Lower Extremity - Module 3 - Ha - Complete

Front 1

What does the pelvic girdle support and protect?

Back 1

-Lower viscera, including reproductive organs
-Developing fetus in females

Front 2

Why are pelvic bones more massive than those of the pectoral girdle?

Back 2

Because of stresses involved in weight bearing and locomotion.

Front 3

What are the bones of the pelvic girdle or pelvis?

Back 3

-Hip bones (coxal or innominate bones)
-Sacrum
-Coccyx

Note: The pelvis is a composite structure that includes the hip bones of the appendicular skeleton and the sacrum and coccyx of the axial skeleton

Front 4

What are the bones of the lower limb?

Back 4

1. Femur (thigh)
2. Patella (kneecap)
3. Tibia and Fibula (leg)
4. Tarsal bones (bones of the ankle)
5. Metatarsal bones and phalanges (bones of the foot)

Front 5

In anatomical terms what do the leg and thigh refer to?

Back 5

Leg: Distal portion of the lower limb rather than the whole lower limb

Thigh: Proximal portion of lower limb

Front 6

What three bones fuse to form the hip bone of the adult pelvic girdle?

Back 6

1. Ilium
2. Ischium
3. Pubis

Front 7

What separates the three hip bones (ilium, ischium, pubis) at birth and when is their growth and fusion complete?

Back 7

At birth the three bones are separated by hyaline cartilage.
Growth and fusion of the three bones is complete by age 25.

Front 8

What three joints form the pelvic girdle?

Back 8

- Two sacro-iliac joints between the posterior and medial portion of the ilium and the auricular surfaces of the coccyx.
-Pubic symphysis fibrous cartilage joint between the anterior and medial portions of the hip bones.

Front 9

What surface of the hip bone articulates at the hip joint?

Back 9

The acetabulum.

Note: The acetabulum lies anterior and inferior to the center of the pelvic bones.

Front 10

What are the three parts of the acetabulum?

Back 10

1. Acetabular fossa: space enclosed by walls of the acetabulum
2. Lunate surface: smooth curved surface that forms the shape of a letter C
3. Acetabular notch: anterior and inferior margins of the acetabulum without a ridge.

Note: A ridge of bone forms the lateral and superior margins of the acetabulum. No ridge present at the acetabular notch.

Front 11

What bones make up the acetabular fossa?

Back 11

1. Ilium (superior two-fifths)
2. Ischium (posterior two-fifths)
3. Superior pubic ramus (anterior one-fifth)

Front 12

What bone markings on the hip bones provide sites for gluteal muscles attachment?

Back 12

Anterior, posterior and inferior gluteal lines

Front 13

What bones marking does the sciatic nerve pass through into the lower limb?

Back 13

The greater sciatic notch

Front 14

Which of the coxal (hip) bones is the strongest?

Back 14

Ischium

Front 15

What bone marking projects superior to the lesser sciatic notch?

Back 15

Ischial spine

Front 16

What hip bone feature bears the body weight when a person is seated?

Back 16

Ischial tuberosities

Front 17

What hip bone features encircle the obturator foramen?

Back 17

Pubic and ischial rami

Front 18

What is the obturator foramen enclosed by in life and what is the function?

Back 18

The obturator foramen is closed by a sheet of collagen fibers whose inner and outer surfaces provide a firm base for attachment of muscles of the hip.

Front 19

Function of the iliac fossa

Back 19

-helps support the abdominal organs
-provides additional surface area for muscle attachment

Front 20

What marks the inferior border of the iliac fossa?

Back 20

The arcuate line

Front 21

What is the articulation between the two pubic bones of the pelvic girdle?

Back 21

Pubic symphysis

Note: The two pubic bones are attached to a median pad of fibrous cartilage

Front 22

What bone feature on the ilium forms the articular surface of the sacro-iliac joint?

Back 22

Auricular surface

Front 23

Where do ligaments that stabilize the sacro-iliac joint arise on the hip bone?

Back 23

Iliac tuberosity

Front 24

What are the four bones that make up the pelvis?

Back 24

-Two hip bones (anterior and lateral part of pelvis)
-Sacrum (posterior part of pelvis)
-Coccyx (posterior part of pelvis)

Front 25

Where do the ligaments that connect the lateral border of the sacrum to the hip bones connect on the hip bone?

Back 25

-Iliac crest
-Ischial tuberosity
-Ischial spine
-Iliopectineal line

Note: Other ligaments bind the ilia to the posterior lumbar vertebrae. These interconnections increase the stability of the pelvis.

Front 26

What are the two divisions of the pelvis?

Back 26

1. Greater (false) pelvis: blade like portions of each ilium superior to the iliopectineal line
2. Lesser (true) pelvis: pelvic structures inferior to iliopectineal line.

Front 27

What structures form the boundaries of the pelvic cavity

Back 27

The lesser pelvis i.e pelvic structures below the iliopectineal line.
-inferior portion of ilium
-both pubic bones
-the ischia
-sacrum
-coccyx

Front 28

Function of the greater pelvis

Back 28

Encloses organs within the inferior portion of the abdominal cavity.

Front 29

What is the iliopectineal line?

Back 29

A compound structure of the arcuate line (from the ilium) and pectineal line (from the pubis)

Front 30

1. What is the bony edge of the lesser pelvis called?

2. What is the space enclosed by it called?

Back 30

1. Pelvic brim

2. Pelvic inlet

Front 31

What makes up the superior limit of the lesser pelvis?

Back 31

A line that extends from either side of the base of the sacrum, along the iliopectineal lines to the superior margin of the pubic symphysis.

Front 32

What makes up the inferior margins of the pelvis?

Back 32

-The coccyx
-The ischial tuberosities
-The inferior border of the pubic symphysis

Note: The opening bound by the inferior margins of the pelvis is called the pelvic outlet

Front 33

What is another name for the pelvic outlet?

Back 33

Perineum

Front 34

What muscles form the floor of the pelvic cavity? What is their function?

Back 34

The pelvic muscles. They support organs enclosed in the pelvic cavity.

Front 35

How do the bone markings of an adult female pelvis differ from an adult male pelvis.

Back 35

Because women are typically less muscular than men, the pelvis of the adult female is usually smoother and lighter and has less prominent markings where muscles or ligaments attach.

Front 36

How is the female pelvis different from the male pelvis?

Back 36

-An enlarged pelvic outlet, due in part to greater separation of the ischial spines
-Less curvature on the sacrum and coccyx which in the male arc into the pelvic outlet
-a wider, more circular pelvic inlet
-a relatively broad, low pelvis
-ilia that project laterally, but do not extend as far superior to the sacrum
-a broader pubic angle, with the inferior angle between the pubic bones greater than 100 degrees

Note: These adaptations are for childbearing

Front 37

What is the significance of adaptations of the female pelvis?

Back 37

They are related to supporting the weight of the developing fetus and uterus and easing the passage of the newborn through the pelvic outlet at the time of delivery.

Front 38

What happens to the pubic symphysis during pregnancy?

Back 38

A hormone produces during pregnancy loosens the pubic symphysis, allowing relative movement between the hip bones that can further increase the size of the pelvic inlet and outlet and thus facilitate delivery.

Front 39

What is the longest and heaviest bone in the body?

Back 39

Femur

Front 40

What attaches at the fovea of the head of the femur?

Back 40

A stabilizing ligament (the ligament of the head)

Front 41

What bones does the femur articulate with proximally and distally?

Back 41

Proximally: acetabulum of pelvis
Distally: Tibia of leg

Front 42

1. What is the significance of the lateral bow (curve) of the femur?

2. When does it become exaggerated?

Back 42

1. Facilitates weight bearing and balance

2. Becomes exaggerated if the skeleton weakens e.g. in rickets.

Front 43

What bone marking on the anterior proximal surface of the femur marks the distal edge of the hip joint articular capsule?

Back 43

The intertrochantaric line

Front 44

What bone markings on the femur mark the attachment of the pectineus muscle and gluteus maximus.

Back 44

Pectineal line (pectineus muscle)

Gluteal tuberosity (gluteus maximus)

Front 45

Where do the adductor hip muscles attach on the femur?

Back 45

Linea aspera

Front 46

What part of the femur does the patella glide over?

Back 46

The patellar surface

Front 47

What bone feature separates the two condyles of the femur?

Back 47

Intercondylar fossa

Front 48

What kind of bone is the patella?

Back 48

Sesamoid bone

Front 49

The patella forms with the tendon of which muscle?

Back 49

Quadriceps femoris

Front 50

What is the function of the patella?

Back 50

-strengthens the quadriceps tendon
-protects anterior surface of knee joint
-increases contraction force of the quadriceps femoris

Front 51

What shape is the patella? Where are the base and apex of the patella located?

Back 51

Triangular
Base: superior border of patella
Apex: inferior border of patella

Front 52

What structures attach to the anterior surface of the patella?

Back 52

1. Quadriceps tendon (anterior and superior surfaces)

2. Patellar ligament (anterior and inferior surfaces)

Front 53

What features are present on the posterior surface of the patella? What do they articulate with?

Back 53

Two concave facets
1. Medial Facet: articulates with medial condyle of femur
2. Lateral facet: articulates with lateral condyle of femur

Front 54

What is the medial bone of the leg?

Back 54

Tibia

Front 55

What two features of the tibia articulate with the medial and lateral condyles of the femur?

Back 55

The medial and lateral condyles of the tibia

Front 56

Which tibial condyle is more prominent? What does it articulate with besides the femur?

Back 56

The lateral condyle is more prominent and possesses a facet for the articulation with the fibula at the superior tibiofibular joint.

Front 57

What bone feature separates the medial and lateral condyles of the tibia?

Back 57

The intercondylar eminence which has two tubercles (medial and lateral)

Front 58

What feature on the tibia can be easily felt beneath the skin?

Back 58

1. The tibial tuberosity. The patellar ligament attaches to it.

2. The anterior margin

Front 59

Does the tibia narrow or widen distally?

Back 59

Narrows

Front 60

What is the large process on the medial border on the distal end of the tibia?

Back 60

The medial malleolus

Front 61

What is the function of the medial malleolus?

Back 61

Provides medial support for talocrural joint, preventing lateral sliding of tibia across the talus.

Front 62

Where do the popliteus and soleus muscles attach on the tibia?

Back 62

Soleal line (also called popliteal line) on the posterior surface of tibia.

Front 63

What two bone markings does the interosseous membrane of the leg (crural interosseous membrane) run between?

Back 63

The interosseous border of tibia and interosseous border of fibula.

Front 64

What feature of the fibula articulates with the inferior and posterior surface of the lateral tibial condyle?

Back 64

The head of the fibula

Front 65

What is the function of the crural interosseous membrane?

Back 65

-Stabilize position of Tibia and Fibula
-Provide additional surface area for muscle attachment

Front 66

Is the fibula a part of the knee joint?

Back 66

No it is not and it does not transfer weight to the ankle and foot.

Front 67

What is the function of the fibula?

Back 67

-Important site for muscle attachment
-Distal tip of fibula provides lateral support to the ankle

Front 68

What is the fibular process at the distal end of the fibula?

Back 68

Lateral malleolus

Note: It provides stability to the ankle joint by preventing medial sliding of the tibia across the surface of the talus.

Front 69

What is the number of tarsal bones? What are they?

Back 69

Seven
-Talus
-Calcaneus
-Cuboid
-Navicular
-three cuneiform bones (medial, intermediate and lateral)

Front 70

What is the second largest bone in the foot? What is it's function?

