Snell's Clinical Anatomy Chapter 11 - Lower Limb
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Questions and Answers

What is the primary function of the obturator internus muscle?

  • Medial rotator of the thigh
  • Extensor of the knee
  • Flexor of the hip
  • Lateral rotator of the thigh at the hip joint (correct)

    • Which muscles insert into the greater trochanter of the femur?

  • Obturator internus only
  • Quadratus femoris only
  • Obturator internus and superior gemellus
  • Obturator internus, superior gemellus, and inferior gemellus (correct)

    • Which nerve exits the pelvis through the lower part of the greater sciatic foramen?

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

    • What is the anatomical position of the piriformis muscle in relation to the sciatic nerve?

    <p>Above the sciatic nerve</p> Signup and view all the answers

    Which of the following structures is NOT associated with the gluteus maximus?

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

    Which nerve primarily arises from the L4, L5, S1, S2, and S3 spinal roots?

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

    Which muscle is innervated by the common fibular nerve?

    <p>Fibularis brevis</p> Signup and view all the answers

    What is the main function of the biceps femoris (short head)?

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

    Which skin area is primarily supplied by the common fibular nerve?

    <p>Dorsum of the foot</p> Signup and view all the answers

    Which nerve branch is responsible for innervating the skin of the lateral side of the foot?

    <p>Lateral cutaneous nerve of the calf</p> Signup and view all the answers

    What action is primarily limited by the ligaments of the hip joint?

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

    Which joint movement is most supported by the structure of the hip joint?

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

    Which of the following nerves is NOT a branch of the sciatic nerve?

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

    Which nerve is primarily responsible for innervating the hamstring muscle group?

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

    What anatomical structure does the sciatic nerve pass above or through?

    <p>Piriformis muscle</p> Signup and view all the answers

    Which of the following muscles is involved in hip extension?

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

    What is the main function of the adductor magnus in hip movement?

    <p>Hip adduction</p> Signup and view all the answers

    Which ligament is primarily responsible for limiting hyperextension of the hip joint?

    <p>Iliofemoral ligament</p> Signup and view all the answers

    What joint movement is primarily limited by the pubofemoral ligament?

    <p>Hip abduction</p> Signup and view all the answers

    Which muscle is NOT part of the lower leg muscles innervated by the tibial nerve?

    <p>Fibularis longus</p> Signup and view all the answers

    Which structure is NOT directly supplied by branches of the tibial nerve?

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

    Which of the following structures aids in stabilizing the hip joint?

    <p>Acetabular labrum</p> Signup and view all the answers

    Which muscle acts as a primary hip flexor?

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

    Which nerve supplies the skin of the lower lateral quadrant of the buttock?

    <p>Sacral plexus</p> Signup and view all the answers

    What is the function of the femoral branch of the genitofemoral nerve in the thigh?

    <p>Piercing the deep fascia</p> Signup and view all the answers

    What area does the Wolngulnal nerve specifically supply?

    <p>Root of the penis and adjacent scrotum</p> Signup and view all the answers

    Which superficial vein is comparable to the basilic vein in the upper limb?

    <p>Great saphenous vein</p> Signup and view all the answers

    What is the primary area of skin supplied by the genital branch of the genitofemoral nerve?

    <p>Scrotum or labium majus</p> Signup and view all the answers

    What function does the deep fascia perform in relation to the femoral branch of the genitofemoral nerve?

    <p>Houses and protects nerves and vessels</p> Signup and view all the answers

    In which location does the femoral nerve branch pierce the deep fascia?

    <p>In the popliteal fossa</p> Signup and view all the answers

    What clinical significance do the superficial veins of the leg have?

    <p>Potential site for varicosities</p> Signup and view all the answers

    What is one key difference between the great saphenous vein and the small saphenous vein?

    <p>The great saphenous vein runs along the medial side of the leg</p> Signup and view all the answers

    Which ligament limits the extension movement of the hip joint?

    <p>Iliofemoral ligament</p> Signup and view all the answers

    Which nerve primarily supplies the gluteus maximus muscle?

    <p>Inferior gluteal nerve</p> Signup and view all the answers

    What is the main function of the superior gluteal nerve?

    <p>To supply the gluteus medius and minimus</p> Signup and view all the answers

    Where does the inferior gluteal nerve exit the pelvis?

    <p>Below the piriformis</p> Signup and view all the answers

    What is the purpose of the trochanteric anastomosis?

    <p>To supply blood to the head of the femur</p> Signup and view all the answers

    What type of branches does the posterior cutaneous nerve of the thigh provide?

    <p>Branches to the lower medial quadrant of the buttock</p> Signup and view all the answers

    Which arteries are involved in the trochanteric anastomosis?

    <p>Superior and inferior gluteal arteries</p> Signup and view all the answers

    What is the location of the cruciate anastomosis?

    <p>At the level of the lesser trochanter</p> Signup and view all the answers

    Which nerve is responsible for the skin sensation in the popliteal fossa?

    <p>Posterior cutaneous nerve of the thigh</p> Signup and view all the answers

    What is one of the functions of the superior gluteal nerve?

    <p>To innervate gluteus medius and minimus</p> Signup and view all the answers

    What type of branches does the superior gluteal nerve provide?

    <p>Branches to gluteal muscles</p> Signup and view all the answers

    What is the primary function of the lower limbs?

    <p>To support the weight of the body and produce locomotion</p> Signup and view all the answers

    Which of the following bones is NOT part of the lower limb?

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

    What condition is commonly encountered by health professionals concerning the lower limbs?

