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Lower Limb

lower limb

Flap 1 nerveAnswer
What does the profunda femoris a. give rise to within the femoral triangle? Medial and lateral circumflex arteries
What is the chief artery to the thigh? Profunda femoris a.
What is the largest branch of the femoral artery? Profunda femoris a.
What does the femoral artery give rise to? desceding genicular a.
What is the chief arterial supply to the lower limb? femoral a.
What nerve supplies the posterior compartment of the thigh? What is the function of this compartment? Sciatic nerve. Flexion.
What muscles are found within the posterior compartment of the thigh? Semimembranosus, semitendinosus, biceps femoris
What innervates the tensor fasciae latae? superior gluteal nerve
What does the sartorius muscle attach to, and what innervates it? ASIS & superior part of medial surface of tibia. Femoral nerve
What is the proximal attachment for the Rectus femoris muscle? Anterior inferior iliac spine
What is the distal attachment for the quadriceps femoris? What is this muscle's function? Continues as ligamentum patella and attaches to tibial tuberosity. Function: chief extensor of the leg
What innervates the gluteus maximus? inferior glueal nerve
What innervates the gluteus medius and minimus? superior gluteal nerve
What muscles are found within the anterior compartment of the thigh? iliopsoas, tensor fasciae latae, sartorius, rectus femoris, vastus medialis, vastus intermedius, and vastus lateralis
What is the main function of the anterior compartment of the thigh? What innervates it? Extension. Femoral nerve
What muscles make up the quadriceps femoris? rectus femoris, vastus medialis, vastus intermedius, and vastus lateralis
What muscles are found in the medial compartment of the thigh? adductor longus, adductor brevis, adductor magnus, gracilis, pectineus, and obturator externus
What is the main function of the medial compartment of the thigh? Innervation? Adduction. Obturator nerve
What innervates the pectineus muscle? femoral nerve and some branches from the obturator nerve
What adductor crosses the knee joint? Gracilis
What are the 2 parts of the adductor magnus muscle? 1. adductor portion 2. hamstring portion
Where does the adductor part of the adductor magnus attach distally? Linea aspera
What innervates the adductor part of the adductor magnus? obturator nerve
What is the function of the adductor part of the adductor magnus? adducts and flexes the thigh
Where does the hamstring part of the adductor magnus distally attach? medial epicondyle
What innervates the hamstring part of the adductor magnus? What is it's function? Tibial division of the sciatic nerve. Adducts and extends the thigh
What are the borders of the femoral triangle? floor = pectineus & iliopsoas. roof = fascia lata
what are the contents of the femoral triangle? NAVL, femoral nerve, femoral artery, femoral vein, and inguinal lymph nodes
Whta artery is the main supply to the femoral head and neck? medial circumflex femoral artery
What muscles does the medial circumflex femoral artery pass between to reach the posterior thigh? iliopsoas and pectineus
What artery passes laterally, deep to the sartorius and rectus femoris? lateral circumflex femoral artery
The profunda femoris artery exits the femoral triangle between what structures? pectineus and adductor longus
The profunda femoris gives rise to what arteries? What muscles do these arteries supply? Perforating arteries. Adductor magnus and hamstring muscles
What is the largest branch of the lumbar plexus? femoral nerve (L2-L4)
What muscles are supplied by the femoral nerve? Iliacus, sartorius, quadriceps femoris (anterior thigh, hip, and knee)
The saphenous nerve runs between what structures? Runs superficially between the sartorius and gracilis
What does the saphenous nerve innervate? Anterior and medial knee and leg and the medial foot
Is the femoral nerve contained within the femoral sheath? no, lateral compartment = femoral artery, intermediate= femoral vein, medial= lymphatics and allows for expansion of the femoral vein
What are the superior and inferior boundaries of the gluteal region? Iliac crest and gluteal sulcus (gluteal fold)
What are two important ligaments between the sacrum and bony pelvis? sacrospinous ligament and sacrotuberous ligament
Name the large gluteal muscles. What is their function? Gluteus maximus, medius, and minimus. Extend and abduct the thigh
Name the smaller deep gluteal muscles. What is their function? piriformis, obturator internus, gemelli, quadratus femoris. Laterally rotate the thigh
What innervates the gluteus maximus? Inferior gluteal nerve
What innervates the gluteus medius? Superior gluteal nerve
What muscles are supplied by the superior gluteal nerve? Gluteus medius and minimus and tensor fasciae latae
What is the distal attachment for the gluteus medius? Greater trochanter--lateral and anterior sides
What is the distal attachmet for the gluteus minimus? greater trochanter--anterior surface
What innervates the gluteus minimus? Where is it found? superior gluteal nerve. Runs between the gluteus medius and minimus
