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Year 2 LCRS Anatomy Limbs > 6: Hip Buttock, Thigh > Flashcards

6: Hip Buttock, Thigh Flashcards

1
Q

What are the two main regions of the lower limb?

A
  1. the gluteal region–> part of the trunk
  2. The “free lower limb”–> (thigh, leg and foot)
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2
Q
A

Acetabular notch

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3
Q
A

Lunate surface of acetablulum

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4
Q

What is the lunate surface of the acetabulum?

A

The articular surface within the acetabular fossa of the acetabulum for the femur

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5
Q

Where is the femural head?

What is the fovea?

A

Femural head= articular surface for acetabulum

Fovea: medial depression on the medial side as attachment for the ligament

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6
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A
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9
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10
Q

What is the trochanteric fossa?

A
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11
Q

What are the two layers of fascia present in the lower limb?

A
  1. Superficial fascia = subcutaneous tissue
  2. Deep fascia –> Fascia lata
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12
Q

What is the fascia lata?

How can it change?

A

The fascia lata extends from the pelvis down the leg underneath the skin like a stocking. A thickened area of it laterally is called the ilio-tibial tract

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13
Q

What are the muscles of the gluteal compartment of the thigh?

A
  1. The gluteal muscles
    • Gluteus maximus
    • Gluteus medius
    • Gluteus minimus
  2. The short external rotators of the hip
    • Piriformis
    • Obturator Internus
    • The gemellus
    • Quadratus Femoris
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14
Q

What are the borders of the femoral triangle?

A

–Superiorly – the inguinal ligament

–Medially – adductor longus

–Laterally - sartorius

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15
Q

What are the contents of the femoral triangle?

What is their organisation?

A

From lateral to medial:

  • Femoral nerve
  • Femoral artery
  • Femoral vein

NAVY

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16
Q

What are the muscles of the anterior compartment of the thigh?

A
  • Pectineus
  • Ilio-psoas
  • (Tensor fasciae latae) (functionally anterior, supply gluteal)
  • Sartorius
  • Quadriceps femoris
    • Rectus femoris
    • Vastus medialis
    • Vastus intermedius
    • Vastus lateralis
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17
Q

What is the main function of the anterior compartment of the thigh?

A

It does hip flexion and knee extension

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18
Q

What is the vascular and neural supply to the anterior compartment of the thigh?

A

By the Femoral nerve (L2-4) and the superficial femoral artery

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19
Q

What is the quadriceps?

What are its individual components?

What its function and supply?

A

It has 4 parts

  1. Rectus femoris (only part that crosses hip joint)
  2. Vastus lateralis
  3. Vastus intermedialis
  4. Vastus medialis

–> All join to a common tendion that embeds the patells

Supplied by the femoral artery and nerve, involved in extension of the leg and flexion of the hip

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20
Q

Explain the route of the quadriceps at the patella

A

All 4 quadriceps muscles tendons join to one common tendon–>

Run to patella that is embedded in them

Continue at the patellar ligament ant attaches to the tibia

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21
Q

Which muscles are part of the median compartment of the thigh?

A

the Hip adductors

  • Adductor longus
  • Adductor brevis
  • Adductor magnus
  • Gracilis
  • Obturator externus
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22
Q

Where do muscles from the medial compartment of the thigh attach?

What is their main function?

A

They all attach around the pubis

–> Cause adduction of the hip

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23
Q

What is the nerve and blood supply of the medial compartment of the thigh?

A

Obturator nerve and artery

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24
Q

Where does the obturator artery originate from?

A

It originates from the internal iliac artery

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25
Q

What is the adductor hiatus?

Which structure forms it?

A
26
Q

Which structures pass through the adductor hiatus ?

How do they change?

A

The femoral artery and vein pass through the adductor hiatus (whole formed by adductor magnus) and become the popliteal vein and artery

27
Q

What is the sartorius muscle?

What its function?

A

It is the longest muscles in the body

–> runs laterally in the anterior compartment of the thigh and crosses to insert at the medial border of the tibia

–> Tailors muscle : abduction of hip and flexion of the knee

28
Q

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

How are they also known?

A

Posterior muscles, also known as “Hamstrings “

  • semimembranous
  • semitendenous
  • biceps femoris
29
Q

Where to the muscles of the posterior comparment of the thigh originate?

What is their main function?

A

Most of them: from Ischium (tuberosity)

They will flex the knee and extend the hip

30
Q

Which structure forms the floor of the femural triangle?

A

The pectineus (+ part of the iliacus)

31
Q

What is the saphenous opening?

A

It is an opening in the femoral sheath that allows the saphenous vein to join the femoral vein

32
Q

What is the neural and vascular supply of the posterior compartment of the thigh?

A

They are supplied by the inferior gluteal and branches from the profund femoral artery

The neural supply is by the tibial branch of the sciatic nerve

33
Q

Explain the nerve supply to the gluteal muscles of the thigh

A

Gluteal muscles=

  • Superior gluteal nerve to medius and minimus
  • Inferior gluteal nerve to maximus
34
Q

What is the femoral sheath?

