Anatomy 31 Flashcards
What is the pelvis?
A bony ring formed by the articulation of the left and right innominate (hip) bones and the sacrum
What is the function of the pelvis?
Takes the weight of the body and transmits it to the lower limbs
What is the hip bone formed from?
3 separate bones
- the pubic bone,
- the ilium,
- the ischium,
which fuse at the acetabulum – the socket of the hip joint
Where do the hip bones articulate anteriorly with each other?
Pubic symphysis
Where do the hip bones articulate posteriorly with the sacrum?
At the sacroiliac joints
What do the superior and inferior pubic rami surround?
The obturator foramen
What passes through the obturator canal?
Allows vessels and nerves to pass between the pelvis and thigh
What is the uppermost part of the ilium?
Iliac crest
What are the parts of the femur?
Head, neck and shaft, and its distal end is expanded
What does the head of the femur articulate with?
The acetabulum of the pelvis to form the hip joint
Where does the neck of the femur extend from?
The head
Where do the greater and lesser trochanters lie distal to?
The neck, they are sites of muscle attachment
Where does the intertrochanteric line lie?
Lies between the greater and lesser trochanters on the anterior surface of the femur
What is the trochanteric fossa?
A small hollow on the medial aspect of the greater trochanter
What is the linea aspera?
A bony vertical ridge on the posterior aspect of the shaft of the femur.
It is a site of muscle attachment.
What is the distal end of the femur expanded to form?
The medial and lateral femoral condyles
What do the medial and lateral femoral condyles articulate with?
The proximal tibia at the knee joint
What movements occur at the hip joint?
Flexion,
Extension,
Abduction,
Adduction,
Medial (internal) and
Lateral (external) rotation and
Circumduction
Which muscles flex the thigh at the hip joint?
Muscles in the anterior thigh
Which muscles adduct the thigh at the hip joint?
Muscles in the medial thigh
Which muscles extend the thigh at the hip joint?
Muscles in the posterior thigh
What movements occur at the knee joint?
Flexion
Extension
Which muscles extend the leg at the knee joint?
Muscles in the anterior thigh
Which muscles flex the leg at the knee joint?
Muscles in the posterior thigh
What does the fascia lata surround?
The thigh
What is the iliotibial band/tract?
A thickening of the lateral part of the fascia lata
What does the iliotibial band/tract attach to?
Attaches to the lateral aspect of the proximal tibia and is important for stabilising the knee joint
What does the intermuscular septa extend from?
The fascia lata to the linea aspera
What does the intermuscular septa separate?
Separates the thigh into anterior, medial and posterior compartments
Describe features of the muscles of the anterior compartment of the thigh
● primarily act as extensors of the knee.
Some of them act upon the hip joint.
● are innervated by the femoral nerve (spinal nerves L2-L4).
Which muscles are found in the anterior compartment of the thigh?
● Quadriceps femoris – a group of four large muscles.
● Sartorius
● Iliopsoas
● Pectineus
Which muscle group are the prime extensor of the knee?
Quadriceps femoris
Which muscles make up the quadriceps femoris?
● Rectus femoris
● Vastus lateralis
● Vastus medialis
● Vastus intermedius
Where do the muscles of the quadriceps femoris converge?
Onto the quadriceps tendon which runs over the patella
(kneecap) to insert onto the tibial tuberosity via the patellar ligament.
Where does the rectus femoris lie?
In the midline of the anterior thigh
What is the rectus femoris attached to?
The AIIS proximally
What does the rectus femoris contribute to?
Flexion of the hip
Where does the vastus lateralis lie?
Lateral to the rectus femoris
What does the vastus lateralis attach to?
The linea aspera on the posterior aspect of the femoral shaft
Where does the vastus medialis lie?
Medial to rectus femoris
What does the vastus medialis attach to?
Linea aspera
Where does the vastus intermedius lie?
Lies deep to rectus femoris
What does the vastus intermedius attach to?
Attaches to the anterior aspect of the femoral shaft
Where does the sartorius lie?
Superficially in the anterior thigh
What does the sartorius attach to?
Attaches proximally at the ASIS
Where does the sartorius insert?
Inserts on the medial aspect of the proximal tibia
It crosses both the hip and knee joints.
What movements does the sartorius contribute towards?
It flexes and laterally rotates the hip joint and can flex the knee joint.
Where does the iliopsas lie?
Lies proximally in the anterior thigh
Where do the psoas major and iliacus converge?
Converge via a common tendon onto the lesser trochanter of the femur
Which muscle is the prime flexor of the hip joint?
Illiopsoas
Where does the pectineus lie?
Lies in the proximal anterior thigh, medial to iliopsoas
What does the pectineus attach to?
Attaches proximally at the superior pubic ramus and distally on the femur, just inferior to the lesser trochanter.
What movements does the pectineus execute?
Flexes and adducts the hip joint
Describe features of the muscles in the medial compartment of the thigh
● primarily act as adductors of the hip.
● are innervated by the obturator nerve (spinal nerves L2-L4).
What do the adductors in the medial compartment of the leg play an important role in?
Normal gait as they help to draw the leg back towards the midline as we walk
What muscles are found in the medial thigh?
● Adductor brevis
● Adductor longus
● Adductor magnus
● Gracilis
● Obturator externus
Where are the points of attachment of the adductor brevis and adductor longus?
Pubic bone and the linea aspera
Where does the adductor brevis lie?
Deep to longus
Which nerve lies between the adductor brevis and adductor longus?
