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CPM II Test 2 > Flexor & Adductor Thigh and Popliteal Fossa > Flashcards

Flexor & Adductor Thigh and Popliteal Fossa Flashcards

1
Q

what are the compartments of the thigh?

A

anterior - femoral n. - flex hip/extend leg
medial - obturator n. - adduct thigh
posterior - sciatic n. - extend hip/flex leg

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2
Q

what are the flexor thigh m. called?

A

hamstring

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3
Q

common features of hamstring m.

A

proximal attachment to ischial tuberosity deep to gluteus maximus
distal attachment to bones of leg
span and act on two joint
innervation of tibial division of sciatic nerve

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4
Q

what mm. make up the hamstring?

A

biceps femoris m., semimembranosus m., semitendinosus m. (possibly hamstring part of adductor magnus m.)

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5
Q

biceps femoris m. origin

A

long head: ischial tuberosity of hip bone

short head: lateral lip of the linea aspera of femur

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6
Q

biceps femoris m. insertion

A

lateral side of head of fibula

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7
Q

biceps femoris m. innervation

A

long head: tibial division of sciatic n. (L4, L5, S1, S2, S3)
short head: common fibular division of sciatic n. (L5, S1, S2, S3)

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8
Q

biceps femoris m. action

A

long head: extend thigh, flexes leg, rotates laterally

short head: flexes leg and rotates laterally

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9
Q

semimembranosus m. origin

A

ischial tuberosity

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10
Q

semimembranosus m. insertion

A

medial condyle of tibia

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11
Q

semimembranosus m. innervation

A

tibial division of the sciatic n. (L4, L5, S1, S2, S3)

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12
Q

semimembranosus m. action

A

extends thigh, flexes leg, rotates medially, when thigh and leg flexed it can extend trunk (along with biceps femoris m.)

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13
Q

semitendinosus m. origin

A

ischial tuberosity

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14
Q

semitendinosus m. insertion

A

medial surface of tibia (via pes anserinus)

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15
Q

semitendinosus m. innervation

A

tibial division of sciatic n. (L4, L5, S1, S2, S3)

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16
Q

semitendinosus m. action

A

extends thigh, flexes leg, rotates medially, when thigh and leg flexed it can extend trunk (along with biceps femoris m.)

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17
Q

what are the actions of the hamstring m.?

A

chief extensor of thigh - walking on flat ground

flexor of knee

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18
Q

what are hamstring injuries?

A

pulled and/or torn hamstrings

tearing of hamstring fibers = painful with movement/stretching of leg

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19
Q

when do hamstring injuries happen?

A

when athletes aren’t properly warmed up for physical activity (i.e. running, jumping, quick-start sports)

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20
Q

what is involved in an avulsion of ischial tuberosity?

A

tearing of part of proximal tendinous attachments of hamstrings

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21
Q

what are the muscles of the adductor thigh?

A

adductor brevis m., adductor longus m., adductor magnus m., pectineus m., gracilis m., and obturator externus m.

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22
Q

pectineus m. innervation

A

femoral n. and obturator n. (L2-L4)

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23
Q

pectineus m. action

A

adducts and flexes thigh, assists in medial rotation

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24
Q

adductor longus m. innervation

A

obturator n. (L2-L4)

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25
Q

adductor longus m. action

A

adducts (and flexes) thigh

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26
Q

adductor brevis m. innervation

A

obturator n. (L2-L4)

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27
Q

adductor brevis m. action

A

adducts (and flexes) thigh

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28
Q

adductor magnus m. innervation

A

obturator n. (L2-L4) = adductor part

distal portion innervated by tibial n. (L4-S3) = hamstring part (post group)

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29
Q

adductor magnus m. action

A

adduct thigh (part flexes and part extends thigh)

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30
Q

gracilis m. innervation

A

obturator n. (L2-L4)

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31
Q

gracilis m. action

A

adducts thigh; flexes and rotates leg medially

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32
Q

obturator externus m. innervation

A

obturator n. (L2-L4)

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33
Q

obturator externus m. action

A

flexes and rotates thigh laterally

34
Q

what are the two clinical correlations for adductor thigh?

A
  • groin pull. damage to anteromedial thigh mm. near inguinal region (sprinting, base stealing, gymnastics)
  • injury to adductor longus (rider’s strain) seen in horse riders due to chronic adduction of thighs to stay on horse
35
Q

what is pes anserinus?

A

common tendinous insertion of 3 two-joint mm. of the thigh into superomedial part of tibia

36
Q

where are the pes anserinus mm. located?

A

3 diiferent innervations from 3 different compartments

37
Q

what are the 3 mm. in pes anserinus?

A

sartorius m. = femoral n. = anterior / extensor thigh
gracilis m. = obturator n. = medial / adductor thigh
semitendinosus = tibial n. = posterior / flexor thigh

38
Q

from where does the sciatic n. arise?

A

L4-S3 ventral rami within the pelvis

39
Q

what is the sciatic n. blood supply?

A

inferior gluteal a.

40
Q

how does the sciatic n. enter then gluteal region and what is its course?

A

through the greater sciatic foramen inferior to piriformis m. then descends along posterior aspect of thigh and divides proximal to knee into tibial and common fibular nn.

41
Q

what are the variations of the passage for the common fibular n. division?

A
  1. most common- divide below piriformis m.
  2. tibial n. below and common fibular n. above piriformis m.
  3. tibial n. below and common fibular n. through the piriformis m.
42
Q

what will damage to the sciatic n. cause?

A
  • impaired extension of thigh and impaired flexion of leg
  • loss of dorsiflexion at ankle and eversion of foot
  • peculiar gait due to increased flexion at hip to lift dropped foot off the ground
43
Q

the sciatic n. is the main n. supply to what compartment?

