nerve and blood lower limb ha11308
Terms in this set (15)
Describe the course of major lower limb arteries
abdominal aorta gives branches to righ and left common illiac
the common iliac continues to become internal iliac (hypogastic) and external illiac - Gluteal
the external illiac becomes the Femoral - thigh
the femoral artery curves around the back, and gives off the popliteal brunch which comes around the front - Knee
Past the knee the femoral artery divides into the tibial - lower leg and peroneal artery - ankle
the peroneal artery gives off to dosalis pedis arteries
and the tibial give off the plantar arteries
dermatomes of the lower limb
L1 spells 1nguinaL
L3 - medial knee
Stand on S1
Lie on S2
Sit (pee) on S3
branches of the lumbar plexus
lateral femoral: skins covering the thigh
femoral - calf muscles
obturator - medial thigh and abductor muscle
branches of the sacral plexus
pudendal: pubic floor muscles, genitals, and is the target for nerve block during labor
limb innervations- name the 9 nerves and their innervation
1. (Lateral)Femoral Cutaneous- yellow
2. (Anterior) Femoral Cutaneous - black
3. (Posterior) Femoral Cutaneous - pink
4. Obturator - whitish blue
5. Saphenous - green
6. Sural - red
7. Common peroneal - dark blue
8. Superficial peroneal - light blue
(between big toe, dark blue area, deep peroneal)
9. Tibial (L/M plantar) - orange
nerve supply - femoral nerve
nerve supply- sciatic nerve
what is the symptom of common peroneal nerve damage
causes, sever adduction, pressure from cast, as the common peroneal nerve winds around the head of fibula
how would one test for femoral nerve damage
Straight leg raise (A-C)
how would one test for sciatic nerve damage
how do we test for malingeres (those that exaggerate/fabricating symptoms)
Straight leg & "bowstring" tests (tibial n.)
Apply firm pressure over nearest hamstring tendon, popliteal fossa, & furthest hamstring tendon.
Ask which causes most pain.
Test is +ve if 2nd manouvre is painful & radiated to back
flip test - for malingeres
Get patient to sit as shown
Extend knee as if to test Achilles reflex (equivalent of straight leg raise)
In malingerers this will not cause pain as they are distracted by reflex test
True patients with root pain "flip" back to relieve the root tension.
venous supply of the lower limb
the saphenous veins are the superfical veins. the greater one is medial and the lesser one is lateral.
the deep veins originated drains into the external iliac vein, from the posterior and anterial tibial vein
Superficial veins have numerous perforating veins that connect with the deep veins
name the places where the greater and lesser saphenous vein makes conection with deeper veins
great saphenous - femoral vein
short saphenous - popliteal vein
describe the mechanism that underlies venous return to the heart
1. Respiratory pump: negative pressure in the thorax.
(Inhalation causes diaphragm to depress into abdominal cavity causing increased pressure compared to thoracic cavity.
This creates a pressure gradient that draws blood up against gravity towards the heart as pressure in abdominal veins compared to thoracic veins.
When pressures reverse on exhalation valves prevent backflow of blood)
2) Venous Valves - flow in one direction
3) Calf muscle pump - only when leg is active
Gastrocnemius, Soleus, Achilles tendon.
(Both valves open & blood flows towards heart as pressure is greater distally.
Heel rise, calf squeezes blood towards heart. Prox. valve forced open, distal valve shuts.
Muscle relaxes, pressure falls in previously compressed part of vein so proximal valve shuts. Distal valve reopens as pressure is greater in foot drawing blood up)
YOU MIGHT ALSO LIKE...
Vascular Class #14
Chapter 5: Venous Anatomy and Hemodynamics
A & P II- Chapter 21 Vessels
OTHER SETS BY THIS CREATOR
Lower Quarter Dermatome Testing L2 - S5
Nerve Stimulation- Brachial Plexus
Oxyhemoglobin Dissociation Curve
THIS SET IS OFTEN IN FOLDERS WITH...
Laws in Anesthesia
Common pKa Values