WK11+12 Flashcards
Compare and contrast the UE with the LE.
Similarities: girdles, long bones with 2 parallel distal bones, carpals/tarsals into metacarpals/tarsals, 2 thumb/toe phalanxes
Differences: UE=more mobile than LE, pectoral girdle is an incomplete ring whereas pelvis is complete. fibular does not connect to femur whereas both radius and ulna articulate with humerus, leg cannot pronate or supinate.
Review structures that connect to iliac crest, ASIS, AIIS, PSIS, Ischial Spine, Ischial Tuberosity etc.
see question #2 on study guide…
Where do the following ligaments live and what is their job ? Iliofemoral, Pubofemoral, ischiofemoral, Ligamentum Teres
Iliofemoral lig: AIIS to inner trochanteric line of femur, responsible for preventing hyperext.
Pubofemoral: obturator crest to joint capsule of femoral head, prevents hyperabduction.
Ischiofemoral: ischial portion of acetabular rim to femoral neck, becomes taught during hip flexion
Ligamentum Teres: fovea of the femoral head, contains small artery supplying femoral head.
Why is the coxafemoral joint so stable ?
deep ball and socket joint, strong ligaments, various muscles cross the joint and reinforce existing structures.
What are the contents of the femoral triangle in order from lateral to medial ?
Femoral, Nerve, Artery, Vein, Lymph Nodes ( N.A.V.L)
Detail the pathways and innervations of the common nerves in thigh region.
Femoral: under inguinal ligament through femoral triangle, supplying motor innervation to anterior muscle quadriceps group, and sensory to antero-medial thigh
Saphenous: branch of femoral nerve, last cutaneous branch, supplies anteromedial knee, leg, foot.
Clunial: arises directly from sponal nerves, supplies skin of buttocks, three different branch regions
Superior Gluteal: arises from lumbosacral plexus through greater sciatic notch, passes superior to piriformis and suppplies glut med and min, TFL muscles
Inferior Gluteal: exits pelvis through greater sciatic foramen, deep to piriformis, supplies glut max
Sciatic: exits pelvis through greater sciatic foramen, inferior to piriformis, supplies muscles of posterior thigh and skin of leg and foot.
N. to quadratus femoris: exits pelvis through greater sciatic foramen, inferior to piriformis, supplies quadratus femoris and inf. gemellus
N. to obturator internus: exits pelvis through greater sciatic foramen, inferior to piriformis, supplies obturator internus and sup. gemellus
Post Femoral Cut: exits pelvis through greater sciatic foramen, inferior to piriformis, supplies posterior thigh and proximal leg
Pudendal: exits pelvis through greater sciatic foramen, inferior to piriformis, re-enters in lesser sciatic notch, supplies some perineum and genital structures
List and describe the area of skin supplied by thigh dermatomes.
L1= Inguinal Region
L2= middle and lateral aspect of anterior thigh
L3= medial epicondyle
L4= medial malleolus
L5= dorsum of foot
S1= lateral malleoulus
S2= middle of popliteal fossa
S3= gluteal crease
S4= peri-anal area
Describe peripheral cutaneous named nerves of the thigh.
See question #7a on study guide, and diagram.
What are the myotomes for the hip, knee, foot, and toes?
Hip;
lat/ext hip rotation: L5, S1
medial/int rotation: L4, L5
Adduction: L2-L4
Abduction: L5-S1
Extension: L4, L5
Flex: L2, L3
Knee;
flex: L5, S1
ext: L3, L4
Foot;
Inversion: L4, L5
Eversion: L5, S1
Dorsiflexion: L4, L5
Plantar flexion: S1, S2
Toe;
flex: S2, S3
ext: L5, S1
which myotomal actions would be weak if a disc were compressing the L5 nerve root ?
external hip rotation, hip abduction, hip extension, knee flexion, foot inversion and eversion and dorsiflexion, toe extension
Describe the arterial branching that occurs in the hip and thigh region.
Ab Aorta, ext and internal iliac, profunda femoris gives rise to circumflex femoral branches
What is a potential consequence of injury to the femoral artery ?
potential death due to bleeding out since femoral artery is a major source of blood supply to the LE
Which artery is most responsible for blood flow to the femoral head ? What would be the consequence of its injury ?
medial circumflex arteries
if damaged, for example in a femoral fracture, it could lead to avascular necrosis of the femoral head
Describe the drainage of the venous system in the LE.
Anterior tibial and post tibial and fibular drain into popliteal vein, into femoral, into ext and internal iliac, into common iliac, into IVC
Explain the organization of thigh and hip muscles and their associated innervations.
Anterior Compartment ( Femoral Nerve ): pectineus, iliopsoas, iliacus
quadriceps femoris: rectus femoris, vastus medialis, vastus lateralis, vastus intermedius
Medial/ Adductors ( Obturator ): adductor longus, adductor brevis, adductor magnus, gracilis, obturator externus
Posterior and Gluteal ( Sciatic ): glut max, min, med, piriformis, obturator internus, superior and inferior gemelli, quadratus femoris, semitendinosus, semimembranosus, biceps femoris
