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Basic Science Test 2 > 2.3 > Flashcards

2.3 Flashcards

1
Q

Nerves of the sacral plexus

A

Superior gluteal n.
Inferior gluteal n.
Posterior femoral cutaneous n.
Pundendal n.
Sciatic n.

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2
Q

Draw sacral plexus

A
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3
Q

Label nerves of sacral plexus.

A
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4
Q

Cutaneous innervation

A

Cutaneous branches of the lumbar and sacral regions give sensory innervation.

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5
Q

Motor innervation

A

The same spinal nerves that supply the skin also supply muscles, but embryologic growth creates a motor pattern that can be different from the cutaneous pattern.

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6
Q

Muscles of the gluteal region

A

Gluteus maximus
Gluteus medius
Gluteus minimus
Tensor fascia lata
Piriformis
Obturator internus
Superior and inferior gemelli
Quadratus femoris

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7
Q

Gluteus maximus

A

O: posterior ilium, sacrum, coccyx, and sacrotuberous ligament
I: IT band, gluteal tuberosity
A: primary hip extensor, lateral rotation
N: inferior gluteal n. (L5, S1, S2)

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8
Q

Gluteus medius

A

O: external surface of ilium
I: greater trochanter
A: hip abduction, medial rotation
N: superior gluteal n. (L4-S1)

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9
Q

Gluteus minimus

A

O: external surface of ilium
I: greater trochanter
A: hip abduction, medial rotation
N: superior gluteal n. (L4-S1)

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10
Q

Tensor fascia lata

A

O: ASIS
I: IT band
A: hip flexion, knee stabilization
N: superior gluteal n. (L4-S1)

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11
Q

Gluteal region hip abductors

A

Gluteal medius and minimus

They stabilize the hip in the coronal plane to maintain a level pelvis when walking or standing on one foot. These muscles abduct the hip to maintain a level pelvis when the opposite limb is elevated.

With superior gluteal nerve injury or weakness, a person is unable to maintain a level pelvis standing on one foot. Instead, the hip will tilt towards the good side and rise on the weak side.

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12
Q

External rotators of posterior thigh

A

piriformis
superior gemellus
obturator internus
inferior gemellus
quadratus

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13
Q

Landmarks for exiting the pelvis:

A

Piriformis occupies the greater sciatic foramen

Coccygeus runs superior to the lesser sciatic foramen forming a muscular borderline

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14
Q

Gluteal Bursae

A

Flattened sacs of synovial fluid
Reduce/prevent friction-related damage

Each separates gluteus maximus from another structure

Trochanteric - maximus from greater trochanter
Ischial - maximus from ischial tuberosity

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15
Q

Trochanteric bursitis

A

Etiology - stair climbing, running on elevated treadmill
Diffuse, deep pain in lateral thigh
Pain tends to radiate along IT band

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16
Q

Ischial bursitis

A

Etiology - repetitive hip extension in seated position (cycling, rowing)
Pain at ischial tuberosity

17
Q

Components of posterior compartment of thigh

A

Fascia lata
3 muscles:
- biceps femoris
- semitendinosus
- semimembranosus
Sciatic nerve
No major arteries or veins
- blood supply from perforating branches of deep femoral artery

18
Q

What are the hamstring muscles?

A

Biceps femoris
Semimembranosus
Semitendinosus

19
Q

Which joints are crossed by hamstring muscles?

A

hip and knee which is why injury is so common

20
Q

Proximal attachments of posterior thigh

A

3/4 attach proximally to ischial tuberosity and sacrotuberous ligament
Biceps short head attaches to linea aspera

21
Q

Group actions of posterior thigh muscles

A

hip extension
knee flexion
knee rotation

22
Q

Hamstring injuries

A

2x as common as quad strains
- 2 joint muscles are easier to injure
Usually result form jumping, kicking, running hard (esp without warming up)
Quick starts and stops

Frequently injury is distal

23
Q

Posterior thigh blood supply

A

Superior gluteal artery: gluteus medius and minimus
inferior gluteal artery: gluteus maximus
Pudendal artery: termination of IIA to the perineum, travels under sacrotuberous ligament; perineum

24
Q

Major nerves of the gluteal region

A

Superior gluteal n – innervates gluteus medius, gluteus minimus, and TFL
Inferior gluteal n – innervates gluteus maximus
Sciatic n – major nerve of lower limb, innervates posterior thigh, all of LL below knee
Posterior femoral cutaneous n – innervates skin of posterior thigh
Pudendal n – major nerve to perineum and external genitalia

25
Q

Minor nerves of gluteal region

A
26
Q

Cutaneous nerves

A
  1. posterior femoral cutaneous n. of the sacral plexus
  2. lateral femoral cutaneous nerve of the lumbar plexus

There are no major superficial veins in the posterior thigh

27
Q

Cluneal nerves

A

Arise from posterior rami L1-L3
Provide sensation to gluteal area
Become entrapped –> neuropathy
- referred pain can be misdiagnosed leading to failed surgery

28
Q

Sciatic nerve

A

Major nerve of the posterior thigh and lower extremity inferior to knee
Exits gluteal region –> posterior leg

Transverses the posterior leg posterior thigh deep to biceps femoris
- gives off several muscular branches to hamstrings
- divides into divisions at variable locations proximal to popliteal fossa

29
Q

Two divisions of the sciatic n.

A

Tibial n. (L4-S3)
- posterior thigh muscles
- posterior leg
- sole of foot

Common fibular (L4-S2)
- posterior thigh (short head of biceps femoris ONLY)
- anterior and lateral leg
- dorsum of foot

30
Q

Variations of the sciatic nerve

A

Sciatic nerve can be divided into its 2 divisions early and pass above or through piriformis muscle.

Variants may increase risk of developing piriformis syndrome (compression neuropathy of sciatic nerve by piriformis muscle)

31
Q

Nerves and arteries that exit greater sciatic foramen

A

Superior to piriformis:
- superior gluteal a.
- superior gluteal n.

Inferior to piriformis:
- inferior gluteal a.
- inferior gluteal n.
- sciatic n.
- posterior femoral cutaneous n.
- internal pudendal a. (travels out)
- pudendal n. (travels out)

32
Q

Nerves and arteries that exit from the pelvis

A

Lesser sciatic foramen:
- Internal pudendal a. (travels in)
- pudendal n. (travels in)

Pudendal a. and n. serve structures of the lower pelvis

33
Q

Intragluteal injections

A

Intragluteal injections are performed in superior-lateral gluteal region
- above line that connects PSIS and greater trochanter
- corresponds to gluteus medius
- must avoid sciatic nerve and gluteal nerves in central and inferior regions

Basic Science Test 2 (6 decks)

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