Anatomy Unit I: Regional Anatomy-Lower Extremity

Front 1

Functions of the lower extremity

Back 1

-weight bearing
-locomotion
-maintenance of equilibrium

Front 2

Composition of Pelvis (bones)

Back 2

-2 innominate/coxal bones (ilium, ischium, pubis)
-sacrum
-coccyx

Front 3

Sex differences of pelvic girdle

Back 3

-subpubic angle: male=70deg., female=90-100deg.
-females have wider sacral width and iliac flare
-females tend to have less thigh muscle development

Front 4

Joints of the pelvic girdle

Back 4

-sacroiliac joint
-hip joint
-pubic symphysis

Front 5

SI joint stabilizer ligaments

Back 5

-sacrospinous ligament (dorsal sacrum to ischial spine)
-sacrotuberous ligament (dorsal sacrum to ischial tuberosity)

Front 6

Boundaries of the greater sciatic foramen

Back 6

-anterior sacroiliac lig. (sup)
-sacrotub (post)
-sacrospin (inf)
-greater sciatic notch (ant)

Front 7

Boundaries of lesser sciatic foramen

Back 7

-spine of ischium (sup/posterior)
-sacrotuberous (post/inf)
-tuberosity of ischium (inf)
-lesser sciatic notch (ant)

Front 8

Contents of greater sciatic foramen

Back 8

-piriformis
-sciatic nerve
-internal pudendal bv/n.
-sup./inf. gluteal nerve/bv
-posterior femoral cutaneous nerve

Front 9

Contents of the lesser sciatic foramen

Back 9

-obturator internus
-internal pudendal vessels
-pudendal nerve

Front 10

Hip joint

Back 10

-acetabulum articulates with the head of the femur
-lunate lines inside of acetabulum but is incomplete
-ligament of the head of the femur attached to inferior aspect
-fibrous joint capsule w/deep synovial membrane

Front 11

Diagnostic measurements of the lower extremity

Back 11

-angle of inclination
-quadriceps angle
-angle of torsion

Front 12

Angle of inclination/normal measurement

Back 12

-angle between median axis of femoral head and axis of femoral shaft
-normal=125deg.

Front 13

Coxa valga

Back 13

-angle of inclination > 125 deg.
-leads to genu varum ("bowed-legs")
-lengthens the lower extremity
-increases load on femoral head, decreases load on femoral neck

Front 14

Coxa varum

Back 14

-angle of inclination <125 deg.
-leads genu valga ("knocked-knees")
-shortens lower extremity
-reduces load on femoral head, increases load on femoral neck

Front 15

Quadriceps angle/normal measurement

Back 15

-angle between axis that connects ASIS-patella midpoint and axis between patella midpoint-tibial tubercle
-men: 12 deg.
-women: 17 deg.
-estimates degree of genu valgum--part of basis of sex differences

Front 16

Sex differences in lower extremity function

Back 16

-females: less muscular thigh development, less-developed VMO, increased flexibility in knee joint/genu valgum
-females: more muscular thigh development, VMO hypertrophy, less knee flexibility/genu varum

Front 17

Angle of torsion/normal measurement

Back 17

-angle between axis of femoral condyles at knee and axis of femoral head
-normal=8-15 deg.

Front 18

Abnormal angles of torsion

Back 18

-anteversion=increased angle-->pigeon-toed
-retroversion=decreased-->duck feet
-abnormal angle causes the natural femur/extremity position to shift so as to maximize femoral head articulation with acetabulum

Front 19

Capsular ligaments and purpose

Back 19

-iliofemoral
-ischiofemoral
-pubofemoral
-restrict extension of the hip

Front 20

Hip disolaction (posterior)

Back 20

-most common, often MVC
-displacement/tearing of ischiofemoral ligament, ligament of femoral head
-critical because possibility of disruption of sciatic nerve

Front 21

Fascia lata

Back 21

-extension of inguinal ligament
-

Front 22

Femoral sheath

Back 22

-continuation of iliacus/transversalis fascia inferior to inguinal ligament
-contains femoral a. v.

Front 23

Anterior fascia

Back 23

-area of venous drainage
-saphenous opening: allows for passage of femoral a. and v.

Front 24

Muscles of the gluteal region

Back 24

-gluteus maximus
-gluteus medius
-gluteus minimus

Front 25

Gluteus maximus function & innervation

Back 25

-extends, laterally rotates the thigh
-inferior gluteal nerve

Front 26

Gluteus medius location

Back 26

-deep/superior to maximus

Front 27

Gluteus medius/minimus action/innervation

Back 27

-abducts/medially rotates the thigh
-superior gluteal nerve

Front 28

Gluteus minimus location

Back 28

-deep to gluteus medius

Front 29

Clinical presentation of hip abductor weakness

Back 29

-trendelengurg gait
-pelvis tilts away from affected side while walking
-gluteals (med/min) are abductors and help to keep pelvis level (tends to sink during leg swing); if they are weak, pelvis on opposite side will sink

Front 30

Lateral rotators of the hip (5/6), general attachments, innervation

Back 30

-piriformis
-superior gemellus
-obturator internus
-inferior gemellus
-quadratus femoris
-general attachments: posterior hip--greater trochanter/ intertrochanteric crest
-innervation?

