Exam 3 Flashcards
What forms the medial border of the femoral triangle?
The adductor longus
What forms the inferior border of the femoral triangle?
There is none
What forms the lateral border of the femoral triangle?
sartorius
What forms the superior border of the femoral triangle?
The inguinal ligament
What makes up the floor of the femoral triangle?
The iliapsoas(lateral) and the pectineus(medial)
What artery is direct supplier of the femoral head?
the medial circumflex artery
What narrow intramuscular passage allows for the passage of the femoral vessels into the popliteal fossa
The hunter’s canal (the adductur canal, subsartorius canal)
What is the longest muscle in the body and acts across two joints (not done with the question)
sartorius……
What is the bony pelvis composed of?
- Os coxae
- Sacrum
- Coccyx
- Pubic symphysis
What are the boundaries of the pelvic cavity?
- Pelvic inlet
- Pelvic outlet
- Anterior pelvic wall
- Lateral pelvic walls
- Posterior pelvic wall
The pelvic inlet is the _____ opening
Superior
The pelvic outlet is enclosed by the _____
Pelvic diaphragm
What bodies make up the anterior pelvic wall?
The pubic rami and the pubic symphysis
The lateral pelvic walls are the ___ & _____
Hip bones, the medial wall of theacetabulum and obturator internus muscles
What makes up the posterior pelvic wall?
The sacrum, coccyx, SI joint and associated ligaments
There’s _____ demarcation in the pelvic inlet and marks change from _____ to ____
No true demarcation.
From abdominal cavity to pelvic cavity
The pelvic inlet runs from ____ to ___
L5/S1 to the pubic symphysis
The pelvic outlet runs from _____ to _____
Pubic symphysis to coccyx
The greater (false) pelvis runs from ____ to ____
The from the iliac crest to the pelvic inlet
The lesser (true) pelvis runs from ____ to ____
The from the pelvic inlet to the pelvic outlet
The pelvic cavity runs from the ___ to the ____
The pelvic inlet to the pelvic outlet
The midplane- horizontal plane in the pelvic cavity runs from
The left to right ischial spine
Characteristics of the male pelvis
- Thick and heavy
- Heart shaped
- Small and narrow
- Narrow, smaller subpubic angle. ( smaller than 70 degrees)
- Round and large
Characteristics of the female pelvis
- Thin and light
- Oval and large
- Wide subpubic angle (larger than 80 degrees)
- Small
The pelvic floor is formed by the ____
funnel shaped pelvic diaphragm
The pelvic floor consists of the ___ and the ____
Levator ani (3 muscles), and the coccygeus
The diaphragm of the pelvic floor stretches from ____ to ___, also ____
The pubis anteriorly to the coccyx posteriorly, also laterally to the walls of the pelvis on both sides
The piriformis runs from the ____ to the ____
Anterior surface of the sacrum passing through the greater sciatic notch
The coccygeus runs from the ____ to the ____
The ischial spine to coccyx (ischial coccygeus)
What is the tendinous arch?
Where the ileococcygeous attaches and with the obturator internus fascia
What is the most important muscle in the pelvic floor?
The levator ani
What are the 3 muscles that compose the levator ani?
Pubococcygeus, pubrectalis, and iliococcygeus
The puborectalis runs from the ___ to the ___
from the pubic bone to the coccyx
What is the ischiocavernous?
The thickening of pelvic diaphragm muscles
The perineal membrane covers part of the ____
pelvic diaphragm
The superficial transverse perineal muscles divide the ____
urogenital and uroanal traingles
The perineal body is between
in females: _____
in male: _____
- In females: between the vagina and the anal opening.
- In males: between the penis base & the anal opening
The puborectalis forms the ____
puborectal sling
The puborectalis allows ___
defacation
_____ relaxes puborectalis, increasing the anorectal angle to allow defacation
Sitting
The puborectalis muscle is contracted at rest, which keeps the _____ closed
anal sphincter
excessive relaxation of pelvic floor muscles lead to…
herniation of vaginal wall, bladder (cystocele) or herniation of the rectum (rectocele)
feces can collect in the ___ and not exit the rectum
Rectole
____ is the only natural defecation posture
Squatting
The sacral plexus anterior is ____ to the piriformis through the greater sciatic notch
deep
_____ is the main supply to the pelvic region
Internal iliac artery
The internal iliac artery branches in to ___
The anterior and the posterior branch
What is consisted in the anterior branch of the internal iliac artery?
