exam 3 Flashcards
what are the ten muscles of the posterior hip?
tensor fascia lata gluteus maximus gluteus medius gluteus minimus piriformis superior gemellus obturator internus inferior gemellus obturator externus quadratus femoris
what is the muscle that lies along the lateral border of the femur, between two layers of the lateral aspect of the fascia lata (illiotibial tract). the muscle forms a superficial elevation below and lateral to the iliac crest?
tensor fascia lata
what is the origin of the tensor fascia lata?
crest of the ilium
what is the insertion of the tensor fascia lata?
iliotibial tract
what muscle flexes, abducts, and medially rotates femur and helps to stabilize the knee joint?
tensor fascia lata
what is the nerve supply of the tensor fascia lata?
superior Gluteal (L4,L5,S1)
what is the largest and most supeficial muscle of the hip region?
gluteus maximus
what is the muscle that is conspicuous in humans for its great bulk, which together with a variable amount of adipose tissue forms the?
gluteus maximus and forms the buttocks
what is the muscle that is the largest by weight in human body and is associated with the assumption of the erect posture and bipedal locomotion?
gluteus maximus
what are the two gluteal bursae?
trochanteric bursae
ischial bursae
there are a number of bursae that separate the gluteus maximus from bone and are collectively known as?
gluteal bursae
what are the three origin points of the gluteus maximus?
posterior gluteal line
sacrum and coccyx
posterior ligaments of the sacroiliac joint
what are the two insertion points of the gluteus maximus?
gluteal tuberosity (line) of femur iliotibial tract
what are the three actions of the gluteus maximus?
- extends and laterally rotates femur
- helps to stabilize the pelvic bone
- stabilizes the knee joint
what is the nerve for the gluteus maximus?
inferior gluteal (L5,S1,S2)
when patients experience a difficulty in getting from a sitting to a standing position (may have to actively push themselves to the standing position), this is due to weakness of what muscle?
gluteus maximus
weakness of what muscle will cause difficulty straightening from a bending position, walking uphill or up stairs?
gluteus maximus
Atrophy of the gluteus maximus does not seriously affect walking on?
level ground or standing still
what is the muscle which is partly deep to the gluteus maximus, but its superior portion remains superficial?
Gluteus medius
origin of the gluteus medius?
external surface of the ilium
insertion of the gluteus medius?
greater trochanter of the femur
what is the smallest of the gluteal muscles and deep to the gluteus medius?
gluteus minimus
origin of the gluteus minimus?
external surface of ilium
insertion of gluteus minimus?
greater trochanter of femur
what are the three actions of the gluteus minimus?
- abducts femur
- medially rotates femur
- helps to keep the pelvic bone steady when the foot on the opposite side is raised off the ground.
nerve of the gluteus minimus?
superior gluteal (L4,L5,S1)
what is the simple test which is used if one suspects atrophy and weakness of the gluteus medius and minimus muscles?
trendelenburg test
(trendelenburg test) the supportive effect of the pelvis when the foot is raised off the ground is dependent partly on what two muscles?
gluteus medius
gluteus minimus
(trendelenburg test) when the muscles are weak, the pelvis will drop on the ____________ side when the foot is raised off the ground
unaffected side
during a trendelenburg test the best observed place to watch is the folds of the?
buttocks
trendelenburg test- the pelvis and buttock fold will fall on the sides that the foot is raised off the ground and this would be a __________ result?
postive trendelenburg sign
this indicates that the muscles on the side opposite from where the foot is raised are not functioning properly
the type of abnormal locomotion due to atrophy and weakness of the gluteus medius and minimus?
gluteal Gait
Trendelenburg Gait
with this type of locomotion, there is displacement of the body (falling of the pelvis) on the unaffected side
weakness of the gluteus medius and minimus muscles will also cause _________ deviations.
postural deviation
when there is a gluteus based postural deviation it will result in the vertebral column deviating toward the side where the pelvis is?
low
giving rise to what is known as C curve of the column
weakness of the ______ gluteus medius and minimus will give rise to a ____ “C” curve of the vertebral column with the opening of the “C” toward the side where the muscle is weak.
right muscles give rise to left C curve
all the muscles of the posterior hip besides the gluteus group all share a common action of what?
lateral rotation of the femur
the muscle which originates within the pelvic cavity and emerges through the greater sciatic notch?
piriformis
it is deep to the gluteus maximus and parallel to the gluteus medius
origin of the piriformis?
anterior surface of the sacrum (within pelvic cavity)
insertion of the piriformis?
greater trochanter of femur
nerve of piriformis?