Front 31

Lateral rotator of hip (6/6), attachment, innervation

Back 31

-obturator externus (anterior quadratus femoris)

Front 32

Adductor longus attachments/action/innervation

Back 32

-pubic crest to midshaft posterior femur
-adducts, flex thigh; also internal rotation due to anterior bowing of femur making distal attachment anterior to axis of femoral head
-obturator nerve

Front 33

Compartments of the thigh

Back 33

-anterior
-posterior
-medial

Front 34

Fascia of thigh

Back 34

-lateral intermuscular septum separates anterior/posterior compartments
-medial intermuscular septum separates anterior/medial compartments

Front 35

Muscles of anterior compartment of the thigh

Back 35

-rectus femoris*
-vastus medialis*
-vastus lateralis*
-vastus intermedius*
*make up "quads"
-sartorius

Front 36

Action of the muscles of anterior thigh

Back 36

-flex hip
-extend knee

Front 37

Innervation of the muscles of anterior compartment of thigh

Back 37

femoral nerve

Front 38

Bloody supply of the muscles of anterior compartment of thigh

Back 38

femoral artery

Front 39

Muscles of medial compartment of thigh

Back 39

-adductor longus
-adductor brevis (deep to adductor longus)
-adductor magnus
-gracilis

Front 40

Action of muscles of medial compartment of thigh

Back 40

-adduct thigh
-medially rotate thigh

Front 41

Innervation of muscles of medial compartment of thigh

Back 41

obturator nerve

Front 42

Blood supply of muscles of medial compartment of thigh

Back 42

obturator artery

Front 43

Adductor magnus attachments, action, innervation

Back 43

-hamstring part: ischial tuberosity-adductor tubercle of distal femur, extends thigh, tibial division of sciatic nerve
-adductor part: ischial tuberosity-posterior femur, adducts thigh, obturator nerve

Front 44

Muscles of the posterior compartment of the thigh

Back 44

-"hamstrings"
-biceps femoris (long & short heads)
-semimembranous
-semitendinosus

Front 45

Action of muscles of posterior compartment of thigh

Back 45

-extend hip
-flex knee

Front 46

Innervation of muscles of posterior compartment of thigh

Back 46

tibial division of the sciatic nerve

Front 47

Blood supply of muscles of posterior compartment of thigh

Back 47

-profunda femoris artery

Front 48

Lateral "aspect" of thigh

Back 48

-iliotibial tract: thickening of the fascia lata
-attaches to gluteus maximus and tensor fasciae latae
-runs alongside of thigh muscles and attaches at knee

Front 49

Femoral nerve (spinal nerve) origin

Back 49

L2-L3-L4

Front 50

Femoral nerve course

Back 50

-saphenous branch descends through femoral triangle
-enters adductor canal
-posterior/deep to inguinal ligament

Front 51

Obturator nerve (spinal nerve) origin

Back 51

L2, L3, L4

Front 52

Obturator nerve course

Back 52

-emerges inferior to superior pubic ramus
-splits into anterior/posterior branch

Front 53

Sciatic nerve course

Back 53

-between greater trochanter and ischial tuberosity
-splits (@biceps femoris?) into common fibular nerve and tibial nerve

Front 54

Borders/contents of femoral triangle

Back 54

-inguinal ligament, adductor longus, sartories
-contains femoral nerve, a. and v.

Front 55

Joints of the knee

Back 55

-tibiofemoral
-patellofemoral
-superior (proximal) tibiofibular

Front 56

Movements of the leg at the knee joint

Back 56

-flex (heel towards butt)/extension

Front 57

Function of the popliteus/attachment

Back 57

-tibia laterally rotates as the knee reaches full extension b/c of large medial condyle of femur
-popliteus attaches to lateral condyle of femur and posterior tibia; medially rotates the tibia to allow for initiation of flexion
-i.e. "unlocks" the knee

Front 58

Patellofemoral joint

Back 58

-posterior surface of patella covered w/thick hyaline cartilage
-patella slides w/in trochlear groove of the femur

Front 59

Patella (sesamoid) bony landmarks

Back 59

-base (superior)
-rounded anterior surface
-apex (inferior)
-flat posterior w/two articular surfaces: lateral (larger) and medial (smaller)

