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Lower Extremities

Anatomy

QuestionAnswer
Gluteal Muscles Tensor Fasciae Latae, Gluteus Maximus, Gluteus Medius, Gluteus Minimus, Piriformis, Superior gemellus, Obturator internus, Inferior gemellus, Quadratus femoris
Muscles of Anterior Thigh Hip Flexors, Quadriceps Femoris, Sartorius
Muscles of Hip Flexors Iliopsoas
Muscles of Quadriceps Femoris Vastus Intermedius, Vastus Medialis, Vastus Lateralis, Rectus Femoris
Muscles of Medial Thigh Obturator externus, Pectineus, Gracilis, Adductor Longus, Adductor Brevis, Adductor Magnus (adductor part)
Muscles of Posterior Thigh Hamstrings (Adductor Magnus (hamstring part), Semimembranosis, Semitendinosus, Biceps Femoris)
Foramina of the Pelvis Gap below inguinal ligament; Greater & Lesser sciatic foramina; Obturator canal
Movements of the hip Flexion/ extension; Abduction/ adduction; Internal/ external rotation; Circumduction
Compartments of the Lower Extremity: thigh Anterior, medial, & posterior compartments; fascia lata, intermuscular septa
Compartments of the Lower Extremity: leg Anterior, lateral, & posterior compartments; deep fascia, intermuscular septa, interosseous membrane
Superficial Veins of thigh Superficial to deep fascia; Great saphenous v. Small saphenous v.
Varicose veins: MOA Malfunction of valves in perforating veins; allows blood to flow back via veins, blood backs up
Lymphatics: route of drainage from Gr saphenous vein Great saphenous vein -> superficial inguinal nodes -> external iliac nodes
Lymphatics: route of drainage from Small saphenous vein Small saphenous v. -> popliteal nodes -> superifical and deep inguinal nodes -> external iliac nodes
Lymphatics: route of drainage from Femoral vein Femoral vein -> deep inguinal nodes -> external iliac nodes
LumboSacral Plexus: Major branches: Femoral nerve (L2-L4); Obturator nerve (L2-L4); Gluteal nerves (L4-S2); Sciatic nerve (L4-S3)
Significance of orientation of hip joint ligaments Ligaments oriented in spiral fashion -> causes ligaments to become taut with hip extension (reduces energy required to maintain standing position)
Borders of femoral triangle Base (inguinal ligament); medial margin (adductor muscles); lateral margin (sartorius)
Branches of the femoral artery Deep a. of thigh; medial circumflex femoral a.; lateral circumflex femoral a.; perforating arteries
Only artery branching directly from femoral artery Deep artery of thigh (other branches come off the deep a. of thigh)
Femoral Nerve gives off cutaneous branches to: Ant. Thigh; anteromedial knee; medial leg; medial foot
Obturator Artery & Nerve run through: Obturator canal of obturator membrane (not in femoral triangle)
Obturator nerve innervates: All muscles in medial compartment of thigh (except pectineus) and skin over medial thigh
Gluteal muscles, in order (sup to inf) Piriformis, Superior gemellus, Obturator internus, Inferior gemellus, Quadratus femoris
Gluteal muscles innervated by: Superior & inferior gluteal nerves (gluteus muscles and tensor fascia lata); all other gluteal nerves: directly from branches of sacral plexus
Posterior thigh muscles: attachment at knee Biceps femoris on lateral side; Semitendinosus & semimembranosus on medial side
Something cute about gluteal nerves: No cutaneous innervation from gluteal nerves; cutaneous innervation only directly from sacral plexus
What pass thru gap below inguinal ligament? Iliac a. & v.; iliopsoas mx
What pass thru greater sciatic foramen? Piriformis mx, sciatic n.
What pass thru lesser sciatic foramen? Obturator internis mx
Obturator canal is formed by: ischium & pubis
What pass thru obturator canal? Obturator a. & nerve
Obturator foramen is bordered by: Obturator externis & internis muscles
Movements of the knee Flexion/ extension (also slight rotation)
Movements of the foot Dorsiflexion/ plantarflexion; Inversion/ eversion
Fascia in thigh = fascia lata
Fascia lata is anchored: superiorly to iliac crest and inguinal ligament
Fascia lata thickens laterally to form: iliotibial tract
Fascia in leg = deep fascia of leg
Deep fascia of leg: continuous superiorly with: fascia lata
Small saphenous v. is analogous to: basilic v.