S1 and S2
a common cause of pain in the gluteal region (sciatica) due to compression of the sciatic nerve by what muscle?
piriformis
the syndrome that causes deep pain in the buttocks which may refer along course of the sciatic nerve (posterior leg and thigh)?
piriformis muscle syndrome
the syndrome that is common for athletes in sports that require extensive lateral rotation of the femur?
piriformis muscle syndrome
how id pirifomris muscle syndrome diagnosed?
diagnosed primarily on symptoms, since there are no tests that accurately confirm the diagnosis
what may help piriformis muscle syndrome?
stretching and correcting biomechanical abnormalities of the lower extremity and vertebral column
what is the small muscle that is situated between the pirifomis and the obturator internus and deep to the gluteus maximus.
superior gemellus
what muscle’s tendon of insertion fuses with that of the obturator internus and inferior gemellus?
superior gemellus
origin of superior gemellus?
spine of ischium
insertion of superior gemellus?
greater trochanter of femur
nerve of superior gemellus?
L4,L5,S1,S2
what s the small muscle which takes its origin within the pelvic cavity and whose tendon emerges through the lesser sciatic notch?
obturator internus
what is the muscle situated between the two gemellus muscles?
obturator internus
what muscle derives its name from its origin on the internal aspect of the membrane which covers the obturator foramen?
obturator internus
origin of obturator internus?
internal surface of the obturator membrane
insertion of the obturator internus?
greater trochanter of the femur
nerve of obturator internus
L4,L5,S1,S2
what is the muscle situated between the obturator internus and the quadratus femoris?
inferior gemellus
origin of inferior gemellus?
tuberosity of ischium
insertion of inferior gemellus?
greater trochanter of femur
nerve of inferior gemellus?
L4,L5,S1,S2
what is the quadrant shaped muscle which is found inferior to the inferior gemellus?
Quadratus Femoris
origin of quadratus femoris?
tuberosity of ischium
insertion of quadratus femoris?
quadrate tubercle of femur
nerve of quadratus femoris?
L4,L5,S1,S2
what is the muscle that derives its name from its origin of the external surface of the obturator foramen?
obturator externus
what is the muscle found deep to the inferior gemellus and the quadratus femoris?
obturator externus
origin of obturator externus?
external surface of the obturator membrane
insertion of the obturator externus?
trochanteric fossa of the femur
nerve of the obturator externus?
obturator (L2,L3,L4)
__________ rotation of the femur is important in the control of the body’s balance and posture.
lateral rotation
the lateral rotators as a group are stronger than the medial rotators of the?
femur
when standing normally the front of your foot should point slightly more?
lateral
this position helps to achieve better balance and posture
what are the three posterior thigh muscles?
semitendinosus
semimembranosus
Biceps Femoris
what muscles make up the hamstrings?
semitendinosus
semimembranosus
Biceps Femoris
the hamstrings all have a common origin point of?
ischial tuberosity
except for short head of biceps femoris
all the hamstrings share what nerve as their supply?
sciatic nerve (L4-S3)
what is the muscle situated on the medial-posterior aspect of the femur?
semitendinosus
what muscle is medial to the biceps femoris and is superficial to the semimembranosus?
semitendinosus
how does the semitendinosus get its name?
its tendon of insertion is very long and thus gives the muscles its name
what is the insertion of the semitendinosus?
medial condyle and proximal posterior shaft of tibia
what is the name to describe the tendons of insertion of the semitendinosus, gracilis, and sartorius?
Pes Anserinus
there is a bursa which separates the tendons from the skin
what is the muscle named for its flattened nature of its proximal attachment. proximally it lies deep to the semitendinosus?
semimembranosus
what is the insertion of the semimembranosus?
medial condyle of tibia
what is the most laterally situated of the hamstring muscles?
biceps femoris
the short head of the biceps femoris originates where?
linea aspera of the femur
what is the insertion of the biceps femoris?
head of fibula
lateral condyle of tibia
actions of all the hamstring muscles?