Back 70

Talus

Function: transmits weight of the body from the tibia anteriorly, towards the toes

Front 71

1. Which tarsal bones articulate with the tibia?

2. What feature of the bone forms the articular surface?

Back 71

1. Talus

2. Trochlea of talus (smooth superior surface)

Front 72

What do the lateral and medial extensions of the trochlea of the talus articulate with?

Back 72

The lateral malleolus of the fibula and the medial malleolus the tibia.

Front 73

What is the general difference between the surfaces of a bone

1. which form the articular surfaces
2. where ligaments connect

Back 73

1. smooth
2. roughened

Front 74

What is the largest tarsal bone?

Back 74

Calcaneus

Note: can be easily palpated

Front 75

When standing normal which bones transmit the weight from the leg to the ground?

Back 75

The tibia to the talus to the calcaneus and then to the ground.

Front 76

What tendon attaches to the rough knob shaped projection on the posterior of the calcaneus?

Back 76

The calcaneal tendon (also called calcanean or Achilles tendon)

Front 77

Which muscles does the calcaneal tendon arise from? What is the function of this muscle?

Back 77

Calf muscles

Function: raise the heel and lift the sole of the food from the ground, as when standing on tiptoe.

Front 78

What bone does the cuboid tarsal bone articulate with proximallt?

Back 78

The calcaneus

Front 79

What tarsal bone articulates with the anterior surface of the talus?

Back 79

Navicular

Front 80

What tarsal bones do the three cuneiform bones articulate with?

Back 80

Navicular (proximally)

Cuboid (lateral cuneiform bone articulate with cuboid on its medial surface)

Front 81

What bones to the cuneiform bones and the cuboid articulate with distally?

Back 81

Metatarsal bones of the foot.

Front 82

What is the number of metatarsal bones? How are they identified?

Back 82

Five. Identified by Roman numeral I-V from medial to lateral.

Note: The metacarpal bones are numbered I-V lateral to medial, however a good way to avoid confusion is that the thumb (pollex) articulates with metacarpal I and the great toe (hallux) articulates with metatarsal I.

Front 83

What bones do the metatarsal bones articulate with proximally?

Back 83

First three - the three cuneiform bones
Last two - cuboid

Front 84

What is the function of the metatarsal bones?

Back 84

Help support the weight of the body during standing, walking and running.

Front 85

How many phalanges in the foot?

Back 85

Fourteen.

Two in great toe (proximal and distal)
Three each in the other four toes (proximal, middle and distal)

Front 86

What are the two functions of the arches of the foot?

Back 86

1. Dampen forces while still adapting to the contours of the surface of the ground. This calls for flexibility in the arch.
2. Provide a stable platform that is able to support the weight of the body while walking or standing. The arches must function as a rigid lever while distributing the weight of the body throughout the foot.

Front 87

What are the two arches of the foot?

Back 87

The longitudinal arch and the transverse arch

Front 88

What maintains the longitudinal arch?

Back 88

Ligaments and tendons maintain this arch by tying the calcaneus to the distal portions of the metatarsal bones.

Front 89

What side of the foots carries most of the weight when standing normally?

Back 89

The lateral side

Front 90

What are the two portions of the longitudinal arch and how are they different?

Back 90

-The lateral (calcneal) portion.
-The medial (talar) portion

The calcaneal portion has less curvature than the medial, talar portion.
The talar portion has more elasticuty than the calcaneal portion.

Front 91

What is the advantage of the elevated medial portion of the sole?

Back 91

The muscles, nerves and blood vessels the supply the inferior of the foot do not get squeezed between the metatarsal bones and the ground.

Front 92

Is the calcaneus more lateral or medial to the talus?

Back 92

Lateral

Front 93

What is the function of the elasticity of the medial portion of the longitudinal arch?

Back 93

Helps absorb shock that accompany sudden changes in weight loading e.g. when running or dancing.

Front 94

When standing normally how is the weight distributed in the foot?

Back 94

Distributed evenly between the calcaneus and the distal ends of the metatarsal bones.

Front 95

What determines s the amount of weight transferred forward in the foot?

Back 95

The position of the foot and the placement of body weight

Note: During dorsiflexion of the foot the body weight rests on the calcaneus.
During plantar flexion the talus and calcaneus transfer the weight to the metatarsal bones and phalanges through more anterior tarsal bones.

Front 96

The fibula does not participate in the knee joint, nor does it bend; but when it is fractured, walking is difficult. Why?

Back 96

Although the fibula is not part of the knee joint and does not bear weight, it is an important point of attachment for many leg muscles. When the fibula is fractured, these muscles cannot function properly to move the leg, and walking is difficult and painful. The fibula also helps stabilize the ankle joint.

Front 97

While jumping off the back steps of his house, 10 year-old Mark lands on his right heel and breaks his foot. What foot bone is most like broken?

Back 97

Mark has most likely fractured his calcaneus (heel bone)

Front 98

What important information can a human skeleton reveal about an individual?

Back 98

-Race (differences in portions of the skeleton, especially the skull)
-Muscular development (development of ridges and general bone mass)
-Medical history (condition of teeth and presence of healed fractures)
-Sex
-Age

Front 99

When does fusion of epiphyseal cartilages begin?

Back 99

Age 3

Front 100

When do degenerative changes in normal skeletal system begin e.g reduction in mineral content of bone matrix?

Back 100

Age 30 - 45

Front 101

What is congenital talipes equinovarus (clubfoot)?

Back 101

-Abnormal muscle development distorts growing bones and joint.
-in most cases tibia, ankle and foot are affected.
-one or both feet may be involved
-longitudinal arch is exagerrated
-the feet turn medially and inverted
-if both feet are involved soles turn towards each other

Front 102

Is congenital talipes equinovarus more common in boys or girls? How is it treated?

Back 102

Twice as common in boys as girls.
Prompt treatment with casts or other supports in infancy helps alleviate the problem and fewer than half the cases require surgery.

Front 103

What is flatfeet (foot conditon)?

Back 103

Loses or never develops the longitudinal arch.

Note: "Fallen" arches" develop as tendons and ligaments stretch and become less elastic.

Front 104

What abnormal foot condition do up to 40% of adults have?

Back 104

Flatfeet

Front 105

How are arches in feet of children different from those in adults?

Back 105

Children have very mobile articulations and elastic ligaments, so they commonly have flexible, flat feet. Their feet look flat only when standing, and the arch appears when they stand on their toes or sit down. In most cases, the condition disappears as growth continues.

Front 106

What is claw feet (foot condition)?

Back 106

The median longitudinal arch becomes exaggerated because of muscular abnormalities (plantar flexors overpower the dorsiflexors)

Note: causes include muscle degeneration and nerve paralysis. Worsens with age.

Front 107

What is a sprain?

Back 107

A ligament is stretched to the point at which some of the collagen fibers are torn. The ligament remains functions and the structure of the joint is not affected.

Front 108

What is the most common cause of a sprained ankle? How is it treated?

Back 108

Forceful inversion of the foot.

Treated with ice pack, support and rest. Heals in about three weeks.

Front 109

What is a dancer's fracture?

Back 109

The proximal portion of the fifth metatarsal is broken.

Caused by sudden shift in weight from the medial portion of longitudinal arch to lateral, less elastic portion of arch.

Front 110

Sexual differences in adult skeleton
1. General appearance (skull)
2. Forehead
3. Sinuses (skull)

Back 110

1. M: Heavier; rougher surface
F: Lighter; smoother surface
2. M: More sloping
F: More vertical
3. M: Larger
F: Smaller

Front 111

Sexual differences in adult skeleton
1. Cranium
2. Mandible
3. Teeth

Back 111

1. M: About 10% larger (average)
F: About 10% smaller
2. M: Larger, more robust
F: Lighter, smaller
3. M: Larger
F: Smaller

Front 112

Sexual differences in adult skeleton
1. General appearance (pelvis)
2. Pelvic inlet
3. Iliac fossa

Back 112

1. M: Narrow; robust; heavier; rougher surface
F: Broad; light; smoother surface
2. M: Heart shaped
F: Oval to round
3. M: Deeper
F: Shallower

Front 113

Sexual differences in adult skeleton
1. Ilium
2. Angle inferior to pubic symphysis
3. Acetabulum

Back 113

1. M: More vertical; extends farther superior
F: Less vertical; less extension superior to the sacro-iliac joint
2. M: Less than 90 degrees
F: 100 degrees or more
3. M: Directed laterally
F: Faces slightly anteriorly as well as laterally

Front 114

Sexual differences in adult skeleton
1. Obturator foramen
2. Ischial spine
3. Sacrum

Back 114

1. M: Oval
F: Triangular
2. M: Points medially
F: Points posteriorly
3. M: Long, narrow triangle with pronounced sacral curvature
F: Broad, short triangle with less curvature

Front 115

Sexual differences in adult human skeleton
1. Coccyx
2. Bone weight
3. Bone markings

Back 115

1. M: Points anteriorly
F: Points inferiorly
2. M: Heavier
F: Lighter
3. M: More prominent
F: Less prominent

Front 116

Age related changes in skeleton (Event and Age)
1. Bony matrix
2. Markings

Back 116

1. Event: Reduction in mineral content
Age: Begins age 30-45; values differ between males versus females between ages 45 and 65; similar reductions occur in both sexes after age 65.
2. Event: Reduction in size, roughness
Age: gradual reduction with increasing age and decreasing muscle strength and mass

Front 117

Age related changes in skeleton (Event and Age)
1. Fontanels
2. Frontal suture
3. Occipital bone

Back 117

1. Event: Closure
Age: Completed by age 2
2. Event: Fusion
Age: 2 - 8
3. Event: Fusion of ossification centers
Age: 1 - 6

Front 118

Age related changes in skeleton (Event and Age)
1. Styloid process
2. Hyoid bone

Back 118

1. Event: Fusion with temporal bone
Age: 12-16
2. Event: Complete ossification and fusion
Age: 25-30 or later

Front 119

Age related changes in skeleton (Event and Age)
1. Teeth
2. Mandible

Back 119

1. Event: Loss of "baby teeth"; appearance of permanent teeth; eruption of permanent molars
Age: Detailed in Chapter 25 (Digestive system)
2. Event: Loss of teeth; reduction in bone mass; change in angle at mandibular notch
Age: accelerates in later years (age 60)

Front 120

Age related changes in skeleton (Event and Age)
1. Curvature
2. Intervertebral discs

Back 120

1. Event: Appearance of major curves
Age: 3 months - 10 years
2. Event: Reduction in size, percentage contribution to height
Age: accelerates in later years (age 60)

Front 121

Age related changes in skeleton (Event and Age)
1. Epiphyseal cartilages (long bones)

Back 121

1. Event: Fusion
Age: Ranges vary according to specific bone under discussion, but general analysis permits determination of approximate age (3-7, 15-22, etc)

Front 122

Age related changes in skeleton (Event and Age)
1. Epiphyseal cartilages (pectoral and pelvic girdles)

Back 122

1. Event: Fusion
Age: Overlapping ranges are somewhat narrower than for epiphyseal cartilages of long bones, including 14-16, 16-18, 22-25 years.

Front 123

What covers the acetabulum in the hip joint?

Back 123

-A pad of fibrous cartilage covers the articular surface of the acetabulum and extends like a horseshoe along the sides of the acetabular notch
-A fat pad covered by a synovial membrane covers the central portion of the acetabulum.

Front 124

What is the function of the fat pad in the acetabulum?

Back 124

-Acts as shock absorber
-The adipose tissue stretches and distorts without damage.

Front 125

What kind of joint is the hip joint?

Back 125

Ball-and-socket joint

Front 126

Does the articular capsule of the hip joint contribute to joint stability?

Back 126

Yes. This is unlike the capsule of the shoulder joint.

Note: The articular capsule of the hip joint is extremely dense, strong and deep.

