Texas Tech questions Flashcards
Which nerve provides cutaneous innervation to the medial leg and foot, but no motor innervation?
Saphenous nerve
Which nerve sensorily innervates the distal third of the leg and dorsal surface of the foot
superficial fibular nerve
Which nerve innervates the muscles of the anterior compartment of the leg and skin between 1st and second toe?
deep fibular nerve (Foot drop is primary symptom)
Which nerve is responsible for foot drop, and which muscles are involved in this?
Deep fibular/peroneal nerve
Innervates the tibialis anterior, extensor digitorum longus, extensor hallucis longus, and fibularis tertius muscles, The extensor digitorum brevis and the first two dorsal interossei muscles in the dorsum of the foot
Where does the great saphenous vein travel in respect to the knee and ankle?
Travels posterily to medial condyle of femur and then anterior to medial malleolus
Where does the lesser saphenous vein travel in the ankle?
Posterior to the lateral malleolus
Where do the lymph from the skin of the lower limbs drain?
They drain into the superficial inguinal lymph nodes
- Anal canal below pectinate line, external genitalia, lower abdominal wall drain to inguinal lymph nodes
Which nerve provides cutaneous innervation to the lower anterior leg and dorsum of the foot?
Superficial fibular
What do the anterior femoral cutaneous branches of the femoral nerve provide sensory innervation to
medial and anterior thigh
Which nerve provides sensory innervation to the posterior surface of the leg and lateral side of foot
lateral sural cutaneous nerve from the common fibular nerve
What are the boundaries of the femoral triangle
Superior: Inguinal ligament
Lateral: Medial edge of sartorius
Medial: medial edge of adductor longus
Which structures pass deep to the inguinal ligament
Femoral nerve, artery, and vein, psoas major
What is the primary nerve responsible for adduction
Obturator
When walking, the action of the iliopsoas muscle results in what motion at the hip joint?
Flexion
The pulse of the femoral artery is best felt at which superficial reference point?
Femoral triangle
If the femoral artery is occluded at the beginning of the adductor canal, which artery could help provide viability to the leg through collateral circulation?
Descending branch of the lateral circumflex femoral
At which site could one expect to enter the femoral vein with a simple percutaneous (through the skin) introduction of an instrument?
Medial to the femoral arterial pulse (NAVL with nerve being most laterally)
What is the roof of the adductor canal
Sartorius
What are the contents of the adductor canal
Femoral artery, femoral vein, saphenous nerve, nerve to vastus medialis
What makes up the posterior boundary of the adductor canal
Adductor longus and magnus
What makes up the lateral boundary of the adductor canal
Vastus medialis
What are the boundaries of the adductor canal
Roof/lateral: Sartorius
Posterior/deep boundary: Adductor longus
Medial boundary: Vastus medialis
Contents: Femoral artery/vein, saphenous nerve, nerve to vastus medialis
Which artery supplies blood to the femoral neck
Medial circumflex femoral
Which artery supplies the lateral thigh and hip
Descending branch of lateral circumflex femoral
Which artery supplies posterior thigh
Perforating branches of deep femoral artery
Where does the femoral artery branch into the deep femoral artery
In the femoral triangle
What are the most important leg extensors
the quadriceps muscles
Which nerve impairment results in impaired adduction
Obturator nerve
Which nerve impairment results in trendelenburg’s sign
superior gluteal nerve (pelvis drops on supported side, gluteus minimus and medius are not working) (i.e. stand on L leg with L leg muscles hurt, R leg (uninjured) will drop).
Where do the femoral vessels leave the adductor canal, travel to the posterior thigh, and become the popliteal vessels?
At the adductor hiatus (in the distal thigh, between 2 insertions of adductor magnus ( Adductor tubricle for hamstring and gluteal tuberosity for adductor part)
Which nerve lies between the illiacus and psoas major muscles
The Femoral nerve
Which nerve injury causes foot drop
Deep fibular/peroneal nerve (Distal branch of sciatic n)
Where does the deep femoral artery branch from the femoral artery
in the femoral triangle (and then travels deep in thigh, posterior to adductor longus
Which artery provides collatoral circulation at the apex of the femoral triangle
descending branch of the lateral circumflex femoral
- It anastamoeses with the descending genicular branch of femoral artery and lateral sperior branch of popliteal
Which muscles and nerves are primarily responsible for hip abduction? Which are of lesser importance?