A

posterior thigh - flexor thigh (but actually extend thigh and flex knee)

44
Q

the obturator n. is the main n. supply to what compartment?

A

medial thigh- adductor thigh

45
Q

the obturator n. arises from where?

A

L2-L4 ventral rami within pelvis

46
Q

How does the obturator n. exit the pelvis?

A

through the obturator foramen

47
Q

what are the branches of the obturator n.?

A

anterior and posterior branches

48
Q

what is the course of the anterior branch of the obturator n. and what does it innervate?

A

branches at hip and passes over obturator externus m. then between adductor longus and adductor brevis mm.
innervates adductor longus, adductor brevis, and gracilis mm.

49
Q

what is the course of the posterior branch of the obturator n. and what does it innervate?

A

pierces the obturator externus m. and passes btwn the adductor brevis and magnus mm.
innervates the adductor magnus m.

50
Q

where does the posterior femoral cutaneous n. arise from?

A

arises from the sacral plexus (S1-S3)

51
Q

what is the course of the posterior femoral cutaneous n.?

A

passes through the greater sciatic foramen below the piriformis m.
runs deep to the gluteus maximus m. and emerges from its inferior border

52
Q

what are the branches of the posterior femoral cutaneous n.?

A

inferior clunial branches - innervate skin of buttock, posterior thigh, and calf
perineal branches- innervate perineum

53
Q

the hamstring mm. are supplied by what artery?

A

medial femoral circumflex a. (transverse branch)

descends posterior thigh

54
Q

what is the largest branch arising from the femoral artery?

A

profunda femoris artery

55
Q

what is the course of the profunda femoris a.?

A

descends in front of pectineus, adductor brevis, and adductor magnus mm.

56
Q

what does the profunda femoris a. give rise to?

A

medial and lateral femoral circumflex aa., muscular branches, and perforating branches

57
Q

How many perforating branches of the profunda femoris a. are there and what do they supply?

A

4

supply the adductor magnus and hamstring mm.

58
Q

what is the course of the first perforating branch of the profunda femoris a.?

A

posterior to the adductor longus m., pierces adductor brevis and magnus mm.

59
Q

what is the course of the second perforating branch of the profunda femoris a.?

A

pierces tendons of adductor brevis and magnus mm.

60
Q

what is the course of the third perforating branch of the profunda femoris a.?

A

arises inferior to adductor brevis m. and pierces adductor magnus m.

61
Q

what is the course of the fourth perforating branch of the profunda femoris a.?

A

terminal branch of profunda femoris a.

62
Q

what is the course of the obturator a. and what is its origin?

A

branch of the internal iliac, passes through the obturator canal, divides into anterior and posterior branches

63
Q

what does the anterior branch of the obturator a. supply?

A

obturator externus, adductors, pectineus, and gracilis mm.

64
Q

what does the posterior branch of the obturator a. supply?

A

mm. of hip joint and ischial tuberosities

65
Q

what is a clinical correlation of the obturator a.?

A

replaced or accessory obturator a.

66
Q

where does a replaced or accessory obturator artery come from?

A

inferior epigastric a.

67
Q

what is an implication of a replaced or accessory obturator a.?

A

can have implications in hernia repairs

68
Q

what are the boundaries of the popliteal fossa?

A

bounded above by hamstrings and below by gastrocnemius
superolateral - biceps femoris tendon
superomedial - semimembranosus and semitendinosus mm.
inferior - heads of the gastrocnemius mm
posterior - skin and popliteal fascia (roof)

69
Q

what is the course of the popliteal artery?

A

continuation of femoral a. as it passes through the adductor hiatus, located posterior to knee joint
runs from adductor hiatus proximally to inferior border of popliteus m distally
bifurcates into anterior and posterior tibial aa.
branches = sural aa. to mm. of fossa AND gives rise to 5 genicular aa.

70
Q

what does the popliteal v. receive blood from?

A

small saphenous n. and corresponding vv. to br. of popliteal a; also receives tributaries from anterior tibial, posterior tibial, and fibular vv. (formed by medial and lateral plantar vv. of foot)

71
Q

what does the popliteal v. become?

A

femoral v.

72
Q

what is frequently involved in injuries to knee joint (fx or dislocations) and why?

A

blockage of popliteal a. due to relatively fixed position by its genicular br. and its close relationship to underlying bones.

73
Q

what are the contents of the popliteal fossa?

A

popliteal vessels (popliteal a and v), tibial n, common fibular n, termination of small saphenous v., popliteus m.

74
Q

what does the tibial n. give off before it passes deep to the gastrocnemius m?

A

medial sural cutaneous n.

75
Q

what type of innervation does the tibial n. provide and to what region?

A

motor- posterior leg

76
Q

what is the course of the common fibular n. and what are the branches?

A

descends along medial border of biceps femoris, then deep to lateral head of gastrocnemius m. to wind around head of fibula to become peroneal n.
lateral sural cutaneous n.

77
Q

what is the origin, insertion, fnxn of the popliteus m.?

A

origin- lateral condyle of femur
insertion- tibia
fnxn- rotate knee to unlock it

78
Q

what is a popliteal cyst?

A

swelling behind the knee caused by escape of synovial fluid posteriorly through knee joint capsule. Impairs flexion and extension of knee joint

79
Q

what aa. contribute to the genicular anastomoses?

A

femoral a and popliteal a.

80
Q

what aa. are directly involved in the genicular anastomoses?

A

descending genicular a., descending lateral circumflex femoral a., superior medial and lateral genicular aa., middle genicular a., inferior medial and lateral genicular aa.
anterior and posterior recurrent br. of anterior tibial a., circumflex fibular a.

CPM II Test 2 (4 decks)

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