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65 Cards in this Set
- Front
- Back
what are the nerve roots for the lumbar and sacral plexus
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T12-S4
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what compartments of the thigh does the lumbar plexus innervate
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anterior thigh, medial thigh, including quadriceps femoris
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what are the nerve roots for the femoral nerve
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Ventral Rami L2-4
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what are the nerve roots that make up the lumbar plexus
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ventral rami T12-L4
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what is the largest branch of the lumbar plexus
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femoral nerve
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what are hte motor branches for the femoral nerve
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1) hip flexors
2) all knee extensors 3) proximal to inguinal lig: psoas major, minor, iliacus 4) distal to inguinal ligament: sartorius, part of pectineus, quadriceps |
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where is the sensory distribution for the femoral nere
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most of the skin of anterior-medial thigh
innervates skin of lower leg via saphenous cutaneous nerve |
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what are the nerve roots for the obturator nerve
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L2-L4
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wha tar ehte motor branches of the obturator nerve
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posterior: obturator externus, anterior head of adductor magnus
anterior: pectineus, adductor brevis, adductor longus, gracilis |
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what is the path of the obturator nerve
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it splits into anterior and posterior as it passes throught the obturator foramen
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what is the sensory innervation of the obturator nerve
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skin of the medial thigh
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what are the nerve roots for the sacral plexus
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ventral rami L4-S4
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what is the motor innervation for the sacral plexus
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muscles of the posterior and lateral hip, posterior thigh, and entire lower leg
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where is the sacral plexus located
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posterior wall of pelvis
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where do most of the nerves of the sacral plexus nerves exit the pelvis
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through the greater sciatic foramen in order to innervate the posterior hip muscles
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what are the nerve roots for the nerve to the piriformis
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S1-2
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what are the nerve roots for the nerves to the quadratus femoris
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L4-S1
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what ar ehte nerve roots for the nerve to the gamellus inferior
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L4-S1
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how are the gluteal nerves names
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according to where they exit the greater sciatic notch
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what are hte nerve roots for the superior gluteal nerve
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L4-S1
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what are the nerve roots for the inferior gluteal nerve
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L5-S2
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what does the superior gluteal nerve innervate
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gluteus medius, gluteus minimis, tensor fasciae latae
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what does the inferior glutela nerve innervate
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gluteus maximus
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what are the nerve roots for the sciatic nerve
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L4-S3
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the sciatic nerve is the ____ and the _____ in teh body
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longest and widest in the body
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where does the sciatic nerve exit the pelvis
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through the greater sciatic foramen (inferior to the piriformis
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the sciatic is made up of which two nerves, and where does it split
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tibial and common peroneal, seperates just proximal the the knee usually
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what is unique about many people who have piriformis syndrome
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sciatic nerve splits more proximal and the common peroneal actually pierces the piriformis
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what does the tibial nerve innervate
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posterior thigh
all biarticular muscles within the hamstrings, and the posterior head of adductor magnus |
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what does the common peroneal nerve innergvate
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short head of the biceps (in the thigh)
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what provides sensory innervation to the capsule
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same nerve roots that supply the overlying muscle
femoral nerve: nerve filaments into anterior capsule Sacral plexus: nerve brances enter posterior capsule froma ll roots Obturator nerve: medial aspect of hip and kene |
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why could inflammation of the hip be perceived as inflammation at the knee
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because the obturator nerve innervates the medial thigh muscles and also the sensory innervation to the hip capsule
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what are the two limitations to his graphs showing the line of force
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1) does NOT represent a force vector, only overall direction of the muscle (so we cannot compare strength)
2) lines of force and lengths of moment arms apply only in anatomic position |
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what is the iliopsoas
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the fibers of the iliacus and the psoas major because they fuse together to form a common tendon anchoring the muscles to the femur
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explain the line of pull for the iliopsoas
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passes anterior to the pubis then must go 35-45 degrees posterior to reach the lesser trochanter....
