Anatomy Limbs 6 - Hip, Buttock and Thigh Flashcards
What is dorsiflexion?
Raising the toes
What is plantar flexion?
Lowering the toes
What type of bone is the patella?
Sesamoid bone
What are 3 major compartments of the hip bone?
Ilium, Ischium and Pubis
What gap does the ilium, ischium and pubis form?
Obturator foramen
What are 2 major types of fracture to the hip/femur?
Which one is more common
- Fracture of femoral neck
- Intertrochanteric fracture
Fracture of femoral neck most common
What are 2 major ligaments in the pelvis?
- Sacrotuberous ligament
2. Sacrospinous ligament
What are the 2 foramina of the region?
Greater and lesser sciatic foramina
How many layers of fascia are there in the hip region?
What is the deep layer of fascia called?
2
Fascia lata = deep layer
What is the lateral thickened area of fascia on the thigh known as?
Iliotibial tract
Where are the extensors, abductors and external rotators of the hip?
Gluteal region
What are the 2 large groups of muscles in the gluteal region?
- Gluteal muscles
2. Short external (lateral) rotators of the hip
What muscles form the gluteal muscles?
- Gluteus maximus
- Gluteus medius
- Gluteus minimus
- Tensor fasciae latae
What muscles form the short external (lateral) rotators of the hip?
- Piriformis
- Obturator internus
- The gemelli (sup. and inf.)
- Quadratus femoris
Where are the 2 attachments of the gluteus Maximus?
- Gluteal tuberosity (25%)
2. Iliotibial tract (75%)
Where does the gluteus Maximus originate?
Posterior part of ilium, sacrum
What other muscle (aside from gluteus Maximus) attaches to the iliotibial tract
Tensor fasciae latae
Where does the tensor fasciae latee originate?
Anterior part of the iliac crest
What action does the gluteus medius and minimus act for?
Abduct and stabilise hip joint
Where does gluteus medius and minimus attach?
Greater trochanter of femur
What is the job of the obturator interns, sup/inf gemelli, piriformis etc
Stabilise the femur in the head of the acetabulum
and also lateral rotating activity
What is a bursa?
A sac of synovial fluid
Which 2 activities is the anterior compartment of the thigh responsible for
Hip flexion and knee extension
What are the anterior muscles of the thigh
- Pectineus
- Ilio-psoas
- (Tensor fasciae latae)
- Sartorius
- Quadriceps femoris:
Rectus femoris, vastus medialis, vastus intermedius, vastus lateralis
The iliopsoas consists of 2 muscles which are
Psoas major and Iliacus
Proximally, where does sartorius attach?
ASIS
What action can the sartorius do?
Flex the knee and give external rotation
Which head is most superficial in quadriceps?
Rectus femoris
Where does the quadriceps attach to?
Patella
What action does the medial compartment of the thigh do?
Hip adductors
What muscles are in the medial compartment of the thigh?
Hip adductor muscles:
- Adductor longus
- Adductor brevis
- Adductor magnus
- Gracilis
- Obturator externus
Where do the hip adductor muscles attach?
Pubic bone
What does the adductor Magnus have to allow structure to pass through?
Adductor hiatus - small gap
What is the action of the posterior compartment of the thigh
Knee flexors and hip extensors
What 3 muscles form the hamstrings
- Semimembranosus
- Semitendinosus
- Biceps femoris
Where do the hamstrings attach proximally?
Ischial tuberosity
Biceps femurs goes from medial to lateral as it descends. Where is its distal attachment?
Head of the fibula
Which structures form the pes anserinus
Sartorius
Gracilis
Semitendinosus
Semimembranosis
Where do semimembranosus and semitendinosus attach distally?
Medial condyle/shaft of tibia
What are the borders of the femoral triangle
Superiorly - inguinal ligament
Medially - adductor longus
Laterally - sartorius
What does the femoral triangle contain
Femoral Vein
Femoral Artery
Femoral Nerve
(medial to lateral)
From where to where does the inguinal ligament run
ASIS to pubic tubercle
What is fascia holds down the femoral triangle?
Fascia lata
What is the opening called that gives rise to the great saphenous vein?
Saphenous opening
What does the saphenous vein drain Ito?
Femoral vein
The adductor canal runs along the medial aspect of the thigh. What are its borders
- Vastus medialis (anteriorly)
- Adductor longus and adductor Magnus posteriorly
- Sartorius (medially)
What does the adductor canal contain
Femoral artery
Femoral vein
Saphenous nerve
How does the sciatic nerve pass from pelvis to buttock?
Via greater sciatic notch
Where does the sciatic nerve lie in the buttock
Inferior medial quadrant
Along what aspect of the thigh does the sciatic nerve pass?
Posterior
What does the sciatic nerve divide into?
Tibial nerve and common perineal nerve
What does the sciatic nerve supply
All hamstring muscles and all muscles below knee-level
Below which muscle does the sciatic nerve usually pass into the thigh?
Piriformis
Where is the safe area for i.m injection?
Upper lateral region (Avoids hitting sciatic nerve)
What does the acetabular labrum do?
Deepens the fossa
What is the acetabular fossa filled with?
Fibro-fatty tissue
To what structure does the ligament of the head of femur attach to?
Attaches to the head of the femur at the fovea
What ligament completes the socket for the femur to insert into?
Transverse acetabular ligament
What are the ligaments of the hip bone?
- Iliofemoral ligament
- Pubofemoral ligament
- Ischio-femoral ligament
- Ligament of the head of the femur
What are the capsular ligaments of the hip bone
- Iliofemoral ligament
- Pubofemoral ligament
- Ischio-femoral ligament
What is the main artery branch that supplies the head of the femur?
Profunda femoris artery
What branches come off the profunda femuris artery
Lateral circumflex femoral artery and medial circumflex femoral artery
What is unusual about blood supply to the head of the femur
It goes distally to proximally - fracture at the neck of the femur can lead to avascular necrosis of the head of the femur
Describe the progression of arteries in the thigh region
Abdominal aorta splits into external and internal iliac - external iliac passes under inguinal ligament and becomes femoral artery - which then gives off a deep branch
How does the femoral artery and vein pass from the anterior compartment to the posterior compartment in the knee?
Via the hiatus of adductor Magnus muscle - they then become the POPLITEAL artery and vein
What are the superficial veins of the region?
- Great saphenous vein - joins femoral artery at sapheno-femoral junction
What are the deep veins of the region
- Popliteal vein
- Femoral vein
- External iliac vein
Explain lymph drainage of the region
Superficial and deep inguinal lymph nodes present - lots of nodes present
Which nerve supplies the anterior compartment of the thigh?
Femoral nerve
Which nerve supplies the medial compartment of the thigh?
Obturator nerve
Which nerve supplies the posterior compartment of the thigh?
Sciatic nerve - also everything below knee
Which roots supply hip flexors?
L2/3
Which roots supply hip extensors
L4/5
Which roots supply knee extensors
L3/4
Which roots supply knee flexors
l5/s1