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Grant's Lower Limb
end of term
313
Anatomy
Graduate
11/18/2007

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Term

What is the lower limb constructed for and what are the 4 parts?

Definition
strength at the cost of mobility, hip, thigh, leg, and foot
Term
What nerves innervate the skin of the gluteal region?
Definition
cluneal nerves
Term
Superior and Middle Cluneal Nerves are branches of...
Definition
dorsal primary rami
Term
Inferior Cluneal Nerves are branches of...
Definition
the posterior cutaneous nerve of the thigh and it wraps around the inferior border of the gluteus maximus msucle
Term

Posterior Cutaneous Nerve of the Thigh runs...

Definition
deep to the deep fascia and branches pierce the deep fascia to supply the skin on the posterior surface of the thigh and popliteal fossa
Term

Small Saphenous Vein passes...

Definition
posterior to the lateral malleolus at the ankle adn arises from the lateral end of the dorsal venous arch, pierces deep fascia in the popliteal fossa superiorly and joins the popliteal vein
Term
What innervates the skin of the lateral aspect of the ankle and foot?
Definition
sural nerve, pierces the deep fascia half way down the posterior aspect of the leg and courses parallel to the small saphenous vein
Term
The great saphenous vein arises from...
Definition
the medial end of the dorsal venous arch of the foot
Term
What is the path of the great saphenous vein?
Definition
at the ankle it passes anterior to the medial malleolus, at the knee it passes over the posterior border of the medial epicondyle of the femur, courses anterolaterally to lie on the anterior surface of the thigh
Term
Saphenous Opening
Definition

inferior to the inguinal ligament, the great saphenous vein passes through it in the deep fascia and drains the femoral vein

Term

Saphenous nerve accompanies...

Definition
the great saphenous vein in the leg
Term
What connect the great saphenous vein to the deep venous system?
Definition
perforating veins
Term
What are the superficial veins that join the great saphenous vein near its proximal end?
Definition
superficial external pudendal, superficial epigastric, and superficial circumflex iliac
Term
What usually drains the skin and superficial fascia of the medial thigh?
Definition
a large accessory saphenous vein
Term
What prevent back flow of blood in the great saphenous vein?
Definition
superficial and perforating veins, if they are insufficient then veins become distended (varicose veins)
Term
Portions of what vein may be removed and used as graft vessels in coronary bypass surgery?
Definition
great saphenous vein, distal end is attached to the aorta reversing the direction of blood flow through the vessel so that the valves do not impede the flow of blood
Term

Where does the lateral femoral cutaneous nerve pass and what does it innervate?

Definition
deep to the inguinal ligament and innervates the skin of the lateral thigh
Term
What do the anterior cutaneous branches of the femoral nerve innervate and where do they enter the superficial fascia?
Definition
innervate the skin of the anterior thigh and enter lateral to teh great saphenous vein
Term
What innervates the skin of the medial thigh?
Definition
cutaneous branches of the obturator nerve
Term
Saphenous nerve is a branch of the ______ nerve and innervates....
Definition
branch of the femoral nerve and innervates the anterior and medial aspects of the leg and the medial side of the ankle and foot
Term
Superficial fibular (peroneal) nerve...
Definition
pierces the deep fascia proximal to the lateral malleolus and innervates teh dorsum of the foot and sends dorsal digital nerves to the skin of the toes
Term
What innervates the skin between the 1st and 2nd toe?
Definition
dorsal digital branches of the deep fibular nerve
Term
Where is the horizontal group of the superficial inguinal lymph nodes?
Definition
2cm below the inguinal ligament
Term
Where is the vertical group of superficial inguinal lymph nodes?
Definition
around the proximal end of the great saphenous vein
Term
The superficial inguinal lymph nodes collect lymph from...and drain into...
Definition
lower limb, lower anterior abdominal wall, gluteal region, perineum, and external genitalia, drain into the deep inguinal lymph nodes
Term
What are the regional names of the deep fascia of the lower limb?
Definition
fascia lata in the thigh, crural fascia in the leg, and pedal fascia in the foot (lateral portion of the fascia lata is particularly strong and is called the iliotibial tract)
Term

What connects the fascia lata to the femur?

Definition
intermuscular septa and forms 3 fascial compartments of the thigh: anterior (extensor), medial (adductor), and posterior (flexor)
Term
What muscles make up the anterior compartment of the thigh?
Definition
sartorius, rectus femoris, vastus lateralis, vastus intermedius, and vastus medialis
Term

What is the major blood supply to the lower limb that passes through the anterior compartment of the thigh?

Definition
femoral artery and deep femoral artery
Term

What does the femoral sheath contain?

Definition
femoral artery, femoral vein, and some depe inguinal lymph nodes (shaped like a short cone)
Term
Lateral compartment of the femoral sheath contains...
Definition
femoral artery
Term
intermediate compartment of the femoral sheath contains...
Definition
femoral vein
Term

Medial compartment of the femoral sheath contains...

