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BPK326 > Unit 5: Lower Limb > Flashcards

Unit 5: Lower Limb Flashcards

1
Q

what muscles make up the glutes?

A
  • gluteus maximus
  • gluteus medius
  • gluteus minimus
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2
Q

what is the collective function of the glutes?

A

abduction and extension of the thigh at the hip joint

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3
Q

what are the OIIs of gluteus maximus?

A
  • O: thoracolumbar fascia, gluteal fossa of the iliac wing, sacrotuberous ligament, posterior and inferior sacrum and coccyx
  • I: iliotibial tract, gluteal tuberosity
  • I: inferior gluteal nerve
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4
Q

what muscle produces the shape of the buttocks?

A

gluteus maximus (most superficial)

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5
Q

what is the sacrotuberous ligament?

A
  • extends from PSIS of ilium and dorsolateral sacrum and coccyx to the ischial tuberosity
  • forms the wall of the greater and lesser sciatic foramina
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6
Q

what is the inferior gluteal nerve?

A

branch of the sciatic nerve
- formed by S1 and S2

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7
Q

what are the OIIs of gluteus medius?

A
  • O: gluteal fossa of the iliac wing
  • I: greater trochanter
  • I: superior gluteal nerve
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8
Q

what are the As of gluteus maximus?

A
  • extension of the thigh at the hip
  • external rotation of the thigh at the hip
  • abduction of the thigh at the hip
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9
Q

what is the superior gluteal nerve?

A

branch of the sciatic nerve
- formed by L5 and S1

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10
Q

what are the As of gluteus medius?

A
  • abduction of the thigh at the hip
  • internal rotation (anterior fibers) of the thigh at the hip
  • external rotation (posterior fibers) of the thigh at the hip
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11
Q

what are the OIIs of gluteus minimus?

A
  • O: gluteal fossa of the iliac wing
  • I: greater trochanter
  • I: superior gluteal nerve
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12
Q

what are the As of gluteus minimus?

A
  • abduction of the thigh at the hip
  • internal rotation of the thigh at the hip
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13
Q

what are the deep posterior thigh muscles?

A
  • piriformis
  • superior gemellus
  • obturator internus
  • inferior gemellus
  • quadratus femoris
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14
Q

what is the collective function of the deep posterior thigh muscles?

A

stabilize head of the femur at the acetabulum and externally rotate thigh

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15
Q

what are the OIIs of piriformis?

A
  • O: anterior surface of the sacrum
  • I: greater trochanter
  • I: nerve to piriformis (S1-S2)
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16
Q

what are the As of piriformis?

A
  • external rotation of the thigh at the hip
  • abduction of the thigh at the hip (if the hip if flexed)
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17
Q

what are the OIIs of superior gemellus?

A
  • O: ischial spine
  • I: greater trochanter
  • I: nerve to obturator internus (L5-S1)
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18
Q

what are the As of superior gemellus?

A
  • external rotation of the thigh at the hip
  • abduction of the thigh at the hip (if the hip is flexed)
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19
Q

what are the OIAIs of obturator internus?

A
  • O: posterior surface of the obturator membrane
  • I: greater trochanter, trochanteric fossa
  • A: external rotation of the thigh at the hip
  • I: nerve to obturator internus (L5-S1)
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20
Q

what are the OIIs of inferior gemellus?

A
  • O: ischial tuberosity
  • I: greater trochanter
  • I: nerve to quadratus femoris (L4-S1)
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21
Q

what are the As of inferior gemellus?

A
  • external rotation of the thigh at the hip
  • abduction of the thigh at the hip (if the hip is flexed)
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22
Q

what are the OIIs of quadratus femoris?

A
  • O: ischial tuberosity
  • I: intertrochanteric crest
  • I: nerve to quadratus femoris (L4-S1)
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23
Q

what are the As of quadratus femoris?

A
  • external rotation of the thigh at the hip
  • adduction of the thigh at the hip
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24
Q

what are the muscles of the posterior compartment of the thigh?

A

hamstrings
- biceps femoris long head
- biceps femoris short head
- semitendinosus
- semimembranosus

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25
Q

what is the function of 3 of the hamstrings?

A
  • hip extensors
  • flexes leg at knee
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26
Q

what are the OIIs of the long head of biceps femoris?