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

    What is the structural significance of the os coxae?

    <p>It forms the lower limb girdle connecting to the vertebral column</p> Signup and view all the answers

    Which of the following regions is NOT a compartment in the lower limb?

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

    The lower limbs are well adapted for which posture or activity?

    <p>Standing upright</p> Signup and view all the answers

    What type of injuries are included in the common lower limb problems?

    <p>Knee effusions</p> Signup and view all the answers

    What components make up the os coxae?

    <p>Ilium, ischium, and pubis</p> Signup and view all the answers

    Which muscle primarily flexes the thigh on the trunk?

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

    What is a primary action of the sartorius muscle?

    <p>Laterally rotates thigh at hip</p> Signup and view all the answers

    What nerve is responsible for innervating the sartorius muscle?

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

    Which of the following muscles acts to flex the leg at the knee joint?

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

    Which structures are primarily involved in the adduction of the thigh?

    <p>Adductor magnus and obturator nerve</p> Signup and view all the answers

    Which structure forms the upper border of the body of the pubis?

    <p>Pubic crest</p> Signup and view all the answers

    What does the acetabular fossa represent?

    <p>Nonarticular floor of the acetabulum</p> Signup and view all the answers

    Which of the following accurately describes the articular surface of the acetabulum?

    <p>Limited to a horseshoe-shaped area</p> Signup and view all the answers

    What characterizes the medial margin of the linea aspera?

    <p>Extends as the medial supracondylar ridge</p> Signup and view all the answers

    What defines the inferior margin of the acetabulum?

    <p>Marked by the acetabular notch</p> Signup and view all the answers

    What is the function of the obturator membrane?

    <p>Fills in the obturator foramen</p> Signup and view all the answers

    How does the shaft of the pubis change as it extends distally?

    <p>Broader toward its distal end</p> Signup and view all the answers

    Which structures are located at the lower end of the femur?

    <p>Lateral and medial condyles</p> Signup and view all the answers

    What is the result of the articulation between the acetabulum and the femur?

    <p>Formation of the hip joint</p> Signup and view all the answers

    Where does the popliteal surface of the femur reside?

    <p>On the posterior surface of the shaft</p> Signup and view all the answers

    What anatomical structure does the great saphenous vein primarily pass through?

    <p>Saphenous opening</p> Signup and view all the answers

    Which group of lymph nodes receives lymph from the anterior abdominal wall below the umbilicus?

    <p>Superficial inguinal lymph nodes</p> Signup and view all the answers

    Which lymphatic vessels drain the external genitalia and lower half of the anal canal?

    <p>Superficial inguinal lymph nodes</p> Signup and view all the answers

    What can cause an enlarged inguinal lymph node?

    <p>Lymphatic spread of pathogens</p> Signup and view all the answers

    Which veins are responsible for draining superficial venous blood from the lower limb?

    <p>Great and small saphenous veins</p> Signup and view all the answers

    What is the primary drainage area for the medial members of the superficial inguinal lymph nodes?

    <p>Anterior abdominal wall</p> Signup and view all the answers

    Where do the superficial inguinal lymph nodes lie in the body?

    <p>In the superficial fascia below the inguinal ligament</p> Signup and view all the answers

    What role do perforating veins play in the lymphatic system of the lower limb?

    <p>Drain superficial veins into deep veins</p> Signup and view all the answers

    Which lymphatic group primarily drains lymph from the skin and superficial fascia of the anterior and posterior abdominal walls?

    <p>Superficial inguinal lymph nodes</p> Signup and view all the answers

    What anatomical region does the drainage from the lateral members of the superficial inguinal lymph nodes originate from?

    <p>Back below the level of the gluteus</p> Signup and view all the answers

    What is the primary route for lymph from the superficial inguinal nodes?

    <p>They pass through the saphenous opening.</p> Signup and view all the answers

    Which muscle is included in the anterior fascial compartment?

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

    What anatomical feature do the deep inguinal lymph nodes typically lie along?

    <p>Medial side of the femoral vein</p> Signup and view all the answers

    What is the role of efferent lymph vessels from the superficial inguinal nodes?

    <p>Send lymph to the abdominal lymph nodes.</p> Signup and view all the answers

    What structure do lymph vessels from the deep inguinal nodes enter to reach the abdominal cavity?

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

    How many deep inguinal lymph nodes are commonly present?

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

    Which muscle is formed by the merging of the iliacus and psoas major in the thigh?

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

    What type of tissue largely composes the great saphenous vein?

    <p>Connective tissue</p> Signup and view all the answers

    What is the primary blood supply to the anterior compartment of the thigh?

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

    What action is primarily associated with the quadriceps femoris muscle?

    <p>Knee extension</p> Signup and view all the answers

    What anatomical region does the popliteal fossa belong to?

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

    Which of the following anatomical structures is involved in arterial anastomosis around the knee?

    <p>Popliteal Artery</p> Signup and view all the answers

    The popliteal lymph nodes are associated with which anatomical structure?

    <p>Popliteal Artery</p> Signup and view all the answers

    What is the main purpose of the femoral sheath?

    <p>To house the femoral artery and vein</p> Signup and view all the answers

    Which of the following joints is found in the foot?

    <p>Metatarsophalangeal Joint</p> Signup and view all the answers

    What does the term 'foot as functional unit' refer to?

    <p>The interaction of the foot's arches with movement</p> Signup and view all the answers

    Which structure is NOT part of the boundaries of the popliteal fossa?

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

    Which joint movement is primarily associated with the tarsal joints?

