A9 - gait/lower limb 3 Flashcards
what are the superficial muscles of the gluteal region?
- gluteus maximus
- gluteus medius
- gluteus minimus
- tensor fascia lata
innervation of superficial gluteal muscles?
gluteus maximus = inferior gluteal nerve
gluteus medius/minimus and tensor fascia lata = superior gluteal nerve
origin and insertion of gluteus maximus
O : outer surface of ilium, sacrum, coccyx and sacrotuberous ligament
I : iliotibial tract and gluteal tuberosity of femur
actions of gluteus maximus
extends and laterally rotates thigh
origin and insertion of gluteus medius
O : outer surface of ilium between the anterior and posterior gluteal lines
I : greater trochanter of femur
actions of gluteus medius
abducts and medially rotates thigh, tilts pelvis when walking to allow opposite limb to clear the ground
origin and insertion of gluteus minimus
O : ilium between anterior and inferior gluteal lines
I : great trochanter of femur
actions of gluteus minimus
abduction and medial rotation of thigh. stabilises the pelvis during locomotion
origin and insertion of tensor fascia latae
O : anterior iliac crest and ASIS
I : iliotibial tract, which itself attaches to the lateral condyle of the tibia
actions of tensor fascia latae
assists in flexion of hip and increases stability of knee when standing
what are the muscles in the deep gluteal region?
- piriformis
- obturator internus
- the gemelli — superior and inferior
- quadratus femoris
what is the most superior of the deep gluteal muscles?
piriformis
what nerve enters the deep gluteal region under the piriformis?
sciatic nerve
origin and insertion of piriformis
O : anterior surface of sacrum
I : greater trochanter of femur
what does piriformis leave the pelvis through?
greater sciatic foramen
innervation of piriformis
nerve to piriformis (S1-S2)
actions of piriformis
lateral rotation and abduction
origin and insertion of obturator internus
O : obturator membrane
I : greater trochanter of femur
what does obturator internus leave the pelvis through?
lesser sciatic foramen
actions of obturator internus
lateral rotation and abduction
what does nerve to obturator internus supply?
obturator internus + superior gemellus
origin and insertion of superior and inferior gemelli
superior O : ischial spine
inferior O : ischial tuberosity
both I : greater trochanter of femur
actions of the gemelli
lateral rotation and abduction
innervation of the gemelli
superior — nerve to obturator internus
inferior — nerve to quadratus femoris
what muscle is the most inferior of the deep gluteal muscles, located below the gemelli and obturator internus?
quadratus femoris
origin and insertion of quadratus femoris
O : ischial tuberosity
I : quadrate tuberosity on the intertrochanteric crest
action of quadratus femoris
lateral rotation
innervation of quadratus femoris
nerve to quadratus femoris
what innervates the anterior compartment of the thigh?
femoral nerve
what muscles are in the anterior thigh compartment?
- sartorius
- quadriceps femoris (consists of 4 individual muscles — 3 vastus muslces and rectus femoris)
- pectineus
the end of what msucle also passes into the anterior compartment?
iliopsoas
what makes up iliopsoas?
psoas major + iliacus
origin and insertion of iliopsoas
O : psoas major from lumbar vertebrae and iliacus from iliac fossa of pelvis
I : lesser trochanter of femur
actions of iliopsoas
flexes the thigh at hip joint
innervation of iliopsoas
psoas major — anterior rami of L1-L3
iliacus — femoral nerve
where does quadriceps femoris insert?
quadriceps tendon
origin of vastus lateralis
greater trochanter and lateral lip of linea aspera
origin of vastus intermedius
anterior and lateral surfaces of femoral shaft
origin of vastus medialis
intertrochanteric line and medial lip of the linea aspera
actions of vastus muscles
extend knee and stabilise patella
origin of rectus femoris
anterior inferior iliac sine and the area of the ilium immediately superior to the acetabulum
actions of rectus femoris
extends the knee and flexes the hip — only muscle of the quadriceps to feels the hip as it crosses the hip joint since it arises from AIIS. the other muscles dont cross the hip therefore they cant act on it
what is the longest muscle in the body?
sartorius
origin and insertion of sartorius
O : ASIS
I : superior, medial surface of tibia
actions of sartorius
at the hip joint, it flexes, abducts and laterally rotates
it is also a flexor at the knee
origin and insertion of pectineus
O : pectineal line on the anterior surface of the pelvis (SUPERIOR PUBIC RAMUS)
I : pectineal line on posterior side of femur, just inferior to the lesser trochanter (PECTINEAL LINE OF FEMUR)
actions of pectineus
adduction and flexion at hip joint
innervation of pectineus
femoral nerve + may also receive branch of obturator nerve
innervation of medial thigh compartment
obturator nerve
muscles in medial thigh compartment
- adductor magnus
- adductor longus
- adductor brevis
- obturator externus
- gracilis
what is the largest muscle of the medial compartment?