Front 127

What bones and their features does the articular capsule of the hip joint extend between?

Back 127

Pelvic girdle: The lateral and inferior surfaces
Femur: Intertrochanteric line and intertrochanteric crest

Front 128

Does the articular capsule enclose both the femoral head and neck? What purpose does this serve?

Back 128

Yes. This arrangement helps keep the head from moving away from the acetabulum.

Front 129

What increases the depth of the acetabulum?

Back 129

Acetabular labrum (a circular rim of fibrous cartilage)

Front 130

How many ligaments reinforce the hip joint articular capsule? What are they?

Back 130

Four
Three are intrinsic ligaments (regional thicknenings of capsule): iliofemoral, pubofemoral and ischiofemoral

The fourth is the transverse acetabular ligament.

Front 131

What ligaments crosses the acetabular notch and completes the inferior border of the acetabular fossa?

Back 131

Transverse acetabular ligament

Front 132

What ligament tenses when the thigh is flexed and undergoing external rotation? Where does it attach?

Back 132

The ligament of the femoral head (ligamentum capitatis femoris)

Origin: transverse acetabular ligament
Attaches: center of the femoral head (fovea)

Front 133

Besides the ligaments, what stabilizes the hip joint?

Back 133

The surrounding muscles

Front 134

What is the most important normal movement of the hip?

Back 134

Flexion

Front 135

What movements are permitted at the hip joint

Back 135

Adduction/abduction
Flexion/extension
Rotation
Circumduction

Front 136

What structures restrict the movement at the hip joint and provide it with stability?

Back 136

1. Ligaments
2. Capsular fibers
3. Depth of the bony socket
4. Surrounding muscles

Front 137

Are hip dislocations or fractures of femoral neck or between the trochanters more common?

Back 137

Fractures of the femoral neck or between the trochanters are more common

Front 138

What joints support the weight of the body during activities like standing, walking and running?

Back 138

Hip, ankle and knee joints

Front 139

How is the knee joint different from the hip or ankle joints when supporting weight?

Back 139

The knee must provide support while:
1. having the largest range of motion (up to 160 degrees) of any joint of lower limb.
2. lacking the large muscle mass that supports and strengthens the hip
3. lacking the strong ligaments that support the ankle joint.

Front 140

What type of joint is the knee joint?

Back 140

Hinge joint

Front 141

Is the knee joint more or less stable than other hinge joints in the body?

Back 141

Less stable than other hinge joints and some degree of rotation is permitted.

Note: The rounded femoral condyles roll across the superior surface of the tibia, so the points of contact are constantly changing.

Front 142

What are the two joints of the knee joint?

Back 142

1. Tibiofemoral joint: a joint between the tibia and femur
2. Patellofemoral joint: joint between the patella and the patellar surface of the femur.

Front 143

What is unique about the articular capsule of the knee?

Back 143

There is no single unified capsule, nor is there a common synovial cavity.

Front 144

How many menisci does the knee joint have? What is their function?

Back 144

Two: medial and lateral mensici

1. act as cushions
2. conform to the shape of the articulating surfaces as the femur changes position
3. increase the surface area of the tibiofemoral joint
4. provide some lateral stability to the joint

Front 145

What is the function of the fat pads of the knee joint?

Back 145

1. Provide padding around the margins of the joint
2. assist the bursae in reducing friction between the patella and other tissues.

Front 146

How many ligaments stabilize the knee? What are they?

Back 146

Seven (2-6 below are intra or extracapsular extrinsic ligaments)
1. Patellar ligament
2. Tibial collateral ligament
3. Fibular collateral ligament
4. Popliteal ligaments (two)
5. Anterior cruciate ligament (ACL)
6. Posterior cruciate ligament (PCL)

Front 147

Patellar ligament (attachments and function)

Back 147

Attachments: patella to anterior surface of tibia

Function: provides support to the anterior surface of the knee joint, where there is no continuous capsule

Front 148

Tibial and fibular collateral ligaments (function)

Back 148

Tibial (medial) collateral ligament: reinforces the medial surface of knee joint

Fibular (lateral) collateral ligament: reinforces the lateral surface of knee joint

Front 149

Popliteal ligaments (attachments and function)

Back 149

Attachments: Femur and the heads of the tibia and fibula

FunctIon: reinforce the back of the knee

Front 150

Anterior and posterior cruciate ligaments (attachments and function)

Back 150

Attachments: intercondylar area of the tibia to the condyles of the femur
Function: limit the anterior and posterior movement of the femur and maintain the alignment of the femoral and tibial condyles.


Note: These are intracapsular ligaments. Anterior and posterior refer to their sits of origin on the tibia. They cross one another as they process to their destinations on the femur.

Front 151

Describe locking of knee

Back 151

-normally extends in extended position
-at full extension slight lateral rotation of the tibia tightens the anterior cruciate ligament and jams the meniscus between the tibia and femur
-unlocking the joint requires muscular contractions that produce medial rotation of the tibia or lateral rotation of the femur.

Front 152

What is the function of locking of the knee?

Back 152

This mechanism allows you to stand for prolonged periods without using (and tiring) the extensor muscles.

Front 153

What symptoms would you expect to see in an individual who has damaged the menisci of the knee joint?

Back 153

-decrease in joint stability
-harder time locking the knee in place while standing and would have to use muscular contractions to stabilize the joint leading to muscle fatigue when standing for long periods of time and the knee "giving out".
- experience pain

Front 154

How is the knee affected by damage to the patellar ligament?

Back 154

The patellar ligament provides support to the anterior surface of the knee joint. Damage to the patellar ligament would affect this support.

Front 155

What is a "trick knee"?

Back 155

A knee that feels unstable

Front 156

Placing a lot of weight on the knee while it is partially flexed can lead to what?

Back 156

Trapping of the meniscus between the tibia and the femur, resulting in a break or tear in the cartilage.

Front 157

What most commonly causes damage to cartilage (menisci) in the knee?

Back 157

driving the lateral surface of the leg medially which leads to tearing of medial meniscus.

Front 158

Besides injury to mensicus what other knee joint structures can get damaged during a knee injury?

Back 158

Ligaments and patella

Note: Torn ligaments can be difficult to correct surgically and healing is slow.

Front 159

What is a common sports knee injury that affects women two to eight times as often as men? What is the frequent cause?

Back 159

Rupture of anterior cruciate ligament (ACL). The frequent cause is twisting on an extended weight bearing knee.

Front 160

How are knee injuries often evaluated by physician?

Back 160

Arthroscopic examination. An arthroscope uses fiber optics to permit the exploration of a joint without major surgery.

Front 161

What form of surgery is commonly used for joint injuries?

Back 161

Arthroscopic surgery

Front 162

What is a total meniscectomy?

Back 162

A total removal of the injured cartilage.

Note: It is avoided because it leaves the joint prone to develop degenerative joint disease.

Front 163

What is a safe noninvasive and cost effective method of viewing soft tissues around a joint?

Back 163

MRI (magnetic resonance imaging)

Front 164

1. What is another name for the ankle joint?

2. What type of a joint is it?

Back 164

1. Talocrural joint

2. Hinge joint

Front 165

What bones articulate in the talocrural joint?

Back 165

The tibia, fibula and talus.

Front 166

What movement does the ankle joint permit?

Back 166

Limited dorsiflexion and plantar flexion.

Front 167

1. What are the two joints of the talocrural (ankle) joint?

2. Which is the primary weight bearing articulation of the ankle?

Back 167

1. Tibiotalar joint and Fibulotalar joint

2. Tibiotalar joint

Front 168

What joints provide medial and lateral stability at the tibiotalar joint?

Back 168

1. The proximal tibiofibular joint
2. The distal tibiofibular joint
3. The fibulotalar joint

Note: Normal function i.e range of motion and weight bearing at the tibiotalar joint is dependent on the stability provided by these joints.

Front 169

What bones form the proximal tibiofibular joint? What type of a joint is it?

Back 169

Posterior surface of tibia and the head of the fibula.

It is a plane joint.

Front 170

What bones form the distal tibiofibular joint? What type of a joint is it?

Back 170

Distal facets of the tibia and fibula.

It is a fibrous syndesmosis.

Front 171

What forms the fibulotalar joint?

Back 171

Lateral malleolus of the fibula and the lateral articular surface of the talus.

Front 172

What holds the tibia and fibula together?

Back 172

A series of ligaments along the length of the tibia and fibula.

Note: Maintaining the proper amount of movement at the two tibiofibular joints and the fibulotalar joint provides the medial and lateral stability of the ankle.

Front 173

The articular capsule of the ankle joint extends between what structures?

Back 173

1. The distal surfaces of the tibia
2. The medial malleolus of the tibia
3. The lateral malleolus of the fibula
4. The talus

Front 174

Which part of the ankle articular capsule are strong and reinforced by stout ligaments?

Back 174

Lateral and medial surfaces.

Front 175

What are the major ligaments of the ankle joint?

Back 175

1. medial deltoid ligament (one)
2. lateral ligaments (three)

Front 176

What are the four groups of synovial joints in the foot?

Back 176

1. Intertarsal joints: tarsal bone to tarsal bone
2. Tarsometatarsal joints: tarsal bone to metatarsal bone
3. Metatarsophalangeal joints: Metatarsal bone to phalanx
4. Interphalangeal joints: Phalanx to phalanx

Front 177

What types of joints are:
1. Intertarsal joints
2. Tarsometatarsal joints
3. Metatarsophalangeal joints
4. Interphalangeal joints
What movements are allowed at them?

Back 177

1. Intertarsal joints: plane joints permitting limited sliding and twisting movements
2. Tarsometatarsal joints: plane joints permitting limited sliding and twisting movements
3. Metatarsophalangeal joints: condylar joints permitting flexion/extension and abduction/adduction.
4. Interphalangeal joints: hinge joints permitting flexion/extension

Front 178

What tarsal bones do the first three metatarsal bones articulate with?

Back 178

Medial, intermediate and lateral cuneiform bones.

Front 179

What tarsal bones do the fourth and fifth metatarsal bones articulate with?

Back 179

The cuboid.

Front 180

What is the difference between the first metatarsophalangeal and first metacarpophalangeal joints?

Back 180

The metatarsophalangeal joint is condylar versus the metacarpophalangeal joints that is saddle type. That is why the great toe lacks the mobility of the thumb.

Front 181

What often forms in the tendons that cross the inferior surface of the first metatarsophalangeal joint? What results due to this formation?

Back 181

A pair of sesamoid bones often form and further restrict movement at the joint.