    <p>Eversion/Inversion</p> Signup and view all the answers

    What is the primary function of the lumbosacral plexus?

    <p>Innervate the muscles of the pelvis and lower limb</p> Signup and view all the answers

    Which movement is classified as 'locking' of the knee?

    <p>Full extension of the knee joint</p> Signup and view all the answers

    What is the consequence of a lesion to the common fibular nerve?

    <p>Loss of ankle dorsiflexion and eversion</p> Signup and view all the answers

    Which structure is primarily responsible for maintaining the medial longitudinal arch of the foot?

    <p>Tibialis posterior tendon</p> Signup and view all the answers

    Which of the following structures is NOT involved in the locking mechanism of the knee?

    <p>Patellar tendon</p> Signup and view all the answers

    What is the primary action of the intrinsic muscles of the foot?

    <p>Support the arch of the foot</p> Signup and view all the answers

    Which ligaments play a critical role in stabilizing the ankle joint?

    <p>Anterior and posterior talofibular ligaments</p> Signup and view all the answers

    What developmental aspect differentiates the lower limb from the upper limb?

    <p>The pattern of muscular attachment</p> Signup and view all the answers

    What defines the boundaries of the femoral triangle?

    <p>Iliopsoas, sartorius, and adductor longus</p> Signup and view all the answers

    Which arches of the foot are crucial for shock absorption during locomotion?

    <p>Medial and lateral longitudinal arches</p> Signup and view all the answers

    What is the main anatomical feature of the obturator internus muscle?

    <p>It lies within the pelvis at its origin.</p> Signup and view all the answers

    Which of the following structures is associated with the gluteus maximus?

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

    What is the relationship between the sciatic nerve and the greater sciatic foramen?

    <p>The sciatic nerve emerges from the pelvis through the lower part of the greater sciatic foramen.</p> Signup and view all the answers

    Which two components constitute the sciatic nerve?

    <p>Tibial and common fibular nerves</p> Signup and view all the answers

    Where is the origin of the obturator internus muscle located?

    <p>Inside the pelvis</p> Signup and view all the answers

    What is the significance of the trochanteric anastomosis?

    <p>It allows for collateral circulation around the hip joint.</p> Signup and view all the answers

    Which muscles are typically involved in the posterior cutaneous nerve of the thigh innervation?

    <p>Hamstring muscle group</p> Signup and view all the answers

    Which nerves originate from the sacral plexus and are associated with the gluteal region?

    <p>Inferior and superior gluteal nerves</p> Signup and view all the answers

    What is the primary function of the quadratus femoris muscle?

    <p>Lateral rotation of the thigh</p> Signup and view all the answers

    Which of the following structures does not associate with the ischial tuberosity?

    <p>Gluteus maximus tendon</p> Signup and view all the answers

    What role do the superficial inguinal lymph nodes play in lymphatic drainage?

    <p>They drain lymph from the superficial fascia of the anterior abdominal wall below the umbilicus.</p> Signup and view all the answers

    Which statement about the great saphenous vein is true?

    <p>It can be used to bypass obstructions in the brachial or femoral arteries.</p> Signup and view all the answers

    What is one common misconception about lymphatic drainage in the inguinal region?

    <p>Only deep lymph nodes are involved in lower limb drainage.</p> Signup and view all the answers

    How does lymphatic drainage from the lower limb operate?

    <p>Superficial lymph vessels enter the deep veins via perforating veins.</p> Signup and view all the answers

    Inguinal lymph nodes receive lymph from which of the following areas?

    <p>Superficial lymph vessels from the back below the iliac crests.</p> Signup and view all the answers

    What is the primary characteristic of a varicosed vein?

    <p>It is elongated and tortuous.</p> Signup and view all the answers

    Which nerve supplies the skin in front of the medial malleolus?

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

    What role do perforating veins play in the lower limb's venous system?

    <p>They connect superficial and deep veins, preventing high pressure in superficial veins.</p> Signup and view all the answers

    What is a common cause of varicose veins?

    <p>Weakness of vein walls</p> Signup and view all the answers

    What procedure is involved in the treatment of varicose veins?

    <p>Incision and excision of the affected vein</p> Signup and view all the answers

    What happens to venous blood as muscles within a closed fascial compartment relax?

    <p>It is sucked from superficial veins into deep veins.</p> Signup and view all the answers

    Why are large-diameter catheters preferred at certain sites in venous procedures?

    <p>To facilitate rapid infusion of large volumes of fluids.</p> Signup and view all the answers

    What is the sensory nerve blocked during a varicose vein procedure?

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

    What is one of the primary effects of high pressure in venous blood on superficial veins?

    <p>Dilation and potential swelling of the veins.</p> Signup and view all the answers

    What is the initial step in the anatomical procedure of ankle vein cutdown?

    <p>Injection of local anesthetic around the nerve</p> Signup and view all the answers

    What is the main cause of varicose veins?

    <p>Weakness of vein walls</p> Signup and view all the answers

    What is the role of perforating veins in the venous system?

    <p>Facilitate blood flow from superficial to deep veins</p> Signup and view all the answers

    Which nerve is blocked for pain relief during a varicose vein procedure near the medial malleolus?

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

    What is the surgical procedure conducted on a varicosed vein near the medial malleolus?

    <p>Transverse incision</p> Signup and view all the answers

    What happens to venous blood as the muscles within the closed fascial compartments relax?

    <p>It is sucked into the deep veins</p> Signup and view all the answers

    What typically causes subcapital fractures of the femur in the elderly?

    <p>A minor trip or stumble</p> Signup and view all the answers

    What is a common complication associated with femoral neck fractures?

