Term
| what is a major function of the lower limbs? |
|
Definition
| to support the weight of the body with minimal energy expenditure |
|
|
Term
| how do our lower limbs support our body weight with minimal energy expenditure/ |
|
Definition
| when standing erect, our center of gravity is just anterior to the 2nd sacral vertebra (S2). A vertical line through the COG falls posterior to our hip joints and anterior to the knee and ankle joints, creating a circular support formed by our feet and holding knee and hip joints in extension |
|
|
Term
| how do our lower limb joints help support our body weight with minimal energy expenditure? |
|
Definition
| by locking into extension while standing |
|
|
Term
| what is a 2nd major function of the limbs besides supporting body weight? |
|
Definition
|
|
Term
| what is minimized to reduce our body's energy expenditure during walking? |
|
Definition
| fluctuations in our center of gravity |
|
|
Term
| what body features minimize fluctuations in our center of gravity during locomotion to reduce our body's energy expenditure? |
|
Definition
| pelvic rotation and tilt, movement of knees toward midline, flexion & extension of knees |
|
|
Term
| how much does our body's COG normally fluctuate laterally and vertically during a gait cycle? |
|
Definition
|
|
Term
| name 3 important transition areas for the passage of major stuctures in the lower limb |
|
Definition
| femoral triangle, popliteal fossa, tarsal tunnel |
|
|
Term
| what does the femoral triangle do? |
|
Definition
| provides passage of femoral artery, vein, and nerve from abdomen to thigh |
|
|
Term
|
Definition
| located posterior to knee. Provides passage for neurovascular structures between thigh and leg |
|
|
Term
| what is the function of the tarsal tunnel? |
|
Definition
| provides passage for neurovascular structures and flexor tendons entering foot |
|
|
Term
| what are the 2 layers of the fascia of the lower limb? |
|
Definition
| superficial fascia, deep fascia |
|
|
Term
| describe the superficial fascia of the lower limb |
|
Definition
| contains cutaneous nerves, superficial vessels & lymphatics, and fat |
|
|
Term
| what is another name for the deep fascia of the thigh? |
|
Definition
|
|
Term
| what does the fascia lata attach to superiorly? |
|
Definition
| inguinal ligament, iliac crest, sacrum |
|
|
Term
| what is another name for the deep fascia of the lower leg? |
|
Definition
|
|
Term
| what are the 3 compartments of the thigh? |
|
Definition
| anterior, medial, posterior |
|
|
Term
| what separates the 3 compartments in the thigh? |
|
Definition
| intermuscular septa that come from fascia and attach to femur at linea aspera |
|
|
Term
| what forms the iliotibial band |
|
Definition
| extremely thick fascia lata and aponeurotic contributions from gluteus maximus and tensor fascia lata |
|
|
Term
| where does the IT band insert? |
|
Definition
| Gerdy's tubercle and patellar retinaculum |
|
|
Term
| where is Gerdy's tubercle |
|
Definition
| superior aspect of lateral knee |
|
|
Term
| where is the patellar retinaculum? |
|
Definition
| lateral aspect of the patella |
|
|
Term
| what is the function of the IT band? |
|
Definition
| helps stabilize the hip joint and maintain the leg in extension |
|
|
Term
| what is the action of the tensor fascia lata muscle? |
|
Definition
| tenses IT band, helps extend knee, abducts thigh, flexes thigh at hip, medially rotates hip |
|
|
Term
| what are the 3 types of veins in the lower limb? |
|
Definition
| superficial, deep, perforating |
|
|
Term
| what kinds of valves are in the veins of the lower limb? |
|
Definition
|
|
Term
| where are superficial veins in the lower limbs? |
|
Definition
|
|
Term
| where are deep veins in the lower limbs? |
|
Definition
| deep veins accompany the major arteries throughout the limbs and are generally paired |
|
|
Term
| describe perforating veins |
|
Definition
| allow blood to flow from superficial to deep veins |
|
|
Term
| describe the great and small saphenous veins |
