Gluteal region and posterior thigh Flashcards
What is this?
What are its primary functions?
What nerve innervates it?
Gluteus Maximus Muscles
- Combined actions include hip extension, abduction
laterall and outwardly (e.g. karate side kick).
Less involved in walking than hamstring but more involved in exagerated movements (hyperextension) like squatting, climbing etc
3. Innervated by the Inferior Gluteal nerve (L4, L5, S1)
What is this muscle?
What is it main functions?
What is it innervated by?
What is its role in maintaining balance in locomotion?
Lesion of what nerve could damage hip abuduction?
- Gluteus medius
- Abducts (along with gluteus minimus) and
(Sacral Plexus) laterally/outwardly
rotates hip - Innervated by the
Superior Gluteal nerve (L4, L5, S1). - In the “stance phase” of the gait cycle the
weight of the body is on one limb. The gluteus medius and minimus
of this weight-bearing limb contract, preventing the pelvis of the nonweight-bearing limb from tilting downward. - Superior Gluteal nerve lesion or Radiculopathy involving L5
nerve root
What is this?
what nerve exits through here?
Greater Sciatic Foramen
Below the pimpiform muscle, the siatic move exists
- What is this?
- What does paralysis of this nerve cause?
- what does it branch from?
- what does it innervagte?
- Superior Gluteal Neurovascular Bundle
comes from above the piniform muscle
- Trendelenburg sign: when asked to stand on one leg, the pelvis on the UNSUPPORTED side descends indicating that the gluteus medius on the SUPPORTED side is weak or nonfunctional.
- lumbosacral plexus l4, l5, s1
what is this?
what is it innervated by?
what is its function?
piniform muscle
comes from the greater siatic foramen
innvervated by: nerve to Piriformis (S1, S2).
lateral rotator of the hip (move away from the midline)
where does it branch off from?
what does it innervate? what aciton is it involved in?
inferior gluteal nerve
branches from the: lumbosacral plexus
innervates the gluteus maximus. invovled in extension
what is this nerve?
what does it innervate? what is it the main motor nerve to?
what are its branches?
what vertebral regions does it come off?
what is one way it can be compromised?
what could lesion of this nerve cause?
Sciatic nerve
brnaches: tibial, common fibular
common fibular portion of this nerve innervates the
short head of the biceps femoris. The tibial portion of this nerve
main motor nerve to the hamstring
innervates the remaining hamstring muscles.
comes off L4-S3 from lumbosacral plexus
actions invovled in: extension, movement of the knee
could be compromsied by: Posterior dislocation
sciatic lesion: may
result in weakness of the hamstring muscles.
what is this?
what runs through it?
Lesser Sciatic Foramen
formed by sacrotubernous and sacrospinous
what runs through it:
pudendal nerve and nerve to obturatory internus
Tendon of the Obturator Internus
Tendon of the Obturator Internus
Superior and Inferior Gemelli Muscles
what is this muscle
what is its action
what is its innervation
Quadratus Femoris Muscle
laterally/outwardly rotate hip
innervation: Nerve to Inferior
Gemellus as well
muscle?
innervation?
action?
Superior and Inferior Gemelli Muscles
innervated by:
Superior Gemellus – Innervated by nerve to Obturator Internus.
Inferior Gemellus – Innervated by nerve to Quadratus Femoris.
action: Laterally/outwardly rotate hip
muscle
action
innervation
Gluteus Minimus Muscle
Abducts and internall rotates the hip
innevation: superior glutael nerve
Lumbosacral Plexus
branches:
superior glutale nerve, inferior gluteal nerve, sciatic nerve, nerve to the obturator iunternus and superior gemellus, nerve to quadratus femoralis and inferior gemellus, posterior femoral cutaneous nerve, nerve to piriformis
except for the superior gluteal nerve, all of the branches of the lumbosacral pass below the piriformis muscle
what is this?
what stays in here?>
Acetabulum
the illium, ischium, and pbusi all make contact with the head of the femur at this point
the femoral head stays in here
what is this liugament?
what is its importance?
what does it cover?
what happens when this ligament is tuaght?
