Lower Extremity, Snell Flashcards
(267 cards)
1
Q
Pelvic girdle: # of bones
A
4
2
Q
Pelvic girdle: Bones
A
1) 2 hip bones
2) Sacrum
3) Coccyx
3
Q
Hip bone: Articulates with the head of the femur
A
Acetabulum
4
Q
Hip bone: Articular vs non articular: Acetabular fossa
A
Non articular
5
Q
Hip bone: Runs between asis and psis
A
Iliac crest
6
Q
Hip bone: Articulates with the opposite hip bone
A
Pubic bone at the pubic crest and tubercle
7
Q
Hip bone: Obturator foramen is bound by
A
1) Ischium
2) Pubis
8
Q
Femur: Fits into the acetabulum
A
Head
9
Q
Femur: Small depression at the center of the head
A
Fovea capitis
10
Q
Femur: Fovea capitis is for the attachment of
A
Ligament of the head
11
Q
Femur: Vessel conveyed along the ligament of the head to enter the bone at the fovea
A
Obturator artery
12
Q
Femur: Junction of neck and shaft
A
1) Trochanters
2) Intertrochanteric line
13
Q
Femur: Attached to the intertrochanteric line
A
Iliofemoral ligament; pubofemoral at lower end
14
Q
Femur: Ridge on the posterior portion of shaft
A
Linea aspera
15
Q
Femur: Medial margin of linea aspera continues below as
A
Medial supracondylar ridge
16
Q
Femur: Lateral margin of linea aspera continues below as
A
Lateral supracondylar ridge
17
Q
Femur: Medial supracondylar ridge ends as the
A
Adductor tubercle
18
Q
Femur: On the posterior surface of the shaft below the greater trochanter
A
Gluteal tuberosity for gluteus maximus
19
Q
Femur: Flat triangular area on the posterior surface of the lower end
A
Popliteal surface
20
Q
Femur: Lateral and medial condyles are separated posteriorly by
A
Intercondylar notch
21
Q
Femur: Lateral and medial condyles are separated anteriorly by
A
Articular surface for patella
22
Q
Femur: Superior to the condyles
A
Medial and lateral epicondyles
23
Q
Femur: Adductor tubercle is continuous with
A
Medial epicondyle
24
Q
Femur: Main blood supply to the head
A
Medial femoral circumflex
25
Femur: Common complication of femoral neck fractures due to interruption of the main blood supply to the head
Avascular necrosis of head
26
Sesamoid bone
A bone that develops within a tendon
27
Largest sesamoid bone in the body
Patella
28
Patella: Lies within the tendon of the
Quadriceps femoris
29
Patella: Shape
Triangular
30
Patella, apex: Superior vs inferior
Inferior
31
Patella, apex: Connected to what bone
Tuberosity of tibia
32
Patella, apex: Connected to the tuberosity of the tibia by the
Ligamentum patellae
33
Patella: Posterior surface articulates with
Condyles of femur
34
Tibia: Medial vs lateral
Medial
35
Tibia: Articulate with the lateral and medial condyles of femur
Lateral and medial condyles
36
Tibia: Lateral aspect of the lateral condyle
Oval articular facet for the head of fibula
37
Tibia: Anterior border is prolonged downward to form
Medial malleolus
38
Tibia: Provides attachment for interosseous membrane
Lateral border of tibia
39
Tibia: Lower end shows a wide, rough depression on its lateral surface for articulation with
Fibula
40
Fibula: T/F Takes part in articulation at the knee joint
F
41
Fibula: T/F Forms part in the ankle joint
T
42
Fibula: Forms the upper end (2)
1) Head
| 2) Articular surface for lateral condyle of tibia
43
Fibula: Distal end
1) Styloid process
| 2) Lateral malleolus
44
Fibula: Shaft attached to tibia by
Interosseous membrane
45
Fibula: Winds around neck
Common peroneal nerve
46
Tarsal Bones
The Circus Needs More Interesting Little Clowns
1) Talus
2) Calcaneum
3) Navicular
4) Medial cuneiform
5) Intermediate cuneiform
6) Lateral cuneiform
7) Cuboid
47
Tarsal Bones: Largest bone of the foot
Calcaneum
48
Tarsal Bones, calcaneum: Articulations
1) Superiorly with the talus
| 2) Anteriorly with the cuboid
