Anatomy Limbs 8 - Review of Lower limb nerves and Vessels Flashcards Preview

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Flashcards in Anatomy Limbs 8 - Review of Lower limb nerves and Vessels Deck (58)
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1
Q

How many C,T,L,S,C vertebrae are there

A
7C
12T
5L
5S
1C
2
Q

C1-4 innervates?

A

Neck

3
Q

C5-T1 innervates?

A

Upper limb

4
Q

T2-L1 innervates?

A

Trunk

5
Q

L2-S3 innervates?

A

Lower limb

6
Q

S2-C1 innervates?

A

Perineum

7
Q

Which nerve supplies the anterior compartment of the thigh?

A

Femoral n

It passes under the inguinal ligament

8
Q

Which nerve supplies the medial (/adductor) compartment of the thigh?

A

Obturator nerve

Passes through the obturator foramen

9
Q

Which nerve supplies the posterior thigh, posterior & anterior foot and leg?

A

Sciatic nerve (which gives off tibial and common peroneal branches)

10
Q

Why is piriformis an important muscle to remember?

A

Superior gluteal nerve passes above it and inferior gluteal nerve passes below it

Sciatic nerve and posterior cutaneous nerve of the thigh emerge inferiorly also

11
Q

When does the tibial nerve split off?

A

Just before it enters the popliteal fossa

12
Q

Where is the common peroneal nerve susceptible to damage?

A

Common peroneal nerve continues superiorly and It wraps around the head of the fibula - there

13
Q

Tibial nerve supplies?

A

Posterior part of the leg

14
Q

What does the tibial nerve divide into?

A

Medial and lateral plantar nerves

15
Q

The common peroneal artery divides to give 2 branches, what are they and what do they supply?

A

Deep peroneal nerve - anterior muscles of the leg

Superficial peroneal nerve - lateral muscles of the leg

16
Q

Where does the saphenous nerve come from and what does it do?

A

It branches off the femoral nerve and supplies part of the leg and the medial side of the foot

17
Q

Which spinal nerves form femoral nerve

A

L234 (posterior fibres)

18
Q

Aside from anterior thigh, what other muscle does femoral nerve supply?

A

Iliopsoas

19
Q

Which spinal nerves form obturator nerve?

A

L234 (anterior fibres)

20
Q

Which spinal nerves for sciatic nerve?

A

L345 S123 (ant. and post. fibres)

21
Q

Which spinal nerves form the superior gluteal nerve?

A

L45S1

22
Q

What muscles does the superior gluteal nerve supply?

A

Gluteus medius and minimus, tensor fascia lata

23
Q

Which spinal nerves supply inferior gluteal nerve?

A

L5 S12

24
Q

What muscle does the inferior gluteal nerve supply?

A

Gluteus maximus

25
Q

Which spinal motor nerve roots are involved in:
flexion of the knee?
extension of the knee?

A

Flexion knee = L5/S1

Extension knee = L3/L4

26
Q

Which spinal motor nerve roots are involved in: flexion of the hip?
extension of the hip?

A

Flexion hip = L2/L3

Extension hip = L4/L5

27
Q
Which spinal motor nerve roots are involved in:
plantar flexion (flexion of ankle)?
dorsiflexion (extension of ankle)?
A

Plantarflexion: S1/S2

Dorsiflexion: L4/L5

28
Q

From which roots doe the fibres of the posterior cutaneous nerve originate

A

S1/S2

29
Q

Give some examples of autonomous sensory zones

A

S1 - lateral calf
L3 - mid thigh
L4 - Lower thigh

30
Q

The dorsal lateral cutaneous nerve is a branch of??

