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86 Cards in this Set

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Define the vertical axis of the hip?
The axis runs from the head of the humerus to the adductor tubercle (not through the shaft)
What are the movements of the knee?
The knee is biaxial, it allows flexion and extension and rotation of a flexed knee. It also rotates to lock
Name the gluteal muscles?
Gluteus maximus, minimus, medius and tensor fascia lata
Why are the gluteal muscles grouped as such?
They are innnervated from the gluteal nerves off the lumbosacral plesus (
What are the nerve fibers of the Superior gluteal nerve?
L4-S1
What are the nerve fibers of the inferior gluteal nerve?
L4-S1
Gluteus maximus
-Attachments
-Nerve
-Artery
-Actions
-Sacrotuberous ligament, ilium, sacrum, coccyx to gluteal tuberosity (minor) andIT band
-Inferior gluteal n.
-Inferior and superior gluteal arteries and profunda femoris (penetrating branch)
-EXTENSION of hip
-lateral rotation
-Maintain extension of an extended knee
Gluteus medius

-Attachments
-Nerve
-Artery
-Actions
-Dorsal ilium to iliac crest to greater trochanter
-Superior gluteal nerve (L4-S1)
-Superior gluteal artery
-ABDUCTION OF THIGH
-extension
-lateral rotation
Gluteus minimus

-Attachments
-Nerve
-Artery
-Actions
-Similar to glut med but more anterior
-Superior gluteal nerve
-superior gluteal artery
-medial rotation
-flexion
-adbuction
Tensor Fascia Lata

-Attachments
-Nerve
-Artery
-Actions
ASIS to IT band
-Superior gluteal n.
Superior gluteal a.
-Abduct
-Medially rotate
-Flex
How does the medius/minimis complex control the motion of the pelvis?
When one leg is off the ground the medius and minimus of the supporing leg contract and raise the pelvis of the opposite side.

Ex. standing on left leg, left medius/minimus contract and elevate right ASIS
How would a patient walk if he/she has lost function of the minimus/medius complex (lesion of the superior gluteal nerve)
As the left foot is not in contact with the ground the right him will sag.
Tendelenburg sign
Name the four anterior thigh muscles, innervated by the femoral n.?
(Quips)
Quadratus femoris
Iliopsoas
Pectineus
Sartorius
Iliopsoas

-Attachments
-Nerve
-Artery
-Actions
-Transverse processes of L1-L5 etc. to lesser trochanter
-Lumbar plexus (psoas)
-Femoral nerve (Iliocus)
-Internal iliac artery
-FLEXION
Sartorius
-Attachments
-Nerve
-Artery
-Actions
ASIS-Medial tibia (near tibial tuberosity)
-Femoral n.
-Femoral a.
-Flexion (hip)
-Lateral rotation (hip)
-Knee flexion and medial rotation
What are the boundaries of the femoral triangle?
Sartorius, inguinal ligament, Adductor longus
What is the pes anserinus?
Tendon at medial tibia where muscles of sartorius and gracilis attach
What is the division status of the femoral nerve?
It is a posterior nerve (L2-4) from the lumbar plexus
What are the nerve roots of the sciatic nerve?
L4 ? to S3
What are the terminal branches of the posterior division nerves in the lumbosacral plexus?
Femoral
gluteals
peroneals
What are the terminal branches of the anterior division nerves in the lumbosacral plexus?
Tibial
Obturator
Which of the quadriceps muscles has actions in the hip?
Rectus femoris,

It is a flexor
Rectus femoris

-Attachments
-Nerve
-Artery
-Actions
-Anterior inferior iliac spine to quadriceps femoris tendon
-Femoral n.
-Lateral circumflex of femoral atery
-Flex hip
-extend knee
Vastus intermedius

-Attachments
-Nerve
-Artery
-Actions`
-Most anterior and lateral surfaces of the femor to part of quadriceps tendon
-femoral n.
-femoral a.
-Extends knee
Vastus Lateralis

