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

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2
Q

What are the cutaneous nerves of the thigh?

A

Lateral femoral cutaneous
Anterior cutaneous branches of femoral
Cutaneous branches of obturator

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3
Q

Which vein drains into the femoral vein?

A

Great saphenous vein

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4
Q

Which nerve emerges from the fascia lata distal to the knee to accompany the great saphenous vein?

A

Saphenous nerve

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5
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6
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8
Q
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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

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10
Q

What is found in the femoral canal?

A

Fat and lymphatics

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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

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12
Q

Which artery arises from the femoral artery in the femoral triangle?

A

The profunda femoris artery

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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.

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14
Q

What is found at the apex of the femoral triable?

A

Adductor canal

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15
Q

What vessels are found in the adductor canal?

A

Femoral artery
Femoral vein
Saphenous nerve

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16
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A
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17
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18
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19
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20
Q
A
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21
Q

What forms the quadriceps tendon?

A

The convergence of all 4 quadriceps muscles

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22
Q

What does the quadriceps tendon attach to?

A

The superior border of the patella

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23
Q

Which four muscles make up the quadriceps?

A

Rectus femoris
Vastus medialis
Vastus lateralis
Vastus intermedius

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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

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25
Q
A
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26
Q

What is the thickening of the fascia lata over the superior border of the gluteus Maximus called?

A

Gluteal aponeurosis

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27
Q

Which muscles lies deep under the gluteus Maximus?

A

Gluteus medius

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28
Q

What arises form the inferior border of the piriformis muscle?

A

The inferior gluteal artery and nerve

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29
Q

Which muscles lies deep to the gluteus medius?

A

Gluteus minimus

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30
Q

What arises from the superior border of the piriformis muscle?

A

Superior gluteal nerve and artery

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31
Q

What are the nerve roots of the sciatic nerve?

A

L4-S3

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32
Q

Which is the largest here in the body?

A

Sciatic nerve (has its own arterial supply!)

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33
Q

What does the sciatic nerve bifurcate into? Where?

A

Into tibial and common fibular neres
Sometimes in the gluts, but most commonly occurs proximal to the apex of the popliteal fossa.

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34
Q

When giving an intragluteal injection, how do you identify a safe area to administer it and which structure do you want to avoid damaging?

A

Safe area is identified by gluteal quadrants, aim for upper outer quadrant, avoid the sciatic nerve

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35
Q
A
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36
Q

Which nerve innervates the following?
- Gluteus medius
- Gluteus minimus
- Gluteus maximus

A

Medius = Superior gluteal nerve
Minimus = Superior gluteal nerve
Maximus = Inferior gluteal nerve

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37
Q

What are the nerve roots for the superior gluteal nerve?

A

L4-S1

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38
Q

What are the nerve roots for the inferior gluteal nerve?

A

L5-S2

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39
Q

What is the function of gluteus medius and minimus?

A

Abducts femur at hip
Medially rotates thigh

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40
Q

What is the function of gluteus Maximus?

A

Extends femur at hip
Laterally rotates and abducts femur at hip joint

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41
Q

Which nerve innervates the tensor fascia lata?

A

Superior gluteal nerve

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42
Q

What are there actions of the tensor fascia lata?

A

Abducts thigh
Medially rotates thigh
Weak hip flexion

43
Q

Which nerve innervates piriformis?

A

S1 & S2

44
Q

What is the function of piriformis?

A

Laterally rotates extended femur at hip joint

Abducts flexed femur at hip joint

45
Q

What is the function of obturator internus?

A

Laterally rotates extended femur at hip joint

Abducts flexed femur at hip joint

46
Q

What is the innervation of the obturator internus?

A

Nerve to obturator internus (L5-S1)

47
Q

What is the innervation of gemellus superior?

A

Nerve to obturator internus (L5-S1)

48
Q

What is the action of gemellus superior?

A

Laterally rotates extended femur at hip joint

Abducts flexed femur at hip joint

49
Q

What is the action of gemellus inferior?

A

Laterally rotates extended femur at hip joint

Abducts flexed femur at hip joint

50
Q

What is the innervation of gemellus inferior?

A

Nerve to quadratus femoris (L5-S1)

51
Q

What is the action of quadratus femoris?

A

Lateral rotation of femur at hip joint

52
Q

What is the innervation of quadratus femoris?

A

Nerve to quadratus femoris (L5-S1)

53
Q

What is the innervation of psoas major?

A

Anterior rami (L1-3)

54
Q

What is the action of psoas major?

A

Flexes the thigh at the hip joint

55
Q

What is the innervation of iliacus?

A

Femoral neve

56
Q

What is the action of iliacus?

A

Flexes the thigh at the hip joint

57
Q

What is the innervation of vastus medialis?