Front 182

Sacro-iliac joint (element, type of articulation, movements)

Back 182

Element: Sacrum/hip bones
Type of articulation: planar diarthrosis
Movements: gliding

Front 183

Pubic symphysis (element, type of articulation, movements)

Back 183

Element: Pubic bone/pubic bone
Type of articulation: amphiarthrosis
Movements: None

Front 184

Hip joint (element, type of articulation, movements)

Back 184

Element: Hip bones/femur
Type of articulation: Ball and socket diarthrosis
Movements: flexion/extension, adduction/abduction, rotation, circumduction

Front 185

Knee joint (element, type of articulation, movements)

Back 185

Element: Femur/tibia
Type of articulation: complex, functions as hinge
Movements: flexion/extension, limited rotation

Front 186

Proximal and distal tibiofibular joints (element, type of articulation, movements)

Back 186

Element: Tibia/fibula
Type of articulation: Planar diarthrosis (proximal); planar diarthrosis and amphiathrotic syndesmosis (distal)
Movements: Slight gliding movements (distal and proximal)

Front 187

Ankle or talocrural joint(element, type of articulation, movements)

Back 187

Element: Tibia and fibula with talus
Type of articulation: hinge diarthrosis
Movements: dorsiflexion/plantar flexion

Front 188

Intertarsal joint (element, type of articulation, movements)

Back 188

Element: tarsal bone to tarsal bone
Type of articulation: planar diarthrosis
Movements: slight gliding movements

Front 189

Tarsometatarsal joint (element, type of articulation, movements)

Back 189

Element: Tarsal bones to metatarsal bones
Type of articulation: planar diarthrosis
Movements: slight gliding movements

Front 190

Metatarsophalangeal joint (element, type of articulation, movements)

Back 190

Element: metatarsal bones to phalanges
Type of articulation: condylar diarthrosis
Movements: flexion/extension, adduction/abduction

Front 191

Interphalangeal joint (element, type of articulation, movements)

Back 191

Element: Phalanx/phalanx
Type of articulation: hinge diarthrosis
Movements: flexion/extension

Front 192

Ramus

Back 192

An extension of a bone making an angle with the rest of the structure

Front 193

Trochanter

Back 193

A large, rough projection

Front 194

Crest

Back 194

A prominent ridge

Front 195

Line

Back 195

A low ridge

Front 196

Condyle

Back 196

A smooth rounder articular surface

Front 197

Trochlea

Back 197

A smooth, grooved articular process shaped like a pulley

Front 198

Facet

Back 198

A small, flat articular surface

Front 199

Foramen

Back 199

A rounded passageway for blood vessels and/or nerves

Front 200

What three groups are the muscles of the upper limb divided into?

Back 200

1. muscles that move the thigh.
2. muscles that move the leg
3. muscles that move the foot and toes

Front 201

Where do muscles that move the thigh originate?

Back 201

On the plevis

Front 202

What are the groups for the muscles that move the thigh?

Back 202

1. The gluteal group
2. The lateral rotator group
3. The adductor group
4. The iliopsoas group

Front 203

What bone and its surface do the gluteal muscles cover?

Back 203

The lateral surface of the ilium

Front 204

Which is the largest and most superficial gluteal muscle?

Back 204

Gluteus maximus

Front 205

What muscle does the gluteus maximus share an insertion with?

Back 205

Tensor fasciae latae muscle

Front 206

What do the gluteus maximus and tensor fasciae latae muscles pull on together?

Back 206

Iliotibial tract

Front 207

What is the iliotibial tract? What is its function?

Back 207

A band of collagen fibers that extends along the lateral surface of the thigh and inserts upon the tibia.

function: Provides a lateral brace for the knee that becomes particularly important when a person balances on one foot.

Front 208

1. Do gluteus medius and gluteus minimus muscles originate posterior or anterior to the gluteus maximus?

2. What action to these two muscles produce?

Back 208

1. Anterior

2. Abduction and medial rotation at hip joint.

Front 209

What bone marking marks the boundary between the gluteus medius and gluteus minimus muscles?

Back 209

The anterior gluteal line.

Front 210

1. Where do the six lateral rotator muscles originate and insert?

2. What is their function?

Back 210

1. All originate at, or are inferior to, the horizontal axis of the acetabulum and insert on the femur.

2. All cause lateral rotation of the thigh.

Front 211

What lateral rotator muscles performs both lateral rotation and abduction at the hip?

Back 211

Piriformis muscle

Front 212

Which are the dominant lateral rotators?

Back 212

1. Piriformis
2. Obturator muscles (externus and internus)

Front 213

Are the hip joint adductor muscles located inferior or superior to the acetabular surface?

Back 213

Inferior

Front 214

Where do all adductor muscles originate and where do they insert?

Back 214

Origin: Pubis

Insertion: Linea aspera on femur (except gracilis muscle)

Front 215

Which hip joint adductor muscles does not insert on the linea aspera of the femur?

Back 215

Gracilis muscle

Front 216

1. What thigh adductor muscles originate inferior and anterior to the hip joint?

2. What actions can they produce at the hip joint?

Back 216

All thigh adductor muscles except adductor magnus.

2. Adduction, flexion and medial rotation

Front 217

What actions can the adductor magnus produce at the hip joint?

Back 217

-Adduction and flexion
-Adduction and extension
-Medial rotation
-Lateral rotation
Note: Depends on the region stimulated.

Front 218

When an athlete suffers a pulled groin what muscles are affected?

Back 218

A strain - a muscle tear or break - in one of the thigh adductor muscles.

Front 219

What muscles dominate the medial surface of the pelvis? What is their function?

Back 219

-The psoas major muscle
-The iliacus muscle

Function: powerful flexors of the hip

Front 220

What ligament do the psoas major and iliacus muscles pass deep to?

Back 220

Inguinal ligament

Front 221

What are the psoas major and iliacus muscles referred to together as a pair?

Back 221

Iliopsoas muscle

Front 222

How many action lines does the adductor magnus have?

Back 222

Three action lines

Front 223

The following muscle groups generally dominate which part of the pelvis?
1. Gluteal muscles
2. Iliopsoas muscle
3. Adductor muscles
4. Lateral rotator muscles

Back 223

1. Lateral surface of the ilium
2. Medial surface of the pelvis
3. Pubis (inferior to acetabular surface)
4. Inferior to the horizontal axis of the acetabulum

Front 224

Which muscle originates in the iliac fossa?

Back 224

Iliacus muscle

Front 225

What are the three things to remember when considering action lines of the muscles that act at the hip?

Back 225

1. The neck of the femur angles inferiorly and laterally away from the acetabulum of the hip
2. The femur is bent and twisted as you move inferiorly from the hip to the knee
3. Many of the muscles acting on the hip are very large, and they have insertions that extend over a broad area. As a result, the muscles have more than one action line producing more than one action at the hip.

Front 226

Muscles that have action lines that pass posterior to the axis of the hip joint produce what action at the hip?

Back 226

Extension

Front 227

Muscles that have action lines that pass anterior to the axis of the hip joint produce what action at the hip?

Back 227

Flexion

Front 228

Muscles that have action lines that pass medial to the axis of the hip joint produce what action at the hip?

Back 228

Adduction.

May also produce medial rotation.

Front 229

Muscles that have action lines that pass lateral to the axis of the hip joint produce what action at the hip?

Back 229

Abduction.

May also produce lateral rotation.

Front 230

Muscles that have action lines that pass anterior to the axis of the knee joint produce what action at the knee?

Back 230

Extension

Front 231

Muscles that have action lines that pass posterior to the axis of the knee joint produce what action at the knee?

Back 231

Flexion

Front 232

1. Where do most knee extensor muscles originate?

2. What surfaces of the thigh do they extend on?

Back 232

1. Femur (mostly the body)

2. Anterior and lateral surface of thigh

Front 233

1. Where do most knee flexor muscles originate?

2. What surfaces of the thigh do they extend on?

Back 233

1. Pelvic girdle (edges of the pelvis)

2. Posterior and medial surfaces of the thigh

Front 234

What are the knee extensor muscles collectively called?

Back 234

Quadriceps muscles or quadriceps femoris

Front 235

How are the three vastus muscles located in relation to the rectus femoris muscle?

Back 235

They cradle the rectus femoris muscle the way a bun surround a hot dog

Front 236

Where do all four knee extensor muscles insert?

Back 236

On the tibial tuberosity via the quadriceps tendon, patella and patellar ligament.

Front 237

Where do the knee flexor muscles insert?

Back 237

Tibia and fibula

Front 238

What action besides knee flexion do the biceps femoris, semimembranosus and semitendinosus muscles produce?

Back 238

Extension at the hip.

Note: This is because the originate on the pelvis inferior and posterior to the acetabulum

Front 239

Which muscles are collectively called the hamstring muscles?

Back 239

The biceps femoris, semimembranosus and semitendinosus muscles

Front 240

What two bone markings does the inguinal ligament attach to?

Back 240

-Anterior superior iliac spine
-Pubic tubercle

Front 241

1. What knee flexor originates superior to the acetabulum?

2. Where does it insert?

3. What actions does it produce besides flexion of knee?

Back 241

1. Sartorius muscle

2. medial aspect of tibia

3. Flexion, abduction and lateral rotation at hip.

Front 242

What muscle helps unlock the knee when the knee is flexed?

Back 242

The popliteus muscle contracts to produce a slight medial rotation of the tibia that unlocks the knee joint.

Front 243

1. What are the two important plantar flexor muscles?
2. Which muscle is superficial?
3. Which is more powerful?

Back 243

1. Gastrocnemius and soleus muscle.
2. The soleus muscle underlies the gastrocnemius muscle.
3. The soleus muscle is more powerful

Front 244

How many tendons does the gastrocnemius muscle have at its origin?

Back 244

Two

Front 245

What bone is often found within the gastrocnemius muscle?

Back 245

The fabella, a sesamoid bone.

Front 246

What is the common tendon of the gastrocnemius and soleus muscle called?

Back 246

Calcaneal tendon (also known as the calcanean tendon and the Achilles tendon)

Front 247

What is another name for the two fibularis muscles?

Back 247

Peroneus muscles

Front 248

What muscle produces the eversion of the foot?

Back 248

The two fibularis muscles

Note: Also produce plantar flexion of ankle

Front 249

What muscle produces inversion of the foot?

Back 249

Tibialis anterior muscle

Note: Also produce dorsiflexion of ankle

Front 250

Do tendon sheaths surround the tendons of the tibialis anterior , extensor digitorum longus and extensor hallucis longus muscles as they cross the ankle joint?

Back 250

Yes

Front 251

What stabilizes the position of the large tendon sheaths that surround the tendons of the tibialis anterior , extensor digitorum longus and extensor hallucis longus muscles as they cross the ankle joint?

Back 251

Superior and inferior extensor retinacula

Front 252

Where do the intrinsic muscles that move the toes originate?

Back 252

Tarsus and foot

Front 253

What intrinsic foot muscles contribute to the maintenance of the longitudinal arch of the foot?

Back 253

Flexor muscles that originate at the anterior border of the calcaneus.

Front 254

What muscles abduct the metatarsophalangeal joints of toes 3 and 4?

Back 254

Dorsal interossei muscles

Front 255

What muscles adduct the metatarsophalangeal joints of toes 3 - 5?

Back 255

Plantar interossei muscles

Front 256

Do most intrinsic foot muscles cause flexion or extension at toes?

Back 256

Flexion

Front 257

What is the only intrinsic foot muscle found on the dorsum of the foot?

Back 257

Extensor digitorum brevis muscle

Front 258

What are the anatomical terms and adjectives for the following common names?
1. Groin
2. Pubic area
3. Pelvis

Back 258

1. Inguen (inguinal)
2. Pubis (pubic)
3. Pelvis (pelvic)

Front 259

What are the anatomical terms and adjectives for the following common names?
1. Thigh
2. Knee cap
3. Leg

Back 259

1. Femur (femoral)
2. Patella (patellar)
3. Crus (crural)

Front 260

What are the anatomical terms and adjectives for the following common names?
1. Ankle
2. Toes
3. Great toe

Back 260

1. Tarsus (tarsal)
2. Digits or phalanges (digital or phalangeal)
3. Hallux

Front 261

What are the anatomical terms and adjectives for the following common names?
1. Buttock
2. Back of knee
3. Calf

Back 261

1. Gluteus (gluteal)
2. Popliteus (popliteal)
3. Sura (sural)

Front 262

What are the anatomical terms and adjectives for the following common names?
1. Heel of foot
2. Sole of foot

Back 262

1. Calcaneus (calcaneal)
2. Planta (plantar)

Front 263

1. What type of fascia support and interconnect adjacent skeletal muscles?

2. Do they permit independent movement of the skeletal muscles?

Back 263

1. Deep Fascia

2. Yes

Front 264

What muscles are more extensively interconnected by the deep fascia and difficult to separate on dissection?

