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WEEK 26:
Introduction to the anatomy of posterior aspect of lower limb:
| Question | Answer |
|---|---|
| key features of the pelvis (8) | ilium, ischium, pubic, ischial tuberosity, sacroiliac joint, acetabulum, pubic symphysis, and posterior superior iliac spine |
| ligaments of the pelvis (2) | sacrotuberous and sacrospinous |
| key features of femur (8) | head, neck, greater trochanter, lesser trochanter, intertrochanteric line and crest, gluteal tuberosity, linea aspera, and condyles |
| key features of tibia (4) | condyles, intercondylar eminence, tuberosity, and medial malleolus |
| key feature in fibula | lateral malleolus |
| movement of the hip (6) | lateral external rotation, medial internal rotation, adduction, and abduction, extension, and flexion |
| movement of foot (4) | inversion, eversion (of subtalar), flexion, extension (of metatarsophalangeal and phalangeal) |
| ankle movement (2) | plantarflexion and dorsiflexion |
| fascia lata | deep fascia of thigh which is strong and limits outward extension of contracting muscles. It's important in venous return- compressing veins to push blood towards heart |
| iliotibial tract | where fascia lata is thickened laterally |
| where is the fascia lata is thickened laterally | iliotibial tract |
| superficial gluteal muscles (4) | gluteus maximum, gluteus medius, gluteus minimus, and tensor fascia lata |
| innervation of gluteus maximus | inferior gluteal nerve |
| innervation of gluteus medius and gluteus minimus | superior gluteal nerve |
| movement of gluteus medius and gluteus minimus (2) | abduction and medial rotation of hip |
| movement of gluteus maximus | extends and laterally rotates thigh |
| tensor fascia lata | flexor of thigh (working along with rectus femoris and iliopsoas) |
| deep gluteal muscles (4) | piriformis, obturator internus, gemelli (superior and inferior), and quadratus femoris |
| innervation of piriformis | branches of anterior rami of S-, S2 |
| innervation of obturator internus and gemelli (superior and inferior) | nerve to obturator intemus (L5-S1) |
| innervation of quadratus femoris | nerve to quadratus femoris (L5-S1) |
| movement of deep gluteal muscles and function | lateral rotation and abduction of hip and to stabilise hip to steady femoral head in acetabulum |
| piriformis | anterior surface of sacrum, superior margin of greater sciatic notch and sacrotuberous ligaments to greater trochanter of femur. |
| movement of piriformis | lateral rotation and abduction of hip |
| obturator internus | pelvic surface of ilum, ischium and obturator membrane to greater trochanter |
| movement of obturator internus | lateral rotation and abduction of hip |
| superior gemelli | ischial spine to greater trochanter of femur |
| gemelli can be split into | superior and inferior |
| movement of superior gemelli | lateral rotation and abduction of hip |
| inferior gemelli | ischial tuberosity to greater trochanter of femur |
| movement of inferior gemelli | lateral rotation and abduction |
| quadratus femoris | ischial tuberosity to quadrate tubercle of intertrochanteric crest of femur |
| quadratus femoris movement | lateral rotation of hip and pulls femoral head into acetabulum |
| landmark muscle in gluteal region | piriformis |
| greater sciatic foramen | major route for structures to pass between the pelvis and gluteal region |
| piriformis muscle passes out from | pelvis to gluteal region through sciatic foramen which is separated by it into 2 parts (above muscle and below muscle) |
| above piriformis | superior gluteal nerve and vessels |
| below piriformis (7) | sciatic nerve, inferior gluteal nerves + v, pudendal nerve + internal pudendal v, supply none in gluteal but perineal region, posterior cutaneous nerve thigh, nerve to obturator internus + femellus superior, +nerve to quadratus femoris + gemellus inferior |
| all nerves are branches of | sacral plexus |
| main continuation of sacral plexus | sciatic nerve |
| the sciatic nerve supplies | non in gluteal region but post thigh muscles, all leg and foot muscles and skin of most of leg and foot also supplies all lower limb joints |
| lesser sciatic foramen | connects the gluteal region with perineum |
| structures passing through lesser sciatic foramen | tendon of obturator internus, pudendal nerve and internal pudenal vessels (exist pelvis through the GSF, enter the perineum through LSF) |
| parts of the posterior compartment of thigh (4) | short head of biceps, long head of biceps femoris, semimembranosus, semitendinosus |
| short head of biceps crosses | crosses knee joint only |
| hamstrings are made of (3) | long head of biceps femoris, semimembranosus, and semitendinosus |
| hamstrings cross both | hip and knee joint |
| all hamstrings originate from | isch tuberosity |
| hamstring are innervated by | tibial division of sciatic nerve |
| innervation of short head of biceps femoris | common fibular division of sciatic nerve |
| hamstring injuries are caused by | tearing isch tuberosity by inadequate warming up in sports eg soccer players |
| long head of biceps femoris | Ischial tuberosity to lateral side of head of fibula |
| movement of long head of biceps femoris | Extend hip joint, flex knee joint and rotates leg laterally when knee flexed |
| semimembranosus | Ischial tuberosity to posterior medial condyle of tibia |
| movement of semitendinosus | Extend hip joint, flex knee joint and rotates leg medially when knee flexed, when hip and knee flexed – can extend trunk |
| semitendinosus | Ischial tuberosity to medial surface of tibia (pes anserinus) |
| short head of biceps femoris | Linea Aspira and lateral supracondylar line of femur to lateral side of head of fibula |