What is the blood supply to the sciatic nerve? Inferior gluteal artery
What does the sciatic nerve divide into? Tibial and common fibular nerves
What does the sciatic nerve innervate? Posterior thigh, leg, and foot ***NO GLUTEAL STRUCTURES****
What nerve supplies more skin than any other cutaneous nerve? posterior cutaneous nerve of the thigh
What is the most medial structure exiting the sciatic foramen? Pudendal nerve
What arteries branch off the internal iliac artery? Superior gluteal artery, inferior gluteal artery, internal pudendal artery
What is the largest branch of the internal iliac artery? Superior gluteal artery
What muscles are supplied by the inferior gluteal artery? gluteus maximus, obturator internus, quadratus femoris, superior hamstrings
What arteries participate in the cruciate anastomosis of the thigh? superior gluteal a, 1st perforating a, medial and lateral circumflex femoral arteries
what is the common proximal attachment of the hamstring muscles? Ischial tuberosity *except the short head of the biceps femoris
What innervates the hamstring muscles? Tibial division of the sciatic nerve **except the short head of the biceps femoris
What is the function of the hamstring muscles? thigh extension **except short head of biceps femoris
What is the proximal attachment for the short head of the biceps femoris? What innervates this muscle? Linea aspera and lateral supracondylar line. Common fibular division of the sciatic nerve
What is the proximal attachment for the long head of the biceps femoris? What is this muscles function? Innervation? Ischial tuberosity, thigh extension, tibial division of sciatic n.
What are the contents of the popliteal fossa (superficial to deep)? popliteal nerves (tibial & common fibular), popliteal vein, popliteal artery
When does he femoral artery become the popliteal artery? after passing thru the adductor hiatus
What does the popliteal artery give rise to? genicular branches
What vessels supply the articular capsule and ligaments of the knee joint? Genicular branches
What arteries make up the genicular anastomosis? Superior lateral, inferior lateral, superior medial, inferior medial, and middle genicular arteries
How does the popliteal artery terminate? It ends by dividing into the anterior tibial artery and posterior tibial artery
What forms the popliteal vein? anterior and posterior tibial veins
When does the popliteal vein become the femoral vein? after traversing the adductor hiatus (opening in tendon of adductor magnus)
What forms the sural nerve? medial sural nerve branches off the tibial nerve and the lateral sural nerve branches off the common fibular nerve. Both the lateral and medial sural nerves combine to form the sural nerve
Why is the common fibular nerve susceptible to injury? It winds around the head and neck of the fibula
How does the common fibular nerve terminate? Terminates deep to the fibularis longus by becoming the deep fibular nerve and superficial fibular nerve
What is crural fascia? It is deep fascia of the lower leg that is continuous witht he fascia lata. It continues distally to thicken and form retinaculum of the lower leg
What does the crural fascia give rise to? superior and inferior extensor retinaculum
What is the function of the crural fascia? It anchors tendons down and prevents bowstringing
Crural fascia gives rise to the intermuscular septum which gives rise to what structures? Anterior, lateral, and posterior compartments
what muscles rae found within the anterior compartment of the leg? anterior tibialis, extensor hallucis longus, extensor digitorum longus, and fibularis tertius
What is the common function of the anterior compartment of the leg? ankle dorsiflexion and toe extension
What is the origin and insertion for the tibialis anterior? O=upper 2/3 shaft of tibia. I=medial cuneiform and 1st metatarsal
What is the function of the tibialis anterior? dorsiflexion and inversion of the ankle
What are shin splints? strain/microtrauma to the tibialis anterior
What is the origin and insertion for the extensor hallucis longus? O=middle 1/2 of medial surface of fibula. I=upper surface of the base of the 1st distal phalanx
What is the function of the extensor hallucis longus? great toe extension and ankle dorsiflexion
What is the origin and insertion for the extensor digitorum longus? O=upper 1/2 of fibula and lateral condyle of tibia. I=descends as one tendon that divides into 4 tendons that insert on the bases of the middle and distal phalanges 2-5
What is the function of the extensor digitorum longus? toe extension and ankle dorsiflexion
What is the origin and insertion for the fibularis tertius? O=medial surface of fibula, below E.D.L. I=dorsum of 5th metatarsal **fused w/extensor digitorum proximally and absent in 4% of population
What is the blood supply and innervation for the anterior compartment of the leg? Anterior tibial artery and deep fibular nerve
What is a good landmark for the division between the anterior and posterior tibial artery? tibial tuberosity
Between what 2 muscles is the anterior tibial artery located? tibialis anterior and extensor hallucis longus
