Anatomy of Lower Limb: Thigh and Leg
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Questions and Answers

Which of the following muscles is responsible for flexing the thigh at the hip and is the most powerful hip flexor?

  • Rectus femoris
  • Sartorius
  • Iliopsoas (correct)
  • Pectineus

    • Which muscle primarily functions as an antagonist to the action of the quadriceps group during knee extension?

  • Iliopsoas
  • Hamstring group (correct)
  • Adductor longus
  • Sartorius

    • Which nerve primarily innervates the quadriceps femoris group?

  • Femoral nerve (correct)
  • Sciatic nerve
  • Inferior gluteal nerve
  • Obturator nerve

    • Which of the following muscles is classified as a synergist to the quadriceps group during knee extension?

    <p>Tensor fascia lata</p> Signup and view all the answers

    Which muscle does NOT belong to the hamstring group?

    <p>Rectus femoris</p> Signup and view all the answers

    What is the primary action of the adductor group of muscles?

    <p>Adduct and medially rotate the thigh</p> Signup and view all the answers

    Which muscle originates from the anterior superior iliac spine (ASIS) and contributes to both flexing the thigh and flexing the leg?

    <p>Sartorius</p> Signup and view all the answers

    What is the role of synergist muscles in relation to prime movers?

    <p>To assist prime movers in performing a movement</p> Signup and view all the answers

    Which muscle is primarily responsible for flexing the hip and is innervated by the femoral nerve?

    <p>Sartorius</p> Signup and view all the answers

    The vastus medialis is part of which muscle group?

    <p>Quadriceps femoris</p> Signup and view all the answers

    Which of the following muscles is not primarily responsible for adduction of the thigh?

    <p>Sartorius</p> Signup and view all the answers

    The obturator nerve provides motor innervation to which of the following muscle groups?

    <p>Adductor muscles</p> Signup and view all the answers

    Which of the following muscles primarily extends the knee?

    <p>Vastus intermedius</p> Signup and view all the answers

    Which nerve is responsible for sensory innervation to the skin of the anterior thigh?

    <p>Femoral nerve</p> Signup and view all the answers

    Which muscle acts as an antagonist to the quadriceps during knee flexion?

    <p>Biceps femoris</p> Signup and view all the answers

    Which muscle primarily contributes to flexion of the thigh at the hip joint?

    <p>Iliopsoas</p> Signup and view all the answers

    Which of the following muscles is primarily innervated by the femoral nerve?

    <p>Rectus femoris</p> Signup and view all the answers

    What is the primary action of the hamstring muscles during walking?

    <p>Flexion of the knee</p> Signup and view all the answers

    Which muscle acts as the primary antagonist to the quadriceps during knee extension?

    <p>Semimembranosus</p> Signup and view all the answers

    Which compartment of the thigh is mainly responsible for thigh adduction?

    <p>Medial compartment</p> Signup and view all the answers

    Which of the following is a characteristic of the fascia lata?

    <p>It serves to enclose the muscles of the thigh.</p> Signup and view all the answers

    What role does the gluteus maximus play in lower limb movement?

    <p>Facilitates hip extension</p> Signup and view all the answers

    Which of the following muscle groups is classified as flexors of the hip?

    <p>Iliopsoas</p> Signup and view all the answers

    What is one of the primary functions attributed to the pelvic bones?

    <p>Support body weight</p> Signup and view all the answers

    Which structure is formed by the fusion of the ilium, pubis, and ischium?

    <p>Pelvic bone</p> Signup and view all the answers

    Which part of the femur is involved in forming the hip joint?

    <p>Neck</p> Signup and view all the answers

    Which of the following actions is primarily performed by the prime movers of hip extension?

    <p>Extension</p> Signup and view all the answers

    What is the role of the iliac crest in muscle attachment?

    <p>Provides leverage for hip abductors</p> Signup and view all the answers

    Which muscle group is primarily responsible for knee flexion?

    <p>Hamstrings</p> Signup and view all the answers

    Which structure forms the intertrochanteric line on the femur?

    <p>Neck of the femur</p> Signup and view all the answers

    What action describes the relationship between prime movers and antagonists during locomotion?

    <p>They work against each other to control movement</p> Signup and view all the answers

    What tissue type comprises the deep fascia of the thigh?

    <p>Dense connective tissue</p> Signup and view all the answers

    Which anatomical landmark serves as a passageway for nerves and blood vessels in the pelvis?

