16. Anatomy of Gluts and Thigh Flashcards
1
Q
What divides the lower limb into compartments?
A
Deep fascial septa (fascia lata)
2
Q
What are the three compartments of the thigh?
A
Anterior
Medial
Posterior
3
Q
Generally what is the function & innervation of the following:
Anterior thigh compartment
Medial thigh compartment
Posterior thigh compartment
A
Anterior = extensor compartment - femoral nerve
Medial = Adductor compartment - obturator nerve
Posterior = Flexor compartment - sciatic nerve (tibial branch)
4
Q
What are the compartments of the gluteal region?
A
Superficial and deep/lateral rotators
5
Q
Which muscles of the abdomen also have a role in flexion of the hip?
A
Psoas major and Iliacus muscles - together = iliopsoas tendon
6
Q
What are the different regions of the lower limb?
A
Gluteal
Hip
Thigh
Knee
Leg
Ankle
Foot
7
Q
A
8
Q
In the femur - what is important about the neck and the surgical neck of the bone?
A
They are in the same location (unlike the humerus)
9
Q
Which muscle attaches to the pectineal line of the humerus?
A
The pectineus
10
Q
What is the innominate bone made from?
A
Ilium
Ischium
Pubis
11
Q
What type of cartilage is found in the acetabulum?
A
Triradiate
12
Q
What are the lines on the Ala of the ilium? What do they demarcate?
A
Gluteal lines - posterior, anterior and inferior.
Demarcate lines of attachment of the gluteal muscles.
13
Q
Which muscle attaches in the iliac fossa?
A
Iliacus muscle
14
Q
Which foramen does the obturator nerve pass through?
A
The obturator foramen
15
Q
Which is the longest bone in the body?
A
Femur
16
Q
What is the joint between the sacrum and the ilium called?
A
Iliosacral joint
17
Q
What does the iliopsoas attach to on the femur?
A
The lesser trochanter
18
Q
A
19
Q
A
20
Q
Generally - what is the difference between a condyle and an epicondyle?
A
Condyle - smoother surface - tends to be for articulation of bone.
Epicondyle - rougher surface - tends to be a site of attachment on a bone
21
Q
What type of socket is the hip joint?
A
Balla and socket
22
Q
What type of surface is found in the acetabulum?
A
Articular lunate surface
23
Q
A
24
Q
What soft tissue components of the hip help to hold the joint in place?
A
Acetabular labrum
Transverse acetabular ligament
Intrinsic ligaments of the joint capsule
25
What are the intrinsic ligaments of the hip joint capsule?
Iliofemoral ligament
Pubofemoral ligament
Ischiofemoral ligament
26
27
What is the function of the acetabular labrum?
Made of connective tissue - makes the socket deeper so the head of the femur sits more tightly and deeply into the socket.
28
What is important clinically about the blood supply to ligament teres femurs?
It has its own unique blood supply (obturator artery) - therefore if this is restricted there is risk of avascular necrosis to the femoral head.
29
30
Which muscles make up the superficial gluteal muscles?
Gluteus maximum
Gluteus medius
Gluteus minimus
Tensor fascia lata
31
What is the action of the superficial gluteal muscles?
Extension of thigh at hip
Rotation of femur
Abduction of thigh
Fascia lata tension
32
What does the thickening of the tensor fascia lata become?
The iliotibial band
33
Which is the main muscle of the butt cheek?
Gluteus maximus
34
Which nerves supply the superficial gluteal region?
Superior gluteal nerve
Inferior gluteal nerve
35
Which nerve roots supply the superficial gluteal nerve?
L4-S1
36
Which nerve roots supply the inferior gluteal nerve?
L5-S2
37
What arises on the anterior surface of the piriformis muscle?
The sacral plexus
38
Which nerves are found at the superior border of the pirformis?
Superior gluteal nerve (and superior gluteal artery)
39
Which test tests the superior gluteal nerve?
The Trendelenberg test
40
41
Which nerve innervates the gluteus medius muscle?
Superior gluteal nerve
42
What is the action of the superior gluteal nerve?
Abduction of femur
Medial rotation of thigh
43
What is the innervation of the gluteus minimus muscle?
Superior gluteal nerve
44
What is the function of the gluteus minimus muscle?
Abduction of femur
Medial rotation of thigh
45
What is the innervation of the gluteus Maximus muscle?
Inferior gluteal nerve
46
What is the function of the gluteus Maximus muscle?
Extension of femur at hip
Lateral rotation & abduction of femur at hip
47
What is the innervation of the tensor fascia lata?
Superior gluteal nerve
48
What is the function of the tensor fasciae lata?