Front 60

Purpose/location of patellar ligament

Back 60

-anterior to sesamoid;lying overtop
-resists knee flexion

Front 61

Bursae of knee/function

Back 61

-suprapatellar bursa: lubrication for patellar tendon; articularis genu prevents bursa from collapsing into joint
-several other bursa (infrapatellar;subpopliteal recess) w/in joint

Front 62

Fibrous capsule of knee joint attachment

Back 62

-margins of femoral condyle to margins of tibial condyles

Front 63

Major ligaments of the knee

Back 63

-Anterior cruciate ligament (ACL)
-Posterior cruciate ligament (PCL)
-Medial collateral ligament (MCL)
-Lateral collateral ligament (LCL)
-Medial meniscus
-Lateral meniscus

Front 64

ACL attachments

Back 64

-intercondylar fossa/posteromedial aspect of lateral femoral condyle (proximal)
-anterior intercondylar area (medial to anterior attachment of lateral mensicus) (distal)
-lateral to PCL

Front 65

PCL attachments

Back 65

-intercondylar fossa; posterolateral aspect of medial femoral condyle (proximal)
-posterior interondylar area (distal)
-medial to ACL

Front 66

ACL function

Back 66

resists anterior displacement of tibia

Front 67

PCL function

Back 67

prevents posterior displacement of tibia

Front 68

MCL function/attachment

Back 68

-resists genu valgus stress (knock-kneed)
-can be injured from blow to outside of knee
-closely applied to joint capsule/medial meniscus

Front 69

LCL function

Back 69

-resists genu varus stress
-injured from blow to inside of knee
-lateral condyle to origin to distal attachment of biceps femoris

Front 70

Muscles that provide knee support

Back 70

-"pes anserine"=goose's foot (b/c attachments looks like goose foot)
-sartorius
-gracilis
-semitendinosus

Front 71

Menisci purpose

Back 71

-medial & lateral
-medial="C" shaped and larger; attached to MCL
-lateral="O" shaped and smaller
-absorb shock, decrease friction, increase contact area for joint

Front 72

tibiofibular joints

Back 72

-proximal/distal ends articulate at notches
-crural interosseus membrane between the shafts of the bones provides stability

Front 73

Movements of the foot at the ankle joint

Back 73

-plantar flex (toes point down); dorsiflexion
-inversion (medial edge rotate towards midline); eversion
-flexion (towards sole of foot)/extension of toes
-abduction (big toe away from others)/adduction of toes

Front 74

Joints of the ankle/foot

Back 74

-talocrural
-talocalcaneal joint/subtalar joints
-tarsometatarsal joints
-metatarsalphalangeal joints
-proximal interphalangeal joints
-distal interphalangeal joints

Front 75

Talocrural joint

Back 75

-"mortise" joint
-talus fits into section formed by lateral malleolus, distal tibia, and medial malleolus

Front 76

Compartments of the leg

Back 76

-anterior
-lateral
-posterior superficial
-posterior deep

Front 77

Deep fascia that surrounds anterior compartment of the leg?

Back 77

Anterior intermuscular septum

Front 78

Deep fascia that surrounds lateral compartment of the leg?

Back 78

Posterior intermuscular septum

Front 79

Deep fascia that surrounds posterior superficial compartment of the leg?

Back 79

transverse intermuscular septum

Front 80

Deep fascia that surrounds posterior deep compartment of the leg?

Back 80

interosseus membrane

Front 81

Muscles of the anterior compartment of the leg

Back 81

-tibialis anterior
-extensor hallucis longus
-extensory digitorum longus
-fibularis teritius

Front 82

Action of muscles of anterior compartment of the leg

Back 82

-dorsiflexion
-inversion
-toe extension

Front 83

Innervation of muscles of anterior compartment of the leg

Back 83

deep fibular nerve

Front 84

Blood supply of muscles of anterior compartment of the leg

Back 84

anterior tibial artery

Front 85

Muscles of lateral compartment of the leg

Back 85

-fibularis longus (most superficial)
-fibularis brevis

Front 86

Action of muscles of lateral compartment of the leg

Back 86

-eversion
-plantar flexion

Front 87

Innervation of muscles of lateral compartment of the leg

Back 87

superficial fibular nerve

Front 88

Blood supply of muscles of lateral compartment of the leg

Back 88

fibular artery

Front 89

Muscles of the posterior superficial compartment of the leg

Back 89

-gastrocnemius (two heads, medial and lateral) + soleus (deep to gastro) = triceps surae
-plantaris (mostly tendon alongside medial edge of soleus)

Front 90

Actions of the posterior superficial compartment of the leg

Back 90

-plantar flexion
-knee flexion (only gastro and plantaris)

Front 91

Innervation of the posterior superficial compartment of the leg

Back 91

tibial nerve

Front 92

Bloody supply of the posterior superficial compartment of the leg

Back 92

posterior tibial artery

Front 93

Muscles of the posterior deep compartment of the leg

Back 93

-popliteus (exception--very superior to others)
-flexor digitorum longus
-flexor hallucis longus
-tibialis posterior

