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70 Cards in this Set
- Front
- Back
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Lateral Rotators of the femur and include innervation
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Piriformis - n. to piriformis L5,S1,S2
Sartorius - femoral Obturator internus, superior gamella - n. to obturator Inferior gamella, Quadratus Femoris - n. to quadratus Obturator externus - obturator n. Gluteus Maximus - inferior gluteal n. |
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Gluteus Maximus
Attachment Innervation Action Blood |
-PSIS, sacrum, ilium posterior to posterior gluteal line
-gluteal tuberosity, iliotibial tract Inferior Gluteal Nerve L5 S1 S2 extend thigh and assist in lateral rotation |
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Tensor fascia latae
Attachment Innervation Action Blood |
ASIS, anterior iliac crest
iliotibial tract Superior Gluteal Nerve L5, S1 Abduct and medially rotate thigh stabilize thigh assists in flexing thigh |
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Medial rotators of femur
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Tensor fascia latae
gluteus medius gluteus minimus |
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What fascial layer lies over the gluteus medius muscle?
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Gluteal aponeurosis
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Gluteus medius
Attachment Innervation Action Blood |
Illium btw anterior and posterior gluteal lines
lateral surface of greater trochanter Superior gluteal nerve Abducts thigh, keeps pelvis level during gait; anterior fibers medially rotate thigh |
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Gluteus minimus
Attachment Innervation Action Blood |
Illium btw anterior and inferior gluteal lines
anterior surface of greater trochanter superior gluteal nerve abducts and medially rotates thigh keeps pelvis level during gait |
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What is the Trendellenburg sign?
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If one of the gluteus medius muscles is weak (perhaps due to superior gluteal nerve injury) then the pelvis will drop on the contralateral side
If the pelvis drops when you ask a patient to raise one foot off the floor during an examination then it is called a positive Trendelenburg sign |
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Piriformis
Attachment Innervation Action Blood |
Anterior surface of sacrum
superior border of greater trochanter anterior rami S1, S2 Laterally rotates thigh abducts thigh from flexed position |
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Quadratus femoris
Attachment Innervation Action Blood |
lateral border of ischial tuberosity
Quadrate tubercle Nerve to quadratus femoris L5, S1 laterally rotates thigh and stabilizes femoral head in acetabulum. |
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Obturator internus
Attachment Innervation Action Blood |
Obturator membrane, margin of obturator foramen
medial aspect of greater trochanter nerve to obturator internus laterally rotates thigh |
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Superior and Inferior Gamelli
Attachment Innervation Action Blood |
Ischial Spine (S)
Ischial tuberosity (I) Medial side of greater trochanter (both) Nerve to Obturator Internus (S) Nerve to Quadratus femoris (I) Laterally rotate the thigh |
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What structures pass above the piriformis?
Below? |
Above
1. Superior Gluteal Nerve 2. Superior Gluteal Artery and Vein Below 1. Sciatic Nerve 2. Posterior Cutaneus Nerve of thigh 3. Inferior Gluteal Nerve 4. Inferior Gluteal Artery 5. Pudendal Nerve 6. Nerve to Ob In 7. Nerve to Quad Fem. |
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After exiting the pelvis via the greater sciatic foramen, where does the Pudendal nerve go?
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It returns to the pelvis via the lesser sciatic foramen to innervate the perineum
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Arteries passing into gluteal region are branches of what artery?
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Internal iliac
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Patients are given IM injections in the upper right quadrant of the gluteal region in order to avoid dammaging what structures?
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Sciatic Nerve
Superior Gluteal Nerve |
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All of the hamstrings flex the leg at the knee and extend the thigh at teh hip except for.
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Short head of biceps femoris
it is attached to the shaft of the femur and only crosses knee joint |
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What are the proximal attachments of the hamstrings? Distal?
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Biceps femoris
LH - Ischial tuberosity SH - shaft of femur // fibular head Semitendonosis - Ischial tuberosity // medial surface of anterior tibia Semimembranosis - ischial tuber.// posterior part of medial condyle (oblique popliteal ligament) |
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Where does the long tendon of semitendonosis attach?
