4A - Glute to Thigh and knee Flashcards
what is the main goal/function of the upper limb
grasping, smaller bones so more mobile
what is the main goal/function of the lower limb
weight bearing, larger bones so more stable
shoulder girdle
minimal articulation with vertebral column
pelvic girdle
firmly attached to vertebral column
hip joint
ball and socket joint
flexion of the knee is on which side?
posterior
for the upper limb, which aspect does flexion occur on?
anterior aspect
limb rotation
process which begins around 8 weeks of gestation in which arms and legs grow out of their “bud” phases
lumbosacral plexus
formed of L2-S2 rami, supplies the lower limb
femoral nerve
innervates extensors of the knee (L2-L4)
obturator nerve
innervates the adductors of hip (extensor, L2-L4)
sciatic nerve
innervates tibial and fibular nerves (L4-S3, flexor)
tibial nerve
supplied by the sciatic nerve, flexor of the knee, plantar flexors and intrinsic flexors of foot
fibular nerve (common peroneal)
supplied by the sciatic nerve, dorsiflexors, extensors, and evertors of the foot
internal iliac artery
supply musculature and viscera of pelvis
external iliac artery
goes on to supply lower limb with oxygenated blood
inguinal ligament
ligament extending from pubic bone to anterior superior iliac spine, forming lower border of abdomen
femoral artery
continuation of external iliac artery inferior to inguinal ligament; supplies quadriceps group
deep artery of the thigh
main artery that serves the thigh muscles, supplies all deep musculature next to the femur
adductor hiatus
gap between the adductor Magnus muscle and the femur that allows the passage of the femoral vessels from the anterior thigh to the posterior thigh and then the popliteal fossa
popliteal artery
continuation of femoral artery, found behind the knee, that branches to supply the legs and feet
anterior tibial artery
continuation of popliteal artery which courses anteriorly between the tibia and fibula to supply the anterior leg
posterior tibial artery
continuation of popliteal artery in the back of the leg
medial plantar artery
continuation of posterior tibial artery, supplies the bottom of the foot
fibular artery
supplies the lateral compartment of the leg
deep veins
responsible for returning blood during exercise.
- starts off at posterior tibial veins and venules then goes to the popliteal vein then to the femoral vein which drains into the internal iliac vein
superficial veins
return blood at rest
- starts with the dorsal venous plexus then to the lesser saphenous vein then to the popliteal vein
lesser saphenous vein
originates on the dorsal of the foot and ascends posterior to the lateral malleolus and runs along the midline of the posterior calf; terminates as it joins the popliteal vein
popliteal vein
the vein that forms when the anterior and posterior tibial veins unite at the knee
fascia lata
layer of connective tissue overlying thigh muscles
iliotibial tract
band of longitudinal fibres on lateral side of fascia late, connects distally to the lateral condyle of tibia
crural fascia
deep fascia of the leg
the crural fascia splits the shank into 3 compartments; what are they called?
anterior, posterior, and lateral
where do the acetabulum and head of the femur articulate?
the hip
head of femur
round articular surface, joins up with pelvis to create hip joint
fovea of femur
dent in head for ligament to acetabulum
greater trochanter of femur
lateral, below neck
lesser trochanter of femur
medial side, below neck of femur
os coxae
the hipbone; formed by the union of the ilium, ischium, and pubis
ilium
anterior, superior
ischium
posterior
pubis
anterior, inferior
auricular surface
where sacrum articulates with os coxae
obturator foramen
hole right at inferior aspect of os coxae
acetabulum
fusing of bones to form socket of hip
pubic tubercle
bony prominence on anterior aspect. Joins up with other half to form pubic symphysis
iliac crest
found on the top of the hip bone
ischial tuberosity
receives the weight of the body when sitting
acetabular labrum
lip of fibrocartilage that surrounds outer margin of the acetabulum on the hip bone
lunate surface
smooth articulating surface on the periphery of the acetabulum
ligament of head of femur
attaches fovea to femur
hip replacement
a surgical procedure in which the acetabulum and head of femur are replaced
sacrospinous ligament
connects sacrum to ischial spine
sacrotuberous ligament
connects sacrum to ischial tuberosity
sacroiliac ligament
connects sacrum to ilium
greater sciatic foramen
pelvic opening formed y the greater sciatic notch of the hip bone, the sacrum, and the sacrospinous ligament
lesser sciatic foramen
pelvic opening formed y the lesser sciatic notch of the hip bone, the sacrospinous ligament, and the sacrotuberous ligament
coccyx
four vertebrae fused together to form the tailbone
sacroiliac joint
the joint between the sacrum and the ilium
- bilateral, synovial
pubic symphysis
cartilaginous joint at which two pubic bones fuse together
open book fracture
separation of pubic symphysis, normal = 4-5mm, pregnancy = 8-9mm
iliofemoral ligament
ligament connecting ilium and femur
pubofemoral ligament
ligament connecting pubis and femur
ischiofemoral ligament
ligament connecting ischium to femur
obturator artery
serves medial thigh, external genitals, perineum
bursae
exist to cushion ligaments and skin that crosses over bone
trochanteric bursa
separates glutes from greater trochanter
ischiogluteal bursa
separates gluteus maximus from ischial tuberosity
iliopsoas bursa
separates iliopsoas from hip joint capsule
hip fracture
foreshortened EXTERNAL rotation. Pull on iliopsoas on greater trochanter of femur, more common in older individuals
hip dislocation
foreshortened INTERNAL rotation. Posterior dislocation causes traction of the adductor group. More common in younger individuals
foot drop
head of femur pushed up against a nerve. Occurs when the hip is in flexion (car accident = knees hit the dash). Characterized by an inability to dorsiflex and reduced eversion
femoral neck fracture
fracture of the neck of the femur (type of hip fracture)
gluteal muscles
- gluteus maximus
- gluteus medius
- gluteus minimus
- tensor fascia latae
gluteus maximus
butt
gluteus medius
abducts and medially rotates thigh
gluteus minimus
abducts and medially rotates thigh
tensor fascia latae
flexes and abducts thigh
iliopsoas
- Iliacus
- psoas
Iliacus function
flexes thigh
psoas
loin
deep rotator muscles
- obturator externus
- obturator internus
- gemelli
- piriformis
- quadrates femoris
obturator externus
laterally rotates thigh
obturator internus
laterally rotates thigh
gemelli (location)
between obturator externus and obturator internus
prirformis
triangular-shaped muscle, laterally rotates and abducts thigh
quadratus femoris
laterally rotates thigh
which muscles make up the thigh flexors
quadriceps femoris, sartorius
sartorius
flexes thigh on hip
hamstring muscles
biceps femoris, semitendinosus, semimembranosus
Hip adductor muscles
adductor longus, adductor brevis, adductor Magnus, gracilis, pectineus
which muscles are innervated by the superior gluteal nerve
gluteus medius, gluteus minimus, tensor fasciae latae
which muscles are innervated by the inferior gluteal nerve
gluteus maximus
where does the pedestal nerve travel
through the lesser sciatic foramen
where does the obturator nerve travel?
