Lower Limb

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Author:
Bobopudge
ID:
57103
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Lower Limb
Updated:
2010-12-28 14:52:04
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Anatomy
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  1. State the functions of the lower limb
    • Weight bearing
    • Locomotion
  2. State structure and function of inguinal ligament
    • Structure: goes from ASIS to pubic tubercle
    • Function: passageway for nerves, vessels, and muscles from abdomen into the thigh
  3. Describe superfiscial fascia of lower limb
    • Continous layer over whole limb
    • Areaolar tissue containing fat
    • Carries superfiscial vessels and nerves in between fat
  4. Describe deep fascia of the thigh
    • Thick membrane like covering
    • Attached to inguinal ligament, iliac crest, sacrum, coccyx, and pubic bone above
    • Continuous with deep fasci of leg below
  5. What is the saphenous opening?
    • Hole in the facial lata on the anterior aspect of thigh
    • Located inferior to medial end of inguinal ligament
    • Enterance for great saphenous vein
    • Which passes from superfiscial fascia to deep fascia to meet the femoral vein
  6. What is the femoral triangle
    • A triangular shaped depression in upper thigh
    • Apex points downwards
  7. What are the boundaries of femoral triangle
    • Laterally: medial border of Sartoria
    • Medially: lateral border of Adductor longus
    • Superiorly: Inguinal ligament
  8. What makes up the floor of the femoral triangle?
    From lateral to medial: the ileopsoas and the pectineus muscles
  9. What are the contents of the femoral triangle?
    From lateral to medial: femoral nerver, artery, vein, and lymphatics
  10. The word fascia comes from the Latin word fascis, meaning ______
    A bundle because it bundles things together
  11. Decribe the path of the great saphenous vein
    • Originates in the medial part of the dorsal venous arch
    • Passes in front of medial malleolus
    • Up the medial side of leg
    • 4 finger width from medial border of patella
    • Joins femoral vein in femoral triangle
  12. Describe path of small saphenous vein
    • Originates from lateral part of dorsal venous arch
    • Curves from lateral to posterior side of leg
    • Joins popliteal vein behind the knee
  13. What are Langer’s lines?
    • Natural crease lines in the skin
    • Surgical incisions are made along these lines
    • Avoid obvious scars
  14. describe the femoral artery
    • Major artery supplying the lower limb
    • Continuation of External Iliac artery
    • Begins under the inguinal ligament
    • Passes inferiorly and medially in adductor canal
    • Ends through the adductor hiatus in adductor magnus muscle
    • Becomes the popliteal artery
  15. Where can u find the femoral pulse?
    Mid inguinal point: half way between ASIS and pubic symphysis
  16. Name the branches of the femoral artery
    • Profunda femoris
    • Lateral circumflex femoral
    • Medial circumflex femoral
    • Perforating arteries
  17. Describe the femoral nerve
    • Originates from lumbar lexus (L2, L3, L4)
    • Enters femoral triangle
    • Divides into anterior and posterior divisions
    • Supplies anterior compartment of thigh
  18. Describe lymph drainage of lower limb
    Drain into superficial and deep inguinal nodes
  19. What is the adductor canal?
    • Aponeurotic tunnel in middle third of thigh
    • Extends from apex of femoral triangle to adductor hiatus
    • Contains femoral artery, vein, saphenous nerve, and nerve to vastus medialis
  20. What are the borders of the Adductor canal?
    • Front and lateral: Vastus medialis
    • Behind: Adductor longus and magnus
  21. Breifly describe the muscular compartments of the thigh
    • Divided into 3 parts seperated by intermuscular septa:
    • anterior (quads)
    • medial (adductors)
    • posterior (hamstrings)
  22. Discuss the actions of muscles
    • Muscles act on joints which they cross
    • Contraction will move the point of insertion towards point of origin
  23. Define the following:
    • Concentric contraction: muscle shorten
    • Eccentric contraction: muscle lengthens
    • Muscles act as opposing pairs
  24. Name the muscle of the anterior compartment of the thigh. List their functions
    • Functions: flex the hip joint, extend the knee joint.