Back 264

Two adjacent muscles that are similar in orientation, action and range of movement.

Note: If their orientations and actions differ, they will be less tightly interconnected and easier to separate on dissection.

Front 265

What do the deep fascia of the limbs extend between?

Back 265

The bones and the superficial fascia.

Note: In the limbs the muscles are packed close together around the bones and the interconnections between the superficial fascia, the deep fascia and the periostea are quite substantial.

Front 266

What separates the soft tissues of the limb into separate compartments?

Back 266

Deep fascia extending between the bones and the superficial fascia.

Front 267

What septa create the compartments in the thigh?

Back 267

Medial and lateral septa

Front 268

What structures creates the compartments in the leg?

Back 268

The tibia and fibula, crural interosseous membrane and septa.

Front 269

How many compartments does the thigh have? What are they?

Back 269

Three
-Anterior compartment
-Posterior compartment
-Medial compartment

Front 270

How many compartments does the leg have? What are they?

Back 270

Four
-Anterior
-Lateral
-Superficial posterior
-Deep posterior

Front 271

What is the function of the muscles in the anterior leg compartment?

Back 271

-Dorsiflex the ankle
-Extend the toes
-Invert/evert the ankles

Front 272

What is the function of the muscles in the lateral leg compartment?

Back 272

-Eversion
-Plantar flexion

Front 273

What is the function of the muscles in the superficial posterior leg compartment?

Back 273

Plantar flexion

Front 274

What is the function of the muscles in the deep posterior leg compartment?

Back 274

-Plantar flex the ankle as well as their specific action on the joints of the foot and the toes.

Front 275

What is compartment syndrome?

Back 275

Compartment pressure caused by accumulated fluids in compartments that compresses the regional blood vessels and eliminates the circulatory supply to the muscles and nerves of the compartment. This compression produces a condition of ischemia or "blood starvation", known as compartment syndrome.

Front 276

What can cause compartment syndrome?

Back 276

A crushing injury, severe contusion (injury in which skin is not broken), or strain that damages blood vessels within one or more compartments. When damaged, these compartments become swollen with tissue, fluid, and blood that has leaked from damaged blood vessels.

Front 277

What is an emergency measure to relieve compartment syndrome?

Back 277

Slicing into the compartment along its longitudinal axis or implanting a drain.

Front 278

What happens if compartment syndrome is left untreated?

Back 278

The contents of the compartment will suffer damage. Nerves in the affected compartment will be destroyed after 2 - 4 hrs of ischemia, although they can regenerate to some degree if the circulation is restored. The muscle tissue will be destroyed after 6 hour with no regeneration possible. The muscle will be replaced by scar tissue and connective tissue fibers shorten (contracture), permanently reducing the muscle length.

Front 279

What muscles make up the gluteal group of the muscles that move the thigh?

Back 279

1. Gluteus maximus
2. Gluteus medius
3. Gluteus minimus
4. Tensor fasciae latae

Front 280

What muscles make up the lateral rotator group of the muscles that move the thigh?

Back 280

1. Obturators (externus and internus)
2. Piriformis
3. Gemelli (superior and inferior)
4. Quadratus femoris

Front 281

What muscles make up the adductor group of the muscles that move the thigh?

Back 281

1. Adductor brevis
2. Adductor longus
3. Adductor magnus
4. Pectineus
5. Gracilis

Front 282

What muscles make up the iliopsoas group of the muscles that move the thigh?

Back 282

1. Iliacus
2. Psoas major

Front 283

Gluteus maximus (origin, insertion, action and innervation)

Back 283

Origin: Iliac crest, posterior gluteal line, and lateral surface of ilium; sacrum, coccyx, and thoracolumbar fascia
Insertion: Iliotibial tract and gluteal tuberosity of femur
Action: Extension and lateral rotation at hip; helps stabilize the extended knee; abduction at the hip (superior fibers only)
Innervation: Inferior gluteal nerve

Front 284

Gluteus medius (origin, insertion, action and innervation)

Back 284

Origin: Anterior iliac crest, lateral surface of ilium between posterior and anterior gluteal lines
Insertion: Greater trochanter of femur
Action: Abduction and medial rotation at hip
Innervation: Superior gluteal nerve

Front 285

Gluteus minimus (origin, insertion, action and innervation)

Back 285

Origin: Lateral surface of ilium between inferior and anterior gluteal lines.
Insertion: Greater trochanter of femur
Action: Abduction and medial rotation at hip
Innervation: Superior gluteal nerve

Front 286

Tensor fascia latae (origin, insertion, action and innervation)

Back 286

Origin: Iliac crest and lateral surface of anterior superior iliac spine
Insertion: Iliotibial tract
Action: Abduction and medial rotation at hip; extension and lateral rotation at knee; tense fasciae latae, which laterally supports the knee
Innervation: Superior gluteal nerve

Front 287

Externus and Internus Obturators (origin, insertion, action and innervation)

Back 287

Origin: Lateral and medial margins of obturator foramen
Insertion: Trochanteric fossa of femur (externus); medial surface of greater trochanter (internus)
Action: Lateral rotation and abduction of hip; help to maintain stability and integrity of the hip
Innervation: Obturator nerve (externus: L3 - L4) and special nerve from sacral plexus (internus: L5-S2)

Front 288

Piriformis (origin, insertion, action and innervation)

Back 288

Origin: Anterolateral surface of sacrum
Insertion: Greater trochanter of femur
Action: Lateral rotation and abduction of hip; help to maintain stability and integrity of the hip
Innervation: Branches of sacral nerves (S1-S2)

Front 289

Superior and Inferior Gemilli (origin, insertion, action and innervation)

Back 289

Origin: Ischial spine (superior gemellus) and ischial tuberosity (inferior gemellus)
Insertion: Medial surface of greater trochanter via tendon of obturator internus
Action: Lateral rotation and abduction of hip; help to maintain stability and integrity of the hip
Innervation: Nerves to obturator internus and quadratus femoris

Front 290

Quadratus femoris (origin, insertion, action and innervation)

Back 290

Origin: Lateral border of ischial tuberosity
Insertion: Intertrochanteric crest of femur
Action: Lateral rotation of hip
Innervation: Special nerves from sacral plexus (L4-S1)

Front 291

Adductor brevis (origin, insertion, action and innervation)

Back 291

Origin: Inferior ramus of pubis
Insertion: Linea aspera of femur
Action: Adduction and flexion at hip
Innervation: Obturator nerve (L3-L4)

Front 292

Adductor longus (origin, insertion, action and innervation)

Back 292

Origin: Inferior ramus of pubis, anterior to adductor brevis
Insertion: Linea aspera of femur
Action: Adduction, flexion, and medial rotation at hip
Innervation: Obturator nerve (L3-L4)

Front 293

Adductor magnus (origin, insertion, action and innervation)

Back 293

Origin: Inferior ramus of pubis, posterior to adductor brevis and ischial tuberosity
Insertion: Linea aspera and adductor tubercle of femur
Action: Whole muscle produces adduction at the hip; anterior part produces flexion and medial rotation; posterior part produces extension
Innervation: Obturator and sciatic nerves

Front 294

Pectineus (origin, insertion, action and innervation)

Back 294

Origin: Superior ramus of pubis
Insertion: Pectineal line inferior to lesser trochanter of femur
Action: Flexion and adduction at hip
Innervation: Femoral nerve (L2-L4)

Front 295

Gracilis (origin, insertion, action and innervation)

Back 295

Origin: Inferior ramus of pubis
Insertion: Medial surface of tibia inferior to medial condyle
Action: Flexion and medial rotation at knee; adduction and medial rotation at hip
Innervation: Obturator nerve (L3-L4)

Front 296

Iliacus (origin, insertion, action and innervation)

Back 296

Origin: Iliac fossa
Insertion: Femur distal to lesser trochanter; tendon fused with that of psoas major
Action: Flexion at hip and/or lumbar intervertebral joints
Innervation: Femoral nerve

Front 297

Psoas major (origin, insertion, action and innervation)

Back 297

Origin: Anterior surfaces and transverse processes of vertebrae (T12-L5)
Insertion: Lesser trochanter in company with iliacus
Action: Flexion at hip and/or lumbar intervertebral joints
Innervation: Branches of lumbar plexus (L2-L3)

Front 298

How are the Muscles that move the leg grouped? (How many muscles in each group)

Back 298

1. Flexors of the knee (5)
2. Extensors of the knee (4)

Front 299

What are the flexor muscles of the knee?

Back 299

1. Biceps femoris
2. Semimembranosus
3. Semitendinosus
4. Sartorius
5. Popliteus

Front 300

What are the extensor muscles of the knee?

Back 300

1. Rectus femoris
2. Vastus intermedius
3. Vastus lateralis
4. Vastus medialis

Front 301

Biceps femoris (origin, insertion, action and innervation)

Back 301

Origin: Ischial tuberosity and linea aspera of femur
Insertion: Head of fibula, lateral condyle of tibia
Action: Flexion at knee; extension and lateral rotation at hip
Innervation: Sciatic nerve; tibial portion (S1-S3 to long head) and common fibular branch (L5-S2 to short head)

Front 302

Semimembranosus (origin, insertion, action and innervation)

Back 302

Origin: Ischial tuberosity
Insertion: Posterior surface of medial condyle of tibia
Action: Flexion at knee; extension and medial rotation at hip
Innervation: Sciatic nerve (Tibial portion L5-S2)

Front 303

Semitendinosus (origin, insertion, action and innervation)

Back 303

Origin: Ischial tuberosity
Insertion: Proximal, medial surface of tibia near insertion of gracilis
Action: flexion at knee; extension and medial rotation at hip
Innervation: Sciatic nerve (Tibial portion L5-S2)

Front 304

Sartorius (origin, insertion, action and innervation)

Back 304

Origin: Anterior superior iliac spine
Insertion: Medial surface of tibia near tibial tuberosity
Action: Flexion at knee; abduction, flexion, and lateral rotation at hip
Innervation: Femoral nerve (L2-L3)

Front 305

Popliteus (origin, insertion, action and innervation)

Back 305

Origin: Lateral condyle of femur
Insertion: Posterior surface of proximal tibial shaft
Action: Medial rotation of tibia (or lateral rotation of femur) at knee; flexion at knee
Innervation: Tibial nerve (L4-S1)

Front 306

Rectus femoris (origin, insertion, action and innervation)

Back 306

Origin: Anterior inferior iliac spine and superior acetabular rim of ilium
Insertion: Tibial tuberosity via quadriceps tendon, patella, and patellar ligament
Action: Extension at knee; flexion at hip
Innervation: Femoral nerve (L2-L4)

Front 307

Vastus intermedius (origin, insertion, action and innervation)

Back 307

Origin: Anterolateral surface of femur and linea aspera (distal half)
Insertion: Tibial tuberosity via quadriceps tendon, patella, and patellar ligament
Action: Extension at knee
Innervation: Femoral nerve (L2-L4)

Front 308

Vastus lateralis (origin, insertion, action and innervation)

Back 308

Origin: Anterior and inferior to greater trochanter of femur and along linea aspera (proximal half)
Insertion: Tibial tuberosity via quadriceps tendon, patella, and patellar ligament
Action: Extension at knee
Innervation: Femoral nerve (L2-L4)

Front 309

Vastus medialis (origin, insertion, action and innervation)

Back 309

Origin: Entire length of linea aspera of femur
Insertion: Tibial tuberosity via quadriceps tendon, patella, and patellar ligament
Action: Extension at knee
Innervation: Femoral nerve (L2-L4)

Front 310

How are the extrinsic muscles that move the foot and toes grouped? (How many muscles in each group)

Back 310

1. Dorsiflexors (1)
2. Plantar flexors (6)
3. Digital flexors (2)
4. Digital extensors (2)

Front 311

What are the dorsiflexor extrinsic muscles of the foot and toes?