A
  • O: ischial tuberosity
  • I: head of fibula, lateral condyle of tibia
  • I: tibial nerve
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27
Q

what are the As of the long head of biceps femoris?

A
  • extension of the thigh at the hip
  • flexes the leg at the knee
  • laterally (external) rotation of the leg if the leg is fixed
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28
Q

what are the OIIs of the short head of biceps femoris?

A
  • O: linea aspera
  • I: head of the fibula, lateral condyle of the tibia
  • I: common fibular (peroneal) nerve
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29
Q

what are the As of the short head of biceps femoris?

A
  • flexes the leg at the knee
  • laterally (external) rotation of the leg if the leg is fixed
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30
Q

what are the OIIs of semitendinosus?

A
  • O: ischial tuberosity
  • I: proximal end of tibia below medial condyle via pes anserinus
  • I: tibial nerve
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31
Q

what are the As of semitendinosus?

A
  • extends the thigh at the hip
  • flexes the leg at the knee
  • internally rotates the leg at the knee
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32
Q

what are the OIIs of semimembranosus?

A
  • O: ischial tuberosity
  • I: medial condyle of tibia
  • I: tibial nerve
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33
Q

what are the As of semimembranosus?

A
  • extends the thigh at the hip
  • flexes the leg at the knee
  • internally rotates the leg at the knee
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34
Q

what is the small saphenous vein?

A
  • lateral vein of the posterior leg draining into the popliteal vein at the popliteal fossa
  • drains fibular vein
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35
Q

where is the small saphenous vein in rabbits?

A

superficial vein that lies along the inferior border of biceps femoris
- separates biceps femoris from semimembranosus and semitendinosus

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36
Q

what are the muscles of the anterior hip?

A
  • iliacus
  • psoas major
  • tensor fasciae latae
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37
Q

what are the OIIs of iliacus?

A
  • O: iliac fossa
  • I: lesser trochanter of femur as iliopsoas tendon
  • I: femoral nerve
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38
Q

what are the As of iliacus?

A
  • flexion of the thigh at the hip
  • flexion of the trunk at the hip (ex. from supine)
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39
Q

what are the OIIs of psoas major?

A
  • O: transverse processes L1-L5
  • I: lesser trochanter of femur as iliopsoas tendon
  • I: femoral nerve
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40
Q

what are the As of psoas major?

A
  • flexes the thigh at the hip
  • flexes the trunk
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41
Q

what is the most powerful hip flexor?

A

iliopsoas

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42
Q

what are the OIIs of tensor fasciae latae?

A
  • O: anterior superior iliac spine
  • I: iliotibial tract
  • I: superior gluteal nerve
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43
Q

what are the As of tensor fasciae latae?

A
  • internal rotation of the thigh at the hip
  • flexes the thigh at the hip
  • abducts the thigh at the hip
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44
Q

what are the muscles of the anterior thigh?

A
  • sartorius
  • quadriceps femoris
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45
Q

what is problematic about pectineus?

A

located in the medial compartment but grouped in the anterior compartment
- adductor (medial) but innervated by the femoral nerve (anterior)

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46
Q

what are the muscles of quadriceps femoris?

A
  • rectus femoris
  • vastus medialis
  • vastus intermedialis
  • vastus lateralis
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47
Q

what are the OIAIs of pectineus?

A
  • O: superior pubic remus (pectineal line of pubic bone)
  • I: pectineal line of femur
  • A: adducts the thigh at the hip
  • I: femoral nerve
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48
Q

what are the OIIs of sartorius?

A
  • O: anterior superior iliac spine
  • I: proximal end of tibia below medial condyle (via pes anserinus)
  • I: femoral nerve
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49
Q

what are the As of sartorius?

A
  • flexes the thigh at the hip
  • flexes the leg at the knee
  • externally rotates the thigh at the hip
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50
Q

what are the OIIs of rectus femoris?

A
  • O: anterior inferior iliac spine
  • I: tibial tuberosity, patella (common quadriceps tendon)
  • I: femoral nerve
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51
Q

what are the As of rectus femoris?

A
  • flexion of the thigh at the hip
  • extension of the leg at the knee
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52
Q

what are the OIAIs of vastus medialis?

A
  • O: linea aspera, intertrochanteric line
  • I: tibial tuberosity, patella (common quadriceps tendon)
  • A: extension of leg at knee
  • I: femoral nerve
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53
Q

what are the OIAIs of vastus intermedius?