A

Femoral nerve

58
Q

What is the action of vastus medialis?

A

Extends the leg at the knee joint

59
Q

What is the innervation of vastus intermedius?

A

Femoral nerve

60
Q

What is the action of vastus intermedius?

A

Extends the leg at the knee joint

61
Q

What is the innervation of vastus lateralis?

A

Femoral nerve

62
Q

What is the action of vastus lateralis?

A

Extends the leg at the knee joint

63
Q

What is the innervation of rectus femoris?

A

Femoral nerve

64
Q

What is the action of rectus femoris?

A

Extends the leg at the knee joint

Flexes the thigh at the hip joint

65
Q

What is the innervation of sartorius?

A

Femoral nerve

66
Q

What is the action of sartorius?

A

Flexes the thigh at the hip joint

Flexes the leg at the knee joint

67
Q

What is the innervation of adductor longus?

A

Obturator nerve (anterior div)

68
Q

What is the action of adductor longus?

A

Adducts and medially rotates thigh at hip joint

69
Q

What is the action of adductor brevis?

A

Adducts and medially rotates thigh at hip joint

70
Q

What is the innervation of adductor brevis?

A

Obturator nerve (anterior division)

71
Q

How many parts are there in the adductor Magnus?

A

2 - adductor part and hamstring part

72
Q

What is the innervation of the adductor magnus (adductor part)?

What is the action of this muscle?

A

Obturator nerve (posterior division)

Action = adducts and medially rotates thigh at hip joint

73
Q

What is the innervation of adductor Magnus (hamstring part)?

What is the action of this muscle?

A

Sciatic nerve

Extends thigh at the hip joint

74
Q

What is the innervation of gracilis?

A

Obturator nerve (anterior division)

75
Q

What is the action of gracilis?

A

Adducts thigh at hip joint and flexes leg at knee joint

76
Q

What is the innervation of pectineus?

A

Femoral nerve

77
Q

What is the action of pectineus?

A

Adducts and flexes thigh at the hip joint

78
Q

What is the innervation of obturator externus?

A

Obturator nerve (posterior division)

79
Q

What is the action of obturator externs?

A

Lateral rotation of thigh at hip joint

80
Q

What is the action of biceps femoris?

A

Flexes leg at the knee

Laterally rotates leg at the knee

Long head - laterally rotates thighs at hip

81
Q

What is the innervation of biceps femoris?

A

Sciatic nerve

82
Q

What is the action of semitendinosus?

A

Flexes leg at the knee joint

Extends thigh at the hip joint

Medial rotation of thigh at hip and leg at knee

83
Q

What is the innervation of semitendinosus?

A

Sciatic nerve

84
Q

What is the action of semimembranous?

A

Flexes leg at the knee joint

Extends thigh at the hip joint

Medial rotation of thigh at hip and leg at knee

85
Q

What is the innervation of semimebranous?

A

Sciatic nerve

86
Q
A
87
Q
A
88
Q

Sagittal MRI

Find biceps femoris & semimembranous

A
89
Q

Coronal MRI

Find vastus lateralis and gracilis muscles

A
90
Q

Superficial muscles of right posterior thigh

A
91
Q

Axial left gluteal MRI

A
92
Q

Which compartment is the sartorius considered to be part of?

A

Anterior or medial compartment - however it has a separate fascial sheath and can often be considered to have a separate compartment

93
Q

Find the gluteus maximus.
Where is the sciatic nerve located?

Coronal MRI

A

Sciatic nerve lies between quadratus femoris muscle and gluteus maximus muscle.

94
Q

Find the gluteus maximus and obturator internus muscles.

A
95
Q

Which muscle passes through the greater sciatic foramen from the posterolateral wall of the pelvis to attach to the greater trochanter of the femur?

A

Piriformis

96
Q

Which nerve passes superiorly to the piriformis muscle to enter the gluteal region?

A

Superior gluteal nerve

97
Q

What are the spinal root values of the sciatic nerve?

A

L4-S3

98
Q

Which muscle arises from the ischial tuberosity and attaches to the head of the fibula?

A

Biceps femoris long head

99
Q

Which nerve supplies the posterior compartment of the thigh?

A

Sciatic nerve

100
Q

The obturator internus is a lateral rotator of the thigh at the hip joint. True or False?

A

True

101
Q

The inferior gluteal nerve has root values L4-S1. True or False?

A

False. The inferior gluteal nerve has root values L5-S2.

102
Q

The superior gluteal artery branches from the posterior division of the internal iliac artery. True or False?

A

True.

103
Q

The semitendinosus muscle attaches to the proximal tibia with the gracilis and sartorius muscles. True or False?

A

True

104
Q

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?

A

True