Iliofemoral ligament
strongest and
most important ligament, covering the anterior and inferior aspects of the
joint
prevents hyperextension
and stopping the femur from moving past the vertical position
Whentaught, the weight of the body is
balanced on the femoral heads. Since little muscle movement is needed to
maintain this position, an individual can stand for long periods of time,
Pubofemoral ligament
one of the ligaments of the hipjoint
Ischiofemoral ligament
one of the three ligaments of the hip joint
Anterior sacroiliac ligament
posterior sacroiliac
semimembranous muscle
Semitendinosus Muscle
red: Long Head of Biceps Femoris Muscle
blue: Short Head of Biceps Femoris Muscle
what is this artery?
what does it branch off of?
what does it feed?
what is its important?
what are its branches
deep branch of femoral artery
branches off the femoral artery
supply the anterior thigh compartment.
anastomozes with the internal iliac artery
- the medial and lateral circumflex femoral arteries branch off deep femoral artery and feed head and neck of the femor
- – Perforating branches of the Deep Femoral artery supply the posterior thigh compartment.
what is this nerve?
what does it innervate?
sx when it is “entrapped”
ex when it is lesioned:
Tibial Division of the Sciatic Nerve in red
is the sciatic nerve which supplies the hamstring
innervation: main MOTOR nerve to ALL of
the muscles in the posterior crural compartment,
all of the muscles on the plantar surface of the foot and is,
SENSORY to the skin on the sole of the foot
entrapment or Tarsal Tunnel Syndrome: The tibial nerve is compressed by the
flexor retinaculum, and pain is typically localized to the medial malleolus and the calcaneus. Caused by irritation and resulting edema of the synovial sheaths of the tendons of the deep posterior compartment muscles.
lesion: weak plantar flexion and toe drag when
taking a step forward. difficulty “Toe Walking”.
makes plantar flexing the ankle difficult or
impossible, depending on severity. Plantar flexion of the ankle is required to take a step when walking.
whjat is this nerve?
what does it innervate:
what does the lesion to this nerve cause?
what are common causes of this lesion?
innervation: main MOTOR nerve to the muscles of theanterior crural compartmentSENSORY to the skin on the dorsum of the foot, in the web space between the first 2 toes.
lesion: damage of axons from l5 weaken ankle dorsiflexion and foot drop.. walk with “slapping” of foot on group. problems heel walking.
entire l5 root damaged: pt also have positive trenedelburg sign
common cause of lesion: trauma to neck of fibula
what is this artery?
what branches from it?
popliteal artery,
branches: Anterior Tibial artery which supply the anterior crutual compartment
what is this muscle?
what is its action?
where does it insert?
what nerve innervates it?
what is its relationship to the iliotibial band?
Tensor Fascia Lata Muscle
ACTION: This muscle medially rotates the hip and assists
in initiation of hip flexion.
ORIGINATES: from the outer portion
of the iliac crest and
INSERTS: distally along with the gluteus maximus into the
fascia lata of the thigh. .
INNERVATED BY: The tensor fascia lata muscle is innervated by the
Superior Gluteal nerve (L4, L5, S1).
The tendinous insertion of both muscles strengthens
the lateral portion of the fascia lata forming the iliotibial band.
what does it attach to?
what does it stabilize and when?
iliotibial band. This band
attaches to the lateral tibial condyle (Gerdy’s tubercle) and stabilizes the
lateral aspect of the knee by keeping the femur from moving on the tibia
when the knee is flexed.