in full extension, this raises the tendon's angle of insertion to the femur therby increaseing the muscle's leverage for flexion |
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what are the actions ofthe iliopsoas
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hip flexion
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what is the iliopsoas' role in rotation (er/ir) at the hip
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not an effective rotator in anatomic position, but in hip abduction, can assist in external rotation
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attachments for psoas minor
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anteiror to psoas major, 12th thoracic and 1st lumbar v. --> pelvis near pectineal line
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what is the action of the psoas minor
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doesnt have one-- it does next to no motion and is absent in about 40% of people
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what is the longest muscle in the body
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sartorius
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what type of muscle is hte sartorius (by fiber)
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fusiform
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what is the action of the sartorius
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hip flexion, external rotation, abduction
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attachments for the tensor fasciae latae
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iliium (lateral to sartorius) --> IT band (extending down to lateral tub. of tibia)
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where is the IT band the thickest
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lateral side (thickened by the muscle attachments - tensor fasciae latae and gluteus medius)
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what seperates the thigh into its compartments
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seperations of the IT band called fascial sheets --> intermuscular septa
partitions the main muscle groups according to innervation |
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what are the actions of the tensor fasciae latae
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primary flexor
primary abductor secondary internal rotator |
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where is the tension in the tensor fascia the greatest
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as it moves distally -- helps stabilize the lateral aspect of extended knee
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what is the optimal stretch of the IT band
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knee extension
hip adduction hip extension |
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what is the "inverted V" in the thigh
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where the rectus femors emerges, between sartorius and tensor fasiae latae
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what type of muscle is the rectus femoris
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bipennate
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waht are the attachments of the rectus femoris
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AIIS and superior rim of acetabulum and into joint capsule --> patellar tendon
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how much of the flexor torque at the hip does the rectus femoris account for
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about 1/3!
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what is the force coupling for an anterior tilt
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hip flexots with low back extensors to increase anterior tilt
ALSO synergy between hip flexors and abdominal muscles - if SLR the abs have to activate in order to maintain a neutral pelvis (counter the anterior tilt of hte hip flexors) |
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which hip flexors are capable of anterior tilting
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ANY muscle that can do flexion of hip (femoral on pelvic) is equally capable of of anteriorly tilting the pelvis
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what is the clinical implication of someone with excessively strong hip flexors
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pull into anterior pelvic tilt --> greater lordosis --> increase compresive loads on lumbar apophyseal joints
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what would be the clinical presenation of someone with very weak abs and very strong hip flexors (who is the only population we really would see this in)
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rectus pulls greatly on pelvis causing anterior tilt --> pull on psoas --> increase lumbar lordosis ... seen in poliomyelitis or muscular dystrophic patients
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what are the primary hip adductors
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pectineus
adductor longus gracilis adductor brevis adductor magnus |
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what are the secondary hip adductors
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Biceps femoris
gluteus maximus (especially inferior fibers) quadratus femorus |
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what are the three layers of muscles in the hip adductors
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superficial: adductor longus and gracilis
Middle: adductor brevis Deep: adductor magnus |
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what are the fiber directions of the adductor magnus
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anterior head:
horizontal (very small) pubic ramus --> linea aspera oblique: ischial ramus --> linea aspeara --> supracondylar line Posteroir head: fibers run vertical |
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what planes of movement do the adductors have line of furce
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they are able to produce torque in all planes of the hip
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explain a situation in which you can accomplish both pelvic on femoral and femoral on pelvic adduction simultaneously
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kicking a soccer ball, stance leg is pelvic on femoral, while the kicking leg is femoral on pelvic
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in what position of the hip does the post. adductor magnus become a powerful hip extensor
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it is always a powerful extender--- doesnt matter what position
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explain the role of the adductors in flexion and extension
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once the adductors pass about 50/60 degrees of hip flexion, they have extension torque because their line of force is shifted posterior
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what are the primary internal rotators of the hip
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there arent any
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