Gluteal region, thigh, and popliteal fossa Flashcards
What ligament is known as the “Y” ligament
iliofemoral
deterioration of the head of the femur following a compromise in the blood supply
avascular necrosis
How does the leg “unlock” during standing?
the popliteus muscle laterally rotates the femur (tibia is fixed due to standing)
Which three muscles are innervated by the superior gluteal nerve (dorsal divisions of L4,L5,S1)?
TFL, Gluteus medius, Gluteus minimus
Which glut muscle originates on the ext surface of the ilium between ANTERIOR and POSTERIOR gluteal lines?
Gluteus medius
One of the glut muscles inserts into the lateral surface of the greater trochanter, the other inserts into the anterior surface. Which one is which?
Glut medius - lateral surface
Glut minimus - ant. surface
the muscle that inserts between ANTERIOR and INFERIOR gluteal lines on the external surface of the ilium is
Glut minimus
the anterior fibers of glut medius and the glut minimus have the same actions. what are they?
abduction of thigh, medial rotation of thigh, steadies pelvis to same side during locomotion allowing opposite side foot to clear the ground
The post fibers of the glut medius have an opposite action of the anterior fibers. what is the action
lateral rotation
The TFL, glut med, and min all are innervated by superior gluteal nerve L4-S1, what is glut max innervated by?
inferior gluteal nerve L5-S2
Who’s origin is this? ant. part of iliac crest, iliac tubercle, ASIS, deep surface of fascia lata
TFL
both these muscles insert on the iliotibial tract
TFL, glut max
Glut max has a huge origin with 6 sites what are they?
ala of ilium, post. to post. gluteal line, iliac crest, dorsal surface of sacrum, coccyx, and sacrotuberous lig
Which muscle flexes and medially rotates the thigh?
Tensor Fasciae Latae
the post fibers of glut med share this action with glut max.
lateral rotation
how does glut max help during sitting?
steadies thigh flexion
when the thigh is fixed, what action does glut max have on the pelvis?
extension
What does the PGOGOQ group do?
laterally rotates thigh
name the muscles in descending order of the lateral rotator group.
Piriformis, gemellus sup, obturator internus, gemellus inferior, obturator externus, Quadratus Femoris
The nerve to obt internus not only innervates that muscle, but which other one?
gemellus superior
from top to down, list the insertions of the lateral rotators on the femur
piriformis - superior border g. trochanter
g. sup, inf, and o. internus - medial surface g. trochanter
o. externus - trochanteric fossa of femur
q. femoris - quadrate tubercle on intertrochanteric crest
The apex of the patella is pointing ____, and the base ____
Inferiorly, superiorly
Which two external rotator muscles originate within the pelvic cavity
piriformis - anterior surface of sacrum, superior margin of greater sciatic notch and sacrotuberous ligament
obterator internus -pelvic surfaces of ilium and ischium; internal surface of obturator membrane
What is the tendon of the obturator internus muscle protected by as it swings around the bony edge of the ischium
a bursa
what does rami mean in latin
arms
what does the piriformis separate from the pelvis
the exiting of the sup. and inf. gluteal nerve and artery
what is the usual orientation of the sup and inf gluteal n and a referring to the piriformis?
they come out inferior, but it is not uncommon for them to split around or through the piriformis
what do the glut med and min do when taking a step
they tilt and stabilize the pelvis, so it doesnt sad on the opposite side when its support is removed
When do we see Trendelenberg’s sign
when there is neuromuscular damage to the superior gluteal nerves and/or the muscles, or a broken bone so that these muscles don’t have a fixed point from which to pull, the pelvis will sag
what are all plexuses formed from
primary ventral rami of spinal nerves.
what do the primary ventral rami divide into?
dorsal and ventral division
which rami are considered mixed nerves ( contain both sensory and motor axons)
ventral rami
what plexus is the dorsal divisions of the ventral rami of L4?
sacral plexus
Which segments for the common peroneal (fibular) part of the sciatic nerve?
L5-S2
What plexus gives rise to the sup and inf gluteal nerves and the nerve to the piriformis
sacral plexus.. these both leave the pelvis via the greater sciatic foramen
The ventral divisions of the sacral plexus give rise to which nerves
n. to the obterator internus and quadratus femoris and the tibial part of the sciatic nerve
what will have effects on the ability to extend and abduct the thigh, flex the leg and dorsiflex the foot?
damage to the sciatic nerve in the gluteal region
which nerve is carrying sensory info an autonomic fibers to and from the genital region?
pudendal nerve ( ventral divisions of the sacral plexus
What forms the lumbar plexus
ventral rami of spinal nerves (T12, L1-L5
dorsal divisions of L2-L4 of the lumbar plexus form
the femoral nerve
the ventral divisions of L2-L4 of the lumbar plexus form
the obturator nerve
Referring to iliopsoas, what’s the difference between the origin and insertions of psoas major and iliacus?
