Acem Primary - Gluteal Region And Anterior Thigh Anatomy

Front 1

What are the borders of the femoral triangle?

Back 1

Superior Border: Inguinal ligament

Lateral Border: Medial aspect of sartorius

Medial Border: Medial aspect of adductor longus

Roof/Anterior: Fascia latta

Base/Posterior: Adductor longus, pectineus, iliopsoas

Front 2

What are the contents of the femoral triangle?

Back 2

Femoral nerve, artery, vein and canal

plus empty space to allow for lymphatic//venous distension

Front 3

What is the function of the inguinal ligament in the femoral triangle?

Back 3

Acts as a flexor retinaculum, supporting the contents of the triangle during hip flexion

Front 4

What is contained within the femoral sheath?

Back 4

Femoral artery, vein and canal

(not the femoral nerve)

Front 5

What is contained within the femoral canal?

Back 5

Lymphatic vessels – draining the deep inguinal lymph nodes.

Deep lymph node – the lacunar node.

Empty space.

Loose connective tissue.

Front 6

What is the clinical relevance of the femoral triangle?

Back 6

Palpation of the femoral pulse

Access to the femoral artery for clinical procedures

Femoral hernias - herniation of bowel underneath the inguinal ligament through the femoral ring into the femoral canal

Front 7

What are the borders of the femoral canal?

Back 7

Medial: Lacunar ligament

Lateral: Femoral vein

Superior: Inguinal ligament

Inferior: Pectineal ligament and superior rami of the pubis

Front 8

What are the muscles of the gluteal region?

Back 8

Superficial:

Gluteus maximus, medius and minimus

Tensor fascia latae

Deep:

Piriformis, obturator internus, superior & inferior gemelli, quadratus femoris

Front 9

What are the general actions of the muscles of the gluteal region as a group?

Back 9

Superficial:

Hip abduction and extension

Deep:

Lateral rotation

Front 10

What are the attachments of the gluteus maximus?

Back 10

Origin: Posterior surface of the ileum, sacrum and coccyx

Insertion: Ileotibial tract and gluteal tuberosity of the femur

Front 11

What are the actions of the gluteus maximus?

Back 11

Main extensor of the thigh

Assists with lateral rotation of the thigh

Front 12

What is the innervation of the gluteus maximus?

Back 12

Inferior gluteal nerve (L5-S2)

Front 13

What is the arterial supply of the gluteus maximus?

Back 13

Superior and inferior gluteal arteries

Front 14

What are the attachments of the gluteus medius?

Back 14

Origin: Gluteal surface of the ileum

Insertion: Lateral greater trochanter

Front 15

What are the actions of the gluteus medius?

Back 15

Abduction and medial rotation of the thigh

Stabilises the pelvis during movement

Front 16

What is the innervation of the gluteus medius?

Back 16

Superior gluteal nerve (L4-S1)

Front 17

What is the arterial supply of the gluteus medius?

Back 17

Superior gluteal artery

Front 18

What are the attachments of the gluteus minimus?

Back 18

Origin: Illeum

Insertion: Anterior greater trochanter

Front 19

What are the actions of the gluteus minimus?

Back 19

Abduction and medial rotation of the thigh

Stabilises the pelvis during movement

Front 20

What is the innervation of the gluteus minimus?

Back 20

Superior gluteal nerve (L4-S1)

Front 21

What is the arterial supply of the gluteus minimus?

Back 21

Superior gluteal artery

Front 22

What are the attachments of the tensor fascia latae?

Back 22

Origin: Asis and anterior iliac crest

Insertion: iliotibial tract

Front 23

What are the actions of the tensor fascia latae?

Back 23

Tenses the fascia latae

Hip abduction flexion and internal rotation

Front 24

What is the innervation of the tensor fascia latae?

Back 24

Superior gluteal nerve

Front 25

What is the arterial supply of the tensor fascia latae?

Back 25

Superior gluteal artery

Front 26

What is the iliotibial band?

Back 26

Longitudinal fibrous reinforcement of the fascia lata

Stabilizes the knee both in extension and in partial flexion

Front 27

What are the attachments of the ITB?

Back 27

Origin: Iliac tubercle

Insertion: Lateral condyle of the tibia

Gluteus maximus muscle and the tensor fasciae latae insert on the ITB

Front 28

What is iliotibial band syndrome

Back 28

Lateral knee pain caused by inflammation secondary to rubbing of the ITB over the lateral femoral epicondyle as it moves from behind the femur to the front of the femur during the repeated flexion and extension of the knee during running

Front 29

How can you test for superior gluteal nerve injury

Back 29

Trendelenburg Test - pelvic drop when standing on one leg is suggestive of superior gluteal nerve injury on the side of the standing leg

Front 30

What are the attachments of the piriformis?

Back 30

Origin: Anterior surface of the sacrum

Travels inferio-laterally through the greater sciatic foramen

Insertion: Greater trochanter

Front 31

What are the actions of the piriformis?