Definition
lymphatics (called the femoral canal and its proximal opening is called the femoral ring)
Term
Femoral Hernia
Definition

femoral ring is a potential site, it is a protrusion of abdominal viscera through the femoral ring into the femoral canal, hernia may become strangulated due to the inflexibility of the inguinal ligament

Term
What are the boundaries of the femoral triangle?
Definition
superior: inguinal ligament, lateral: sartorius, medial: adductor longus, floor: iliopsoas and pectineus, roof: fascia lata
Term
What are the contents of the femoral triangle?
Definition
femoral nerve and its branches, femoral artery and some of its branches, femoral vein and some of its tributaries (esp. great saphenous vein), and femoral sheath
Term

Where can the pulse of the femoral artery be palpated?

Definition

3cm inferior to the midpoint of the inguinal ligament within the femoral triangle

Term
 A catheter introduced into the femoral artery can be advanced proximally into...
Definition
the aorta and its branches
Term
A catheter introduced into the femoral vein can be advanced through the...
Definition
IVC into the right atrium of the heart
Term
What small arteries arise from the femoral artery just distal to the inguinal ligament?
Definition
superficial external pudendal artery (passes medially), superficial epigastric artery (passes superiorly), and superficial circumflex iliac artery (passes laterally) -- supply surperficial fascia of the abdominal wall, proximal thigh, and part of the perineum
Term
What large arteries arise within the femoral triangle?
Definition
deep artery of the thigh (deep femoral artery, profunda femoris artery), lateral circumflex femoral artery, and medial circumflex femoral artery (medial and later circumflex arise from deep artery of thigh)
Term
Femoral artery courses...
Definition
distally between the sartorius muscle and adductor longus
Term
deep artery of the thigh courses...
Definition
parallel to the femoral artery but posterior to teh adductor longus, supplies medial and posterior compartments of the thigh
Term
lateral circumflex femoral artery passes...
Definition
laterally, deep to the proximal end of the rectus femoris muscle, and supplies the lateral part of the thigh
Term
medial circumflex femoral artery passes...
Definition
posteriorly, between the pectineus and iliopsoas muscles
Term
Iliacus Proximal Attachment
Definition
iliac fossa
Term
Psoas Major Proximal Attachment
Definition
transverse processes and bodies of vertebra T12-L5
Term
Iliopsoas Distal Attachment
Definition
lesser trochanter of the femur
Term
Iliopsoas Muscle
Definition
strong flexor of the thigh
Term
Pectineus Proximal Attachment
Definition
superior ramus of the pubis
Term
Pectineus Distal Attachment
Definition
pectineal line of the femur
Term
Pectineus Movement
Definition
adducts and flexes the thigh
Term
What innervates the anterior thigh muscles and the skin of the anterior thigh?
Definition
femoral nerve
Term
Adductor canal runs between...
Definition

apex of the femoral triangle and the adductor hiatus

Term
Adductor hiatus is...
Definition
an opening in the tendon of the adductor magnus muscle located just above the knee
Term
What pass through the adductor canal?
Definition
femoral vessels pass through to reach the popliteal fossa
Term
Sartorius Proximal Attachment
Definition
anterior superior iliac spine
Term
Sartorius Distal Attachment
Definition
medial surface of the proximal tibia
Term

Sartorius Movement

Definition
flexes and laterally rotates the thigh and flexes the leg (crosses both the hip and knee joints)
Term

What lies posterior to the femoral artery?

Definition
femoral vein
Term
Where does the femoral artery change names?
Definition
courses distally through the adductor hiatus and becomes popliteal artery
Term

What nerves accompany the femoral vessels in the adductor canal?

Definition
nerve to vastus medialis and the saphenous nerve
Term
What innervates the skin of the medial side of the leg, ankle, and foot?
Definition
saphenous nerve
Term
What is the fascia lata continuous with?
Definition
lateral intermuscular septum (attached to the linea aspera on the posterior aspect of the femur)
Term
What are the four parts of the quadriceps femoris?
Definition
rectus femoris, vastus lateralis, vastus intermedius, and vastus medialis (all 4 unite to make the quadriceps femoris tendon)
Term
Patellar Ligament
Definition
attaches the patella to the tibial tuberosity (ultimate attachment of the quadriceps femoris muscle)
Term
Patellar Tendon (Quadriceps) Reflex
Definition
knee jerk, afferent impulses travel in the femoral nerve to spinal segments L2, L3, and L4, efferend are carried by femoral nerve to quads causing a brief contraction, tests function of the femoral nerve and spinal cord segments L2-L4
Term
Rectus Femoris Proximal Attachment
Definition
anterior inferior iliac spine
Term
Rectus Femoris Distal Attachment
Definition
tibial tuberosity
Term
Recuts Femoris Movement
Definition
flexes the thigh and extends the leg (crosses both the hip and knee joints)
Term
Vastus Lateralis Proximal Attachment
Definition
lateral lip of the linea aspera and greater trochanter of the femur
Term