Abduction of thigh
Medial rotation of thigh
Weak hip flexion
49
Which muscles make up the deep gluteal muscles?
Piriformis
Superior & Inferior Gemellus
Obturator Internus
Quadratus Femoris
50
What is the action of the deep gluteal muscles?
Lateral rotation of extended thigh
Abduction of flexed thigh
51
What is the bloody supply to the deep gluteal muscles?
Inferior gluteal artery
52
What is the obturator internus flanked by on each side?
The superior and inferior gemellus muscles
53
Which is the deepest of the gluteal muscles?
The quadratus femoris
54
Which is piriformis important clinically?
It passes through the greater sciatic foramen along with nerves to the lower limb. Compression by the muscle can cause impingement of these nerves --> sciatic pain.
55
What is the innervation of the piriformis muscle?
S1 & S2
56
What is the action of the piriformis muscle?
Laterally rotates the extended femur at hip
Abducts flexed femur at hip
57
What is the innervation of the obturator internus?
Nerve to obturator internus
58
What is the action of obturator interns?
Lateral rotation of extended femur
Abduction of flexed femur
59
What is the innervation of gemellus superior?
Nerve to obturator internus
60
What is the action of gemellus superior?
Lateral rotation of extended femur
Abduction of flexed femur
61
What is the innervation of gemellus inferior?
Nerve to quadratus femoris
62
What is the action of gemellus inferior?
Lateral rotation of extended femur
Abduction of flexed femur
63
What is the innervation of quadratus femoris?
Nerve to quadratus femoris
64
What is the action of quadratus femoris?
Lateral rotation of femur
65
Which muscles form the hip flexors?
Psoas Major
Iliacus
66
What is the action of the hip flexor muscles?
Flex thigh at hip joint
Flex lumbar spine (when lower limb fixed)
67
What is the blood supply to the hip flexor muscles?
Lumbar arteries
External iliac artery
Femoral artery
Iliolumbar artery
68
What is the innervation of psoas major?
Anterior rami L1-L3
69
What is the innervation of iliacus?
Femoral nerve (L2 & L3)
70
Which muscles from each compartment of the thighs join together to insert o the pes anserinus?
Sartorious
Gracilis
Semitendinosus
Say Grace before Tea
71
On which part of the tibia do the sartorious, gracilis and semitendinosus insert?
The pes anserinus
72
73
Which muscles make up the quadriceps?
Vastus Medialis
Vastus Lateralis
Vastus Intermedius
Rectus Femoris
74
Which muscles are found in the anterior compartment of the thigh?
Quadriceps
Sartorius
Pectineus
75
What is special about the innervation of the pectineus muscle?
Innervation is predominantly from the femoral nerve in the anterior compartment, but it also has some innervation from the obturator nerve in the medial compartment.
76
What action does the pectineus muscle follow? That of the anterior or that of the medial compartment?
Follows the action of the medial compartment
77
What is the action of the quadriceps muscles?
All extend the leg at the knee joint
Rectus Femoris additionally flexes the thigh at the hip
78
What is the action of the sartorius muscle?
Flexes thigh at the hip
Flexes leg at the knee joint
And external rotation of the lower limb (= cross legged position)
79
What is the action of the Pectineus muscle?
Flexion of the thigh at the hip joint
80
What is the innervation of the muscles of the anterior thigh compartment?
All innervated by the femoral nerve
81
82
What nerve roots make up the femoral nerve?
L2-4
83
Which muscles are found in the medial compartment of the thigh?
Obturator externs
Gracilis
Adductor Longus, Brevis & Magnus
Pectineus (action)
84
What is the general action of the muscles of the medial compartment of the thigh?
Adduction of the thigh at the hip joint (all do this)
85
In addition to adduction of the thigh, the gracilis muscle has an extra function - what is it?
Flexes leg at the knee joint
86
What is the blood supply to the muscles of the medial compartment of the thigh?
The obturator artery (anterior)
87
Which nerves innervate the medial compartment of the thigh?
Obturator nerve - superficial and posterior
Tibial nerve
88
89
What is the innervation of the gracilis muscle?
Obturator nerve (anterior division)
90
Which nerve roots make up the obturator nerve, anterior division and posterior division?
L2-3 - anterior
L3-4 - posterior
91
What is the innervation of the pectineus muscle?
Femoral nerve
92
What is the innervation of obturator externs?
Obturator nerve (posterior division)
93
What is the innervation of adductor longus?
Obturator nerve - anterior branch
94
What is the innervation of adductor brevis?
Obturator nerve, anterior division
95
What are the two parts of the adductor Magnus?
