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MSK > 16. Anatomy of Gluts and Thigh > Flashcards

16. Anatomy of Gluts and Thigh Flashcards

1
Q

What divides the lower limb into compartments?

A

Deep fascial septa (fascia lata)

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2
Q

What are the three compartments of the thigh?

A

Anterior
Medial
Posterior

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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)

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4
Q

What are the compartments of the gluteal region?

A

Superficial and deep/lateral rotators

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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

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6
Q

What are the different regions of the lower limb?

A

Gluteal
Hip
Thigh
Knee
Leg
Ankle
Foot

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7
Q
A
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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)

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9
Q

Which muscle attaches to the pectineal line of the humerus?

A

The pectineus

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10
Q

What is the innominate bone made from?

A

Ilium
Ischium
Pubis

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11
Q

What type of cartilage is found in the acetabulum?

A

Triradiate

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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.

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13
Q

Which muscle attaches in the iliac fossa?

A

Iliacus muscle

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14
Q

Which foramen does the obturator nerve pass through?

A

The obturator foramen

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15
Q

Which is the longest bone in the body?

A

Femur

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16
Q

What is the joint between the sacrum and the ilium called?

A

Iliosacral joint

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17
Q

What does the iliopsoas attach to on the femur?

A

The lesser trochanter

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18
Q
A
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19
Q
A
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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

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21
Q

What type of socket is the hip joint?

A

Balla and socket

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22
Q

What type of surface is found in the acetabulum?

A

Articular lunate surface

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23
Q
A
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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

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25
Q

What are the intrinsic ligaments of the hip joint capsule?

A

Iliofemoral ligament
Pubofemoral ligament
Ischiofemoral ligament

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26
Q
A
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27
Q

What is the function of the acetabular labrum?

A

Made of connective tissue - makes the socket deeper so the head of the femur sits more tightly and deeply into the socket.

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28
Q

What is important clinically about the blood supply to ligament teres femurs?

A

It has its own unique blood supply (obturator artery) - therefore if this is restricted there is risk of avascular necrosis to the femoral head.

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29
Q
A
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30
Q

Which muscles make up the superficial gluteal muscles?

A

Gluteus maximum
Gluteus medius
Gluteus minimus
Tensor fascia lata

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31
Q

What is the action of the superficial gluteal muscles?

A

Extension of thigh at hip
Rotation of femur
Abduction of thigh
Fascia lata tension

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32
Q

What does the thickening of the tensor fascia lata become?

A

The iliotibial band

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33
Q

Which is the main muscle of the butt cheek?

A

Gluteus maximus

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34
Q

Which nerves supply the superficial gluteal region?

A

Superior gluteal nerve
Inferior gluteal nerve

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35
Q

Which nerve roots supply the superficial gluteal nerve?

A

L4-S1

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36
Q

Which nerve roots supply the inferior gluteal nerve?

A

L5-S2

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37
Q

What arises on the anterior surface of the piriformis muscle?

A

The sacral plexus

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38
Q

Which nerves are found at the superior border of the pirformis?

A

Superior gluteal nerve (and superior gluteal artery)

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39
Q

Which test tests the superior gluteal nerve?

A

The Trendelenberg test

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40
Q
A
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41
Q

Which nerve innervates the gluteus medius muscle?

A

Superior gluteal nerve

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42
Q

What is the action of the superior gluteal nerve?

A

Abduction of femur
Medial rotation of thigh

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43
Q

What is the innervation of the gluteus minimus muscle?

A

Superior gluteal nerve

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44
Q

What is the function of the gluteus minimus muscle?

A

Abduction of femur
Medial rotation of thigh

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45
Q

What is the innervation of the gluteus Maximus muscle?

A

Inferior gluteal nerve

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46
Q

What is the function of the gluteus Maximus muscle?

A

Extension of femur at hip
Lateral rotation & abduction of femur at hip

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47
Q

What is the innervation of the tensor fascia lata?

A

Superior gluteal nerve

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48
Q

What is the function of the tensor fasciae lata?

A

Abduction of thigh
Medial rotation of thigh
Weak hip flexion

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49
Q

Which muscles make up the deep gluteal muscles?

A

Piriformis
Superior & Inferior Gemellus
Obturator Internus
Quadratus Femoris

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50
Q

What is the action of the deep gluteal muscles?

A

Lateral rotation of extended thigh
Abduction of flexed thigh

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51
Q

What is the bloody supply to the deep gluteal muscles?

A

Inferior gluteal artery

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52
Q

What is the obturator internus flanked by on each side?

A

The superior and inferior gemellus muscles

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53
Q

Which is the deepest of the gluteal muscles?

A

The quadratus femoris

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54
Q

Which is piriformis important clinically?

A

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.