- Obturator artery
- Pudendal artery
- Inferior gluteal artery
What is consisted in the posterior branch of the internal iliac artery?
- Superior gluteal artery
- Iliolumbar artery
- Lateral sacral artery
____ is the main supplier of blood to the muscles of the pelvic diaphragm
The inferior gluteal artery
The inferior gluteal artery exits through the _____ to supply the ____
The greater sciatic foramen to supply the gluteal region.
Exits inferior to piriformis muscle(hence, its name)
The _____ is longest and heaviest bone in body
femur
The bones in the leg are the
Tibia and the fibula
The leg runs from the ___ to the ___
Knee to the ankle
The quadrate tubercle is the _____ attachment site
Quadratus femoris
_____ ligament holds the head of the femur in place
Ligamentum teres
The elderly usually fracture the ___
Neck of the femur or the along intertrochanteric line(easier rehabilitation post-operatively)
A fracture in the neck of the femur can develop ____.
a vascular necrosis of femur head
To prevent vascular necrosis of the femur head, the patient can _____
Get partial hip replacement or a hemi-athroplasty
What is hemi-athroplasty?
A metallic piece that replaces the head & neck of femur
What is the forea capitis?
The area in the femur head without cartilage where the ligamentum teres inserts
What is the posterior name to the intertrochanteric line?
intertrochanteric crest
The pectineal (spiral) line becomes
Linea aspera
The linea aspera is curved anteriorly with a flat posterior shape, due to ___
deep fascia that create thigh compartments
The _____ more laterally rotates the femur
Gluteus minimus attachment site
The _____ more medially rotates the femur
Gluteus medialis attachment site
The ACL attaches medially to the ____
lateral epicondyle
The PCL attaces laterally to the
medial epicondyle
The ___ is the attachment site for the adductor magnus
Adductor tubercle
In x-rays the lateral compartment of the patella may appear thinner than the medial compartment due to ___
- Patellar tracking problems
- More hyaline cartilage o the medial side
The soleal line attaches the ___ muscle
soleus muscle
The ___ is the attachment of patellar ligament (AKA patella tendon)
Tibial tuberosity
___ is a common site of irritation
Tibial tuberosity
What causes osgood-schlater’s disease?
- From constant pull of quads and patellar tendon
- Outgrowth of bone/enlarged tibial tuberosity from jumping sports (apophysitis of tibial tubercle)
Where is the femoral triangle located?
At the anterior thigh just inferior to the inguinal ligament
What are other names for the adductor canal?
Hunter’s canal
Subsartorial canal
What passes through the adductor canal?
Femoral artery & vein
What are the contents of the femoral triangle?
- lateral femoral cutaneous nerve
- femoral nerve
- femoral artery and vein with femoral sheath
- profunda femoris artey which gives rise to the lateral ad medial femoral circumflex arteries
What is a femoral sheath?
A thick connective tissue encircling the femoral artery and vein.
What allows blood to move superiorly against gravity?
- Arterial pulses: compresses veins
- venous valves
The ____ is the main supplier of blood to the thigh
Profunda femoris
Medial and lateral femoral circumflex arteries are the main suppliers to the ____
head and neck of the femur
_____ can be possibly damage with a femur neck fracture
Medial and lateral femoral circumflex arteries
Where does the saphenous vein pass through?
The saphenous vein within the femoral sheath
What is within the femoral sheath?
