Bones and Joints of the Proximal Lower Limb and Muscles of the Gluteal Region adn Thigh and Neurovasculature of the Thigh Flashcards
What is the structure and function of the Pelvis?
Bony ring formed by the articulation of the right and left innominate bones and sacrum
Takes weight of body and transmits it to lower limbs
What is each innominate/hip bone formed from? (3) Where do they fuse?
Pubic, Ilium and Ischium
Acetabulum
Name structures a-d
a- Anterior Superior Iliac spine
b- Iliac crest
c- Sacrum
d- Sacroiliac joint
Name structures e-h
e- Anterior Inferior iliac spine
f- acetabulum
g-Obturator Foramen
h- Pubic symphysis
Name structures i and j.
I-Inferior pubic ramus
J-Superior pubic Ramus
What surrounds the Obturator Foramen? What is it covered with in life?
Superior and Inferior Pubic Rami
Obturator membrane
What is the hole called in the Obturator membrane? What is present inside it?
Obturator canal
Vessels and nerves to pass between the pelvis and thigh
What are the to key bony prominences from the Ischium, posteriorly and Inferiorly?
Sharp Ischial spine
The Bulky ischial tuberosity
Name structures a-e
a- Ischial spine
b- Ischial tuberosity
c- Inferior Ischial ramus
d- Body of Ischium
e- Superior Ischial ramus
What ligaments attach to the Ischial spine and Ischial tuberosity respectively?
Sacrospinous ligament (Ischial spine)
Sacrotuberous ligament and Muscles of the posterior thigh (Ischial tuberosity)
What is found above and below the Ischial spines? (2)
Greater and Lesser sciatic notches
Which ligaments close these notches? To form?
Sacrotuberous and Sacrospinous ligaments
Greater and Lesser sciatic foramen
Which ligament is this? What does it connect?
Sacrotuberous ligament
Sacrum to the the Ischial tuberosity
Which ligament is this? What does it connect?
Sacrospinous ligament
Sacrum to the Ischial spine
Name structures a-e
a- Ischial tuberosity
b- Ischium
c- Pubis
d- Ischial spine
e- Sacrospinous ligament
Name structures f-j
f- Ilium
g- Posterior superior Iliac spine
h- Sacrum
i- Posterior Sacroiliac ligament
j- Greater sciatic foramen
Name structures k-p
k-Sacrospinous ligament
l- Lesser sciatic foramen
m- Sacrotuberous ligament
n- Ischiopubic ramus
o- Subpubic angle
p- Obturator foramen
Name structures a-d
a- Inter-trochanteric line
b- Greater trochanter
c- Neck
d- Head
Name structures e-g
e- neck
f- Greater trochanter
g- Lesser trochanter
Name structures h and i
h- Linea aspera
i- Lesser trochanter
What is the hip joint formed by the articulation of? What are the greater and lesser trochanters for?
Head of femur and acetabulum
sites of muscle attachment (similar to the humerus)
What is the Line located between the greater and lesser trochanters called?
Intertrochanteric line
Bony vertical ridge on the posterior aspect of shaft? Function?
Linea aspera
Muscle articulation
What is the structure located inferior to the trochanters? What aspect of the Humerus? Function?
Gluteal tuberosity
Posterior
Muscle attachment
What is the distal end of the femur expanded to form? What do they articulate with?
Medial and Lateral femoral condyles
Proximal tibia at the knee joint
What is found Superior to the medial femoral condyle? What is located anterior to the knee joint?
Adductor tubercle
Patella
What type of joint is the hip joint? Articulation of?
Ball and socket
Acetabulum of the hip and femoral head
What deepens the acetabulum?
Fibrocartilage known as acetabular labrum
Name structures a-d
a- Femoral head
b- Acetabulum
c- Acetabular labrum
d- Ligament of head of femur
What are the movements of the hip joint? Done by which thigh muscles? (VAGUE)
Flexion- Anterior thigh muscles
Adduction- Medial thigh muscles
Extension- Posterior thigh muscles
Abdution- Muscles of the Gluteal region
What two other movements can the muscles of the Gluteal region cause in the hip joint?
Extension and Rotation
What arteries supply the Hip joint? Where do they arise from?
Medial and lateral circumflex femoral arteries
Profunda femoris
What arteries are an extension of the lateral and medial circlumflex arteries? Where do they run? What do they supply?
