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165 Cards in this Set
- Front
- Back
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What are the borders of the femoral triangle? |
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 |
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What are the contents of the femoral triangle? |
Femoral nerve, artery, vein and canal plus empty space to allow for lymphatic//venous distension |
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What is the function of the inguinal ligament in the femoral triangle? |
Acts as a flexor retinaculum, supporting the contents of the triangle during hip flexion |
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What is contained within the femoral sheath? |
Femoral artery, vein and canal (not the femoral nerve) |
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What is contained within the femoral canal? |
Lymphatic vessels – draining the deep inguinal lymph nodes.
Deep lymph node – the lacunar node.
Empty space.
Loose connective tissue. |
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What is the clinical relevance of the femoral triangle? |
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 |
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What are the borders of the femoral canal? |
Medial: Lacunar ligament Lateral: Femoral vein Superior: Inguinal ligament Inferior: Pectineal ligament and superior rami of the pubis |
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What are the muscles of the gluteal region? |
Superficial: Gluteus maximus, medius and minimus Tensor fascia latae
Deep: Piriformis, obturator internus, superior & inferior gemelli, quadratus femoris |
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What are the general actions of the muscles of the gluteal region as a group? |
Superficial: Hip abduction and extension
Deep: Lateral rotation |
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What are the attachments of the gluteus maximus? |
Origin: Posterior surface of the ileum, sacrum and coccyx
Insertion: Ileotibial tract and gluteal tuberosity of the femur |
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What are the actions of the gluteus maximus? |
Main extensor of the thigh
Assists with lateral rotation of the thigh |
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What is the innervation of the gluteus maximus? |
Inferior gluteal nerve (L5-S2) |
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What is the arterial supply of the gluteus maximus? |
Superior and inferior gluteal arteries |
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What are the attachments of the gluteus medius? |
Origin: Gluteal surface of the ileum
Insertion: Lateral greater trochanter |
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What are the actions of the gluteus medius? |
Abduction and medial rotation of the thigh
Stabilises the pelvis during movement |
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What is the innervation of the gluteus medius? |
Superior gluteal nerve (L4-S1) |
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What is the arterial supply of the gluteus medius? |
Superior gluteal artery |
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What are the attachments of the gluteus minimus? |
Origin: Illeum
Insertion: Anterior greater trochanter |
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What are the actions of the gluteus minimus? |
Abduction and medial rotation of the thigh
Stabilises the pelvis during movement |
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What is the innervation of the gluteus minimus? |
Superior gluteal nerve (L4-S1) |
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What is the arterial supply of the gluteus minimus? |
Superior gluteal artery |
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What are the attachments of the tensor fascia latae? |
Origin: Asis and anterior iliac crest
Insertion: iliotibial tract |
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What are the actions of the tensor fascia latae? |
Tenses the fascia latae
Hip abduction flexion and internal rotation |
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What is the innervation of the tensor fascia latae? |
Superior gluteal nerve |
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What is the arterial supply of the tensor fascia latae? |
Superior gluteal artery |
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What is the iliotibial band? |
Longitudinal fibrous reinforcement of the fascia lata
Stabilizes the knee both in extension and in partial flexion |
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What are the attachments of the ITB? |
Origin: Iliac tubercle
Insertion: Lateral condyle of the tibia
Gluteus maximus muscle and the tensor fasciae latae insert on the ITB |
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What is iliotibial band syndrome |
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 |
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How can you test for superior gluteal nerve injury |
Trendelenburg Test - pelvic drop when standing on one leg is suggestive of superior gluteal nerve injury on the side of the standing leg |
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What are the attachments of the piriformis? |
Origin: Anterior surface of the sacrum
Travels inferio-laterally through the greater sciatic foramen
Insertion: Greater trochanter |
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What are the actions of the piriformis? |
Lateral rotation and abduction of the thigh |
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What is the innervation of the piriformis? |
Nerve to piriformis - direct branches of sacral plexus (L5-S1) and ventral rami (S1-S2) |
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What is the arterial supply of the piriformis? |