|
Definition
| both arise in the foot and ascend within the subcutaneous tissue (they are superficial) |
|
|
Term
| what is the final path of the small saphenous vein? |
|
Definition
| pierces the deep fascia behind the knee and enters the popliteal vein |
|
|
Term
| what type of vein is the popliteal vein? |
|
Definition
|
|
Term
| what is the path of the great saphenous vein? |
|
Definition
| ascends up the leg and thigh and passes through the saphenous hiatus in the fascia lata to enter the femoral vein |
|
|
Term
| what type of vein is the femoral verin? |
|
Definition
|
|
Term
| what helps venous blood return from lower limb to heart? |
|
Definition
| musculovenous pump = contraction of muscles |
|
|
Term
| where is the saphenous hiatus? |
|
Definition
| inferior to the inguinal ligament |
|
|
Term
| describe the path of venous blood through veins in lower limbs |
|
Definition
| venous blood in skin and subcutaneous tissue goes from superficial veins to perforating veins to deep veins to iliac veins to inferior vena cava |
|
|
Term
| what happens when valves in the perforating veins become incompetent? |
|
Definition
| venous blood reverses and backs up in superficial veins causing large, dilated varicose veins |
|
|
Term
| what do anterior thigh muscles do? |
|
Definition
| hip flexors, knee extensors/ |
|
|
Term
| what do medial thigh muscles do? |
|
Definition
|
|
Term
| what are the 6 flexors of the hip joint? |
|
Definition
| psoas major, psoas minor, pectineus, iliacus, tensor fascia lata, sartorius |
|
|
Term
| how do the hip flexors pass in relation to the hip? |
|
Definition
|
|
Term
| what muscle is the chief flexor of the thight? |
|
Definition
|
|
Term
| which ventral rami innervate the hip flexors except tensor fascia lata? |
|
Definition
|
|
Term
| describe the passage of the iliopsoas muscle |
|
Definition
| passes deep to inguinal ligament then inserts on lesser trochanter on femur |
|
|
Term
| what action does iliopsoas assist with besides being the chief hip flexor? |
|
Definition
| lateral rotation of the thigh |
|
|
Term
| what group of muscles are the exensors of the knee? |
|
Definition
|
|
Term
| what do all 4 parts of the quadriceps insert into? |
|
Definition
|
|
Term
|
Definition
| sesamoid bone located within the quadraceps tendon |
|
|
Term
| where does the quadraceps tendon insert? |
|
Definition
| continues as patellar ligament and inserts into tibial tuberosity |
|
|
Term
| what innervates the quadraceps? |
|
Definition
| femoral nerve L2L3L4 (kick the garbage out the door) |
|
|
Term
| what are the 4 quadraceps femoris muscles? |
|
Definition
| vastus lateralis, vastus medialis, vastus intermedius, rectus femoris |
|
|
Term
| where does the rectus femoris attach and what action does this attachment allow it to assist with? |
|
Definition
| anterior inferior iliac spine; hip flexion |
|
|
Term
| what does osgood schlatter disease affect? |
|
Definition
|
|
Term
| what population gets osgood schlatter disease? |
|
Definition
| pediatrics, usually boys age 10-15 |
|
|
Term
| what causes osgood schlatter disease? |
|
Definition
| stress from quadraceps inflames a not yet fully developed tibial tuberosity |
|
|
Term
| where do kids with osgood schlatter disease feel pain? |
|
Definition
| just below top of knee cap along top of shin |
|
|
Term
| how is osgood schlatter disease cured? |
|
Definition
| it is a self limiting condition that typically lasts 1-3 years |
|
|
Term
| how is osgood schlatter disease treated? |
|
Definition
| local therapy: ice, rest; sometimes a cast is needed to immobilize until tuberosity is completely ossified |
|
|
Term
| what does the femoral nerve innervate? |
|
Definition
| quadriceps, sartorius, pectineus |
|
|
Term
| what does femoral nerve give rise to in anterioro thigh? |
|
Definition
| cutaneous branches that provide sensory to skin |
|
|
Term
| how does the femoral nerve terminate? |
|
Definition
| as saphenous nerve which provides sensation to medial lower leg and foot |
|
|
Term