    <p>Avascular necrosis of the head</p> Signup and view all the answers

    Which muscles contribute to the upward pull of the distal fragment in femur fractures?

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

    Which factor contributes to the gender predisposition for subcapital femoral neck fractures?

    <p>Thinning of cortical and trabecular bone</p> Signup and view all the answers

    What happens to the distal fragment in femur fractures of the middle third of the shaft?

    <p>It rotates backward due to muscle action</p> Signup and view all the answers

    Which of the following muscles exerts pressure on the popliteal artery in femur fractures?

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

    Which measurement indicates leg shortening due to femur fractures?

    <p>Measurement from the anterosuperior iliac spine to the medial malleolus</p> Signup and view all the answers

    What is crucial to understand in relation to the displacement of fragments in femur fractures?

    <p>Understanding the actions of the thigh muscles</p> Signup and view all the answers

    What is the primary role of the patella in the knee joint?

    <p>Acts as a lever for knee extension</p> Signup and view all the answers

    Which surface of the patella articulates with the condyles of the femur?

    <p>Posterior surface</p> Signup and view all the answers

    What connects the apex of the patella to the tibia?

    <p>Patellar ligament</p> Signup and view all the answers

    Which structure protects the patella by separating it from the skin?

    <p>Prepatellar bursa</p> Signup and view all the answers

    What shape is the patella commonly described as?

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

    Which parts of the quadriceps femoris muscle attach to the edges of the patella?

    <p>All parts of the quadriceps femoris</p> Signup and view all the answers

    Which anatomical feature lies between the anterior and posterior intercondylar areas of the tibia?

    <p>Intercondylar eminence</p> Signup and view all the answers

    Which part of the tibia's shaft is notable for its triangular cross-section?

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

    What type of bone is the patella classified as?

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

    Where is the head of the fibula located in relation to the patella?

    <p>To the side of the patella</p> Signup and view all the answers

    What is the anatomical location of the saphenous opening in relation to the pubic tubercle?

    <p>About 1.5 in. below and lateral to the pubic tubercle</p> Signup and view all the answers

    Which nerve is responsible for supplying the medial aspect of the thigh?

    <p>Medial cutaneous nerve of the thigh</p> Signup and view all the answers

    Which branch supplies the skin of the lateral aspect of the thigh?

    <p>Lateral cutaneous nerve of the thigh</p> Signup and view all the answers

    What anatomical structure does the saphenous opening attach to?

    <p>The pectineal line of the superior ramus of the pubis</p> Signup and view all the answers

    Which nerve branches are involved in forming the patellar plexus?

    <p>Lateral cutaneous nerve of the thigh, anterior cutaneous branches of the femoral nerve, and infrapatellar branch of the saphenous nerve</p> Signup and view all the answers

    What direction does the border of the saphenous opening curve?

    <p>Curves upward and medial, then laterally</p> Signup and view all the answers

    Which nerve supplies a variable area of skin on the medial aspect of the thigh?

    <p>Branches from the anterior division of the obturator nerve</p> Signup and view all the answers

    Where does the lateral cutaneous nerve of the thigh enter the thigh?

    <p>Behind the lateral end of the inguinal ligament</p> Signup and view all the answers

    Which of the following areas does not include branches from the medial cutaneous nerve of the thigh?

    <p>Anterior aspect of the thigh</p> Signup and view all the answers

    Which structure lies in front of the knee and forms part of the patellar plexus?

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

    Which vein connects the great saphenous vein with the deep veins along the medial side of the calf?

    <p>Perforating vein</p> Signup and view all the answers

    What structure assists in the function of the 'venous pump' in the lower limb?

    <p>Valved perforating veins</p> Signup and view all the answers

    Where does the great saphenous vein join the femoral vein?

    <p>About 1.5 in. (4 cm) below the pubic tubercle</p> Signup and view all the answers

    What is the primary characteristic of the great saphenous vein?

    <p>Connected to the small saphenous vein by several branches</p> Signup and view all the answers

    What anatomical location marks the significant passage of the great saphenous vein?

    <p>Lower part of the saphenous opening</p> Signup and view all the answers

    In which layer does the great saphenous vein ascend over the medial side of the leg?

    <p>Superficial fascia</p> Signup and view all the answers

    What is the role of the small saphenous vein in relation to the great saphenous vein?

    <p>It connects to the deep veins via perforating veins</p> Signup and view all the answers

    What anatomical structure is located at the medial malleolus associated with venous drainage?

    <p>Great saphenous vein</p> Signup and view all the answers

    Which term describes the veins that accompany arteries in the leg?

    <p>Venae comitantes</p> Signup and view all the answers

    What is one key feature of perforating veins?

    <p>They possess valves to prevent backflow</p> Signup and view all the answers

    Which compartment contains muscles primarily involved in hip movement?

    <p>Gluteal Region</p> Signup and view all the answers

    Which structure surrounds the femoral artery and vein in the thigh?

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

    What is the role of the popliteal artery?

    <p>Supply blood to the lower limb</p> Signup and view all the answers

    Which joint is predominantly related to the arches of the foot?

    <p>Tarsal Joints</p> Signup and view all the answers

    What anatomical area does the inguinal lymph node drain primarily?

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

    Which compartment contains the major arterial supply to the leg?

    <p>Posterior Fascial Compartment</p> Signup and view all the answers

    Which joint is primarily supported by the ligaments surrounding the tibiofibular articulation?

    <p>Distal Tibiofibular Joint</p> Signup and view all the answers

    Which component is critical for the foot's propulsive action?