-Attachments
-Nerve
-Artery
-Actions
-Lateral lip of linea apsera to quadriceps tendon
-femoral n.
-femoral artery
-no action at the hip
-extend the knee
Follow the quadriceps tendon to the leg?
Quadriceps tendon to patellar ligament to tibial tuberosity
Vastus medialis
-Attachments
-Nerve
-Artery
-Actions
-Medial line of the linea aspera to quadriceps tendon
-femoral n.
-femoral a.
-extends knee
Pectineus
-Pecten of pubis to pectineal line of femur (medial superior portion)
-Femoral n and some times Obturator
-Medial circumflex femoral atery and obturator artery
-Adducts thigh
-flex hip (poorly)
Why does the pectineus some times have an identity crisis?
It can be innervated by the femoral n (posterior division) and the obterator (anterior division).
What muscle is innervated by the obturator and crosses the knee?
gracilis
What compartment is the original source of the adductor muscles?
they were anterior (obturator nerve)
What are the adductors?
Gracilis,
(Pectineus always adducts sometimes innervated by obterator always innervated by the femoral)
-Adductor longus
-Adductor brevis
-Adductor magnus
Gracilis
-Attachments
-Nerve
-Artery
-Actions
-pubic symphysis to medial surface of tibial shaft
-obturator n
-obturator artery, medial cirumflex, and profunda femoris
-FLEX knee
-adduct hip
-MEDIALLY rotates KNEE
Adductor longus
-Attachments
-Nerve
-Artery
-Actions
-Pubis to linea aspera (superificial to the brevis)
-obturator n.
-obturator artery, and medial cirumflex femoral
-adducts hip
-flexes hip
-medially rotates (weakly)
Adductor brevis
-Attachments
-Nerve
-Artery
-Actions
-Pubic symphosis (inferior to longus) to linea aspera
-Anterior and posterior obturator n.
-Obturator artery and medial cirumflex femoral a.
-Adducts hip
-Flexes hip
-Medially rotates
Adductor magnus (anterior)
-Attachments
-Nerve
-Artery
-Actions
-Pubis and ramus of ischium to linea aspera
-Obturator n.
-Obturator a.
-Adducts
-Flexes
-medially rotates
What is unique about the innervation of the adductor magnus?
It has dual innervation
Anterior portion-obturator
Posterior portion-tibial nerve
Adductor magnus (posterior)
-Attachments
-Nerve
-Artery
-Actions
-Ischial tuberosity to linea aspera and adductor tubercle
-TIBIAL n.
-popliteal a.
-Adducts hip
-extends hip
What occurs in the adductor hiatus?
The femoral vessels pass through and become the popliteal vessels
What muscle medially rotate the knee?
Gracilis
popliteus
sartorius
semitendinous and semimembranous
What are the posterior thigh muscles?
Semitendous
Semimembranous
Biceps femoris
What is the original location of the posterior thigh muscles?
They were originally anterior muscles (tibial nerve)
What is an exception to the anterior origin of the posterior muscles?
The short head of the biceps femoris was originally posterior and remained so (peroneal nerve).
Semitendinous
-Attachments
-Nerve
-Artery
-Actions
-Ischial tuberosity to medial tibia
-tibial n.
-Inferior gluteal artery and popliteal artery
-Extends hip
-Flexes knee
-medially rotates knee
Semimembranous
-Attachments
-Nerve
-Artery
-Actions
-Ischial tuberosity to medial condyle (superior to tendinous)
-Tibial n.
-Profunda femoris a, inferior gluteal, popliteal
-Extends hip
-Flexes knee
-Rotates tibia medially
Biceps femoris
-Attachments
-Nerve
-Artery
-Actions
-Long head-from ischial tuberosity, short head from lina aspera to LATERAL fibula
-long head from tibial n.
-short head from common peroneal n.
-inferior gluteal, popliteal, profunda femoris
-flex knee
-extend hip
-LATERALLY rotate knee
What is unique about the biceps femoris?
It is innervated by two nerves, one from each division
-long head from tibial (anterior)
-short head from peroneal (posterior)
Does the biceps femoris have an identity crisis?
Sort of.
The long head was anterior and migrate posterior (tibial n.)
The short head was posterior and remained (common peroneal n.)
What are the nerves of the lumbar plexus?
Subcostal (T12)
iliohypogastric (T12-L1)
Ilioinguinal (T12-L1)
Genitofemoral (L1-2)
Lateral femoral cutaneous (L2-3)
Obturator (L2-4)
Femoral (L2-4)
What is the course of the subscostal nerve?
Leaves T12 and traces quadratus lumborum just inferor to the 12 rib
What is innnervated by the subcostal, iliohypogastric, ilioinguinal nerves?
They are T12-L1 and innervate the lowest two dermatomes of the trunk as well as muscular innervation to the abdominal muscles.
What can result from dennervation of the iliohypogastric nerve?
greater risk of direct inguinal hernia
Trace the course of the genitofemoral nerve?
L1-2 traces superior margin of psoas spilts into genital branch to deep ring of inguinal and to cremaster muscles and sensory to laterl portion of the scrotum or labia majorum.
Femoral branch travels with the external iliac artery to proximal thigh
What is the course of the lateral cutaneous nerve?
(L1-2) L 1 and 2 dermatomes and sensory to lateral thigh
*susceptible to compression under inguinal ligament
What is the course of the femoral nerve?
L2-4 descends lateral to the psoas major

