Anatomy of Lower Limb Flashcards
Movements of Hip Joint
Flexion
Extension
Abduction
Adduction
Medial/Lateral Rotation
Circumduction
Hip Joint formed by articulation of…
Acetabulum an Proximal Femur (head of femur)
Knee Joint articulation of…
Distal Femur and Tibia
Ankle Joint articulation of…
Distal ends of tibia and fibia with the talus
Pelvis is a bony ring formed of the left and right …. bones
Innominate (hip) bones
Each hip bone formed of 3 separate bones…
Pubic Bone
Ilium
Ischium
(fuse at acetabulum)
Hip bones articulate with each other anteriorly at…
Posteriorly at…
Pubic Symphysis
The sacrum at sacroiliac joints
What surround the obturator foramen on each side of the hip?
Superior and inferior pubic rami
In early life, obturator foramen is…
Almost completely closed by obturator membrane and muscles attached (small gap in membrane - obturator canal - allows vessels/nerves to pass between pelvis and thigh)
Uppermost part of ilium is called…
The iliac crests (which are palpable)
2 anterior prominences of the hip
ASIS
AIIS
Posterior landmarks of the hip
Ischial Tuberosity
Ischial Spine
Greater and Lesser Sciatic Notches
Distal to the neck of the femur lies 2 sites of muscle attachment called..
The greater and lesser trochanters
Where is the intertrochanteric line?
Lies between the greater and lesser trochanters on anterior surface of femur
What is the trochanteric fossa?
Small hollow on medial aspect of greater trochanter
What is the linea aspera?
Bony vertical ridge on posterior aspect of shaft of femur (site of muscle attachment)
Distal end of femur expanded to form…
These articulate with… at the knee joint
Medial and lateral femoral condyles
These articulate with proximal tibia at knee joint
Just superior to the medial femoral condyle lies…
The small adductor tubercle
What lies anterior to the knee joint?
Patella
What is the name of the fascia that surrounds the thigh like a sleeve?
Fascia lata
What is the iliotibial band (or tract)?
Thickening of lateral part of fascia lata which attaches to lateral aspect of proximal tibia so is important for stabilising knee joint
What separates the thigh into anterior, medial and posterior compartments?
Intermuscular septa which extend from the fascia lata to the linea aspera
Anterior compartment of the thigh contains 7 muscles which are all innervated by…
The Femoral Nerve (L2-L4)
7 Muscles of the Anterior Compartment of the Thigh
Quadriceps Femoris (group of 4 muscles)
Sartorius
Iliopsoas
Pectineus
4 muscles of quadriceps femoris
Rectus femoris
Vastus lateralis
Vastus medialis
Vastus intermedius
The 4 quadriceps femoris muscles converge onto the… which runs over the patella to insert onto … via the …
Converge onto the quadriceps tendon which runs over patella to insert onto tibial tuberosity via the patellar ligament
Proximal attachment of the Rectus Femoris
AIIS
Vastus lateralis attachment
Attaches to linea aspera on posterior aspect of femoral shaft
Vastus medialis attachment
Attaches to linea aspera
Vastus intermedius attachment
Attaches to anterior aspect of femoral shaft
Quadricep muscles position relative to rectus femoris (which lies in midline of anterior thigh)
Vastus lateralis is lateral
Vastus medialis is medial
Vastus intermedius is deep
Sartorius relative position, attachment and movement
Superficial in anterior thigh
Attaches proximally at ASIS
Inserts onto medial aspect of tibia (crossing both hip and knee joints)
Flexes and laterally rotates hip and flexes knee (not a prime mover)
Iliopsoas insertion and movement
Psoas major and iliacus converge via common tendon onto lesser trochanter of femur
Prime flexor of hip
Pectineus attachment and movement
Attaches proximally to superior pubic ramus
Inserts distally on femur just inferior to lesser trochanter
Flexes and adducts hip
Medial thigh muscle innervation
Obturator nerve (L2-L4)
Primary movement of medial thigh muscles
Adduction at hip
5 muscles of medial thigh
Adductor brevis
Adductor longus
Adductor magnus
Gracilis
Obturator externus
Adductor brevis and adductor longus points of attachment
Pubic bone and linea aspera
What lies between adductor brevis and adductor longus?