Retinacular arteries
Neck of femur
femoral head
What three ligaments stabilise the Hip joint?
Iliofemoral
Pubofemoral
Ischiofemoral (ligaments)
Name a-b
a- Iliofemoral ligament (anterior)
b- Pubofemoral ligament (anterior)
c- Ischiofemoral ligament (posterior)
What type of Joint is the Knee joint? Articulation of?
Synovial Hinge joint
Femoral condyles and tibial condyles
Name a-d
a- Fibula
b- Lateral meniscus
c- Lateral collateral ligament
d- Anterior cruciate ligament
Name e-g
e- Femur
f- Articular surface of patella
g- Posterior cruciate ligament
Name h-j
h- Medial collateral ligament
i- Medial meniscus
j- Tibia
Name a-d
a- Lateral collateral ligament
b- Fibula
c- Posterior cruciate ligament
d- Medial collateral ligament
Name e-g (right knee)
e- Medial meniscus
f- Anterior cruciate ligament
g- Lateral meniscus
When do the femur and tibia achieve their best fit? What prevents them being a good fit?
Extension
Tibia plateaus are flat
What does the femur do to allow us to stand for long periods of times? What does this mean the knee does?
Rotates slightly
Locks in place
Which muscle is responsible for unlocking the knee? How?
Popliteus muscle
Allows flexion
What are the menisci? Where do they sit?
C shaped cartilages
Tibial plateaus
What is the function of the Meniscus? What are the two menisci?
Deepen tibial condyles for articulation
Medial and lateral
What is the Medial meniscus attached to?
Joint capsule and Medial collateral ligament
Where are the Meniscus thickest and thinnest respectively?
Thickest- Peripherally
Thinnest- in centre
two main ligaments in the knee?
Collateral and Cruciate ligaments
What do the medial and lateral collateral ligaments support and prevent respectively?
Support knee
Prevent sideways movement of tibia
What does the Lateral collateral ligament attach? Is it attached to the lateral meniscus?
Femur to the fibula
No it is not
What do the Anterior and posterior cruciate ligaments connect together?
Tibia and femur
What part of the Tibia and Femur does the Anterior cruciate ligament (ACL) attach to respectively?
Tibia- Intercondylar area
Femur- Lateral condyle of femur
What does the anterior cruciate ligament do?
Prevents tibia moving anterior to the femur
What parts of the tibia and Femur is the Posterior cruciate ligament attached to respectively?
Posterior intercondylar area of tibia
Lateral aspect of the medial condyle of the femur
What does the Posterior cruciate ligament (PCL) prevent?
Tibia moving posterior to the femur
How many Gluteal muscles are there?
four
Name muscles a-c
What are these?
a- Gluteus medius
b- Gluteus Maximus
c- Gluteus Mimimus
Superficial muscles of the gluteal region
Name structures d-f
d- Pririformis
e- Gemellus superior
f- Obturator internus
Name g & h
g- Gemellus inferior
h- Quadratus femoris
What muscle is this? What three points does it attach to proximally?
Gluteus maximus:
Posterior surface of ilium
Sacrotuberous ligament
Sacrum
Where does the gluteus maximus insert onto?
Iliotibial band and (less of) gluteal tuberosity
3 Movements of the Gluteus Maximus
Extensor of the hip
External rotator of the hip
Stabilises knee joint
Which two muscles lie deep to the gluteus maximus?
Gluteus medius and Gluteus minimus
Attachments of the Gluteus minimus and medias?
Posterior ilium to greater trochanter
What muscle is this?
Gluteus medius
Movements of the Gluteus Medias and minimus?
Abduct and Internally rotate the hip
Importance of Gluteus medius and maximus?
Hold pelvis ‘level’ when one foot is off the ground during walking etc
What muscle is this? What group is it a part of?
Tensor fascia latae
Superficial gluteal muscles
What is the origin and insertion of the Tensor fascia latae?
ASIS- Origin
Iliotibal band- insertion
Functions of the tensor fascia latae?
Tenses the fascia latae
Stabilises knee and weakly flexes the hip joint
What is the fascia lata?
Thick fascia that envelopes muscles of the thigh
What nerve is this? What superficial gluteal muscle does it innervate?
