Gluteal Region/Thigh Flashcards

1
Q

boundaries of gluteal region

A

superior- iliac crest
inferior - gluteal fold
laterally - greater trochanter
medially - intergluteal cleft
*covered by thick layer of fascia

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2
Q

greater and lesser sciatic foramina

A

formed by greater and lesser sciatic notches, sacrotuberus,
and sacrospinous II
transmits muscles, nerves, arteries and veins from pelvis to gluteal region and gluteal region to pelvis1

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3
Q

hip joint type

A

synovial , ball and socket

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4
Q

articulations of hip joint

A

head a femur and acetabulum

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5
Q

movements of hip joint

A

flexion/extension , ADD/ABD, MR/LR, circumduction

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6
Q

acetabular labrum

A

attached to margin of acetabulum
increases articular area

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7
Q

hip extension

A

winds spiraling ll. tightly
pulls femoral head into acetabulum
limits extension

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8
Q

hip flexion

A

unwinds spiraling ll.
permits considerable flexion

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9
Q

transverse acetabuluar l.

A

continuation of acetabular labrum
bridges acetabular notch

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10
Q

most common type of hip dislocation

A

posterior

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11
Q

causes of hip dislocation

A

most commonly car accidents

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12
Q

limb position when hip dislocation happnes

A

flexed, ADD, and MR
knees strike dash

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13
Q

femoral head in hip dislocation

A

head is pushed out of acetabulum

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14
Q

limb position after hip dislocation

A

semi flexed and MR

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15
Q

sciatic nerve in hip dislocation

A

weakness/paralysis of hamstrings and everything distal to knee

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16
Q

sensation loss in dislocation of hip

A

posterolateral leg and much of foot

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17
Q

anterior dislocation of hip

A

result from violent injury
limb forced into extension, ABD and LR

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18
Q

femoral head in anterior hip dislocation

A

inferior to acetabular margin

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19
Q

femoral n. in anterior dislocation of hip

A

weakness/paralysis to sartorius and quadriceps mm

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20
Q

sensation in anterior dislocation of hip

A

medial leg and foot

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21
Q

what muscles exit the greater sciatic foramen? lesser?win

A

piriformis/ obturator internus m

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22
Q

do ligaments of hip wind of unwind with extension?

A

wind

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23
Q

what direction of hip dislocation is most common

A

posterior

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24
Q

what nerve might be damaged with posterior dislocation of hip? anterior?

A

sciatic/ femoral

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25
Q

superficial layer of gluteal muscles

A

gluteus maximus
gluteus medius
gluteus minimus
tensor fascia latae (located anteriorly but innervated by superior gluteal n)

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26
Q

deep layer of gluteal muscles

A

*lateral rotators
piriformis
gemellus superior
obturator internus
gemellus inferior
obturator externus
quadratus femoris

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27
Q

gluteus maxiumus

A

covers other gluteal muscles
moves superiorly when sitting (sit on ischial tuberosity)

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28
Q

actions of gluteus maximus

A

extension of thigh
LR of thigh
extension of trunk

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29
Q

innervation of gluteus maxiumus

A

inferior gluteal n.

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30
Q

gluteus medius

A

palpable just inferior to iliac crest posteriorly

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31
Q

gluteus medius actions

A

ABD of thigh
MR of thigh
keeps pelvis level when ipsilateral leg is weight bearing and unsupported side is in swing phase

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32
Q

gluteus medius innervation

A

superior gluteal n.

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33
Q

gluteus minimus

A

deep to gluteus medius
has shiny white fan shaped tendon

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34
Q

actions of gluteus medius

A

ABD of thigh
MR of thigh
keeps pelvis level when ipsilateral leg is weight bearing and unsupported side is in swing phase

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35
Q

gluteus minimus innervation

A

superior gluteal n.

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36
Q

tensor fascia latae

A

located more anteriorly
enclosed between layers of fascia lata

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37
Q

actions of tensor fascia latae

A

flexion of thigh
ABD of thigh
MR of thigh
helps knee extend by tensing IT band

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38
Q

tensor fascia latae innervation

A

superior gluteal n.