| what are the 5 muscles in the medial compartment that adduct the thigh at the hip? |
|
Definition
| adductor longus, adductor brevis, adductor magnus, gracilis, obturator externus |
|
|
Term
| which nerve innervates the adductors? |
|
Definition
|
|
Term
| what are the two portions of the adductor magnus? |
|
Definition
| adductor portion, hamstring portion |
|
|
Term
| what nerve innervates the adductor portion of the adductor magnus? |
|
Definition
|
|
Term
| what never innervates the hamstring portion of the adductor magnus? |
|
Definition
|
|
Term
| what is between the adductor and hamstring portions of the adductor magnus? |
|
Definition
|
|
Term
| what goes through the adductor hiatus? |
|
Definition
|
|
Term
| what are the actions of the pectineus? |
|
Definition
|
|
Term
| what nerves innervate the pectineus? |
|
Definition
|
|
Term
| which muscle is the long, thin adductor muscle? |
|
Definition
|
|
Term
| which muscle is the tailor's muscle? |
|
Definition
|
|
Term
| what are the actions of the sartorius? |
|
Definition
| abducts, externally rotates, and flexes hip; also assists in knee flexion |
|
|
Term
| what are the 3 muscles that insert into the pes anserinus? |
|
Definition
| gracilis, sartorius, semitendinosus |
|
|
Term
| where is the pes anserinus? |
|
Definition
|
|
Term
| what are the 4 major routes through which structures pass from abdomen/pelvis into lower limbs? |
|
Definition
| obturator canal, beneath inguinal ligament, greater sciatic foramen, lesser sciatic foramen |
|
|
Term
| what goes through the obturator canal? |
|
Definition
| obturator nerve, artery, and vein |
|
|
Term
| what do the obturator nerve, artery, and vein innerate and vascularize after going through obturator canal? |
|
Definition
|
|
Term
| what 2 divisions does the obturator nerve divide into? |
|
Definition
|
|
Term
| what does the anterior division of the obturator nerve do? |
|
Definition
| gives off small sensory branch to medial thigh |
|
|
Term
| what are the 2 parts beneath the inguinal ligament? |
|
Definition
| muscular lacuna (lateral), vascular lacuna (medial) |
|
|
Term
| what 3 things go through the muscular lacuna? |
|
Definition
| iliopsoas muscle, lateral femoral cutaneous nerve, femoral nerve |
|
|
Term
| what 3 things go through the vascular lacuna? |
|
Definition
| femoral artery, femoral vein, lymphatics |
|
|
Term
| what separates the vascular and muscular compartments? |
|
Definition
|
|
Term
| what things go under inguinal ligament? |
|
Definition
| iliopsoas, pectineus, femoral artery, femoral nerve, lateral cutaneous nerve, femoral vein |
|
|
Term
| what do structures emerge into after passing under inguinal ligament? |
|
Definition
|
|
Term
| what are the borders of the femoral triangle? |
|
Definition
| superior: inguinal ligament, medial: adductor longus, lateral: sartorius, roof: skin and fascia, floor: iliopsoas pectineus and adductor longus |
|
|
Term
| what things are in the femoral triangle? |
|
Definition
| femoral sheath, femoral nerve, femoral artery, femoral vein |
|
|
Term
| what is the femoral sheath? |
|
Definition
| funnel-shaped fascial tube beneath the inguinal ligament |
|
|
Term
| what forms the femoral sheath? |
|
Definition
| inferior extension of the iliopsoas fascia |
|
|
Term
| what encloses the proximal portions of the femoral vessels and the femoral canal? |
|
Definition
|
|
Term
| does the femoral sheath enclose the femoral nerve? |
|
Definition
| no, the femoral nerve is in the muscular space |
|
|
Term
| how does the femoral sheath end? |
|
Definition
| by becoming continuous with adventitia of femoral vessels |
|
|
Term
| what is the purpose of the femoral sheath? |
|
Definition
| allows the femoral artery and vein to guide beneath inguinal ligament during hip movements |
|
|
Term
| what are the 3 compartments of the femoral sheath? |
|
Definition
| lateral compartment that holds the femoral artery, interior compartment that holds the femoral vein, medial compartment (femoral canal) that holds the lymphatics |