Obturator nerve
What is the adductor magnus?
Large muscle that has an adductor part and a hamstring part
What does the adductor part of the adductor magnus attach to?
The inferior pubic ramus and the linea aspera
What is the adductor part of the adductor magnus innervated by?
Obturator nerve
What does the hamstring part of the adductor magnus attach to?
The ischial tuberosity and the adductor tubercle
What is the adductor hiatus?
Is a gap formed between the distal attachments of the two
parts of adductor magnus
What travels through the adductor hiatus?
The femoral artery and vein travel through the adductor hiatus to enter the posterior thigh
What is the gracilis?
Most medial muscle
What does the gracilis attach to?
Attaches to the pubic bone and the medial aspect of the tibia
What type of muscle is the gracilis?
It is a weak adductor and flexor of the hip and a weak flexor of the knee.
It is not a prime mover
What is the obturator externus attached to?
The external surface of the obturator membrane
What does the obturator externus insert on?
The femur near the greater trochanter
What is the function of the obturator externus?
It stabilises and laterally rotates the hip joint
Which artery is the femoral artery a continuation of?
External iliac artery
Where does the femoral artery travel?
It travels deep to the inguinal ligament to enter the proximal anterior thigh
Where does the femoral artery lie?
Lies relatively superficially here and can be palpated
Which artery does the femoral artery give a large branch of?
Profunda femoris (deep artery of the thigh) which travels deep into the thigh and supplies it
What course does the femoral artery take?
Continues distally, traverses the adductor hiatus and enters the distal part of the posterior thigh (the popliteal fossa)
What artery does the femoral artery become when it enters the popliteal fossa?
Popliteal artery
Which artery is the obturator artery a branch of?
Internal illiac actery
Where does the obturator artery travel through?
Travels through the obturator canal into the medial compartment of the thigh.
It anastomoses with branches from the femoral artery.
What course does the femoral vein take?
Follows the course of the femoral artery
Where does the femoral artery lie?
Lies medial to the femoral artery in the proximal thigh
Where does the femoral vein travel under?
Inguinal ligament
Which vein is the femoral vein continuous with?
External iliac vein
Which course does the obturator vein take?
Follows the course of the obturator artery
What does the obturator vein travel through?
Obturator canal
Which vein does the obturator vein join at the pelvis?
Internal iliac vein
Which spinal nerves is the femoral nerve formed from?
L2 - L4
Where does the femoral nerve travel?
Travels deep to the inguinal ligament to enter the proximal anterior thigh lateral to the femoral artery
What is the saphenous nerve?
A sensory branch of the femoral nerve that innervates skin over the leg
Which spinal nerves form the obturator nerve?
L2 - L4
Where does the obturator nerve travel?
It travels along the lateral wall of the pelvis and exits through the obturator canal
Where does the obturator nerve emerge?
It emerges onto the superficial surface of adductor brevis
What does the obturator nerve give rise to?
Gives rise to branches that innervate the medial compartment muscles and skin over the medial thigh
What is the femoral triangle?
Clinically important region of the proximal anterior thigh
What is the lateral border of the femoral triangle formed by?
The medial border of sartorius
What is the medial border of the femoral triangle formed by?
Lateral border of adductor longus
What is the superior border of the femoral triangle formed by?
Inguinal ligament
Where is the apex of the femoral triangle?
Where sartorius and adductor longus meet
What is the floor of the femoral triangle formed by?
Iliopsoas laterally and pectineus medially
Which artery can be palpated and accessed in the femoral triangle?
Femoral artery
Where does the femoral vein lie?
Medial to the femoral artery
What does the femoral vein receive in the femoral triangle?
It receives an important tributary in the femoral triangle
– a superficial vein called the great saphenous vein.
Where does the femoral nerve lie?
Lateral to the femoral vein
Where does the femoral nerve travel?
Travels deep to the inguinal ligament to enter the anterior thigh
Where do the femoral artery and vein lie in the femoral triangle?
Lie superficially and are vulnerable to penetrating injuries.
Because of their superficial position, bleeding vessels can be
compressed at the mid-inguinal point
What does a ‘fractured hip’ refer to?
A fracture of the femoral neck
What is a contributing factor to a fracture of the femoral neck?
Osteoporosis
What is the typical finding on examination of a fracture of the femoral neck?
Shortening and lateral rotation of the affected limb compared to the uninjured limb
What can a fracture of the femoral neck lead to?
May tear the vessels that supply the femoral head and neck, leading to avascular necrosis of the femoral head.
Where can the femoral artery be accessed?
In the femoral triangle, which is commonly undertaken for coronary angiography
What can the femoral nerve be blocked by?
Infiltrating local anaesthetic around it.
This is used to relieve pain in lower limb fractures.
What is a femoral hernia?
This is an abnormal protrusion of intestine into the upper anterior thigh. It is more common in females.
The intestine passes deep to the inguinal ligament and causes a lump to appear in the inguinal region or upper thigh.
Strangulation of the herniated intestine leads to ischaemia and infarction of the tissue.
What is obturator nerve irritation?
Ovarian pathology, such as a cyst, may irritate the nerve as the obturator nerve lies close to the ovary.
This typically results in sensory abnormalities (tingling, itching or pain) in the medial thigh
What type of dislocation of the patella is more common?
Lateral dislocation, because the femur is angled obliquely relative to the tibia and so the angle of the pull of quadriceps is also oblique.
How are the distal fibres of the vastus medialis arranged?
Arranged horizontally and these usually resist lateral movement of the patella
