Workbook - Living anatomy Flashcards
What is the round shape of the gluteal region mainly due to?
Gluteus maximus.
What marks the inferior border of the gluteus maximus?
The gluteal fold.
-transition between gluteal region and posterior thigh
Which muscles contribute to the quadriceps? (4)
- Rectus femoris
- Vastus lateralis
- Vastus intermedius
- Vastus medialis
Which of the quadriceps muscles in not visible on the anterior surface of the thigh?
Vastus intermedius.
-beneath rectus femoris
What is the most prominent bony feature of the pelvic girdle?
The iliac crest.
-from ASIS to PSIS
Why is the posterior superior iliac spine (PSIS) often difficult to palpate?
Normally covered by fat.
What are the skin dimples lateral to the midline on the back caused by?
Attachment of overlying fascia to the posterior superior iliac spine (PSIS).
-can be used to locate it
What does the line joining the dimples on the lower back pass through? (3)
- S2 spinous processes
- Middle of the sacroiliac joints
- Bifurcation of the iliac arteries
What structure within the vertebral canal terminates at S1-2?
The dural sac.
What is the line joining the highest points of the iliac crests called, and what does it pass through?
Supracristal plane.
-intervertebral disc between L4/L5
What clinical procedure is the supracristal plane used as a landmark for?
Epidural.
Where is the tibia particularly prominent?
On the anteromedial surface.
-covered only skin and thin layer of fat
Which bone in the leg is palpable along its whole course?
The tibia.
Where is the fibula palpable?
Proximal and distal ends.
-head and lateral malleolus
What is the femoral artery often used for clinically?
- Access to arterial system (radiologists)
- Insert catheters/stents
- Angiograms
What are the boundaries of the femoral triangle?
SUPERIOR - inguinal ligament LATERAL - sartorius (med border) MEDIAL - adductor longus (med border) FLOOR - pectineus, iliopsoas, adductor longus ROOF - fascia lata
What are the contents of the femoral triangle?
Med»_space; lat:
- Femoral canal (lymphatics)
- Femoral vein
- Femoral artery
- Femoral nerve
What are contained within the femoral sheath?
Femoral artery, vein and lymphatics.
What are the boundaries of the popliteal fossa?
SUPEROMEDIAL - semimembranosus & semitendinosus
SUPEROLATERAL - biceps femoris
INFERIOR - lat/med heads of gastrocnemius
What are the contents of the popliteal fossa?
Med»_space; lat:
- Popliteal artery
- Popliteal vein
- Tibial nerve (»down midline)
- Common fibular nerve (» laterally)
Which nerve passes around the head of the fibula?
Common fibular nerve.
What are the important pulse points in the lower limb? (4)
- Femoral pulse
- Popliteal pulse
- Posterior tibial pulse
- Dorsalis pedis pulse
Where is the femoral pulse palpated?
Halfway between the ASIS and the pubic tubercle.
-just inferior to inguinal ligament
Where is the popliteal pulse palpated, and why is it difficult?
In the popliteal fossa.
- difficult as it’s the deepest structure
- knee should be flexed with foot resting to relax hamstrings
Where is the posterior tibial pulse palpated?
Posterior to the medial malleolus.
Where is the dorsalis pedis pulse palpated?
Lateral to the tendon of extensor hallucis longus.
Why might it be necessary to palpate all the pulse points of the lower limb?
Check for differences.
-e.g. due to thrombosis/embolism
Where do the superficial veins of the lower limb originate?
Dorsal venous arch of the foot.
What are the superficial veins of the lower limb? (2)
- Great saphenous vein
- Small saphenous vein
What does the great saphenous vein originate from?
Dorsal venous arch and dorsal vein of great toe.
Where does the great saphenous vein run?
Medial leg.
Where does the great saphenous vein drain?
Femoral vein.
-inferior to the inguinal ligament
What does the small saphenous vein originate from?
Dorsal venous arch and dorsal vein of the little toe.
Where does the small saphenous vein run?
Posterior leg.
-between 2 heads of gastrocnemius
Where does the small saphenous vein drain?
Popliteal vein.
-in the popliteal fossa
What causes varicose veins?
Damaged valves»_space; blood flows backwards and collects in veins.
What are the main risk factors for varicose veins?
Pregnancy
Overweight
Old age
Where is the best place to test L3 dermatome?
Medial epicondyle of femur (knee).
Where is the best place to test L5 dermatome?
Great toe.
How would you test mainly for the L3 and L4 myotomes?
Knee extension.
How would you test for the S1 and S2 myotomes?
Plantarflexion.
How do you elicit a knee reflex, and what vertebrae levels are tested?
Patient sits down with leg dangling (knee flexed with weight supported).
» patella ligament tapped with hammer, halfway between patella and tibial tuberosity
» knee extension
-vertebrae levels L2-4 are tested
How do you elicit an ankle reflex, and what vertebrae levels are tested?
Push the foot into dorsiflexed position.
» tap calcaneal tendon superior to its insertion on calcaneal bone
» plantarflexion
-vertebrae levels S1-2 are tested
What myotomes are tested by hip extension?
L4, L5.
What myotomes are tested by hip flexion?
L2, L3.
What myotomes are tested by lateral rotation of the hip?
L5, S1.
What myotomes are tested by medial rotation of the hip?
L1, L2, L3.
What myotomes are tested by hip adduction?
L1, L2, L3, L4.
What myotomes are tested by hip abduction?
L5, S1.
What myotomes are tested by knee flexion?
L5, S1.
What myotomes are tested by knee extension?
L3, L4.
What myotomes are tested by ankle dorsiflexion?
L4, L5.
What myotomes are tested by ankle plantarflexion?
S1, S2.
What myotomes are tested by foot dorsiflexion?
L5, S1.
What myotomes are tested by foot plantarflexion?
S1, S2.
What myotomes are tested by foot inversion?
L4, L5.
What myotomes are tested by foot eversion?
L5, S1.
