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Questions and Answers
Following a traumatic injury to the lower limb, a patient presents with an inability to plantarflex the foot and flex the toes. Electrophysiological studies reveal nerve damage. Which nerve is MOST likely affected?
Following a traumatic injury to the lower limb, a patient presents with an inability to plantarflex the foot and flex the toes. Electrophysiological studies reveal nerve damage. Which nerve is MOST likely affected?
- Deep fibular nerve
- Obturator nerve
- Tibial nerve (correct)
- Superficial fibular nerve
A surgeon is performing a hip replacement and needs to detach muscles that insert onto the greater trochanter to access the hip joint capsule. Which set of muscles would the surgeon MOST likely need to detach?
A surgeon is performing a hip replacement and needs to detach muscles that insert onto the greater trochanter to access the hip joint capsule. Which set of muscles would the surgeon MOST likely need to detach?
- Adductor longus, adductor brevis, and gracilis
- Gluteus medius, gluteus minimus, and piriformis (correct)
- Gluteus maximus, biceps femoris, and piriformis
- Tensor fasciae latae, sartorius, and rectus femoris
A patient reports difficulty with hip abduction and medial rotation. After examination, it's determined that a single nerve is damaged. Which nerve is MOST likely affected?
A patient reports difficulty with hip abduction and medial rotation. After examination, it's determined that a single nerve is damaged. Which nerve is MOST likely affected?
- Femoral nerve
- Obturator nerve
- Inferior gluteal nerve
- Superior gluteal nerve (correct)
A weightlifter strains a muscle while performing a squat. They experience pain and weakness in extending the knee. Which muscle is LEAST likely to be the source of the pain?
A weightlifter strains a muscle while performing a squat. They experience pain and weakness in extending the knee. Which muscle is LEAST likely to be the source of the pain?
A patient is diagnosed with compartment syndrome in the anterior compartment of the leg. What vascular structure is MOST at risk?
A patient is diagnosed with compartment syndrome in the anterior compartment of the leg. What vascular structure is MOST at risk?
Following a motorcycle accident, a patient has lost sensation on the dorsum of the foot between the first and second toes. Which nerve is MOST likely injured?
Following a motorcycle accident, a patient has lost sensation on the dorsum of the foot between the first and second toes. Which nerve is MOST likely injured?
A runner experiences chronic pain along the medial aspect of their ankle. Imaging reveals inflammation of a tendon posterior to the medial malleolus. Which tendon is MOST likely affected?
A runner experiences chronic pain along the medial aspect of their ankle. Imaging reveals inflammation of a tendon posterior to the medial malleolus. Which tendon is MOST likely affected?
A patient has a complete transection of the femoral nerve. Which muscle group will be MOST affected by this injury?
A patient has a complete transection of the femoral nerve. Which muscle group will be MOST affected by this injury?
A patient presents with a 'foot drop,' an inability to dorsiflex the foot. Lesion of what nerve would MOST likely cause this condition?
A patient presents with a 'foot drop,' an inability to dorsiflex the foot. Lesion of what nerve would MOST likely cause this condition?
A patient has difficulty with eversion of the foot. Which muscle's function is MOST likely compromised?
A patient has difficulty with eversion of the foot. Which muscle's function is MOST likely compromised?
A surgeon is planning to perform a popliteal artery bypass. Which anatomical landmark is MOST critical for the surgeon to locate the popliteal artery?
A surgeon is planning to perform a popliteal artery bypass. Which anatomical landmark is MOST critical for the surgeon to locate the popliteal artery?
A patient sustains a severe crush injury to the foot and develops necrosis of the plantar muscles. Which artery is MOST likely compromised to cause this?
A patient sustains a severe crush injury to the foot and develops necrosis of the plantar muscles. Which artery is MOST likely compromised to cause this?
A patient is unable to extend the interphalangeal joint of the great toe. Which intrinsic muscle of the foot is MOST likely affected?
