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Lower Limb 1&2
MSK
| Question | Answer |
|---|---|
| • Ball and socket joint • Pelvic bone and femur | Hip joint |
| • Hinge joint • Femur, tibia, patella • Tibia and fibula linked by interosseous membrane | Knee joint |
| • Hinge joint • Tibia, fibula and tarsal bone | Ankle joint |
| • Anterior to the edge of the SV2 vertebra in the pelvis • Anterior to the knee and ankle joints • Directly over the support base formed by the feet on the ground | center of gravity |
| heel strike to heel strike | Gait cycle |
| • Stance: 60% • Swing: 40% | Phases of gait |
| Head of the femur is covered with | articular cartilage |
| • Partially covered with cartilage • Deepened by fibrocartilage | Acetabulum |
| • Surrounded by a capsule: • Proximally attaching to the acetabulum • Distally attaching to the femoral neck | Femur head |
| Oriented in a spiral fashion, becomes taut when joint is extended • Ilio-femoral ligament: AIIS to intertrochanteric line & prevents hyperextension • Pubo-femoral ligament: pubic bone to femur • Ischio-femoral ligament: Ischium to femur | Ligaments of the Joint Capsule |
| Blood to hip • Branches of medial and lateral circumflex arteries • Inferior gluteal artery • Branch of the superior gluteal | Trochanteric anastomosis |
| Blood supply to hip • Branches medial and lateral circumflex arteries • Branch of 1st perforating branch of profunda femoris artery • Branch of inferior gluteal artery | Cruciate anastomosis |
| Blood to femur head • Medial and lateral circumflex femoral arteries gives rise to | Retinacular branches |
| Blood supply to femur head • Arises as a branch from the obturator artery • Located in the ligament of head of femur • Decreased or absent as you get older | Acetabular branch of obturator artery |
| • damages the retinacular arteries • compromises blood supply to the head of femur • risk of avascular necrosis | Intra-capsular – fracture of the femoral neck |
| • does not affect blood supply to the head of femur | Extra-capsular – intertrochanteric fracture |
| Common in individuals > 60 years old Displaced intra and extracapsular fractures can result in shortening and external rotation of the leg | Proximal Femoral Fractures |
| Normal: 120-135 Coxa vara: <120 Coxa valga: >135 | Femoral Neck Anomalies |
| fracture caused a decrease in the angle, thus creating a shorter right limb. This decrease in angle between neck and shaft is called | acquired coxa vara |
| lies posterolateral to the bony pelvis and proximal end of the femur | Gluteal Region |
| • piriformis • gemellus superior • obturator internus • gemellus inferior • quadratus femoris | Gluteal Region Lateral rotators |
| gluteus maximus | Gluteal Region extensor |
| • gluteus medius • gluteus minimus | Gluteal Region Abductors and medial rotators |
| branches of sacral plexus | Gluteal Region MOTOR & SENSORY INNERVATION |
| greater and lesser sciatic foramen | Gluteal Region OPENINGS |
| branches of internal iliac | Gluteal Region BLOOD SUPPLY |
| • Superior gluteal nerve • Abducts thigh/hip joint • Stabilizes the knee in extension | Tensor fasciae lata |
| • Inferior gluteal nerve • Extends the flexed thigh/hip joint • Lateral stabilizer of the hip and knee • Abducts and assists in lateral rotation of thigh/ hip joint | Gluteus maximus |
| • Abductsand medially rotates the thigh/hip joint • Prevents excessive downward tilt of the opposite pelvis during its swing phase | Gluteus medius & minimus |
| on the stance leg (weight bearing limb) prevents excessive downward tilt of the opposite, unsupported pelvis during its swing phase | Contraction of the gluteus medius and minimus |
| if the superior gluteal nerve is injured, the pelvis on the unsupported side drops when the patient is asked to stand on the affected limb • Waddling gait | Positive Trendelenburg sign |
| • Nerve to piriformis (S1 & S2) • lateral rotator of the thigh/hip joint • abducts flexed thigh/hip joint | Piriformis |
| • Nerve to quadratus femoris • lateral rotator of the thigh/hip joint • abducts flexed thigh/hip joint | Inferior gemellus |
| • Nerve to quadratus femoris • lateral rotator of the thigh/hip joint | Quadratus femoris |
| • Nerve to obturator internus • lateral rotator of the thigh/hip joint • abductsflexed thigh/hip joint | Superior gemellus |
| • Nerve to obturator internus • lateral rotator of the thigh/hip joint • abductsflexed thigh/hip joint | Obturator internus |
| Safest place: btw iliac crest and ASIS | Gluteal Intramuscular Injection |
| 1. Superior clunial nerve (dorsal rami L1-3) 2. Medial clunial nerve (dorsal rami S1-S3) 3. Inferior clunial nerve (ventral rami S1-3 - ascending branches from the posterior femoral cutaneous nerve) 4. Iliohypogastric nerve | Cutaneous innervation of the gluteal region |
| Branches of the inferior gluteal, superior gluteal, obturator and femoral arteries, interconnect to form an anastomotic network giving blood supply to the | Gluteal Region Blood |
| • Loose connective tissue • Fat • Cutaneous nerves • Superficial veins • Blood supply to the skin • Lymphatic vessels and lymph nodes | Superficial fascia |
Created by:
Zariea
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