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The Lower Extremity

What are the muscles of the anterior compartment of the thigh? -tensor fascia -sartorius -quadriceps femoris -articularis genu
What are the 4 parts of the quadriceps femoris? -rectus femoris -vastus medialis -vastus intermedius -vastus lateralis
Where does articularis genu lie? deep to the quadriceps
What are the muscles of the medial compartment of the thigh? -pectineus -gracilis -adductor brevis -adductor longus -adductor magnus -obturator externus
What is a pulled groin? The stretching or tearing of the adductor longus and part of the adductor magnus muscles
What are the 8 Gluteal muscles? Gluteus maximus, medius and minimus, Piriformis, gemellus superior and inferior, obturator internus, and quadratus femoris
What is the iliotibial band? a thickening of the deep fascia on the lateral side of the thigh
What muscles form the iliopsoas muscle? Psoas major and Iliacus muscles
What is genu valgum? (knock kneed) It is where the distal aspect of the tibia is bet outward. Valgus= bent outward
What is genu varum? (bow legged) It is where the distal aspect of the tibia is bent inward. Varus=bent inward
What is chondromalacia patellae? It is soreness and aching around and deep to the patella. It is seen in runners and weight lifters.
What is osteoarthritis of the knee? It is the breakdown of the articular cartilage along with the development of osteophytes. It leads to joint replacement.
Popliteal cysts have similar symptoms with what else? Deep vein thrombosis
What are the three most common knee injuries? medial meniscus, tibial collateral ligament and anterior cruciate ligament
What is the function of the lateral and medial menisci? They distribute the force of the femur over the condyles of the femur
What type of joint is the knee? It is a hinge type of synovial joint. It is biaxial.
What are the motions allowed by the knee joint? flexion and extension and slight medial and lateral rotation
What are the capsular ligaments of the knee? -articular capsule -ligamentum patellae -oblique popliteal -arcuate popliteal -tial collateral
What is the one extracapsular ligament of the knee? fibular collateral
What are the two intracapsular ligaments of the knee? anterior and posterior cruciate ligaments
What are the muscles of the posterior compartment of the thigh? -biceps femoris (long and short head) -semitendinosus -semimembranosus
Congenital hip dislocation is caused by what? a shallow acetabulum
Hip resurfacing or replacement is usually caused by what? degenerative joint disease (DJD)
If the artery in the ligamentum capitis femoris or arteries in the femoral neck are ruptured, what can happen? necrosis of the femoral head
What type of joint is the hip joint? ball and socket type of synovial joint and triaxial
what are the motions allowed by the hip joint? extension/ flexion, abduction/adduction, medial/lateral rotation
What are the 4 major capsular ligaments of the hip? -articular capsule -iliofemoral -ishiofemoral -pubofemoral
What are the two intracapsular ligaments of the hip joint? ligamentum capitis femoris and transverse acetabular
What deepens the acetabulum? acetabular labrum or fibrocartilage
Why are the fibers of the ligaments of the hip important? They give stability.
In what direction is patellar dislocation common? lateral direction
What structures are located on the posterior side of the patella? medial and lateral facets
What type of bone is the patella? sesamoid
What are the structures at the distal end of the femur? medial and lateral condyles, medial and lateral epicondyles, patellar surface, intercondylar notch and the adductor tubercle
What are the important structures on the shaft of the femur? linea aspera, spiral line, gluteal tuberosity, and the medial and lateral supracondylar lines
What are the structures of the proximal end of the femur? head with fovea capitis femoris, neck, great and lesser trochanter, intertrochanteric line, and intertrochanteric crest
What is the angle of inclination? It is the angle between the longitudinal axis of the shaft of the femur and the longitudinal acis of the neck of the femur
What is coxa vara? decreased angle of inclination
What is coxa valga? increased angle of inclination
What is a hip pointer? It is a contusion of the iliac crest.
What is Trendelenburg gait? It is when the pelvis dips to the opposite side of weightbearing.
What is the Trendenlenburg's test used for? It is used to test the osseomuscular integrity of the hip joint.
