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Anatomy Block 4 > Gluteal & Posterior Thigh > Flashcards

Gluteal & Posterior Thigh Flashcards

1
Q

What are the actions of the muscle that is innervated by the inferior gluteal n.?

A

The gluteus maximus is responsible for hip extension and lateral rotation of femur

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2
Q

Where does the gluteus maximus muscle originate?

Insert?

A

Origin: dorsl ilium, sacrum, cocyx, sacrotuberous ligament and iliac crest

Insertion: gluteal tuberosity and iliotibial tract

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3
Q

Where does the gluteus medius originate? Insert?

A

Origin: Ilium, between anterior and posterior gluteal lines

Insertion: Greater trochanter of the femur, lateral aspect

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4
Q

What three muscles would be affected in a lesion of the superior gluteal nerve?

A

Gluteus Medius, Gluteus Minimus, Tensor Fascia Latae muscles

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5
Q

Where does the gluteus minimus orginate? Insert?

A

Origin: Ilium, between anterior and inferior gluteal lines

Insert: Greater trochanter of femur, anterior aspect

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6
Q

What are the actions of the gluteus medius and gluteus minimus muscles?

A

They are the same:

Stabilization of the pelvis during gait

abduction of the thigh

medial rotation of Thigh (Ant. Fibers)

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7
Q

What two muscles insert on the iliotibial tract?

A

Gluteus maximus and tensor fascia latae

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8
Q

Where does the tensor fascia latae muscle originate?

A

iliac crest, lateral aspect

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9
Q

What are the actions of the tensor fascia latae muscle?

A

stabilization of the knee in extension, hip flexion (weak), abduction of thigh

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10
Q

What muscles keep your pelvis level when one leg is lifted off the ground?

A

Gluteus medius and gluteus minimus

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11
Q

What two muscles insert on the IT band?

A

Gluteus maximus and tensor fascia latae

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12
Q

What does the piriformis pass through to exit the pelvis and reach the thigh?

A

Greater sciatic foramen

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13
Q

What nerve emerges superior to the piriformis muscle?

A

superior gluteal nerve

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14
Q

What nerves emerge inferior to the piriformis muscle?

A

Sciatic nerve and Inferior gluteal nerve

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15
Q

What nerve lies medial to sciatic nerve as it passes inferiorly to the piriformis muscle?

A

posterior femoral cutaneous nerve of thigh

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16
Q

What nerve lies medial to posterior femoral cutaneous nerve as it passes inferior to the piriformis muscle?

A

nerve to obturator internus (superior gemellus) which then continues into lesser sciatic foramen

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17
Q

What structures pass through the lesser sciatic foramen?

A

4 things:

Pudendal N

Internal Pudendal vessels

Obturator internus tendon

obturator internus N.

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18
Q

What is the only thing the common fibular nerve innervates in the thigh?

A

Short head of the biceps

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19
Q

What is Trendelenburg gait and what nerve deficit would you suspect?

A

Weakness of gluteus medius and gluteus minimus results in dropping of the opposite hip and a lean to compensate for the increased leg lenght. Usually caused by superior gluteal nerve lesion.

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20
Q

What 5.5 muscles does the obturator nerve innervate?

What ventral rami contribute to the obturator nerve?

A
  1. Adductor Longus
  2. Adductor Brevis
  3. Gracilis
  4. Pectineus
  5. Adductor Magnus
    (5. 5) Pectineus has split innervation between obturator and femoral

L2-L4

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21
Q

What arteries does the popliteal artery give rise to?

(5)

A
  1. Superior Lateral Genicular Artery
  2. Superior medial genicular artery
  3. Inferior lateral genicular artery
  4. Inferior medial genicular artery
  5. Middle Genicular Artery
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22
Q

What is the clinical implication of an inactivated gluteus minimus and gluteus medius / damage to the superior gluteal nerve?

A

The supporting and steadying function of these muscles will be lost. the patient will have a collapse of the pelvis on the side that is not supported when walking?

**The Duchenne Limp **

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23
Q

What structures transverse the greater sciatic foramin superior to the piriformis?