49
Tarsal Bones, calcaneum: Shelflike ridge on medial surface
Sustentaculum tali
50
Tarsal Bones, calcaneum: Function of sustentaculum tali
Supports talus
51
Talus: Articulations
1) Superiorly with the tibia and fibula
2) Inferiorly with the calcaneum
3) Anteriorly with the navicular bone
52
Talus: Muscles attached
None
53
Navicular: Attached to its tuberosity
Tibialis posterior tendon
54
Cuboid: Deep groove on inferior aspect is attached to
Peroneus longus tendon
55
Cuneiform: Wedge shape maintains
Transverse arch of foot
56
Metatarsals: Attached to the prominent tubercle on the base of 5th metatarsal
Peroneus brevis tendon
57
Hip joint: Bridges the acetabular notch
Transverse acetabular ligament
58
Hip joint: Ligaments
1) Iliofemoral
2) Ischiofemoral
3) Pubofemoral
59
Hip joint: Strongest and most important ligament
Iliofemoral ligament of Bigelow
60
Iliofemoral ligament: Shape
Inverted Y
61
Iliofemoral ligament: Base attached to
ASIS
62
Iliofemoral ligament: 2 limbs attached to
Intertrochanteric line
63
Iliofemoral ligament: Resists
Hyperextension and lateral rotation
64
Pubofemoral ligament: Shape
Triangular
65
Pubofemoral ligament: Base
Superior ramus of pubis
66
Pubofemoral ligament: Apex
Lower end of intertrochanteric line
67
Pubofemoral ligament: Resists
Abduction and lateral rotation
68
Ischiofemoral ligament: Shape
Spiral
69
Ischiofemoral ligament: Attachments
1) Body of ischium
| 2) Greater trochanter
70
Ischiofemoral ligament: Limits
Medial rotation
71
Ligament of head of femur: Shape
Flat and triangular
72
Ligament of head of femur: Apex
Fovea capitis
73
Ligament of head of femur: Base
1) Transverse acetabular ligament
| 2) Margins of acetabular notch
74
Ligament of head of femur: Resists
Adduction, slightly
75
Hip joint: Nerve supply (3)
1) Femoral
2) Obturator
3) Sciatic
76
Hip joint: Flexion (4)
RAISe
1) Rectus femoris
2) Adductors
3) Iliopsoas
4) Sartorius
77
Hip joint: Extension (2)
1) Gluteus maximus
| 2) Hamstrings
78
Hip joint: Abduction (5)
1) Gluteus medius
2) Gluteus minimus
3) Sartorius
4) Tensor fascia lata
5) Piriformis
79
Hip joint: Adduction (5)
Shorten the GAAAP
1) Gracilis
2) Adductor longus
3) Adductor brevis
4) Adductor magnus
5) Pectineus
80
Hip joint: Lateral rotation (7)
GQ POG
1) Gluteus maximus
2) Quadratus femoris
3) Piriformis
4) Obturator internus and externus
5) Superior and inferior gemelli
81
Hip joint: Medial rotation (3)
1) Anterior fibers of gluteus medius
2) Anterior fibers of gluteus minimus
3) Tensor fascia lata
82
Hip joint: Combination of all movements
Circumduction
83
Hip joint: Anterior
Femoral vessels and nerves
84
Hip joint: Posterior
Sciatic nerve
85
Hip joint: Stability depends on
1) Gluteus medius and minimus
2) Head of femur
3) Neck of femur
86
Hip joint: Hip sinks on opposite unsupported side
Trendelenburg sign
87
Knee joint: Articulations
1) Condyles of femur superiorly
2) Condyles of tibia and their menisci inferiorly
3) Lower end of femur and patella anteriorly
88
Knee joint: Type between tibia and femur
Synovial hinge
89
Knee joint: Type between patella and femur
Synovial gliding
90
Knee joint: Capsule is deficient
Anteriorly where it pouches superiorly beneath the quadriceps tendon forming the suprapatellar bursa
91
Knee joint: Extracapsular ligaments
1) Ligamentum patellae
2) Lateral collateral ligament
3) Medial collateral ligament
4) Oblique popliteal ligament
92
Knee joint: Ligamentum patellae is a continuation of
Quadriceps femoris tendon
93
Knee joint: Lateral collateral ligament is attached to
1) Lateral condyle of the femur superiorly
| 2) Head of fibula inferiorly
94
Knee joint: Lateral collateral ligament is separated from the lateral meniscus by the