    <p>Greater sciatic notch</p> Signup and view all the answers

    Study Notes

    Femoral Region, Thigh and Leg

    • The lower limb is divided into the gluteal region, thigh, leg and foot.
    • The thigh comprises three compartments: anterior, posterior and medial.
    • The femoral triangle, popliteal fossa and ankle are important transition areas.
    • Varicose veins are most common in superficial veins of the legs, especially the great saphenous vein.
    • Varicose veins can be painful and lead to swelling, skin thickening, and ulceration.
    • Treatment options for varicose veins include vein obliteration, support stockings, elevating legs, and exercise.

    MSK Rules

    • All muscles pass at least one joint.
    • If a muscle passes a joint, it will work on that joint.
    • A movement is not produced by the action of one muscle:
      • Prime mover: The muscle primarily responsible for producing a movement.
      • Antagonist: A muscle with the opposite action of a muscle.
      • Synergist: Muscles that work and assist the prime movers.

    Anterior Compartment

    • The anterior compartment contains:
      • Quadriceps group (extensors of the leg)
      • Iliopsoas (flexor of the trunk/hip)
      • Sartorius (flexes thigh and leg)
      • Tensor fascia lata
    • The femoral nerve innervates all muscles in the anterior compartment (except tensor fascia lata).

    Posterior Compartment

    • The posterior compartment contains:
      • Hamstring group (extend the thigh except the short head of biceps femoris, flex the knee)
    • The sciatic nerve innervates the posterior compartment.

    Medial Compartment

    • The medial compartment contains:
      • Adductors of the thigh
    • The Obturator nerve innervates the medial compartment (except pectineus and hamstring part of adductor magnus).

    Anterior Thigh Muscles

    • Rectus femoris:
      • Originates from the anterior inferior iliac spine (AIIS).
      • Inserts into the quadriceps femoris tendon.
      • Extends the leg at the knee and flexes the thigh at the hip.
      • Innervated by the femoral nerve.
    • Vastus lateralis:
      • Originates from the femur.
      • Inserts into the quadriceps femoris tendon and lateral patella.
      • Extends the leg at the knee.
      • Innervated by the femoral nerve.
    • Vastus intermedius:
      • Originates from the femur.
      • Inserts into the quadriceps femoris tendon.
      • Extends the leg at the knee.
      • Innervated by the femoral nerve.
    • Vastus medialis:
      • Originates from the femur.
      • Inserts into the quadriceps femoris tendon and medial patella.
      • Extends the leg at the knee.
      • Innervated by the femoral nerve.
    • Quadriceps femoris tendon:
      • Connects the quadriceps muscles to the patella.
    • Patellar tendon:
      • Connects the patella to the tibia.

    Other Anterior Compartment Muscles

    • Iliopsoas:
      • Originates from the psoas major (posterior abdominal wall, lumbar vertebrae and discs) and iliacus (iliac fossa).
      • Inserts into the lesser trochanter of the femur.
      • Flexes the thigh at the hip (most powerful hip flexor).
      • Innervated by L1-3 nerve roots.
    • Sartorius:
      • Originates from the anterior superior iliac spine (ASIS).
      • Inserts into the medial tibia.
      • Flexes thigh at the hip, flexes the leg at the knee, abducts and laterally rotates the thigh.
      • Innervated by the femoral nerve.

    Medial Compartment Muscles

    • Pectineus:
      • Originates from the pectineal line of the pubis.
      • Inserts into the oblique line of the femur.
      • Adducts and flexes the thigh.
      • Innervated by the femoral nerve.
    • Adductor longus:
      • Originates from the pubis.
      • Inserts into the mid-femur.
      • Adducts and medially rotates the thigh.
      • Innervated by the obturator nerve.
    • Adductor brevis:
      • Originates from the pubis.
      • Inserts into the proximal femur (upper 1/3 linea aspera).
      • Adducts and medially rotates the thigh.
      • Innervated by the obturator nerve.
    • Adductor magnus:
      • Adductor part: originates from the ischiopubic ramus and inserts into the femur.
      • Hamstring part: originates from the ischial tuberosity and inserts into the femur (adductor tubercle).
      • Adducts and medially rotates the thigh.
      • Innervated by the obturator nerve (adductor part) and sciatic (tibial) nerve (hamstring part).
    • Gracilis:
      • Originates from the inferior pubic ramus.
      • Inserts into the tibia.
      • Adducts the thigh, flexes the leg, and medially rotates the leg.
      • Innervated by the obturator nerve.
    • Obturator externus:
      • Originates from the obturator membrane.
      • Inserts into the trochanteric fossa.
      • Laterally rotates the thigh at the hip and stabilises the femur in the acetabulum.
      • Innervated by the obturator nerve.