adductor magnus
what are the 2 components of adductor magnus?
adductor component and hamstring component
origin and insertion of adductor magnus
O adductor part : inferior pubic rami and ischial rami
I adductor part : linea aspera of femur
O hamstring part : ischial tuberosity
I hamstring part : adductor tubercle and medial supracondylar line of femur
actions of adductor magnus
adductor part — adduction and flexion of thigh
hamstring part — adduction and extension of thigh
innervation of adductor magnus
adductor part — obturator nerve (L2-L4)
hamstring part — tibial component of sciatic nerve (L4-S3)
origin and insertion of adductor longus
O : pubis bone of pelvis
I : linea aspera of femur
actions of adductor longus
adduction of thigh
origin and insertion of adductor brevis
O : body of pubis and inferior pubic rami
I : linea aspera on posterior surface of femur (proximal to the adductor longus attachment)
actions of adductor brevis
adduction of thigh
origin and insertion of obturator externus
O : membrane of the obturator foramen and adjacent bone
I : greater trochanter
actions of obturator externus
adduction and lateral rotation of thigh
what is the most superficial and medial muscle in the medial thigh compartment?
gracilis
origin and insertion of gracilis
O : inferior rami of the pubis and body of pubis
I : medial surface of tibial shaft
actions of gracilis
adduction of the thigh at the hip and flexion of the leg at the knee
what muscles are in the posterior thigh compartment?
- biceps femoris
- semitendinosus
- semimembranosus
what is the most lateral of the posterior thigh muscles?
biceps femoris
the common tendon of the 2 heads of biceps femoris can be felt laterally where?
within the popliteal fossa
what 2 heads does biceps femoris have?
long head and short head
origin and insertion of biceps femoris
O : long head from ischial tuberosity, short head from linea aspera on posterior femur
I : together the heads form a tendon which inserts onto the head of the fibula
innervation of biceps femoris
long head — tibial part of sciatic nerve
short head — common fibular part of sciatic nerve
what muscle is on the medial aspect of the posterior thigh and superficial to the semimembranosus?
semitendinosus
origin and insertion of semitendinosus
O : ischial tuberosity
I : medial surface of tibia
innervation of semitendinosus and semimembranosus
tibial part of sciatic nerve
origin and insertion of semimembranosus
O : ischial tuberosity (more superiorly than the origin of semitendinosus and biceps femoris)
I : medial condyle of tibia
what muscles are collectively termed the hamstrings? where do they all originate? what else originates here?
- semimembranosus, semitendinosus, biceps femoris
- ischial tuberosity (biceps femoris also has a short head that originates from the linear aspera and lateral supracondylar ride of femur)
- adductor magnus of the medial compartment also has a hamstring part that originates here
what are the hamstrings innervated by?
sciatic nerve
actions of the hamstrings
- extend the thigh and flex the knee
- semimembranosus and semitendinosus medially rotate the knee
- biceps femoris laterally rotates the knee
A = vastus lateralis
B = rectus femoris
C = vastus medialis
- quadriceps tendon
- rectus femoris — arises from AIIS
- femoral nerve
- sartorius
- adductor longus
C = pectineus
D = iliopsoas
what forms the superior border of the femroal triangle?
inguinal ligament
A = adductor brevis
B = gracilis
C = adductor magnus
D = obturator externus
adductor longus not shown
E - pectineus (cut) — usually considered to be in anterior compartment but may receive innervation from obturator nerve of the medial compartment
A = semitendinosus and semimembranosus (not shown)
B = biceps femoris
C = medial head of gastrocnemius
D = lateral head of gastrocnemius
E = plantaris
from superficial to deep:
sciatic nerve, popliteal vein, popliteal artery
A = vastus medialis
B = rectus femoris
C = vastus intermedius
D = vastus lateralis
E = sartorius
great saphenous
A = adductor magnus
B = adductor longus
C = gracilis
D = semitendinosus
E = biceps femoris
F = semimembranosus
femoral
muscle strain ambulation etc
read notes
what is a trendelenburg gait?
caused by a unilateral weakness of the hip abductors, often due to a superior gluteal nerve damage. drop is on opposite side to nerve damage.
what attaches to ASIS?
inguinal ligament, sartorius, tensor fascia latae
adductor canal boundaries
anteromedial = satorius
lateral = vastus medialis
posterior = adductor longus and adductor magnus
what runs through the adductor canal?
femoral artery, femoral vein and saphenous nerve
what do the femoral artery and vein become after leaving the adductor canal?
popliteal artery and vein
what innervates the muscles of the posterior leg?
tibial part of sciatic nerve
what provides sensory innervation to the skin of the posterolateral leg, lateral foot and sole of the foot?
tibial part of sciatic nerve
sensory functions: tibial nerve vs common fibular nerve
Tibial nerve – supplies the skin of the posterolateral leg, lateral foot and the sole of the foot
Common fibular nerve – supplies the skin of the lateral leg and the dorsum of the foot