Back 311

1. Tibialis anterior

Front 312

What are the plantar flexor extrinsic muscles of the foot and toes?

Back 312

1. Gastrocnemius
2. Fibularis brevis
3. Fibularis longus
4. Plantaris
5. Soleus
6. Tibialis posterior

Front 313

What are the digital flexor extrinsic muscles of the foot and toes?

Back 313

1. Flexor digitorum longus
2. Flexor hallucis longus

Front 314

What are the digital extensor extrinsic muscles of the foot and toes?

Back 314

1. Extensor digitorum longus
2. Extensor hallucis longus

Front 315

Tibialis anterior (origin, insertion, action and innervation)

Back 315

Origin: Lateral condyle and proximal shaft of tibia
Insertion: Base of first metatarsal bone and medial cuneiform
Action: Dorsiflexion at ankle; inversion of foot
Innervation: Deep fibular nerve (L4-S1)

Front 316

Gastrocnemius (origin, insertion, action and innervation)

Back 316

Origin: Femoral condyles
Insertion: Calcaneus via calcaneal tendon
Action: Plantar flexion at ankle; flexion at knee
Innervation: Tibial nerve (S1-S2)

Front 317

Fibularis brevis (origin, insertion, action and innervation)

Back 317

Origin: Midlateral margin of fibula
Insertion: Base of fifth metatarsal bone
Action: Eversion of foot and plantar flexion at ankle
Innervation: Superficial fibular nerve (L4-S1)

Front 318

Fibularis longus (origin, insertion, action and innervation)

Back 318

Origin: Head and proximal shaft of fibula
Insertion: Base of first metatarsal bone and medial cuneiform
Action: Eversion of foot and plantar flexion at ankle; supports ankle; supports longitudinal and transverse arches
Innervation: Superficial fibular nerve (L4-S1)

Front 319

Plantaris (origin, insertion, action and innervation)

Back 319

Origin: Lateral supracondylar ridge
Insertion: Posterior portion of calcaneus
Action: Plantar flexion at ankle; flexion at knee
Innervation: Tibial nerve (L4-S1)

Front 320

Soleus (origin, insertion, action and innervation)

Back 320

Origin: Head and proximal shaft of the fibula, and adjacent posteromedial shaft of tibia
Insertion: Calcaneus via calcaneal tendon (with gastrocnemius)
Action: Plantar flexion at ankle; postural muscle when standing
Innervation: Sciatic nerve, tibial branch (S1-S2)

Front 321

Tibialis posterior (origin, insertion, action and innervation)

Back 321

Origin: Interosseous membrane and adjacent shafts of tibia and fibula
Insertion: Navicular, all three suneirforms, cuboid, second, third, and fourth metatarsal bones
Action: Inversion of foot; plantar flexion at ankle
Innervation: Sciatic nerve, tibial branch (S1-S2)

Front 322

Flexor digitorum longus (origin, insertion, action and innervation)

Back 322

Origin: Posteromedial surface of tibia
Insertion: Inferior surface of distal phalanges, toes 2-5
Action: Flexion joints of toes 2-5; plantar flexes ankle
Innervation: Tibial branch (L5-S1)

Front 323

Flexor hallucis longus (origin, insertion, action and innervation)

Back 323

Origin: Posterior surface of fibula
Insertion: Inferior surface, distal phalanx of great toe
Action: Flexion at joints of great toe; plantar flexes ankle
Innervation: Tibial branch (L5-S1)

Front 324

Extensor digitorum longus (origin, insertion, action and innervation)

Back 324

Origin: Lateral condyle of tibia, anterior surface of fibula
Insertion: Superior surfaces of phalanges, toes 2-5
Action: Extension of toes 2-5; dorsiflexes ankle
Innervation: Deep fibular nerve (L5-S1)

Front 325

Extensor hallucis longus (origin, insertion, action and innervation)

Back 325

Origin: Anterior surface of fibula
Insertion: Superior surface, distal phalanx of great toe
Action: Extension at joints of great toe; dorsiflexes ankle
Innervation: Deep fibular nerve (L5-S1)

Front 326

What are the intrinsic muscles of the foot?

Back 326

1. Extensor digitorum brevis
2. Flexor digitorum brevis
3. Abductor hallucis
4. Adductor hallucis
5. Flexor hallucis brevis
6. Abductor digiti minimi
7. Flexor digiti minimi brevis
8. Quadratus plantae
9. Lumbiricals (4)
10. Dorsal interossei (4)
11. Plantar interossei (3)

Front 327

Extensor digitorum brevis (origin, insertion, action and innervation)

Back 327

Origin: Calcaneus (superior and lateral surfaces)
Insertion: Dorsal surface of toes 1-4
Action: Extension at metatarsophalangeal joints of toes 1-4
Innervation: Deep fibular nerve (S1, S2)

Front 328

Abductor hallucis (origin, insertion, action and innervation)

Back 328

Origin: Calcaneus (tuberosity on inferior surface)
Insertion: Medial side of proximal phalanx of great toe
Action: Abduction at metatarsophalangeal joint of great toe
Innervation: Medial plantar nerve (S2, S3)

Front 329

Flexor digitorum brevis (origin, insertion, action and innervation)

Back 329

Origin: Calcaneus (tuberosity on inferior surface)
Insertion: Sides of middle phalanges, toes 2-5
Action: Flexion of proximal interphalangeal joints of toes 2-5
Innervation: Medial plantar nerve (S2, S3)

Front 330

Abductor digiti minimi (origin, insertion, action and innervation)

Back 330

Origin: Calcaneus (tuberosity on inferior surface)
Insertion: Lateral side of proximal phalanx, toe 5
Action: Abduction and flexion at metatarsophalangeal joint of toe 5
Innervation: Lateral plantar nerve (S2, S3)

Front 331

Quadratus plantae (origin, insertion, action and innervation)

Back 331

Origin: Calcaneus (medial, inferior surfaces)
Insertion: Tendon of flexor digitorum longus
Action: Flexion at joints of toes 2-5
Innervation: Lateral plantar nerve (S2, S3)

Front 332

Lumbricals (origin, insertion, action and innervation)

Back 332

Origin: Tendons of flexor digitorum longus
Insertion: Insertions of extensor digitorum longus
Action: Flexion metatarsophalangeal joints; extension at interphalangeal joints of toes 2-5
Innervation: Medial plantar nerve (1), lateral plantar nerve (2-4)

Front 333

Flexor hallucis brevis (origin, insertion, action and innervation)

Back 333

Origin: Cuboid and lateral cuneiform
Insertion: Proximal phalanx of great toe
Action: Flexion at metatarsophalangeal joint of great toe
Innervation: Medial plantar nerve (L4-S5)

Front 334

Adductor hallucis (origin, insertion, action and innervation)

Back 334

Origin: Bases of matatarsal bones II-IV and plantar ligaments
Insertion: Proximal phalanx of great toe
Action: Adduction and flexion at metatarsophalangeal joint of great toe
Innervation: Lateral plantar nerve (S1-S2)

Front 335

Flexor digiti minimi brevis (origin, insertion, action and innervation)

Back 335

Origin: Base of metatarsal bone V
Insertion: Lateral side of proximal phalanx of toe 5
Action: Flexion at metatarsophalangeal joint of toe 5
Innervation: Lateral plantar nerve (S1-S2)

Front 336

Dorsal interossei (origin, insertion, action and innervation)

Back 336

Origin: Sides of metatarsal bones
Insertion: Medial and lateral sides of toe 2; lateral sides of toes 3 and 4
Action: Abduction at metatarsophalangeal joints of toes 3 and 4; flexion of metatarsophalangeal joints and extension at interphalangeal joints of toes 2 through 4
Innervation: Lateral plantar nerve (S1-S2)

Front 337

Plantar interossei (origin, insertion, action and innervation)

Back 337

Origin: Bases and medial sides of metatarsal bones
Insertion: Medial sides of toes 3-5
Action: Adduction of metatarsophalangeal joints of toes 3-5; flexion of metatarsophalangeal joints and extension at interphalangeal joints
Innervation: Lateral plantar nerve (S1-S2)

Front 338

Anterior Compartment of Thigh (muscles, blood vessels, nerves)

Back 338

Muscles: Iliopsoas, quadriceps femoris, sartorius
Blood vessels: Femoral artery, femoral vein, deep femoral artery, lateral circumflex femoral artery
Nerves: Femoral nerve, saphenous nerve

Front 339

Medial compartment of Thigh (muscles, blood vessels, nerves)

Back 339

Muscles: Pectineus, adductor brevis, adductor longus, adductor magnus, gracilis, obturator externus
Blood vessels: Obturator artery, obturator vein, deep femoral artery, deep femoral vein
Nerves: Obturator nerve

Front 340

Posterior compartment of Thigh (Muscles, blood vessels, nerves)

Back 340

Muscles: Biceps femoris, semimebranosus, semitendinosus
Blood vessels: Deep femoral artery, deep femoral vein
Nerves: Sciatic nerve

Front 341

Anterior Compartment of Leg (muscles, blood vessels, nerves)

Back 341

Muscles: Extensor digitorum longus, Extensor hallucis longus, fibularis tertius, tibialis anterior
Blood vessels: Anterior tibial artery, anterior tibial vein
Nerves: Superficial fibular nerve

Front 342

Lateral compartment of Leg (muscles, blood vessels, nerves)

Back 342

Muscles: Fibularis brevis, fibularis longus
Blood vessels: None listed
Nerves: Superficial fibular nerve

Front 343

Posterior Superifical compartment of Leg (muscles, blood vessels, nerves)

Back 343

Muscles: Gastrocnemius, plantaris, soleus
Blood vessels: None listed
Nerves: None listed

Front 344

Posterior Deep compartment of Leg (Muscles, blood vessels, nerves)

Back 344

Muscles: Flexor digitorum longus, flexor hallucis longus, politeus, tibialis posterior
Blood vessels: posterior tibial artery, fibular artery, fibular vein, posterior tibial vein
Nerves: Tibial nerve

Front 345

What is a nerve plexus?

Back 345

A complex interwoven network of nerves formed by ventral rami of adjacent spinal nerves that blend their fibers to produce a series of compound nerve trunks.

Front 346

What two nerve plexus supply the pelvis and lower limb?

Back 346

1. Lumbar plexus
2. Sacral plexus

Front 347

What are the lumbar and sacral plexuses collectively referred to as?

Back 347

Lumbosacral plexus

Front 348

1. What ventral rami form the lumbar plexus?

2. What ventral rami form the sacral plexus?

Back 348

1. Ventral rami of spinal nerves T12-L4

2. Ventral rami from spinal nerves L4-S4

Front 349

What are the major nerves of the lumbar plexus?

Back 349

1. Genitofemoral nerve
2. Lateral femoral cutaneous nerve
3. Femoral nerve

Front 350

What are the major nerves of the sacral plexus?

Back 350

1. Sciatic nerve
2. Pudendal nerve

Front 351

1. The ventral rami of L4 and L5 form what nerve trunk?

2. What nerve plexus does the nerve trunk contribute to?

Back 351

1. Lumbosacral trunk

2. Sacral plexus

Front 352

What two branches does the sciatic nerve divide into as it approaches the popliteal fossa?

Back 352

1. The common fibular nerve
2. Tibial nerve

Front 353

Does the sciatic nerve pass anterior or posterior to the femur?