Compression leads to wasting in the anterior compartment of the thigh
What is the course of the obturator nerve?
L2-4 descends medial to psoas major through obturator foramen to innervate the adductor compartment
What is the function of the lumbosacral trunk?
Connects the sacral plexus to the lumbar plexus
Sacral plexus is L4 and L5
Where does the superior gluteal nerve emerge from the gluteal region?
Superior to the piriformis
Where does the inferior gluteal nerve emerge from the gluteal region?
Inferior to the piriformis
What does the sciatic nerve innnervate?
Muscles of the posterior compartment of the thigh (tibial nerve) and all muscles of the lower leg
What are the lateral rotator muscles?
PGOGOQ
Piriformis
Superior gemellus
Obturator internus
Inferior gammellus
Obturator externus
Quadratus femoris
Piriformis
-Attachments
-Nerve
-Artery
-Actions
-Anterior sacrum through greater sciatic foramen to greater trochanter
-nerve to piriformis
-Superior/inferior gluteal
-Lateral rotation
Superior and inferior gemellus

-Attachments
-Nerve
-Artery
-Actions
-Ishcium to greater trochanter
-nerve to each
-Inferior gluteal artery
-Lateral rotation
What does the tendon of the obturator internus run between?
The superior and inferior gemellus
Quadratus externus
-Attachments
-Nerve
-Artery
-Actions
-ischial tuberosity to intertrochanteric crest
-nerve to quatratus femoris
-medial cirumflex artery
-Lateral rotation
Through what does the tendon of the obturator internus pass?
Lesser sciatic foramen
Where do the nerves that innervate the lateral rotators arise?
Sacral plexus
Where does the sciatic divide?
Into what does it divide?
It divides into the tibial nerve and the common peroneal at the top of the popliteal fossa.
Where is the safe injection site for gluteal injections?
The superior lateral portion.
Describe the safe hand position for gluteal injections.
Under the palm when the thum is along the iliac crese and the tip of the thumb touches the ASIS.
What becomes of the external iliac artery?
It becomes the femoral and deep femoral, etc.
What becomes of the internal iliac artery?
It becomes the obturator and the gluteal branches
How does the internal and external iliac arterial systems anastomose?
They use the cruciate anastomosis gluteal branches of internal to circumflex and penetrating branches of deep femoral.
Describe the cruciate anastomosis
4 branches
3 from deep femoral connect to 1 from internal iliac
Deep femoral
-transverse branch of lateral cirumflex
-transverse branch medial circumflex
-Transverse branches
What supplies the artery to the head of the ligament of the femur?
Not the femoral
the obturator
What provides the majority of the blood to the head of the femur?
The femoral cirumflex
Medial branch is more significant
Which branch of the cirumflex artery is the most important?
The medial
What are the general movements of the Adductors?
GAAAP
-Adduction
-Medial Rotation
-no action at the knee
What are the general actions of the anterior (formerly posterior compartment) muscles?
Extension of the knee
*only the rectus femoris has any other action flexion of the hip
**Sartorius and Pecineus do their own thing
What is the general action of the glutes?
-all but maximus ABduct
-Max and Med- Extend the hip and laterally rotate hip
-Minimus and TFL Flex hip and medially rotate the hip
What are the actions of PGOGOQ?
Lateral rotation of the hip
What are the Abductors of the hip?
Sartorius and the Gluts (not Maximus)
What muscle ABducts that is not innervated by the a gluteal branch?
Sartorius
What muscles of adduction are not innervated by the obturator?
Pectineus (can be partly obturator but is always femoral)
Adductor magnus inferior portion is innervated by tibial nerve
what muscles extend the knee?
Quadriceps femoris
What is the single lateral rotator of the knee?
biceps femoris