    <p>Metatarsophalangeal Joints</p> Signup and view all the answers

    Which nerve is primarily responsible for innervating the biceps femoris short head?

    <p>Common fibular nerve</p> Signup and view all the answers

    Which skin area is NOT directly supplied by the common fibular nerve?

    <p>Skin of the medial side of the leg</p> Signup and view all the answers

    What is the primary origin of the sciatic nerve?

    <p>L4, L5, S1, S2, S3</p> Signup and view all the answers

    Which muscle is innervated by the tibial nerve?

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

    Which branch of the sciatic nerve runs along the back of the thigh?

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

    Which surface of the os coxae articulates with the sacrum?

    <p>Anterior surface</p> Signup and view all the answers

    What structure is highlighted as the area where the iliac crest is located?

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

    What joint is formed by the articulation of the femur with the acetabulum?

    <p>Hip joint</p> Signup and view all the answers

    Which of the following describes the position of the symphysis pubis?

    <p>Faces upwards and backward</p> Signup and view all the answers

    Which feature is located at the upper end of the femur?

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

    Which muscle is associated with the external surface of the hip bone according to the provided content?

    <p>Obturator externus</p> Signup and view all the answers

    What is the anatomical position of the iliac crest in relation to the os coxae?

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

    What articulates with the femur below to form the knee joint?

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

    Which part of the os coxae is NOT mentioned to articulate with one another?

    <p>Iliac crest</p> Signup and view all the answers

    What type of cartilage is mentioned relating to the acetabulum?

    <p>Triradiate cartilage</p> Signup and view all the answers

    What is the primary function of the lower limbs?

    <p>To support the weight of the body and produce locomotion</p> Signup and view all the answers

    Which of the following bones contributes to the structure of the os coxae?

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

    What factors provide stability to the lower limbs?

    <p>The articulate structure of the hip bones and strong joint connections</p> Signup and view all the answers

    Which region is NOT part of the lower limb compartments?

    <p>Pectoral girdle</p> Signup and view all the answers

    Which of the following conditions is least likely to be encountered by health professionals dealing with lower limb issues?

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

    The stable structure of the lower limbs supports which activities?

    <p>Standing, walking, and running</p> Signup and view all the answers

    What is the anatomical significance of the symphysis pubis in the lower limb?

    <p>It allows for mobility between the two os coxae</p> Signup and view all the answers

    Which skeletal element does NOT form part of the os coxae?

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

    What is a key characteristic of the lower limb's muscle compartments?

    <p>Each compartment has distinct muscles, nerves, and blood supply</p> Signup and view all the answers

    Which of the following accurately describes the lower limbs' role in the body?

    <p>They are essential for stable locomotion and support</p> Signup and view all the answers

    What indicates the presence of arthritis in the hip joint based on the tenderness felt?

    <p>Tenderness over the head of the femur</p> Signup and view all the answers

    Which statement about the blood supply to the femoral head is accurate?

    <p>The upper part of the neck of the femur has a rich blood supply from the medial femoral circumflex artery.</p> Signup and view all the answers

    What is the consequence of a fracture in the neck of the femur?

    <p>It can cause avascular necrosis of the head of the femur.</p> Signup and view all the answers

    Where can the part of the head of the femur that is not intra-acetabular be palpated?

    <p>Just inferior to the inguinal ligament and lateral to the femoral artery</p> Signup and view all the answers

    Which of the following statements is true regarding blood flow after the epiphyseal cartilage disappears in adults?

    <p>There is an established anastomosis between the two sources of blood supply.</p> Signup and view all the answers

    What complicates the blood supply to the head of the femur in the event of a fracture?

    <p>Disruption of blood flow from the medial femoral circumflex artery.</p> Signup and view all the answers

    Which artery is primarily responsible for supplying the head of the femur?

    <p>Medial femoral circumflex artery</p> Signup and view all the answers

    What is the role of the round ligament in relation to blood supply?

    <p>It carries a small artery that may supply the head of the femur.</p> Signup and view all the answers

    Which aspect of the hip joint is indicated by the presence of tenderness in specific areas?

    <p>Points towards arthritis in the hip joint.</p> Signup and view all the answers

    What is the primary concern regarding avascular necrosis following a femoral neck fracture?

    <p>The blood supply might be permanently compromised.</p> Signup and view all the answers

    Study Notes

    Sciatic Nerve

    • The sciatic nerve is the largest nerve in the body
    • The sciatic nerve originates from the sacral plexus, specifically L4, L5, S1, S2, and S3
    • The sciatic nerve emerges from the pelvis through the greater sciatic foramen
    • It travels down the back of the thigh and branches into the tibial and common fibular nerves
    • The sciatic nerve typically does not have branches in the gluteal region
    • The sciatic nerve supplies the skin on the back of the thigh
    • The sciatic nerve supplies the skin of the posterior lower leg
    • The sciatic nerve provides motor innervation to various muscles, including the biceps femoris (long head), semitendinosus, and semimembranosus

    Common Fibular (Peroneal) Nerve

    • The common fibular (peroneal) nerve is a branch of the sciatic nerve.
    • The common fibular nerve branches into the superficial and deep fibular nerves
    • The common fibular nerve supplies the skin in the popliteal fossa
    • The common fibular nerve supplies the skin of the lateral side of the foot
    • The common fibular nerve provides motor innervation to muscles involved in foot dorsiflexion and eversion, including the fibularis longus and fibularis brevis

    Tibial Nerve

    • The tibial nerve is a branch of the sciatic nerve.
    • The tibial nerve supplies the skin of the sole of the foot and the ankle
    • The tibial nerve provides motor innervation to muscles involved in plantar flexion and foot inversion, including the gastrocnemius, soleus, tibialis posterior, flexor digitorum longus, and flexor hallucis longus.

