Lower Extremity
OSTEOLOGY, LIGAMENTS, GLUTEAL MUSCULATURE
Which of the following is most likely
pertaining to the two pelves depicted?
95%
ro
m
a
yo
un
ge
a
sf
ro
m
Th
e
r ig
ht
i
sf
ft
i
le
Th
e
rp
er
s..
ti
le
f
th
e
nd
ea
sm
al
yo
un
ge
rp
er
so
...
s..
.
..
is.
r ig
ht
th
e
ht
i
The right is from a younger person than the left
an
d
D.
r ig
The left is from a younger person than the right
Th
e
C.
0% 5% 0%
sm
al
e
The right is male and the left is female
ft
i
B.
le
The left is male and the right is female
Th
e
A.
LE Unit Overview

Superficial fascia, veins, lymph

Skeletal structures / joint surfaces

Ligamentous support

Musculature / vasculature

Nerves

Forces and injuries
Objectives

Describe the gross anatomy for each system (circulatory, muscular,
nervous, and skeletal) in the lower extremity.

Integrate the systems to discuss the lower extremity stability and
mobility functions.

Analyze common injuries in the lower extremities.

For each muscle, describe how the attachment sites result in an
action around a joint.

For each muscle, identify the innervation (peripheral nerve and
nerve roots).
LE Overview
Coxae (Pelvis)
Obturator
Membrane
Anatomical
Position
Sacroiliac Joint
- Ligaments


Primary:

Anterior Sacroiliac

Interosseus

Short and long posterior
sacroiliac
Secondary:

Sacrotuberous

Sacrospinous
Sacroiliac
Joint Motions

Anterior Tilt and Posterior Tilt

Nutation (sacral flexion) and Counternutation (sacral extension)

Stability vs. Mobility

http://www.youtube.com/watch?v=elo2_sWBXaM
Your patient has significant posterior tilt in his
pelvis but when palpating, you notice his
sacrum is nutated. What ligament would be
most stretched?
18%
of
th
es
e
w
ou
ld
be
os
pi
n
Sa
cr
No
ne
s..
.
ou
s
8%
c
None of these
would be stretched
lia
D.
23%
ro
i
Sacrospinous
ac
C.
ac
Anterior Sacroiliac
ro
ili
B.
51%
An
te
r io
rS
Posterior Sacroiliac
Po
st
er
io
rS
ac
A.
Your female patient has anterior pelvic
tilt due to excessive lumbar lordosis.
Which of the following is TRUE?
Sh
e
is
be
in
co
un
te
at
rn
ris
ut
k
at
fo
io
rp
n
os
te
rio
rd
isc
h.
..
No
ne
of
th
es
e
nu
ta
tio
n
in
be
m
us
t
D.
0%
Sh
e
C.
15% 15%
m
us
t
B.
She must be in nutation
She must be in
counternutation
She is at risk for posterior
disc herniation
None of these
Sh
e
A.
69%
Femur:
Torsion Angle
Averages:
7 degrees in males
12 degrees in females
Discussion question:
What effect does this difference
have?
Femur:
Angle of
Inclination
D.
E.
0% 0% 0%
ha
ft.
m
ed
ia
th
lc
e
on
in
te
dy
rt
le
ro
.
ch
an
te
ric
lin
e.
C.
al
on
g
B.
mid-shaft.
medial condyle.
along the
intertrochanteric line.
neck.
intercondylar area.
m
id
-s
A.
100%
0%
ne
in
ck
te
.
rc
on
dy
la
ra
re
a.
The part of the femur that is most
susceptible to fracture in conjunction
with osteoporosis is:
In the following radiograph of the
hip, the arrow points to the:
95%
or
al
ne
ck
.
0%
fe
m
pi
ne
.
femoral neck.
0%
isc
hi
al
s
D.
5%
nt
er
.
ischial spine.
tro
ch
a
C.
er
lesser trochanter.
r.
B.
le
ss
greater trochanter.
gr
ea
te
rt
ro
ch
an
te
A.
Coxa vara refers to:
an abnormal decrease in the angle
between the shaft of the femur and the
tibia.
B. an abnormal decrease in the angle
between the head and neck of the femur
and its shaft (angle of inclination).
C. an abnormally short distance between the
anterior superior iliac spine and the center
of the acetabulum.
D. an abnormally short distance between the
iliac crest and the greater trochanter.
E. an abnormally short femur.
A.
79%
18%
an
ab
no
rm
al
de
an
cr
ab
ea
no
se
rm
in
al
th
de
e
an
an
cr
e
...
ab
as
e
no
in
rm
th
al
e
ly
an
an
sh
g.
ab
or
.
no
td
rm
i st
an
al
ly
ce
sh
...
or
an
td
i st
ab
an
no
ce
rm
...
al
ly
sh
or
tf
em
ur
.
0% 3% 0%
Hip musculature

Gluteal region

Anterior hip

Gluteus maximus

Iliopsoas

Gluteus medius

Pectineus

Gluteus minimus

Sartorius

TFL

Rectus femoris

Piriformis

Obturator internus

Gemelli

Obturator externus

Quadratus femoris
Bursa

Ischial

Obturator internus

Trochanteric

Gluteofemoral
The iliotibial tract is the conjoint distal
aponeurotic attachment of which of the
following pairs of muscles?
100%
gluteus medius and
minimus
B. gluteus medius and
maximus
C. gluteus maximus and the
tensor of the fascia lata
D. the tensor of the fascia
lata and rectus femoris
E. rectus and biceps femoris
A.
0% 0%
gl
ut
eu
sm
ed
iu
gl
sa
ut
nd
eu
sm
m
gl
in
ed
ut
im
eu
iu
us
s
sm
an
ax
d
m
im
th
ax
us
e
im
te
a
nd
us
ns
or
th
e
of
te
th
ns
e
or
fa
sc
..
ia
re
la
ct
ta
us
an
an
d
d
...
bi
ce
ps
fe
m
or
is
0% 0%
Which of the following is incorrect
pertaining to the great saphenous vein?
E.
0% 5% 3% 0%
po
st
It
er
pa
io
rt
ss
es
o
th
po
e
st
m
er
ed
io
ia
r
It
...
to
dr
th
ai
e
ns
m
in
It
ed
to
ha
ia
th
sa
l..
.
e
ne
fe
m
ar
ly
or
It
al
un
tra
ve
ifo
ve
in
rm
rs
.
es
di
am
th
e
et
sa
er
ph
...
en
ou
so
pe
n.
..
D.
es
C.
pa
ss
B.
92%
It passes posterior to the
medial malleolus.
It passes posterior to the
medial condyle of the femur.
It drains into the femoral vein.
It has a nearly uniform
diameter because blood is
shunted to deeper veins.
It traverses the saphenous
opening in the fascia lata.
It
A.
For Monday

Readings in Moore

Study for lab quiz