Popliteus
95
Knee joint: Medial collateral ligament is attached to
1) Medial condyle of femur superiorly
| 2) Medial surface of shaft of tibia
96
Knee joint: Medial collateral ligament is strongly attached to
Medial meniscus
97
Knee joint: Strengthens the back of capsule
Oblique popliteal ligament
98
Knee joint: Oblique popliteal ligament is an expansion of
Semimembranosus
99
Knee joint: Intracapsular ligaments
Cruciate ligaments
100
Knee joint: Cruciate ligaments are termed anterior and posterior according to
Tibial attachments
101
Anterior cruciate ligament: Attachments
1) Anterior intercondylar area of tibia inferiorly
| 2) Upward, backward, and laterally to the lateral femoral condyle
102
Posterior cruciate ligament: Attachments
1) Posterior intercondylar area of tibia inferiorly
| 2) Upward, forward, and medially to the medial femoral condyle
103
Knee joint: Upper surface of menisci are in contact with
Femoral condyles
104
Knee joint: Lower surface of menisci are in contact with
Tibial condyles
105
Knee joint: Each meniscus is attached to the tibia by
Anterior and posterior horns
106
Knee joint: Function of menisci
Deepen the articular surfaces of tibial condyles
107
Knee joint: Medial vs lateral, damaged more frequently
Medial
108
Knee joint, synovial membrane: Prolonged downward posteriorly to form the popliteal bursa behind
Popliteus tendon
109
Knee joint, synovial membrane: Reflected backward from the ligamentum patellae to form
Infrapatellar fold
110
Knee joint, bursae: Largest
Suprapatellar bursa
111
Knee joint, bursae: Always communicate with knee joint
1) Suprapatellar
| 2) Popliteal
112
Knee joint, bursae: Between patella and skin
Prepatellar bursa
113
Knee joint, bursae: Between ligamentum patella and skin
Superficial infrapatellar bursa
114
Knee joint, bursae: Between ligamentum patella and tibia
Deep infrapatellar bursa
115
Knee joint, bursae: Semimembranosus bursa lies between
Semimembranosus tendon and medial condyle of tibia
116
Knee joint: Nerve supply (4)
1) Femoral
2) Obturator
3) Common peroneal
4) Tibial
117
Knee joint, muscles: Flexion
1) Biceps femoris
2) Semitendinosus
3) Semimembranosus
118
Knee joint, muscles: Extension
Quadriceps femoris
119
Knee joint, muscles: Medial rotation
1) Sartorius
2) Semitendinosus
3) Gracilis
120
Knee joint, muscles: Lateral rotation
Biceps femoris
121
Knee joint: Most stable in what position
Full extension
122
Knee joint, muscles: Most important muscle group that stabilizes the knee joint and capable of stabilizing it in the presence of torn ligaments
Quadriceps femoris
123
Ankle joint: Formed by articulations among which bones
1) Tibia
2) Malleoli
3) Talus
124
Ankle joint: Type of joint
Synovial hinge
125
Ankle joint: Stronger, medial vs lateral ligament
Medial
126
Ankle joint: Nerve supply
1) Deep peroneal
| 2) Tibial
127
Ankle joint: More extensive, inversion vs eversion
Inversion
128
Ankle joint muscles: Eversion (4)
1) Peroneus longus
2) Peroneus brevis
3) Peronius tertius
4) Lateral tendons of extensor digitorum longus
129
Gluteal region: Boundaries
1) Iliac crest superiorly
| 2) Fold of the buttock inferiorly
130
Gluteal region muscles: Inferior gluteal nerve
Gluteus maximus
131
Gluteal region: Superior gluteal nerve (3)
1) Gluteus medius
2) Gluteus minimus
3) Tensor fascia latae
132
Gluteal region: S1 and S2
Piriformis
133
Gluteal region: Sacral plexus (4)
1) Obturator internus
2) Superior and inferior gemelli
3) Quadratus femoris
134
Gluteal region, fascia: Deep fascia is continuous with
Fascia lata
135
Gluteal region: Deep fascia splits to enclose
Gluteus maximus
136
Greater sciatic foramen is formed by
1) Greater sciatic notch
