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76 Cards in this Set
- Front
- Back
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During development, the lower limbs are rotated 90 degrees _____ and the upper limbs are rotated 90 degrees _____
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-medially
-laterally |
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The bony pelvis consists of:
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pelvic girdle
sacrum coccyx |
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Name the bones of the lower limb
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-femur
-tibia and fibula -tarsal bones (7) -metatarsal bones (5) -phalanges (14) |
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The hip joint is an articulation of what?
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head of femur and acetabulum
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The knee joint is an articulation of what?
What is also included in the knee joint? |
-femoral and tibial condyles
-patellofemoral joint |
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What is another name for the ankle joint what articulations make up the ankle joint?
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-talocrural joint
-tibia, fibula, and talus |
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Hip fracture or "broken hip" usually refers to a fracture in what region of the lower limb?
Which is most common in elderly women with osteoporosis? |
-neck of femur (common in elderly women with osteoporosis)
-femoral head -trochanters |
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After a fracture of the femoral neck, what structure may be torn?
What could this result in? |
-Retinacular branches of the femoral circumflex
-Can result in avascular necrosis of the femoral head |
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What is an avulsion fracture?
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injury to part of bone that serves as attachment for tendon or ligament
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Hamstring muscles may avulse ____
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the ischial tuberosity
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_____ may be avulsed in skeletally immature individuals. The sartorius muscle may avulse the ____ in adolescents
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-Muscle attachments
-ASIS |
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_____ is an over use syndrome with traction epiphysitis or partial avulsion of the tibial tuberosity (quadriceps femoris insertion) in adolescents
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Osgood-Schlatter disease
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What is the deep fascia of the thigh?
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fascia lata
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What is the lateral thickening of the fascia lata?
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illiotibial tract
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What inserts into the illiotibial tract?
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gluteus maximus and the tensor fasciae latae
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The fascia lata sends _____________________ to the linea aspera to define the three compartments of the thigh.
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intermuscular septa
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The deep fascia of the leg is called...
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the crural fascia
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The deep fascia of the leg is thickened at ankle and dorsum of the foot to form...
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retinacula
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The deep fascia of the leg is thickened at the sole of the foot to form the...
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plantar aponeurosis
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Increases in intracompartmental pressures due to muscle swelling from trauma, overuse, hemorrhage or local infection may produce ___________________
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compartment syndrome
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Compartment syndrome may result in occlusion of blood vessels with possible development of _______________________.
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Volkmann's ischemic contracture
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Muscles of the anterior compartment of the thigh are innervated by what nerve?
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femoral nerve
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Muscles of the medial compartment of the thigh are innervated by what nerve?
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obturator nerve
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Muscles of the posterior compartment of the thigh are innervated by what nerve?
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tibial nerve, coming from the sciatic nerve...except for the short head of the biceps femoris which is supplied by the common fibular nerve
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Muscles of the anterior compartment of the leg are innervated by what nerve?
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deep fibular nerve
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Muscles of the lateral compartment of the leg are innervated by what nerve?
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superficial fibular nerve
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Muscles of the posterior compartment of the leg are innervated by what nerve?
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tibial nerve
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The four layers of plantar muscles are innervated by...
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the lateral and medial plantar nerves
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An injury to a ligament is called a
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sprain
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An injury to a muscle-tendon unit is called a
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strain
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Explain the blood flow of the lower limb...
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abdominal aorta divides into 2 COMMON ILLIAC ARTERIES. Each common illiac artery divides into the INTERNAL AND EXTERNAL ILLIAC ARTERY. Internal supplies pelvis and thigh, dividing into the SUPERIOR/INFERIOR GLUTEAL ARTERIES and the OBTURATOR ARTERY. External becomes the FEMORAL ARTERY at the inguinal ligament and supplies most of the lower extremities
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Collateral circulation occurs in the lower extremities with the cruciate anastomoses, which include:
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1. inferior gluteal
2. medial femoral circumflex 3. lateral femoral circumflex 4. first perforating arteries |
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Chronic arterial occlusive disease most commonly occurs within the ______________ as it passes through the ______________.
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-femoral artery
-adductor canal |
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Chronic arterial occlusive disease is caused by repetitive injury of the arterial epithelium from _____________________________.
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buildup of lipid and formation of plaque called ATHEROSCLEROSIS, narrowing the lumen of the vessel
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Shiny skin, very little hair, thick toenails on the affected limb, a nonpalpable popliteal or dorsalis pedis anterior pulse and ischemic ulcers are all signs and symptoms of...
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chronic arterial occlusive disease
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What is claudication?
