12 - Gluteal Region, Posterior Thigh, Posterior Leg & Popliteal Fossa Flashcards
Gluteus maximus action
-Action - extends a flexed thigh at hip
tensor fasciae latae m. action
-Action: hip flexion
functions to help stabilize the the hip and knee joints
Iliotibial tract/band
- thickening of the lateral aspect of the fascia lata.
- connects the iliac tubercle and proximal tibia
- site of insertion for the gluteus maximus and tensor fasciae latae muscles
bursae
- membranous sacs containing synovial fluid that act to reduce friction
- often found between a soft tissue structure and a bony prominence or ligament
ischial bursa
separates gluteus maximus from ischial tuberosity
trochanteric bursa
separates gluteus maximus and iliotibial tract from greater trochanter
lesser gluteals action and function
- intermediate muscle layer of gluteal region
- gluteus medius
- gluteus minimus
- Actions: Abduct thigh/ medially rotate thigh
- Function: prevent pelvic drop of contralateral hip during stance phase
lateral rotators of the hip and innervation
piriformis
In - n. to piriformis
obturator internus
In - n. to obturator internus
Structures passing through greater sciatic foramen (between pelvis and gluteal region)
- internal pudendal artery/vein
- pudendal nerve
- superior gluteal V AN
- piriformis muscle
- inferior gluteal V AN
- n. to obturator internus
- n. to quadratus femoris
- sciatic nerve
- posterior femoral cutaneous nerve
structures passing through lesser sciatic foramen (between perineum and gluteal region)
- internal pudendal artery/vein
- pudendal nerve
- n. to obturator internus
- obturator internus muscle/tendon
intragluteal injections
should be performed in the upper lateral quadrant of the gluteal region so as not to damage the sciatic nerve or structures passing through the sciatic foramina
problems associated with excessive use of gluteal muscles
may develop hypertrophy and spasm of the piriformis muscle which can result in compression of any of the structures passing through the greater sciatic foramen.
insertion of semitendinosus and semitendinosus
medial side of proximal tibia (at pes anserinus)
origin and insertion of biceps femoris
inserts on head of fibula
long head originates from ischial tuberosity
short head arises from femoral shaft
innervation of the posterior thigh
tibial nerve (off sciatic nerve) common fibular only innervates short head of biceps femoris
main blood supply of posterior thigh
perforating branches of deep femoral artery
origin, innervation, and action of hamstrings
-arise from ischial tuberosity, cross two joints
innervated by tibial portion of sciatic nerve
extend hip and flex knee
SEMITENDINOSUS, SEMIMEMBRANOSUS and LONG HEAD OF BICEPS FEMORIS ARE THE ONLY HAMSTRING MUSCLES
(short head of biceps femoris lacks all three criteria and therefore is not considered to be a hamstring muscle
boundaries of popliteal fossa
-popliteal fossa is a diamond shaped depression on the posterior aspect of the knee
-boundaries are:
Superolateral - biceps femoris
Superomedial - semimembranosus (semitendinosus)
Inferolateral - lateral head of gastrocnemius
Inferomedial - medial head of gastrocnemius
contents of popliteal fossa
- Popliteal artery and vein (including genicular branches)
- tibial and common fibular nerves
- Lymph
- small saphenous vein
popliteal pulse
The Popliteal artery is the deepest structure in the popliteal fossa (deep to both the tibial nerve and popliteal vein).
-pulse of the popliteal a. pulsations are best felt when you push hard on superior aspect of popliteal fossa (where the artery lies on the posterior surface of the femur). Weakening or loss of popliteal pulse is a sign of femoral artery obstruction
what could result from fractures of distal femur
damage to the popliteal artery
genicular anastomosis
periarticular anastomosis around the knee joint that provides collateral circulation for bypassing
popliteal artery branches arise from: -femoral a. -lateral circumflex femoral a. -popliteal a. -anterior tibial a.
when does genicular anastomosis come into play
during common occlusion of popliteal a. during full knee flexion
how does blood get to the leg if there is an occlusion of femoral a. after branching of profunda femoris
via the descending branch of the lateral circumflex femoral artery and its communication with the genicular anastomosis
which joints are involved in eversion and inversion of foot
subtalar and transverse tarsal joints
what forms compartments in the leg
anterior and posterior septa (from crural fascia) and interosseous membrane
Leg: posterior compartment a, v, and innervation
- plantarflexors/ toe flexors/ inverters
- tibial nerve
- posterior tibial & fibular arteries
Leg: anterior compartment a, v, and innervation
- dorsiflexors/ toe extensors/ inverters
- deep fibular nerve
- anterior tibial artery
Leg: lateral (fibular) compartment a, v, and innervation
- everters of foot
- superficial fibular nerve
- supplied by perforating branches of the fibular artery.
flexor retinaculum
forms the roof of the tarsal tunnel on the posteromedial aspect of the ankle joint
where do all superficial muscles of posterior leg insert
calcaneal tuberosity
what is the action of all superficial muscles of the posterior leg
plantarflexion of the foot at the ankle
ankle jerk reflex
Strike the calcaneal tendon (just proximal to the calcaneal tuberosity) with a reflex hammer when the patient’s legs are dangling over the side of a table. The normal result is plantar flexion
of the ankle joint. If the S1 nerve root is injured or compressed, the ankle reflex is virtually absent.
action of flexor digitorum longus
Plantarflexion & flexion of all joints of the lateral 4 toes
action of tibialis posterior
plantarflexion and inversion
action of popliteus
medial rotation of leg. “unlocks” knee joint
does not cross ankle
action of flexor hallucis longus
plantarflexion and flexion of all joints of the hallux
poplitial artery origin and end
begins at the adductor hiatus, travels through the popliteal fossa and ends by dividing into the anterior and posterior tibial arteries.
anterior tibial artery
pierces the interosseous membrane to reach the anterior compartment of the leg.
posterior tibial artery
-gives off the fibular artery, supplies structures of the posterior compartment of the leg and then enters the sole of the foot by passing through the tarsal tunnel.
tarsal tunnel
depression on the posteromedial aspect of the ankle between the medial malleolus and calcaneal tuberosity. It’s roof is formed by the flexor retinaculum. It is a pathway for structures passing between the posterior leg and the plantar surface of the foot.
tarsal tunnel components
Medial malleolus Tibialis posterior Flexor Digitorum Longus Posterior tibial Artery Posterior tibial Vein (not shown) Tibial Nerve Flexor Hallucis longus