Superior & inferior gluteal arteries Internal pudendal artery |
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What are the attachements of the obturator internus? |
Origin: Pubis and ischium at the obturator foramen
Travels through the lesser sciatic foramen
Insertion: Greater trochanter of the femur |
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What are the actions of the obturator internus? |
Lateral rotation and abduction of the thigh |
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What is the innervation of the obturator internus? |
Nerve to the obturator internus + direct branches from the sacral plexus (L5-S1) |
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What is the arterial supply of the obturator internus? |
Obturator artery |
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What are the attachments of the gemelli? |
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 |
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What is the action of the gemelli? |
Lateral rotation and abduction of the thigh |
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What is the innervation of the gemelli? |
Superior gemellus: Nerve to obturator internus
Inferior gemellus: Nerve to quadratus femoris |
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What is the arterial supply of the gemelli? |
Inferior gluteal artery |
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What are the attachments of the quadratus femoris? |
Origin: Lateral ischial tuberosity
Insertion: Intertrochanteric crest (quadrate tuberosity) |
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What is the action of the quadratus femoris? |
Lateral rotation of the thigh |
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What is the innervation of the quadratus femoris? |
Nerve to the quadratus femoris + direct branches from the sacral plexus (L5-S1) |
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What is the arterial supply of the quadratus femoris? |
Inferior gluteal artery |
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What are the muscles within the anterior compartment of the thigh? |
(Iliopsoas) Quadriceps femoris Sartorius Pectiuneus |
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What are the general actions and innervation of the muscles of the anterior compartment of the thigh as a group? |
Actions: Knee extension
Innervation: Femoral nerve |
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What are the attachments of the iliopsoas? |
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 |
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What are the actions of the iliopsoas? |
Hip flexion Assists with lateral rotation |
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What is the innervation of the iliopsoas? |
Psoas major: L1-3
Iliacus: Femoral nerve |
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What is the arterial supply of the iliopsoas? |
Psoas major: Subcostal artery, lumber arteriea
Iliacus: Iliolumbar artery |
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What are the attachments of the quadriceps femoris? |
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 |
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What is the action of the quadriceps femoris? |
All knee extension
Rectus femoris also hip flexion |
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What is the innervation of the quadriceps femoris? |
Femoral nerve (L2-L4) |
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What is the arterial supply of the quadriceps femoris? |
RF, VI: Lateral femoral circumflex artery
VM, VL: Lateral femoral circumflex artery, perforating branches of deep femoral artery |
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What are the attachments of the sartorius? |
Origin: ASIS
Insertion: Supero-medial tibia
Longest muscle in the body, most superficial in the leg. Runs inferomedially. |
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What is the action of the sartorius? |
Hip flexion, abduction and lateral rotation Knee flexion
(Tailor's position) |
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What is the innervation of the sartorius? |
Femoral nerve |
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What is the arterial supply of the sartorius? |
Lateral femoral circumflex artery Saphenous artery |
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What are the attachments of the pectineus? |
Origin: Pectineal line anterior surface of pelvis
Insertion: Pectineal line posterior femur |
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What are the actions of the pectineus? |
Adduction and hip flexion |
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What is the innervation of the pectineus? |
Femoral nerve |
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What is the arterial supply of the pectineus? |
Medial femoral circumflex artery |
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What are the muscles of the medial thigh? |
Adductor magnus Adductor longus Adductor brevis Obturator externus Gracilis |
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What are the general actions and innervation of the muscles of the medial compartment of the thigh as a group? |
Actions: Hip adduction
Nerve: Obturator nerve |
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What are the attachments of the adductor magnus? |
Adductor magnus functional division into adductor and hamstring parts
Adductor: Origin: inferior rami pubis and rami ischium Insertion: linea aspera of femur
Hamstring: Origin: Ischial tuberosity Insertion: adductor tubercle on distomedial femur |
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What is the action of the adductor magnus? |
Adductor magnus functional division into adductor and hamstring parts
Hamstring & adductor: Adduct thigh
Adductor only: hip flexion Hamstring: hip extension |
