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MM Test 2 > B6.028 Gluteal Region, Posterior Thigh, Anterior Thigh, Femoral Triangle, and Medial Thigh > Flashcards

B6.028 Gluteal Region, Posterior Thigh, Anterior Thigh, Femoral Triangle, and Medial Thigh Flashcards

1
Q

thigh

A

from hip joint to knee joint

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2
Q

leg

A

from knee joint down

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3
Q

3 palpable landmarks in gluteal region

A

posterior superior iliac spine (possible dimple)
greater trochanter of the femur
ischial tuberosity

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4
Q

purpose of gluteal and posterior thigh muscles

A

act at the hip and knee joints

many powerful anti-gravity muscles

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5
Q

which two portions of the pelvis are aligned anatomically

A

anterior superior iliac spine
pubic tubercle
(forward facing mickey mouse ears)

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6
Q

which 3 ligaments act as anchors for large gluteal muscles

A

sacrospinous ligament
sacrotuberous ligament
sacroiliac ligament

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7
Q

deep fascia of the thigh

A

“fascia lata”
wraps around entire thigh region
lateral aspect thickens to form “iliotibial tract”
continuous with deep fascia of the leg

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8
Q

iliotibial tract

A

connects the gluteus maximus to the lateral leg (tibia)

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9
Q

4 superficial gluteal muscles

A

gluteus maximum
gluteus medius
gluteus minimum
tensor fascia latae

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10
Q

major function of gluteus muscles

A

resist gravity during the gait and posture

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11
Q

largest skeletal muscle

A

gluteus maximum

can be up to 4 lb

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12
Q

function of iliotibial track

A

dramatically increases the length of the lever arm used by gluteus maximum

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13
Q

function of bursas in the hip joint

A

minimize excessive shearing during extreme jumping, walking/running, or climbing

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14
Q

trochanteric bursa

A

between gluteus maximus and greater trochanter

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15
Q

ischial bursa

A

between ischial tuberosity and skin when sitting

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16
Q

gluteofemoral bursa

A

between iliotibial track and vastus lateralis

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17
Q

function of piriformis muscle

A

does not have an important function

useful anatomical marker that divides superior vs inferior gluteal regions

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18
Q

important vessels/nerves that exit the pelvis above the piriformis

A

superior gluteal nerve, artery and vein

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19
Q

important vessels/nerves that exit the pelvis below the piriformis

A

inferior gluteal nerve, artery, and vein

sciatic nerve

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20
Q

major branches of internal iliac artery

A

superior gluteal

inferior gluteal

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21
Q

what is the sciatic nerve composed of

A

2 separate nerves: tibial and common fibular

do not exchange fibers

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22
Q

major nerves to the gluteal region

A

superior gluteal
inferior gluteal
sciatic
posterior femoral cutaneous

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23
Q

result of injuries to superior gluteal nerve

A

waddling or hip drop gait

pelvis cannot be maintained in a level position

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24
Q

sciatica

A

irritation and inflammation of sciatic nerve due to chronic pressure

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25
Q

causes of sciatic nerve damage

A

thick wallets, prolonged sitting on rigid surfaces

unsafe intramuscular injection into inferior gluteal quadrants

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26
Q

how to do an anesthetic block of the sciatic nerve

A

inject anesthetics a few centimeters inferior to the midpoint of the line joining the posterior superior iliac spine and the superior greater trochanter

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27
Q

3 posterior thigh muscles (hamstrings)

A

semitendinosus
semimembranosus
biceps femoris

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28
Q

general parameters of hamstring muscles

A

originate from ischial tuberosity (pelvis)
cross 2 joints - hip and knee - to attach to leg bone
extend the thigh at the hip joint (extend the trunk) and flex the knee, but not both simultaneously
innervated by tibial nerve
short head of biceps femoris is an exception to these

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29
Q

common hamstring injuries

A

hamstring strain or avulsion of ischial tuberosity

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30
Q

why cant you extend a fully flexed hip and flex a knee at the same time

A

hamstring tendons are unusually long, but the muscle fiber bundles are too short to accomplish both actions simultaneously (not enough muscle contraction length)

31
Q

describe the arteries to the posterior thigh

A

external iliac > femoral > profundal femoris (deep femoral) > medial and lateral circumflex femoral arteries
extensive anastomosis around hip

32
Q

what is unusual about the blood supply to the posterior thigh

A

no big, main artery

supplied by tributaries from anterior thigh arteries

33
Q

anastomoses between internal and external iliac crests

A

branches of inferior gluteal (internal iliac) join deep femoral branches (external iliac)
arteries that contribute to femoral anastomosis also comprise a potential “bypass” should a blockage occur in the femoral artery

34
Q

which nerves of the gluteal region are from the posterior rami

A

superior cluneal

middle cluneal

35
Q

which nerves of the gluteal region are from the anterior rami

A

inferior cluneal (posterior femoral cutaneous)

36
Q

nerves of the sacral plexus

A

nerves: superior gluteal, inferior gluteal, posterior femoral cutaneous
branches: piriformis, obturator, quadratus femoris

37
Q

anatomy of great saphenous vein

A 
originates from dorsum of foot
passes anterior to the medial malleolus
runs behind the medial side of knee joint
remains medial on the distal thigh
ascends to the saphenous opening
dives deep to join the femoral
38
Q

anatomy of small saphenous vein

A

originates from lateral foot/sole
passes posterior to lateral malleolus
runs on posterior surface of calf
drains into popliteal vein