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39
Q

piriformis

A

has intra and extrapelvic parts
exits greater sciatic foramen

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40
Q

piriformis superior and inferior vasculature

A

pass above and below this muscle respectively
*other contents leaving GSF exit below

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41
Q

piriformis actions

A

LR of extended thigh
ABD of flexed thigh
steadies femoral head

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42
Q

innervation of piriformis

A

ventral rami S1 and S2

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43
Q

gemellus superior

A

*sometimes absent
acts as extrapelvis reinforcement of obturator internus m

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44
Q

gemellus superior action

A

LR of extended thigh
ABD of flexed thigh
steadies femoral head

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45
Q

gemellus superior innervation

A

N. to obturator internus

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46
Q

obturator internus

A

triceps coxae formed by this muscle and gemelli
fills gaps between piriformis and quadratus femoris
incapable of independent action

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47
Q

path of obturator internus

A

leaves pelvis via lesser sciatic foramen
makes 90 degree turn inferior to ishcial spine

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48
Q

obturator internus actions

A

LR of extended thigh
ABD of flexed thigh
steadies femoral head

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49
Q

obturator internus innervation

A

N to obturator internus

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50
Q

gemellus inferior

A

also serves as extrapelvic reinforcement of obturator internus m

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51
Q

gemellus inferior actions

A

LR of extended thigh
ABD of flexed thigh
steadies femoral head

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52
Q

gemellus inferior innervation

A

N. to quadratus femoris

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53
Q

obturator externus (not on lab exam)

A

obturator canal opens superiorly to this
deep in superomedial part of thigh

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54
Q

obturator externus path

A

tendon passes under acetabulum and neck of femur
visible deep to quadratus femoris

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55
Q

obturator externus actions

A

LR of thigh
steadies femorial head

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56
Q

innervation of obturator externus

A

obturator n.

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57
Q

quadratus femoris

A

inferior to inferior gemellus
sciatic nerve lies over it
may look small depending on how thigh is rotated

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58
Q

quadratus femoris actions

A

LR of thigh
steadies femoral head

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59
Q

quadratus femoris innervation

A

N. to quadratus femoris

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60
Q

superior gluteal n. VPR

A

VPR L4-S1

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61
Q

superior gluteal n. innervates

A

gluteus medius
gluteus minimus
tensor fascia latae

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62
Q

inferior gluteal n. VPR

A

VPR L5- S2

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63
Q

inferior gluteal n. innervates

A

gluteus maximus

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64
Q

sciatic n. VPR

A

VPR L4-S3

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65
Q

sciatic n. innervates

A

nothing in gluteal region

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66
Q

what two nerves is the sciatic nerve?

A

common fibular
tibular

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67
Q

N to quadratus femoris VPR

A
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68
Q

N to quadratus femoris VPR

A

VPR L4-S1

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69
Q

N to quadratus femoris innervates

A

gemellus inferior
quadratus femoris

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70
Q

N to obturator internus orgin

A

VPR L5-S2

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71
Q

N to obturator internus innervates

A

gemellus superior
obturator internus

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72
Q

pudendal n. orgin

A

VPR S2- 4

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73
Q

pudendal n. innervates

A

nothing in gluteal region
leaves GSF and enters LSF

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74
Q

injury to superior gluteal n. caused by

A

pelvic fracture
wound to gluteal region
compression by fetal head

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75
Q

injury to superior gluteal n. muscles impaired

A

gluteus minimus and medius

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76
Q

injury to superior gluteal n. sign

A

Positive Trendelenburg Sign
when asked to stand on one leg pelvis descends on unsupported side
tilts toward undamaged side
indicates mm on supported side are weakened or not fully functional

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77
Q

results of injury to superior gluteal n.

A

gluteal gait - list of body to weakened side; raises pelvis and allows foot room to clear ground

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78
Q

cause of injury to sciatic nerve

A

intragluteal injections
posterior dislocation of hip

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79
Q

muscles affected in injury to sciatic nerve

A

hamstrings
all muscles of leg and foot
* would maintain extension of leg (femoral nerve), rest of leg useless

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80
Q

sensory loss in injury to sciatic nerve

A

all areas below knee (exception medial leg and foot - saphanous n.)