| 2) Sacrotuberous and sacrospinous ligaments
137
Lesser sciatic foramen is formed by
1) Lesser sciatic notch
| 2) Sacrotuberous and sacrospinous ligaments
138
Greater sciatic formen contents
Piriformis PINS PINS
1) Piriformis
2) Posterior cutaneous nerve of thigh
3) Inferior and superior gluteal nerve
4) Nerve to obturator internus
5) Sciatic nerve
6) Pudendal nerve
7) Internal pudendal vessels
8) Nerve to quadratus femoris
9) Superior and inferior gluteal vessels
139
Lesser sciatic foramen contents
PINT
1) Pudendal nerve
2) Internal pudendal vessels
3) Nerve to obturator internus
4) Tendon of obturator internus
140
Thigh: Compartments
1) Anterior
2) Posterior
3) Medial
141
Thigh: Deep fascia
Fascia lata
142
Thigh: Deep fascia, shape
Trouser
143
Thigh: Deep fascia attached superiorly to
Pelvis
144
Thigh: Thickening of fascia lata on lateral side
Iliotibial tract
145
Thigh: Iliotibial tract is attached superiorly to
Iliac tubercle
146
Thigh: Iliotibial tract is attached inferiorly to
Lateral condyle of tibia
147
Thigh: Iliotibial tract is the insertion of
1) Gluteus maximus
| 2) Tensor fascia lata
148
Thigh: Gap in deep fascia in front of the thigh just below the inguinal ligament
Saphenous opening
149
Thigh: Saphenous opening transmits
1) Great saphenous vein
2) Branches of femoral artery
3) Lymphatic vessels
150
Thigh: Saphenous opening is filled with loose connective tissue called
Cribriform fascia
151
Thigh, nerve supply: Anterior compartment
Femoral
152
Thigh, nerve supply: Posterior compartment
Sciatic
153
Thigh, nerve supply: Medial
Obturator
154
Femoral triangle: Borders
SAIL
1) Sartorius laterally
2) Adductor longus medially
3) Inguinal ligament superiorly
155
Femoral triangle: Contents
1) Femoral nerve
2) Femoral sheath
3) Femoral artery
4) Femoral vein
5) Inguinal nodes
156
Femoral sheath: Downward protrusion of
1) Fascia transversalis
| 2) Fascia iliaca
157
Femoral sheath: Approx ___ below inguinal ligament
1in or 2.5cm
158
Femoral sheath: Contents (lateral to medial)
1) Femoral artery
2) Femoral vein
3) Lymphatic vessels
159
Thigh, anterior compartment: All are supplied by femoral nerve except
Psoas
160
Thigh, anterior compartment: Psoas muscle is supplied by
Lumbar plexus
161
Thigh, anterior compartment: Muscles (7)
```
VIP PQRST
[1) Vastus lateralis, intermedius, medialis]
2) Iliacus
3) Psoas
4) Pectineus
5) Quadriceps femoris
[6) Rectus femoris]
7) Sartorius
8) Tensor fascia lata
```
162
Thigh, anterior compartment: Quadriceps femoris group
1) Rectus femoris
2) Vastus lateralis
3) Vastus intermedius
4) Vastus medius
163
Thigh, medial compartment: Muscles (5)
1) Gracilis
2) Adductor longus
3) Adductor brevis
4) Adductor magnus
5) Obturator externus
164
Thigh, posterior compartment: Muscles
1) Biceps femoris
2) Semitendinosus
3) Semimebranosus
4) Adductor magnus
165
Thigh: Small medial compartment of femoral sheath occupied by lymphatics
Femoral canal
166
Thigh: Site of femoral hernia
Femoral canal
167
Thigh: Upper opening of femoral canal filled by extra peritoneal fat (femoral septum)
Femoral ring
168
Femoral ring: Anterior
Inguinal ligament
169
Femoral ring: Posterior
Superior ramus of pubis and pectineal ligament
170
Femoral ring: Lateral
Femoral vein
171
Femoral ring: Medial
Lacunar ligament
172
Femoral hernia: Women vs men
Women
173
Femoral ring: Hernial sac
Below and lateral to the pubic tubercle
174
Femoral ring: Hernial sac neck, anterior
Inguinal ligament
175
Femoral ring: Hernial sac neck, posterior
Pectineal ligament
176
Femoral ring: Hernial sac neck, lateral
Femoral vein
177
Femoral ring: Hernial sac neck, medial
Lacunar ligament
178
Intermuscular cleft on the medial aspect of the middle 3rd of thigh beneath the sartorius
