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How many regions are in the lower limb? What are they?
6
-gluteal, femoral, knee, leg, ankle, foot
What is the main function of the pelvic girdle?
transfer weight of upper body
How many bones make up the bony pelvis?
3 fused bones
-R hip, L hip, and sacrum
Which 3 bones fuse to form the hip bones
ilium, ischium, pubis
Where on the hip articulates with the femur?
acetabulum
-formed by ilium (superior), pubis (anterior), and ischium (post-inferior)
Which bone forms the posteroinferior part of the acetabulum and hip bone?
ischium
What two features are unique to the ilium?
iliac crest and ASIS
What is the longest and heaviest bone in the body (approx. ¼ person’s height)?
femur
Features of the proximal end of the femur:
femoral head, femoral neck, greater trochanter, lesser trochanter
Features of the distal end of the femur:
lateral and medial epicondyles, lateral and medial condyles, patellar surface
What is the linea aspera?
line on the posterior shaft of the femur
What supplies blood to the femoral head?
medial femoral circumflex a.
-disruption of supply leads to avascular necrosis
What is another word for femoral neck fracture?
broken hip
Describe the patella:
large triangular shaped sesamoid bone
How is the patella attached to the quadriceps?
superior attachment - tendons of quadriceps
Describe the tibia:
larger for weight bearing, medial
Tibia features:
medial condyle, lateral condyle, tibial plateau, tibial tuberosity
What is the medial malleolus?
medial projection on distal aspect of tibia
Describe the fibula:
lies posterolateral to tibia; not involved with weight bearing
-major function is for muscle attachment
What does the knee joint stability depend on?
muscle/tendon strength and ligaments connecting femur-tibia
What are the ligaments of the knee?
LAMP
-lateral collateral ligament (LCL)
-anterior cruciate ligament (ACL)
-medial collateral ligament (MCL)
-posterior cruciate ligament (PCL)
role of the ACL
prevents hyperextension and posterior displacement
role of the PCL
prevents hyperflexion and anterior displacement of femur
What is the role of the meniscus?
protects the tibia and femur from rubbing on each other (shock absorption)
-both lateral and medial (know locations)
Where does the meniscus lie?
tibial plateau
Define bursae:
fluid-filled sac where the muscle or tendon slides across bone
Name the bursae of the knee
suprapatellar, prepatellar, infrapatellar -deep, infrapatellar -superficial
What are the bones of the foot?
tarsals (7), metatarsals (5), phalanges (14) 3 for each digit except for great toe (2)
What are the 7 tarsals?
calcaneus, talus, cuboid, navicular, medial cuneiform, intermediate cuneiform, lateral cuneiform
Talus role
bears body weight, transmitted from tibia
articulates anteriorly with navicular bone
location of the cuboid
most lateral bone in distal row of tarsus, articulates with 2 metatarsals
deltoid ligament
medial, stabilizes during eversion and prevents subluxation
lateral ankle ligaments
CAP
calcaneofibular ligament (CFL)
anterior talofibular ligament (ATFL)
posterior talofibular ligament (PTFL)
1st metatarsal
shorter, stouter
significant role in supporting weight of body
-has sesamoid bones
which metatarsal is the longest?
2nd metatarsal
1st digit of the foot:
great toe -has 2 phalanges (proximal and distal)
Metatarsophalageal joints
MTPs -between metatarsals and phalanges
Which nerve innervates the anterior thigh, hip flexors, and knee extensors?
femoral nerve
what 3 muscles make up the posterior compartment of the thigh (hamstrings)?
biceps femoris m., semitendinosus m., semimembranosus m.
Which 4 muscles make up the quadriceps femurs?
rectus femoris m., vastus lateralis m., vastus intermedius m., vastus medialis m.
What is the longest muscle in the body? (know as the “tailor’s muscle)
sartorius m. (crosses two joints (hip & knee))
What is collectively the most powerful muscle in the body?
Quadricep muscles
What nerve is the primary innervation for the medial compartment of the thigh?
obturator n.
What muscles make up the medial compartment of the thigh?
adductor longus m., adductor brevis m., adductor Magnus m., gracilis m., obturator externus m.
What is the most superficial muscle on the medial thigh?
Gracilis m.
What is the femoral triangle bounded by?
Inguinal ligament (superiorly) (forms the base)
Sartorius m. (laterally)
Adductor longus m. (medially)
What is the femoral triangle?
subfascial space located in the anterosuperior 1/3 of the thigh
When and where is the femoral triangle visible?
when: visible when the thigh is abducted, flexed, and laterally rotated
where: triangular depression inferior to the inguinal ligament
What muscles compose the floor of the femoral triangle?
medially - pectinous and adductor longus
laterally - iliopsoas
Contents of the femoral triangle
NAVeL
femoral Nerve, femoral Artery, femoral Vein, deep inguinal Lymph nodes
What does the femoral sheath hold?
encloses femoral vessels, not nerves
creates a canal for the femoral artery, femoral vein, and femoral canal
Where does the femoral sheath lie?
deep to the inguinal ligament
What is the chief artery of the lower limb?
femoral artery
What is the chief artery of the thigh?
profunda femoris artery
What are the branches of the profunda femoris artery?
medial circumflex femoral artery (femoral head)
lateral circumflex femoral artery (lateral thigh)
Venous drainage of the lower limb
greater saphenous v., femoral v., external iliac v., common iliac v.
What is the function of the sciatic nerve?
supplies most of the leg and foot muscles
Where does the sciatic nerve split? What does it split into?
divides into tibial and common fibular (perineal) nerves in popliteal fossa
Where does the sciatic nerve exit the pelvis?
exits pelvis via greater sciatic foramen
What are the boundaries of the popliteal fossa?
biceps femoris m. (superior lateral)
Semimembranosus m. & semitendinosus m. (superior medial)
gastrocnemius m. (inferolateral and inferomedial)
What is the popliteal fossa?
triangular space posterior to the knee
What does the popliteal fossa contain?
small saphenous v., popliteal artery & vein, sciatic n.
What muscles are in the anterior compartment of the leg?
tibialis anterior m., extensor digitorum longus m., extensor hallucis longus m., peroneus (fibularis) tertius m.
What is in the lateral compartment of the leg?
peroneus (fibularis) longus m. , peroneus (fib) brevis m., superficial peroneal n.
-NO arteries course through lateral compartment
Where does the superficial perineal n. most commonly get injured? What does this lead to?
most often injured in the lower limb; results in foot drop, loss of dorsiflexion of ankle
What nerve supplies the posterior compartment of the leg?
tibial nerve
superficial muscles of the posterior compartment of the leg
gastrocnemius m., soleus m., plantaris m.
deep muscles of the posterior compartment of the leg
popliteus m., flexor hallucis longus m., flexor digitorum longus m., tibialis posterior m.
Where can the dorsalis pedis artery be palpated?
lateral to extensor hallucis longus tendon
Where does inversion of the ankle occur?
occurs at the subtalar joint
What muscles are involved with inversion of the ankle?
tibialis anterior m. and tibialis posterior m.
What muscles are involved with eversion of the ankle?
peroneus longus m. and peroneus brevis m.