| movement of short head of biceps femoris | Flex knee joint and rotate leg laterally when knee flexed. |
| boundaries of popliteal fossa (5) | superomedial, superolateral, inferomedial, and inferolateral |
| superomedial boundary of popliteal fossa | semimembranosus |
| superolateral boundary of popliteal fossa | biceps femoris |
| inferomedial boundary of popliteal fossa | gastrocnemius (medial head) |
| inferolateral boundary of popliteal fossa | gastrocnemius (laterl head) |
| contents of popliteal fossa (4) | popliteal artery, popliteal vein, tibial nerve, and common fibular nerve |
| popliteal artery is deep to | popliteal vein |
| popliteal vein is deep to | tibeal nerve |
| superficial parts of the posterior aspect of the leg (3) | gastrocnemius, soleus, and plantaris (which insert through calcaneal tendon) |
| innervation of superficial muscles in the posterior aspect of leg | tibial nerve |
| triceps surae made of | gastrocnemius and soleus |
| movement of gastrocnemius | Plantarflexion of ankle when knee extended, flexes knee joint and raises heel on walking. |
| lateral head of gastrocnemius | lateral condyle of femur to post. surface of calcaneus via calcaneal tendon. |
| medial head of gastrocnemius | Popliteal surface of femur, superior to medial epicondyle to post. Surface of calcaneus via calcaneal tendon. |
| heads of gastrocnemius (2) | medial and lateral |
| soleus | Posterior head of fibula, superior posterior surface of fibula, soleal line and medial tibial border to posterior surface of calcaneus via calcaneal tendon |
| movement of soleus | Plantarflexion of ankle, antigravity msl, |
| plantaris | inferolateral supracondylar line of femur and oblique popliteal ligament to posterior surface of calcaneus via calcaneal tendon |
| plantaris movement | Weakly assists gastrocnemius in plantarflexion of ankle |
| deep muscles of the posterior aspect of leg (4) | popliteus, tibialis posterior, flexor digitorum longus, and flexor hallucis longus |
| popliteus movement | Weak knee flexion & unlocks knee |
| tibialis posterior movement | Plantarflexion of ankle, foot inversion and arch support |
| flexor digitorum longus movement | Flexes lateral 4 digits, plantarflexion of ankle and arch support |
| flexor hallucis longus movement | Flexion of great toe, weak plantarflexion and arch support |
| innervation of deep muscles in posterior aspect of leg | tibial nerve |
| popliteus | Lateral condyle of femur and lateral meniscus (intra-articular) to post. surface of tibia, superior to soleal line |
| tibialis posterior | Tibialis posterior – Posterior surface of tibia (inf. to soleal line), fibula and interosseous membrane to tuberosity of navicular, cuneiforms, cuboid and bases of 2nd-4th metatarsals |
| flexor digitorum longus | Posterior surface of tibia (inf. to soleal line) to bases of distal phalanges of lateral 4 digits. |
| flexor hallucis longus | Inferior 2/3 posterior fibula and interosseous membrane to base of distal phalanx of great toe. |
| lateral compartment of leg includes (2) | fibularis longus and fibularis brevis |
| fibularis longus | head of fibula and superior 2/3 fibula surface to base of 1st metatarsal and medial cuneiform |
| movement of fibularis longus | foot eversion and weak plantarflexion |
| fibularis brevis | middle part of lateral surface of fibula to dorsal surface of tuberosity of base of 5th metatarsal |
| movement of fibularis brevis | foot eversion and weak plantarflexion |
| innervation of the muscles in the lateral compartment of the leg | superficial fibular nerve |
| another name for fibularis term | peroneus |
| contents of the tarsal tunnel (medial malleolus) (6) - tom dick and very naughty harry | Tibialis Posterior Flexor Digitorum longus Posterior Tibial Artery Posterior Tibial Vein Tibial Nerve Flexor Hallucis Longus |
| arteries of lower limb (2) | internal and external iliac artery |
| internal iliac artery splits into (2) | obturator artery and superior and inferior gluteal arteries |
| obturator artery supplies | medial compartment of thigh |
| superior and and inferior gluteal arteries supply | gluteal muscles |
| external iliac artery -> | femoral artery |
| femoral artery splits into (2) | profunda femoris artery and popliteal artery |
| profunda femoris artery -> | 3-4 perforating branches to supply adductor magnus, hamstrings, vastus lateralis |
| popliteal artery splits into (2) | anterior tibial artery and posterior tibial artery |
| anterior tibial artery -> | dorsalis pedis artery |
| posterior tibial artery -> | medial and lateral plantar arteries |
| dorsal venous arch drains into | anterior tibial vein |
| plantar digital veins drain into | plantar arch |
| anterior tibial vein drains into | popliteal vein |
| plantar arch drains into | posterior tibial and fibular vein |
| posterior tibial and fibular vein drains into | popliteal vein |
| profunda femoris vein drains into | femoral vein |
| popliteal vein drains into | femoral vein |
| femoral vein drains into | external iliac vein |
| dorsal digital vein of 5th digit drains into | small saphenous vein |
| small saphenous vein | popliteal vein |
| dorsal venous arch drains into (2) | small saphenous vein and great saphenous vein |
| dorsal digital vein of great toe drains into | great saphenous vein |
| great saphenous vein drains into | femoral vein |
| superficial veins | dorsal digital vein of 5th digit, small saphenous vein, dorsal venous arch, great saphenous vein, dorsal digital vein of great toe |
| deep veins | dorsal venous arch, anterior tibial vein, profunda femoris vein, plantar digital veins, plantar arch, posterior tibial and fibular vein, popliteal vein, femoral vein |
| all veins directly and indirectly drain into | external iliac vein |
Created by:
kablooey
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