Inferior gluteal nerve
Gluteus maximus
Which nerve innervates the Gluteus medius, minimus and Tensor Fascia latae? Where does the Superior and inferior gluteal nerves leave the pelvis?
Superior gluteal nerve
Sciatic foramen
What are the four deep gluteal muscles?Gre
Pririformis
Superior and Inferior gemelli
Obturator internus
Quadratus femoris
Where do all the Deep gluteal muscles insert?
Greater trochanter
Where does the Pririformis muscle attach?
Pass through?
Anterior sacrum
Greater sciatic foramen
What emerges on the inferior surface of the Pririformis?
Sciatic nerve
Where do the deep gluteal muscles (apart from pririformis and Obturator internus) and obturator internus Originate from respectively?
Ischium
Obturator membrane (Obturator internus)
Name structures a-c
a- Patella
b- Vastus lateralis
c- Iliotibial band
Name structures d-f
d- Rectus femoris
e- Tensor fascia latae
f- Anterior superior iliac spine
Name structures g-i
g- Iliacus
h- Quadratus lumborum
i- Psoas major
Name structures j-l
j- Inguinal ligament
k- Pectineus
l- Sartorius
Name structures m,n, o (Bottom right should be o)
m- Vastus medialis
n- Quadriceps tendon
o- Patellar ligament
Four muscles of the Quadriceps femoris
Rectus femoris
Vastus lateralis
Vastus medialis
Vastus intermeidus
Four muscles of the Anterior thigh?
Quadriceps femoris (group of 4 muscles)
Sartorius
Iliopsoas
Pectineus
Where do all the quadriceps femoris converge? Inserting on via which ligament?
Quadriceps tendon
Tibial tuberosity via the patellar ligament
Where does the Rectus femoris attach?
AIIS (anterior inferior iliac spine)
What do the vastus lateralis and Vastus medialis both attach to?
Linea aspera (posterior aspect of the femoral shaft)
What muscles lies deep to rectus femoris? What does it attach to?
Vastus intermedius
Anterior femoral shaft
Where does the Sartorious muscle attach and insert onto?
ASIS (attach) and Medial aspect of proximal tibia
Secondary function of sartorious muscle?
Flex and externally rotate the hip
What is the Iliopsoas made up of? What is it innervated by?
Psoas major and Iliacus muscles converging
L1-L3 spinal nerves and femoral nerve
Where does the tendon of the Iliopsoas insert? What is the function?
Lesser trochanter
Primary flexor of the hip
What is the psoas muscle innervated by?
L1-L3
Where does the Pectineus attach and insert?
Superior pubic ramus and Lesser trochanter
Function of pectineus muscle?
Flexes and adducts the hip joint
What is the primary function of the Quadriceps femoris? What are all the muscles of the anterior thigh innervated by?
Extensor of knee
Femoral nerve (L2-L4)
How many muscles are present in the Medial thigh? What is there primary action?
5
Adductors of the hip
Innervation of the Medial thigh?
Obturator nerve (L2-L4)
Name muscles a-c
a- Gracilis
b- Adductor magnus
c- Adductor longus
Name muscles d-f (d&f are same)
d- Adductor brevis
e- Obturator externus
f- Adductor brevis
Name g-i
g- Adductor magnus (adductor part)
h- Adductor magnus (Hamstring part)
i- Adductor hiatus
Where do the Adductor brevis and Adductor longus both attach to? Which is deep?
Pubic bone and linea aspera
Adductor brevis is deep to longus
Where does the Adductor part of the adductor magnus attach to and insert on?
Inferior pubic ramus and linea aspera
Function and innervation of adductor part of adductor magnus?
Function- adductor
Innervation- obturator nerve
Attachment and insertion of hamstring part of adductor magnus?
Attachment- Ischial tuberosity
Insertion- Adductor tubercle
Function and innervation of the hamstring part of the Adductor magnus?
Function- extensor of hip
Innervation- sciatic nerve
What is the name of the gap between the distal attachments of the adductor magnus?
Adductor hiatus
What muscle is this? Attachement and insertion?
Gracilis
Pubic bone and medial aspect of tibia
What is the obturator externus attached to and inserts??
External surface of obturator externus
Femur near the greater trochanter
Functions of gracilis and Obturator externus respectively?