Vastus Lateralis Distal Attachment

Definition
tibial tuberosity
Term

Vastus Lateralis Movement

Definition
extends the leg
Term
Vastus Medialis Proximal Attachment
Definition
medial lip of the linea aspera of the femur and the intertrochanteric line
Term
Vastus Medialis Distal Attachment
Definition
tibial tuberosity
Term
Vastus Medialis Movement
Definition
extends the leg
Term
Vastus Intermedius Proximal Attachment
Definition
anterior and lateral surfaces of the femur
Term
Vastus Intermedius Distal Attachment
Definition
tibial tuberosity
Term
Vastus Intermedius Movement
Definition
extends the leg
Term
What innervates the sartorius muscle, pectineus muscle, and the quads?
Definition
femoral nerve
Term
Motor branches of the femoral nerve are located...
Definition
between the rectus femoris muscle and the vastus muscles
Term
All the muslces in the anterior compartment of the thigh are innervated by the...
Definition
femoral nerve
Term
What muscles make up the medial compartment of the thigh?
Definition
adductor magnus, adductor longus, adductor brevis, gracilus, and obturator externus (all adduct the thigh)
Term
Inferior Attachment of the Gracilus Muscle
Definition
medial condyle of the tibia (crosses both hip and knee joints)
Term
Gracilus Muscle Movement
Definition
adducts the thigh and assists in flexion of the leg
Term

Where do the pectineus, adductor longus, and gracilus muscles proximally attach?

Definition
along a curved line on the pubic bone
Term
What muscles fan out to their distal attachments on the pectineal line and the linea aspera of the femur?
Definition
pectineus and adductor longus
Term
What artery passes between the pectineus and adductor longus muscles?
Definition
deep artery of the thigh
Term
What arteries penetrate the adductor brevis muscle, encircle the femur, and supply the muscles of the medial and posterior compartments of the thigh?
Definition
penetrating arteries
Term
Adductor Brevis Proximal Attachment
Definition
body and inferior ramus of the pubis
Term
Adductor Brevis Distal Attachment
Definition
pectineal line and linea aspera of the femur
Term
Adductor Brevis Movement
Definition
adducts the thigh
Term
What nerve crosses the adductor brevis surface?
Definition
anterior branches of the obturator nerve on the anterior surface and posterio branches on the posterior surface
Term

Superior border of the adductor brevis is deep to the...

Definition
pectineus muscle
Term
Posterior branches of the obturator nerve pass between...
Definition
the adductor brevis and adductor magnus
Term
Adductor Magnus Proximal Attachment
Definition
ischiopubic ramus and the ischial tuberosity
Term
Adductor Magnus Distal Attachment
Definition
gluteal tuberosity, linea aspera, medial supracondylar line, and adductor tubercle of the femur
Term
Adductor Magnus Movement
Definition
adducts and extends the thigh
Term
Adductor magnus tendon goes to the...
Definition
adductor tubercle on the medial epicondyle of the femur
Term
Adductor hiatus in the adductor magnus tendon...
Definition
allows passage of the femoral artery and vein from the anterior compartment of the thigh to the posterior compartment of the thigh
Term
What muscle lies deep to the pectineus muscle and iliopsoas tendon?
Definition
obturator externus muscle
Term
Obturator Externus Movement
Definition
lateral rotator of the thigh
Term
What innervates the muscles of the medial compartment of the thigh?
Definition
obturator nerve (pectineus muscle may also receive a motor contribution from obturator in addition to femoral nerve)
Term
Gluteus Maximus Proximal Attachment
Definition
ilium, sacrum, coccyx, ans sacrotuberous ligament
Term
Gluteus Maximus Distal Attachment
Definition
iliotibial tract, and through it, the lateral condyle of the tibia, small part attaches to the gluteal tuberosity of the femur
Term
Gluteus Maximus Movement
Definition

powerful extensor of the thigh

Term
Gluteal Aponeurosis
Definition
thickening of the fascia lata that spans from the iliac crest to the superior border of the gluteus maximus muscle
Term
What is the only nerve to supply the gluteus maximus muscle?
Definition
inferior gluteal nerve
Term
Gluteus Medius Proximal Attachment
Definition
deep surface of the gluteal aponeurosis and the lateral surface of the ilium between the posterior gluteal line and the anterior gluteal line
Term
Gluteus Medius Distal Attachment
Definition
greater trochanter of the femur and it is an abductor of the thigh
Term
What is located infereior to the gluteus medius muscle?
Definition
piriformis muscle
Term
Piriformis Proximal Attachment
Definition
anterior surface of the sacrum
Term
Piriformis Distal Attachment
Definition
greater trochanter of the femur
Term
Piriformis Movement
Definition
lateral rotator of the thigh
Term
What does the piriformis pass through?
Definition
greater sciatic foramen
Term
What passes between the piriformis muscle and the gluteus medius muscle?
Definition
superior gluteal artery, vein, and nerve
Term
What appears at the inferior border of the piriformis muscle?
Definition
sciatic nerve, posterior cutaneous nerve of the thigh, inferior gluteal vessels, inferior gluteal nerve, pudendal nerve, and internal pudendal vessels
Term
What is the largest nerve of the body and what are its divisions?
Definition
sciatic nerve--tibial and common fibular divisions
Term
What lies on the median side of the sciatic nerve?
Definition
posterior cutanesous nerve of the thigh
Term
Where do the pudendal nerve and internal pudendal vessels course?
Definition
they enter the gluteal region by passing though the greater sciatic foramen and enter the perineum by passing though the lesser sciatic foramen
Term
What do the pudendal nerve and internal pudendal vessels supply?
Definition
anal and urogenital triangles
Term
What is inferior to the piriformis muscle?
Definition
obturator internus
Term