A
  • O: anterior surface of the femoral shaft (body of femur)
  • I: tibial tuberosity, patella (common quadriceps tendon)
  • A: extension of the leg
  • I: femoral nerve
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54
Q

what are the OIAIs of vastus lateralis?

A
  • O: linea aspera, greater trochanter
  • I: tibial tuberosity, patella (common quadriceps tendon)
  • A: extension of the leg
  • I: femoral nerve
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55
Q

what is the collective function of the muscles of the anterior thigh (excluding pectineus)?

A

extend the leg at the knee and flex the thigh at the hip

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56
Q

what are the muscles of the medial thigh?

A
  • obturator externus
  • adductor brevis
  • adductor longus
  • adductor magnus
  • gracilis
  • pectineus
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57
Q

what are the OIAIs of obturator externus?

A
  • O: anterior side of obturator membrane
  • I: trochanteric fossa
  • A: adducts the thigh at the hip when flexed
  • I: obturator nerve
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58
Q

what are the OIIs of adductor brevis?

A
  • O: body and inferior ramus of pubis
  • I: linea aspera
  • I: obturator nerve
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59
Q

what are the As of adductor brevis?

A
  • adducts the thigh at the hip
  • externally rotates the thigh at the hip
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60
Q

what is the collective function of the muscles of the medial thigh?

A

hip adductors innervated by the obturator nerve

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61
Q

what are the OIIs of adductor longus?

A
  • O: body of pubis
  • I: linea aspera
  • I: obturator nerve
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62
Q

what are the As of adductor longus?

A
  • adducts the thigh at the hip
  • externally rotates the thigh at the hip
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63
Q

what are the OIAIs of the adductor part of adductor magnus?

A
  • O: inferior pubic ramus, ischial ramus
  • I: linea aspera
  • A: adduction of the thigh at the hip
  • I: obturator nerve
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64
Q

what are the OIAIs of the hamstring part of adductor magnus?

A
  • O: ischial tuberosity
  • I: adductor tubercle of femur
  • A: extends the thigh at the hip
  • I: sciatic nerve
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65
Q

what are the OIIs of gracilis?

A
  • O: body and inferior ramus of pubis
  • I: pes anserinus
  • I: obturator nerve
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66
Q

what are the As of gracilis?

A
  • adducts the thigh at the hip
  • flexes the leg at the knee
  • internally rotates the leg at the knee
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67
Q

what is the adductor hiatus?

A

gap between adductor magnus and femur that allows passage for the femoral artery, femoral vein, and saphenous nerve (terminal branch of femoral nerve)

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68
Q

what is the femoral nerve?

A

main division of the lumbar plexus, formed by L2-L4 spinal nerves

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69
Q

what is the femoral artery?

A

distal continuation of the external iliac artery past the inguinal ligament; continues as the popliteal artery at the popliteal fossa

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70
Q

what is the femoral vein?

A

drains all venous circulation of the lower limb, distal to the inguinal canal

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71
Q

what is the sciatic nerve?

A

formed by S1 and S2 spinal nerves, passes through the greater sciatic foramen
- bifurcates into tibial and common fibular nerves at the popliteal fossa

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72
Q

what is the inferior gluteal nerve?

A

derived from L5-S2 spinal nerves, passes through greater sciatic foramen

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73
Q

what is the popliteal artery?

A

distal continuation of femoral artery, bifurcates into the anterior tibial artery and posterior tibial artery

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74
Q

what is the popliteal vein?

A

drains the small saphenous vein, anterior tibial vein, posterior tibial vein

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75
Q

what is the tibial nerve?

A

terminal branch of the sciatic nerve

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76
Q

what are the landmarks of the proximal femur?

A
  • head
  • fovea capitis
  • neck
  • greater trochanter
  • lesser trochanter
  • intertrochanteric line
  • intertrochanteric crest
  • trochanteric fossa
  • pectineal line
  • gluteal tuberosity
  • linea aspera
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77
Q

what is the function of the head of the femur?

A

interacts with acetabulum of pelvis

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78
Q

what is the fovea capitis?

A

small depression in the head where the foveal ligament attaches to stabilize the hip

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79
Q

what is the function of the greater trochanter?