A patient is unable to extend the interphalangeal joint of the great toe. Which intrinsic muscle of the foot is MOST likely affected?
During a Trendelenburg test, a patient stands on their right leg, and their left hip drops. This indicates weakness MOST likely in what muscle on the right side?
During a Trendelenburg test, a patient stands on their right leg, and their left hip drops. This indicates weakness MOST likely in what muscle on the right side?
A gymnast injures the medial side of their knee. Which ligament is MOST likely affected?
A gymnast injures the medial side of their knee. Which ligament is MOST likely affected?
A patient experiences a fracture involving the surgical neck of the femur. Which artery is MOST at risk?
A patient experiences a fracture involving the surgical neck of the femur. Which artery is MOST at risk?
A patient is diagnosed with plantar fasciitis. Which arch of the foot is MOST directly involved in this condition?
A patient is diagnosed with plantar fasciitis. Which arch of the foot is MOST directly involved in this condition?
Following a deep laceration to the anterior thigh, a patient has difficulty flexing the hip and extending the knee. Which muscle is LEAST likely affected?
Following a deep laceration to the anterior thigh, a patient has difficulty flexing the hip and extending the knee. Which muscle is LEAST likely affected?
A patient is undergoing a total hip arthroplasty (THA). During the procedure, the surgeon needs to carefully dissect the posterior hip capsule to avoid injury to a nerve that laterally rotates the hip. Which of the following nerves is MOST at risk during this step?
A patient is undergoing a total hip arthroplasty (THA). During the procedure, the surgeon needs to carefully dissect the posterior hip capsule to avoid injury to a nerve that laterally rotates the hip. Which of the following nerves is MOST at risk during this step?
A patient complains of numbness and tingling in the plantar aspect of the foot, especially in the toes. The symptoms worsen with prolonged standing and tight footwear. Which condition is MOST likely causing these symptoms?
A patient complains of numbness and tingling in the plantar aspect of the foot, especially in the toes. The symptoms worsen with prolonged standing and tight footwear. Which condition is MOST likely causing these symptoms?
Flashcards
Lower Limb Function
Lower Limb Function
Specialized for weight-bearing and locomotion.
Lower Limb Divisions
Lower Limb Divisions
Gluteal region, thigh, knee, leg, ankle, and foot.
Pelvic Girdle
Pelvic Girdle
Formed by the two hip bones which articulate with the sacrum. Connects the lower limb to axial skeleton.
Femur
Femur
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Patella
Patella
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Tibia Bone
Tibia Bone
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Fibula Bone
Fibula Bone
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Hip Joint
Hip Joint
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Knee Joint
Knee Joint
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Gluteus Maximus Function
Gluteus Maximus Function
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Gluteus Medius & Minimus
Gluteus Medius & Minimus
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Tensor Fasciae Latae (TFL)
Tensor Fasciae Latae (TFL)
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Gracilis Muscle
Gracilis Muscle
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Tibialis Anterior
Tibialis Anterior
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Fibularis Longus Function
Fibularis Longus Function
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Plantar Fascia
Plantar Fascia
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Obturator Nerve
Obturator Nerve
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Femoral Nerve
Femoral Nerve
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External Iliac Artery
External Iliac Artery
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Great Saphenous Vein
Great Saphenous Vein
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Study Notes
- The lower limb is specialized for weight-bearing and locomotion
