Gluteal, Thigh, & Popliteal Fossa

Question 1

Explain the organization of the fascia lata and its thickening, the iliotibial tract.

Answer 1

An extension of the inguinal ligament, deep fascia, wrapping all the way around the thigh

• abducts, flexes, and IR rotates hip, assists in maintaining knee extension
• IT tract: extends from TFL and gluteus Maximus m to proximal lateral tibia

Question 2

Describe the fascia compartments of the thigh and list their contents, general actions, innervation, and blood supply.

Answer 2

Femoral Sheath: continuation of iliacus and transversalis fascia inferior to inguinal ligament (contains: femoral a., v., canal)
Fascia Lata: continuation of inguinal ligament (lateral femoral cutaneous n. Punches through and lays on top)
- saphenous opening just below inguinal ligament (great saphenous v.)

Anterior: bounded by inter muscular septum, femoral n., hip flexors, knee extensors
Medial: obturator n., extensors of hip, flexors of knee
Posterior: adductors of thigh,

Question 3

Name the boundaries and contents of the femoral triangle.

Answer 3

Borders: 
- inguinal ligament superioris
- Adductor longus m medial 
- Sartorius m laterally
Floor: iliopsoas (lat), pectineus (med)
Contents: 
- Femoral n., a., v.

Question 4

Name the structures that pass through the greater and lesser sciatic foramina

Answer 4

Greater sciatic foramen:

• piriformis m
• sciatic n.
• posterior femoral cutaneous n.
• superior gluteal van
• inferior gluteal van
• internal pudendal a., v.
• pudendal n.

Lesser sciatic foramen:

• obturator internus
• internal pudendal a., v.
• pudendal n.

Question 5

Explain what a Trendelenburg gait looks like and what structures are impaired in this condition.

Answer 5

Pelvis sag during locomotion

• could be cause by disc herniation affecting superior gluteal n. (L4-S1)
• gluteus medius and minimus weakness and thus pelvis is not stable
• pelvis sags away from affected side, shifted center of gravity

Question 6

Draw and label the sacral plexus, including anterior and posterior divisions.

Answer 6

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Question 7

Identify the location of a lesion on the sacral plexus that would account for patient sensory and motor deficits.

Answer 7

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Question 8

Name the axon functions found in the peripheral nerves of the gluteal, thigh, and popliteal fossa.

Answer 8

Motor, sensory, postganglionic sympathetic

*exception femoral br.

Question 9

Identify the segmental innervation of the skin of the gluteal region, thigh and popliteal fossa using a dermatome map.

Answer 9

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Question 10

Describe the path taken by and the location of muscular branch origin of the sciatic, tibial, common fibular, obturator, and femoral nerves in the thigh.

Answer 10

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What it innervates?

Question 11

Trace a single red blood cell from the abdominal aorta to the gluteal region, thigh and popliteal fossa by naming every vessel the cell passes through.

Answer 11

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Question 12

Trace a single red blood cell from the gluteal region, thigh and popliteal fossa back to the right atrium of the heart by naming every vessel the cell passes through.

Answer 12

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Question 13

Describe the territory and path of drainage for lymph node groups of the gluteal region, thigh and popliteal fossa.

Answer 13

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Question 14

Describe the typical blood supply of the head and neck of the femur and how this changes with age.

Answer 14

Children under 10 have obturator a but becomes medial circumflex femoral a.

Question 15

Name the contents of the femoral sheath.

Answer 15

Femoral a., femoral v., femoral canal

Question 16

Describe the locations where one would take the femoral pulse.

Answer 16

Femoral triangle: where femoral a. Is most superficial

Question 17

Name the primary motions that occur at the joints of the hip, thigh, and knee.

Answer 17

Leg at knee joint: flexion, extension, external rotation, internal rotation
Hip:
Coxa vara/Genu valgum: knock-kneed
Coxa valgum/genu vara: bow-legged

Question 18

Name the attachments and motions restricted for the ligaments.

Answer 18

Pelvic:
- sacrospinous
- sacrotuberous
- fibrous joint capsule
Capsular:
- iliofemoral “Y”: limits extension of thigh at hip joint
- ischiofemoral: assists the iliofemoral in limiting extension of the femur
- pubofemoral: limits abduction of the femur
Extracapsular:
- ligamentum teres: does not offer stability to hip joint
- transverse acetabular: interconnects margins of acetabular notch

Knee:

• Tibial (medial) collateral: resists genu valgus stress (prevents abduction of tibia)
• Fibular (lateral) collateral: resists genu varus stress (prevents adduction of tibia)
• Anterior cruciate ligament: prevents anterior displacement of tibia (unloaded LE), prevents posterior displacement of femur (loaded LE) — hyper extension of knee
• Posterior Cruciate ligament: prevents posterior displacement of tibia (unloaded LE), prevents anterior displacement of femur (loaded LE)
• fibrous capsule of knee
• medial/lateral meniscus
• patellar ligament
• rural interosseous membrane

Question 19

Identify the ligaments that are closely applied to joint capsules (thickening of joint capsules).

Answer 19

MCL: closely applied to joint capsule and medial meniscus

Question 20

Name the synovial joint classification for the joints.

Answer 20

Pelvis: Sacroiliac (plane), hip (ball and socket)
Knee: tibiofemoral (bi-condylar), proximal tibiofibular (plane)

Pubic symphysis
Patellofemoral

Question 21

Describe the identifying features of the medial and lateral menisci.

Answer 21

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