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C&M Lower Limb > Week 2 L2: Thigh and Knee > Flashcards

Week 2 L2: Thigh and Knee Flashcards

1
Q

The lumbosacral plexus gives rise to 3 major branches that innervate the lower limb. What are they?

A
  • femoral nerve
  • obturator nerve
  • lumbosacral trunk
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2
Q

Which ventral rami are the obturator and femoral nerve from?

A

L2, L3 and L4

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3
Q

Which 2 nerves are bound together to make the sciatic nerve?

A

common fibular part and tibial part

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4
Q

Which part of the lower limb does the tibial part of the sciatic nerve innervate?

A

posterior

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5
Q

Which part of the lower limb does the common fibula part of the sciatic nerve innervate?

A

anterior and lateral parts

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6
Q

What is the bone of the thigh?

A

femur

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7
Q

Which bone does the femur articulate with at the knee joint?

A

tibia (large bone of leg)

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8
Q

Which features are seen on the anterior femur?

A
  • shaft
  • adductor tubercle
  • patellar surface
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9
Q

Which features are seen on the posterior femur?

A
  • medial and lateral lips of the linea aspera
  • medial and lateral supracondylar lines
  • medial and lateral condyles
  • intercondylar notch
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10
Q

What are the tibial plateaus?

A

flattened regions of the proximal tibia that articulate with the femoral condyles

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11
Q

What is the anatomical name for the knee cap?

A

patella

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12
Q

What movements are allowed at the knee joint?

A

flexion and extension and a very small degree of rotation

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13
Q

What are the 3 articulations at the knee joint?

A

2 femorotibial - articulation between femur and tibia

1 femoropatella - articulation between femur and patella

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14
Q

What are the menisci?

A
  • crescent shaped ligaments
  • 2 plates of fibrocartilage that deepens the tibial plateau
  • thicker at external margins
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15
Q

What are the functions of the menisci?

A
  • increase joint congruency between the femoral condyles and tibial plateau
  • distribute weight evenly
  • shock absorption
  • assist in locking mechanism
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16
Q

Is the knee joint more stable and congruent in flexion or extension?

A

extension is most congruent and most stable

in flexion, less of the femoral condyles are in contact with the proximal tibia so it is less stable

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17
Q

What are the two collateral ligament in the knee?

A
  1. Fibula collateral ligament

2. Tibial collateral ligament

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18
Q

What is the difference in the fibula collateral and tibial collateral ligament?

A

tibial collateral ligament is attached to the meniscus whereas the fibula collateral ligament isn’t

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19
Q

What is the function of the:

  1. Fibula collateral ligament
  2. Tibial collateral ligament
A
  1. Prevents adduction of the leg at the knee

2. Prevents abduction of the leg at the knee

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20
Q

What is the function of the anterior cruciate ligament?

A
  • prevents anterior displacement of tibia on femur

- prevents hyperextension

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21
Q

What is the function of the posterior cruciate ligament

A
  • prevents posterior displacement of tibia on femur

- prevents hyperflexion

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22
Q

What are the muscles in the enclosed by what?

A

fascia lata

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23
Q

Where do the extensor muscles of the knee lie?

A

anterior thigh

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24
Q

Where do the flexor muscles of the knee lie

A

posterior thigh

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25
Q

What are the muscles found in the anterior thigh?

A
  1. iliopsoas
  2. Pectineus
  3. Quadratus femoris
  4. Sartorius
  5. Tensor fascia lata
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26
Q

What is the function of the pectineus?

A

flexes and abducts the hip

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27
Q

What is the function of the quadratus femoris?

A

4 muscles- “the quads”

  • extension of the knee
  • 1 of them flexes the hip
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28
Q

Where does the sartorius muscle originate and insert?

A

originates at the ASIS and inserts onto the medial tibia

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29
Q

What does the sartorius muscle do?

A

flexes the hip, laterally rotates the hip and flexes the knee
it takes a diagonal course across the medial thigh, crossing the hip and knee so it will act on both

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30
Q

Which nerve innervates the quadratus femoris?

A

femoral nerve L2-L4

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31
Q

What are the 4 muscles that make up the quadriceps femoris, and which one also flexes the hip

A
  1. Vastus intermedius
  2. Vastus Lateralis
  3. Vastus medialis
  4. Rectus femoris (attaches to AIIS so also flexes hip)
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32
Q

Where does the vastus lateralis originate and insert?

A
  • originates at greater trochanter/ linear aspera

- attaches to posterior femur

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33
Q

Where does the vastus medialis originate and insert?

A
  • originates at intertrochanteric line / linea aspera

- attaches to posterior femur

34
Q

What does the great saphenous vein drain into?

A

femoral vein

35
Q 
What is the:
1. Superior border
2. Medial border
3. Lateral border
of the femoral triangle
A
  1. Inguinal ligament
  2. Adductor longus
  3. Sartorius
36
Q

What does the saphenous nerve innervate?

A

skin of medial aspect of leg and foot

37
Q

Which are the adductor muscles in the medial thigh and which one also weakly flexes the knee?

A
  1. Adductor brevis
  2. Adductor longus
  3. Adductor magnus (deeper muscle)
  4. Gracillis (weakly flexes knee)
  5. Pectineus
  6. Obturator externus (deeper muscle)
38
Q

Where does the adductor brevis originate and insert?