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81
Q

sciatica

A

compression of sciatic nerve or related roots

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82
Q

causes of sciatica

A

piriformis syndrome (muscle pinches
spinal tumors/injections
pregnancy
lumbar herniated discs
lumbar spinal stenosis

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83
Q

symptoms of sciatica

A

may be mild or intense
shooting pain - lower back, gluteal region, thigh, leg and foot
severe symptoms can make walking or standing difficult

84
Q

what muscles of the gluteal regions MR the thigh?

A

gluteus medius and minumus

85
Q

if your standing on your left leg which gluteus med and min are contracting to keep pelvis level

A

left side

86
Q

which nerves pass through gluteal region but dont innervate anything

A

sciatic and pudendal

87
Q

fascia lata

A

forms IT band laterally
from ilia tubercle to anterolateral tibial tubercle (gerdy’s tubercle)

88
Q

fascia latta compartments

A

3 intermuscular septa which extend centrally to femur
3 compartments - anterior, posterior, medial

89
Q

posterior compartment of thigh muscles

A

semimembranosus
semitendinosus
biceps femoris

90
Q

joints crossed by muscles of posterior thigh

A

hip and knee

91
Q

what is the common origin of the muscles of the posterior thigh muscles

A

ischial tuberosity (pulled hamstring usually happens here)

92
Q

common innervation of posterior compartment of thigh

A

majority by tibial division of sciatic n. (except short head of biceps femoris)

93
Q

common functions of muscles of posterior compartment of thigh

A

extension of hip
flexion of leg

94
Q

semitendinosis

A

“true hamstring” attaches at ischial tuberosity
distal part has cord like tendon (hence name)

95
Q

actions of semitendinosis m

A

extension of thigh
flexion of leg
MR of leg when knee is flexed

96
Q

innervation of semitendinosis

A

tibial division of sciatic n.

97
Q

semimembranosus

A

true hamstring
flattened membranous proximal attachment

98
Q

actions of semimembranosus

A

extension of thigh
flexion at knee
MR of leg when knee is flexed

99
Q

innervation of semimembranosus

A

tibial division of sciatic n.

100
Q

biceps femoris heads

A

long head-crosses hip and knee
short head( most lateral) - crosses knee

101
Q

biceps femoris long head

A

only long head is true hamstring
covers sciatic nerve

102
Q

biceps femoris actions

A

extension of thigh - long head only
flexion of leg - both heads
LR of leg when knee is flexed - both

103
Q

biceps femoris innervations

A

long head- tibial division of sciatic n.
short head - common fibular division of sciatic nerve

104
Q

hamstring injuries common in

A

those that kick or run hard
inadequate warm up

105
Q

most common torn in hamstring

A

semimembranosus

106
Q

causes of hamstring injuries

A

violent muscular extension may tear proximal part of hamstrings from ischial tuberosity

107
Q

what could result in avulsion of ischial tuberosity

A

forcible flexion of hip with knee extended (proximal part of biceps femoris and semitendinosis)

108
Q

hamstring injury damage

A

bruising(contained by fascia lata) and tearing of muscle

109
Q

innervation of posterior compartment of thigh

A

sciatic and post femoral cutaneous

110
Q

sciatic nerve origin

A

VPR L4-S3

111
Q

sciatic nerve divisions

A

tibial - L4-S3; semibranosus, semitendinous, long head of biceps femoris and hamstring portion of adductor magnus
common fibular - L4 -S2: supplies short head of biceps femoris

112
Q

posterior femoral cutaneous n origin

A

VPR S1- S3

113
Q

posterior femoral cutaneous n, innervates

A

skin over posterior thigh and popliteal fossa

114
Q

posterior femoral cutaneous n. AKA

A

posterior cutaneous nerve of thigh

115
Q

the it band is a thickening of what fascia

A

fascia lata

116
Q

what actions would be affected by avulsion of ischial tuberosity

A

extension of thigh
flexion of knee

117
Q

where is sciatic nerve located?

A

deep to biceps femoris long head

118
Q

anterior compartment of thigh muscles

A

pectineus
iliospsoas
sartorius
quadriceps femoris

119
Q

pectineus

A

between ant and post compartments of thigh
forms part of floor of femoral triangle

120
Q

actions of pectineus

A

ADD of thigh
flexion of thigh

121
Q

innervation of pectineus

A

femoral n.
may receive branch from obturator n.