    • Names:
    • Illiacus
    • Psoas
    • Quadriceps (Vastus medialis, lateralis, intermedialis, Rectus femoris)
    • Sartorius
  25. State the origin, insertion, action, and innervation of the PSOAS muscle
    • Origin: lumbar vertebrae
    • Insertion: lesser trochanter
    • Action: hip flexion
    • Nerve supply: lumbar plexus (L1, L2, L3)
  26. State the origin, insertion, innervation and action of the Illiacus muscle
    • Origin: iliac fossa
    • Insertion: lesser trochanter
    • Action: hip flexion
    • Nerve supply: femoral nerve (L2, 3, 4)
  27. State the origin, insertion, action and nerve supply of Vastus medialis
    • Origin: medial shaft of femur
    • Insertion: patella through the quadriceps tendon
    • Action: extend knee
    • Nerve supply: femoral nerve (L2, 3, 4)
  28. State the origin, insertion, action and nerve supply of Vastus Lateralis
    • Origin: lateral shaft of femur
    • Insertion: patella through the quadriceps tendon
    • Action: knee extension
    • Nerve supply: femoral nerve (L2, 3, 4)
  29. State the origin, insertion, action and nerve supply of Vastus Intermedius
    • Origin: anterior shaft of femur
    • Insertion: patella through quadriceps tendon
    • Action: knee extension
    • Nerve supply: Femoral Nerve (L2, 3, 4)
  30. State the origin, insertion, action and nerve supply of Rectus femoris
    • Origin: straight head- AIIS, relected head – ilium
    • Insertion: patella through quadriceps tendon
    • Action: flexes hip, extends knee
    • Nerve supply: Femoral nerve (L2,3, 4)
  31. State the origin, insertion, action and nerve supply of Sartorius muscle
    • Origin: ASIS
    • Insertion: anteromedial aspect of proximal tibia
    • Action: flexes hip and knee
    • Nerve supply: femoral nerve (L2,3,4)
  32. What is the obturator canal?
    • Defficiency at the top of obturator foramen
    • Conducts the obturator nerve and vessels
  33. Name the muscles of the medial compartment of the thigh. State their function
    • Function: adduct, stabilize stance, lateral rotation
    • Names:
    • Gracilis
    • Pectinius
    • Adductor Longus
    • Adductor Magnus
    • Adductor Brevis
    • Obturator Externus
  34. State the origin, insertion, action and nerve supply of Gracilis muscle
    • Origin: pubis
    • Insertion: superior surface of tibia
    • Action: adducts thigh, flexes leg
    • Nerve supply: Obturator nerve (L2,3,4)
  35. State the action and nerve supply of the Pectineus
    • Action: Adducts and flexes thigh
    • Nerve supply: Femoral Nerve (L2,3,4)
  36. State the origin, insertion, action and nerve supply of Obturator Externus
    • Origin: obturator membrane
    • Insertion: trochanteric fossa
    • Action: lateral rotation
    • innervation: Obturator nerve (L2,3,4)
  37. State the origin, insertion, action and nerve supply of Adductor Longus
    • Origin: pubis
    • Insertion: middle linea aspera
    • Action: adducts thigh
    • Nerve supply: Obturator nerve (L2,3,4)
  38. State the origin, insertion, action and nerve supply of Obturator Brevis
    • Origin: pubis
    • Insertion: upper linea aspera
    • Action: adducts thigh
    • Innervation: obturator nerve (L2,3,4)
  39. State the origin, insertion, action and nerve supply of Adductor Magnus
    • 2 parts
    • Adductor Part:
    • Origin: pubis
    • Insertion: linea aspera (which is a ridge on the posterior side of the femur)
    • Nerve supply: Obturator (L2,3,4)
    • Action: adducts thigh
    • Hamstring part:
    • Origin: ischial tuberosity
    • Insertion: Adductor tubercle
    • Nerve supply: Sciatic nerve (tibial part) L4-S3
    • Action: adducts thigh
  40. Describe the sacrospinal ligament
    Runs from the sacrum to ischial spine
  41. Describe the sacrotuberous ligament
    Runs from sacrum to ischial tuberosity
  42. Describe the greater sciatic foramen
    • Major route from pelvis to gluteal region
    • Piriformis muscle runs through it
    • Divides it into upper and lower part
  43. Name the structures which pass through the greater sciatic foramen
    • Above piriformis:
    • superior gluteal nerve and vessels
    • Below piriformis:
    • sciatic nerve
    • inferior gluteal nerves and vessels
    • pudenal nerve and internal pudenal vessels
    • posterior cutaneous nerve of thigh
    • nerves to obturator internus; gammelli; and quadratus femoris
  44. Describe the lesser sciatic foramen
    • Connects gluteal reagion with perineum
    • Structures passing through:
    • - Tendon of obturator internus
    • - Pudenal nerve and internal pudenal vessels
    • (which exit the pelvis through GSF and enter perineum through LSF)