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55
Q

What is the innervation of the piriformis muscle?

A

S1 & S2

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56
Q

What is the action of the piriformis muscle?

A

Laterally rotates the extended femur at hip

Abducts flexed femur at hip

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57
Q

What is the innervation of the obturator internus?

A

Nerve to obturator internus

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58
Q

What is the action of obturator interns?

A

Lateral rotation of extended femur
Abduction of flexed femur

59
Q

What is the innervation of gemellus superior?

A

Nerve to obturator internus

60
Q

What is the action of gemellus superior?

A

Lateral rotation of extended femur
Abduction of flexed femur

61
Q

What is the innervation of gemellus inferior?

A

Nerve to quadratus femoris

62
Q

What is the action of gemellus inferior?

A

Lateral rotation of extended femur
Abduction of flexed femur

63
Q

What is the innervation of quadratus femoris?

A

Nerve to quadratus femoris

64
Q

What is the action of quadratus femoris?

A

Lateral rotation of femur

65
Q

Which muscles form the hip flexors?

A

Psoas Major
Iliacus

66
Q

What is the action of the hip flexor muscles?

A

Flex thigh at hip joint
Flex lumbar spine (when lower limb fixed)

67
Q

What is the blood supply to the hip flexor muscles?

A

Lumbar arteries
External iliac artery
Femoral artery
Iliolumbar artery

68
Q

What is the innervation of psoas major?

A

Anterior rami L1-L3

69
Q

What is the innervation of iliacus?

A

Femoral nerve (L2 & L3)

70
Q

Which muscles from each compartment of the thighs join together to insert o the pes anserinus?

A

Sartorious
Gracilis
Semitendinosus

Say Grace before Tea

71
Q

On which part of the tibia do the sartorious, gracilis and semitendinosus insert?

A

The pes anserinus

72
Q
A
73
Q

Which muscles make up the quadriceps?

A

Vastus Medialis
Vastus Lateralis
Vastus Intermedius
Rectus Femoris

74
Q

Which muscles are found in the anterior compartment of the thigh?

A

Quadriceps
Sartorius
Pectineus

75
Q

What is special about the innervation of the pectineus muscle?

A

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
Q

What action does the pectineus muscle follow? That of the anterior or that of the medial compartment?

A

Follows the action of the medial compartment

77
Q

What is the action of the quadriceps muscles?

A

All extend the leg at the knee joint

Rectus Femoris additionally flexes the thigh at the hip

78
Q

What is the action of the sartorius muscle?

A

Flexes thigh at the hip
Flexes leg at the knee joint

And external rotation of the lower limb (= cross legged position)

79
Q

What is the action of the Pectineus muscle?

A

Flexion of the thigh at the hip joint

80
Q

What is the innervation of the muscles of the anterior thigh compartment?

A

All innervated by the femoral nerve

81
Q
A
82
Q

What nerve roots make up the femoral nerve?

A

L2-4

83
Q

Which muscles are found in the medial compartment of the thigh?

A

Obturator externs
Gracilis
Adductor Longus, Brevis & Magnus
Pectineus (action)

84
Q

What is the general action of the muscles of the medial compartment of the thigh?

A

Adduction of the thigh at the hip joint (all do this)

85
Q

In addition to adduction of the thigh, the gracilis muscle has an extra function - what is it?

A

Flexes leg at the knee joint

86
Q

What is the blood supply to the muscles of the medial compartment of the thigh?

A

The obturator artery (anterior)

87
Q

Which nerves innervate the medial compartment of the thigh?

A

Obturator nerve - superficial and posterior

Tibial nerve

88
Q
A
89
Q

What is the innervation of the gracilis muscle?

A

Obturator nerve (anterior division)

90
Q

Which nerve roots make up the obturator nerve, anterior division and posterior division?

A

L2-3 - anterior
L3-4 - posterior

91
Q

What is the innervation of the pectineus muscle?

A

Femoral nerve

92
Q

What is the innervation of obturator externs?

A

Obturator nerve (posterior division)

93
Q

What is the innervation of adductor longus?

A

Obturator nerve - anterior branch

94
Q

What is the innervation of adductor brevis?

A

Obturator nerve, anterior division

95
Q

What are the two parts of the adductor Magnus?

A

Adductor part
Hamstring part

96
Q

What is the innervation of the adductor magus muscle in relation to its (a) adductor part and (b) Hamstring part

A

(a). Obturator nerve - posterior division

(b) Sciatic nerve

97
Q

What is the function of adductor Magnus?

A

Adducts and medially rotates thigh at hip joint (adductor part)

Extends thigh at hip joint (hamstring part)

98
Q

Which muscles are found in the posterior compartment of the thigh?

A

Hamstrings

99
Q

Which muscles make up the hamstrings?