Saphenous nerve
Femoral vein and artery
Nerve to vastus medialis
The lacunar ligament runs from the ____ to the _____
Inguinal ligament to the lateral pubic tubercle
Each digit drains in the _____
Dorsal venous arch
____ travels anteromedially up leg and drains into the femoral vein
The great saphenous vein
The small saphenous vein (part of superficial drainage system) drains into the _____
Popliteal region (deeper vein system)
In the venous system of the lower extremity, blood flows from ____ veins to ____ veins
Superficial veins to deep veins
Characteristics of the venous valves
- Cup like endothelium that fill from above
- Prevent reflux of blood distally
- Valve mechanism allows blood to overcome force of gravity
The small saphenous vein becomes the ____, then the _____
Popliteal vein, then the femoral vein
Where does the lateral marginal vein pass?
Passes behind the lateral malleolus, then becomes the small saphenous vein
This vein pases interior to the medial malleolus then becomes the great saphenous vein
Medial marginal vein
The adductor canal allows ____
femoral artery and vein to pass from anterior thigh compartment into posterior knee area
The narrow fascia tunnel in the anterior thigh allows passage from the ____ to the _____
From the femoral vessels to the popliteal fossa
Where does the adductor canal start?
At the point where the sartorius muscle passes over the adductor longus muscle
Where does the adductor canal end?
Ends at the adductor hiatus in the tendon of the adductor magnus muscle
What is the adductor hiatus?
The place where the adductor magnus splits
As the femoral artery and vein exit through the adductor hiatus then change names to the ____
Popliteal artery and vein
The _____ accompanies the femoral artery and vein into the adductor canal
The saphenous nerve
The thigh is divided into 3 comparments by extension of the deep fascia lata: _____
Intermuscular septa
The anterior compartment of the thigh contains ___ & is innervated by ____
Contains eg extensors and the femoral nerve innervates them
The medial compartment of the thigh contains ___ & is innervated by ____
Contains thigh adductors and is innervated by the obturator nerve
The posterior compartment of the thigh contains ___ & is innervated by ____
Contains the leg flexors and thigh extensors. Innervated by the sciatic nerve
The posterior component of the thigh does what?
Flexes the knee and extends the thigh
The anterior component of the thigh does what?
Muscles extend leg/knee
The medial component of the thigh does what?
Adducts the thigh/hip
Subcostal nerve (T12) supplies the ____
Lateral aspect of the thigh anterior to the greater trochanter
The Iliohypogastric (little bit of T12 & mostly L1) divides into _____ and ____ branches
Lateral and anterior branches
The lateral branch of the Iliohypogastric supplies the skin over the _____
Superolateral part of the buttock
The anterior branch of the Iliohypogastric supplies the skin superior to the _____
Pubis
The ilioinguinal (L1) nerve travels through the ___ to innervate the ____
Superficial inguinal ring to innervate the inferior pelvis
The ilioinguinal also travels into the ____
Proximal medial aspect of the thigh
The genitofemoral branches extend into the ____
Pelvis
The branches genitofemoral innervates the _____
Skin of thigh inferior to the inguinal ligament on the medial aspect
The lateral femoral cutaneous nerve is the most _______
Lateral nerve in the femoral triangle
The lateral femoral cutaneous innervates the _____
lateral and anterior parts of the skin of the thigh
The lateral femoral cutaneous passes under the _____
lateral aspect of the inguinal ligament
The lateral femoral cutaneous nerve extends ______ and ____ from the greater trochanter to an area just proximal to the ____
extends laterally and distally from the greater trochanter to an area just proximal to the knee
The femoral nerve innervates the ____
Skin of the anterior and medial thigh. And muscle in anterior compartment, NOT medial compartment
The anterior femoral cutaneous nerve arises from the ____
femoral nerve in the femoral triangle
The anterior femoral cutaneous nerve runs along the path of the _____ and innervates the ___
Sartorius muscle, and innervates the skin of the anterior, medial aspect of the thigh
What are the muscles of the anterior compartment of the thigh?
Quadriceps femoris, sartorius, and iliopsoas
What are the 4 heads of the Quadraceps femoris?
Rectus femoris, vastus intermedialis, vastus lateralis, and vastus medialis (obliqus)
The vastus intermedius wraps itself around the shaft of the ___
femur
_____ is the only diarthrodial muscle in the quadriceps
Rectus femoris
____ is the only muscle in the bunch that moves the hip, because it passes anterior to the hip & attaches to the anterior inferior iliac spine
Rectus femoris
The ____ muscle is deep to the quads, and attaches to the suprapatellar bursa.