  45. What is the largest nerve in the body? What are its roots?
    • Sciatic nerve
    • L4-S3
  46. Describe the path of Sciatic nerve. What does it supply?
    • Path:
    • leaves pelvis through GSF (under piriformis)
    • passes through gluteal region
    • enters posterior compartment of thigh
    • Supplies:
    • all muscles in posterior compartment of thigh
    • part of adductor magnus
    • all muscles in leg and foot
    • skin on lateral side of leg, and lateral side of sole of foot
  47. What is sciatica?
    • Pain in lower limb
    • Due to compression of lumbar spine nerve root
    • Irritates of sciatic nerve
  48. Name the Gluteal muscles. State their function
    • Function: Abduct, extend, laterally rotate hip joint
    • Names:
    • Superfiscial
    • - Gluteus minimus, maximus, and medius
    • - Tensor of fascia lata
    • Deep
    • - Piriformis
    • - Obturator internus
    • - Gamellus superior and inferior
    • - Quadratus femoris
  49. State the origin, insertion, action and nerve supply of Gluteus Maximus
    • Origin: external surface of ileum, sacrum, coccyx
    • Insertion: Posterior part of iliotibial tract, gluteal tuberosity, proximal femur
    • Action: hip extension
    • Nerve supply|: Inferior gluteal nerve (L5, SI, S2)
  50. State the origin, insertion, action and nerve supply of Gluteus Medius
    • Origin: external surface of ileum, gluteus minimus
    • Insertion: greater trochanter
    • Action: hip abduction, reduce pelvic drop
    • Nerve supply: Superior gluteal nerve (L4, L5, S1)
  51. State the origin, insertion, action and nerve supply of Gluteus Minimus
    • Origin: external surface of ileum
    • Insertion: greater trochanter
    • Action: hip abduction, reduce pelvic drop
    • Nerve supply: Superior gluteal nerve (L4, L5, S1)
  52. State the origin, insertion, action and nerve supply of Tensor of Fascia Lata
    • Origin: iliac crest
    • Insertion: anterior part of iliotibial tract
    • Action: stabilize knee in extension
    • Nerve supply: Superior gluteal nerve (L4, L5, S1)
  53. Describe Superior gluteal nerve
    • Passes through GSF above piriformis
    • Passes laterally between medius and minimus
    • Supplies medius, minimus, and tesor fascia lata
  54. Describe the Inferior gluteal nerve
    • Passes through GSF below piriformis
    • Innervates gluteus maximus
  55. Describe pudenal nerve
    • Passes through GSF below piriformis
    • Passes over sacrospinous ligament and into peineum via LSF
  56. What is the iliotibial tract?
    • Longitudinal fibrous reinforcement of fascia lata.
    • Runs down the lateral thigh to attach to the upper tibia
    • Attachments: gluteus maximus (posterior part) and tensor fascia lata (anterior part)
  57. Describe gluteal arteries
    • Superior:
    • starts from internal ileac artery
    • enters gluteal region with superior gluteal nerve
    • divides into superficial and deep branches
    • supplies adjacent muscles and part of hip
    • Inferior:
    • starts from internal iliac artery
    • enters gluteal region with inferior gluteal nerve
    • supplies adjacent muscles

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