122
Q

iliopsoas

A

chief flexor of thigh
forms part of floor of femoral triangle

123
Q

iliopsoas composition

A

ilicaus and psoas major

124
Q

iliopsoas actions

A

flexion of thigh or trunk
stabilize hip joint

125
Q

iliopsoas innervations

A

iliacus - femoral n.
psoas major -VPR L1 - L3

126
Q

sartorius m.

A

tailors muscle
forms border of femoral triangle

127
Q

sartorius m. joints crossed

A

hip and knee

128
Q

sartorius m. permits

A

crossed knee flexion

129
Q

sartorius m. actions

A

ABD of thigh
LR of thigh
flexion of thigh
flexion of leg
MR of leg when knee is flexed

130
Q

pes anserinus

A

gooses foot
3 muscles from 3 compartments insert here

131
Q

rectus femoris joints crossed

A

hip and knee

132
Q

rectus femoris actions

A

flexion of thigh
extension of leg (limited when thigh is flexed)
steadies hip joint

133
Q

rectus femoris innervation

A

femoral n.

134
Q

vastus muscles joints crossed

A

just knee

135
Q

vastus muscles

A

vastus lateralis, vastus intermedius,vastus medialis

136
Q

vastus muscles action

A

extension of leg

137
Q

vastus muscles innervation

A

femoral n.

138
Q

vastus lateralis

A

deep to IT band

139
Q

vastus intermedius

A

deep to rectus femoris

140
Q

vastus medialis

A

forms part of adductor canal

141
Q

medial compartment of thigh muscles

A

adductor longus
adductor brevis
adductor magnus
gracilis
obturator externus

142
Q

medial compartment of thigh common innervation

A

obturator n.

143
Q

medial compartment of thigh common function

A

ADD of thigh

144
Q

adductor longus

A

most anterior of adductors
forms border of femoral triangle
covers anterior aspects of adductor brevis and magnus

145
Q

adductor longus action

A

ADD of thigh

146
Q

adductor longus innervation

A

obturator n.

147
Q

adductor brevis

A

deep to adductor longus
2 division of obturator n pass anterior and posterior to this muscle

148
Q

adductor brevis actions

A

ADD of thigh
limited flexion of thigh

149
Q

adductor brevis innervation

A

obturator nerve

150
Q

adductor magnus

A

largest most powerful and most posterior of ADD group

151
Q

adductor magnus parts

A

adductor - horizantal
hamstring-vertical

152
Q

adductor magnus actions

A

ADD of thigh
adductor part - flexes thigh
hamstring part - extends thigh

153
Q

adductor magnus innervation

A

adductor part - obturator n.
hamstring part - tibial division of sciatic n.

154
Q

adductor hiatus

A

opening between parts of adductor magnus
transmits femoral a./ v. to and from adductor canal, to and from popliteal fossa

155
Q

gracilis joints crossed

A

hip and knee

156
Q

gracilis actions

A

ADD of thigh
flexion of leg
MR of leg

157
Q

gracilis innervation

A

obturator n

158
Q

groin pull indivduals affected

A

quick starts
hockey, baseball, sprinting

159
Q

groin pull types of injuries

A

strains
stretching and tearing of proximal attachments in medial thigh

160
Q

muscles involved in groin pull

A

adductor muscles
most commonly adductor longus

161
Q

femoral a path

A

direct continuation of external iliac a. distal to inguinal ligament
passes through femoral triangle lateral to femoral

162
Q

one of 4 places to take pulse

A

femoral a,

163
Q

femoral a. branches

A

profunda femoris (deep a of thigh)- supplies perforating aa. to posterior thigh

164
Q

termination of femoral a.

A

becomes politeal a. as traverse adductor hiatus

165
Q

femoral v.

A

continuation of popliteal v. as it goes through adductor hiatus

166
Q

great saphenous v.

A

greatest tributary

167
Q

great saphenous v. path

A

arises from medial aspect of dorsal venous arch of foot
ascends ant to medial maleolus
passes posterior at medial femoral condyle
found in subcutaneous tissue of medial thigh
traverses saphenous opening (hiatus)
drains into femoral v

168
Q

saphenous vein grafts uses

A

CABG (used to bypass blocked arteries)
veins are inverted as to not block blood flow
readily accesible
usable lengths to be harvested
walls contain higher number of muscular and elastic fibers

169
Q

femoral n. origin

A

posterior division of VPR L2-4
located in femoral triangle lateral to femoral a.