Adductor canal
179
Adductor canal: Aka (2)
1) Subsartorial canal
| 2) Hunter's canal
180
Adductor canal: Walls, posterior
Adductor magnus
181
Adductor canal: Walls, lateral
Vastus medialis
182
Adductor canal: Walls, anteromedial
Sartorius
183
Adductor canal: Contents
1) Femoral artery and vein
2) Deep lymph vessels
3) Saphenous nerve
4) Nerve to vastus medialis
184
Popliteal fossa: Shape
Diamond
185
Popliteal fossa: Contents
1) Popliteal vessels
2) Small saphenous vein
3) Common peroneal nerve
4) Tibial nerve
5) Posterior cutaneous nerve of thigh
6) Connective tissue and lymph nodes
186
Popliteal fossa: Boundaries, lateral
1) Biceps femoris superiorly
| 2) Gastrocnemius and plantaris inferiorly
187
Popliteal fossa: Boundaries, medial
1) Semimembranosus and senitendinosus superiorly
| 2) Gastrocnemius inferiorly
188
Leg: Compartments
1) Anterior
2) Posterior
3) Lateral
189
Leg: Muscles of anterior compartment (4)
1) Tibialis anterior
2) Extensor digitorum longus
3) Extensor hallucis longus
4) Peroneus tertius
190
Leg: Nerve supply to the anterior compartment
Deep peroneal
191
Leg: Muscles of lateral compartment (2)
1) Peroneus longus
| 2) Peroneus brevis
192
Leg: Nerve supply to the lateral compartment
Superficial peroneal nerve
193
Leg: Posterior compartment, superficial group (3)
1) Gastrocnemius
2) Plantaris
3) Soleus
194
Leg: Posterior compartment, deep group (4)
1) Popliteus
2) Flexor digitorum longus
3) Flexor hallucis longus
4) Tibialis posterior
195
Leg: Posterior compartment is supplied by
Tibial nerve
196
Muscle on dorsum of foot
Extensor digitorum brevis
197
Ankle, retinacula: Attached to the distal ends of the anterior borders of tibia and fibula
Superior extensor retinaculum
198
Ankle, retinacula: Y-shaped band located in front of the ankle joint
Inferior extensor retinaculum
199
Ankle, retinacula: From medial malleolus to medial surface of calcaneum
Flexor retinaculum
200
Arches of foot: Forms the transverse arch (3)
1) Base of metatarsals
2) Cuboid
3) 3 cuneiform bones
201
Arches of foot: Forms the lateral longitudinal arch (3)
1) Base of 4th and 5th metatarsals
2) Cuboid
3) Calcaneum
202
Arches of foot: Medial longitudinal arch (3)
1) First 3 metatarsals
2) Navicular
3) Talus
4) 3 cuneiform bones
203
Femoral artery: Continuation of the
External iliac artery
204
Femoral artery: Begins at
Behind inguinal ligament
205
Femoral artery: Leaves anterior thigh through
Opening in adductor magnus
206
Femoral artery: Enters popliteal space as
Popliteal artery
207
Femoral artery: Branch that arises just below the inguinal ligament and runs upward to the abdominal wall
Superficial epigastric artery
208
Femoral artery: Large branch that supplies the structures of the 3 compartments of the thigh
Profunda femoris
209
Vessels of the trochanteric anastomosis (4)
1) Medial femoral circumflex
2) Lateral femoral circumflex
3) Superior gluteal
4) Inferior gluteal
210
Important connection between internal iliac and femoral arteries
Cruciate anastomosis
211
Popliteal artery: Continuation of the
Femoral artery
212
Popliteal artery: Begins at
Opening of the adductor magnus
213
Popliteal artery: Ends at
Lower border of popliteus
214
Popliteal artery: Divides into
Anterior and posterior tibial arteries
215
Anterior tibial artery: Arises at
Popliteal fossa
216
Anterior tibial artery: Branch of
Popliteal artery
217
Anterior tibial artery: Supplies
Anterior compartment of leg
218
Anterior tibial artery: Ends as
Dorsalis pedis
219
Dorsalis pedis artery: Continuation of
Anterior tibial artery
220
Dorsalis pedis artery: Joins what artery to form the plantar arch
Lateral plantar artey
221
Posterior tibial artery: Descends into