What does the anterior tibial artery become? What does this supply? dorsalis pedis artery--supplies the dorsum of the foot
What does the deep fibular nerve innervate? muscles of the anterior compartment of the leg, extensor digitorum brevis, 2 dorsal interossei muscles, and dorsal web space between 1st and 2nd toes
What muscles are foundwithin the lateral compartment of the leg? fibularis longus and fibularis brevis
What is the common function of the lateral compartment of the leg? ankle eversion and plantarflexion
What is the origin and insertion for the fibularis longus? O=upper lateral surface of the fibula I=medial cuneiform and 1st metatarsal
What is the function of the fibularis longus? ankle eversion and plantarflexion
Which muscles work together to provide dynamic arch support during the standing phase of gait? tibialis anterior, fibularis longus, and posterior tibialis
What are the insertions of the muscles responsible for dynamic arch support? medial cuneiform
What is the origin and insertion for fibularis brevis? O=lower 2/3 of the fibula I=lateral tubercle of the 5th metatarsal
What is the function of fibularis brevis? ankle eversion and plantarflexion
What is the blood supply to the lateral compartment? branches from the fibular artery located in the popsterior compartment
What is the largest branch of the posterior tibial artery? fibular artery
What innervates the lateral compartment of the leg? superficial fibular nerve
Damage to the common fibular nerve causes what? drop foot: loss of dorsiflexion and eversion, loss of sensation along the dorsum of foot/lateral leg
What is an early sign that the common fibular nerve has been damaged? loss of sensation in the dorsal web space between the 1st and 2nd toes
What divides the posterior compartment of the leg into 2 groups? transverse septa
What muscles are found within the superficial posterior group of the leg? gastrocnemius, soleus, and plantaris
what muscles are found within the deep posterior group of the leg? popliteus, flexor hallucis longus, flexor digitorum longus, tibialis posterior
what 2 headed muscle crosses the knee and ankle joint? gastrocnemius
Where does the gastrocnemius insert? posterior surface of calcaneus via the tendo calcaneus
what is the function of the gastrocnemius? plantarflexion and flexes the leg at the knee joint
what is a fabella? sesamoid bone associated with the proximal attachment of the gastrocnemius. found in 3-5% of people
what muscle lies deep to the gastrocnemius? soleus
What muscle has a tendon that runs between the gastrocnemius and soleus? plantaris
What muscle tendon is commonly used in reconstructive surgery of hand tendons? plantaris
What muscle forms the floor of the popliteal fossa? popliteus
where does the popliteus attach? posterior tibia (superior to soleal line)
what is the function of the popliteus muscle? unlocks extended leg by laterally rotating femur on a stationary tibia--also weakly flexes the leg
What is the largest deep posterior muscle in the leg? flexor hallucis longus (deep to soleus)
What is the superior attachment of the flexor hallucis longus? posterior fibula
What muscle is posterior to the tibia? flexor digitorum longus
Where does the tendon of the flexor digitorum pass? It passes posterior to the tibialis posterior
What is the deepest posterior crural muscle? Tibialis posterior
What muscles does the tibialis posterior lie between? Flexor digitorum longus and flexor hallucis longus
Which muscle's tendon passes anterior to the flexor digitorum longus? tibialis posterior
What nerve supplies the posterior compartment of the leg? tibial nerve
What nerve travels with the posterior tibial vessels? tibial nerve
What are the terminal branches of the tibial nerve? medial and lateral plantar nerves
What artery supplies the posterior compartment of the leg? posterior tibial artery
What artery arises from the posterior tibial artery? fibular artery
What are the terminal branches of the posterior tibial artery? medial and lateral plantar arteries
What is the largest branch of the posterior tibial artery? fibular artery
As the fibular artery runs obliquely toward the fibula it is usually found under which muscle? flexor hallucis longus
Which artery does the fibular artery anastomose with? lateral malleolar artery
Where would you palpate the posterior tibial pulse? posterior surface of medial malleolus, medial border of calcaneal tendon, deep to flexor retinaculum **relax patient's retinaculum by inverting foot
Why would you palpate the posterior tibial pulse? To check for intermittent claudication
What are the 3 components of the talus? body, neck, and head
The posterior process of the talus has a groove for what muscle? flexor hallucis longus tendon
What is the sustentaculum tali? shelf-like projection on the calcaneus that supports the talus
What is the fibular trochlea? ridge on the lateral surface of the calcaneus
What muscle attaches at the navicular tuberosity? tibialis posterior
What is significant about the cuboid tuberosity? Groove for fibularis longus