    Superior Gluteal Nerve

    • The superior gluteal nerve leaves the pelvis through the greater sciatic foramen, superior to the piriformis muscle.
    • The superior gluteal nerve supplies the gluteus medius and minimus muscles
    • The superior gluteal nerve also supplies the tensor fascia latae muscle

    Inferior Gluteal Nerve

    • The inferior gluteal nerve leaves the pelvis through the greater sciatic foramen, inferior to the piriformis muscle.
    • The inferior gluteal nerve supplies the gluteus maximus muscle.

    Trochanteric Anastomosis

    • The trochanteric anastomosis is a network of arteries that provide blood supply to the head of the femur.
    • It is formed by several arteries, including the superior gluteal artery, inferior gluteal artery, medial femoral circumflex artery, and lateral femoral circumflex artery.

    Cruciate Anastomosis

    • The cruciate anastomosis is located near the lesser trochanter of the femur.
    • The cruciate anastomosis, along with the trochanteric anastomosis, connects the internal iliac and femoral arteries.

    Posterior Cutaneous Nerve of the Thigh

    • The posterior cutaneous nerve of the thigh emerges from the gluteal region through the lower part of the greater sciatic foramen.
    • The posterior cutaneous nerve of the thigh travels on the back of the thigh and pierces the deep fascia in the popliteal fossa.
    • The posterior cutaneous nerve of the thigh supplies the skin on the back of the thigh and the upper part of the leg.
    • It has gluteal branches supplying the lower, medial quadrant of the buttock.
    • It has perineal branches supplying the skin of the back of the scrotum or labium majus.

    Superficial Veins of the Leg

    • The superficial veins of the leg are the great and small saphenous veins and their tributaries.
    • They are comparable to the basilic and cephalic veins of the upper limb.
    • They have clinical significance.

    Obturator Internus

    • The obturator internus muscle originates within the pelvis and exits through the lesser sciatic foramen to enter the gluteal region.
    • Its tendon is joined by the superior and inferior gemellus muscles.
    • The obturator internus, along with the superior and inferior gemellus muscles, inserts onto the greater trochanter of the femur.
    • The obturator internus has three associated bursae, which act as cushions between tendons, the greater trochanter, and the vastus lateralis.

    Lower Limb Functions

    • Primary functions: support body weight and locomotion.
    • Stability provided by hip bones articulating with the trunk via strong sacroiliac joints and with each other via the symphysis pubis.
    • Foundation for: standing, walking, and running.

    Lower Limb Organization

    • Divided into regions: thigh, hip, popliteal fossa, leg, ankle, and foot.
    • Compartmentalized thigh and leg: each compartment contains muscles with specific functions, innervations, and blood supply.

    Bone Anatomy

    • Os Coxae (Hip Bone): equivalent of the upper limb clavicle and scapula.

      • Forms the lower limb girdle, connecting the limb to the vertebral column.
      • Consists of three elements: ilium, ischium, and pubis.
      • Acetabulum: deep depression that articulates with the femoral head to form the hip joint.
      • Acetabular notch: inferior margin deficiency of the acetabulum.
      • Acetabular fossa: non-articular floor of the acetabulum.

    • Femur: longest and strongest bone in the body.

      • Head: spherical, articulates with the acetabulum.
      • Shaft: diaphysis of the femur, contains the linea aspera (rough ridge).
      • Lateral and medial condyles: distal end of the femur, part of the knee joint.
      • Intercondylar notch: posterior separation of the condyles.
      • Patellar surface: anterior articular surface between the condyles.
      • Medial and lateral epicondyles: above the condyles.
      • Adductor tubercle: continuous with the medial epicondyle.

    Lower Limb Lymphatics

    • Inguinal lymph nodes: divided into superficial and deep groups.

      • Superficial inguinal lymph nodes: located in the superficial fascia below the inguinal ligament.
        • Horizontal group: receives superficial lymph vessels from anterior abdominal wall, perineum, urethra, and external genitalia.
        • Vertical group: receives superficial lymph vessels from the lower limb.
      • Deep inguinal lymph nodes: located beneath the deep fascia along the medial side of the femoral vein.
        • Receive lymph from superficial inguinal nodes.
        • Efferent vessels pass through the femoral canal to lymph nodes along the external iliac artery.

    Lower Limb Compartments

    • Thigh: compartmentalized into anterior, medial, and posterior compartments.
      • Anterior compartment:
        • Muscles: Sartorius, iliopsoas, pectineus, and quadriceps femoris.
        • Blood supply: Femoral artery.
        • Nerve supply: Femoral nerve.

    Muscles of the Anterior Fascial Compartment of the Thigh

    • Sartorius: anterior and superior iliac spines to upper, medial surface of the tibial shaft. Action: flexes, abducts, and laterally rotates thigh at the hip; flexes and medially rotates leg at the knee joint.
    • Iliacus: iliac fossa to lesser trochanter of femur. Action: flexes thigh on trunk; if thigh is fixed, it flexes the trunk on the thigh.
    • Psoas Major: transverse process of lumbar vertebrae to lesser trochanter of femur. Action: flexes thigh on trunk.