Obturator Internus Proximal Attachment

Definition
margin of the obturator foramen and the inner surface of the obturator membrane
Term
Obturator Internus Distal Attachment
Definition
trochanteric fossa on the medial side of the greater trochanter of the femur
Term
Obturator Internus Movement
Definition
lateral rotator of the thigh
Term
How does the obturator internus muscle exit the lesser pelvis?
Definition
by passing through the lesser sciatic foramen
Term
Superior Gemellus Muscle Proximal Attachment
Definition
ischial spine superior to the obturator internus muscle
Term
Inferior Gemellus Proximal Attachment
Definition
ischial tuberosity inferior to the obturator internus muscle
Term
Gemullus Muscles Attach...
Definition
with the obturator internus muslce on the greater trochanter of the femur
Term
Gemullus Muscles Movement
Definition
lateral rotators of the thigh
Term
What is inferior to the inferior gemellus muscle?
Definition
quadratus femoris muscle
Term
Quadratus Femoris Proximal Attachment
Definition
ischial tuberosity
Term
Quadratus Femoris Distal Attachment
Definition
intertrochanteric crest of the femur
Term
Quadratus Femoris Movement
Definition
lateral rotator of the thigh
Term
Where are the branches of the superior gluteal vessels?
Definition
superior to the piriformis
Term
Gluteus Minimus Proximal Attachment
Definition
lateral surface of the ilium between the anterior gluteal line and the inferior gluteal line
Term
Gluteus Minimus Distal Attachment
Definition
greater trochanter of the femur
Term
Gluteus Minimus Movement
Definition
abducts the thigh
Term
Where is the tensor of the fascia lata?
Definition
within the fascia lata inferior to the ASIS
Term
Tensor Fasica Lata Proximal Attachment
Definition

ASIS

Term
Tensor Fascia Lata Distal Attachment
Definition
iliotibial tract
Term
Tensor Fascia Lata Movement
Definition
abductor and medial rotator of the thigh
Term
Intragluteal Injections
Definition
IM injections in the gluteal region are common, made in the superior lateral quadrant of the gluteal region, in the 2 inferior quadrants of the gluteal region would endanger sciatic nerve or the nerves and vessels that pass inferior to the piriformis muscle, superior medial may injure the superior gluteal nerve and vessels, superior lateral is safe b/c superior gluteal nerve and vessels are well ramified
Term
What muscles make up the posterior compartment of the thigh?
Definition
biceps femoris, semimembranosus, and semitendinosus (extend and flex the leg) -- known as the "hamstring" muscles
Term
Where does the sciatic nerve pass?
Definition
deep to the long head of the biceps femoris muscle
Term
Long Head of the Biceps Femoris Proximal Attachment
Definition
ischial tuberosity
Term
Long Head of the Biceps Femoris Distal Attachment
Definition
head of the fibula
Term

Short Head of the Biceps Femoris Proximal Attachment

Definition
lateral lip of the linea aspera of the femur
Term

The tendon of the short head of the biceps femoris joins the tendon of the long head to...

Definition
extend the thigh and flex the leg
Term
What muscle is on the medial side of thigh in the posterior group?
Definition
semitendinosus
Term
Semitendinosus Proximal Attachment
Definition
ischial tuberosity
Term

Semitendinosus Distal Attachment

Definition
medial surface of the superior part of the tibia
Term
Semimembranosus Proximal Attachment
Definition
ischial tuberosity
Term
Semimembranosus Distal Attachment
Definition
posterior part of the medial condyle of the tibia
Term
Where does the hamstring part of the adductor magnus muscle arise?
Definition
from the ischial tuberosity deep to the proximal attachment of the posterior thigh muscles
Term

What forms the deep boundary of the posterior compartment of the thigh?