A

origin: body of pubis/ inferior ramus
insert: pectineal line/ linear aspera

39
Q

Where does the adductor longus originate and insert?

A

Origin: body of pubis
Insert: middle 1/3 linea aspera

40
Q

Where does the gracilis originate and insert?

A

Origin: body of pubis/ inferior ramus
Insert: tibia

41
Q

Where does the pectineus originate and insert?

A

Origin: superior pubic ramus to pectineal line

42
Q

What are the two parts of the adductor magnus and where do each originate and insert?

A

Adductor part: inferior pubic ramus to gluteal tuberosity and linear aspera
Hamstring part: ischial tuberosity to adductor tubercle

43
Q

Which nerve is the adductor part of the adductor magnus innervated by?

A

obturator nerve

44
Q

Which nerve is the hamstring part of the adductor magnus innervated by?

A

tibial nerve

45
Q

What is the function of:

  1. The adductor part of the adductor magnus?
  2. The hamstring part of the adductor magnus?
A
  1. Adducts the hip

2. Extensor of the hip

46
Q

What is the adductor hiatus?

A

passage way for femoral artery and vein into the popliteal fossa

47
Q

Where does the obturator externus originate and insert?

A

obturator foramen –> trochanteric fossa

48
Q

Which nerve innervates the medial thigh?

A

obturator nerve

49
Q

Where does the obturator nerve exit the pelvis and which muscle does it overlie in the medial thigh?

A
  • exits pelvis through obturator foramen

- overlies adductor brevis

50
Q

Where do the hamstrings in the posterior thigh arise from?

A

ischial tuberoisty

51
Q

What is the function of the hamstrings?

A

extend the hip and flex the knee

52
Q

Which nerve are the hamstrings innervated by?

A

tibial nerve

53
Q

What is the popliteal fossa?

A

diamond-shaped fossa behind the knee

54
Q

What are the boundaries of the popliteal fossa?

A

Medial: Semitendinosus and semi membranosus
Lateral: biceps femoris
Inferior: medial and lateral heads of gastrocneumius

55
Q

When the femoral artery and vein enter the popliteal fossa through the adductor hiatus, what is the name of the vessels they become?

A

popliteal vessels

56
Q

Which division of the sciatic nerve runs directly through the popliteal fossa?

A

tibial nerve

57
Q

What is ‘locking’ the knee?

A

as the knee joint approaches full extension, the femur undergoes a few degrees of medial rotation on the tibia

58
Q

How is the knee ‘unlocked’

A

by the popliteus muscle which laterally rotates the femur

59
Q

Which artery supplies the anterior thigh?

A

femoral artery

60
Q

which artery supplies the posterior thigh and hamstring?

A

profunda femoris

61
Q

Which artery supplies the lateral thigh?

A

lateral femoral circumflex artery

62
Q

The anastomoses around the knee is formed by branches by which arteries?

A

femoral, popliteal and anterior/posterior tibial arteries

63
Q

What are bursae around the knee?

A

fluid filled pouches

64
Q

What is meant by an ‘unhappy triad’?

A
  • combined knee injury
  • excessive lateral twisting of the flexed knee or blow to the lateral side of extended knee
  • tears the tibial collateral ligament which is attached to the medial meniscus which also then tears
  • ACL may tear too
65
Q

The muscles of the thigh are surrounded by a strong layer of fascia called?

A

fascia lata –> divides the thigh into anterior, medial and posterior compartments

66
Q

What is the iliotibial tract?

A

thickened band of the fascia lata on the lateral side of thigh

67
Q

What are the muscles of the anterior thigh?

A
  1. Quadriceps muscles - vastus intermedius, vastus lateralis, vastus medialis and rectus femoris
  2. Sartorius, pectineus and iliopsoas
68
Q

Which common tendon do the quadriceps converge onto?

A

quadriceps tendon

69
Q

How is the patella connected to the tibial tuberosity?

A

via the patellar ligament

70
Q

Which quadricep muscle lies deep to rectus femoris?

A

vastus intermedius

71
Q

What is the common insertion of the quadricep muscles?

A

tibial tuberosity

72
Q

What is the knee jerk reflex?

A
  • peripheral neurological examination
  • tests femoral nerve (and the spinal nerve it contains L2, L3, L4)
  • finds half way point between patella and tibial tuberosity and taps with tendon hammer
73
Q

Which 2 muscles form the medial and lateral floor of the femoral triangle?

A

medial floor - pectineus

lateral floor - iliopsoas

74
Q

What are the muscles in the medial thigh?

A
  • adductor brevis
  • adductor longus
  • adductor magnus
  • obturator externus
  • gracilis
  • pectineus
75
Q

Is a patella fracture more common in males or females?

76
Q

Muscles of the anterior thigh generally act as?

A

hip flexors and knee extensors

77
Q

What forms the:

  1. Floor of popliteal fossa
  2. Roof of popliteal fossa
A
  1. Popliteus muscle

2. fascia lata

78
Q

The popliteal artery is the direct continuation of which vessel?

A

superficial femoral artery

79
Q

The popliteal vein leaves the popliteal fossa and enters the anterior thigh via the adductor hiatus, continuing proximally as which vessel?

A

femoral vein

80
Q

What is a sesamoid bone?

A

bone embedded within a tendon or a muscle e.g patella

81
Q

What nerve innervates the popliteus?

C&M Lower Limb (4 decks)

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