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drops down farther than all the other hamstrings and wraps around the leg medially to the anterior surface
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The hamstring muscles are innervated by what nerve?
Any exceptions? |
The tibial component of the sciatic nerve
Short head of biceps femoris is instead innervated by common fibular nerve (aka peroneal nerve) |
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Comment on the blood supply to the hamstrings.
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The blood supply is via the 4 perforating arteries that pass through the adductor magnus muscles and arise from the deep femoral artery which is a branch of the femoral artery.
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What is the femoral artery called after it passes through the adductor hiatus?
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popliteal artery
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The hamstrings include what medial compartment muscle?
Innervation? |
Hamstring portion of the adductor magnus.
Tibial branch of sciatic nerve |
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Draw the pathway of the femoral artery through thigh and include the following:
Femoral artery Medial femoral circumflex lateral femoral circumflex deep femoral artery perforating branches popliteal artery superior and inferior genicular genicular arteries |
refer to slide 44 of gluteal region and posterior thigh lecture
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Name the hip extensors.
Give innervation |
Gluteus maximus - inferior gluteal n.
Semimembranosus - tibial part of sciatic Semitendinosus - tibial part of sciatic Biceps femoris long head - tibial sciatic Adductor magnus (ham) - tibial sciatic |
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Give the medial rotators of the thigh
Innervation |
Gluteus medius
Gluteus minimus (anterior fibers) superior gluteal nerve |
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Give the abductors of the thigh
innervation |
Gluteus medius
Gluteus minimus Tensor Fasciae Latae Superior gluteal nerve |
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Which nerves innervate the skin over the gluteal region?
From where are they derived? |
Superior, medial, inferior cluneal n
Superior - posterior rami of lumbar 1-3 Medial - posterior rami of sacral 1-3 Inferior - branch of posterior cutaneous nerve of thigh (anterior rami) |
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Which of the cluneal nerves is derived from anterior rami?
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Inferior
branch of posterior cutaneous nerve of thigh |
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What vessels supply the gluteal region?
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Superior gluteal artery
Inferior gluteal artery |
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What is triradiate cartillage?
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the cartilage present before the ilium, ischium, and pubis fuse together
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Which ligament converts the greater sciatic notch into the greater sciatic foramen?
lesser into lesser foramen? |
sacrospinous - greater
sacrotuberous - lesser |
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In anatmois position what is in the same plane as the anterosuperior aspect of the pubis?
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ASIS
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Which muscles occupy the anterior component of the thigh?
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psoas
illiacus sartorius vastus lateralis vastus intermedialis vastus medialis rectus femoris |
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which parts of quadriceps help stabilize the patella and keep it from being displaced laterally?
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inferior fibers of vastus medialis
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Give the blood supply and nerve supply of the quadriceps, sartorius
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femoral nerve and femoral artery
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Sartorius
attachment nerve blood function |
ASIS
Medial surface of tibia femoral femoral laterally rotate adduct and flex thigh, flex knee |
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What three muscles attach at pes anserinus?
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Sartorius, gracillis, semitendinosus
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Give proximal attachments for quadriceps muscles
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Rectus femoris - AIIS
Vastus lateralis - greater trochanter, linea aspera Vastus intermedius - anterior and lateral surfaces of femoral shaft Vastus Medialis - intertrochanteric line, linea aspera |
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How is the patella beneficial?
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it is a sesamoid bone that increase the mechanical advantage of the quadriceps muscle by transmitting forces away from center of rotation (bigger lever arm)
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Which quadriceps muscle(s) flex the thigh at the hip?
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Rectus femoris - only one to cross hip joint
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The femoral nerve (L2,L3,L4) innervates which muscles in the thigh?
Give their functions |
Iliacus - flex thigh
Pectinius - flex and adduct thigh Sartorius - flex, abduct, laterally rotate thigh, flex leg Vastus lateralis - extend knee Vastus intermedius - extend knee Vastus medialis - extend knee Rectus Femoris - extend knee and flex thigh |
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What is the innervation of the psoas muscle?