Definition
adductor magnus
Term
What innervates the hamstring part of the adductor magnus muscle?
Definition
sciatic nerve
Term
Where does the sciatic nerve typically divide?
Definition
at the level of the knee
Term
Sciatic nerve innervates...
Definition
the posterior muscles of the thigh and the muscles of the leg which act on the foot, when injured causes significant peripheral neurological deficits -- paralysis of the flexors of the knee and all muscles below the knee, and widespread numbness of the skin of the postrior aspect of the lower limb
Term
Superolateral border of the popliteal fossa...
Definition
biceps femoris muscle
Term
Superomedial border of the popliteal fossa...
Definition
semitendinosus and semimembranosus
Term
Inferolateral and inferomedial borders of the popliteal fossa...
Definition
2 heads of the gastrocnemius muscle
Term
Posterior border of the popliteal fossa...
Definition
skin and deep fascia
Term
Anterior border of the popliteal fossa...
Definition
popliteal surface of the femur and the popliteus muscle
Term

Common Fibular Nerve courses...

Definition
parallel to the biceps femoris tendon and passes superficial to the lateral head of the gastrocnemius (most injured nerve --> floppy foot)
Term
Tibial nerve bisects...
Definition
the popliteal fossa and passes deep to the gastrocnemius muscle at the inferior border of the popliteal fossa
Term
Where are the popliteal artery and vein?
Definition
deep to the tibial division of the sciatic nerve enclosed by a common connective tissue sheath
Term
What arteries are located deep in the popliteal fossa, proximal to the attachments of the gastrocnemius muscle?
Definition
superior lateral genicular and superior medial genicular arteries
Term
Where do the inferior genicular arteries pass?
Definition
between the proximal attachments of the gastrocnemius muscle and the tibia
Term

What forms the floor of the popliteal fossa?

Definition
popliteus muscle
Term
What muscles converge on the proximal end of the tibia and what is their arrangement named?
Definition
sartorius, gracilis, semitendinosus tendons -- pes anserinus (goose's foot)
Term
What nerve innervates the anterior thigh muscles?
Definition
femoral nerve
Term
What nerve innervates the medial thigh muscles?
Definition
obturator nerve
Term
What nerve innervates the posterior thigh muscles?
Definition
sciatic nerve
Term
What bone is larger and weight-bearing in the leg?
Definition
tibia
Term
Is the fibula surrounded by muscles at its proximal and distal ends?
Definition
no
Term
What joins the tibia and fibula?
Definition
interosseous membrane
Term
What attaches the crural fascia to the fibula?
Definition
intermuscular septa: anterior and posterior
Term
What muscles make up the anterior compartment of the leg?
Definition
tibialis anterior, extensor hallucis longus, extensor digitorum longus, and fibularis (peroneus) tertius
Term
What innervates the muscles of the anterior compartment of the leg?
Definition
deep fibular (peroneal) nerve
Term
What action do the muscles of the anterior compartment of the leg have?
Definition
dorsiflexion of the foot, inversion of the foot, and extension of the toes
Term
Retinacula
Definition
transverse thickenings of the deep fascia of the leg that hold tendons in place
Term
Superior Extensor Retinaculum
Definition
on the anterior surface of the ankle, extends across tendons superior to the ankle joint
Term
Inferior Extensor Retinaculum
Definition
on the anterior surface of the ankle, at the level of the ankle joint, shaped like a Y with the stem attaching to the calcaneus
Term
What are the proximal attachments of the anterior muscles of the leg?
Definition
on the proximal tibial, fibula, and interosseous membrane
Term
Tibialis Anterior Distal Attachment
Definition
first cuneiform bone and the base of the first metatarsal bone
Term
Tibialis Anterior Movement
Definition
dorsiflexes and inverts the foot
Term
Extensor Hallucis Longus Distal Attachment
Definition
base of the dital phalanx of the great toe
Term
Extensor Hallucis Longus Movement
Definition
extends the great toe and dorsiflexes the foot
Term

Extensor Digitorum Longus attaches to...

Definition
the middle and distal phalanges of the lateral four toes
Term

Extensor Digitorum Longus Movement

Definition
extends the toes and dorsiflexes the foot, each tendon forms and extensor expansion
Term
Fibularis Tertius Disal Attachment
Definition
tuberosity of the 5th metatarsal bone
Term
Fibularis Tertius Movement
Definition
dorsiflexes the foot and assists in eversion of the foot (may be absent)
Term
Anterior Tibial Artery
Definition
passes over the superior border of the interosseous membrane, gives rise to unnmaed muscular branches, joined by the deep fibular nerve just below the knee
Term
What is the motor nerve of the anterior compartment of the leg and the dorsum of the foot?
Definition
deep fibular nerve (a branch of the common fibular nerve)
Term
Where does the anterior tibial artery change names and what does it change to?
Definition
as it crosses the ankle joint, dorsalis pedis artery
Term
What are deep to the tendons of the extensor digitorum longus muscle?
Definition
extensor digitorum brevis and extensor hallucis brevis (they share a common muscle belly attached to the calcaneus -- 4 tendons arise and attach to toes 1-4, the portion that attaches to the big toe is extensor hallucis brevis), extend the toes and are innervated by the deep fibular nerve
Term
Dorsalis Pedis Artery
Definition
passes deep to the tendon of the extensor hallucis brevis, palpated between the tendons of the extensor hallucis longus and extensor digitorum longus
Term
Arcuate Artery
Definition
branch of the dorsalis pedis artery that crosses the proximal ends of the metatarsal bones, origin of the dorsal metatarsal arteries
Term
Lateral Tarsal Artery
Definition
arises from the dorsalis pedis artery, deep to the extensor digitorum brevis and extensor hallucis brevis, joins lateral end of the arcuate artery to complete an arterial arch
Term