A

A layer of fascia that embeddes the femoral artery and vein (not the nerve!) around the femoral triangle

35
Q

What is the adductor canal?

What are other names for it?

A

Also called: Hunters canal:

It is a canal formed by the

  • Vastus medialis (anteriorly)
  • Adductor longus and adductor magnus (posteriorly)
  • Sartorius (medially)

that carries the femoral atery+ vein and the saphenous nerve

Picture: section halfway of femur

36
Q

Generally speaking: Which structure do most structures passing from the pelvis to the thigh go through?

A

The greater sciatic foramen

37
Q

Explain the route of the sciatic nerve from the hip to the knee

A
  • Passes from pelvis to buttock via greater sciatic notch/foramen
  • In the buttock, lies in the inferior and medial quadrant
  • Passes along posterior aspect of the thigh
  • Divides into the tibial nerve and the common peroneal nerve (also called: common fibular nerve)
38
Q

Explain the position of the sciatic nerve in respect to the piriformis muscle

A

Normally: Sciatic nerve enters glueal region below piriformis

but there can be anatomical variation: might pierce the muslce or one part comes off superior to prirformis, one part inferior to piriformis

39
Q

What is the safe area in the thigh/ gluteal area?

Why is it important?

How do you determine it?

A

It is the area wher IM injections can be performed without hitting the sciatic nerve

Position the index finger on the ASIS and the middle finger on the iliac tubercle –> safe area is the area in between!

40
Q

What happens physiologically, when you stand on one leg?

A

Normally: the abductors of the thigh prevent tilting of the pelvis when a limb is raised.

41
Q

Which muscles are the hip adductors?

A

Gluteus medius
Gluteus minimus
Tensor fascia lata

42
Q

What is the Trendelbergs Test?

A

Test for hip abductors:

  1. Subject stands upright on both feet
  2. Examiner stands behind.
  3. Note the level of both iliac crests.
  4. Subject is asked to stand on one leg. A drop in the level of iliac crest on the unsupported side indicates weakness of the hip abductors on the stance side.
43
Q

What type of joint is the hip joint?

A

It is a synovial joint with hyaline cartilage between the head of the femur and the acetabulum

44
Q

What is the acetabular notch?

A

The lower part of the acetabulum without bony support

45
Q

How is the acetabular notch stabelised?

A

It is stabelised by the transverse ligament of the acetabulum

46
Q

Explain the difference between the anterior and the posterior part of the capuse of the hip bone

A

The capsule of the hip bone extends further anteriorly that posteriorly

47
Q

Which ligaments stablelise the hip joint?

A
  • Ilio-femoral ligament
  • Pubo-femoral ligament
  • Ischio-femoral ligament
  • The ligament of the head of the femur (less important)
48
Q

Summarise the blood supply to the head of the femur.

Why might this be clinically relevant?

A

Blood supply travels in the joint capsule of the hip joint:

  • Acetabular branch of the obturator artery
  • Lateral circumflex
  • and Medial circumflex femoral arteries

Most of the supply is distally–> in fracture of the femural neck it might lead to vascular acrosis when blood supply is disrupted

49
Q

Explain the couse of the arteries in the thigh from the Aorta to the Knee

A
  1. Aorta –> bifurcates into
    • Right and left common iliac
      • Internal iliac artery
      • External iliac artery becomes
        • Femoral artery beneath the inguinal ligament
        • Bifurcates into
          • Superficial femoral artery
          • Profund femoral artery
50
Q

What are the perfurating arteries of the thigh?

A

Branches of the prfund femoral artery

51
Q

What is the name of the large superficial vein of the tigh?

Where does it run?

A

The long saphenous vein

It runs medially in the thigh

52
Q

Summarise the deep venous drainage of the thigh

A
  1. Popliteal vein becomes the
  2. Femoral vein at the adductor hiatus,
    • joined by the saphenoid vein at the Sapheno-femoral junction and becomes
    • Venae comitantes of the profunda femoris artery
  3. External iliac vein at the inguinal ligament
53
Q

Summarise the lymphatic drainiage of the thigh and areas of prominent lymph nodes

A

•Lymph flows with the superficial and deep veins

There are important:

  • •Superficial inguinal lymph nodes
  • •Deep inguinal lymph nodes
  • •External iliac lymph nodes
  • Polpiteal lymph nodes
54
Q

Which spinal nerves supply the Hip Flexors?

A

L2,3

55
Q

Which spinal nerves supply the Hip Extensors?

A

L4,5

56
Q

Which spinal nerves supply the Knee extensors?

A

L3,4

57
Q

Which spinal nerves supply the Knee flexors?

A

L5, S1

58
Q

Map the dermatomes of the thigh and leg

A
59
Q

How is the anatomical region between the hip and the knee called, and the knee and the foot called?

A

Between hip and knee= thigh

Between knee and foot= leg

60
Q

The fascia of which muscles forms the iliotibial trace?

A

the facia of gluteus maximus and tensor facia lata

Year 2 LCRS Anatomy Limbs (15 decks)

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