A

attachment point for hip abductors and external rotators of the thigh
- on posterior side

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80
Q

what is the function of the lesser trochanter?

A

attachment for iliopsoas
- posteromedial side

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81
Q

what is the function of the intertrochanteric line?

A

where the neck and the shaft join; attachment for iliofemoral ligament
- anterior

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82
Q

what is the function of the intertrochanteric crest?

A

joins trochanters
- posterior

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83
Q

where is the trochanteric fossa?

A

fossa in intertrochanteric crest on the posterior side

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84
Q

what is the function of the pectineal line?

A

insertion for pectineus
- medial, posterior side

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85
Q

what is the function of the gluteal tuberosity?

A

insertion for glute max
- posterior

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86
Q

what is the function of linea aspera?

A

attachment for adductors of the thigh
- posterior

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87
Q

what are the landmarks of the distal femur?

A
  • patellar surface
  • lateral condyle
  • medial condyle
  • lateral epicondyle
  • medial epicondyle
  • intercondylar fossa
  • lateral supracondylar line
  • medial supracondylar line
  • adductor tubercle
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88
Q

what is the patellar surface?

A

small anterior depression to allow for articulations with the patella
- anterior

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89
Q

what is the lateral condyle of the femur?

A

posterior protrusion, articulates with lateral condyle of the tibia and lateral meniscus + attachment for ACL

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90
Q

what is the medial condyle of the femur?

A

posterior protrusion, articulates with medial condyle of the tibia and medial meniscus + attachment for PCL

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91
Q

what is the lateral epicondyle for the femur?

A

posterior above lateral condyle; attachment for LCL

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92
Q

what is the medial epicondyle of the femur?

A

posterior above medial condyle; attachment for MCL

93
Q

where is the intercondylar fossa?

A

posterior, in between condyles

94
Q

what is the lateral supracondylar line?

A

posterior, lateral continuation of linea aspera

95
Q

what is the medial supracondylar line?

A

posterior, medial continuation of linea aspera

96
Q

what is the adductor tubercle?

A

on the medial condyle, tendinous attachment for adductor magnus

97
Q

what are the landmarks of the proximal tibia?

A
  • lateral condyle
  • medial condyle
  • intercondylar eminences (left and right)
  • tibial tuberosity
  • Gerdy’s tubercle
  • articular facet for fibula
  • anterior border
  • interosseous border
  • soleal line
98
Q

what is the function of the medial condyle of the tibia?

A

attachment for semimembranosus and MCL

99
Q

what is the function of the lateral condyle of the tibia?

A

attachment for iliotibial tract and LCL

100
Q

what is the tibial tuberosity?

A

anterior, distal attachment for the patellar ligament

101
Q

what is the Gerdy’s tubercle?

A

insertion for the iliotibial tract
- on anterior part of lateral condyle

102
Q

where is the articular facet for fibula?

A

on inferior part of lateral condyle

103
Q

what is the soleal line of the tibia?

A

attachment for popliteus, soleus, flexor digitorum longus, tibialis posterior
- formed by origin of soleus muscle
- on upper posterior surface

104
Q

what are the landmarks of the distal femur?

A
  • medial malleolus
  • fibular notch
105
Q

what is the function of the medial malleolus?

A

articulates with talus, attaches medial (deltoid) ligament

106
Q

what is the function of the fibular notch?

A

distal articulation with fibula on lateral side

107
Q

what are the landmarks of the fibula?

A
  • head of fibula (proximal)
  • articular facet (on head)
  • lateral malleolus
  • malleolar fossa
108
Q

what is the lateral malleolus?

A

forms lateral border of ankle joint, attachment for anterior talofibular ligament and calcaneofibular ligament

109
Q

what is the function of the malleolar fossa?

A

attachment for the posterior talofibular ligament

110
Q

what are the landmarks of the foot?

A
  • calcaneus
  • talus
  • navicular
  • cuboid
  • medial cuneiform
  • intermediate cuneiform
  • lateral cuneiform
  • metatarsals
  • phalanges
111
Q

what is the calcaneus?

112
Q

what is the talus?

A

receives the weight of the body via the tibia; divides force between calcaneus and forefoot

113
Q

what is the navicular?

A

located between talus and 3 cuneiforms; provides tendinous attachment to help maintain the longitudinal arch of the foot

114
Q

where is the cuboid bone?

