Inferior Extremity

Plantarflexion vs. dorsiflexion

Plantar flexion occurs when you squish a Plant with your foot.

 

Popliteal fossa: medial to lateral arrangment

“Serve And Volley Next Ball”:

• Semimembranosus/ Semitendonosus
• Artery
• Vein
• Nerve
• Biceps femoris

Lateral and medial heads of Gastrocnemius are inferior borders.

 

Popliteal fossa: muscles arrangement

The two Semi’s go together, Semimembranosus and Semitendonosus.

The Membranosus is Medial and since the two semis go together, Semitendonosus is also medial.

Therefore, Biceps Femoris has to be lateral.

Of the semi’s, to remember which one is superficial: the Tendonosus is on Top.

 

Buttock quadrant safest for needle insertion

“Shut up and butt out“:

The Upper Outer quadrant of the Buttock safely avoids hitting sciatic nerve.

 

Ankle: anterior compartment of leg contents

“The Hamptons Are Never Dull Parties”:

From medial malleolus:

• Tibialis anterior tendon
• (Extensor) Hallacus longus
• Artery (anterior tibial)
• Nerve (deep peroneal)
• (Extensor) Digitorum
• Peroneus tertius

 

Inversion vs. eversion direction in the foot

Little INtroVERted boys roll their feet in when talking to girls.

Also, can just watch which way the sole of the foot goes: does it face in or out?

 

Genu valgum vs. genu vargum

Genu valGUM (knock-knee): knees are GUMmed together.

Varum (bowleg) is the other by default, or Far rhymes with Var, so knees are far apart.

 

Hip posterior dislocation: most likely arrangement for one

“Hitting the brake pedal before the accident”:

You are sitting, so hip is flexed, and adducted and medially rotated so can move your foot away from the gas pedal over to the brake pedal.

Note: car accidents are most likely cause of posterior dislocation because in this position.

 

Medial malleolus: order of tendons, artery, nerve behind it

“Tom, Dick, And Nervous Harry”:

From anterior to posterior:

• Tibialis
• Digitorum
• Artery
• Nerve
• Hallicus

Full names for these are: Tibialis Posterior, Flexor Digitorum Longus, Posterior Tibial Artery, Posterior Tibial Nerve, Flexor Hallicus Longus.

Alternatively: “Tom, Dick ANd Harry”.

Alternatively: “Tom, Dick And Not Harry”.

 

Menisci attachments in knee

“Each meniscus has something attached to it”:

The medial meniscus has the medial collateral ligament.

The lateral meniscus is attached to the popliteal muscle.

 

Saphenous veins: path of great vs. small at malleolus

“MAGdelaine has varicose veins” [The saphenous veins are important for varicose veins]:

Medial maleolus, Anterior to maleolus, and Great saphenous go together.

Then the opposites of these go together: Small saphenous is posterior to the lateral maleolus.

Femoral artery deep branches

“Put My Leg Down Please”:

• Profundus femoris (deep femoral artery)
• Medial circumflex femoral artery
• Lateral circumflex femoral artery
• Descending genicular arteries
• Perforating arteries

Adductor magnus innervation

“AM SO!“:

Adductor Magnus innervated by Sciatic and Obturator.

 

Lower limb peripheral nerve injurys

“Drop into a DEeP PIT and shuffle your way out”:

Foot Drop results from Dorsiflexors and Evertors paralysis, due to common Peroneal nerve lesion.

Plantar flexion and Inversion impairment due to Tibial nerve lesion, results in a shuffling gait.

 

Psoas major: innervation

If you hit L2, 3, 4

Psoas gets sore!

Hip: lateral rotators

“Piece Goods Often Go On Quilts”:

• Piriformis
• Gemellus superior
• Obturator internus
• Gemellus inferior
• Obturator externus
• Quadratus femoris

Hip: lateral rotators

“Play Golf Or Go On Quaaludes”:

From top to bottom:

• Piriformis
• Gemellus superior
• Obturator internus
• Gemellus inferior
• Obturator externus
• Quadratus femoris

Alternatively: “P-GO-GO-Q“.

Inversion vs. eversion muscles in leg

Second letter rule for inversion/eversion:

Eversion muscles:

• pErineus longus
• pErineus brevis
• pErineus terius

Inversion muscles:

• tIbialis anterior
• tIbialis posterior

Leg: anterior muscles of leg

“Tom’s Hairy ANd Dirty Penis”:

• T: Tibialis anterior
• H: extensor Hollicis longus
• AN: anterior tibial Artery & deep fibular Nerve
• D: extensor Digitorum longus
• P: Peronius tertius [aka fibularis tertius]

Leg: anterior muscles of leg

“The Hospitals Are Not Dirty Places”:

• T: Tibialis anterior
• H: extensor Hallucis longus
• A: anterior tibial Artery
• N: deep fibular Nerve
• D: extensor Digitorum longus
• P: Peronius tertius [aka fibularis tertius]

Soleus vs. Gastrocnemius muscle function

“Stand on your Soles. Explosive gas“:

You stand on soles of your shoes, so Soleus is for posture.

Gasoline is explosive, so Gastrocnemius is for explosive movement.

 

Cruciate ligaments: insertions

PAMS APPLES:

Posterior [passes] Anterior [inserts] Medially.

Anterior [passes] Posteriorly [inserts] Laterally.

 

Tibia: muscles of pes anserinus (the muscles attached to tibia’s medial side)

“A Girl between Two Sargeants”:

Gracilus is between

Sartorius and

Semitendonosus

 

Thigh: innervation by compartment

“MAP OF Sciatic“:

• Medial compartment: Obturator
• Anterior compartment: Femoral
• Posterior compartment: Sciatic

So all the thigh muscles in that compartment get innervated by that nerve.

Navicular contacts 3 of 5 cuneiform bones

“Navicular is like the Navigator logo”:

There are 3 things coming off each.

Therefore, cuboid has to contact 2 of the 5.

 

Tarsal bones

“Traverse City (is) Noted (for) MIchigan’s Lovely Cherries”:

• Talus
• Calcaneus
• (new row)
• Navicular
• (new row)
• Medial Intermediate cuneiforms
• Lateral cuneiform
• Cuboid

Tarsal bones

“Tall Californian Navy Medcial Interns Lay Cuties”:

In order (right foot, superior to inferior, medial to lateral):

• Talus
• Calcanous
• Navicular
• Medial cuneiform
• Intermediate cuneiform
• Lateral cuneifrom
• Cuboid

Tarsal tunnel: contents

“Tiny Dogs Are Not Hunters”:

From superior to inferior:

• T: Tibialis posterior
• F: flexor Digitorum longus
• A: posterior tibial Artery
• N: tibial Nerve
• H: flexor Hallucis longus

 

Tibia vs. fibula: which is lateral

The FibuLA is LAteral.

 

Fibula vs. tibia: which is the bigger one

People talk of telling just a “little white lie”, or a “little fib“:

Therefore, the fibula is smaller.

Alternatively: TIBia is the Thicker Inner Bone.

Alternatively: “Little lat FIB, big fat TIB”.

 

You can suggest more mnemonics …

Warm regards,

Dr. Indrajit Rana