39
Q

what is the saphenous opening

A

defect in the upper anterior thigh fascia

40
Q

crural fascia

A

deep fascia of the leg

41
Q

where is the femoral nerve

A

passes behind inguinal ligament at the midpoint

42
Q

branches of the femoral nerve

A

muscular: to anterior thigh muscles
branches to hip and knee joints
all terminal branches form within the femoral triangle

43
Q

saphenous nerve

A

only femoral nerve branch which travels below the knee joint

serves the skin of the medial leg and foot

44
Q

femoral cutaneous branches

A

anterior femoral cutaneous (medial anterior thigh)

saphenous (medial leg and heel)

45
Q

superficial cutaneous branches of the femoral artery

A

superficial epigastric
inferior epigastric
superficial circumflex iliac
external pudendal (superficial and deep)

46
Q

femoral artery tributaries to muscle

A

deep femoral > medial femoral and lateral femoral circumflex > 3 perforating arteries

47
Q

blood supply to the head of the femur and hip joint

A

medial circumflex femoral- posterior retinacular arteries
lateral circumflex femoral-anterior retinacular arteries
these two branches anastomose with inferior gluteal artery and 1st perforating branch of the deep femoral

48
Q

fracture of the femoral neck

A

endangers retinacular arteries of the femoral neck

49
Q

4 bursae at the insertion of the quadriceps femoris

A

prepatellar (subcutaneous)
suprapatellar (sebtendinous)
subcutaneous infrapatellar
deep infrapatellar

50
Q

which bursa communicates with the joint cavity

A

suprapatellar
most common site of quadriceps tendon bursitis
important in infections

51
Q

how might the psoas muscle be infected

A

a retroperitoneal pyogenic infection can arise from lung or vertebral column due to TB or enteritis (Crohns), infiltrating the investing fascia of the psoas

52
Q

pus accumulation in the psoas

A

pus accumulation in the thoracic portion may infiltrate through muscle into the inguinal region and then into the hip joint synovial space via communicating bursae

53
Q

differential of edema in the inguinal region

A 
psoas abscess
inguinal hernia
femoral hernia
inguinal lymph node enlargement
local dilation of the great saphenous vein
54
Q

poor or unequal quad function

A

can cause arthritis or trauma to the knee joint, abnormal patella wear, resulting in loss of knee joint stability and function

55
Q

chondromalacia patellae

A

runners knee
deterioration of the patellar articular cartilage due to excessive wear
observed in young and old
can be caused by repeated misaligned quad contractions or by excessive rising from a squatting position under heavy loads

56
Q

patellar fractures

A

caused by direct blows such as front end auto collisions

57
Q

abnormal ossification of the patella

A

multiple ossification centers
may be bipartite or tripartite
sometimes mistaken as fractures

58
Q

what is the femoral triangle

A

triangular compartment inferior to the inguinal ligament in the superficial space

59
Q

boundaries of the femoral triangle

A

inguinal ligament
sartorius
adductor longus

60
Q

contents of femoral triangle

A

iliopsoas muscle
femoral nerve
femoral sheath (femoral artery, vein, and canal)

61
Q

roof/anterior wall of the femoral triangle

A

fascia lata has an opening just below the inguinal ligament called the saphenous opening

62
Q

saphenous opening/hiatus

A

size of a quarter

covered by delicate perforated CT layer called the cribriform fascia

63
Q

what is the femoral canal

A

cone shaped potential space that extends to the saphenous opening
typically contains fat, loose CT, and lymph nodes

64
Q

clinical importance of femoral canal

A

potential passageway for femoral hernia

65
Q

femoral triangle from lateral to medial

A 
nerve
artery
vein
canal
lacunar ligament
66
Q

clinical considerations for the femoral triangle

A

palpate femoral artery
compress femoral artery against superior ramus of pubic bone
place catheter into femoral artery for left cardiac angiography
place catheter into femoral vein for right cardiac angiography
femoral venipuncture site for fluid infusion

67
Q

femoral hernia

A 
more frequent in females
deep to inguinal ligament, soft subcutaneous lump
never enters scrotum
distinct from inguinal hernia
can lead to strangulated intestine
68
Q

obturator artery

A

provides blood supply to medial adductor muscle group
from internal iliac
anastomose with circumflexes from deep femoral for collateral circulation

69
Q

anastomoses between internal and external iliac

A
  1. inferior gluteal and circumflex femoral arteries
  2. obturator and deep femoral artery twigs
  3. internal pudendal and external pudendal
70
Q

obturator nerve

A

from L2-L4 exits pelvic cavity at the obturator foramen
splits into 2 branches:
superficial- runs between adductor longus and brevis
deep- runs posterior to adductor brevis

71
Q

pulled groin

A

strain and possible tearing of the proximal attachments of the adductor muscle groups
usually occurs in sports requiring quick acceleration from a rest position

72
Q

cause of pes anserinus bursitis

A

3 thin, strap like muscles all insert at the upper part of the medial surface of the tibia
due to close proximity of these muscles tendons to the knee joint capsule, there is an intervening bursa to reduce friction during gait

73
Q

symptoms of pes anserius bursitis

A

pain and tenderness on the inside of the knee, 5-7 cm below the joint
runners susceptible

74
Q

common clinical problems affecting gluteal and thigh regions

A 
deep and superficial VT
pelvic and hip fractures
muscle strain injuries
hip, gluteal, and back pain
OA and RA of the hip
bursitis at gluteal and trochanteric friction points

MM Test 2 (23 decks)

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