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Anterior rami
L1, L2, L3 |
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This muscle is located deep to vastus intermedius and inserts on suprapatellar bursa.
What is its innervartion? |
articularis genus
femoral nerve |
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Femoral nerve gives off lateral and anterior cutaneous branches and the saphenous nerve which does what?
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A&L - sensory nerve for A&L thigh
saphenous - sensory nerve for medial leg |
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What are the most powerful hip flexors?
Which others help out? |
Psoas
Illiacus Rectus femoris Sartorius Tensor Fascia Latae Pectineus |
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Function of psoas and iliacus
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hip flexors
can also laterally rotate the thigh bilaterally will flex trunk if legs are anchored |
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What is Gerdey's tubercle?
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lateral epicondyle of tibia. serves as attachment for tensor fascia latae
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Draw the femoral nerve from its roots to the muscles and skin it innervates.
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refer to Anterior and medial thigh lecture slide 19
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Which muscles occupy the medial compartment of the thigh?
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Gracillis
pectineus Obturator Externus Adductor Longus Adductor Brevis Adductor Magnus |
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The adductor magnus receives which two nerves.
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obturator
tibial portion of sciatic n. |
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Which structures pass thru the adductor hiatus?
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femoral artery
femoral vein |
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Does the saphenous nerve pass thru the adductor hiatus with the femoral artery and vein?
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No
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The perforating branches that pass thru adductor magnus are derived from what blood supply?
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deep femoral artery (profundus femoris) which is a branch of the femoral artery
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The adductor part of the Adductor magnus attaches to:
the hamstring part: How are they innervated? |
P: ischipubic ramus
D: posterior surface of femur, linea aspera, medial supracondylar line P: ischial tuberosity D: adductor tubercle, medial supracondylar line Adductor: obturator n. Hamstring: tibial division of sciatic n. |
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The obturator nerve enters the medial thigh with the obturator artery via the_______ and divides into anterior and posterior branches that innervate what?
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obturator canal
most of the adductor muscles and obturator externus skin over medial thigh |
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adductor longus and brevis
attachment nerve function |
pubis
linea aspera obturator n. adducts thigh |
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Pectineus
attachment nerve function |
pubis (pectineal line)
pectineal line of femur femoral nerve adducts and flexes thigh |
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Gracillis
attachment nerve function |
pubis
medial surface of tibia obturator nerve adduct thigh flexes leg, medially rotate leg at knee joint |
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Obturator externus
attachment nerve function |
exterior obturator foramen
intertrochanteric fossa obturator nerve laterally rotates femur |
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Which muscles of the medial compartment are supplied by the obturator nerve?
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adductor longus
adductor brevis adductor magnus obturator externus gracillis |
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if you injure the obturator nerve, what lower limb movement will be very weak?
Where would there be sensory disturbance? |
adduction of thigh
medial thigh |
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Draw the path of the obturator nerve and muscle attachment and cutaneous inervation
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refer to anterior and medial thigh lecture slide 37
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Which muscles cross both the hip and knee?
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Rectus femoris
Sartorious Gracillis Biceps femoris long head Semitendonosis Semimembranosis |
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Thee deep femoral artery gives off what branches?
What do they supply? |
Lateral and medial femoral circumflex and perforating arteries
muscles in posterior thigh |
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the lateral femoral circumflex supplies what muscles
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anterior thigh muscles
rectus femoris vastus lateralis vastus intermedius |
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Which vessels are found in the femoral sheath?
Femoral canal? is the femoral nerve in the femoral sheath? |
femoral artery, vein and lymphatic
lymphatic no lies outside superficial to illiacus |
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In what order do these structures run lateral to medial?
femoral vein femoral artery vemoral lymphatics femoral nerve |
NAVEL
nerve artery vein lymphatic |
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Give the boudaries of the femoral triangle.
what runs within it? What makes up the floor |
inguinal ligament
adductor longus sartorious femoral nerve, artery, vein, lymphatic iliacus, psoas, pectineus |
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Where is the adductor canal?
What runs thru it? |
Runs right below the sartorious
femoral artery and vein saphenous nerve nerve to vastus medialis (Femoral) |