    Gluteal Region

    • The Gluteal Region is located at the back of the pelvis, containing various muscles, vessels, and nerves.
    • Muscles:
      • Gluteus Maximus: Largest muscle, used for hip extension, and lateral rotation
      • Gluteus Medius: Abducts and medially rotates femur at the hip joint
      • Gluteus Minimus: Abducts and medially rotates femur at the hip joint
      • Piriformis: Externally rotates the thigh and abducts the lower limb
      • Obturator Internus: Externally rotates thigh, and assists in abduction
      • Superior gemellus: Externally rotates thigh, and assists in abduction
      • Inferior gemellus: Externally rotates thigh, and assists in abduction
      • Quadratus femoris: Externally rotates thigh
    • Nerves:
      • Superior gluteal nerve: Innervates Gluteus Medius, Gluteus Minimus, and Tensor Fasciae Latae muscles
      • Inferior gluteal nerve: Innervates Gluteus Maximus muscle
      • Sciatic Nerve: The largest nerve in the body comprised of the tibial and common fibular nerves. It controls leg movements and sensation.
    • Vessels:
      • Superior Gluteal Artery and Vein: Supply blood to the upper gluteal region
      • Inferior Gluteal Artery and Vein: Supply blood to the lower gluteal region
      • Internal pudendal artery and vein: Supply blood to the perineum and external genitalia
    • Popliteal Fossa: Located behind the knee, containing the popliteal artery, vein, nerve, and lymph nodes.
      • Popliteal Artery: Supplies blood to the posterior compartment of the thigh
      • Popliteal Vein: Drains blood from the posterior compartment of the thigh
      • Popliteal Nerve: Supplies sensation and motor control to the back of the lower leg
      • Popliteal lymph nodes: Filter lymph from the leg and foot

    Thigh

    • Fascia: A sheath of connective tissue encompassing the thigh muscles
    • Cutaneous Nerves: Provide sensation to the skin of the thigh
      • Femoral Nerve: Provides sensation to the anterior and medial thigh
      • Saphenous Nerve: Supplies sensation to the skin of the medial leg and ankle
      • Obtruator Nerve: Supplies sensation to the medial aspect of the thigh
    • Superficial Veins:
      • Great Saphenous Vein: The longest vein in the body, located on the medial surface of the leg and thigh.
      • Small Saphenous Vein: Begins on the lateral side of the foot and joins the popliteal vein behind the knee.
    • Inguinal Lymph Nodes: Located in the groin, and drain lymph from the lower limb, anterior abdominal wall, perineum, and external genitalia.

    Leg

    • Fascia: A dense sheath of connective tissue surrounding the muscles of the leg.
    • Compartments:
      • Anterior Compartment: Contains muscles that dorsiflex the foot and extend the toes.
        • Muscles: Tibialis Anterior, Extensor Digitorum Longus, Extensor Hallucis Longus, Peroneus Tertius
        • Nerve: Deep Peroneal Nerve (Fibular Nerve)
      • Lateral Compartment: Controls eversion and plantarflexion of the foot.
        • Muscles: Peroneus Longus, Peroneus Brevis
        • Nerve: Superficial Peroneal Nerve
      • Posterior Compartment: Contains muscles that plantarflex the foot, flex the toes, and invert the foot.
        • Muscles: Gastrocnemius, Soleus, Plantaris, Popliteus, Tibialis Posterior, Flexor Digitorum Longus, Flexor Hallucis Longus
        • Nerve: Tibial Nerve
    • Cutaneous Nerves:
      • Saphenous Nerve: Provides sensation to the medial side of the leg and ankle
      • Sural Nerve: Supplies sensation to the lateral side of the ankle
      • Superficial Peroneal Nerve: Provides sensation to the anterior and lateral surfaces of the leg, ankle, and foot.
    • Superficial Veins:
      • Great Saphenous Vein: Drains blood from the medial side of the leg and thigh.
      • Small Saphenous Vein: Drains blood from the lateral side of the foot and leg.
    • Foot Bones:
      • Tarsals: Seven tarsal bones forming the rear section of the foot: Calcaneus, Talus, Navicular, Cuboid, Lateral cuneiform, Intermediate cuneiform, Medial cuneiform.
      • Metatarsals: Five metatarsal bones forming the midfoot that connect to the phalanges.
      • Phalanges: 14 phalanges, 2 in the big toe and 3 in each of the other toes.
    • Joints:
      • Ankle Joint: A hinge joint made up of the distal ends of the tibia and fibula and the talus bone.
        • Movements: Dorsiflexion, Plantarflexion
      • Subtalar Joint: A joint between the talus and calcaneus bones, allowing for inversion and eversion movements.
      • Transverse Tarsal Joint: A joint between the talus and calcaneus bones and the navicular and cuboid bones. Allows for pronation and supination.
      • Tarsometatarsal Joint: Connects the tarsal and metatarsal bones, important for stability and foot mechanics.
      • Metatarsophalangeal Joints: Joints between the metatarsals and phalanges, allowing for flexion, extension, abduction, and adduction of the toes.
      • Interphalangeal Joints: Joints between the phalanges, allowing for flexion and extension of the toes.
    • Arches:
      • Medial Longitudinal Arch: Provides support and shock absorption, runs along the medial side of the foot.
      • Lateral Longitudinal Arch: Supports plantar flexion, lies along the lateral side of the foot.
      • Transverse Arch: Runs across the midfoot and helps to distribute weight evenly across the plantar surface.
    • Muscles:
      • Intrinsic Muscles: Muscles that originate and insert within the foot, and control the fine movements of the toes and foot.
        • Dorsal Interossei: Abduct the toes
        • Plantar Interossei: Adduct the toes
        • Lumbricals: Flex the metatarsophalangeal joint and extend the interphalangeal joints.
      • Extrinsic Muscles: Muscles that originate in the leg and insert into the foot. They control the larger movements of the foot, such as dorsiflexion, plantarflexion, inversion, and eversion.
    • Ligaments:
      • Ligaments of the foot provide support and stability to the foot.
      • Dorsal ligaments: Provide stability and support to the dorsal aspect of the foot (top), preventing excessive plantarflexion. Examples: Dorsiflexion ligaments
      • Plantar ligaments: Provide stability and support to the plantar aspect of the foot (bottom), preventing excessive dorsiflexion. Examples: Plantar ligaments
      • Medial ligaments: Support the medial aspect of the foot, preventing excessive inversion. Examples: Deltoid ligaments
      • Lateral ligaments: Support the lateral aspect of the foot, preventing excessive eversion. Examples: Lateral ligaments