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pain in a muscle group during activity in the legs due to poor blood supply (ischemia)
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Advanced CAOD causes extreme burning pain in the legs and feet at night called
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ischemic rest pain
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What is used by clinicians to determine the extent of arterial insufficiency?
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ankle-brachial index (ABI)
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How do you calculate ABI?
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systolic BP at ankle / systolic BP of the arm.
Ex: 72 (ankle)/120 (arm) = 0.6 |
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Very low ABI values indicate
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peripheral arterial disease (PAD)
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PAD refers to what vessels in the body?
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smaller and more peripheral vessels
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The dorsal venous arch of the foot drains into the superficial veins of the leg, including the...
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great saphenous vein and small saphenous vein
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What vein is found on the medial aspects of the foot, ankle, leg and thigh and empties into the femoral vein?
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great saphenous vein
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What vein is found on the lateral aspects of the foot and ankle, then moves posteriorly to join the popliteal vein at the popliteal fossa to become the femoral vein?
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the small saphenous vein
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The great saphenous vein passes through the _______________ to empty into the femoral vein.
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saphenous opening in the fascia lata
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The great saphenous vein is easily accessed ______________________ for intravenous access (saphenous cutdown) for cardiac bypass surgery. The ____________ nerve, which accompanies it, can be easily injured.
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-accessed anterior to the medial malleolus
-saphenous nerve |
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The small saphenous vein begins ________________.
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posterior to the lateral malleolus
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The small saphenous vein passes between ____________________ to drain into the _________________.
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-heads of the gastrocnemius
-popliteal vein |
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Enlarged superficial veins, usually in the lower extremities, are called...
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varicose veins
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A major treatment of varicose veins is _____________, in which a _________________ is injected to cause the vein to shrink and close.
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-sclerotherapy
-sclerosing agent |
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In surgery for varicose veins, vein stripping/ligation/removal is done to the _____________________.
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great saphenous vein at its entrance to the femoral vein in the groin
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Venous return to the heart from the legs is impaired in patients with ____________ because their valves become enlarged, making the valves incompetent and allowing reflux of blood.
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varicose veins
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What is the classic triad etiology for DVT?
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1. Venous stasis
2. Injury to vessel wall 3. Hypercoagulable state |
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Surgery, prolonged bed rest, and travel can all cause
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DVT
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What are the two serious consequences of DVT?
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1. Pain/chronic swelling in areas occluded by the clot leading to VENOUS HYPERTENSION
2. PULMONARY EMBOLISM where the clot travels to the lung |
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Approximately ______% of all pulmonary embolisms arise from ______.
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90% from DVT
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What can be a common source for a fat embolism?
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fractured long bone
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What is the difference between a thrombus and an embolism?
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thrombus - when a clot is lodged
embolism - when a clot is dislodged and travels up a vessel |
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The superficial inguinal nodes receive lymph from...
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1. gluteal region
2. abdominal wall below umbilicus 3. external genitalia and perineum (but not testes) 4. inferior vagina 5. inferior anal canal |
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The superficial inguinal nodes receive lymph from lymph vessels accompanying the...
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great saphenous vein
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The deep inguinal lymph nodes are found along the...
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medial aspect of the femoral vein
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The superficial and deep inguinal lymph nodes all drain to the..
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external iliac nodes
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The anterior regions of the lower extremities are innervated by the ________________.
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posterior divisions of ventral rami
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The posterior regions of the lower extremities are innervated by the ___________________.
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anterior divisions of ventral rami of the lumbosacral plexus
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Muscles of the sole of the foot are innervated by the
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tibial nerve
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Muscles of the anterior leg and dorsum of the foot are innervated by the
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deep fibular nerve
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Muscles of the lateral leg are innervated by the
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superficial fibular nerve
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Entrapment of the lateral femoral cutaneous nerve results in...
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Meralgia paresthetica
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The femoral nerve divides into the...
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1. anterior femoral cutaneous (anterior thigh)
2. saphenous nerve (medial aspect of leg, ankle and foot) |
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The deep fibular nerve affects the cutaneous _______________________.
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web between the great and second toes
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The superficial fibular nerve affects the cutaneous _______________________________.
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distal third of ant. foot and dorsum of foot and toes except web between great and second toes
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The sural nerve affects the cutaneous ______________.
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posterior leg and lateral side of leg and foot
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The posterior femoral cutaneous affects the
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posterior thigh
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The lateral femoral cutaneous affects the
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lateral thigh
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The medial 3.5 of the sole of the foot is innervated by what cutaneous nerve?
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medial plantar nerve
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The lateral 1.5 of the sole of the foot is innervated by what cutaneous nerve?
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lateral plantar nerve
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