-flexion of the leg at the knee joint
actions of all the hamstrings except the short head of biceps femoris?
- stabilize hip joint
- extension of the femur
actions of the semitendinosus and semimembranosus hamstring muscles?
-medially rotates the leg (tibia)
actions of the biceps femoris?
laterally rotates the knee (tibia)
the _______ of hamstrings will vary considerably from individual to individual.
length of hamstrings
what is the other name for a hamstring strain?
pulled hamstring
a pulled hamstring is _____ as common as a strain of the quadriceps?
twice
a pulled hamstring will be seen in athletes who run very hard and have?
quick starts
the strong muscular contractions required to excel in sports that run hard or quick start, may lead to a tearing of the muscle , which are classified as what?
grade 1,2,3
many hamstring tears are accompanied by painful hemorrhaging which can lead to?
painful hematomas
pulled hamstrings can become _______ in some individuals.
chronic
running style, over developed quadriceps, biomechanical factors, and inadequate warming up and stretching may contribute to what?
pulled hamstrings
what may result from a forcible flexion of the hip when the knee is extended?
avulsion of the ischial tuberosity
if you have weak or tight hamstrings muscles, the body may compensate by changing the position of what bone?
pelvic bone
this can place stress on other muscles in the area by compression on spinal nerves
what is found in the pelvic cavity embedded for the most part in the psoas major muscle?
lumbar plexus
what forms the lumbar plexus?
ventral rami of L1-L4 although T12 may contribute
what is the term given to the nerve axons of L4 and L5 that allow communication between the lumbar plexus and sacral plexus?
lumbosacral trunk
which nerve is found just lateral to the psoas major muscle?
iliohypogastric
segmental innervation of iliohypogastric nerve?
L1 (sometimes T12)
division of the iliohypogastric nerve?
anterior
motor supply from the iliohypogastric nerve?
internal oblique and transverse abdominis
iliohypogastric is the cutaneous supply for what?
proximal lateral aspect of buttock
the cutaneous only nerve branch off of L1 that is found just lateral to the psoas major muscle?
ilioinguinal
segment innervation of ilioinguinal nerve?
L1
division of ilioinguinal nerve?
anterior
the ilioinguinal nerve is the cutaneous supply for what?
proximal medial aspect of thigh
which nerve enters the thigh by passing beneath the inguinal ligaments, just medial to the anterior superior iliac spine?
lateral (femoral) cutaneous nerve of the thigh
seg innervation of lateral cutaneous nerve of the thigh?
L2,L3
division of the lateral cutaneous nerve of the thigh?
posterior
the lateral cutaneous nerve of the thigh is the cutaneous supply for what?
lateral aspect of the anterior and posterior thigh
meralgia means what?
thigh pain
what is a compression neuropathy of the lateral femoral cutaneous nerve as it leaves the pelvic cavity beneath the inguinal ligament?
meralgia paresthesia
lateral femoral cutaneous nerve entrapment
what would cause symptoms of pain, burning and tingling sensation along the lateral aspect of the thigh?
meralgia paresthesia
what are the common causes of meralgia paresthesia?
obesity, wearing tight fitting clothing, or an activity which puts the femur in a flexed position for long periods of time?
meralgia paresthesia is sometimes confused with certain hip disorders, such as?
trochanteric bursitis
which nerve pierces the psoas major and runs inferiorly on its anterior aspect?
genitofemoral
as the genitofemoral nerve descends it divides into a ________ and a _________ branch.
femoral and genital
segmental innervation of genitofemoral?
L1,L2
divison of genitofemoral?
anterior
the genitofemoral is the motor supply for males of what?
cremaster muscle (found within the spermatic cord
the genitofemoral is the cutaneous supply for what?
skin of the genitalia and a small area of skin below the inguinal ligament.
what is the largest branch of the lumbar plexus?
femoral nerve
what is the nerve that passes from the pelvic cavity to the thigh by going deep to the inguinal ligament?
Femoral nerve
what is the nerve that gives off some muscular branches and then terminates in the thigh into several cutaneous and muscular branches before it leaves the pelvic cavity?
femoral nerve
segmental innervation of the femoral nerve?
