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