170
Q

femoral cauda equina

A

collective term for numerous branches of femoral n.

171
Q

femoral n. innervates

A

anterior compartment of thigh
sensory to anterior thigh and anteromedial leg

172
Q

femoral n. branches

A

saphenous n. - runs in adductor canal
- bypasses adductor hiatus
- doesn’t supply anything in thigh

173
Q

obturator n. origin

A

anterior division of VPRL2- 4

174
Q

obturator n. exits pelvis via

A

obturator canal

175
Q

obturator n. innervates

A

adductor compartment mm.
obturator externus
adductor part of adductor magnus
sensory:skin of medial thigh just above knee

176
Q

lateral femoral cutaneous n.

A

VPR L2-3
supplies skin of anterior and lateral thigh

177
Q

femoral branch of genitofemoral n,

A

VPR L1-2
supplies skin over lateral femoral triangle

178
Q

ilioinguinal n.

A

VPR L1
supplies skin of inguinal region

179
Q

injury to femoral n. causes

A

pelvis fracture
psoas absess
gunshot of penetrating wound

180
Q

injury to femoral n. muscles affected

A

anterior compartment of thigh

181
Q

injury to femoral n. sensory loss

A

anterior and parts of medial thigh
anteriomedial leg and foot (saphenous n.)

182
Q

injury to femoral n. function affected

A

weakened flexion of hip
loss of leg extension
diffculty walking up stairs/ uphill (person will push into thigh to force knee into extension)

183
Q

which quadriceps femoris cross hip and knee

A

rectus femoris

184
Q

what medial thigh muscle crosses hip and knee

A

gracilis

185
Q

where is adductor hiatus

A

inferior portion of adductor magus
contains femoral a./v. become popliteal a./v on when through

186
Q

femoral triangle borders

A

superior- inguinal ligament
medial border- adductor longus
lateral border -sartorius
floor - pectineus, ilospsoas
roof -skin/fascia

187
Q

femoral triangle contents

A

femoral N -> A-> V

188
Q

retro inguinal space

A

deep to inguinal ligament

189
Q

2 compartments formed by iliopectenal arch

A

from inguinal l. to iliopubic eminence

190
Q

retro inguinal space lateral compartment

A

outside femoral sheath
ilispsoas and femoral n. (femoral n does not sit in femoral sheath - outside)

191
Q

retro inguinal space medial compartment

A

encloses femoral sheath
femoral a.
femoral v.
femoral canal - deep inguinal lymph nodes/vessels

192
Q

area of lymphatics in femoral sheath is weak so

A

site for hernias

193
Q

femoral seath

A

funnel shaped fascial tube
terminates inferiorly by blending with adventitia of femoral vessels
enclosed proximal parts of femoral vessels and makes femoral canal medial to them

194
Q

femoral sheath compartments

A

lateral - femoral a.
intermediate - femoral v.
medial - femoral canal - lymph nodes

195
Q

femoral canal location

A

between medial edge of femoral canal and femoral v.
extends to level of saphenous opening

196
Q

purpose of femoral canal

A

allows for venous expansion
temporary stasis
increases venous return from lower limb

197
Q

contents of femoral canal

A

loose connective tissue and lymphatic

198
Q

base of femoral canal

A

femoral ring(small opening at proximal end of canal)

199
Q

adductor hiatus

A

opening between distal attachements of 2 adductor magnus parts

200
Q

location of adductor hiatus

A

lateral and superior to adductor tubercle

201
Q

contents of adductor hiatus

A

Femoral a.v. to/from adductor canal to/from popliteal fossa
does NOT contain saphenous vein

202
Q

femoral hernias more common in

A

females (wider pelvis)

203
Q

femoral hernias

A

protrusion of abdominal viscera through femoral ring (passes through femoral canal

204
Q

location of mass of femoral hernias

A

femoral triangle and inferolateral to pubic tubercle

205
Q

femoral hernias boundaries

A

femoral v. laterally, lacunar l. medially, inguinal l. superiorly

206
Q

how can femoral hernias enlarge

A

pass through saphenous hiatus into thigh

207
Q

risk of femoral hernias

A

strangulation (necrotic)