    Testing the Quadriceps Group

    • To test the quadriceps group:
      • Place one hand on the posterior aspect of the thigh.
      • Place the other hand slightly superior to the ankle.
      • Ask the patient to extend their leg against the resistance of your hand.
      • Observe the patient for leaning backward, using hip flexors, or exclusively using the rectus femoris.

    Femoral Triangle

    • Boundaries:
      • Superior: Inguinal ligament
      • Medial: Adductor longus
      • Lateral: Sartorius
    • Function of Femoral Triangle:
      • Supports body weight.
      • Assists with locomotion and balance.

    Pelvis Bones

    • The pelvic bone is irregular in shape made up of the ilium, pubis, and ischium.
    • Ilium:
      • Iliac crest: The superior border of the ilium.
      • Anterior superior iliac spine (ASIS): The anterior projection of the iliac crest.
      • Anterior inferior iliac spine (AIIS): The inferior projection of the iliac crest.
      • Posterior superior iliac spine (PSIS): The posterior projection of the iliac crest.
      • Posterior inferior iliac spine (PIIS): The inferior projection of the iliac crest.
    • Ischium:
      • Ischial spine: A bony projection on the posterior aspect of the ischium.
      • Ischial tuberosity: The inferior portion of the ischium on which the body sits.
    • Pubis:
      • Superior pubic ramus: The upper portion of the pubis.
      • Inferior pubic ramus: The lower portion of the pubis.
      • Body of the pubis: The central portion of the pubis.

    Sacrum

    • Ala: The laterally expanded wing-like portion of the sacrum.
    • Sacral canal: The canal within the sacrum that houses the spinal cord.
    • Promontory: The anterior projection of the sacrum.
    • Anterior sacral foramina: Holes on the anterior surface of the sacrum that allow for the passage of nerves and blood vessels.
    • Sacral hiatus: The opening at the bottom of the sacrum.

    Femur

    • Head: The rounded proximal end of the femur.
    • Neck: The constricted area connecting the head and shaft of the femur.
    • Greater trochanter: A large bony projection on the lateral aspect of the femur.
    • Lesser trochanter: A smaller bony projection on the medial aspect of the femur.
    • Intertrochanteric crest: The ridge between the greater and lesser trochanters.
    • Intertrochanteric line: The oblique ridge on the anterior aspect of the femur.
    • Linea aspera: A roughened line on the posterior aspect of the femur.
    • Shaft: The long middle portion of the femur.
    • Medial epicondyle and Lateral epicondyle: Projections on the distal end of the femur.
    • Medial condyle and Lateral condyle: Rounded portions on the distal end of the femur.
    • Intercondylar fossa: The depression between the condyles.

    Deep Fascia of the Thigh

    • The deep fascia of the thigh is a strong stocking-like layer that compartmentalises the thigh muscles.

    Femoral Hernia

    • A femoral hernia occurs when abdominal content protrudes through the femoral canal.
    • More common in females.
    • Presents as a swelling below and lateral to the pubic tubercle.

    Nerves

    • Femoral nerve (L2-L4):
      • Motor: Sartorius, Pectineus, Quadriceps.
      • Sensory: Skin of anterior thigh, and medial side of the leg (saphenous nerve).
    • Obturator nerve (L2-L4):
      • Motor: Adductor Longus, Brevis, and part of Magnus and Gracilis.
      • Sensory: Skin of medial thigh.

    Saphenous Nerve

    • The saphenous nerve is a branch of the femoral nerve, which provides sensation to the medial side of the leg.

    Clinical Case 1

    • A 25-year-old man presents to the emergency department following a car accident with pain, swelling, and bruising to the front of the knee and two lumps.
    • An X-ray shows a possible diagnosis of patellar fracture and possible distal femur fracture.

    Clinical Case 2

    • A 20-year-old man presents to the emergency department after injuring his knee while playing rugby.
    • An X-ray shows a possible diagnosis of patellar fracture.

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    Description

    This quiz covers the anatomy and functions of the lower limb, particularly focusing on the thigh and leg regions. It includes details about the thigh's compartments, important transition areas, and common conditions such as varicose veins. Additionally, it addresses the mechanics of muscle movements and their roles as prime movers, antagonists, and synergists.

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