L2,L3,L4
what is the division of the femoral nerve?
posterior
what muscles are motor supplied by the femoral nerve?
iliacus psoas major sartorius quadriceps pectineus
what is cutaneously supplied by the femoral nerve?
medial and intermediate aspect of anterior thigh;
medial aspect of the thigh and foot
what is the specific cutaneous branch of the femoral nerve that supplies the medial aspect of the thigh and foot?
saphenous
which accompanies the femoral artery in the adductor canal
what joint does the femoral nerve articular supply?
hip and knee
what nerve is damaged when the leg cannot be extended and flexion at the hip is diminished?
femoral nerve
when the femoral nerve is damaged, what will be the motor symptoms?
- Quadriceps are involved and the leg cannot be extended.
- flexion at the hip is diminished (iliopsoas)
what will be the sensory symptoms when the femoral nerve is damaged?
medial and intermediate anterior aspect of the thigh and medial aspect of the leg and foot will be numb
how does one test for damage of the femoral nerve?
assesing both flexion at hip and extension of the leg>
in athletes what nerve may become compressed within the adductor canal or where it exits the fascia to supply the medial leg?
saphenous nerve
enttrapment of the saphenous nerve will cause______ pain and paresthesia along the distribution of the nerve.
Knee pain
what nerve is the smaller and more medial of the two terminal branches of the lumbar plexus?
obturator nerve
what nerve passes from the pelvic cavity to the medial aspect of the thigh by passing through an opening in the membrane that covers the obturator foramen?
obturator nerve
what is the segmental innervation of the obturator nerve?
L2,L3,L4`
what is the division of the obturator nerve?
anterior
what muscles are motor supplied by the obturator nerve?
pectineus, adductor magnus, adductor longus and brevis, gracilis, obturator externus
what does the obturator nerve cutaneous supply?
distal medial aspect of the thigh
what joint has its articular supply from the obturator nerve?
hip and knee
accessory obturator nerve is found in what percentage of the population?
20%
when the accessory obturator nerve is present, where is it found?
- found just lateral to the obturator
what is the segmenatl innervation of the accessory obturator nerve?
L3 and L4
what muscle doe sthe accessory obturator nerve supply?
pectineus
what joint does the accessory obturator nerve articular supply?
hip joint
damage to what nerve may occur during a difficult birth or by an anterior dislocation of the hip joint?
obturator nerve
what are the primary functions of the lower extremity?
- to support the weight of the body
- to provide a stable foundation while standing
- to allow locomotion IE. running/walking
in comparison to the upper extremity the bones of the lower extremity are _________ and ________ with very well marked areas for muscular and ligamentous attachments.
heavier and stronger
in comparison to the upper extremity the ________ of the lower extremity are stronger and more stable with good bony configurations.
joints
muscles of the lower extremity are more powerful and less capable of delicate movements than those of?
the upper extremity
the lower extremity has fewer ________ nerve fibers, accounting for less defined application of tactile sensations
sensory nerve fibers
what is larger in the lower extremity due to the greater bulk and workload?
blood vessels
what is well adapted so it can take the impact of the whole body with every step?
the “foot” clan
what is responsible for sustaining the body’s weight during prolonged standing and must be adaptable to standing and walking on uneven ground?
the foot
what are the three parts that make up each innominate?
ilium
ischium
pubis
the three bones of the innominate are separate until they fuse at the age of?
18-20
what two bones does the innominate articulate with?
femur and sacrum
what is the large depression on the lateral aspect of each innominate?
acetabulum
the acetabulum receives the head of the femur to form what joint?
hip joint
what is the horseshoe shaped articular surface in the acetabulum?
lunar surface
what is the rough non-articular center portion of the acetabulum?
acetabular fossa
what is the outside edge of the acetabulum?
acetabular rim
what is the inferiorly deficient section of the acetabular rim called?
acetabular notch
the acetabular notch is bridged by a piece of connective tissue called the?
transverse acetabular ligament
what is the largest and uppermost portion of the pelvic bone?
ilium
what are the three oblique lines found on the external or lateral surface of the bone?
anterior gluteal line
posterior gluteal line
inferior gluteal line
the anterior, posterior, and inferior gluteal lines indicate the bony origins of what muscles?
