Tutorial on the Lower Extremity

1.  The roots of the sacral plexus lie primarily on the anterior
surface of the piriformis muscle.    

 Hint This muscle originates from the lateral border of the sacrum.

2.  All parts of the lumbo-sacral plexus, excluding its terminal branches, are in the pelvis.    

 Hint Is the ilioinquinal nerve part of this plexus?

3.  The muscles of the flexor compartment of the thigh flex
which joint(s)?    

 Hint The flexor compartment is posterior.

4.  The muscles of the flexor compartment of the leg are
innervated by one nerve only.    

 Hint There are two parts to the compartment.

5.  There are no muscles in the lower limb which have a dual innervation.    

 Hint Think of the anterior compartment.

6.  All muscles of the flexor compartment of the thigh are
innervated by the same nerve.    

 Hint Remember the short head of the biceps femoris.

7.  Generally, the flexor muscles of the lower limb arise from
the anterior surface of the limb skeleton.    

 Hint Remember flexion of the knee and ankle joints.

8.  Do you know which parts of the lower limb skeleton can be
easily palpated?    

 Hint Find out on yourself.

9.  The inquinal lymph nodes receive lymph from which regions of the body?    

 Hint Don't forget the perineum.

10. The knee joint allows rotation.    

 Hint How does the knee joint stabilize on full extension.

11. At which sites can you palpate the pulse?    

 Hint Where are arteries easily compressed against bone?

12. Which muscles cause a medial rotation of the thigh?    

 Hint No muscle is solely responsible.

13. Which muscles of the leg do not cross the ankle joint?    

 Hint They do not act on this joint.

14. Which fractures could injure a nerve?  Visualize the bone(s)
and the related nerve(s).    

 Hint Especially where they are closely apposed.

15. Can you explain the foot drop of a common peroneal nerve
lesion in terms of the muscles involved?    

 Hint What compartments are innervated by the nerve?

16. Which muscle(s) can provide(s) some flexion of the leg in a
lesion of the tibial nerve?    

 Hint See number 6.

17. The femoral nerve contains fibers from spinal segments L3-L5.    

 Hint The femoral nerve is formed from the lumbar plexus.

18. Can you visualize the blood vessels participating in a
collateral circulation around the hip joint?  What is this anastomosis called?    

 Hint It forms a cross.

19. Which parts of the os coxae provide attachments to parts of
muscles of the thigh?    

 Hint The os coxae comprises all the pelvic bones.

20. A thigh is severed accidentally through its middle.  Which
muscles, major blood vessels, and nerves would have to be
joined in the surgical reattachment of the limb?    

 Hint Some muscles do not extend the length of the thigh.

21. All joints of the lower extremity have collateral ligaments.    

 Hint Collateral ligmanents are found at hinge joints.

22. Which nerves of the lower limb are accompanied by blood vessels?    

 Hint They do not always have the same name.

23. The iliofemoral ligament is the strongest ligament of the hip joint.    

 Hint Hip dislocations are most common posteriorly.

24. Where would you expect loss of sensation in a lesion of the
common peroneal nerve?     

 Hint What is the distribution of this nerve?

25. All muscles originating from the ilium insert into the
greater trochanter.    

 Hint Think of a muscle that tenses.

26. An artery which contributes to the anastomoses around the
knee joint originates in the upper half of the thigh.    

 Hint It is a branch of the lateral femoral circumflex.

27. Do you know the actions of the plantar and dorsal interossei?    

 Hint Remember DAB and PAD..

28. Name the branches of the femoral artery.    

 Hint See Moore p. 406.

29.  The femoral nerve is contained within the femoral sheath.    

 Hint Nerves do not run in the subserous fascia.

30. Where do the saphenous veins end?    

 Hint The long (great) extends the length of the limb.

31. What bones articulate at the knee and what ligaments hold
them together?    

 Hint Two bones, 5 primary ligaments.

32. What are the branches of the tibial artery?    

 Hint See Moore p. 406.

33. Which bones and ligaments participate in maintenance of the arches?    

 Hint There is a medial and lateral arch.

34. What forms the deep plantar arch?    

 Hint Two arteries contribute to its formation.

35. What muscles are innervated by the lateral plantar nerve?    

 Hint This nerve is homologous to the ulnar nerve in the hand, but there are differences.

36. What actions are performed by the interossei besides abduction
and adduction?    

 Hint The tendons cross the MP joint on its plantar aspect.

37. Name the superficial group of muscles in the posterior leg.    

 Hint There are three.

38. How does the common peroneal nerve get to the anterior
aspect of the leg?    

 Hint This pathway endangers the nerve.

39. What arteries supply the leg?    

 Hint They are branches of the popliteal artery.

40. What actions will test the femoral, obturator, tibial, and
common peroneal nerve functions?    

 Hint Think of the muscle compartments innervated by the nerves.

41. Where can the above nerves be checked for sensory loss?    

 Hint Remember the saphenous nerve.

42. Which part of the limb is most severely affected in an L4-L5 lesion?    

 Hint Extensor compartments