19. Dissection of Gluteal and Posterior Thigh Region Flashcards
1
Q
What vessels can be found superficially medially in the thighs and knee?
A
Great saphenous vein and saphenous nerve
2
Q
What are the cutaneous nerves of the thigh?
A
Lateral femoral cutaneous
Anterior cutaneous branches of femoral
Cutaneous branches of obturator
3
Q
Which vein drains into the femoral vein?
A
Great saphenous vein
4
Q
Which nerve emerges from the fascia lata distal to the knee to accompany the great saphenous vein?
A
Saphenous nerve
5
Q
A
6
Q
A
7
Q
A
8
Q
A
9
Q
What makes up the following borders of the femoral canal?
- Medial
- Lateral
- Superior
- Floor
- Roof
A
Medial - medial border of adductor longus
Lateral - medial border of sartorius
Superior - inguinal ligament
Floor - pectineus and iliopsoas muscle
Roof - cribriform fascia
10
Q
What is found in the femoral canal?
A
Fat and lymphatics
11
Q
What is the clinical significance of the femoral canal?
A
Femoral canal clinical significance: femoral hernia (female more prevalent than male), access for vascular procedures/imaging
12
Q
Which artery arises from the femoral artery in the femoral triangle?
A
The profunda femoris artery
13
Q
What is unique about the sartorius muscle?
A
Starts on ASIS - then passes inferioromedially to insert on the tibia at pet anserinus - this means it crosses both the hip and the knee joint.
14
Q
What is found at the apex of the femoral triable?
A
Adductor canal
15
Q
What vessels are found in the adductor canal?
A
Femoral artery
Femoral vein
Saphenous nerve
16
Q
A
17
Q
A
18
Q
A
19
Q
A
20
Q
A
21
Q
What forms the quadriceps tendon?
A
The convergence of all 4 quadriceps muscles
22
Q
What does the quadriceps tendon attach to?
A
The superior border of the patella
23
Q
Which four muscles make up the quadriceps?
A
Rectus femoris
Vastus medialis
Vastus lateralis
Vastus intermedius
24
Q
Which muscles do the anterior and posterior branches of the obturator nerve supply?
A
Obturator nerve divisions innervate:
a. Anterior – adductor brevis, adductor longus, pectineus, gracilis
b. Posterior – adductor magnus, obturator externus
25
26
What is the thickening of the fascia lata over the superior border of the gluteus Maximus called?
Gluteal aponeurosis
27
Which muscles lies deep under the gluteus Maximus?
Gluteus medius
28
What arises form the inferior border of the piriformis muscle?
The inferior gluteal artery and nerve
29
Which muscles lies deep to the gluteus medius?
Gluteus minimus
30
What arises from the superior border of the piriformis muscle?
Superior gluteal nerve and artery
31
What are the nerve roots of the sciatic nerve?
L4-S3
32
Which is the largest here in the body?
Sciatic nerve (has its own arterial supply!)
33
What does the sciatic nerve bifurcate into? Where?
Into tibial and common fibular neres
Sometimes in the gluts, but most commonly occurs proximal to the apex of the popliteal fossa.
34
When giving an intragluteal injection, how do you identify a safe area to administer it and which structure do you want to avoid damaging?
Safe area is identified by gluteal quadrants, aim for upper outer quadrant, avoid the sciatic nerve
35
36
Which nerve innervates the following?
- Gluteus medius
- Gluteus minimus
- Gluteus maximus
Medius = Superior gluteal nerve
Minimus = Superior gluteal nerve
Maximus = Inferior gluteal nerve
37
What are the nerve roots for the superior gluteal nerve?
L4-S1
38
What are the nerve roots for the inferior gluteal nerve?
L5-S2
39
What is the function of gluteus medius and minimus?
Abducts femur at hip
Medially rotates thigh
40
What is the function of gluteus Maximus?
Extends femur at hip
Laterally rotates and abducts femur at hip joint
41
Which nerve innervates the tensor fascia lata?
Superior gluteal nerve
42
What are there actions of the tensor fascia lata?
Abducts thigh
Medially rotates thigh
Weak hip flexion
43
Which nerve innervates piriformis?
S1 & S2
44
What is the function of piriformis?
Laterally rotates extended femur at hip joint
Abducts flexed femur at hip joint
45
What is the function of obturator internus?
Laterally rotates extended femur at hip joint
Abducts flexed femur at hip joint
46
What is the innervation of the obturator internus?
Nerve to obturator internus (L5-S1)
47
What is the innervation of gemellus superior?
Nerve to obturator internus (L5-S1)
48
What is the action of gemellus superior?
Laterally rotates extended femur at hip joint
Abducts flexed femur at hip joint
49
What is the action of gemellus inferior?
Laterally rotates extended femur at hip joint
Abducts flexed femur at hip joint
50
What is the innervation of gemellus inferior?