the gluteal muscles
the internal or medial surface of the ilium is known as?
iliac fossa
posterior to the iliac fossa are two distinct areas. The more superior is known as?
and the more inferior is?
superior- iliac tuberosity
inferior- auricular surface
what is important about the iliac tuberosity?
attachment site for ligaments
what is important about the auricular surface?
where the innominate articulates with the sacrum
what is the curved line just inferior to the iliac fossa?
arcuate line
what marks the boundary between the major or false pelvis from the minor or true pelvis?
arcuate line
what is the superior border of the ilium known as?
iliac crest
the iliac crest terminates anteriorly as what two things?
anterior superior iliac spine
anterior inferior iliac spine
the iliac crest terminates posteriorly as what two structures?
posterior superior iliac spine
posterior inferior iliac spine
if you missed this, you are fucking retarded…
what is the distinct bump that is found on the lateral most aspect of the iliac crest?
iliac tubercle
what is the deep notch found just inferior to the posterior inferior iliac spine?
greater sciatic notch
what is the “L” shaped bone consisting of a body and ramus?
ischium
what is the portion the ischium that enters into formation of the acetabulum?
Body
what is the small projection of the ischial body?
ischial spine
what is the small notch just below the below the ischial spine?
lesser sciatic notch
what is the large roughened area inferior to the lesser sciatic notch?
ischial tuberosity
what is the most inferior portion the ischium?
Ramus
the portion of the innominate that consists of a body and two rami?
Pubis
The medial body of the pubis consists of the?
symphyseal surface
pubis symphysis
what does the symphyseal surface articulate with?
the pubis of the opposite innominate?
what is the on the superior aspect of the pubis body?
pubic tubercle
what is the line going from the pubic crest to the symphyseal surface?
pubic crest
the superior ramus is above the body and terminates as the?
iliopubic eminence
what is the prominent ridge on the superior ramus?
pubic pecten (pectineal line)
what part of the pubis extends posterior and inferior from the body to join the ramus of the ischium?
inferior ramus
the obturator foramen is closed by a piece of coonective tissue known?
obturator membrane
the arcuate line form each innominate forms the?
pelvic brim
what does the pelvic brim separate?
minor/ true pelvis
major/ false pelvis
what is bounded ppsteriorly by the lumbar vertebrae, laterally by the ilium and anteriorly by the abdominal wall. it helps support and protect much of the andominal viscera?
false pelvis (major)
what is bounded posteriorly by the sacrum and coccyx, laterally and anteriorly by the ilium, ischium, and pubis? this portion of the pelvis surround the birth canal in females.
true pelvis (minor)
what are the four functions of the pelvic bone?
- protect the viscera
- transmit body weight to the limbs and absorb the stresses of muscular activity
- allow locomotion by causing pelvic bone to swing from side to side
- in the female, provides bony support for the birth canal
the most obvious sexual dimorphism between male and female is what?
adaptation of the female pelvis for child bearing
male general pelvic structure?
thicker; prominent processes; longer
female general structure of pelvic?
thinner; processes less prominent; shorter
male pelvic inlet shape?
heart shaped
female pelvic inlet shape?
round or oval
male pelvic outlet shape?
narrower
female pelvic outlet shape?
wider
male anterior iliac spine difference?
close together
female anterior iliac spine difference?
farther apart
male greater sciatic notch?
narrower
female greater sciatic notch?
wider
male obturator foramen?
round
female obturator foramen?
triangular
male acetabulum?
face laterally
female acetabulum?
face more anteriorly
male symphysis pubis?
longer
female symphysis pubis?
shorter
male pelvic arch?
acute angle
female pelvic arch?
obtuse angle
the typical male pelvis?
android pelvis
the typical female pelvis?
Gynecoid pelvis
an exaggerated male pelvis?
anthropoid pelvis
an exaggerated female pelvis?
platyplelloid pelvis
pelvic fractures can occur from?
- direct trauma
- force transmitted to the bone during a fall on the feet or knees
what are the areas of the pelvis most prone to fractures?
