Dissection: Lower Limb Flashcards
What is the origin and insertion of the gluteus maximus muscle?
From the gluteal surface of the ilium, sacrum and coccyx and inserting mainly at the IT band, but also at the greater trochanter of the femur
What does the gluteus maximus do?
Extension and lateral rotation of the thigh
What is the innervation and blood supply to the gluteus maximus?
Inferior gluteal artery and nerve
What is the origin and insertion of the gluteus medius muscle?
Origin = gluteal surface of ilium Insertion = greater trochanter of femur
What do gluteus medius, minimus and tensor fascia lata do?
Hip abduction and medial rotation
What is innervation and blood supply to the gluteus medius and minimus?
Superior gluteal artery and nerve
What is the origin and insertion of the gluteus minimus muscle?
Origin = ilium Insertion = greater trochanter of femur
What is the origin and insertion of tensor fascia lata?
Origin = anterior iliac crest, to ASIS Inserts = IT band
What is the innervation to tensor fascia lata?
superior gluteal nerve
What are the superficial muscles of the gluteal region?
Gluteus maximus, medius, minimus and tensor fascia lata
What are the deep muscles of the gluteal region?
Piriformis, superior and inferior gemelli, obturator internus and quadratus femoris
What is the origin and insertion of piriformis?
Origin = anterior sacrum Insertion = greater trochanter (through greater sciatic foramen)
What does the piriformis muscle do?
lateral rotation and hip abduction
What is the origin and insertion of the superior gemelli muscle?
Origin = ischial spine Insertion = greater trochanter
What do the superior and inferior gemelli muscles do?
Lateral rotation and hip abduction
What is the innervation to the superior gemelli muscle?
The nerve to the obturator internus muscle
What is the innervation to the inferior gemelli muscle?
The nerve to the quadratus femoris muscle
What is the origin and insertion of the quadratus femoris muscle?
Origin = Lateral ischial tuberosity Insertion = Quadrate tuberosity
What does the quadratus femoris do?
Lateral rotation of the hip
What is the innervation to the quadratus femoris?
Nerve to the quadratus femoris
What are the two main ligaments of the pelvis?
Sacrotuberous and sacrospinous
What is the origin and insertion of the sacrotuberous ligament?
Sacrum to ischial tuberosity
What is the origin and insertion of the sacrospinous ligament?
Sacrum to the ischial spine
What passes through the greater sciatic foramen?
Piriformis with superior and inferior gluteal vessels and nerves
What passes through the lesser sciatic foramen?
Obturator internus tendon with internal pudendal vessels and pudendal nerve
What passes through the obturator foramen?
obturator artery, nerve and vein
What forms the obturator foramen?
Ischium and pubis bone
What are the boundaries of the femoral triangle?
Superior = inguinal ligament Lateral = sartorius Medial = adductor longus Roof = fascia lata Floor = iliopsoas and pectineus
What are the contents of the femoral triangle?
Femoral nerve and femoral canal (contains femoral artery + vein as well as deep inguinal lymphatics/nodes)
What are the four main anterior muscles of the thigh?
Iliopsoas, quadriceps, sartorius and pectineus
What is the ‘iliopsoas’ muscle?
Includes psoas major (stems from cervical spine) and iliacus
What is the insertion of iliopsoas?
Lesser trochanter of femur
What does iliopsoas do?
Hip flexion and lateral rotation
What does the ‘quadriceps’ consist of?
Rectus femoris, vastus medialis, intermedius and lateralis
What do the quadriceps do?
Hip and knee flexion
What is the innervation to the quadriceps, pectineus and sartorius?
femoral nerve
What is the origin and insertion of sartorius?
From anterior superior iliac spine to superior medial tibia (in pes anserinus)
What does sartorius do?
Hip flexion, abduction and lateral rotation as well as knee flexion
What does pectineus do?
Hip adduction and flexion
What main group of muscles lies in the medial part of the thigh?
Adductors
What is the role of adductor magnus?
Both adductor and forms part of hamstrings (extension)
What is the origin and insertion of adductor magnus?
Origin = pubis Insertion = linea aspera and adductor tubercle of medial femur
What is the innervation to the adductor muscles?
Obturator nerve
What is the origin and insertion of adductor longus and brevis?
Pubis to linea aspera
What does adductor longus do?
Adduction and medial rotation
What is the origin and insertion of gracilis?
Pubis to medial tibia (pes anserinus)
What is the pes anserinus?
A conjoined tendon of 3 muscles: sartorius, gracilis and semitendinosus inserting onto the anteromedial surface of the proximal tibia
What are the 3 main muscles in the posterior compartment of the thigh?
Biceps femoris, semitendinosus and semimembranosus
What is the origin and insertion of biceps femoris?
Origin = ischial tuberosity (long head) and linea aspera (short head)
Insertion: head of fibula
What does biceps femoris do?
Knee flexion, hip extension and lateral rotation of knee and hip
What is the innervation to the biceps femoris?
Sciatic nerve branches:
Long head = tibial
Short head = common peroneal
What is the origin and insertion of semitendinosus?
Origin: ischial tuberosity
Insertion = medial tibia (pes anserinus)
What is the innervation to semitendinosus and semimembranosus?
Tibial part of sciatic nerve
What do semitendinosus and semimembranosus do?
Knee flexion, hip extension and medial rotation at hip and knee
Describe the path of the femoral artery
Through inguial canal (of inguinal ligament), then gives rise to profunda (deep) femoris in the femoral triangle. The artery then descends in the anterior compartment in the adductor canal to supply anterior thigh muscles. It then exits through adductor hiatus in adductor magnus where it then enters popliteal fossa –> popliteal artery.