What is hallux valgus? foot deformity characterized by lateral deviation of the great toe
What is a bunion? tender and inflammed bursa
What is a corn? inflamed area of thick skin
What is the fascia of the sole of the foot called? plantar fascia and plantar aponeurosis
What purpose does the plantar aponeurosis serve? helps support the longitudinal foot arches
What muscles are found on the dorsum of the foot? What innervates these muscles? Extensor hallucis brevis and extensor digitorum brevis. Deep fibular nerve
What muscles are found within the 1st layer of the sole of the foot? 3 short muscles that extend from calcaneus to phalanges--abductor digiti minimi, flexor digitorum brevis, and abductor hallucis
what muscles are found in the second layer of the sole of the foot? quadratus plantae and lumbricals
What 2 muscles have tendons located in the 2nd layer, but are not considered second layer plantar muscles? flexor hallicus longus and flexor digitorum longus
What muscles are found in the 3rd layer of plantar muscles? flexor digiti minimi brevis, adductor hallucis, and flexor hallucis brevis
The tendons of which muscle have sesamoid bones? flexor hallucis brevis
Which muscles are found in the 4th layer of plantar muscles? interossei-- 3 plantar interossei and 4 dorsal interossei
What muscles have tendons located in the fourth layer? fibularis longus and tibialis posterior
What nerve supplies the intrinsic muscles of the foot and plantar skin? medial and lateral plantar nerves
From what nerve do the medial and lateral plantar nerves arise from? tibial nerve--divides posterior to the medial malleolus
Which nerve passes deep to the abductor hallucis? medial plantar nerve
The medial plantar nerve terminates and provides sensory innervation to what? medial three and a half digits
The medial plantar nerve provides motor innervation to what muscles? abductor hallucis, flexor digitorum brevis, most medial lumbrical, and flexor hallucis brevis
The lateral plantar nerve passes deep to what muscle? abductor hallucis
What muscles are innervated by the lateral plantar nerve? abductor digiti minimi, quadratus plantae, lateral 3 lumbricals, adductor hallucis, flexor digiti minimi brevis, and interossei
What is the blood supply of the foot? terminal branches of the anterior and posterior tibial arteries
What artery supplies the dorsum of the foot? dorsalis pedis artery (continuation of anterior tibial artery)
What are the branches of the dorsalis pedis artery? arcuate artery and deep plantar artery
What artery supplies the sole of the foot? medial and lateral plantar arteries (from the posterior tibial artery)
Which arteries form the plantar arterial arch? medial plantar artery and the deep plantar artery
Name the intrinsic ligaments of the hip joint. Iliofemoral ligament, pubofemoral ligament, ischiofemoral ligament, and ligament of the head of the femur
Which hip joint ligament helps prevent overabduction and overextension?overextension? pubofemoral ligament
Which hip joint ligaments helps prevent overextension? iliofemoral ligament and ischiofemoral ligament
Which hip joint ligament contains the obturator vessels? femoral head ligament
What type of joint is the knee? hinge type of synovial joint
What stabilizes the knee joint? strength of surrounding muscles/tendons and the ligaments that bind the femur to the tibia
List the extracapsular ligaments of the knee patellar ligament, fibular collateral ligament, tibial collateral ligament, oblique popliteal ligament, and the arcuate popliteal ligament
The continuation of the quadriceps femoris tendon forms what structure? patellar ligament
What muscle's tendon passes deep to the fibular collateral ligament? popliteus tendon
Fibers of the tibial collateral ligament attach to what structure? medial meniscus
What is the purpose of the anterior cruciate ligament? prevents posterior displacement of the femur and prevents anterior displacement of the tibia
What is the purpose of the posterior cruciate ligament? prevents anterior displacement of femur amd prevents posterior displacement of tibia
What is the purpose of the menisci within the knee? deepens articular surface and absorb shock
What type of joint is the ankle? hinge synovial joint that allows dorsiflexion and plantarflexion
What are 2 important intertarsal joints? transverse tarsal joint and subtalar joint (inversion and eversion)
What is the subtalar joint? What is its function? Where the talus rests on the calcaneus. Inversion and eversion
What are the functions of foot arches? absorb shock during weightbearing and makes foot adaptable to surface and weight changes
What are the two foot arches? longitudinal and transverse arch
What are the most important structures responsible for maintaining foot arches? **plantar calcaneonavicular (spring) ligament**, long plantar ligament, plantar aponeurosis, and plantar calcaneocuboid (short plantar) ligament
What ligament is important in maintaining the longitudinal arch of the foot? plantar calcaneonavicular ligament (spring ligament)
What is the most frequently injured joint? ankle
What is pes planus? fallen arches
Created by: lizroe0423