Gluteal Region and Thigh Flashcards
What are the boarders the gluteal region
Superiorly by iliac crest and inferiorly by the fold of the buttock.
What are the three gluteal muscles
Gluteus maximus, medius and minimus. These are external rotators of the thigh..
Describe the features of the gluteus maximus
It is the prime extensor of the hip, used when standing from sitting and climbing stairs. It is used in external rotation, abducts and adducts. Some fibres insert on the iliotibial tract and therefore extends and locks the knee via iliotibial tract.
Describe some of the features of gluteus medius and gluteus minimis
Gluteus medius lies deep to maximus, and minimus lies deep to medius. These are the abductors of the hip.
What other muscle also aids in hip abduction
Tensor fascia latae
What is the role of the abductors
They keep the pelvis level when walking. Contraction of the muscles prevent drop.
What are the lateral rotators of the hip and name them
They are a group of muscles that pass from the pelvis to the femur, lying close to and posterior to the hip joint. These muscles are piriformis, superior gemellus, obturator internus, inferior gemellus, quadrator femoris and obturator externus
What are the origins and insertions for the gluteal muscles?
Gluteus maximus - posterior gluteal surface of ilium and inserts on iliotibial tract and gluteal tuberosity.
Gluteus Medius - gluteal surface of ilium, inserts on lateral surface of greater trochanter
Gluteus minimus - Ilium and inserts on anterior side of greater trochanter
Tensor fascia latae - ASIS to lateral condyle of tibia via iliotibial tract
All gluteal muscles are supplied by what?
Superior gluteal nerve, except gluteus maximus which is supplied by inferior gluteal nerve
Where does the sciatic nerve originate from and therefore where should intramuscular injection be preformed
- SN emerges into gluteal region inferior to piriformis. So the safe ares for intramuscular injections is the upper outer quadrant.
What are the flexors of the thigh
- Muscles passing anterior to hip joint. These are Psoas major and illiacus which are collectively known as iliopsoas which are the most powerful flexor. Also Sartorius and Rectus femoris which also act upon the knee joint
How do illiacus and Psoas major pass into the thigh?
Through the retro-inguinal space into the femoral region where the fascia of psoas divides the space into muscular and vascular compartments. Illiacus and the femoral nerve enter the muscular compartment.
What are the origins and insertions of the flexor muscles of the thigh?
Illiacus - Illiac fosa, inserts on lesser trochanter
Psoas Major - Posterior abdo wall, inserts of lesser trochanter
Rectus femorus - Straight head from AIIS and reflected head from ilium, inserts on base of patella via common quadricepts femoris tendon
Satorius - ASIS, inserts on medial surface of medial tibial condyle
Pectineus - Superior ramus of pubis, inserts on pectineal line of femur.
What are the muscles in the posterior compartment of the thigh (extensors of the thigh) their action and what they are supplied by
Biceps femoris, semitendinosus, semimembraneous (hamstrings). Their action is to extend the hip but also flex the leg. They are supplied by the sciatic nerve, except short head of biceps
What are the origins and insertions of the extensors of the thigh
Biceps femoris - ischial tuberosity (long head) and lateral lip of linea aspera (short head), inserts onto head of fibula
Semitendionsus - ischial tuberosity, inserts onto medial surface of medial tibial condyle
Semimembraneous - Ischial tubercosity to medial condyle of tibia
What are the muscles of the medial compartment of the thigh
Adductor magnus, adductor longus, adductor brevis and gracilis. All preform adduction and are all supplied by obturator nerve
What are the main extensors of the knee
Quadricepts femoris which is a group of muscles made up of; Rectus femoris, Vastus intermedius, Vastus medialis and Vastuc lateralis
What is the stability if the knee joint dependant on/
The tone of quadriceps
What are the origins and insertions of the extensors of the knee
Rectus femoris - AIIS to tuberosity of tibia via patella ligament
Vastus medialis - intertrochanter line of femur and inserts on tuberosity of tiba
Vastus lateralis - Linea aspera/greater trochanter, inserts onto tuberosity of tiba.
Vastus intermedius - anterior shaft femur to tuberosity of tibia
What is the Pes Anserinus
It is the common site of attachement for sartorius, gracilis and semitendinosus on the tibia. It also adds stability to the medial side of the knee
Describe the features of the patella ligament reflex
Deep tendon reflex which is elicited by tapping the patellar ligament. It tests the femoral ligament and spinal segments L3 and L4
What are the boarders of the femoral triangle
Inguinal ligament (base) the sartorius muscle laterally, the adductor longus medially, pectineus (medial floor) and illiopsoas (lateral floor), roof is fascia lata
What is the femoral canal?
A short conical space between the medial wall of femoral sheath and the femoral vein.
What is contained in the femoral canal and what are some features of it.
Deep inguinal lymph nodes found in canal. It allows the femoral vein to expand. Femoral ring at base of canal is a weak area, can lead to femoral hernia.
What are the boarders of the femoral ring?
Anteriorly - medial part of inguinal ligament
Medially - Lacunar ligament
Laterally - septum between femoral canal and vein
Posteriorly - pectineus muscle and fascia
What are the features of femoral hernia’s
There is a protrusion of abdominal viscera through the femoral ring into the canal. If untreated this viscera can undergo necrosis.
What is the adductor canal? what runs through it?
(Hunter’s or subsartorial canal) It starts at inferior cornor of femoral triangle and ends at adductor hiatus. The femoral vessels and saphenous nerve and nerve to vastus medialis enter.
What are the boarders of the adductor canal?
Anterolateral - Vastus medialis
Posteriorly - Adductor longus and adductor magnus.
Anteromedially - sartorius
What are the origins and insertions of the adductor magnus?
Adductor part - Inferior rami of pubis and ischium to linea aspara
Hamstring part - Ischial tuberosity to adductor tubercle and medial supracondylar line of femur
What are the origins and insertions of the adductor longus?
Pubis to linea aspera
What are the origins and insertions of the adductor brevis
Body of pubish and inferior pubic rami to linea aspera
What are the origins and insertions of the Gracilis
Inferior rami of pubis and pubis to medial surface of tibia