A

Semimembranous
Semitendinosus
Biceps femoris

100
Q

The muscles of the posterior compartment of the thigh all cross the hip joint, except which one?

A

Short head of biceps femoris - only crosses the knee joint

101
Q

What is the function of the muscles of the posterior compartment of the thigh?

A

Flex leg at knee

Extend thigh at hip (apart from short head of biceps)

102
Q

What is the blood supply to the posterior compartment of the thigh?

A

Obturator artery (posterior) and profunda femoris

103
Q

What is the innervation to the muscles of the posterior compartment of the thigh

A

Tibial nerve (sciatic nerve)

Biceps femoris = Fibular nerve (sciatic nerve)

104
Q
A
105
Q

What are the boundaries of the femoral triangle?

A

Superior - inguinal ligament
Medial - adductor longus
Lateral - sartorius
Floor = Iliopsoas & Pectineus
Roof = cribriform fascia

106
Q

What are the contents of the femoral triangle?

A

Femoral nerve
Femoral artery
Femoral vein (great saphenous vein)

107
Q

What is the femoral triangle composed of?

A

Composed of a CT sheath - which is divided into three compartments (medial, lateral and intermediate).

108
Q

What is important about the femoral canal?

A

Can be a site of herniation (more common in F than M due to wider pelvis)

109
Q

What are the two biggest branches of the femoral artery?

A

Profunda femoris
Circumflex femoral artery

110
Q

What is found at the apex of the femoral triangle?

A

Adductor canal

111
Q

What is the terminal branch of the femoral nerve?

A

Saphenous nerve

112
Q

What passes through the adductor canal?

A

Femoral artery
Femoral vein
Saphenous nerve

113
Q

Why is the femoral triangle important clinically?

A

Pulse point (radio-femoral delay)
Femoral hernia
Femoral access
Imaging

114
Q

Where do the great saphenous and small saphenous veins arise from?

A

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
Q

What is the order of vessels in the femoral triangle?

A

NAVY
Nerve
Artery
Vein
lYmphatics

116
Q

What are the nerves of the lumbar plexus?

A

Iliohypogastric
Ilioinguinal
Genitofemoral
Lateral Cutaneous Nerve of the Thigh
Obturator
Femoral

I twice Get Lost On Fridays

117
Q
A
118
Q

Nerve root value of iliohypogastric?

A

T12 & L1

119
Q

Nerve root value of Ilioinguinal?

A

L1

120
Q

Nerve root value of genitofemoral?

A

L1 & 2

121
Q

Nerve root value of Obturator?

A

L2-4

122
Q

Nerve root value of Lateral Cutaneous Nerve of the Thigh?

A

L2-3

123
Q

Nerve root value of Femoral Nerve?

A

L2-4

124
Q

What are the nerves of the gluteal region?

A

SIPPS

Super gluteal
Inferior gluteal
Posterior cutaneous nerve of the thigh
Pudendal
Sciatic

125
Q

Nerve root value of superior gluteal?

A

L4-S1

126
Q

Nerve root value of Inferior gluteal?

A

L5-S2

127
Q

Nerve root value of Posterior cutaneous nerve of thigh?

A

S2-3

128
Q

Nerve root value of Pudental?

A

S2-4

129
Q

Nerve root value of Sciatic?

A

L4-S3

130
Q

What muscles does the superior gluteal nerve innervate?

A

Quadratus femoris
Inferior gemellus

131
Q

What muscles does the inferior gluteal nerve innervate?

A

Obturator internus
Superior gemellus
Piriformis

132
Q

What does the posterior cutaneous nerve of the thigh innervate?

A

Perforating cutaneous nerve

133
Q

What does the pudendal nerve innervate?

A

Levator ani
Coccygeus

134
Q
A
135
Q

The obturator nerve passes through the obturator canal and divides into what?

What do they then run alongside?

A

Anterior and posterior divisions

They then descend on either side of adductor brevis

136
Q

What is the terminal nerve of the femoral nerve?

A

Saphenous nerve

137
Q

What does the femoral nerve travel with?

A

The great saphenous vein

138
Q

Once vessels leave the adductor canal what happens to them?

A

They pass through the adductor hiatus and into the popliteal fossa

139
Q

What does not pass through the adductor hiatus to enter the popliteal fossa?

What does it do instead?

A

The saphenous nerve does not pass through the hiatus - remains superficial proximal to it and becomes purely cutaneous.

140
Q

When the femoral artery passes through the adductor hiatus, what does it become?

A

The popliteal artery

141
Q

What does the femoral artery originate from?

A

The external iliac artery - when it passes under the inguinal ligament it becomes the femoral artery

142
Q
A
143
Q
A

MSK (21 decks)

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