A

The sural nerve

31
Q

Give an example of root injury of L5/S1 prolapsed disc. What are the signs

A

Motor - loss of foot eversion

Sensory - loss of sensation on outer border of foot

Reflex - loss of ankle jerk

32
Q

Lesion of common peroneal nerve at the fibular neck - what are the signs

(common peroneal nerve = anterior and lateral part of leg)

A

Motor - foot drop

Sensory - dorsal of foot at least

33
Q

Explain how circumflex femoral artery arises

A

Aorta - Common iliac - ext and int - (ext) femoral - profunda femoris - circumflex

34
Q

At the knee, how does the femoral artery split

A

Femoral artery - popliteal artery - TRIFURCATION INTO:

  1. Anterior tibial artery - becomes dorsalis pedis artery
  2. Posterior tibial artery
  3. Peroneal artery
35
Q

After the femoral has given off the deep branch (profunda femoris), the femoral artery continues downwards via?

A

The adductor canal

36
Q

The femoral artery goes from anterior to posterior via what structure?

A

Adductor Magnus hiatus

It then becomes the popliteal artery

37
Q

What are the borders of the femoral triangle

A

Superiorly - Inguinal ligament

Medially - lateral border of adductor longus

Laterally - medial border of sartorius

38
Q

What is present in the femoral triangle

A

Femoral Nerve, artery and vein

39
Q

What forms the popliteal fossa

A

Diamond shape

Formed by borders of the semimembranosus, biceps femoris and heads of gastrocnemius

40
Q

What does the popliteal fossa contain

A

Popliteal artery and vein

Tibial and common peroneal nerves (but common peroneal nerve leaves the fossa)

41
Q

What drains into the popliteal vein?

A

Small saphenous vein

42
Q

The posterior tibial artery passes behind?

A

The medial malleolus

Post. tibial forms a plantar arch in the foot by giving off medial and lateral plantar arteries

43
Q

How does the superficial venous supply go?

A

Dorsal venous arch - Long saphenous & short saphenous - perforating veins - saphenofemoral junction (long saphenous)

44
Q

Short saphenous arises more from which venous network

A

Plantar venous network

45
Q

The deep veins run alongside the arteries, often as?

A

Venae comitantes (2/3 veins together)

46
Q

Where and when would you do a long saphenous vein cut down?

A

At the medial malleolus (just superior and lateral to)

Done if patient is in shock

Now superseded by intraosseous administration

47
Q

What are the deep veins progression

A

Anterior and posterior tibial veins - popliteal vein - profunda femoris vein -femoral vein (receives long saphenous vein) - external iliac vein

48
Q

Intermittent claudication can be caused by?

A

Arterial embolism (often associated with arterial disease)

49
Q

What is compartment syndrome

A

Ischaemia caused by trauma-induced increased pressure in confined limb compartment -

Commonly occurs in anterior, lateral and posterior compartments of the leg

50
Q

What pressure is required to collapse small vessels in the leg?

A

Normal pressure = 25mmHg

Pressure of 50-60mmHg can collapse small vessels and cause compartment syndrome

(Pulse still present as it comes from large vessel with high BP)

51
Q

What are the 2 types of compartment syndrome and what causes them?

A

Acute compartment syndrome - trauma associated

Chronic compartment syndrome - exercise induced

52
Q

How is acute compartment syndrome treated to prevent muscle death in the affected compartment?

A

Emergency fasciotomy

53
Q

What vein connects superficial veins to deep veins

A

Perforating veins

54
Q

What causes varicose veins?

A

When the valves of the perforating veins are weak - causes blood to be pushed from deep veins back to superficial veins

55
Q

What is the most important valve in terms of varicose veins?

A

Sapheno-femoral junction valve

THIS IS THE MAJOR CONNECTION

56
Q

What can varicose veins cause?

A

Venous insufficiency (not enough venous return) and lipodermatosclerosis (skin thickening), venous ulcers

57
Q

Where are DVT formed?

A

Clot in the deep veins - can cause PE and death

Can be prevented by contracting leg muscles

58
Q

Which 2 veins can be used for CABG?

A

Long and short saphenous veins

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