psoas major originates on the TP and bodies of L5-T12 and inserts into the lesser trochanter via the strong tendon
iliacus originates inf to that. (sup 2/3 of iliac fossa, ala of sacrum and ant sacroiliac ligament) also inserts into the lesser trochanter via the strong psoas tendon AND the shaft of femur just inf to the lesser trochanter
What does iliacus do when the vert column is fixed
flexes thigh
when iliacus acts inferiorly unilaterally, what does it do
laterally flexes trunk
when iliacus acts inferiorly bilaterally with fixed thigh, what does it do
flexes trunk
what’s the difference in innervation in the iliacus muscles?
psoas major - lumbar plexus- ventral rami L1-3(4)
iliacus L2-L4
TFL originates at ASIS and the iliac crest to the…
iliac tubercle
Where does the iliotibial tract eventually end up
lateral condyle of tibia
What four muscles receive innervation from the femoral n. L2-L4?
iliacus, sartorius, quadriceps (4 muscles), and pectineus
both TFL and Sartorius originate at ASIS, flex, and abduct the thigh, what do they do differently?
TFL internally rotates thigh
Sartorius externally rotates thigh
Sartorius’ origin and insertion both have the “superior part” of something. what are they
o - sup. part of notch inferior
i - sup. part of medial surface of tibia
Which Quad muscle does not originate on the femur alone
Rectus femoris - AIIS and groove sup to acetabulum
where do all quad muscles insert
base of patella & via patellar lig to tibial tuberosity
The easiest o and i are of the pectineus. what are they
o- pectineal line of the pubis
i - pectineal line of the femur
it is also the floor of the femoral triangle
Which 4 medial muscles of the thigh are innervated by the obturator nerve L2-L4?
Adductor longus, brevis, adductor part of magnus and gracilis
obturator externus is innervated by the obturator n but only L3-L4
Which adductor muscles also flex thigh at the hip
pectineus, brevis, adductor part of magnus
A magnus has two parts, adductor and hamstring. both adduct the thigh, but what do they do opposite?
adductor part flexes thigh
hamstring part extends thigh
What is obturator externus innervated by?
obturator n L3-L4
Does the tibial portion of sciatic n L4(L5-S1) innervate
Adductor magnus hamstring part
What do most of the hamstring get innervated by?
tibial division of sciatic n. L5-S2. the only one that does not is the short head of biceps femoris, which is the common peroneal div of sciatic nerve L5-S2
What’s the common origin of the hamstring muscles?
Ischial tuberosity. the short head originates at the lateral lip of the linea aspera
What is the only difference between Semitendinosus and semimembranosus
their insertion
semitendinosus - medial surface of sup part of tibia
semimembranosus - posterior part of medial condyle of tibia, oblique popliteal ligament
The hamstring muscles share which actions
extension of thigh, flexion of leg. semiten and semimem internally rotate leg, bicep femoris externally rotate
where do the becep femoris muscles insert and what is the tendon split by
lateral side of fibular head
LCL
What are the superficial veins of the thigh connected to the deep veins
valved interconnections
a breakdown in the valve system of deep veins creates
vericose veins
what does the saphenous opening allow the greater saphenous vein to do?
dump into the femoral vein
What does the external iliac artery become after passing the inguinal ligamant?
femoral artery
what does the femoral artery become after it passes through adductor canal
popliteal artery
what does the saphenous nerve enter the femoral triangle with?
femoral nerve. then travels with femoral a through adductor canal
Name the boundaries of the femoral triangle
superior - inguinal ligament
medial - adductor longus
lateral - sartorius
floor - bodies of pectineus and iliopsoas
from lat to med, the contents of femoral triangle
Femoral nerve, artery, vein, canal
what is the purpose of the femoral canal
allows for venous expansion of vein during times of high venous return
If this structure is ruptured, small intestine can bulge into and/or become stranulated
femoral sheath. different than inguinal hernia
what is the femoral sheath an extension of
abdominal transversalis fascia and iliac fascia
what does the femoral sheath contain?
contens of the femoral triangle for 4 cm, not femoral and saphenous nerves
what three compartments is the femoral sheath divided into
for artery, vein, and femoral canal
What is the tunnel beneath the sartorius that carries the femoral artery, vein, and saphenous nerve
adductor canal
where does the adductor canal end?
the adductor hiatus in adductor magnus
what are the boundaries of the adductor canal
lateral - vastus medialis
posteromedial - a longus and magnus
anterior - sartorius
roof - sartorius and subsartorial fascia
what is the diamond shaped area at the posterior aspect of the knee
popliteal fossa
what are the boundaries of the politeal fossa
superolateral - biceps femoris
superomedial - semitendinosus and semimembranosus
inferomedial and inferolateral - medial and lateral heads of gastrocnemius
floor - popliteal surfaces of femur and tibia, oblique popliteal lig., part of the semimembranosus tendon, popliteus fascia
roof - skin and fascia
contents of popliteal fossa
popliteal artery, vein, and genicular anastomosis
tibial nerve and common peroneal nerve