A

most lateral bone in the distal row of tarsal bones, cube shaped

115
Q

what are characteristics of the cuneiform bones?

A
  • medial = largest
  • intermediate = smallest
  • lateral articulates with cuboid
116
Q

how many phalanges does each digit have?

A

big toe has 2 (proximal and distal), rest have 3 (proximal, middle, distal)

117
Q

what are the muscles of the anterior compartment of the leg?

A
  • tibialis anterior
  • extensor digitorum longus
  • extensor hallucis longus
118
Q

what is the function and innervation of the anterior compartment of the leg?

A

dorsiflex and invert the foot at the ankle, innervated by the deep peroneal (fibular) nerve

119
Q

what are the OIIs of tibialis anterior?

A
  • O: lateral condyle of the tibia, lateral aspect of the tibia, interosseous membrane of the leg
  • I: base of the first metatarsal; medial cuneiform bone
  • I: deep peroneal nerve
120
Q

what are the As of tibialis anterior?

A
  • dorsiflexes the foot at the ankle
  • inverts the foot at the ankle
121
Q

what are the OIIs of extensor digitorum longus?

A
  • O: lateral condyle of the tibia, medial aspect of the fibula, interosseous membrane of the leg
  • I: middle and distal phalanges of the lateral 4 digits
  • I: deep peroneal nerve
122
Q

what are the As of extensor digitorum longus?

A
  • dorsiflexes the foot at the ankle
  • extends the lateral 4 digits
123
Q

what are the OIIs of extensor hallucis longus?

A
  • O: medial aspect of the fibula, interosseous membrane of the leg (halfway, distal to other muscle origins)
  • I: base of the first distal phalanx
  • I: deep peroneal nerve
124
Q

what are the As of extensor hallucis longus?

A
  • dorsiflexes the foot at the ankle
  • extends the big toe
125
Q

what are the muscles of the lateral compartment of the leg?

A
  • fibularis (peroneus) longus
  • fibularis (peroneus) brevis
126
Q

what is the function and innervation of the lateral compartment of the leg?

A

evert the foot at the ankle (prevent excessive inversion), innervated by superficial peroneal (fibular) nerve

127
Q

what are the OIIs of fibularis (peroneus) longus?

A
  • O: head of the fibula, lateral surface of the fibula
  • I: base of the first metatarsal, medial cuneiform bone
  • I: superficial peroneal nerve
128
Q

what are the OIIs of fibularis (peroneus) brevis?

A
  • O: lateral fibula (distal)
  • I: base of the fifth metatarsal
  • I: superficial peroneal nerve
129
Q

what are the As of fibularis longus and fibularis brevis?

A
  • everts the foot at the ankle
  • weakly plantar flexes the foot at the ankle
130
Q

what are the muscles of the superficial posterior compartment of the leg?

A
  • gastrocnemius
  • soleus
  • plantaris
131
Q

what is the function and innervation of the superficial posterior compartment of the leg?

A

plantar flexion of the foot, innervated by the tibial nerve

132
Q

what are the Os of gastrocnemius?

A
  • lateral head: lateral epicondyle of the femur
  • medial head: medial epicondyle of the femur
133
Q

what are the IIs of gastrocnemius?

A
  • I: tuber calcanei (calcaneus tubercle - back of heel bone) via the calcaneal (Achilles) tendon
  • I: tibial nerve
134
Q

what are the As of gastrocnemius?

A
  • plantar flexes the foot at the ankle (leg extended)
  • flexes the leg at the knee
135
Q

what are the OIIs of soleus?

A
  • O: posterior fibula, soleal line of the tibia
  • I: tuber calcanei (calcaneus tubercle - back of heel bone) via the calcaneal (Achilles) tendon
  • I: tibial nerve
136
Q

what are the As of soleus?

A
  • plantar flexes the foot at the ankle (independent of leg extension)
  • high percentage of slow twitch fibres
137
Q

what are the OIAIs of plantaris?

A
  • O: lateral supracondylar line of the femur
  • I: tuber calcanei (calcaneus tubercle - back of heel bone) via the calcaneal (Achilles) tendon
  • A: weakly plantar flexes the foot at the ankle
  • I: tibial nerve
138
Q

what is the calcaneal (Achilles) tendon?

A

strongest and largest tendon of the body

139
Q

what are the muscles of the deep posterior compartment of the leg?