- It is divided into the gluteal region, thigh, knee, leg, ankle, and foot
Bones of the Lower Limb
- Pelvic girdle: formed by the two hip bones which articulate with the sacrum
- Femur: the bone of the thigh
- Patella: a sesamoid bone located anterior to the knee joint
- Tibia: the larger, weight-bearing bone of the leg
- Fibula: the smaller, non-weight-bearing bone of the leg
- Tarsals: seven bones of the ankle
- Metatarsals: five bones of the foot
- Phalanges: bones of the toes
Joints of the Lower Limb
- Hip joint: articulation between the head of the femur and the acetabulum of the hip bone
- Knee joint: articulation between the femur, tibia, and patella
- Ankle joint: articulation between the tibia, fibula, and talus
- Intertarsal joints: articulations between the tarsal bones
- Tarsometatarsal joints: articulations between the tarsal bones and metatarsal bones
- Metatarsophalangeal joints: articulations between the metatarsal bones and the phalanges
- Interphalangeal joints: articulations between the phalanges
Muscles of the Gluteal Region
- Gluteus maximus: extends and laterally rotates the hip
- Gluteus medius: abducts and medially rotates the hip
- Gluteus minimus: abducts and medially rotates the hip
- Tensor fasciae latae: flexes, abducts, and medially rotates the hip
- Piriformis: laterally rotates the hip
- Obturator internus: laterally rotates the hip
- Superior gemellus: laterally rotates the hip
- Inferior gemellus: laterally rotates the hip
- Quadratus femoris: laterally rotates the hip
Muscles of the Thigh
- Anterior compartment (flexors of the hip, extensors of the knee):
- Sartorius: flexes, abducts, and laterally rotates the hip; flexes and medially rotates the knee
- Rectus femoris: flexes the hip and extends the knee
- Vastus lateralis: extends the knee
- Vastus medialis: extends the knee
- Vastus intermedius: extends the knee
- Medial compartment (adductors of the hip):
- Gracilis: adducts the hip, flexes and medially rotates the knee
- Pectineus: adducts, flexes, and laterally rotates the hip
- Adductor longus: adducts, flexes, and laterally rotates the hip
- Adductor brevis: adducts, flexes, and laterally rotates the hip
- Adductor magnus: adducts, flexes, and extends the hip
- Obturator externus: laterally rotates the hip
- Posterior compartment (extensors of the hip, flexors of the knee):
- Biceps femoris: extends the hip, flexes and laterally rotates the knee
- Semitendinosus: extends the hip, flexes and medially rotates the knee
- Semimembranosus: extends the hip, flexes and medially rotates the knee
Muscles of the Leg
- Anterior compartment (dorsiflexors of the ankle, extensors of the toes):
- Tibialis anterior: dorsiflexes and inverts the ankle
- Extensor hallucis longus: dorsiflexes the ankle and extends the great toe
- Extensor digitorum longus: dorsiflexes the ankle and extends the lateral four toes
- Fibularis tertius: dorsiflexes and everts the ankle
- Lateral compartment (evertors of the ankle):
- Fibularis longus: everts and plantarflexes the ankle
- Fibularis brevis: everts and plantarflexes the ankle
- Posterior compartment (plantarflexors of the ankle, flexors of the toes):
- Superficial group:
- Gastrocnemius: plantarflexes the ankle and flexes the knee
- Soleus: plantarflexes the ankle
- Plantaris: plantarflexes the ankle and flexes the knee (weakly)
- Deep group:
- Popliteus: flexes and medially rotates the knee
- Flexor hallucis longus: plantarflexes the ankle and flexes the great toe
- Flexor digitorum longus: plantarflexes the ankle and flexes the lateral four toes
- Tibialis posterior: plantarflexes and inverts the ankle
- Superficial group:
Intrinsic Muscles of the Foot
- Dorsal group:
- Extensor hallucis brevis: extends the great toe
- Extensor digitorum brevis: extends the second to fourth toes
- Plantar group:
- First layer:
- Abductor hallucis: abducts and flexes the great toe
- Flexor digitorum brevis: flexes the second to fifth toes
- Abductor digiti minimi: abducts and flexes the little toe
- Second layer:
- Quadratus plantae: assists flexor digitorum longus in flexing the toes
- Lumbricals: flex the metatarsophalangeal joints and extend the interphalangeal joints of the second to fifth toes