What muscles make up the hamstrings? long head of the biceps, the semitendinosus, and semimembranosus
Where does the hamstring originate? ischial tuberosity
Where are intragluteal injections done? the upper lateral quadrant of the gluteal region
What are the contents of the femoral triangle? femoral artery and vein, profunda femoral artery and vein, and femoral nerve and its branches
What is the femoral artery within the femoral triangle cannulated for? left cardiac angiography
What is the femoral vein within the femoral triangle cannulated for? right cardiac angiography
What runs through the adductor canal? femoral artery and vein and the saphenous nerve
What can the great saphenous veins be used for? They are harvested for heart bypass surgery.
What is the gluteal region vasculized by? superior and inferior gluteal arteries
What are the routes of the superior and inferior gluteal arteries? They are branches of the internal iliac artery that leave the pelvis through the greater sciatic foramen. They enter the gluteal region superior and inferior to the piriformis muscle
What compartments does the profunda femoral artery vascularize? anterior, medial and posterior comparments of the thigh
Where is a femoral pulse palpated? within the femoral triangle close to a midinguinal point
What are the branches of the femoral artery? -profunda femoral -meidal and lateral femoral circumflex -perforating arteries
What compartment does the obturator artery vascularize? medial compartment
What are the major branches of the popliteal artery? -sural -genicular -anterior and posterior tibial
What are the contents of the popliteal fossa? 0popliteal artery and vein and their genicular branches -tibial and common peroneal nerves -popliteal lymph nodes -termination of the small saphenous vein -fatty tissue
What is the lumbosacral plexus derived by? Ventral rami of L1-L5, S1-S5 and Co1
The lumbar and sacral portions of the lumbosacral plexus innervate what? the lower extremity, lower abdominal wall and most of the perineum
The coccygeal portion of the lumbosacral plexus innervates what? the anococcygeal region
What are the major portions of the lumbar portion of the lumbosacral plexus? -lateral femoral cutaneous -femoral -oburator -lumbosacral trunk
What are the branches of the femoral nerve? -medial femoral cutaneous -intermediate femoral cutaneous -saphenous
What are the major branches of the sacral postion of the lumbosacral plexus? -superior and inferior gluteal -posterior femoral cutaneous -sciatic
What are the two main branches of the sciatic nerve? tibial and common peroneal nerve
What is the sural nerve formed by? the tibial and common peroneal nerves
What are the branches of the tibial nerve? -medial calcaneal -medial plantar -lateral plantar
What are the branches of the common peroneal nerve? superficial and deep peroneal nerves
What are radiculopathies? injury at nerve root
What are the cutaneous nerves of the gluteal region? Superior, middle and inferior cluneal
The gluteus maximus, medius and minimus originate where? Gluteal surface of ala of ilium
What is the action of the piriformis, obturator internus, gemellus superior and inferior, and quadratus femoris? (all gluteal muscles except gluteus mm) Laterally rotate the thigh
Where does the iliopsoas insert? the lessor trochanter of femur
What is the action of the iliopsoas? Major flexor of the thigh
What is the action of all of the quadriceps femoris muscles? Extends the leg
What is the action of the tensor fascia lata? It stabilizes the hip joint. Steadies the femur on the tibial condyles.
What is the action of the Sartorius muscle? It abducts, flexes, and laterally rotates the thigh. It flexes and medially rotates the leg.
What is the action of the articularis genu? It retracts the capsule of the knee joint during extension.
What is the innervation of the hamstrings? tibial portion of the sciatic nerve
What three muscles insert on the pes anserinus? sartorius, gracillis, and semitendinosus
What are the proximal structures of the tibia? medial and lateral condyles, and the tibial tuberosity
What are the distal structures on the tibia? medial malleolus, fibular notch, and medial malleolar sulcus
What is the function of the fibula? It carries no weight but rather serves for muscular attachment.