    Femoral Triangle

    • Located in the upper thigh, bordered by the inguinal ligament, sartorius muscle, and adductor longus muscle
    • Contents:
      • Femoral Nerve
      • Femoral Artery
      • Femoral Vein
      • Deep inguinal lymph nodes

    Adductor Canal

    • A narrow muscular-fascial space located in the medial thigh
    • Boundaries:
      • Sartorius muscle
      • Vastus medialis muscle
      • Adductor longus and magnus muscles
    • Contents:
      • Femoral artery and vein
      • Saphenous nerve
      • Deep inguinal lymph nodes

    Clinical Notes:

    • Vein Cutdown: A procedure where a vein is surgically accessed to administer fluids or medications, usually performed on the great saphenous vein near the medial malleolus.
    • Varicose Veins: Enlarged and tortuous veins, typically caused by weak vein walls, incompetent valves, or high venous pressure.
    • Lymphatic Drainage: The lymphatic system helps to filter and drain waste products from the body. The inguinal lymph nodes are a major drainage site for the lower limb, the anterior abdominal wall, and the external genitalia.
    • Ankle Vein Cutdown: A procedure used to administer fluids or medications. The great saphenous vein is accessed near the medial malleolus.
    • Varicose Veins: Enlarged and tortuous veins, often in the lower limbs, can be caused by weakened vein walls, valves, or high venous pressure.
    • Femoral Sheath and Femoral Ring: The femoral sheath is a fascial compartment that contains the femoral artery, vein, and nerve. The femoral ring is the opening in the femoral sheath, through which structures can pass into the thigh.
    • Femoral Canal: A small passageway through the femoral sheath, containing the femoral artery, vein, and lymphatic vessels.
    • Lower Limb Lymphatics: The lower limb is drained by both superficial and deep lymphatic vessels, which ultimately connect to the inguinal lymph nodes.
    • Sacral Plexus: A network of nerves that arises from the spinal cord in the sacral region, responsible for providing innervation to the lower limb, pelvis, and perineum.
    • Lower Limb Muscles: The muscles of the lower limb are responsible for movement, stability, and support; divided into anterior, lateral, and posterior compartments within the thigh and leg.
    • Foot Arches: The foot has three arches: the medial longitudinal arch, the lateral longitudinal arch, and the transverse arch. These arches are critical for shock absorption, weight distribution, and locomotion.
    • Knee Joint: A complex hinge joint consisting of the femur, tibia, and patella.
    • Hip Joint: A ball-and-socket joint between the femur and the acetabulum of the pelvis.
    • Ankle Joint: A hinge joint formed by the tibia, fibula, and talus. It allows for dorsiflexion, plantarflexion, inversion, and eversion.
    • Radiographic Anatomy: The anatomical features of the bones of the lower limb can be identified on radiographic images.
    • Surface Anatomy: Key anatomical landmarks of the lower limb can be located through palpation. The gluteal fold, the greater trochanter, the femoral triangle, the adductor canal, the patella, the medial malleolus, the lateral malleolus, and the Achilles tendon are examples of palpable landmarks.

    Os Coxae

    • The os coxae (hip bone) is comprised of three skeletal elements: the ilium, ischium, and pubis.
    • The ilium is the upper flattened part of the bone and possesses the iliac crest, which can be felt through the skin along its entire length.

    Femur

    • The femur articulates with the acetabulum to form the hip joint, and with the tibia and patella to form the knee joint.
    • The upper end of the femur has a head, a neck, and greater and lesser trochanters.
    • The head of the femur receives a blood supply from the medial femoral circumflex artery, which pierces the joint capsule.
    • Fractures of the femoral neck can interrupt the blood supply to the femoral head, which can lead to avascular necrosis.

    Sciatic Nerve

    • The sciatic nerve originates from the sacral plexus, which is formed by the ventral rami of spinal nerves L4, L5, S1, S2, and S3.
    • The sciatic nerve passes through the greater sciatic foramen and divides into the tibial and common fibular branches.
    • The common fibular nerve divides into the superficial fibular and deep fibular nerves.
    • The superficial fibular nerve innervates the muscles that dorsiflex the foot and evert the ankle, and the skin of the lateral side of the foot and the little toe.
    • The deep fibular nerve innervates the muscles that dorsiflex the foot and plantarflex the ankle, and the skin of the dorsum of the foot.

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    Snell's Clinical Anatomy Lower Limb Chapter 11 PDF

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    This quiz will test your knowledge of the sciatic nerve and its branches, including the common fibular nerve. Learn about the anatomy, functions, and innervation provided by these critical nerves. Challenge yourself and deepen your understanding of the nervous system.

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