Adductor part
Hamstring part
96
What is the innervation of the adductor magus muscle in relation to its (a) adductor part and (b) Hamstring part
(a). Obturator nerve - posterior division
(b) Sciatic nerve
97
What is the function of adductor Magnus?
Adducts and medially rotates thigh at hip joint (adductor part)
Extends thigh at hip joint (hamstring part)
98
Which muscles are found in the posterior compartment of the thigh?
Hamstrings
99
Which muscles make up the hamstrings?
Semimembranous
Semitendinosus
Biceps femoris
100
The muscles of the posterior compartment of the thigh all cross the hip joint, except which one?
Short head of biceps femoris - only crosses the knee joint
101
What is the function of the muscles of the posterior compartment of the thigh?
Flex leg at knee
Extend thigh at hip (apart from short head of biceps)
102
What is the blood supply to the posterior compartment of the thigh?
Obturator artery (posterior) and profunda femoris
103
What is the innervation to the muscles of the posterior compartment of the thigh
Tibial nerve (sciatic nerve)
Biceps femoris = Fibular nerve (sciatic nerve)
104
105
What are the boundaries of the femoral triangle?
Superior - inguinal ligament
Medial - adductor longus
Lateral - sartorius
Floor = Iliopsoas & Pectineus
Roof = cribriform fascia
106
What are the contents of the femoral triangle?
Femoral nerve
Femoral artery
Femoral vein (great saphenous vein)
107
What is the femoral triangle composed of?
Composed of a CT sheath - which is divided into three compartments (medial, lateral and intermediate).
108
What is important about the femoral canal?
Can be a site of herniation (more common in F than M due to wider pelvis)
109
What are the two biggest branches of the femoral artery?
Profunda femoris
Circumflex femoral artery
110
What is found at the apex of the femoral triangle?
Adductor canal
111
What is the terminal branch of the femoral nerve?
Saphenous nerve
112
What passes through the adductor canal?
Femoral artery
Femoral vein
Saphenous nerve
113
Why is the femoral triangle important clinically?
Pulse point (radio-femoral delay)
Femoral hernia
Femoral access
Imaging
114
Where do the great saphenous and small saphenous veins arise from?
The medial aspect of the dorsal arch in the foot - they travel up medially and pass through the cribriform fascial roof of the femoral triangle to drain into the femoral vein.
115
What is the order of vessels in the femoral triangle?
NAVY
Nerve
Artery
Vein
lYmphatics
116
What are the nerves of the lumbar plexus?
Iliohypogastric
Ilioinguinal
Genitofemoral
Lateral Cutaneous Nerve of the Thigh
Obturator
Femoral
I twice Get Lost On Fridays
117
118
Nerve root value of iliohypogastric?
T12 & L1
119
Nerve root value of Ilioinguinal?
L1
120
Nerve root value of genitofemoral?
L1 & 2
121
Nerve root value of Obturator?
L2-4
122
Nerve root value of Lateral Cutaneous Nerve of the Thigh?
L2-3
123
Nerve root value of Femoral Nerve?
L2-4
124
What are the nerves of the gluteal region?
SIPPS
Super gluteal
Inferior gluteal
Posterior cutaneous nerve of the thigh
Pudendal
Sciatic
125
Nerve root value of superior gluteal?
L4-S1
126
Nerve root value of Inferior gluteal?
L5-S2
127
Nerve root value of Posterior cutaneous nerve of thigh?
S2-3
128
Nerve root value of Pudental?
S2-4
129
Nerve root value of Sciatic?
L4-S3
130
What muscles does the superior gluteal nerve innervate?
Quadratus femoris
Inferior gemellus
131
What muscles does the inferior gluteal nerve innervate?
Obturator internus
Superior gemellus
Piriformis
132
What does the posterior cutaneous nerve of the thigh innervate?
Perforating cutaneous nerve
133
What does the pudendal nerve innervate?
Levator ani
Coccygeus
134
135
The obturator nerve passes through the obturator canal and divides into what?
What do they then run alongside?
Anterior and posterior divisions
They then descend on either side of adductor brevis
136
What is the terminal nerve of the femoral nerve?
Saphenous nerve
137
What does the femoral nerve travel with?
The great saphenous vein
138
Once vessels leave the adductor canal what happens to them?
They pass through the adductor hiatus and into the popliteal fossa
139
What does not pass through the adductor hiatus to enter the popliteal fossa?
What does it do instead?
The saphenous nerve does not pass through the hiatus - remains superficial proximal to it and becomes purely cutaneous.
140
When the femoral artery passes through the adductor hiatus, what does it become?
The popliteal artery
141
What does the femoral artery originate from?
The external iliac artery - when it passes under the inguinal ligament it becomes the femoral artery
142
143