|
|
Term
| what is the femoral canal? |
|
Definition
| a compartment in the femoral sheath that contatins lymphtatics |
|
|
Term
| what is the femoral ring? |
|
Definition
| the top of the femoral canal |
|
|
Term
| what is the lacunar ligament? |
|
Definition
| part of the inguinal ligament that goes back posteriorly at the medial end and is very strong, tight, and sharp |
|
|
Term
| what is a femoral hernia? |
|
Definition
| a protrusion of the bowel through the femoral ring and into the femoral canal |
|
|
Term
| what can happen over time if a femoral hernia continues to fall? |
|
Definition
| can pass through saphenous hiatus into subcutaneous tissue |
|
|
Term
| where is a femoral hernia palpated? |
|
Definition
|
|
Term
| where is the femoral triangle (be general)? |
|
Definition
| inferior to the inguinal ligament |
|
|
Term
| what happens if the lacunar ligament affects a femoral hernia? |
|
Definition
| the lacunar ligament strangulates the loop of bowel and interferes with blood supply resulting in necrosis of the intestine segment |
|
|
Term
| are femoral hernias more common in males or females? |
|
Definition
|
|
Term
| after going through the femoral triangle in the femoral sheath, what happens to the femoral artery and vein? |
|
Definition
| they enter the adductor canal |
|
|
Term
| where is the adductor canal |
|
Definition
| deep to the sartorius muscle in the middle third of the thigh |
|
|
Term
| how far does the adductor canal go? |
|
Definition
| from apex of femoral triangle to to adductor hiatus in the tendon of the adductor magnus |
|
|
Term
| which 4 structures go through the adductor canal? |
|
Definition
| femoral artery, femoral vein, saphenous nerve, nerve to vastus medialis |
|
|
Term
| what happens to the femoral artery and vein after they go through the adductor canal? |
|
Definition
| femoral artery and vein pass through adductor hiatus and enter the popliteal fossa where they become the popliteal artery and vein |
|
|
Term
| what are the only 2 structures that go through the adductor hiatus? |
|
Definition
|
|
Term
| what is the chief artery to the lower limb? |
|
Definition
|
|
Term
| what large branch comes off the femoral artery in the femoral triangle? |
|
Definition
|
|
Term
| what branches come from the deep artery of the thigh? |
|
Definition
| medial circumflex, lateral circumflex, 3-4 perforating branches |
|
|
Term
| what do the medial and lateral circumflex arteries that come from thee deep artery of the thigh vascularize? |
|
Definition
| muscles and proximal femur/head |
|
|
Term
| what do the perforating branches from the deep artery of the thigh vascularize? |
|
Definition
| they pierce the adductor magnus and vascularize muscles within the posterior compartment |
|
|
Term
| where does the femoral artery go after the adductor canal? |
|
Definition
| exits adductor canal via adductor hiatus and becomes the popliteal artery |
|
|
Term
|
Definition
| the area of skin innervated by a single spinal nerve or spinal cord level |
|
|
Term
| how is sensory information from a dermatome conveyed to the CNS? |
|
Definition
|
|
Term
| what are the 4 cutaneous nerves of the thight? |
|
Definition
| lateral femoral cutaneous nerve L2-3, femoral nerve L2-4 cutaneous branches, saphenous nerve L3-4, obturator nerves L2-L3 cutaneous branches |
|
|
Term
| describe the path of the femoral artery and vein in the thigh |
|
Definition
| course through the femoral triangle, adductor canal, and adductor hiatus then enter popliteal fossa behind the knee |
|
|
Term
| what nerve innervates the adductors? |
|
Definition
|
|
Term
| what nerve innervates the quadriceps? |
|
Definition
| femoral nerve L2L3L4 (kick the garbage out the door) |
|
|
Term
| what are the structures that pass beneath the inguinal ligament from lateral to medial/ |
|
Definition
| Nerve (femoral nerve), Artery (femoral artery), Vein (femoral vein), Empty space (within the femoral canal), Lacunar ligament |
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|