Deep Plantar Artery

Definition
arises from dorsalis pedis artery near origin of the arcuate artery, passes between 1st and 2nd metatarsal bones to enter the sole of the foot, anastomoses with the deep plantar arch in the sole of the foot
Term
What innervates the extensor digitorum brevis and extensor hallucis brevis muscles?
Definition
deep fibular nerve, gives rise to 2 dorsal digital branches of the deep fibular nerve
Term
What is the only skin on the dorsum of the foot that is innervated by the deep fibular nerve?
Definition
skin between the great toe and the 2nd toe (superficial fibular nerve innervates all other skin on the dorsum of the foot)
Term
All muscles in the anterior compartment of the leg and the dorsum of the foot are innervated by...
Definition
the deep fibular nerve
Term
What makes up the lateral compartment of the leg?
Definition
fibularis (peroneus) brevis and fibularis (peroneus) longus
Term
What nerve supplies the lateral compartment of the leg?
Definition
superficial fibular (peroneal) nerve
Term

Superior Fibular (peroneal) Retinaculum

Definition

on the lateral side of the ankle posterior to the lateral malleolus

Term
Where does the superifical fibular (peroneal) nerve penetrate the deep fascia?
Definition
at the mid-level of the leg (primary nerve to dorsum of foot and gives rise to several dorsal digital branches)
Term

What is attached to the inner surface of the deep fascia of the leg?

Definition
fibularis longus
Term
Fibularis Brevis Distal Attachment
Definition
tuberosity of the 5th metatarsal bone
Term
Fibularis Longus Distal Attachment
Definition
hooks around the cuboid bone and enters the sole of the foot to attach to the inferior surface of the first metatarsal bone
Term
Common Fibular Nerve
Definition
most injured b/c of its superficial position and relationship to the head and neck of the fibula, injury causes impairment of eversion, dorsiflexion, and extension of the toes, sensory loss on the dorsum of the foot and toes, "foot drop", results in steppage gait
Term
What innervates all muscles of the lateral compartment of the leg?
Definition
superficial fibular nerve
Term
What divides the muscles of the posterior compartment of the leg into superficial and deep groups?
Definition
transverse intermuscular septum
Term
What are the muscles of the superficial posterior group of the leg?
Definition
gastrocnemius, soleus, and plantaris -- plantar flex the foot
Term
What are the muscles of the deep posterior group of the leg?
Definition
popliteus, tibialis posterior, flexor digitorum longus, flexor hallucis longus -- invert the foot, plantar flex the foot, and flex the toes
Term
What innervates both the superficial and deep posterior muscle groups of the leg?
Definition
tibial nerve
Term
Gastrocnemius Proximal Attachments
Definition

2 heads attach to the femoral condyles

Term

Gastrocnemius Distal Attachment

Definition
calcaneal tuberosity by way of the calcaneal tendon (tendo calcaneus, Achille's tendon)
Term
Gastrocnemius Movement
Definition
plantar flexes the foot
Term
What is deep to the gastrocnemius muscle?
Definition
soleus muscle
Term
Soleus Proximal Attachments
Definition
soleal line of the tibia and the head of the fibula
Term
Soleus Distal Attachment
Definition
calcaneal tendon
Term
Soleus Movement
Definition
plantar flexes the foot
Term
Plantaris Muscle belly lies in...
Definition
the popliteal fossa
Term
Plantaris Proximal Attachment
Definition
lateral supracondylar line of the femur
Term