Rectus Femoris Muscle
Initiates Hip
Rectus Femoris Flexion,
Extends Knee
Vastus Lateralis
action: extend knee
innervated by: femoral nerve
origin: femor
attached superiorly to the lateral and posterior
aspect of the femoral shaft.
what is this?
innervation?
action? what is its importance in this action?
attached where?
vastus medialis
innervation: fmoral nerve
aciton: knee extension
attached superiorly to the medial and
posterior aspect of the femoral shaft. The lower portion of thismuscle has an oblique direction to its fibers;
it contracts powerfully during the final stages of knee extension to helpprevent the patella from dislocating laterally.
(lower probe)
action?
innervation?
origin?
Vastus Intermedius
action: extend knee
innervation: femoral nerve
attached superiorly to the anterior surface
of the femoral shaft.
what is this?
action?
innervation?
origin?
insertion?
what is its role in posterior hip dislocation
iliopsoas muscle
action: involved in all aspects of hip flexion
Innervated by L1- L2 ventral rami.
The Iliacus arises from the iliac fossa, while the Psoas Major arises from the lumbar vertebral bodies.
inserts onto the lesser trochanter of the femur
if the hip is posterioly dislocated, the affected limb looks shorter due to unapposed action of this muscle.
what is this?
action?
what does it form?
sartorius muscle
It has a combined action of flexing the hip, flexing the
knee and abducting and laterally rotating the hip.
It forms part of the
Pes Anserinus where it inserts
what is this?
what spiunal level does it come from?
what are its components and what do they innervate?
femoral nerve
l2-l4
main MOTOR nerve to muscles in the
anterior compartment of the thigh.
SENSORY branches from the femoral nerve supply the anterior and medial portions of the thigh and medial portion of the leg.
what is this?
what is it protected by?
quadratus tendon
protected anteriorly by the platella
iliopsoas muscle
what is this?
where does it go?
great saphneus vein
join the common femoral vein in the region of the femoral triangle
what is this nerve?
what is it a branch off of?
Saphenous Nerve
branches off the femoral nerve
Pectineus Muscle
under the sartorus
runs from the superior pubic ramus to the posterior aspect of the femur, just below the lesser trochanter.
Innervated:
the femoral nerve, sometimes by the obturator nerve
action:m It acts to start hip flexion; it also participates in
hip adduction and medial rotation of thigh.
Adductor Longus Muscle
runs from the body of the pubic bone to the
middle portion of the linea aspera of the femur.
adductor brevis
in between and posterior to adductor lungus and pectineus
what is this?
what are its actions?
what is it a part of?
Gracilis muscle
runs from the body and inferior ramus of the pubic bone to the antero-medial surface of the tibia.
flexes: the hip joint and knee joint
adducts the: hip joint
It forms part of the Pes Anserinus.
what is this?
where is it located?
what does it have anastomoses with?
femoral artery
located in femoral sheath (NAVEL from lateral to medial)
supplies the anterior thigh cimparment
internal iliac artery
gives blood to anterior and posterior comparment
branches off of the femoral artery
gives lateral and medial femoral circumflex arteries
what is this?
where does it supply blood to?
what does it branch off?
what happens if it is blocked?
lateral femoral circumflex
supplies blood to hip joint
branches off deep femoral
. If blood supply via the medial and lateral
circumflex femoral arteries is disrupted, this small artery within the ligament
of the head of the femur may prevents necrosis of the femoral head
what is this artery?
what doesa it branch off of?
what does it supply blood to?
medial femoral circumflex artery
branches off deep femoral and dives right down
supplies blood to the hip joint
. If blood supply via the medial and lateral
circumflex femoral arteries is disrupted, this small artery within the ligament of the head of the femur may play a key role in preventing avascular
necrosis of the femoral head
what is this?
where does it insert?
what is its action
Tibialis Anterior
Passes anterior to the medial malleolus and
inserts onto the inferior surface of the 1st cuneiform bone and 1st metatarsal.
ACTION: It acts to dorsiflex the ankle joint. It is also one of the
primary supinators of the foot.
what is this?
where does it inset?
what is its action
Extensor Hallicus Longus
Attaches to the distal phalanx of the
great or 1st toe.
action It acts to extend the interphalangeal (IP) joint of the
big toe and dorsiflex the ankle joint
what is this?
where does it insert?
what is its action?
