal cord L2-L4, through the obturator foramen to innervate medial thigh muscles
46
Role and what is inside the femoral sheath
The femoral vein, artery, and lymphatic vessels that enter the abdominopelvic cavity and the sheath allows them to glide under the inguinal ligament while the hip joint moves
47
Course of the femoral artery
External iliac artery becomes this and the femoral artery supplies the anterior and anteromedial thigh. Early on, the deep artery of the thigh branches from it
48
Course of the obturator artery
Along obturator nerve into the medial thigh
49
What branches off the deep artery of the thigh
Medial circumflex femoral artery supplies the head and neck of femur
50
How does palpation of the femoral arterial pulse differ from palpation of an enlarged femoral hernia?
Palpation of the femoral arterial pulse requires firm pressing between the ASIS and pubic symphysis. Palpation of a hernia is easier and the area is tender
51
Why can aseptic vascular necrosis of the displaced femoral head occur after femoral neck fractures?
The medial circumflex femoral artery could be damaged and the blood supply from the artery into the ligament of the femoral head is not enough to supply the bone
52
What are compartment syndromes and how are prolonged symptoms relieved?
There are two compartments in the leg and trauma or inflammation or something that increases the size of the muscles or builds pressure in a compartment can compress structures or impede circulation in that compartment. A fasciotomy would relieve the pressure
53
How are tibialis anterior muscle strains and deep fibular nerve entrapment distinguished by their symptoms?
tibialis anterior muscle strains - pain in distal two thirds of tibia and muscles are swollen/tender Deep fibular nerve entrapment - pain in dorsum of foot that radiates between the first two toes
54
Tibialis anterior attachments/function
tibia to plantar surface of medial foot - dorsiflexes ankle and inverts foot
55
Extensor digitorum longus and extensor hallucis longus
tibia to dorsal of the toes - extends lateral four digits and dorsiflexes ankle and the hallucis muscle extends the big toe and also dorsiflexes ankle
56
What does the deep fibular nerve innervate?
The tibialis anterior, extensor digitorum longus and extensor hallucis longus
57
Fibularis longus and fibularis brevis
Longus - fibula to the plantar surface Brevis - fibula to the lateral side of foot Longus is posterior around the lateral malleolus
58
What does the superficial fibular nerve innervate?
Fibularis longus and fibularis brevis
59
How does the femoral artery divide?
It becomes the political artery in the proximal leg and then bifurcates into the anterior tibial and posterior tibial arteries
60
What does the anterior tibial artery become
The dorsal pedis artery on the dorsum of the foot to the first interosseous space leading to the digital arteries to the big toe
61
Why is the common fibular (peroneal) nerve frequently injured and what are the symptoms after its injury?
It is superficial around the fibular neck. Causes footdrop because all the dorsiflexors are knocked out (they are all controlled by the deep fibular nerve). Some loss of sensation on the anterolateral leg and dorsum of foot
62
Where is the dorsal pedis pulse palpated and what is the most common cause of its diminution or absence?
Palpated just lateral to EHL tendon. Diminution of pulse is sign of arterial disease

ACE Unit 1 (8 decks)

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