Plantaris Distal Attachment

Definition

courses between the gastrocnemius and soleus to attach on the calcaneal tendon

Term
Plantaris Movement
Definition
plantar flexor of the foot and weak flexor of the knee, may be absent
Term
Where do the tibial nerve and posterior tibial vessels exit?
Definition
popliteal fossa by passing deep to the tendinous arch of the soleus muscle, the course distally in the transverse intermuscular septum
Term
Where does the popliteal artery bifurcate?
Definition
at the inferior border of the popliteus muscle to form the posterior tibial artery and the anterior tibial artery
Term
Popliteus Proximal Attachment
Definition
lateral condyle of the femur
Term
Popliteus Distal Attachment
Definition
posterior surface of the proximal tibia
Term
Popliteus Movement
Definition
unlocks the knee and is a weak flexor of the leg
Term
Tibialis Posterior Proximal Attachment
Definition
tibia, fibula, and interosseous membrane
Term
Tibialis Posterior Distal Attachment
Definition
inferior surfaces of several tarsal bones
Term
Tibialis Posterior Movement
Definition
inverter and plantar flexor of the foot
Term
Flexor Digitorum Longus Proximal Attachment
Definition
tibia
Term
Flexor Digitorum Longus Distal Attachment
Definition
bases of the dital phalanges of the lateral four toes
Term
Flexor Digitorum Longus Movement
Definition
flexes toes 2-5 and plantar flexes the foot
Term
Flexor Hallucis Longus Proximal Attachment
Definition
inferior 2/3 of teh fibula and interosseous membrane
Term
Flexor Hallucis Longus Distal Attachment
Definition
base of the distal phalanx of the great toe
Term
Flexor Hallucis Longus Movement
Definition
flexes the great toe and plantar flexes the foot
Term
What lies posterior to the medial malleolus?
Definition
posterior tibial artery and tibial nerve, lie between the tendons of the flexor digitorum longus and flexor hallucis longus muscles deep to the flexor retinaculum 
Term
(Tom, Dick, ANd Harry)
Definition
Tibialis posterior, flexor Digitorum longus, posterior tibial Artery, tibial Nerve, flexor Hallucis longus)
Term
Fibular (peroneal) Artery arises from...
Definition
the posterior tibial artery about 2 or 3cm distal to the inferior border of the popliteus muscle, couses between the tibialis posterior muscle and the flexor hallucis longus muscle, supplies blood to the muscles of the lateral compartment of the leg and lateral side of the posterior compartment of the leg
Term
What perforates the interosseous membrane and anastomoses with a branch of the anterior tibial artery?
Definition
perforating branch of the fibular artery
Term
What innervates all muscles in the posterior compartment of the leg?
Definition
tibial nerve
Term
What are the weight bearing points of the foot?
Definition
calcaneus and teh head of teh 5 metatarsal bones
Term
What supports the longitudinal arch of the foot?
Definition
plantar aponeurosis
Term
What is the point of reference for abduction and adduction of the toes?
Definition
the 2nd toe
Term
Flexor Digitorum Brevis Proximal Attachment
Definition
calcaneal tuberosity and the plantar aponeurosis
Term
Flexor Digitorum Brevis Distal Attachment
Definition
middle phalanges of the lateral 4 toes
Term
Flexor Digitorum Brevis Movement
Definition
flexes the lateral 4 toes
Term

What is located on the medial side of the flexor digitorum brevis muscle?

Definition
abductor hallucis
Term
Abductor Hallucis Proximal Attachments
Definition
medial side of the calcaneal tuberosity and the plantar aponeurosis
Term
Abductor Hallucis Distal Attachment
Definition
medial side of the base of the proximal phalanx of the great toe and it abducts the great toe
Term
Abductor Digiti Minimi Proximal Attachment
Definition
lateral side of the calcaneal tuberosity and the plantar aponeurosis
Term
Abductor Digiti Minimi Distal Attachment
Definition
lateral side of the base of the proximal phalnax of the 5th (small) toe
Term

Abductor Digiti Minimi Movement

Definition
abducts the 5th toe
Term
What nerves go to the distal 1/3 of the sole of the foot?
Definition
common and proper plantar digital nerves (branches of the medial and lateral plantar nerves)
Term
What lies deep to the flexor digitorum brevis muscle?
Definition
quadratus plantae (flexor accessorius) muscle
Term
Quadratus Plantae Proximal Attachment
Definition
calcaneus
Term