What is another name for the fibula's distal extremity? the lateral malleolus
What 3 parts make up the ankle? the distal extremity of tibia, fibula and talus
What is the proximal structure of the fibula? the apex or styloid process which points posteriorly
How can you tell the difference between a right and left fibula? The right fibula's styloid process will point posterior. The articular facet for the talus will be seen anterior. The malleolar fossa will be posterior.
How do fractures of the fibula commonly occur? They occur proximal to the lateral malleolus and are commonly associated with fracture dislocation of the ankle joint.
What are the tibia and fibula connected by? the tibiofibular syndesmosis and the interosseous membrane
What is the tibiofibular joint? It is a synovial joint formed by the head of the fibula and the lateral condyle of the tibia.
How is the tibiofibular syndesmosis formed? It is formed by the fibular notch on the distal extremity of the tibia and the distal aspect of the shaft of the fibula.
What is the only non synovial joint of the lower extremity? tibiofibular
What does the deep fascia of the leg region give rise to? septa that form the anterior, lateral, and posterior compartment of muscles
What is the deep transverse fascia? The posterior compartment of the leg is further divided into a deep and superficial compartment by this septa.
What vessels are in the superficial posterior compartment? There are no vessels or nerves.
All of the leg muscles except what muscle are extrinsic? the popliteus
Tendons passing anterior to the ankle joint axis are... dorsiflexors
Tendons passing posterior to the ankle joint axis are... plantarflexors
What is the primary function of the anterior leg muscles? dorisflexion of the foot for toe clearance during the swing phase and the prevention of foot slap at heel strike
What are the anterior compartment of the leg muscles? (4) -tibialis anterior -extensor hallucis longus -extensor digitorum longus -peroneus (fibularis) tertius
What are the two lateral compartment leg muscles? Peroneus (fibularis) longus and brevis
What is the primary function of the lateral compartment leg muscles? pronation (eversion) and plantarflexion of the foot
What two joints do the lateral compartment muscles cross to allow pronation? subtalar and midtarsal
What are the three muscles of the superficial posterior compartment of the leg? gastrocnemius, soleus, and plantaris
What is the primary function of the superficial posterior leg muscles? plantarflexion
What are the four muscles of the deep posterior compartment of the leg? popliteus, flexor hallucis longus, flexor digitorum longus, and tibialis posterior
What is the primary function of the deep posterior leg muscles? plantarflexion and supination
What is the action of the popliteus muscles? It unlocks the knee joint at the beginning of flexion. The unlocking is slight lateral rotation.
What is venae commitantes? It means accompanying vein. Artery is accompanied by paired veins. There are cross connections as you go up. The pulse of the artery helps venous return.
What is found in the space between the flexor hallucis and flexor digitorum longus? The posterior tibial artery and tibial nerve are found here. You take the posterior tibia pulse here.
What is the insertion of the gastrocnemius and soleus? the posterior surface of the calcaneus via the tendo calcaneus
What is the insertion of the flexor digitorum longus? distal phalanges of the lesser digits
What is the insertion of the flexor hallucis longus?
What is the innervation of the anterior compartment of the leg? deep peroneal (fibular) nerve
What is the innervation of lateral compartment of the leg muscles? superficial peroneal (fibular) nerve
What is the innervation of the posterior compartment of the leg? (superficial and deep) the tibial nerve
What is anterior compartment syndrome? It is an increased pressure within the anterior compartment of the leg which compresses the nerve and vascular supply to the muscles. Loss of function of the anterior compartment muscles results in foot drop and loss of sensation in the first web space.
What are spin splints? It is pain at the front of the leg usually during exercise. Pain is due to an inflammation of the periosteum at the origin of the tibialis anterior.
What do the superficial veins flow into? the great saphenous vein and small saphenous vein
The leg is vascularized by what three arteries? the anterior and posterior tibial artery and the peroneal artery
What is the path of the anterior tibial artery? It is a branch of the popliteal artery. It courses through the interosseous membrance and descends in the anteior compartment of the leg. It's name changes to dorsalis pedis artery on the talcural joint.
What does the posterior tibial artery divide into? medial and lateral plantar arteries, and peroneal artery
Created by: tzibern2



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