(3)

A

Superior gluteal artery

Superior Gluteal Vein

Superior Gluteal Nerve

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24
Q

What structures pass through the greater sciatic foramin inferior to the piriformis muscle?

(7) seems like to much for one card but cantrel said it was important

A
  1. Inferior gluteal artery / vein / nerve
  2. Sciatic Nerve
  3. Post. Femoral Cutaneous nerve
  4. Nerve to quadratus femoris
  5. Nerve to obturator internis
  6. Internal peudendal artery / vein
  7. Peudendal nerve
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25
Q

How do the superior gluteal vessels enter the gluteal region?

A

They travel with the superior gluteal nerve in the plane between the gluteus medius and gluteus minimius. They then enter the gluteal region superior to the piriformis

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26
Q

How do the inferior gluteal vessels enter the gluteal region?

A

They travel with the inferior gluteal nerve on the underside of the gluteus maximius and enter the gluteal region inferior to the gluteus maximius

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27
Q

What is the main purpose of the lesser sciatic foramin?

what are the 4 structures that pass in the lesser sciatic foramin?

A

Passageway for structures passing from the gluteal region ot the perineum

  1. Peudendal nerve
  2. Internal peudendal vessels
  3. Nerve to the obturator internis
  4. Tendon of the obturator internis
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28
Q

What tendons form the lesser sciatic foramin?

A

Sacrospinous and sacrotuberous

29
Q

Where is the safe region of the gluteal compartment to give an IM injection

A

Upper Lateral Quadrant

30
Q

What are the three muscles that make up the posterior compartment of the thigh?

A
  1. Semitendenous
  2. Semimembrainosus
  3. Biceps femoris
31
Q

What are the primary & Secondary functions of the posterior thigh?

A

Primary= Knee Flexion

Secondary= Hip Extension and Knee Rotation

32
Q

What are the three muscles that insert on the pes anserinus?

A
  1. Sartorius (Anterior)
  2. Gracilis (Medial)
  3. Semitendinosus (posterior)
33
Q

Describe the locking mechanism of the knee

What muscle unlocks the knee?

A

Involves the rotary movement of the femur relative to the fixed tibia when the foot is planted on the ground

The “locking” and stabilization of the extended position is due to the medial rotation of the femur

**The popliteus muscle unlocks the knee**

34
Q

What is the superiorlateral border of the popliteal fossa?

A

Biceps Femoris

35
Q

What is the superiormedial border of the popliteal fossa?

A

Semimembrainosus & Semitendinosus

36
Q

What is the inferior lateral border of the popliteal fossa?

A

Lateral head of the gastrocnemius

37
Q

What is the inferiormedial border of the popliteal fossa?

A

Medial head of the gastrocnemius

38
Q

What nerve terminates at the superior border of the popliteal fossa? What are the nerves that this termination gives rise to?

A

Sciatic nerve terminates into the tibial and common fibular nerves.

39
Q

What veins run through the popliteal fossa?

A

The small saphenous vein terminates into the popliteal vein.

40
Q

What structure is the deepest and most medial in the popliteal fossa?

A

The anterior and posterior tibial arteries are branches of the popliteal artery which is formed when the femoral artery passes through the adductor hiatus.

41
Q

What does the tibial nerve terminate into?

A

Medial sural cutaneous nerve

42
Q

What does the fibular nerve terminate into?

A

Lateral sural cutaneous nerve

43
Q

What is the only muscle in the posterior compartment that does not recieve innervation from the tibial nerve?

A

Short Head of Biceps Femoris

Tibial Nerve

44
Q

If their is a blockage of the popliteal artery how will blood get to the distal part of the lower extremity?

A

Genicular anastomoses- 5 genicular branches of the popliteal artery from a genicular anastomosis around the knee within the popliteal fossa

  1. Lateral superior genicular artery
  2. Medial superior genicular artery
  3. Middle genicular artery
  4. Lateral inferior genicular artery
  5. Medial inferior genicular artery
45
Q

Describe the course of teh sciatic nerve in general.

A

The sciatic nerve courses poster to the adductor magnus and deep the the long head of biceps femoris to the popliteal fossa where it divides into its terminal branches.

