ANATOMY
Lower Extremities
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| Quadrant | Contents | Symptoms |
|---|---|---|
| Upper lateral | No major vessels or nerves; A preferred location for -?-intramuscular injection | |
| Upper medial | Superior gluteal neurovascular bundle | -?-Abductor lurch |
| -?-Lower lateral | Inferior gluteal neurovascular bundle | Difficulty climbing stairs or rising from a chair |
| Lower medial | Sciatic nerve | -?-Foot-drop |
Intracapsular fractures of the femoral neck
or hip dislocations tear the retinacular arteries that supply the -?-Proximal
fragment; avascular -?-Necrosis may result.
The femoral triangle is bounded by the
-?-Inguinal ligament, the sartorius muscle, and the adductor longus muscle. A
femoral pulse is palpable high within the femoral triangle just -?-Inferior to the
inguinal ligament. The femoral vein, lying just lateral to the -?-Femoral pulse,
is a preferred site for the insertion of the venous lines.
The anterior cruciate ligament is a key
stabilizer of the knee joint, preventing posterior movement of the -?-Femur on the
tibial plateau.
The medial meniscus, being more -?-Mobile and
attached to the medial collateral ligament, is most likely to be injured.
Twisting movements that combine lateral -?-Displacement with lateral rotation pull the
medial meniscus toward the center of the joint where it may be trapped and
crushed by the medial femoral condyle.
The adductor canal, the location of popliteal
-?-Aneurysms, contains the femoral artery, femoral vein, and saphenous nerve.
The deep -?-Fibular nerve innervates the muscles of
the anterior compartment (dorsiflexors of the foot and pedal digits). The
superficial fibular nerve inner-vates the lateral -?-Crural compartment (plantar
flexors and everters of the foot). The tibial nerve innervates the posterior
crural muscles which plantarflex and -?-Invert the foot.
The posterior tibial artery descends
posteriorly to the medial malleolus where the posterior tibial pulse is
normally -?-palpable.
Inversion sprains, the most -?-Common ankle
injury, involve the lateral collateral ligaments.
The plantar calcaneonavicular (spring)
ligament supports the head of the talus and thereby maintains the -?-Longitudinal plantar
arch. Laxity of this ligament results in fallen arches or "flat feet."
Sensory distribution of the anterior leg: the
web space between the first and second toes is specific for the -?-Fibular nerve.
| Nerve | Muscle Group | Reflex | Sign of Functional Deficit |
|---|---|---|---|
| -?-Genito-femoral | Cremaster | Cremasteric (L2-L3) | Cremaster paralysis |
| Femoral | -?-Anterior thigh | Patellar (L4) | Weakness of hip flexion and loss of knee extension |
| Obturator | Medial thigh | -?-Loss of thigh adduction | |
| -?-Superior gluteal | Gluteus medius and minimus | Abductor lurch (inability to keep pelvis level when contralateral fott is raised) | |
| Inferior Gluteal | -?-Gluteus maximus | Difficulty rising from seated position and difficulty climbing stairs |
| Nerve | Muscle Group | Reflex | Sign or Functional Deficit |
|---|---|---|---|
| Sciatic | Hamstrings | -?-Hamstring (L5) | Weakness of hip extension and knee flexion |
| Fibular | Anterior and lateral crural compartments | -?-Foot slap, inability to stand back on heels | |
| Tibial | Posertior crural compartment | -?-Achilles (S1) | Inability to stand on tip-toes |