Posterior compartment of leg
222
Posterior tibial artery: Terminates where
Behind medial mallelous
223
Posterior tibial artery: Terminates as
Medial and lateral plantar arteries
224
Veins: Drains medial side of leg
Great saphenous vein
225
Veins: Drains lateral side of leg
Small saphenous vein
226
Great saphenous vein: Ascends behind vs in front of medial malleolus
In front
227
Great saphenous vein: Ascends through the leg with
Saphenous nerve
228
Great saphenous vein: In front vs behind knee
Behind
229
Great saphenous vein: Joins femoral vein by passing through
Saphenous opening in the deep fascia
230
Great saphenous vein: Tributaries near its termination
1) Superficial circumflex iliac
2) Superficial epigastric
3) Superficial external pudendal
231
Great saphenous vein: Constant position
Anterior to medial malleolus
232
Vein: Most commonly used as a bypass graft
Great saphenous vein
233
Small saphenous vein: Behind vs in front of lateral malleolus
Behind
234
Small saphenous vein: Ascends accompanied by
Sural nerve
235
Small saphenous vein: Drains into
Popliteal vein
236
All lymph vessels of the lower limb drain into
Deep inguinal nodes
237
Superficial inguinal nodes: Location
Below the inguinal ligament
238
Superficial inguinal nodes, horizontal group: Receives lymph from (5)
1) Anterior abdominal wall below umbilicus
2) Perineum
3) External genitalia (except testes)
4) Lower half of anal canal
5) Skin of buttocks
239
Superficial inguinal nodes, vertical group: Receives lymph from
Most of the superficial vessels of lower limb
240
Deep inguinal nodes: #
3
241
Deep inguinal nodes: Location
Medial side of femoral vein and femoral canal
242
Deep inguinal nodes: Drain into
External iliac nodes
243
Popliteal nodes: Receive lymph from (3)
1) Lateral side of foot
2) Back of calf
3) Lateral side of calf
244
Femoral nerve: Arises from
Lumbar plexus (L234)
245
Femoral nerve: Terminates by dividing into
Anterior and posterior divisions
246
Femoral nerve: Cutaneous branches supply (3)
1) Medial surface of thigh
2) Anterior surface of thigh
3) Medial side of foot
247
Obturator nerve: Arises from
Lumbar plexus (L234)
248
Obturator nerve: Divides into
Anterior and posterior divisions
249
Obturator nerve: Cutaneous branch
Medial side of thigh
250
Sciatic nerve: Arises from
Sacral plexus (L45S123)
251
Sciatic nerve: Appears below what muscle
Piriformis
252
Sciatic nerve: Covered by what muscle
Gluteus maximus
253
Sciatic nerve: Divides into
1) Tibial nerve
| 2) Common peroneal nerve
254
Tibial nerve: Divides into
Medial and lateral plantar nerves
255
Tibial nerve: Cutaneous branches
1) Sural nerve
| 2) Medial calcaneal nerve
256
Tibial nerve: Cutaneous supply
1) Calf
2) Back of leg
3) Lateral border of foot
4) Lateral side of little toe
5) Medial surface of heel
257
Common peroneal nerve: Pierces
Peroneus longus
258
Common peroneal nerve: Divides into
Superficial and deep peroneal
259
Superficial peroneal nerve: Cutaneous supply
Dorsum of foot except between the first and second toes
260
Deep peroneal nerve: Cutaneous supply
Between the first and second toes
261
Foot drop
Sciatic nerve lesion
262
Hamstrings
1) Semitendinosus 2) Semimembranosus 3) Biceps femoris
263
Femoral artery: Pulse
Midway between asis and symphysis pubis
264
Popliteal artery: Pulse
Popliteal space provided the deep fascia is fully relaxed by passive flexion of knee
265
Anterior tibial artery: Pulse
1) Extensor hallucis longus medially
| 2) Extensor digitorum longus laterally
266
Dorsalis pedis artery: Pulse
1) Extensor hallucis longus medially
| 2) Extensor digitorum longus laterally
267
Posterior tibial artery: Pulse
Midway between medial malleolus and heel