46
Q

How would you lovate the gluteal safe zone utilizing surface anatomy?

A

If you place your hand on the pelvis with your middle finger on the iliac crest and index finger on the ASIS the safe zone would be between your middle and index fingers.

47
Q

What provides blood supply to the posterior compartment of the thigh?

A

The four perforating arteries of the profunda femoris branch of the femoral artery

48
Q

Where do the long head and the short head of biceps femoris origionate?

A

Longhead= ischial tuberosity

Short head= linea aspira

49
Q

What innervates the long head of biceps femoris?

A

Tibial nerve L4-S3

50
Q

What innervates the short head of biceps femoris?

A

Common Fibular Nerve (L4-S2)

51
Q

Where does the semitendinosus muscle insert?

A

Posterior portion of the pes Anserinus

52
Q

Where does the Semimembrainous muscle insert?

What innervates it?

A

Medial aspect of the tibial condyle

Tibial Nerve (L4-S3)

53
Q

What is the major Extensor of the hip?

A

Gluteus Maximus

54
Q

What are the 5 muscles involved in hip adduction?

A

Adductor Longus

Adductor Brevis

Adductor Magnus

Pectineus

Gracilis

55
Q

What are the 4 muscles involved in Abduction

A
  1. Gluteus Medius
  2. Gluteus Minimus
  3. Sartoris
  4. Tensor Fascia Latae
56
Q

What are the 5 muscles that flex the hip?

A
  1. Ilioposas
  2. Sartorius
  3. Pectineus
  4. Rectus Femoris
  5. Tensor Fascia Latae
57
Q

What are the 5 muscles that extend the hip?

A
  1. Gluteus Maximius
  2. Semitendinosus
  3. Semimembranosus
  4. Biceps femoris (long head)
  5. Adductor Magnus (Vertical Fibers)
58
Q

What 9 muscles laterally rotate the hip?

A
  1. Gluteus maximius
  2. Obturator externis
  3. Obturator Internis
  4. Piriformis
  5. Superior Gemellus
  6. Inferior Gemellus
  7. Quadratus Femoris
  8. Sartorius
  9. Biceps femoris
59
Q

What two muscles extend the knee?

A

Quadraceps Femoris

Iliotibial tract

60
Q

What muscles laterally rotate the knee (locking it)

A

Biceps Femoris

61
Q

What muscles medially rotate the knee (unlocking it)

A

Semitendinosus

Semimembranosus

Popliteus

62
Q

What are the six muscles the obturator nerve innervates?

A
  1. Pectineus
  2. Obt. Externus
  3. Gracilis
  4. Adductor Magnus
  5. Adductor Brevis
  6. Adductor Longus
63
Q

What are the six muscles the femoral nerve innervates?

A
  1. Rectus Femoris
  2. Vastus Lateralis
  3. Vastus Medialis
  4. Vastus Imtermedius
  5. Sartorius
  6. Iliacus
64
Q

What are the three muscles the tibial nerve innervates

A
  1. Biceps Femoris long head
  2. Semitendinosus
  3. Semimembrainosus
65
Q

What are the three muscles the superior gluteal nerve innervates?

A

Gluteus medius

Gluteus Minimus

Tensor Fascia Latae

66
Q

What two muscles does the nerve to quadratus femoris innervate?

A

Quadratus femoris

Inferior Gemellus

67
Q

What two muscles do the nerve to obturator internis innervate?

A

Obturator internis

Superior Gemellus

68
Q

Which of the following provide innervation to obturator internus muscle?

a. Femoral N. (L2-L4)
b. Obturator N. (L2-L4)
c. Direct branches off L5 and S1
d. Pudendal N. (S2-S4)

A

c. Direct branches off L5 and S1

These form the N. to Obturator Internus

69
Q

Which of the following provide innervation to obturator externus muscle?

a. Femoral N. (L2-L4)
b. Obturator N. (L2-L4)
c. Direct branches off L5 and S1
d. Pudendal N. (S2-S4)

A

b. Obturator N. (L2-L4)

Anatomy Block 4 (10 decks)

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