Back 31

Lateral rotation and abduction of the thigh

Front 32

What is the innervation of the piriformis?

Back 32

Nerve to piriformis

- direct branches of sacral plexus (L5-S1) and ventral rami (S1-S2)

Front 33

What is the arterial supply of the piriformis?

Back 33

Superior & inferior gluteal arteries

Internal pudendal artery

Front 34

What are the attachements of the obturator internus?

Back 34

Origin: Pubis and ischium at the obturator foramen

Travels through the lesser sciatic foramen

Insertion: Greater trochanter of the femur

Front 35

What are the actions of the obturator internus?

Back 35

Lateral rotation and abduction of the thigh

Front 36

What is the innervation of the obturator internus?

Back 36

Nerve to the obturator internus

+ direct branches from the sacral plexus (L5-S1)

Front 37

What is the arterial supply of the obturator internus?

Back 37

Obturator artery

Front 38

What are the attachments of the gemelli?

Back 38

Superior and inferior gemelli separated by the obturator internus tendon

Origin: Superior gemellus from ischial spine, inferior from the ischial tuberosity

Insertion: Greater trochanter of the femur

Front 39

What is the action of the gemelli?

Back 39

Lateral rotation and abduction of the thigh

Front 40

What is the innervation of the gemelli?

Back 40

Superior gemellus: Nerve to obturator internus

Inferior gemellus: Nerve to quadratus femoris

Front 41

What is the arterial supply of the gemelli?

Back 41

Inferior gluteal artery

Front 42

What are the attachments of the quadratus femoris?

Back 42

Origin: Lateral ischial tuberosity

Insertion: Intertrochanteric crest (quadrate tuberosity)

Front 43

What is the action of the quadratus femoris?

Back 43

Lateral rotation of the thigh

Front 44

What is the innervation of the quadratus femoris?

Back 44

Nerve to the quadratus femoris

+ direct branches from the sacral plexus (L5-S1)

Front 45

What is the arterial supply of the quadratus femoris?

Back 45

Inferior gluteal artery

Front 46

What are the muscles within the anterior compartment of the thigh?

Back 46

(Iliopsoas)

Quadriceps femoris

Sartorius

Pectiuneus

Front 47

What are the general actions and innervation of the muscles of the anterior compartment of the thigh as a group?

Back 47

Actions:

Knee extension

Innervation: Femoral nerve

Front 48

What are the attachments of the iliopsoas?

Back 48

Iliopsoas is composed of psoas major and iliacus muscles

Origin: Psoas major originates from the lumbar vertabrae. Iliacus originates from the iliac fossa of the pelvis

Insertion: Lesser trochanter of the femur

Front 49

What are the actions of the iliopsoas?

Back 49

Hip flexion

Assists with lateral rotation

Front 50

What is the innervation of the iliopsoas?

Back 50

Psoas major: L1-3

Iliacus: Femoral nerve

Front 51

What is the arterial supply of the iliopsoas?

Back 51

Psoas major: Subcostal artery, lumber arteriea

Iliacus: Iliolumbar artery

Front 52

What are the attachments of the quadriceps femoris?

Back 52

Quariceps femoris: Rectus femoris, vastus x3 (medialis, intermedius, lateralis)

Origin:

RF: Anterior inferior iliac spine & superior acetabulum

VM: Medial lip linea aspera & intertrochanteric line of femur

VI: Anerior and lateral surface femur

VL: Greater trochanter, lateral lip linea aspera, gluteal tuberosity

Insertion: Quadriceps tendon -> patella -> patella tendon -> tibial tuberosity

Front 53

What is the action of the quadriceps femoris?

Back 53

All knee extension

Rectus femoris also hip flexion

Front 54

What is the innervation of the quadriceps femoris?

Back 54

Femoral nerve (L2-L4)

Front 55

What is the arterial supply of the quadriceps femoris?

Back 55

RF, VI: Lateral femoral circumflex artery

VM, VL: Lateral femoral circumflex artery, perforating branches of deep femoral artery

Front 56

What are the attachments of the sartorius?

Back 56

Origin: ASIS

Insertion: Supero-medial tibia

Longest muscle in the body, most superficial in the leg. Runs inferomedially.

Front 57

What is the action of the sartorius?

Back 57

Hip flexion, abduction and lateral rotation

Knee flexion

(Tailor's position)

Front 58

What is the innervation of the sartorius?

Back 58

Femoral nerve

Front 59

What is the arterial supply of the sartorius?

Back 59

Lateral femoral circumflex artery

Saphenous artery

Front 60

What are the attachments of the pectineus?

Back 60

Origin: Pectineal line anterior surface of pelvis

Insertion: Pectineal line posterior femur

Front 61

What are the actions of the pectineus?

Back 61

Adduction and hip flexion

Front 62

What is the innervation of the pectineus?

Back 62

Femoral nerve

Front 63

What is the arterial supply of the pectineus?

Back 63

Medial femoral circumflex artery