Superior gluteal nerve, supplying the Gluteus medius, gluteus minimus, and tensor fasciae late.
- Periformis, Obturator internus, Sup and inf gemelli abduct flexed hip (Also laterally rotate extended hip)
In respect to the adductor longus, which arteries run along it?
The Femoral artery is superficial to the adductor longus, the deep femoral artery( profunda femoris) is deep to the adductor longus
What artery supplies blood to the femoral neck
Medial circumflex femoral
Lateral circumflex femoral
( called cruciate anastamoses)
Which nerve provides cutaneous innervation to the medial side of the leg
The saphenous nerve
Which nerve provides cutaneous innervation to the skin of the posterior surface of the lower leg and lateral side of the foot
Lateral sural cutaneous nerve (off fibular nerve)
- When more in foot area, becomes superficial fibular nerve
What nerves does the common fibular nerve give rise to
lateral sural cutaneous nerve, superficial fibular nerve, deep fibular nerve
What vein does the lateral sural cutaneous nerve run directly next to
the lesser saphenous vein
Which nerve causes a pelvis dip on the ipsilateral side as weightbearing when injured?
Superior gluteal nerve (innervating gluteus medius and minimus)
The team doctor tells a football player that he has “a pulled hamstring” muscle. This results from a tearing of the origin of a hamstring muscle from the:
Ischial tuberosity
Where do the hamstring muscles insert
Tibia and fibula (biceps)
Innervations of hamstrings
Tibial of sciatic (common fibular (peroneal) for Short head of biceps)
If the head of the femur is dislocated postero-medially, compression of which nerve is likely to result?
Sciatic nerve ( If the sciatic nerve was completely paralyzed, the compartments innervated by its two branches: the common fibular and tibial nerves, would lose function. This would mean that the hamstrings and all the muscles of below the knee would lose their innervation.)
What muscle passes through the lesser sciatic foramen?
obturator internus
The femoral artery enters the popliteal fossa (becoming the popliteal artery) by passing through the:
Adductor hiatus
The short head of biceps femoris muscle is innervated by which nerve?
Common fibular nerve (all other hamstrings are tibial)
As a patient with paralyzed gluteus medius and minimus muscles on the left side attempts to stand on the left limb only, the right side of the pelvis typically:
Drops
What is the deepest structure in the popliteal fossa
Popliteal artery- if there was a femur fracture and it was dislocated posteriorly, could hurt popliteal artery
The deep femoral artery is the principle blood source for the muscles in which compartment of the thigh?
Posterior (hamstring)
The femoral artery is the principle blood source for the muscles in which compartment of the thigh?
the quadriceps (anterior compartment)
The obturator artery is the principle blood source for the muscles in which compartment of the thigh?
Medial compartment (Also supplied by medial circumflex and deep femoral)
Which arteries supply the gluteal region
superior and inferior gluteal arteries
A fracture of the ischial tuberosity might be expected to most directly affect the muscles that produce which lower limb movement?
Flexion at the knee
- Hamstrings muscles originate at ischial tuberosity
What are the most important hip abductors, and which nerve injury will impact them most?
Gluteus medius and minimus- superior gluteal nerve
What are the most important hip adductors
adductor longus, brevis, magnus
- insert on linea aspera, innervated by obturator nerve
When, in approximately 12% of people, the common fibular nerve passes through the piriformis muscle, the nerve may be compressed. This would affect part of which muscle?
The short head of the biceps femoris is innervated by the common fibular nerve ( peroneal nerve)
- The other hamstrings (semitendinous, semimembranous, biceps long head are innervated by the tibial nerve)
An elderly patient complains of difficulty in walking up stairs. Tests by her doctor reveal weakness in extension at her hip, but no change in hip flexion, or flexion or extension of the knee. Based upon these results, what muscle is most likely not functioning properly.
Gluteus maximus
- Extends thigh.
Not Semitendinosus because, although that extends thigh, it also flexes knee
Weakness in climbing stairs or jumping would indicate a lesion of which nerve?
Inferior gluteal
- Weakness in hip extension (gluteus maximus is pimary mover)
- Or, Tibial division of sciatic, Hamstrings extend hip
Which arteries supply the posterior compartment of the thigh
Perforating branches of deep femoral artery
Which muscles rotate the thigh laterally
Sartorius
Gluteus maximus
Obturator externus
Quadratus femoris
Periformis and Obturator internus and superior and inferior gemellus also do when the hip is extended