Gracilis- Weak adductor and flexor of the hip
Obturator externus- Rotates the hip joint
Name a-d
a-Long head of biceps femoris
b- Short head of biceps femoris
c- Semimembranosus
d- Semitendinosus
What do the semimembranosus, semitendinosus and Long head of biceps femoris produce?
Hamstrings
Where do the Hamstrings attach to proximally?
Ischial tuberosity
Where do the semimembranosus and semitendinosus muscles insert onto ?
Medial aspect of proximal tibia
What does the Long head of the biceps femoris form a common tendon with? Where does it insert onto?
Short tendon of the biceps femoris
Head of the fibula
Name structures a-c
A- sartorius
B- Lymphatics
C- Femoral vein
Name structures d-f
d- Femoral artery
e- Femoral nerve
f- Anterior superior iliac spine
Name structures g-i
g- iliopsoas
h- Inguinal ligament
i- Pectineus
Name structures j and k
j- Adductor longus
k- Great saphenous vein
What forms the Lateral border of the Femoral triangle?
Medial border of sartorius
What forms the Medial border of the Femoral triangle?
Lateral border of adductor longus
WHat forms the Superior border of the Femoral triangle?
Inguinal ligament
What forms the apex of the Femoral triangle?
Where the sartorius and adductor longus meet
What forms the floor of the femoral triangle?
Iliopsoas (laterally)and pectineus (Medially)
3 parts of the femoral triangle?
Femoral artery
Femoral vein
Femoral nerve
Where is the femoral vein located in respect to the femoral artery?
Medial to the femoral artery
What are the femoral artery and vein easily accessible for? Why?
Clinical procedures
Located superficially
Name arteries a,b,c
a- Dorsal arch
b- Dorsalis pedis
c- Fibular
Name arteries def
d- Posterior tibial
e- anterior tibial
f- Popliteal
Name arteries ghi
g- Femoral
h- Obturator
i- Internal pudendal
Name arteries jkl
j- Lateral sacral
k- Internal iliac
l- Common iliac
Name arteries mnop
m- External iliac
n- Inguinal ligament
o- Deep femoral
p- Lateral femoral circumflex
Name abc
a- Fibular
b- Posterior tibial
c- Anterior tibial
Name def
d- Popliteal
e- Femoral
f- Right external iliac
Name ghi
g- Deep femoral
h- Lateral femoral circumflex
i- Peroneal
Name jkl
j- Lateral plantar
k- Medial plantar
l- Plantar arch
What are the Gluteal muscles supplied by? WHat is this a continuation of? Where does it leave the pelvis?
Superior and inferior gluteal arteries
Internal iliac artery
Greater sciatic foramen
What artery supplied the deep anteiror thigh muscles? WHat is it a branch of?
Profunda femoris
Femoral artery
WHat artery supplies the medial thigh? WHat is it a branch of?
Obturator artery
Internal iliac artery
WHat artery supplies the hamstring muscles?
Perforating arteries that arise from the profunda femoris
name abc
a- fibular
b- Posterior tibial
c- Anterior tibial
name def
d- Small saphenous
e- Popliteal
f- Great saphenous
name ghi
g- Femoral
h- femoral circumflex
i- femoral
name jkl
j- obturator
k- internal pudendal
l- lateral sacral
name mno
m-Gluteal
n- Internal iliac
o- common iliac
name pqrs
p- external iliac
q- deep femoral
r- digital
s- dorsal venous arch
What nerves supply the gluteal muscles? How do they leave the pelvis?
Superior and Inferior gluteal nerves
greater sciatic foramen
What is the femoral nerve formed from? Where does it travel?
L2-L4
Deep to the inguinal ligament lateral to the femoral artery
What branch of the femoral nerve innervates the skin over the leg?
Saphenous nerve
WHere does the obturator nerve travel into the leg via?
Lateral wall of pelvis and enters via obturator foramen
What nerve innervates the medial thigh muscles and skin over it?
Obturator
Where does the sciatic nerve originate? Where does it leave the pelvis?
L4-S3
Greater sciatic foramen
Where does the sciatic nerve enter inferior to? WHat two nerves make it up?
Lower border of pririformis
Tibial and common fibular nerve
What does the tibial nerve innervate?
Muscles of the posterior thigh and posterior leg
What does the common fibular nerve innervate?
Muscles of the anterior and lateral leg