lower limb questions adam smith. what structures are within the femoral triangle? femoral nerve,...
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Lower limb questionsADAM SMITH
What structures are within the femoral triangle?
Femoral nerve, artery and vein
Nerve most laterally
Mid-inguinal point +/- 1.5cm = artery
How do you find the mid-inguinal point?
Half way between ASIS and pubic tubercle
What passes through the lesser sciatic foramen?
Pudendal nerve
Internal pudendal vessels
Nerve to obturator internus
Which structures pass through the greater sciatic foramen?
Piriformis
Superior gluteal artery nerve and vein
Sciatic nerve, inferior gluteal nerve artery vein, pudendal nerve, inferior pudendal artery and vein, posterior femoral cutaneous nerve, nerves to lateral rotators
What contributes to hip joint stability?
Acetabular labrum
Ligaments – ischiofemoral, iliofemoral, pubofemoral, ligamentum teres
Why can avascular necrosis of the femoral head occur?
Interruption to blood supply due to fractured neck of femur
Leaves only branch from obturator artery (through ligamentum teres), as lateral and medial circumflex (femoral branches) and nutrient artery move proximally
What structures are in the popliteal fossa?
Popliteal artery is deep, popliteal vein, tibial nerve is superficial. Common fibular nerve is lateral
What structures run behind the medial malleolus?
Tarsal Tunnel
Tibialis posterior, flexor digitorum longus, posterior tibial artery, tibial nerve, flexor hallucis longus
What is the lymphatic drainage of the lower limb?
Superficial inguinal nodes
Deep inguinal nodes
External iliac nodes
Para-aortic nodes
Which blood vessel from the leg is commonly used in CABG?
Great saphenous vein
RTC where 1 car hits the other from the driver’s side, the driver is unable to dorsiflex, why?
Damage to common fibular nerve as it is compressed against head of fibular
What is housemaid’s knee? What is clergyman’s knee?
Pre-patellar bursitis
Infra-patellar bursitis
What is a valgus deformity of the knee?
Distal part of the joint is angled laterally
What does ACL do and how is it injured?
Prevents anterior movement of the tibia on the femur
Hyperextension or medial rotation of femoral condyles on the tibial plateau
May be contact causing hyperextension or valgus stress on the knee or non contact, classically sudden deceleration and pivoting movement whilst running (causing valgus stress)
What are the pulses of the lower limb? Femoral pulse
Mid-inguinal point
Popliteal pulse
Popliteal fossa, medial side, artery deepest structure in fossa so push hard
Posterior tibial pulse
Located posterior and inferior to medial malleolus
Dorsalis pedis pulse
Dorsum of foot, between tendons of extensor hallucis longus and extensor digitorum longus to second toe
Dorsalis pedis artery from anterior tibial artery
What are the reflexes of the lower limb?
S1,2 Achilles
L3,4 Patella
What is compartment syndrome? And why is it dangerous?
Increased pressure within a fascial compartment due to increased fluid
Often follows acute trauma, can be chronic
Signs
Pallor
Pulselessness
Parasthesia
Paralysis
Pain
Perishingly cold
Ischaemic injury to compartment and distal structures
Which side of the ankle is more likely to suffer a sprain?
Lateral as the lateral collateral ligament is weaker
What strucutres hold tedons to the ankle?
Flexor retinaculum
Extensor retinaculae – superior and inferior