Extensor Digitorum Longus
Attaches to the extensor expansion of
the lateral 4 toes.
It acts to extend the metatarsophalangeal (MTP)
what is this?
where does it insert?
what is its action?
Fibularis (Peroneus) Tertius –
peroneus tertius muscle that arises from the extensor digitorum longus muscle tendons
Attaches to the dorsum of the 5th metatarsal.
It acts to dorsiflex the ankle joint. It is also a pronator ofthe foot.
Action Works with the extensor digitorum longus to dorsiflex, evert and abduct the foot
Innervation Deep peroneal nerve (L5, S1)
Arterial Supply Anterior tibial artery
what is this?
where does it innervate
common fibilary nerve
main motor nerve to the muscles of the
anterior crural compartment.
It also provides sensation to the skin on the
dorsum of the foot, in the web space between the first 2 toes.
barnch of the sciatic nerve
what is this?
what is it from?
what does it supply blood to?
whats its importance?
dorsalis pedis artery
continuation of the anterior tibial atery
It terminates at the proximal part of the first intermetatarsal space, where it divides into two branches, the first dorsal metatarsal artery and the deep plantar artery.
its importance is that it can be palpated but not the anterior tibial artery
**goes around ankle proninance and attaches underneath food
fibularies longus muscle
**goes around ankle and attaches underneath foot
inserts onto the 1st metatarsal and
medial cuneiform bone.
ACTION eversion of the foot, assists in plantar flexion (moving it downward), and helps support the arch of the foot.
** goes around ankle prominenae on lateral side but does not insert under foot
peroneus brevis Brevis Muscle
medial to the peroneus longus
inserted into the tuberosity at the base of the fifth metatarsal bone, on its lateral side.
It extends and abducts the foot.
branch of sciatic nerve that is medial and does not wrap around to anterior side
tibial nerve
branches off of the sciatic nerve
its the bigger branch that runs medially
branches at knee and wraps around to anterior side and is more lateral
common fibrilar nerve
spinal levels (L4, L5, S1 and S2
on the superior part of the politeal fossa about
winds around the fibula to the anterior side
main MOTOR nerve to the muscles of the
anterior crural compartment.
SENSORY to the skin on the
dorsum of the foot, in the web space between the first 2 toes
popliteal artery
near the bifurcation of the sciatic nerve
source: its an extension of the femoral artery
branches: Anterior Tibial artery
what is this muscle
what is its function
popliteus muscle
origin: lateral condyle of the femur
inserts: posdterior surface of the tibia
FUNCTION; unlock the knee
artery that comes off of popliteal and immediately goes laterally to anterior side
anterior tibial artery
upplies the anterior crural
compartment.
it cant be palpated until it becomes the dorsalis pedis
branch of poplitesl atery that goes straight down to the ankle
posterior tibial artery
branch of popliteal that branches off of the 2nd popliteal branch (the one that goes straight down)
fibular artery
branches from the posterior tibial
proivdes the muscles and fascia of the LATERAL leg
achilles tendon
GASTROCNEMIUS to the CALCANEUS
formed by two heads of the Gastrocnemius muscle and the Soleus muscle forming a common tendon
function plantar flexors of the ankle joint
enabling the foot to leave the ground during the transition from weight-bearing to non-weight-bearing.
tendon of the posterior tibilias
goes from medial to lateral but stays posterior to the malleus
below the tendon of flexor digitorum longusmuscle
above the tendon of the posterior tibialis, and once past ankle it is more posterior than it
tendon of flexor digitorum longusmuscle
tendon of Flexor Hallicus Longus Muscle
more posterior than the flexor digitous and tibilaris posterior
what nerve runs over the medial malleus (ie, part of tom dick and harry)
tibial nerve * from the sciatic nerve
medial plantar nerve
branch of the tibial nerve
medial plantar artery
*branch of tibial artery
lateral plantar artery
*branch of tibial nerve
branch of tibial nerve
lateral planatar nerve branch of itbial nerve
resits valgus forces
MCL orTibial Collateral Ligament
connects from medial femur to medial tibia
what is this attached from lateral condyle of the femur to the head of the fibula
LCL
it is stressed by Sudden stops which force the TIBIA
forward on the FEMUR.