- pubic rami
- acetabulum (or surrounding area)
- region of sacroiliac joint
- most lateral aspect of the ilium
there is a high morbidity and mortality rate associated with fractures of what bone?
pelvis bone
what is the common painful contusion injury of the soft tissue associated with the iliac crest?
hip pointers
may result in a painful hematoma in the area of injury
what are the three primary ossification centers of the pelvic bone?
pubis, ischium, ilium
what are the five secondary centers of ossification of the pelvis?
iliac crest anterior inferior iliac spine ischial tuberosity pubis symphysis center of acetabulum
what age does the pelvis bone complete its ossification?
age 20-22
iliac crest
how many ossifications centers does the femur have?
1 primary
4 secondary
what is the primary ossification of the femur?
the shaft
what are the secondary ossification centers of the femur?
head greater trochanter lesser trochanter distal end (condyles and epicondyles)
what are the male and female ages that the femur completes its ossification?
15 yrs in female
17 and a half in male
when the neck of the femur meets the shaft of the bone, an angle is formed. what is this angle called?
angle of inclination
when is the angle of inclination greatest? and what is the angle?
birth
145 degrees
the angle of inclination gradually diminishes, until the adult angle is reached when the bone is?
what is the angle?
completely ossified
125 degrees
what allows greater mobility at the hip joint by increasing the leverage of the muscles that attach to the proximal part of the femur?
angle of inclination
the angle of inclination is a great advantage for what?
bipedal locomotion
though the angle of inclination is great for bipedal locomotion, it puts considerable stress on the neck of the femur, which can lead to what as we age?
increased fractures
an increase of the angle of inclination, which can occur with developmental dysplasia of the hip (congenital dislocation). this is called?
Coxa Valga
a decrease in the angle of inclination, which occurs in fractures of the proximal part of the femur and in the condition known as rickets. Causes a mild shortening of the affected limbs. this is called?
Coxa Vara
even though the femur is the strongest and largest bone in the body, it is commonly fractured. the type of fracture that occurs is frequently _____ and _______ related
age and sex
what are fractures through the neck of the femur called?
subcapital fractures
AKA broken hip
what type of femur fracture is fairly common, especially in older individuals who suffer from osteoporosis?
subcapital fractures
what disease is common in post-menopausal women due to estrogen deficiency?
osteoporosis
subcapital fractures often interrupt the blood supply to the femoral head, leading to a degeneration of the head. this is called?
avascular necrosis
the femur head is supplied by a small branch of what artery?
obturator artery
the artery that supplies the head of the femur passes to the head how?
within the ligament of the femoral head
the neck of the femur receives a rich blood supply from what branches of the femoral artery?
medial and lateral circumflex arteries
the patella develops within what tendon?
common tendon of insertion of the quadriceps
the superior border of the patella is called what?
base
the inferior border of the patella is called what?
apex
the posterior surface of the patella is marked by what?
two articular surfaces
lateral and medial
the lateral and medial articular surfaces of the posterior patella articulate with what features?
patellar facet
condyles of the femur
what is the main function of the patella?
gives additional leverage to the quadriceps during the last part of leg extension
ossification of the patella comes from a single center that appears early in what year?
3rd year
the patella is completely ossified at what age?
10 years in female
13 years in male
what kind of trauma to the patella will cause it to break into a small number of small pieces?
direct trauma
usually non-displaced
what kind of trauma to the patella is due to the quadriceps contracting suddenly and causing a transverse fracture through the body of the bone?
indirect trauma
might be displaced of non-displaced
the condition when the superior lateral portion of the patella remains unossified?
patella Emarginata
what is the name given to a patella that the superior lateral portion ossified independently?
Bipartite or Tripartite patella
occurs in 3% of population
what is the condition in which there is softening and fissuring of the articular cartilage on the posterior aspect of the patella
chondromalacia
what patella condition is common in young adults, and caused by trauma, overuse or muslce weakness which will cause a misaligment to the patella?`
chondromalacia
what is the deep fascia of the thigh that encloses it like a pant leg?
fascia lata
what provides a dense envelope for the thigh and prevents bulging outward of thigh muscles during contraction?
fascia lata
what functions to enhance the effectiveness of the contraction of the thigh muscles, and attaches proximally to the pelvic bone and distally to the tibia?
fascia lata
what is the thickened lateral aspect of the fascia lata, which receives insertions from the tensor fascia lata and gluteus maximus muscles?