passes through obturator foramen
what does the obturator nerve innervate?
hip adductor muscles
femoral triangle
femoral nerve, femoral artery, femoral vein
intercondylar notch of femur
on the posterior side of the femur, between the medial and lateral condyles
patellar surface of femur
smooth distal anterior surface between the condyles; articulates with the patella
what is the function of the muscles in the anterior thigh compartment, which nerve innervates them
extensors, innervated by the femoral nerve
- hip flexion and knee extension
what is the function of the muscles in the medial thigh compartment, which nerve innervates them
adductors, innervated by the obturator nerve
- hip adduction, flexion, and medial rotation
what is the function of the muscles in the posterior thigh compartment, which nerve innervates them
flexors (knee), innervated by sciatic nerve
- knee flexion, hip extension
which muscles are in the anterior thigh compartment?
- sartorius
- pectineus
- rectus femoris (lateralis, medialis, intermedius)
which muscles are in the medial thigh compartment
- gracilis
- adductor brevis
- adductor longus
- adductor magnus
which muscles are in the posterior thigh compartment
- semi-tendinosis
- semi-membranosis
- biceps femoris
what action does the rectus femoris perform
extends leg and flexes thigh
what action does the vastus intermedius perform
extends knee
what action does the vastus medialis perform
extends knee
what action does the vastus lateralis perform
extends knee
patella
kneecap, attaches to tibial tuberosity via patellar ligament, innervated by femoral nerve
what action does the pectineus perform
adducts, flexes, and medially rotates thigh
adductor brevis
deep to pectineus
adductor longus
deep to pectineus
adductor magnus
2 parts: adductor component and hamstring component
semi-tendinosus
flexion of leg at the knee, extension of thigh at the hip, most superficial, rounder in shape
semi-membranosus
deep to semi-tendinosus, medial, flatter in shape
biceps femoris innervation
sciatic nerve
biceps femoris location
lateral, long head (more superficial) and short head (more deep)
pes anserine
“gooses foot”, insertion of sartorius, gracilis, semitendinosus. Tripod muscles
femoral sheath
fascial tube containing the artery and vein (not the nerve)
knee purpose
allow weight of body/thigh to be transferred to shank/ankle
femur purpose
transmits force from pelvis through the knee
tibia
weight bearing bone of the lower leg
tibial tuberosity
attachment point for quadriceps femoris via patellar liagement
intercondylar eminence
irregular projection located between the two condyles
fibula purpose
provides rotational stability
patella
increases force production (moment arm) at a joint
femorotibial joint
joint between the femur and tibia
patellofemoral joint
joint between the patella and femur
menisci
pads of cartilage that lie between the articular surfaces of the bones
what is the purpose of menisci
deepen and stabilize articulating surfaces
collateral ligaments
ligaments that run along the sides of the knee and limit sideways motion
lateral collateral ligament
a lodgement that attaches to the femur and the fibula; maintain stability of the lateral aspect of the knee joint
medial collateral ligament
attached to medial meniscus, prevents abduction of tibia
cruciate ligaments
make possible the movements of the knee
anterior cruciate ligament (ACL)
a ligament in the knee that attaches to the anterior spect of the tibial plateau, restricting anterior movement of the tibia on the femur
posterior cruciate ligament (PCL)
attaches to posterior tibia, prevents backward sliding of tibia and forward sliding of femur
PCL rupture
anything that moves the tibia posteriorly on the femur causes an injury
ACL rupture
rotation of knee where foot rotates medially and thigh rotates laterally, causes an injury
unhappy triad
ACL, MCL, medial meniscus
screw home mechanism
allows femur to position itself on the knee to lock itself into place
popliteus
unlocking of the knee. Causes rotation of the tibia and femur in opposing directions
patellar dislocation
the patella becomes dislocated from the joint, most often laterally
3 knee bursae
subpatellar, prepatellar, infrapatellar
subpatellar bursa
protects patella from femur
prepatellar bursa
protects skin from anterior aspect of knee that will move overtop of patella every time the knee is bent
infrapatellar bursa
superficial and deep, cushion patellar ligament