The obturator nerve
(adductor brevis lies deep to adductor longus)
2 parts of adductor magnus (action, attachment, innervation)
Adductor part - attaches to inferior pubic ramus and linea aspera, adduction, innervated by obturator nerve
Hamstring part - attaches to ischial tuberosity and adductor tubercle, innervated by the sciatic nerve (L4)
Adductor Hiatus
Gap formed between the distal attachments of adductor magnus
Femoral artery and vein travel through it to enter posterior thigh
Gracilis attachment and movement
Attaches to pubic bone and medial aspect of tibia
Weak adductor and flexor of hip and weak flexor of knee (not a prime mover)
Femoral artery is a continuation of … and travels deep to … to enter the proximal anterior thigh
External Iliac Artery
Inguinal Ligament
The femoral artery gives a large branch which is the deep artery of the thigh called…
Profunda Femoris
Femoral artery continues distally through the adductor hiatus into the posterior thigh then…
Through the popliteal fossa where it becomes the popliteal artery
Obturator artery
Branch of internal iliac which travels through obturator canal into medial compartment of thigh and anastomoses with branches from femoral artery
Femoral vein follows the course of…
The femoral artery
Obturator vein follows the course of…
The obturator artery
Femoral nerve formed from which spinal nerve?
L2-L4
Through what does the femoral nerve enter the proximal anterior thigh?
Deep to inguinal ligament
Sensory branch of femoral nerve that supplies skin over leg?
Saphenous nerve
Obturator nerve formed from spinal nerves…
L2-L4
Obturator nerve entry to thigh
Travels along lateral wall of pelvis exiting through obturator canal emerging onto superficial surface of adductor brevis
Femoral triangle boundaries
Lateral - medial border of sartorius
Medial - lateral border of adductor longus
Superior - inguinal ligament
Apex is distal and is where sartorius and adductor longus meet
Floor formed by iliopsoas laterally and pectineus medially
Contents of femoral triangle
Femoral artery
Femoral vein (receives a tributary - superficial vein called the great saphenous vein - in the femoral triangle)
Femoral nerve
3 ridges of posterior ilium
Anterior, posterior, and inferior gluteal lines
2 notches of posterior ilium and ischium
Greater and lesser sciatic notches
Ischial spine projects from posterior ischium. What attaches to it?
The sacrospinous ligament
Part of the pelvis we sit on?
Ischial tuberosity (bulky prominence at posterior aspect of ischium)
Name for the ridge of bone between the 2 trochanters on posterior aspect of femur
Intertrochanteric crest
Gluteal tuberosity
Lies just inferior to trochanters on posterior femur (site of muscle attachment)
4 superficial gluteal muscles
Gluteus maximus
Gluteus medius
Gluteus minimus
Tensor fascia latae
Gluteus maximus proximal attachments
Posterior surface of ilium
Sacrotuberous ligament
Sacrum
Gluteus maximus distal attachments
Most fibres insert into the iliotibial tract
Some attach to gluteal tuberosity
Actions of gluteus maximus
Hip extensor
Also lateral rotator of hip
Gluteus medius and gluteus minimus relative position, insertion and action
Medius is deep to maximus, minimus is deep to medius
Both insert onto greater trochanter
Both abduct and medially rotate hip
Tensor fascia latae (TFL) attachments
Attached to ASIS and inserts onto iliotibial band
TFL action
Contraction tenses fascia latae and iliotibial band stabilising the knee when extended (not a prime mover)
Superficial gluteal muscles innervated by gluteal nerves which leave …. in the pelvis via the ….
Sacral plexus
Greater sciatic foramen
What innervates gluteus maximus?
Inferior gluteal nerve
What innervates gluteus medius, minimus an TFL?
Superior gluteal nerve
4 deep gluteal muscles
Piriformis
Superior and inferior gemelli
Obturator internus
Quadratus femoris
All deep gluteal muscles insert onto…
Greater trochanter (or close to it)
