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HFD Exam 2_ Lower Limb

Terms in this set (42)

difference between bioed humands and quadrupedal animals
femur in human is oblique in the thigh going more lateral to medial so body weight is returned tot he central line just belwo the trunk
muscles that are working when in anatomical position
erector spinae muscles
iliopsoas
plantar flexors (across knee joint)
significance of the angle of inclination
angle between the head of the femur and the shaft of the femur
typically called the angle of inclination and allows the oblique position of the femur in the thigh which is normally greater the younger you are and gets smaller with age

average "normal" angle is 126 degrees
coxa vera
angle of inclination between the head and shaft of the femur is smaller than normal
coxa valga
angle of inclination between head and shaft of the femur is greater than normal
angle of declination
also known as the torsion angle
it is the angle between the axis of the neck of the femur and the axis of the two condyles
in female average is 12 degrees and male it is 7 degrees
toeing - in
when the angle of declination is too big
toeing - out
when the angle of declination is too small
three common femoral fractures
transcervical fracture of femoral neck (called hip fracture)
intertrochanteric fracture
spiral fracture
anatomical vs. functional divisions of the foot
midfoot anatomically is just the metatarsals and the midfoot functionally is metatarsals + 5 of the tarsal bones
3 of phalanges in the toes
2 in the big toe and 3 in the lateral 4 toes
regions of deep fascia
fascia lata = on the thigh
popliteal fascia = deep fascia on posterior aspect of hte knee joint
crural fascia = deep fascia of the leg (lower leg)
deep fascia of the foot

all continuous with the scarpa's fascia
intermuscular septa
fibers running between the deep fascia and either the femur or fibula that divide the leg into different compartments
retinaculum
thickening of the deep fascia along the ankle joint where the tendons of the big muscles come across the ankle joint
fascial compartments of the thigh
anterior, medial and posterior created by the intermuscular septa attaching to the lineal aspera of the femur
fascial compartments of the thigh
anterior, lateral, medial, posterior
transverse intermuscular septum
divides the posterior compartment of the leg into deep and superficial
compartment syndromes
because the compartments of the lower limbs are completely closed off and unable to communicate with things outside of the compartment, if there is trauma or inflammation within the compartments it can't leave which causes increased intracompartmental pressure; this can compresses neurovascular structures and cause these structures to become ischemic and permanently injure distal structures

in the most serious cases a fasciotomy is done to open the compartment
venae comitantes
deep veins of the lower limbs that are paired, interconnecting veins accompanying the arteries of the lower limb and the pairs interconnect with each other and surround the artery and have communicating branches to the superficial veins
significance of the venae comitants
present in upper and lower limbs - when it is cold limbs get cold easily and the venous blood get cold but don't want cold blood to go to the heart so the arteries work as a warming system and warm the blood in the veins before it returns back to the heart
superficial veins of the lower limb
on the anterior aspect you have the great saphenous vein and on the posterior aspect you have the small saphenous vein
characteristics of the great saphenous vein
accompanied by the saphenous nerve
has 10-12 venous valves that prevent reflux
sometimes has an accessory saphenous vein
use this vein for graft when doing coronary arterial bypass
nerve with the small saphenous vein
sural nerve
perforating veins
how the superificial veins communicate with the deep veins of the lower limb
valvular incompetence
happens in the superficial valves when the valves aren't working and causes varicose veins
saphenous opening
called the fascia ovalis
a hiatus in the fascia lata (deep fascia of the thigh) just inferior to the inguinal ligament where a femoral hernia can occur

has a falciform margin: sharp crescentic lateral and inferior margin of the opening

and covered by cribriform fascia which is a fibrofatty tissue covering and closing the saphenous opening from its medial margin
Illiotibial Tract
(IT Band) which is a thick band of fascia lata on the lateral aspect of the thigh
extends from iliac tubercle and attaches to the anterolateral tibial tubercle called Gerdy's Tubercle
is basically a double layer of fascia lata that serves as an aponeurosis for the tensor of fascia lata and gluteus maximus
stabilized the lateral hip and knee
characteristics of the muscles of the anterior compartment of the thigh
extensors of the knee, some flexors of the hip and are innervated by the femoral nerve
biarticular muscles
muscles that cross two joints
monoarticular muscles
muscles that cross a single joint
muscles of the anterior compartment of the thigh
sartorius, quadriceps femoris (rectus femoris, vastus lateralis, vastus medialis, vastus intermedius), iliopsoas and pectineus (which also could be listed as part of the medial compartment)
sartorius - origin, insertion, innervation and action
"Tailors Muscle" "indian-style muscle"
origin = ASIS
Insertion = superior part of medial aspect of the tibia
innervated by femoral nerve
flexes, abducts, and laterally rotates the thigh and flexes leg at knee
(think about what your leg does to sit indian style)
rectus femoris
part of the quadriceps femoris which is the kicking muscle
origin is AIIS and then becomes tendinous fibers that become the quadriceps tendon that crosses over the patella and is continuous with the patellar ligament that terminates at the tibial tuberosity
steadies hip joints and flexes the thigh
three portions of vastus
all part of the quadriceps femoris
medialis, intermedius and lateralis that all originate at the intertrochanteric line (meaning they are not involved with the hip joint) and then cross knee joint as lateral and medial patellar retinaculum
extends leg at knee
Hip pointer
contusion of the sartorius at ASIS
patellar tendon reflex
tests the function of femoral nerve and spinal segments L2-L4
hit patellar tendon and it sends sensory fiber info to L2-L4 and from there the sensory fiber in the posterior horn are going to synapse on the motor neurons on the ventral horn of spinal cord which then send motor info to the quadriceps femoris muscles and produce contraction
increased lumbar lordosis
caused by tightness and shortness of the iliopsoas muscle since this muscle is involved with posture
action of the iliopsoas muscle
flexes the thigh, stabilizes the hip joint, postural muscle, control deviation of the trunk and is active during standing
muscle with duel innervation and duel function
pectineus muscle
innervated by femoral nerve and obturator nerve
adduction of thigh and flexes the thigh
transitional muscle so can be considered anterior or medial
IT Band Syndrome
when on one side your IT band becomes shortened (Running on uneven pavement) and it clicks on your Gerdy's Tubercel
significance of the piriformis location
goes from anterior part of the sacrum to the greater trochanter and splits the greater sciatic foramen in half into suprapiriformis region and infrapiriformis region
superior border of the piriformis would mark the path between the PSIS and the greater trochanter and above this = safe zone of the gluteal region
so suprapiriformis region = safe zone
Piriformis Muscle Syndrome
piriformis muscle is compressing the sciatic nerve, could be due to multiple reasons, and this is an under diagnosed cause of sciatica
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