Small saphenous v. runs up & joins: popliteal v.
Gr saphenous v. joins femoral v. after traveling thru: saphenous ring in fascia lata
Veins communicating btw deep & superficial veins of legs = perforating veins
Lymphatics of legs follow: venous system
LumboSacral Plexus = Ventral rami of: L1-S3
Femoral nerve (L2-L4) innervates: Anterior thigh
Obturator nerve (L2-L4) innervates: Medial thigh
Gluteal nerves (L4-S2) innervate: Gluteal muscles
Sciatic nerve (L4-S3) innervates: Posterior thigh, leg, foot
Sciatic nerve splits into: Tibial nerve; common fibular (peroneal) nerve
Hip joint includes: Acetabular labrum; Round ligament; Synovial membrane
Acetabular labrum assoc with ____ ligament Transverse acetabular ligament
Round ligament of hip = ligamentum teres (ligament of femoral head)
Round ligament of hip: attaches where? inside acetabulum
Ligaments surrounding hip joint Pubofemoral, Iliofemoral, & ischiofemoral ligaments
Most common hip fracture: femoral neck fracture
Types of hip fractures Pelvic fractures; femoral neck fracture; avascular necrosis of femoral head
Hip dislocation: Types posterior hip dislocation; hip dysplasia
Danger of posterior hip dislocation: may impinge sciatic nerve
Quads: which lies deep to the others? Vastus intermedius
Quads: crossing what Rectus femoris crosses hip & knee; other quads cross knee only
Pes anserinus = tendons of 3 muscles = Sartorius, semitendinosus, gracilis
Femoral Triangle: between: anterior and medial compartments
Femoral Triangle contains: Femoral nerve, artery, vein, lymphatics (NAVL)
Femoral Triangle: analogous to: axilla
Femoral hernia: location Medial to femoral vein; can emerge through saphenous opening
Femoral hernia: prevalence Occurs more frequently in females
Femoral Artery is continuous proximally with: external iliac a.
Femoral Artery becomes: femoral artery after passing inguinal ligament
Femoral Artery runs in: adductor canal (partly covered by sartorius mx)
Femoral Artery passes thru: adductor hiatus (in adductor magnus m.) and becomes popliteal artery
Location of femoral pulse halfway btw ASIS & pubic tubercle
Femoral veins run with: arteries and share their names
Femoral Nerve = lateral to: femoral artery
Muscles that help prevent pelvic tilt (drop) Gluteal muscles
Actions of gluteal muscles to laterally rotate hip and extend femur
Hamstring part of adductor magnus crosses: Does not cross knee
Posterior thigh muscles cross: Semitend, semimem, & biceps femoris cross hip & knee
Lumbar plexus innervates: Ant. thigh (hip flexors); Ant. thigh (knee extensors); Medial thigh (adductors)
Sacral plexus innervates: Gluteal muscles; Posterior thigh (hamstrings)
Iliopsoas innervated by: femoral n. (lumbar plexus)
Quads innervated by: femoral n.
Sartorius innervated by: femoral n.
Obturator externus innervated by: obturator n.
Mx of medial thigh, sometimes included in anterior thigh: pectineus
Pectineus mx innervated by: femoral n.
Medial thigh mx innervation: mostly obturator n. (exceptions: pectineus, hamstring part of adductor magnus)
Femoral Nerve innervates: all anterior thigh muscles (and pectineus)
Gluteal muscles: innervation from: branches of sacral plexus
Innervation of gluteal muscles and TFL: gluteal nerves
Posterior thigh muscles: innervation tibial part of sciatic nerve
Sciatic nerve: motor innervation: muscles of posterior thigh, all muscles of leg & foot
Sciatic nerve: cutaneous innervation: to skin of lateral leg &foot, sole of foot, & dorsum of foot
Sciatic nerve: exits: greater sciatic foramen inferior to piriformis muscle
Sciatic nerve runs through: posterior compartment of thigh & into popliteal fossa
Sciatic n. splits into: tibial & common fibular nerves in posterior thigh
12% of sciatic n. passes thru: piriformis mx
12% of what nerve passes thru piriformis mx? sciatic n.
Fn of Round ligament of hip: Carries branch of obturator artery to femoral head
Created by: Abarnard