Articularis genus
____ muscle contracts and pulls, so the bursa is not pinched under the patellar tendon with leg extension
Articularis genus
The oblique fibers were thought to provide medial pull on the patellar, because people tend to dislocate their patellar ____, not ____
laterally, not medially
What are the muscles of the medial compartment of the thigh?
- Pectineus
- Gracilis
- Adductor longus
- Adductor magnus
- Adductor brevis
The adductor brevis is ___ to the pectineus and adductor longus
deep
The ___ artery passes through the adductor hiatus
Femoral artery
The deep artery of the thigh is the _____ & gives off the ___
Profunda femoral artery.
Circumflex femoral arteries
The lateral circumflex femoral artery moves ____ and ____ from the profunda artery under the ___
Laterally and anteriorly.
Under the rectus femoris
______ artery passes between the pectineus and the sartorius
Medial circumflex femoral artery
____ artery goes through the adductor hiatus
Popliteal artery
The terminal end of the profunda femoris artery goes through the ____
The last muscle perforation
_____ artery supplies the posterior hip and passes between the quadratus femoris and superior border of the adductor magnus
Medial circumflex femoral artery
The lateral femoral circumflex artery supplies the ___
anterior hip
What is the superior boundary of the gluteal region?
The crest of the ilium
What is the medial boundary of the gluteal region?
Sacrum and coccyx
What is the inferior boundary of the gluteal region?
Sacrotuberous ligament and ischial tuberosity
What is the lateral boundary of the gluteal region?
Greater trochanter
The ASIS is for the attachment of the ____ and the ____ muscle
Inguinal ligament & sartorius muscle
The most posterior ligament of the ligaments that form the greater or less sciatic notch is the ____
The sacrotuberous ligament
The superior cluneal nerves comes from the
dorsal rami of first 3 lumbar nerves
The middle cluneal nerves comes from the
dorsal rami of first 3 sacral nerves
The inferior cluneal nerves comes from the
posterior femoral cutaneous nerve
Branches of the subcostal (T12), ____, and ___ may also reach the area
iliohypogastric, and lateral
femoral cutaneous nerve
The muscles of the gluteal region are involved primarily with abduction and lateral rotation of the ____
the thigh.
Innervation of the muscles in the gluteal region are by the ____
superior and inferior gluteal nerves and smaller branches of the lumbosacral plexus
Gluteus maximus is primarily considered an ____, because of its location
Extensor
___ and ____ are primarily considered abductors
Gluteus medius and minimus
The sacrotuberous ligament of the gluteal region extends from the ___
posterior inferior iliac spine, sacrum, and coccyx to the ischial tuberosity
The sacrospinous ligament of the gluteal region extends from the ___. Its anterior to the ____
sacrum and coccyx to the ischial spine. It is anterior to the
sacrotuberous ligament.
The two ligaments of the gluteal region transforms the ___ and ___ into foraminas
greater and lesser sciatic
notches
What is a trendelenburg test?
a test for gait abnormalities
If a person conducts the trendelenburg test and fails, it is because their ___ and ___ muscles on the side with the foot on the ground is weak
Gluteus medius and gluteus minimus
The superior gluteal nerve and vessels passes through the ____
greater sciatic foramen superior to the piriformis
Superior gluteal vessels provide superficial branches to the _____, pass between the ____ and ____ to reach the ____
Gluteus maximus
Gluteus medius and minimus
Tensor fascia lata (TFL)
Inferior gluteal nerve and vessels exit the ____ and enter the ____
greater sciatic foramen inferior to the piriformis and enter the
deep surface of the gluteus maximus
The sciatic nerve and vessels passes through the ____
greater sciatic foramen inferior to piriformis
The sciatic nerve and vessels descends posterior to the ___, _____, ____ to enter the ____
descends posterior to the obturator internus, gemelli, and quadratus femoris to enter the thigh.