A
  • popliteus
  • flexor hallucis longus
  • flexor digitorum longus
  • tibialis posterior
140
Q

what are the OIIs of popliteus?

A
  • O: lateral epicondyle of the femur
  • I: proximal posterior tibia
  • I: tibial nerve
  • covers popliteal fossa
141
Q

what are the As of popliteus?

A
  • flexes the leg at the knee
  • internally rotates the leg at the knee
142
Q

what are the OIIs of flexor hallucis longus?

A
  • O: posterior fibula; IOM
  • I: base of the first distal phalanx
  • I: tibial nerve
  • posterior, lateral
143
Q

what are the As of flexor hallucis longus?

A
  • flexes the big toe
  • weakly plantar flexes the foot at the ankle
144
Q

what are the OIIs of flexor digitorum longus?

A
  • O: posterior tibia (body)
  • I: base of distal phalanges of toes 2-5
  • I: tibial nerve
  • posterior, medial
145
Q

what are the As of flexor digitorum longus?

A
  • flexes the toes
  • plantar flexes the foot at the ankle
  • inverts the foot at the ankle
146
Q

what are the OIIs of tibialis posterior?

A
  • O: posterior fibula, posterior tibia, IOM
  • I: lateral cuneiform bone, intermediate cuneiform bone, medial cuneiform bone, tuberosity of the navicular bone
  • I: tibial nerve
  • between digitorum longus and hallucis longus
147
Q

what are the As of tibialis posterior?

A
  • plantar flexes the foot at the ankle
  • inverts the foot at the ankle, major role in supporting the medial arch
148
Q

what muscles are missing in the rabbit?

A
  • tibialis posterior
  • extensor hallicus longus
  • adductor brevis
149
Q

what landmark divides the hip region from the thigh region?

A

greater trochanter of the femur

150
Q

where does the inguinal ligament attach?

A
  • anterior superior iliac spine
  • pubic tubercle
151
Q

what joint anchors the pelvis to the vertebral column?

A

sacroiliac joint: between sacrum and ilium
- permits minimal movement and is designed to transfer force from pelvis to sacrum
- heavily facilitated by ligaments

152
Q

what can cause pelvic girdle pain during or after pregnancy?

A

movement at the SI joint

153
Q

what are the ROMs of flexion/extension at the hip joint?

A
  • flexion: 110-120 degrees
  • extension: 10-15 degrees
154
Q

what are the ROMs of abduction/adduction at the hip joint?

A
  • abduction: 30-50 degrees
  • adduction: 25-30 degrees
155
Q

what are the ROMs of external/internal rotation at the hip joint?

A
  • external rotation: 40-60 degrees
  • internal rotation: 30-40 degrees
156
Q

how does pelvic rotation accompany extreme hip flexion?

A

posterior pelvic rotation/tilt with lumbar flexion

157
Q

how does pelvic rotation accompany extreme hip extension?

A

anterior pelvic rotation/tilt with lumbar extension

158
Q

what is the collum/inclination angle?

A

angle between the femoral shaft and the neck

159
Q

what is a normal inclination angle and how does it vary among individuals?

A
  • 125-130 degrees = in line with centre of acetabulum
  • in tall people, the angle is larger
  • in short people, the angle is smaller
160
Q

what is coxa vara?

A

a decrease in the inclination angle
- unaligns with centre with acetabulum

161
Q

what is coxa valga?

A

an increase in the inclination angle
- unaligns with centre of acetabulum

162
Q

what is the angle of anteversion/femoral torsion?

A

the angle the femoral neck makes with the acetabulum in the transverse plane
- can have excessive anteversion or retroversion

163
Q

what is a normal angle of anterversion?

A

5-15 degrees anterior to the mediolateral axis

164
Q

what angle of anteversion are most infants born with?

A

30 degrees
- decreases to 15 degrees by 6 years of age because of bone growth and increased muscle activity

165
Q

what type of joint is the hip and what makes it more stable than the shoulder joint?

A

ball-and-socket
- deep socket (acetabulum) enclosing the femoral head
- surrounded by many muscles
- reinforced by multiple intrinsic ligaments

166
Q

what is the foveal ligament (ligamentum teres)?

A

intracapsular ligament
- consists of 2 bands that originate on the ischial and pubic sides of the acetabular notch and insert on the fovea capitis of the femoral head

167
Q

what are the extracapular ligaments that reinforce the hip joint?