iliotibial tract
what is the opening found in the proximal anterior aspect of the fascia lata. It allows the great saphenous vein to reach its termination at the femoral vein?
saphenous opening
where does the great saphenous vein terminate?
femoral vein
what is the name of the overuse syndrome which occurs when the distal end of the iliotibial band repetively rubs over the lateral condyle of the femur?
iliotibial band syndrome
three muscles of the anterior hip region?
iliacus
psoas major
psoas minor
what is the muscle that occupies the iliac fossa within the abdominal cavity.
iliacus
what muscle’s tendon of insertion fuses with the tendon of insertion of the psoas major as it leaves the abdominal cavity to become the iliopsoas?`
iliacus
what is the large situated along the lateral aspect of the lumbar vertebrae, within the abdominal cavity?
psoas major
weakness of the psoas major will result in marked disability in carrying out such activities as?
- stair climbing
- walking up inclines
- getting up from a reclining position
- bringing up the trunk forward in the sitting position before rising from a chair
what is it called when an infection such as from tuberculosis may spread from the vertebral column into the space between the muscle and its fascial covering?
psoas abscess
what muscle is missing in about half the population (unilaterally and bilaterally)?
psoas minor
what is the collective name for the rectus femoris and the three vastus muscles?
quadriceps
what is the narrow, superficial muscle, which is the longest muscle in the body. it passes obliquely downward and medial across the anterior aspect of the thigh?
sartorius
what are the group of 4 muscles that occupy the anterior aspect of the femur and are divided into separate parts?
quadriceps
the quadriceps femoris muscles all have a common tendon of insertion on the?
base of the patella
the portion of the quadriceps tendon of insertion which runs to the apex of the patella is known as?
patellar ligament
what is the most superficial of the quadriceps and is situated in the middle of the thigh between the vastus lateralis and vastus medialis and superficial vastus intermedius?
rectus femoris
what is the largest of the quadriceps muscles, it forms a broad, fleshy mass on the thigh?
vastus lateralis
the quadricep muscle that is situated on the anterior medial aspect of the thigh?
vastus medialis
what is the muscle deep to the other quadriceps and covers most of the anterior aspect of the femur?
vastus intermedialis
occasionally a distinct bundle of muscle fibers separates from the deepest layers of the vastus intermedius and become a separate muscle attached to the synovial membrane of the knee joint. what is this separate muscle called?
Articularis Genu
an individual with atrophy of what muscles will have difficulty extending the leg against resistance and will usually press on the distal end of the femur during walking to prevent flexion at the knee joint?
paralysis of the quadriceps
what is the term to indicate a cramping or spasm of the quadriceps muscles. also used to indicate trauma to the muscles which can cause tearing of the muscle fibers and lead to a painful hematoma?
charley horse
what is the painful overuse injury of the common tendon of insertion of the quadriceps and/or the patellar ligament?
Jumper’s knee
what is carried out by tapping the patellar ligament and is used to test for the segmental innervation of L2,L3, and L4?
patellar reflex
patellar reflex test is used to test the segemental innervation of what nerves?
L2,L3 and L4
what is the long narrow muscle which passes vertically downward on the medial aspect of the thigh and is superficial through out its course. it is the only muscle of the medial thigh which crosses both the hip and knee joint?
gracilis
surgeons often use what muscle to replace a damaged muscle?
gracilis as its a relatively weak adductor muscle
what is the small muscle that is teh most superior of the medial thigh muscles and is found just medial to the iliopsoas?
pectineus
what is the muscle found just medial and slightly inferior to the pectineus?
adductor longus
what is the small muscle found deep to the pectineus and adductor longus?
adductor brevis
what is the large, composite muscle (part medial thigh and part posterior thigh). this muscle is found deep to the adductor longus (anteriorly) and the hamstrings (posteriorly)?
adductor magnus
what muscle has a tendon of insertion that has a slit like opening, the hiatus tendinosus (adductor hiatus) which leads to the popliteal fossa?
adductor magnus
the slit in the adductor magnus tendon of insertion is the point at which what happens?
the femoral vessels become the popliteal vessels
what is the condition when there is stretching of the origin of an adductor muscle beyond their tensile strength?
pulled groin
adductor strain
how is pulled groin severity classified?
grade 1- micro tears
grade 2- partial tears
garde 3- complete tears
if one suspects damage to the accessory obturator nerve one should do what to test?
adduction of the femur against resistance
the sacral plexus is formed from what nerves?