ACL
what causes a tear of this?
posterior crucinate ligament
tears happen less than ACL
caused by a direct blow to the knee of dashboard tear
what ligament attaches to it?
Medial Meniscus
the MCL attaches to the edial meniscus
lateral meniscus
more circular in shape and not attached to either collateral ligament
resists pronation (eversion)
on the medial surface
what is it formed from?
calcaneotibial, anterior tibiotalar, posterior tibiotalar, and
tibionavicular ligaments
connect the medial malleolus with 3
tarsal bones: the calcaneus, talus and navicular
whjat ligaments are these?
LATERAL LIGAMENTS OF THE FOOT
Anterior talofibular ligament
Posterior talofibular ligament
Calcaneal fibular ligament
Lateral talocalcaneal ligament
between the tibia and fibula?
Interosseous Membrane
what are these ligaments?
are they apart of the ankle joint?
anterior and posterior Inferior Tibiofibular Ligaments
NOT a part of ankle joint
However they play an
important role in stabilizing the joint since they form a very strong
connection between the tibia and the fibula.
connects the calcaneus with the navicular bone
part of the medial longitudinal arch
spring ligament
long plantar ligament
short plantar ligament
Fibular Longus Tendon
tibular nerve
tibilas posterior tendon
spring ligament
rectus femoris
has superior originin so also going to act as a flexor of the hip
also a part of quadaceps femoris so going to be main extensors of the knee
vastus lateralus muscle
vastus meaning big
femoral nerve
femoral artery and deep femoral artery
vastus intermedius
below the rectus femoris and between the vastus medialis and vastus lateralis
hip flexor
important for locomotion
illiopsoas
medial to it is femoral nerve and artery
pectineus muscle
underneath the femoral artery
anterior compartment
adductor magnus
goes between the abductor brevis and abductor magnus
posterior brnach of obturator
goes between the abductor brevis and abductor magnus
mediates: MOTOR muscles of the medial thigh comparment: pectineus, adductor longus, adductor bresiv, adductor magenus,gracilis. SENSORY to mid thigh
tibilias anterior tendon
looking posteriorly
PCL
looking posterioly
popliteal muscle
needed for lateral rotation that is necessary for unlocking knee
lateral collateral ligament
*free of capsula of knee joint
transverse medial ligament
What are these two? how do you tell the difference? What are their functions?
fibularis longus and brevis
- brevis is medial and looks liek it is attacheing first*
- longus is wrapping around to plantar surface and attaching to be toe!*
purpose is to pronate the foot or invert
tibilias posterior
“flexor digitorum longus”
dick.. posterior to the tibilias posterior
posterior tibilal artery
tibial nerve
(nervous)
flexor hallucis longus
very deep.. almost deep to the tibial nerve
anterior surface of the leg
Anterior Tibial Artery
retract the extensor digitorum lungus to the side
branches off of the popliteal
supplies blood to the:
knee (*via recurrent branches)
anterior crural artery
dorsal part of foot (but now its the dorsalis pedis artery)
superificial branch of the common fibular nerve
The superficial branch of the common fibral nerve
tracks along the fascia between the lateral and anterior compartments of the leg to emerge by piercing the fascia lata and enter the subcutaneous tissues
innervates the fibrial longus and brevis muscles of the lateral compartment of the leg.
tendon of the tibularis posterior
vastus medialis
pectineus
anterior compartment
adductor magnus
short head of biceps femoris
short head of biceps femoris
adductor magnus
long head of biceps
semitendous
semimembranous
MEDIAL for MEMBRANE