Back 353

Posterior

Front 354

Which of the following provides more conclusive information about location of injuries along the spinal cord?
1. Loss of sensation in dermatomes
2. Loss of motor control

Back 354

Loss of motor control (on the basis pf the origin and distribution of peripheral nerves originating at nerve plexuses.

Note: Dermatomes do not provide exact information because the boundaries of dermatomes are not precise, clearly defined lines.

Front 355

Femoral nerve (nerve plexus, spinal segments, distribution)

Back 355

Nerve plexus: Lumbar plexus
Spinal Segments: L2-L4
Distribution: Anterior muscles thigh (sartorius and quadriceps group); adductors of hip (pectineus and ilipsoas); skin over anterio medial surface of thigh, medial surface of leg and foot

Front 356

Obturator nerve (nerve plexus, spinal segments, distribution)

Back 356

Nerve plexus: Lumbar plexus
Spinal Segments: L2-L4
Distribution: Adductors of hip (adductors magnus, brevis and longus); gracilis; skin over medial surface of thigh

Front 357

Saphenous nerve (nerve plexus, spinal segments, distribution)

Back 357

Nerve plexus: Lumbar plexus
Spinal Segments: L2-L4
Distribution: Skin over medial surface of leg

Front 358

Superior Gluteal nerve (nerve plexus, spinal segments, distribution)

Back 358

Nerve plexus: Sacral plexus
Spinal Segments: L4-S2
Distribution: Abductors of hip (gluteus minimus and medius, and tensor fasciae latae)

Front 359

Inferior Gluteal nerve (nerve plexus, spinal segments, distribution)

Back 359

Nerve plexus: Sacral plexus
Spinal Segments: L4 - S2
Distribution: Extensor of hip (gluteus maximus)

Front 360

Posterior femoral cutaneous nerve (nerve plexus, spinal segments, distribution)

Back 360

Nerve plexus: Sacral plexus
Spinal Segments: L4-S3
Distribution: Skin of perineum and posterior surface of thigh and leg

Front 361

Sciatic nerve (nerve plexus, spinal segments, distribution)

Back 361

Nerve plexus: Sacral plexus
Spinal Segments: L4-S3
Distribution: Two hamstrings (semimebranosus and semitedinosus); adductor magnus (with obturator nerve)

Front 362

Tibial Sciatic nerve (nerve plexus, spinal segments, distribution)

Back 362

Nerve plexus: Sacral plexus
Spinal Segments: L4-S3
Distribution: Flexors of knee and plantar flexors of ankle (popliteus, gastrocnemius, soleus, and tibialis posterior muscles and long head of the biceps femoris muscles); flexors of toes; skin over posterior surface of leg; plantar surface of foot

Front 363

Sciatic Fibular nerve (nerve plexus, spinal segments, distribution)

Back 363

Nerve plexus: Sacral plexus
Spinal Segments: L4-S3
Distribution: Short head of biceps femoris muscle; fibularis (brevis and longus) and tibialis anterior muscles; extensors of toes; skin over anterior surface of leg and dorsal surface of foot; skin over lateral portion of foot (through the sural nerve)

Front 364

What nerves from the lumbar plexus innervate muscles of the lower limb?

Back 364

1. Femoral Nerve
2. Obturator nerve

Front 365

What nerves from the sacral plexus innervate muscles of the lower limb?

Back 365

1. Superior and inferior gluteal nerves
2. Sciatic nerve
3. Tibial and fibular sciatic nerve

Front 366

What are peripherial neuropathies (peripheral nerve palsies)?

Back 366

Regional losses of sensory and motor function as a result of nerve trauma or compression.

Front 367

Which nerve plexus do crural palsies involve?

Back 367

Lumbusacral plexus

Front 368

List three crural palsies.

Back 368

1. Sciatic compression
2. Sciatica
3. Fibular palsy

Front 369

What can cause sciatic compression and what are the symptoms?

Back 369

Cause: Sitting in one position for long periods of time with a large wallet in hip pocket
Symptoms: Lumbar and gluteal pain, numbness along back of leg and weakness in leg muscles

Front 370

What can cause sciatica and what are the symptoms?

Back 370

Cause: Compression of nerve roots that form the sciatic nerve by a distorted lumbar intervertebral disc.
Symptoms: Lumbar and gluteal pain, numbness along back of leg and weakness in leg muscles (in one or both legs depending on site of compression)

Front 371

What can cause fibular palsy and what are the symptoms?

Back 371

Cause: Sitting with legs crossed
Symptoms: Sensory loss from the top of the foot and side of the leg are accompanied by a decreased ability to dorsiflex ("foot drop) or evert the foot.

Front 372

In assessment of motor performance what distinction is made?

Back 372

A distinction is made between:
-the conscious ability to control motor activities and
-the performance of automatic, involuntary motor responses (reflexes)

Front 373

What are reflexes?

Back 373

Autonomic, involuntary motor responses (programmed motor patterns)

Front 374

What arteries does the abdominal aorta divide into at vertebra L4? What do these arteries supply?

Back 374

-Right and left common iliac arteries
-Small sacral artery

These arteries carry blood to the pelvis and lower limbs.

Front 375

What arteries do the right and left common iliac arteries divide into at the lumbosacral joint?

Back 375

1. Internal iliac artery
2. External iliac artery

Front 376

What are the major tributaries of the internal iliac artery?

Back 376

1. Superior gluteal artery
2. Internal pudendal artery
3. Obturator artery
4. Lateral sacral artery

Front 377

What organs or structures does the internal iliac artery supply?

Back 377

Urinary bladder, internal and external walls of pelvis, external genitilia and medial side of thigh.

In females, also supply the uterus and vagina

Front 378

What doe the external iliac arteries supply blood to?

Back 378

The lower limbs

Front 379

Which is larger in diameter: Internal or external iliac artery?

Back 379

External iliac artery

Front 380

What does the external iliac artery turn into when it emerges on the anteromedial surface of the thigh?

Back 380

The femoral artery

Front 381

1. Which artery does the deep femoral artery branch form?
2. What two arteries does the deep femoral artery branch into?
3. What does it supply?

Back 381

1. The femoral artery.
2. Medial and lateral circumflex arteries
3. Supplies blood to ventral and lateral regions of the skin and deep muscles of the thigh in the posterior compartment.

Front 382

1. What part does the descending genicular artery supply?

2. What artery does it branch from?

Back 382

1. Supplies medial aspect of knee

2. Branches from femoral artery before it as it reaches popliteal fossa

Front 383

As the femoral artery passes through the adductor magnus, what does it become?

Back 383

The popliteal artery

Front 384

What arteries does the popliteal artery branch into after crossing popliteal fossa?

Back 384

1. Posterior tibial artery
2. Anterior tibial artery

Front 385

What artery rises from the posterior tibial artery?

Back 385

Fibular artery

Front 386

What is another name for the fibular artery?

Back 386

Peroneal artery

Front 387

What two bones does the anterior tibial artery pass through?

Back 387

Passes between the tibia and fibula, emerging on the anterior lateral surface of the tibia.

Front 388

When the anterior tibial artery reaches the ankle what artery does it turn into?

Back 388

Dorsalis pedis artery

Front 389

What does the dorsalis pedis arteyr supply?

Back 389

Branches repeatedluy to supply
-ankle
-dorsal portion of foot

Front 390

As it reaches the ankel, what arteries does the posterior tibial artery divide into?

What does these arteries supply?

Back 390

-Medial plantar artery
-Lateral plantar artery

The above arteries supply the plantar surface of the foot.

Front 391

What arch in the foot is formed by dorsalis pedis artery?

Back 391

The dorsal arch

Front 392

What arch in the foot is formed by medial and lateral plantar arteries?

Back 392

The plantar arch

Front 393

How are the dorsal and plantar arches of the foot connected?

Back 393

By a pair of anastomoses

Front 394

Trace the arteries from the abdominal aorta to the foot

Back 394

Abdominal aorta --> Right or Left common iliac artery --> External iliac artery --> Femoral artery --> Popliteal artery --> Anterior and posterior tibial artery -->dorsalis pedis artery (from anterior tibial artery) and medial and lateral plantar arteries (from posterior tibial artery) --> dorsal arch (from dorsalis pedis artery) and plantar arch (from plantar arteries)

Front 395

What is another name for the dorsal arch in the foot?

Back 395

Arcuate arch

Front 396

What is another name for the fibular artery?

Back 396

Peroneal artery

Front 397

1. What vein drains blood from the lower limbs, pelvis and lower abdomen?

2. What vein drains blood from the pelvic organs?

Back 397

1. External iliac vein

2. Internal iliac vein

Front 398

What veins fuse to form the internal iliac vein?

Back 398

1. Gluteal vein
2. Internal pudendal vein
3. Obturator vein
4. Lateral sacral vein

Front 399

What two veins merge to form the common iliac vein?

Back 399

The external and internal iliac veins

Front 400

Does the medial sacral usually empty into the right or left common iliac vein?

Back 400

Left common iliac vein

Front 401

What vein do the left and right common iliac vein merge into?

Back 401

Inferior vena cava

Front 402

What veins collect blood from the capillaries in the sole of each foot?

Back 402

Plantar veins

Front 403

1. What are the deep veins of the leg?

2. What venous arch drains into them?

Back 403

1. Anterior tibial vein, posterior tibial vein and fibular vein

2. Plantar venous arch

Front 404

What does the dorsal venous arch collect blood from?

Back 404

1. Capillaries on the dorsal surface of the foot.
2. Digital veins of the toe.

Front 405

1. Are the dorsal and plantar venous arches connected?

2. What is the purpose?

Back 405

1. There are extensive interconnections between the plantar arch and the dorsal arch.

2. The path of blood flow can easily shift from superficial to deep veins.

Front 406

1. What are the superficial veins of the leg?

2. What venous arch drains into them?

Back 406

1. Great saphenous vein and small saphenous vein

2. Dorsal venous arch

Front 407

What vein is used in coronary bypass operations?

Back 407

Great sephanous vein

Front 408

Which vein is the longest vein in the body?

Back 408

Great sephanous vein

Front 409

Which aspect of the leg do the small and great sephanous veins ascend along?

Back 409

Great sephanous vein: medial aspect of the leg and thigh

Small sephanous vein: posterior and lateral aspect of arch

Front 410

Where and what veins do the small and great sephanous veins drain into?

Back 410

Great sephanous vein: femoral vein near the hip joint

Small sephanous vein: popliteal vein in the popliteal fossa

Front 411

What veins merge to form the popliteal vein?

Back 411

Tibial (anterior and posterior) and femoral veins

Front 412

When it reaches the femur, the popliteal vein becomes what vein?

Back 412

Femoral vein

Front 413

Where can the popliteal vein be palpated?

Back 413

In the popliteal fossa adjacent to the adductor magnus muscle.

Front 414

Which artery does the femoral vein ascend along in the thigh?

Back 414

The femoral artery

Front 415

Immediately before penetrating the abdominal wall, the femoral vein receives blood from what veins?

Back 415

1. The great sephanous vein
2. Deep femoral vein
3. The femoral circumflex vein

Front 416

What parts does the deep femoral vein drain?

Back 416

Collects blood from deeper structures of the thigh

Front 417

What parts does the femoral circumflex vein drain?

Back 417

The area around the neck and head of the femur

Front 418

What is the femoral vein called after it penetrates the body to emerge in the pelvic cavity?