L4,L5,S1,S2,S3,S4
the sacral plexus lies largely on what muscle?
piriformis
the sacral nerves enter the pelvis via the?
anterior sacral foramina
which nerve supplies a large area of skin on the buttock and posterior thigh region?
posterior femoral cutaneous nerve
seg. innervation of posterior femoral cutaneous nerve?
S1,S2,S3
what division is the posterior femoral cutaneous nerve?
anterior and posterior
what is the cutaneous supply of the posterior femoral cutaneous nerve?
loweer part of buttocks, posterior thigh and popliteal fossa
what nerve leaves the pelvis through the greater sciatic notch, superior to the piriformis muscle?
superior Gluteal nerve
Seg. innervation of superior gluteal nerve?
L4,L5,S1
what is the division of the superior gluteal nerve?
posterior
what is the motor supply of the superior gluteal nerve?
gluteus medius
gluteus minimus
tensor fascia lata
what is the nerve that leaves the pelvis through the greater sciatic notch, inferior to the piriformis muscle and superior to the sciatic nerve?
L5,S1,S2
what is the division of the inferior gluteal nerve?
posterior
what is motor supplied by the inferior gluteal nerve?
gluteus maximus
what is the main nerve of the perineum and chief sensory nerve of the external genitalia. it leaves the pelvic cavity via the greater sciatic notch?
pudendal nerve
Seg innervation of the pudendal nerve?
S2,S3,S4
what is the division classification of the pudendal?
anterior
what is the largest nerve in the body and is the continuation of the sacral plexus into the leg and foot?
sciatic nerve
where does the sciatic nerve leave the pelvic cavity?
through the greater sciatic notch, deep to the piriformis muscle
what are the two main branches of the sciatic nerve?
tibial
common fibular nerve
what nerve supplies the muscles and most of the skin of the posterior leg and plantar surface of the foot?
tibial nerve
what nerve wraps around the neck of the fibula and has two branches?
common fibular nerve
what are the two branches of the common fibular nerve?
deep fibular
superficial fibular
what two nerves supply the muscles and skin of the anterior leg, lateral leg and dorsum of the foot?
deep fibular
superficial fibular
what is the Seg. innervation of the sciatic nerve?
L4,L5,S1,S2,S3
what is the division classification of the sciatic nerve?
anterior and posterior
motor supply of the sciatic?
adductor magnus
semitendinosus
semimembranosus
biceps femoris
the sciatic nerve may be injured in what three common ways?
- fracture of the pelvis
- posterior dislocation of the hip joint
- penetrating wounds
motor clinical sign of sciatic nerve damage?
- hamstring muscles are atrophied but weak flexion of leg is possible due to actions of the sartorius and gracilis
- all muscles distal to the knee may be involved
- the foot due to gravity falls into the plantar flexed position
sensory clinical signs of sciatic nerve damage?
loss of sensation below the knee except for an area along the medial side of the leg and foot
what is the term used to describe a condition in which patients complain of pain along the sensory distribution of the sciatic nerve?
sciatica
where is pain usually experienced with sciatica?
in the gluteal region of posterior thigh and leg
3 possible causes of sciatica?
- compression, inflammation and/or subluxation of L4-S3 ( prolapse of an intervertebral disc/herniated disc)
- compression neuropathy of the sciatic nerve in the gluteal region
- intrapelvic tumor
what could cause a compression neuropathy of the sciatic nerve in the gluteal region?
piriformis syndrome
wallet in the back pocket
what does L1 cutaneous supply?
proximal anterior thigh
what does L2 cutaneous supply
middle anterior thigh
what does L3 cutaneous supply?
distal anterior thigh; posterior medial leg
what does L4 cutaneous supply?
distal lateral thigh; medial leg and foot; digit one
what does L5 cutaneous supply?
lateral leg; digits two, three and four
what does S1 cutaneous supply?
posterior lateral thigh and leg; lateral aspect of foot, digit five
what does S2 cutaneous supply?
medial posterior thigh and leg
what does S3 cutaneous supply?
perineum