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What is the innervation of the adductor magnus? |
Adductor magnus functional division into adductor and hamstring parts
Adductor: Obturator nerve (L2-4) Hamstring: Tibial nerve (L4-S3) |
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What is the arterial supply of the adductor magnus? |
Obturator artery Deep femoral artery Medial femoral circumflex artery |
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What are the attachments of the adductor longus? |
Origin: Pubis
Insertion: Linea aspera of femur |
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What is the action of the adductor longus? |
Adduction and medial rotation of the thigh |
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What is the innervation of the adductor longus? |
Obturator nerve |
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What is the arterial supply of the adductor longus? |
Obturator artery Deep femoral artery |
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What are the attachments of the adductor brevis? |
Origin: body of pubis, inferior pubic rami
Insertion: Linea aspera of posterior femur, proximal to adductor longus |
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What is the action of the adductor brevis |
Adduction of the thigh |
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What is the innervation of the adductor brevis? |
Obturator nerve |
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What is the arterial supply of the adductor brevis? |
Obturator artery Deep femoral artery |
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What are the attachments of the obturator externus? |
Origin: Membrane of the obturator foramen and adjacent bone
Passes under neck of femur
Insertion: Posterior greater trochanter |
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What is the action of the obturator externus? |
Lateral rotation of the thigh |
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What is the innervation of the obturator externus? |
Obturator nerve |
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What is the arterial supply of the obturator externis? |
Obturator artery |
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What are the attachments of the gracilis? |
Origin: Inferior rami of pubis, body of pubis
Insertion: medial tibia - in between tendons of sartorius & semitendinosus |
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What are the actions of the gracilis? |
Adduction of the hip Knee flexion |
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What is the innervation of the gracilis? |
Obturator nerve |
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What is the arterial supply of the gracilis? |
Obturator artery |
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What are the muscles of the posterior compartment of the thigh? |
Hamstrings: Biceps femoris Semitendinosus Semimembranosus |
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What are the general actions and innervation of the muscles of the posterior compartment of the thigh as a group? |
Actions: Knee flexion Hip extension
Innervation: Sciatic nerve |
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What are the attachments of the biceps femoris? |
Biceps femoris comprises long and short heads
Origin: Long head: ischial tuberosity of the pelvis Short head: linea aspera of posterior femur
Insertion: Head of fibula |
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What are the actions of the biceps femoris? |
Knee flexion Hip extesnion Lateral rotation hip & knee |
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What is the innervation of the biceps femoris? |
Long head: Tibial part of the sciatic nerve Short head: Common fibular part of the sciatic nerve |
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What is the arterial supply of the biceps femoris? |
Perforating branches of the deep femoral artery |
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What are the attachments of the semitendinosus? |
Origin: Ischial tuberosity of the pelvis
Insertion: Medial tibia |
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What are the actions of the semitendinosus? |
Knee flexion Hip extension Medial rotation of the hip/knee |
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What is the innervation of the semitendinosus? |
Tibial part of the sciatic nerve |
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What is the arterial supply of the semitendinosus? |
Perforating branches of the deep femoral artery |
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What are the attachments of the semimembranosus? |
Origin: Ischial tuberosity of the pelvis - more superior than semitendinosus and biceps femoris
Insertion: Medial tibial condyle |
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What are the actions of the semimembranosus? |
Knee flexion Hip extension Medial rotation hip/knee |
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What is the innervation of the semimembranosus? |
Tibial part of the sciatic nerve |
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What is the arterial supply of the semimembranosus? |
Perforating branches of the deep femoral artery |
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What are the borders of the popliteal fossa? |
Superiomedial: Semimembranosus Superiolateral: Biceps femoris Inferiomedial: Medial head of gastrocnemius Inferiolateral: Lateral head of gastrocnemius and Plantaris
Floor: Posterior surface of knee joint capsule, posterior femur Roof: Popliteal fascia, skin |
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What are the contents of the popliteal fossa? |
Popliteal artery Popliteal vein Tibial nerve Common fibular nerve |
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What is the clinical relevance of the popliteal fossa? |
Site of palpable mass...
