glute/thigh/popliteal fossa LOs Flashcards
organization of fascia lata and its thickening, iliotibial tract
- fascia lata: extension of inguinal ligament deep fascia
- attaches to exposed bone around knee and deep fascia of leg inferior to knee
- encloses large thigh muscles
- thickens/strengthened laterally by longitudinal fibers
- forms iliotibial track: from tensor fascia latae and gluteus maximus muscles to proximal lateral tibia
fascial compartments of thigh
anterior compartment
medial compartment
posterior compartment
anterior compartment of thigh
- flexors of hip, extensors of knee
- contents:
- hip flexor: iliopsoas (psoas major/minor, iliacus), sartorius
- knee extensors: quadriceps femoris, rectus femoris, vastus lateralis, vastuc medialis, vastus intermedius
- actions: flex hip, extend knee
- innervation: femoral nerve (L2-4)
- TFL is superior gluteal
- blood supply: femoral artery
medial compartment of thigh
- thigh adductors
- contents: adductor longus/brevis/magnus, gracilis, obturator externus
- actions: adducts thigh, laterally rotates thigh
- innervation: obturator nerve (L2-4)
- adductor magnus is sciatic nerve
- blood supply: obturator nerve
adductor magnus
- adductor portion: obturator nerve, adducts hip
- hamstring portion: sciatic nerve (tibial division), extends hip
posterior compartment of thigh
- contents: semimembranosus, semitendinosus, biceps femoris
- action: extend hip, flex knee
- innervation: tibial divison of sciatic nerve
- blood supply: perforating branches of profunda femoris, medial circumflex femoral
lateral aspect of thigh
- iliotibial tract (band)
- bursae
- tightness
- gluteus maximus attachment
boundaries and contents of femoral triangle
- borders:
- superior: inguinal ligament
- medial: adductor longus
- lateral: sartorius
- floor:
- lateral: iliopsoas
- medial: pectineus
- contents: femoral nerve, artery, vein
structures that pass through greater sciatic foramen
- piriformis muscle
- sciatic nerve
- inferior to piriformis
- posterior femoral cutaneous nerve
- medial to sciatic nerve
- superior gluteal vessels/nerve
- superior to piriformis
- inferior gluteal vessels/nerve
- inferior to piriformis
- internal pudendal vessels
- posterior to sacrotuberous ligament
- pudendal nerve
structures that pass through lesser sciatic foramin
- obturator internus
- internal pudendal vessels
- pudendal nerve
trendelenburg gait
- when walking, pelvis tilts away from affected side
- insufficient small gluteals
- gluteus medius and minimus
- could be caused by disc herniation affecting superior gluteal nerve (L4, L5, S1)
sacral plexus
- posterior: fibular division
- branch to biceps femoris short head
- common fibular
- superficial fibular
- deep fibular
- superior gluteal: L4-S1
- inferior gluteal: L5-S2
- nerve to piriformis: S1-S2
- perforating cutaneous: S2-S3
- anterior: tibial division
- branches to lateral rotators
- tibial nerve
- lateral plantar nerve
- medial plantar nerve
- pudendal: S2-S4
- branches to levator ani: S4
- posterior cutaneous nerve of thigh:
- anterior: S2-S3
- posterior: S1-S2
nerves with motor, sensory, and postganglionic sympathetic innervation off the lumbar plexus
iliohypogastric
ilioinguinal
genitofemoral (genital br)
femoral
obturator
lumbosacral trunk
quadratus lumborum
psoas
nerves with motor, sensory, and postganglionic sympathetic off of sacral plexus
nerve to piriformis
nerve to quadratus femoris
nerve to obturator internus
superior gluteal nerve
inferior gluteal nerve
medial plantar nerve
lateral plantar nerve
tibial nerve
deep fibular
superficial fibular
nerves with only sensory and postganglshionic sympathetic off of lumbar plexus
lateral femoral cutaneous
saphenous
path taken by sciatic nerve
- L4-S3
- between greater trochanter and ischial tuberosity
- splits to tibial (long head of biceps femoris) and common fibular (short head of biceps femoris)
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obturator nerve
- L2-4
- anterior lumbar
- emerges inferior to pubic ramus
- anterior and posterior branches sandwish adductor brevis muscle
- cutaneous medial and superior to knee
- S/PS/M: gracilis, adductor brevis, adductor longus, adductor magnus, obturator externus
typical blood supply of head and neck of femur and how it changes with age
- children > 10 years old: obturator artery is primary supply
- adults: medial circumflex femoral artery (from profunda brachii) is primary supply
contens of the femoral sheat
- continuation of iliacus and transversalis fascia inferior to inguinal ligament
- contains/surrounds femoral artery and vein, canal (for lymph)
LE lymphatic drainage
- lumbar trunks (left and right): drain lateral aortic lumph nodes, from LE
- lymph nodes
- superficial inguinal node: drain superficially, inferior to umbilicus (not anus or genital glands)
- deep inguinal: drain deep tissues of thigh, popliteal nodes, superficial inguinal nodes
- popliteal: drain knee and deep tissues of leg and foot
ligaments closely applied to joint capsules (thickening of joint capsule)
- synovial membrane: secretes synovial fluid
- fibrous membrane
- 3 capsular ligaments: taught in extension of thigh at hip
- iliofemoral “Y” ligament: can hold body weight balanced over femoral head
- pubofemoral ligament
- ischiofemoral ligament
identifying features of medial and lateral menisci
- medial: C shape, larger, attaches to MCL
- lateral: O shape, smaller