A

anterior:
- ileofemoral ligament
- pubofemoral ligament
posterior:
- ischiofemoral ligament

168
Q

what ligaments are the major components of the lateral pelvic wall?

A
  • sacrospinous ligament
  • sacrotuberous ligament
169
Q

what is the sacrotuberous ligament?

A

fan shaped ligament, with a broad base extending from the PSIS and the dorso-lateral sacrum and coccyx to the ischial tuberosity
- forms the wall of the greater and lesser foramina

170
Q

what is the sacrospinous ligament?

A

smaller ligament, with its apex attached to the ischial spine and its based attached to the lateral sacrum and coccyx

171
Q

what is the fascia of the lower limb called?

A
  • deep fascia of the thigh: fascia lata
  • deep fascia of the leg: crural fascia
172
Q

what does the fascia lata specialize into?

A

the fascia lata is thick laterally, forming the iliotibial tract

173
Q

what is one of the most common causes of lateral knee pain in endurance athletes?

A

iliotibial tract (band) syndrome (ITBS)
- fricion of the IT band against the lateral epicondyle of the femur with flexion and extension of the knee may cause inflammation of the IT band over the lateral aspect of the knee or at Gerdy’s tubercle
- can also occur in hip region in older individuals

174
Q

what are the superficial gluteal muscles?

A
  • glute max
  • glute med
  • glute min
  • tensor fascia latae
175
Q

what are the deep gluteal muscles?

A
  • piriformis
  • obturator internus
  • superior gemellus
  • inferior gemellus
  • quadratic femoris
176
Q

what nerve roots form the sacral plexus and what does it innervate?

A
  • L4-S4
  • muscles of the gluteal region and the entire lower limb
177
Q

what are the branches of the sacral plexus?

A
  • superior gluteal nerve
  • inferior gluteal nerve
  • nerve to piriformis
  • sciatic nerve
178
Q

what nerves arise from the lumbar plexus (L2-L4)?

A
  • femoral nerve
  • obturator nerve
179
Q

what do lumbosacral nerves exit through?

A

greater sciatic foramen

180
Q

what characteristic distinguishes gluteus minimus?

A

shiny aponeurosis

181
Q

what is the function of the deep glute muscles?

A

external rotators of the thigh at the hip

182
Q

why is piriformis clinically important?

A

directly over neurovascular structures
- most importantly the sciatic nerve

183
Q

what is the pudendal nerve?

A

sensory nerve for pelvic organs including genitals, rectum, anus
- crucial for continence and sexual function

184
Q

where is psoas major in cross-sections?

A

immediately adjacent to lumbar vertebrae

185
Q

what is the only muscle in the anterior compartment that has substantial contribution to flexion of thigh at hip?

A

rectus femoris
- sartorius helps

186
Q

how does rectus femoris appear in cross-sections?

A
  • proximally: 2 distinct bellies
  • distally: small tendon
187
Q

what muscle envelopes the femur in cross-sections?

A

vastus intermedius

188
Q

when does the femoral artery turn into the popliteal artery?

A

distal to the adductor hiatus

189
Q

what is the femoral triangle?

A

a subfascial space in the proximal anterior thigh, containing nerves, vasculature, and lymph vessels passing into the lower limb

190
Q

what structures create the femoral triangle?

A
  • medial border of sartorius
  • lateral border of adductor longus
  • inguinal ligament
  • pectineus makes the floor
191
Q

what is the lateral-to-medial order of neurovasculature in the femoral triangle?

A

femoral:
- nerve
- artery
- vein
NAV

192
Q

what is the midpoint of the inguinal ligament?

A

halfway between the ASIS and the pubic tubercle
- landmark for the femoral nerve

193
Q

what is the mid-inguinal point?

A

halfway between the ASIS and the pubic symphysis
- landmark for the femoral artery

194
Q

what is the process of a coronary angiography?

A
  • catheter inserted in leg and guided up the aorta
  • catheter tip stops at the left coronary artery
  • contrast agent injected to show any stenosis (narrowing) that can be opened using a balloon catheter
195
Q

how is a femoral nerve block used for analgesia?

A

for procedures in the anterior thigh (trauma to the thigh/hip)
- needle injected into the femoral triangle near the femoral nerve

196
Q

where is the adductor canal and what is its purpose?