Baker's cyst - inflammation & swelling of the semimembranosus bursa
Popliteal aneurysm - can compress tibial nerve
Ddx: DVT, neoplasia |
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What are the muscles of the anterior compartment of the lower leg? |
Tibialis anterior Extensor digitorum longus Extensor hallucia longus Fibularis tertius |
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What are the actions, innervations and arterial supply of the muscles of the anterior compartment of the lower leg as a group? |
Actions: Dorsiflexion and inversion of the ankle
Innervation: Deep fibular nerve
Arterial supply: Anterior Tibial Artery |
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What are the attachments of the tibialis anterior? |
Origin: proximo-lateral surface of the tibia
Insertion: Medial surface of the medial cuniform and 1st meatarsal |
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What is the action of the tibialis anterior? |
Dorsiflexion and inversion of the foot |
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What is the innervation of the tibialis anterior? |
Deep fibular nerve |
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What is the arterial supply of the tibialis anterior? |
Anterior tibial artery |
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What are the attachments of the extensor digitorum longus? |
Origin: Lateral tibial condyle and medial fibula
Converges into a tendon
Insertion: Tendon splits into the extensor expansion, inserting into the bases and dorsal aponeuroses of the lateral 4 digits |
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What are the actions of the extensor digitorum longus? |
Extension of the lateral 4 toes at MTPJ & ITPJ Dorsiflexion of the foot (talocrural joint) Eversion of the subtalar joint |
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What is the innervation of the extensor digitorum longus? |
Deep fibular nerve |
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What is the arterial supply of the extensor digitorum longus? |
Anterior tibial artery |
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What are the attachments of the extensor hallucis longus? |
Origin: Medial fibular shaft
Tendon crosses anterior to the ankle joint
Insertion: Base of the distal phalanx of the great toe |
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What is the action of the extensor hallucis longus? |
Extension great toe Ankle dorsiflexion |
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What is the innervation of the extensor hallucis longus? |
Deep fibular nerve |
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What is the arterial supply of the extensor hallucis longus? |
Anterior tibial artery |
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What are the attachments of the fibularis tertius? |
Arises from the inferior EDL, not present in all individuals
Origin: With the extensor digitorum longus from the medial fibula
Tendon descends with EDL until diverging at the dorsal surface of the foot
Insertion: 5th Metatarsal |
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What is the action of the fibularis tertius? |
Eversion and dorsiflexion of the foot |
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What is the innervation of the fibularis tertius? |
Deep fibular nerve |
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What is the arterial supply of the fibularis tertius? |
Anterior tibial artery |
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What are the muscles in the lateral compartment of the lower leg? |
Fibularis longus Fibularis brevis |
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What is the action and innervation of the muscles of the lower leg as a group? |
Action: Eversion of the foot
Innervation: Superifical fibular nerve |
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What are the attachments of the fibularis longus? |
Origin: Lateral tibial condyle and superio-lateral proximal fibula
Fibres converge into a tendon, descending to the foot posterior to the malleolus before crossing under the foot
Insertion: Medial aspect of the medial cuneiform and base of 1st metatarsal |
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What are the actions of the fibularis longus? |
Eversion and plantarflexion of the foot Supports the lateral and transverse arches of the foot |
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What is the innervation of the fibularis longus? |
Superficial fibular nerve |
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What is the arterial supply of the fibularis longus? |
Fibular artery |
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What are the attachments of the fibularis brevis? |
Origin: Inferio-lateral fibular shaft
Insertion: Tubercle on 5th metatarsal |
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What is the action of the fibularis brevis? |
Eversion of the foot |
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What is the innervation of the fibularis brevis? |
Superficial fibular nerve |
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What is the arterial supply of the fibularis brevis? |
Fibular artery |
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What are the muscles in the posterior compartment of the lower leg? |
Superficial: Gastrocnemius, Plantaris, Soleus
Deep: Popliteus, Tibialis Posterior, Flexor Digitorum Longus, Flexor Hallucis Longus |
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What are the actions and innervation of the muscles of the posterior compartment of the lower leg as a group? |