Quadratus Plantae Distal Attachment

Definition
tendon of the flexor digitorum longus muscle
Term

Quadratus Plantae Movement

Definition
assists the flexor digitorum longus muscle in flexing the lateral four toes
Term
What tendons pass through the tendons of the flexor digitorum brevis muscle?
Definition
flexor digitorum longus 4 tendons
Term
What gives rise to the 4 lumbrical muscles?
Definition
tendons of the flexor digitorum longus muscle
Term
Lumbrical Distal Attachment
Definition
extensor expansions of the lateral 4 toes
Term
Flexor Hallucis Brevis Proximal Attachment
Definition
first metatarsal bone, cuboid bone, and 3rd cuneiform bone
Term
2 Heads of Flexor Hallucis Brevis
Definition
(medial and lateral) 2 tendons each with a sesamoid bone
Term
Flexor Hallucis Brevis Distal Attachment
Definition
base of the proximal phalanx of the great toe
Term
Flexor Hallucis Brevis Movement
Definition
flexes the great toe
Term
Where does the tendon of the flexor hallucis longus muscle run?
Definition
between the 2 sesamoid bones of the flexor hallucis brevis muscle
Term
Where does the tendon of the flexor hallucis longus attach?
Definition
base of the distal phalanx of the great toe
Term
Both heads of the adductor hallucis muscle attach...
Definition
to the lateral side of the base of the proximal phalanx of the great toe
Term
Adductor Hallucis Movement
Definition
adducts the great toe
Term
Flexor Digiti Minimi Proximal Attachment
Definition
base of the 5th metatarsal bone
Term
Flexor Digiti Minimi Distal Attachment
Definition
base of the proximal phalanx of the 5th toe
Term
Flexor Digiti Minimi Movement
Definition
flexes the 5th toe
Term
The 4 dorsal interosseous muscle are...
Definition
abductors of the toes 
Term
The 3 plantar interosseous muscles are...
Definition
adductors of the toes
Term
Fibularis Longus tendon distal attachment
Definition
base of the 1st metatarsal bone and the 1st cuneiform bone
Term
Fibularis Longus tendon occupies...
Definition
deepest plane of the sole of the foot
Term
Tibialis Posterior Tendon Distal Attachment
Definition
navicular bone, all 3 cuneiform bones, and the bases of the 2nd, 3rd, and 4th metatarsal bones
Term
What disappears into an osseofibrous tunnel at the medial side of the ankle?
Definition
flexor hallucis longus muscle
Term
The flexor hallucis longus muscle crosses the inferior surface of the...
Definition
sustentaculum tali (acts as a pulley to change direction of force of the flexor hallucis longus muscle)
Term
What typically innervates the abductor hallucis, flexor digitorum brevis, flexor hallucis brevis, and teh medial lumbrical muscles?
Definition
medial plantar nerve (provides cutaneous innervation to the plantar surfaces of the medial 3 1/2 toes)
Term
What 3 bones form the acetabulum?
Definition
ilium, ischium, and pubis
Term
The distal end of the iliofemoral ligament is attached to the...
Definition
intertrochanteric line of the femur
Term
Proximal end of the iliofemoral ligament is attached to the...
Definition

anterior inferior iliac spine and the margin of the acetabulum

Term
When is the iliofemoral ligament lax?
Definition
in flexion of the femur -- it prevents overextension of the hip joint
Term
What passes inferior to the neck of the femur?
Definition
obturator externus muscle
Term
What runs from the acetabular margin to the neck of the femur?
Definition
ischiofemoral ligament
Term
What runs in the center of the ligament of the head of the femur?
Definition
artery of the ligament of the head of the femur
Term
What lies in the acetabular notch?
Definition
ligament of the head of the femur
Term
What bridges the acetabular notch?
Definition
transverse acetabular ligament
Term
What surrounds the rim of the acetabulum?
Definition
acetabulum labrum
Term
Neck of the Femur
Definition
fracture disrupts blood supply to the head of the femur, the head can become necrotic a common complication in femoral neck fractures of the elderly
Term
Tibial Collateral Ligament
Definition
MCL, attached to the medial meniscus through the joint capsule
Term
Fibular Collateral Ligament
Definition
LCL, not attached to the external surface of the joint capsule (popliteus tendon passes between the fibular collateral ligament and the joint capsule)
Term
Cruciate Ligaments are located...
Definition
outside the synovial cavity but are inside the joint capsule
Term
What helps keep the patella centered?
Definition
patella retinaculum
Term
Anterior Cruciate Ligament
Definition
attaches to the tibia anteriorly
Term
Posterior Cruciate Ligament
Definition
attaches to the tibia posteriorly
Term
With the leg extended...
Definition
tibia and femur are in max contact, joint is "locked", ACL is taut and prohibits further extension
Term
With the leg flexed...
Definition
less contact between femur and tibia, some rotation occurs at the knee joint, PCL prevents tibia from being pushed posteriorly, ACL prevents tibia from being pulled anteriorly
Term
Knee Injuries
Definition
medial meniscus is injured 6 to 7 times more often than the lateral meniscus b/c medial is firmly attached to MCL, forced abduction and lateral rotation of the leg may cause MCL, medial meniscus, and ACL injury -- "unhappy triad" -- caused by a blow to the lateral side of the knee
Term
What are the parts of the medial (deltoid) ligament of the ankle?
Definition
posterior tibiotalar ligament, tibiocalcaneal ligament, tibionavicular ligament, and anterior tibiotalar ligament
Term
What are the parts of the lateral ligament of the ankle?
Definition
posterior talofibular ligament, calcaneofibular ligament, and anterior talofibular ligament
Term
What are the only actions of the ankle joint?
Definition
dorsiflexion and plantar flexion
Term
Ankle Injuries
Definition
very common, inversion causes injury to the lateral ligament resulting in ankle sprain, in severe cases - calcaneofibular and talofibular ligaments are torn and the inferior tip of the lateral malleolus may be avulsed
Term
With inversion and eversion of the foot...
Definition
the talus remains fixed, entire foot rotates about the inferior and anterior surfaces of the talus (subtalar joint)
Term
In what joint do inversion and eversion occur?
Definition
transverse tarsal joint (calcaneocuboid and talonavicular joints) and the subtalar joint
Term
What supports the head of the talus and the longitudinal arch?
Definition
the plantar calcaneonavicular (spring) ligament and the tibialis posterior tendon
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