A
  • lies deep to sartorius
  • extends from the apex of the femoral triangle to the adductor hiatus in the tendon in adductor magnus
  • tunnel in which NAV travels from front to back of thigh
197
Q

what muscles border the adductor canal?

A
  • anterior: sartorius
  • lateral: vastus medialis
  • posterior: adductor longus and adductor magnus
198
Q

what is the tibial nerve?

A

medial branch of sciatic nerve, innervates posterior compartment

199
Q

what is the common peroneal nerve?

A

lateral branch of sciatic nerve, bifurcates into deep and superficial peroneal nerves

200
Q

what does the deep peroneal nerve innervate?

A

anterior compartment of the leg

201
Q

what does the superficial peroneal nerve innervate?

A

lateral compartment of the leg

202
Q

what is the genicular anastamosis?

A

a network of vessels surrounding the knee that are capable of maintaining circulation to the leg in full knee flexion

203
Q

what arteries make up the genicular anastomosis?

A
  • superior lateral genicular a.
  • inferior lateral genicular a.
  • superior medial genicular a.
  • inferior medial genicular a.
204
Q

what does the popliteal artery branch into distal to the popliteal fossa?

A
  • anterior tibial artery
  • posterior tibial artery
205
Q

what does the anterior tibial artery supply?

A

anterior compartment
- lateral branch, travels anteriorly through posterior musculature

206
Q

what does the posterior tibial artery branch into?

A
  • distal continuation of posterior tibial artery
  • fibular artery
    medial branch
207
Q

what does the posterior tibial artery supply?

A

posterior compartment

208
Q

what does the fibular artery supply?

A

lateral compartment

209
Q

what drains the fibular artery?

A

small saphenous vein

210
Q

what is the patella?

A

a triangle-shaped bone that articulates in the intercondylar notch of the femur and is embedded in the tendon of the quadriceps femoris muscle above and the patellar tendon below

211
Q

what does the patella do?

A

elevates the quadriceps muscle from the center of knee rotation + provides leverage for extending the leg

212
Q

what does removal of the patella compromise?

A

leg extension

213
Q

what are the 2 different articulations of the knee?

A
  • tibiofemoral joint
  • patellofemoral joint
214
Q

what is the tibiofemoral joint?

A

medial and lateral condyles of the distal femur articulate with the medial and lateral condyles of the proximal tibia

215
Q

what is the patellofemoral join?

A

the anterior distal femur articulates with the patella
- intercondylar notch of femur

216
Q

what type of joint is the knee and what movements does it permit?

A

modified hinge joint
- flexion (130-140 degrees)
- extension (0- -10 degrees)

217
Q

what causes the patella to experience a laterally directed force?

A

the force of the quadriceps muscle contraction transmitted through the tibial tuberosity

218
Q

what force resists the laterally directed force of the patella?

A

vastus medialis

219
Q

what is the quadriceps (Q) angle?

A

angle formed by the bisection of two lines:
- ASIS to centre of patella
- centre of patella to tibial tuberosity

220
Q

what does the Q angle measure?

A

the tendency of the patella to move laterally when the quadriceps muscles are contracted

221
Q

what is a normal Q angle?

A
  • males: 8-14
  • females: 15-17
222
Q

what is genu varum?

A

bow-legged
- Q angle is reduced
- distal bones are pointing medially

223
Q

what is genu valgum?

A

knock-kneed
- Q angle is increased
- distal bones are pointing laterally

224
Q

what intrinsic factors contribute to excessive lateral tracking of the patella?

A
  • hypertrophy of vastus lateralis
  • weakness of vastus medialis
  • tight iliotibial band
225
Q

what extrinsic factors contribute to excessive lateral tracking of the patella?

A
  • weak external rotators or abductors of the hip (causing internal rotation of the femur)
  • pronation of the foot
226
Q

what is the unhappy/terrible/horrible triad?

A

simultaneous tear of the ACL, medial meniscus, and MCL
- caused by a lateral force

227
Q

what are menisci?

A

fibrocartilage structures in the knee
- act as shock absorbers
- deepen the articular surface of the tibia, to increase stability

228
Q

what is the medial meniscus attached (fused) to?

A

MCL
- tend to be damaged together

BPK326 (5 decks)

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