Actions: Plantarflexion and inversion of the foot
Innervation: Tibial nerve |
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What mechanism reduces friction at the calcaneal tendon? |
Bursae: Subcutaneous calcaneal Bursa Deep bursa of the calcaneal tendon |
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What are the attachments of the gastrocnemius? |
Comprises of medial and lateral heads
Origin: Lateral head: lateral femoral condyle Medial head: medial femoral condyle
Insertion: Calcaneal tendon (with soleus, plantaris) -> calcaneus |
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What is the action of the gastrocnemius? |
Ankle plantarflexion Knee flexion |
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What is the innervation of the gastrocnemius? |
Tibial nerve |
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What is the arterial supply of the gastrocnemius? |
Sural arteries Posterior tibial artery |
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What are the attachments of the plantaris? |
Origin: Lateral supracondylar line of the femur
Insertion: Calcaneal tendon (with gastrocnemius, soleus) -> calcaneus
Absent in 10% people |
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What is the action of the plantaris? |
Ankle plantarflexion Knee flexion |
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What is the innervation of the plantaris? |
Tibial nerve |
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What is the arterial supply of the plantaris? |
Popliteal artery |
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What are the attachments of the soleus? |
Origin: Soleal line of the tibia and proximal fibula
Insertion: Calcaneal tendon (with gastrocnemius, plantaris) -> calcaneus |
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What is the action of the soleus? |
Ankle plantarflexion |
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What is the innervation of the soleus? |
Tibial nerve |
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What is the arterial supply of the soleus? |
Posterior tibial artery |
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What are the attachments of the popliteus? |
Origin: Posterior proximal tibia
Insertion: Lateral condyle of the femur |
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What is the action of the popliteus? |
Lateral rotation of the femur on the tibia, unlocking the joint so that knee flexion can occur |
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What is the innervation of the popliteus? |
Tibial nerve |
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What is the arterial supply of the popliteus? |
Popliteal artery |
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What are the attachments of the tibialis posterior? |
Origin: Interosseous membrane between the tibia and fibula and posterior surface of the bones
Insertion: Plantar surfaces of the medial tarsal bones (navicular tuberosity, medial cuneiform, bases 2nd-4th metatarsals) |
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What is the action of the tibialis posterior? |
Inversion and plantarflexion of the foot Maintains the medial arch of the foot |
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What is the innervation of the tibialis posterior? |
Tibial nerve |
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What is the arterial supply of the tibialis posterior? |
Fibular artery Tibial artery |
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What are the attachments of the flexor digitorum longus? |
Origin: Medial tibia
Insertion: Plantar surface of the bases of the distal palanges of the lateral 4 digits |
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What is the action of the flexor digitorum longus? |
Flexion lateral 4 toes |
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What is the innervation of the flexor digitorum longus? |
Tibial nerve |
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What is the arterial supply of the flexor digitorum longus? |
Tibial artery |
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What are the attachments of the flexor hallucis longus? |
NB: Lateral side of the leg, ie: opposite the great toe
Origin: Posterior fibula
Insertion: Plantar surface of the distal phalanx of the great toe |
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What is the action of the flexor hallucis longus? |
Flexion great toe |
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What is the innervation of the flexor hallucis longus? |
Tibial nerve |
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What is the blood supply of the flexor hallucis longus? |
Fibular artery Tibial artery |
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What is contained in the first layer of the foot? |
Flexor digitorum brevis Abductor hallucis Abductor digiti minimi |
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What is contained in the second layer of the foot? |
Tendon of flexor hallucis longus Tendon of flexor digitorum longus Quadratus plantae Lumbricals |
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What is contained in the third layer of the foot? |
Flexor hallucis brevis Adductor hallucis Flexor digiti minimi brevis |
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What is contained in the fourth layer of the foot? |
Dorsal and plantar interosseous muscles Tendon of peroneus longus Tendon of tibialis posterior |