- Third layer:
- Flexor hallucis brevis: flexes the great toe
- Adductor hallucis: adducts the great toe
- Flexor digiti minimi brevis: flexes the little toe
- Fourth layer:
- Plantar interossei: adduct the toes towards the second toe and flex the metatarsophalangeal joints
- Dorsal interossei: abduct the toes away from the second toe and flex the metatarsophalangeal joints
- First layer:
Nerves of the Lower Limb
- Lumbar plexus (L1-L4):
- Obturator nerve: supplies the medial compartment of the thigh
- Femoral nerve: supplies the anterior compartment of the thigh
- Sacral plexus (L4-S4):
- Sciatic nerve: the largest nerve in the body, it splits into the tibial and common fibular nerves
- Tibial nerve: supplies the posterior compartment of the leg and the plantar muscles of the foot
- Common fibular nerve: divides into the superficial and deep fibular nerves
- Superficial fibular nerve: supplies the lateral compartment of the leg
- Deep fibular nerve: supplies the anterior compartment of the leg and the dorsal muscles of the foot
- Superior gluteal nerve: supplies the gluteus medius, gluteus minimus, and tensor fasciae latae
- Inferior gluteal nerve: supplies the gluteus maximus
- Pudendal nerve: supplies the perineum
Arteries of the Lower Limb
- External iliac artery: becomes the femoral artery after passing under the inguinal ligament
- Femoral artery: the main artery of the thigh
- Deep femoral artery: a major branch of the femoral artery that supplies the posterior and lateral thigh
- Popliteal artery: continuation of the femoral artery after it passes through the adductor hiatus
- Anterior tibial artery: branch of the popliteal artery that supplies the anterior compartment of the leg and the dorsum of the foot, becomes dorsalis pedis artery
- Posterior tibial artery: branch of the popliteal artery that supplies the posterior compartment of the leg and the plantar aspect of the foot
- Fibular (peroneal) artery: branch of the posterior tibial artery that supplies the lateral compartment of the leg
Veins of the Lower Limb
- Deep veins: accompany the arteries and have the same names
- Femoral vein
- Popliteal vein
- Anterior tibial vein
- Posterior tibial vein
- Fibular (peroneal) vein
- Superficial veins:
- Great saphenous vein: ascends along the medial side of the leg and thigh to drain into the femoral vein
- Small saphenous vein: ascends along the posterior side of the leg to drain into the popliteal vein
- Perforating veins: connect the superficial and deep veins
Fascia of the Lower Limb
- Fascia lata: deep fascia of the thigh
- Iliotibial tract: lateral thickening of the fascia lata that runs from the iliac crest to the tibia
- Crural fascia: deep fascia of the leg
- Plantar fascia (aponeurosis): thick band of fibrous tissue on the sole of the foot
Hip Joint
- A ball and socket joint formed by the head of the femur and the acetabulum of the hip bone.
- Movements: flexion, extension, abduction, adduction, medial rotation, lateral rotation, and circumduction.
- Ligaments: iliofemoral, pubofemoral, ischiofemoral, and ligament of the head of the femur.
Knee Joint
- A complex hinge joint formed by the femur, tibia, and patella.
- Movements: flexion, extension, and some rotation.
- Ligaments: anterior cruciate ligament (ACL), posterior cruciate ligament (PCL), medial collateral ligament (MCL), and lateral collateral ligament (LCL).
- Menisci: medial and lateral menisci for shock absorption and stability.
Ankle Joint
- A hinge joint formed by the tibia, fibula, and talus.
- Movements: dorsiflexion and plantarflexion.
- Ligaments: deltoid ligament (medial) and lateral ligaments (anterior talofibular, calcaneofibular, and posterior talofibular).
Foot Arches
- Medial longitudinal arch: the highest and most important arch, formed by the calcaneus, talus, navicular, cuneiforms, and the first three metatarsals.
- Lateral longitudinal arch: formed by the calcaneus, cuboid, and the fourth and fifth metatarsals.
- Transverse arch: formed by the cuboid, cuneiforms, and the bases of the metatarsals.
- These arches provide shock absorption and flexibility to the foot during weight-bearing activities.
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