Back 418

The external iliac vein

Front 419

Trace the path from the dorsal venous arch to the inferior vena cava

Back 419

Dorsal venous arch --> great saphenous vein --> femoral vein --> external iliac vein --> common iliac vein (left or right) --> inferior vena cava

Dorsal venous arch --> small saphenous vein --> popliteal vein --> femoral vein --> external iliac vein --> common iliac vein (left or right) --> inferior vena cavae

Front 420

Trace the path from the plantar venous arch to the inferior vena cava

Back 420

Plantar venous arch --> tibial (anterior or posterior) or fibular veins --> popliteal vein --> femoral vein --> external iliac vein --> common iliac vein (left or right) --> inferior vena cava

Front 421

What is another name for the fibular vein?

Back 421

Peroneal vein

Front 422

What vein does the fibular vein drain into?

Back 422

Posterior tibial vein

Front 423

What muscle inserts at adductor tubercles of femur?

Back 423

Adductor magnus

Front 424

Nerves and blood vessels enter the lower extremity via what three distinct routes?

Back 424

1. Entering the anterior compartment of the thigh posterior to the inguinal ligament
2. Entering the medial compartment of the thigh through the obturator canal
3. Entering the gluteal region through the greater sciatic foramen

Front 425

What are the three major nerves of the lower extremity arising from lumbar and sacral plexus?

Back 425

1. The femoral nerve
2. The obturator nerve
3. The sciatic nerve

Front 426

What nerves supply the skin of the lower extremity?

Back 426

Cutaneous branches of the lumbar and sacral plexus

Front 427

Is there an overlap of dermatomes in the lowers extremity?

Back 427

Yes

Front 428

Which artery do the inferior and superior gluteal arteries arise from?

Back 428

The internal iliac artery

Front 429

Does the lower extremity have deep or superficial lymphatics?

Back 429

Both

Note: The superficial lymphatics accompany the superficial veins while the deep lymphatics accompany arteries.

Front 430

The superficial lymphatics run parallel to the great saphenous and the short saphenous vein and rain into what lymphatic nodes?

Back 430

1. Parallel to great saphenous: deep inguinal nodes through the superficial inguinal nodes

2. Parallel to short saphenous: lymphatic nodes in the popliteal fossa

Front 431

Trace lymphatics from popliteal fossa to the external iliac group of lymphatic nodes.

Back 431

From the popliteal fossa, the lymphatics ascend through the thigh, alongside the femoral artery, to the deep inguinal nodes and on to the external iliac group.

Front 432

Where do blood vessels enter the hip joint?

Back 432

Through the acetabular notch.

Front 433

What is a Trendelenburg test?

Back 433

The Trendelenburg Test or Brodie-Trendelenburg test is a test which can be carried out as part of a physical examination to determine the competency of the valves in the superficial and deep veins of the legs in patients with varicose veins.

Front 434

The head of the femur is quite wide and the neck is quite narrow. What is the advantage of this?

Back 434

This maximizes the range of motion of the hip joint by allowing the femur to move quite a distance before it's course is limited by the innominate (hip) bone.

Front 435

What is another name for the ligament of the femoral head?

Back 435

The round ligament

Front 436

What is the function of the round ligament?

Back 436

Limits adduction

Front 437

What part of the hip joint capsule is the thinnest?

Back 437

The inferior aspect

Front 438

What is the function of the three internal ligaments (iliofemoral, ischiofemoral, pubofemoral) of the hip joint capsule?

Back 438

Limit extension and medial rotation

Front 439

Which ligament of the hip joint capsule is the thickest? What is its function?

Back 439

Iliofemoral ligament.

Prevents hyperextension.

Front 440

What hip joint capsule ligament attaches to the anterior inferior iliac spine and the intertrochanteric line?

Back 440

Iliofemoral ligament

Front 441

What hip joint capsule ligament extends from the iliopubic eminence to the neck of the femur?

Back 441

Pubofemoral ligament

Front 442

What separates the hip joint capsule from the iliopsoas tendon and the obturator externus?

Back 442

Two bursae

Front 443

What muscles produce flexion at the hip joint?

Back 443

Iliopsoas assisted by sartorius, rectus femoris, and pectineus

Front 444

What muscles produce extension at the hip joint?

Back 444

Gluteus maximus, semimembranosus, semitendinosus and biceps femoris.

Front 445

What muscles produce abduction at the hip joint?

Back 445

Gluteus medius and gluteus maximus

Front 446

What muscles produce adduction at the hip joint?

Back 446

Adductor longus, adductor brevis, adductor magnus, pectineus, and gracilis.

Front 447

What muscles produce medial rotation at the hip joint?

Back 447

Iliopsoas, tensor fascia latae, and portions of the gluteus medius and gluteus minimus.

Front 448

What muscles produce lateral rotation at the hip joint?

Back 448

Piriformis, quadratus femoris, obturator externus, obturator internus, superior gemellus and inferior gemellus

Front 449

What blood vessels supply blood to the hip joint?

Back 449

Branches from the obturator arter, the superior gluteal arter, the inferior gluteal artery, the medial circumflex femoral artery, the lateral circumflex femoral artery, and the trochanteric anstamosis.

Front 450

What is the clinical significance of nutrient arteries running within the reticular fibers of the fibrous capsule that pass into foramina on the femoral neck, terminating at the head of the femur.

Back 450

A fracture that results in tearing of the retinacular fibers may result in diminished blood flow to the head of the femur. If substantial this will result in avascular necrosis of the head of the femur which leads, quite rapidly to joint destruction and femoral head collapse.

Front 451

Besides the nutrient arteries of the hip joint capsule, what other arteries supply the femoral head?

Back 451

A branch of the obturator artery conveyed in the ligament of the femoral head (ligament teres femoris), and from the perforating branch of the profunda femoris artery.

Front 452

What nerves supply the hip joint?

Back 452

Branches of femoral nerve, obturator nerve and nerve from sacral plexus (that innervates the quadratus femoris)

Front 453

Where does the gluteal fold lie?

Back 453

The junction of the buttock and the posterior thigh.

Front 454

What muscles are in the gluteal compartment?

Back 454

Gluteus maximus, gluteus medius and gluteus minimus.

Front 455

What shape is the gluteus maximus?

Back 455

Trapezoidal shape

Front 456

What lies between the gluteus maximus and the ischial tuberosity?

Back 456

A synovial bursa

Front 457

What gluteal muscle helps stabilize the knee joint, extend the trunk when the lower extremities are stabilized and is most active in hip extension during stair climbing, walking up a steep grade or riding a bicylce?

Back 457

Gluteus maximus

Front 458

Lack of development of what muscles produces the exaggerated "torso-swing"?

Back 458

Gluteus medius and minimus

Front 459

Is the sciatic nerve a single nerve?

Back 459

No. It is composed of the tibial and common peroneal (fibular) nerve that run the entire length of the sciatic nerve enclosed by a common sheath. This division may occur at the sacral plexus.

Front 460

Why is the location of the sciatic nerve in the pelvis clinically significant?

Back 460

When seeking to avoid piercing the the nerve when administering an injection in the region of the buttock.

Front 461

What muscle exits the pelvis through the greater sciatic foramen and lesser sciatic foramen?

Back 461

Greater sciatic foramen: Piriformis

Lesser sciatic foramen: obturator internus

Front 462

What are two large ligaments that attach the sacrum to the ischium?

Back 462

-Sacrospinous (connects to ischial spine)
-Sacrotuberous (connects to ischial tuberosity)

Front 463

Is the femoral artery anterior or posterior to the femur?

Back 463

Anteromedial as it branches from the external iliac artery and then posterior as it reaches reaches the popliteal fossa

Front 464

Which is the only quadriceps femoris muscle crosses the hip joint?

Back 464

The rectus femoris

Front 465

What is a clinically significant region of the anterior compartment?

Back 465

The femoral triangle, occupying the upper-medial portion of the thigh.

Front 466

What structures delineate the femoral triangle?

Back 466

Superiorly: Inguinal canal
Laterally: Sartorius
Medially: Adductor longus
Roof: Fascia lata and iliopsoas
Floor: Pectineus and adductor longus

Front 467

What canal does the saphenous vein, the femoral vein, the femoral artery and the femoral nerve pass through to get from the femoral triangle to the popliteal fossa i.e. from the anterior to posterior aspect of thigh?

Back 467

The adductor canal

Front 468

What vessel is easily palpable and accessible for catheterization to perform anteriograms near the inguinal ligament?

Back 468

Femoral artery

Front 469

What forms the femoral ring (upper limit of the femoral canal)?

Back 469

Anterior: inguinal ligament
Posterior: pubis

Front 470

What thick fascial sheet surrounds the femoral artery and vein?

Back 470

Femoral sheath.

Front 471

What are the three compartments of the fascial sheath and which one is called the femoral canal?

Back 471

1. Lateral (femoral artery)
2. Intermediate (femoral vein)
3. Medial (fat and lymph nodes)

The medial compartment is called the femoral canal.

Front 472

What is a hernia?

Back 472

A hernia is the protrusion of an organ or the fascia of an organ through the wall of the cavity that normally contains it

Front 473

What hernia descends through the femoral ring to enter the femoral canal?

Back 473

Femoral hernia

Front 474

Which muscle in the thigh medial compartment crosses both the hip joint and knee joint?

Back 474

Gracilis

Front 475

Does the long or short head of the biceps femoris cross the hip joint?

Back 475

The long head.

Front 476

The tibial collateral ligament blends with the capsule of the knee joint which attaches to the medial meniscus of the knee joint vs. the fibular collateral ligament which does not blend into the capsule and is separated from the lateral meniscus. What is the significance of this?

Back 476

Increase in probability of medial meniscus tears.

Front 477

What is the function of the anterior and posterior cruciate ligaments of the knee?

Back 477

Prevent anterior and posterior shearing of the femur on the tibia.

Front 478

What nerves supply the knee joint?

Back 478

The femoral, obturator and sciatic nerves

Front 479

What shape is the popliteal fossa and where does it lie? What does it contain?

Back 479

It is a diamond-shaped space on the posterior aspect of the knee containing the principal blood vessels and nerves passing between the thigh and the leg.

Front 480

What forms the roof, floor and walls of the popliteal fossa?

Back 480

Roof: Deep fascia
Floor: femur, capsule and popliteus.
Superior (medial): Semimembranosus and semitendinosus
Superior (lateral): Biceps femoris
Inferior: medial and lateral heads of gastrocnemius.

Front 481

What are the contents of the popliteal fossa?

Back 481

-Popliteal artery and vein
-Common fibular nerve
-Tibial nerve

Front 482

Does the leg have extensor and flexor retinacula at its distal end?

Back 482

Yes.

Note: They form a fibro-osseous tunnel like the carpal tunnel in the wrist

Front 483

What nerve may be compressed in the tunnel formed by the extensor and flexor retinacula of leg causing pain in the heel and foot?

Back 483

The tibial nerve

Front 484

What are vena comitentes?

Back 484

Vena comitans is Latin for accompanying vein. It refers to a vein that is usually paired, with both veins lying on the sides of an artery.

Front 485

What compartment is the fibularis tertius in? What is its function?

Back 485

Anterior compartment of leg.

Function: Evert the foot and dorsiflex the ankle.

Front 486

What arteries contribute to the genicular anastomosis?

Back 486

Femoral (superior and inferior genicular)
Anterior and posterior tibialis (recurrent genicular)
Popliteal (descending genicular)

Front 487

What vessels supply blood to the ankle joint?

What nerves supply the ankle joint?

Back 487

The anterior and posterior tibial arteries which anastomose at the level of the melleoli.

Nerve supply is via the deep fibular nerve and tibial nerve.

Front 488

What are aponeuroses?

Back 488

Aponeuroses are layers of flat broad tendons.

Front 489

What does the tibial nerve branch into as it crosses into the foot deep to the the flexor retinaculum?

Back 489

Medial and lateral plantar nerves?

Front 490

Which is larger: lateral or medial plantar nerve?

Back 490

Medial