Front 94

Actions of the posterior deep compartment of the leg

Back 94

-plantar flexion
-toe flexion
-inversion
-knee flexion (popliteus)

Front 95

Innervation of the posterior deep compartment of the leg

Back 95

tibial nerve

Front 96

Blood supply of the posterior deep compartment of the leg

Back 96

posterior tibial artery

Front 97

Causes/symptoms/treatment of compartment syndrome

Back 97

-trauma, burns, intense use may produce edema or hemorrhage w/in compartments
-compression of nerves/vessels compromises fxn
-fasciotomy may be performed

Front 98

Symptoms of anterior compartment syndrome

Back 98

-weakness in dorsiflexion or toe extension
-parathesias (tingling) over dorsum of foot

Front 99

Symptoms of deep posterior compartment syndrome

Back 99

-weakness in toe flexion and inversion
-parasthesias (tingling) in plantar aspect

Front 100

Symptoms of superficial posterior compartment syndrome

Back 100

-weakness in plantar flexion
-dorsolateral foot hypoesthesia (partial/total loss of sensation)

Front 101

Course of the common fibular nerve

Back 101

-branches from sciatic nerve
-deep to proximal fibularis longus
-curves lateral to neck of fibula
-splits deep to fibularis longus

Front 102

Course of superficial fibular nerve

Back 102

-begins at bifurcation of common fibular n.
-innervates fibularis longus and brevis m.
-emerges as cutaneous branch
-innervates lateral compartment of leg

Front 103

Course of deep fibular nerve

Back 103

-approaches interosseus membrane
-between tibialis anterior and extensor hallucis longus
-descends with anterior tibial artery
-innervates anterior compartment of leg

Front 104

Course of tibial nerve

Back 104

-joins with popliteal a. v.
-continues with posterior tibial artery
-gives off sural n. (posterior cutaneous)
-splits into lateral and medial plantar n. in foot
-innervates posterior superficial compartment of leg

Front 105

Major ligaments of the ankle

Back 105

-medial collateral (deltoid) ligament
-lateral ligament complex

Front 106

Medial collateral (deltoid) ligament attachments/function

Back 106

-medial malleoulus to talus, navicular, sustentaculum tali of calcaneous
-stabilizes joint
-resists eversion
-much stronger than lateral collateral ligaments

Front 107

Tarsal tunnel syndrome

Back 107

-tibial n. and posterior tibial a. v. are w/in tarsal tunnel
-entrapment/compression of tibial n.
-edema, tightness of ankle
-pain, tingling, numbness in plantar
-weakness of intrinsic foot muscles

Front 108

Function/attachments of lateral ligament complex of angle

Back 108

-lateral malleolus to talus and calcaneous
-stabilize joint
-resist inversion
-much weaker than medial

Front 109

Typical ankle sprain

Back 109

-90% of ankle spains are inversion
-b/c ligaments of lateral complex are weaker/less able to resist inversion than the medial are able to resist eversion

Front 110

Plantar ligaments of the foot

Back 110

-long plantar ligament
-short plantar (calcaneocuboid) ligament (deep to long)
-plantar calcaneonavicular ligament (spring)

Front 111

What covers plantar surface of foot

Back 111

-plantar fascia/plantar apoeneurosis

Front 112

First layer of muscles on plantar surface of foot

Back 112

-flexor digitorum brevis
-abductor hallucis
-abductor digiti minimi

Front 113

Innervation of first layer of muscles on plantar surface of foot

Back 113

lateral/medial plantar nn.

Front 114

Second layer of muscles on plantar surface of foot

Back 114

-quadratus plantae
-lumbricals (from flex digitorum longus)

Front 115

Innervation of second layer of muscles on plantar surface of foot

Back 115

lateral/medial plantar nn.

Front 116

Third layer of muscles on plantar surface of foot

Back 116

-adductor hallucis
-flexor hallucis brevis
-flexor digiti minimi brevis

Front 117

Innervation of third layer of muscles on plantar surface of foot

Back 117

lateral/medial plantar nn.

Front 118

Fourth layer of muscles on plantar surface of foot

Back 118

-plantar interossei (3)
-dorsal interossei (4)

Front 119

Innervation of fourth layer of muscles on plantar surface of foot

Back 119

lateral plantar nerve

Front 120

Muscles of dorsal aspect of foot

Back 120

-extensor hallucis brevis
-extensor digitorum brevis

Front 121

Innervation of muscles of dorsal aspect of foot

Back 121

deep fibular nerve

Front 122

Arterial supply of the foot (plantar)

Back 122

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Front 123

Nerve supply of the foot

Back 123

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Front 124

Arterial supply of foot (dorsal)

Back 124

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Front 125

Arterial supply to leg

Back 125

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