The posterior femoral cutaneous nerve runs ____
medial to the sciatic nerve
The posterior femoral cutaneous supplies ____
cutaneous information to the posterior thigh
The sciatic nerve usually travels under the ____ muscle.
In rare occasions, the common perineal component of the sciatic nerve passes through it or over it
piriformis
The medial sciatic nerve is the ___ compartment
Tibial
The lateral sciatic nerve is the ___ compartment
Common perineal
The superficial branch of the superior gluteal artery and vein supplies the ____
under surface of the gluteus maximus
The deep branch of the superior gluteal artery and vein supplies the ____
gluteus medius and gluteus minimus
The inferior gluteal artery and vein supplies the ____& joins the ____
- under surface of the gluteus maximus
- medial femoral circumflex artery
The posterior femoral cutaneous (S1-S3) supplies branches to the skin on the posterior aspect of the _____ over _____
Posterior aspect of the thigh and over the popliteal fossa
Superior lateral boundary of the popliteal fossa
Biceps femoris
Superior medial boundary of the popliteal fossa is ___
semitendinosus and semimembranosus
Inferior lateral boundary of the popliteal fossa is ___
lateral head of the gastrocnemius
Inferior medial boundary of the popliteal fossa is ___
medial head of the gastrocnemius
What makes up the roof of the popliteal fossa?
Fascia lata with branches of the posterior femoral cutaneous
nerve and the lesser saphenous vein
What makes up the floor of the popliteal fossa?
–Popliteal surface of the femur
–Capsule of the knee joint
–Oblique popliteal ligament
What are the contents of the popliteal fossa?
–Tibial nerve
–Common peroneal nerve
–Popliteal vessels
–Origins of the sural nerve
What is the popliteal fossa?
Diamond shaped area or hollow on posterior surface of the thigh
What is the sural nerve?
Sural nerve is the cutaneous nerve to the posterior leg and
lateral aspect of the dorsum of the foot.
The popliteal artery is a continuation of the ____
femoral artery
_____ passes through the popliteal fossa and divides at the inferior borders
Popliteal artery
The anterior tibial artery supplies the ____
anterior compartment of the leg
The posterior tibial artery supplies the ____ and gives rise to the ____
posterior compartment and gives rise to the peroneal
artery which supplies the posterior and lateral compartments of the leg
All the blood supply to the knee is from the ___
back
What are genicular anastomoses?
Branches of the popliteal artery that surround the knee
The genicular anastomoses arteries supply the
knee capsule, patella and
surrounding bone
The 4 types of genicular anastomoses arteries are…
Superior medial and lateral genicular arteries and
inferior medial and lateral genicular arteries
____ nerve ends at the superior angle of the
popliteal fossa
Sciatic nerve
The sciatic nerve divides into which 2 nerves in the popliteal fossa
- Tibial nerve
- Common peroneal nerve
The tibial nerve is the most _____ component of the popliteal fossa
superficial
The tibial nerve gives off several genicular branches for innervation of ____
the knee joint
The tibial nerve descends to the posterior compartment of the leg to innervate ___
the posterior musculature
The tibial nerve gives off the medial sural cutaneous nerve to help form the ____
sural nerve
The common Peroneal (Fibular) Nerve leaves the popliteal fossa passing superficially to the ____
lateral head of the gastroc.
The common Peroneal (Fibular) Nerve passes over the posterior aspect of the __
head of the fibula.
After passing the head of the fibula the common Peroneal (Fibular) Nerve divides into a superficial peroneal nerve supplies innervation to the ______ and a deep peroneal nerve that supplies ____
lateral compartment of the leg
the anterior compartment of the leg
The common peroneal nerve gives off several genicular branches for innervation of ______
the knee joint
The obturator internus passes between the ____ and ____ towards its attachment on the greater trochanter
Superior and inferior gemilli muscles
Which peripheral nerve is most likely involved in a patient exhibiting a trendelenburg sign during gait?
Superior gluteal nerve
Which nerve is palpable halfway between the ischial tuberosity and the greater trochanter of the femur
Sciatic nerve