What are the ‘perforating branches’ of the femoral artery?
arteries which perforate adductor magnus to supply muscles of medial and posterior thigh
What are the medial and lateral circumflex branches of the femoral artery?
Medial circumflex - wraps around posterior femur (neck and head supply)
Lateral circumflex - wraps around anterolateral side of femur, supplying some lateral thigh muscles
Which nerve roots give rise to the femoral and obturator nerves?
L2-L4
Which structures does the femoral nerve innervate?
Hip flexors (iliopsoas, pectineus and sartorius) and knee extensors (quadriceps femoris)
Which structure does the obturator nerve supply?
Medial compartment of thigh
Which nerve roots give rise to the sciatic nerve?
L4-S3
Which structures does the sciatic nerve supply?
Muscles of posterior thigh and hamstring part of adductor magnus
What are the boundaries of the popliteal fossa?
Superolateral = biceps femoris Superomedial = semimembranosus Inferolateral = lateral head of gastrocnemius (and plantaris) Inferomedial = medial head of gastrocnemius
What are the contents of the popliteal fossa?
Popliteal artery and vein, small saphenous vein, tibial (medial) nerve and common peroneal nerve (lateral)
Where does the small saphenous vein drain?
Popliteal vein
What are the four muscles of the anterior compartment of the leg?
Tibialis anterior, extensor digitorum longus, extensor hallucis longus and fibularis tertius
What is the origin and insertion of tibialis anterior?
Origin = lateral tibia Inserion = base of 1st metatarsal (and medial cuniform)
What does tibialis anterior do?
Dorsiflexion and inversion
What is the innervation to tibialis anterior, EDL and EHL?
Deep peroneal nerve
What is the origin and insertion of extensor digitorum longus?
Origin = lateral tibial condyle and medial fibula Insertion = each of 4 toes
What is the origin and insertion of extensor hallucis longus?
Origin = medial surface of fibular shaf Insertion = distal phalanx of big toe
What does extensor digitorum longus do?
Dorsiflexion and extension of lateral 4 toes
What does extensor hallucis longus do?
Dorsiflexion and extension of big toe
What is the origin and insertion of the fibularis tertius?
Origin = medial surface of fibula alongside EDL
Insertion - 5th metatarsal (little toe)
What does the fibularis tertius do?
Eversion and dorsiflexion
What are the two main muscles in the lateral compartment of the leg?
Fibularis longus and brevis
What is the origin and insertion of fibularis longus?
Origin = Superior lateral surface of fibular Insertion = medial cuniform and base of little toe metatarsal
What does fibularis longus do?
Eversion and plantar flexion
What is the innervation to fibularis longus and brevis?
Superficial peroneal nerve
What does fibularis brevis do?
Eversion
What are the 3 superficial muscles of the posterior compartment of the leg?
Gastrocnemius, soleus and plantaris
What is the insertion of gastrocnemius, soleus and plantaris?
Calcaneus
What do gastrocnemius, soleus and plantaris do?
Plantarlexion
What is the innervation to muscles of the posterior compartment of the leg?
Tibial nerve
What are the 4 deep muscles of the posterior compartment of the leg?
Tibialis posterior, FDL, FHL and popliteus
Which compartment of the leg has the extensors and flexors?
Extensors = anterior Flexors = posterior
What does flexor digitorum longus do?
Flex the lateral 4 toes
What does the flexor hallucis longus do?
Flex the big toe
What is the origin and insertion of the popliteus?
Posterior surface of proximal tibia to the lateral condyle of femur
What does popliteus do?
Unlocks the knee
Describe the path of the popliteal artery
Popliteal artery goes through popliteal fossa (gives off genicular branches) and eits between gastroc and popliteus. Splits into anterior and posterior tibial arteries at lower border of popliteus.
Describe the path of the anterior tibial artery
Passes from popliteus, then between tibia and fibula (gap in interosseous membrane) then into anterior compartment, travels inferiorly and becomes dorsalis pedis
Describe the path of the posterior tibial artery
From popliteus travels inferiorly along surface of deep muscles (tibialis posterior), then accompanies tibial nerve into foot via tarsal tunnel to supply plantar surface. Posterior tibial also branches just after popliteus to give off fibular artery (lateral)
Describe the path of the fibular artery
Penetrates into lateral compartment of leg to supply muscles here
Which nerve roots give rise to the tibial and common peroneal nerves?
L4-S3
What does the tibial nerve innervate?
Posterior compartment of leg (travels through tarsal tunnel)
What does the common peroneal nerve supply?
Short head of biceps femoris
What are the two branches of the common peroneal nerve?
Superficial peroneal and deep peroneal nerves
What does the superficial peroneal nerve supply?
Lateral compartment of the leg
What does the deep peroneal nerve supply?
Anterior compartment of the leg
Name the three lateral ligaments of the ankle
Anterior and posterior talofibular and calcaneofibular
Name the medial ligament of the ankle
Deltoid ligament
How do the medial and lateral ligaments of the ankle compare?
Deltoid ligament is technically 5 joined (adjacent) ligaments, so medial ligaments are much stronger
What is the function of the anterior cruciate ligament?
To prevent the tibia coming anterior to the femur
What is meant by the terrible triad?
You are likely to damage your medial collateral ligament, medial meniscus and ACL at once if there is subjected force to the lateral side of the knee
What is the function of the posterior cruciate ligament?
To prevent the tibia from going posterior to the femur