Nerve to quadratus femoris (L5-S1)
51
What is the action of quadratus femoris?
Lateral rotation of femur at hip joint
52
What is the innervation of quadratus femoris?
Nerve to quadratus femoris (L5-S1)
53
What is the innervation of psoas major?
Anterior rami (L1-3)
54
What is the action of psoas major?
Flexes the thigh at the hip joint
55
What is the innervation of iliacus?
Femoral neve
56
What is the action of iliacus?
Flexes the thigh at the hip joint
57
What is the innervation of vastus medialis?
Femoral nerve
58
What is the action of vastus medialis?
Extends the leg at the knee joint
59
What is the innervation of vastus intermedius?
Femoral nerve
60
What is the action of vastus intermedius?
Extends the leg at the knee joint
61
What is the innervation of vastus lateralis?
Femoral nerve
62
What is the action of vastus lateralis?
Extends the leg at the knee joint
63
What is the innervation of rectus femoris?
Femoral nerve
64
What is the action of rectus femoris?
Extends the leg at the knee joint
Flexes the thigh at the hip joint
65
What is the innervation of sartorius?
Femoral nerve
66
What is the action of sartorius?
Flexes the thigh at the hip joint
Flexes the leg at the knee joint
67
What is the innervation of adductor longus?
Obturator nerve (anterior div)
68
What is the action of adductor longus?
Adducts and medially rotates thigh at hip joint
69
What is the action of adductor brevis?
Adducts and medially rotates thigh at hip joint
70
What is the innervation of adductor brevis?
Obturator nerve (anterior division)
71
How many parts are there in the adductor Magnus?
2 - adductor part and hamstring part
72
What is the innervation of the adductor magnus (adductor part)?
What is the action of this muscle?
Obturator nerve (posterior division)
Action = adducts and medially rotates thigh at hip joint
73
What is the innervation of adductor Magnus (hamstring part)?
What is the action of this muscle?
Sciatic nerve
Extends thigh at the hip joint
74
What is the innervation of gracilis?
Obturator nerve (anterior division)
75
What is the action of gracilis?
Adducts thigh at hip joint and flexes leg at knee joint
76
What is the innervation of pectineus?
Femoral nerve
77
What is the action of pectineus?
Adducts and flexes thigh at the hip joint
78
What is the innervation of obturator externus?
Obturator nerve (posterior division)
79
What is the action of obturator externs?
Lateral rotation of thigh at hip joint
80
What is the action of biceps femoris?
Flexes leg at the knee
Laterally rotates leg at the knee
Long head - laterally rotates thighs at hip
81
What is the innervation of biceps femoris?
Sciatic nerve
82
What is the action of semitendinosus?
Flexes leg at the knee joint
Extends thigh at the hip joint
Medial rotation of thigh at hip and leg at knee
83
What is the innervation of semitendinosus?
Sciatic nerve
84
What is the action of semimembranous?
Flexes leg at the knee joint
Extends thigh at the hip joint
Medial rotation of thigh at hip and leg at knee
85
What is the innervation of semimebranous?
Sciatic nerve
86
87
88
Sagittal MRI
Find biceps femoris & semimembranous
89
Coronal MRI
Find vastus lateralis and gracilis muscles
90
Superficial muscles of right posterior thigh
91
Axial left gluteal MRI
92
Which compartment is the sartorius considered to be part of?
Anterior or medial compartment - however it has a separate fascial sheath and can often be considered to have a separate compartment
93
Find the gluteus maximus.
Where is the sciatic nerve located?
Coronal MRI
Sciatic nerve lies between quadratus femoris muscle and gluteus maximus muscle.
94
Find the gluteus maximus and obturator internus muscles.
95
Which muscle passes through the greater sciatic foramen from the posterolateral wall of the pelvis to attach to the greater trochanter of the femur?
Piriformis
96
Which nerve passes superiorly to the piriformis muscle to enter the gluteal region?
Superior gluteal nerve
97
What are the spinal root values of the sciatic nerve?
L4-S3
98
Which muscle arises from the ischial tuberosity and attaches to the head of the fibula?
Biceps femoris long head
99
Which nerve supplies the posterior compartment of the thigh?
Sciatic nerve
100
The obturator internus is a lateral rotator of the thigh at the hip joint. True or False?
True
101
The inferior gluteal nerve has root values L4-S1. True or False?
False. The inferior gluteal nerve has root values L5-S2.
102
The superior gluteal artery branches from the posterior division of the internal iliac artery. True or False?
True.
103
The semitendinosus muscle attaches to the proximal tibia with the gracilis and sartorius muscles. True or False?
True
104
The biceps femoris muscle flexes the leg at the knee joint, extends the thigh at the hip joint, and externally/laterally rotates the lower limb. True or False?
True
