Gluteus and Posterior Thigh Flashcards
Which way does the lower extremity rotate during development?
medially
Which nerves innervate lower extremity?
lumbar and sacral plexus
What is the blood supply of the lower extremity?
mostly femoral artery
obturator a and gluteal vessels also help
Where do femoral hernias occur?
femoral triangle where femolral nerves and vessels live
What innerveates the gluteal region?
lumbosacral plexus
what is the blood supply of gluteal?
superior and inferior gluteal artery
What does the sciatic nerve become>?
L4-S3
1 tibial nerve = preaxial
2 common peroneal nerve = postaxial
What does posterior femoral cutaneous n become?
S1-S3
1 cluneal n to butt
2 perineal br to perineum
What does superior gluteal n go?
L4-S1
glut med
glut mini
tensor fascia lata
what does inferior gluteal n do?
L5-S2
gluteaus maximum
Where does n to obturator internus and superior gemellus come from?
L5, S1-2
Where does n to quadratus femoris and inferior gemellus come from?
L4, L5, S1
What does superior gluteal artery supply?
branch of internal iliac
superficial division to glut max
deep division to glut med and mini
what does inferior gluteal supply?
musucalr
cutaneous
coccygeal
sciatic
What is the thickening of fascia on obturator internus?
pudendal canal (alcocks)
What is the route of pudendal n and internal pudendal a?
leave pelvis through greater sciatic foramen
loop over sacrospinous ligament
enter perineum through lesser sciatic foramen
What do glut med and glut min do?
both abduct and med rotate
nerve = superior gluteal
What divides superior vs inferior gluteal?
above or below piriformis m
What dividies greater and lesser sciatic foramen?
sacrospinous ligment
what sits on the piriformis muscle?
sacral plexus branches
What causes sciatica?
prolapse of disk at L4-5
results in pain
what happens if the sciatic nerve is cut?
everything below knee is paralyzed and sensation is lost on lateral leg and both sides of foot
injections in butt should onky be made in superolateral quadrant
What is the thick fascial band that crosses the lateral knee?
iliotibial band
tensor facia lata helps to extend knee
obturator internus
origin: inner surface of obturator membrane and rim of pubis and ischium bordering membrane
insertion: middle part of medial aspct of greater trochanter of femur
action: laterally rotate and stabilize thigh
Nerve: nerve to obturator internus L5 S1 S2
Gemellus superior
origin: spine of ischium
insertion: middle part of medial aspect of greater trochanter of femur
action: laterially rotates and stablizes thigh
Nerve: nerve to obturator internus
Gemellus inferior
origin: upper border of ischial tuberosity
insertion: middle part of medial aspet of greater trochanter of femur
action: laterally rotatates and stabilizes thigh
Nerve: nerve to quadratus femoris L4 5 S1
Piriformis
origin: 2 3 4 costotransverse bars of anterior sacrum, few fibers from superior border of greater sciatic notch
insertion: anterior part of medial aspect of greater trochanter of femur
action: laterally rotates and stablizes thigh
Nerve: nerve to piriformis
Gluteus minimus
origin: outer surface of ilium between middle and inferior gluteal lines
insertion: anterior surface of greater trochanter of femur
action: abducts and MEDIALLY rotates thigh. tilts pelvis on walking
Nerve: superior gluteal nerve L4 5 S1
Gluteus medius
origin: outer surface of ilium between posterior and middle gluteal lines
insertion: posterolateral surface of greater trocanter of femur
action: abducts and medially rotaes thigh. tilts pelvis on walking
Nerve: superior gluteal nerve L4 5 S1
Quadratus femoris
origin: lateral border of ischial tuberosity
insertion: quadrate tubercle of femur and a vertical line below this to the level of lesser trocanter
action: laterally rotaes and stablies hip
Nerve: nerve to quadratus femoirs L4 .5 S1
Gluteus maximus
origin: ilium, sacrum, sacrotuberous ligament
insertion: gluteal tuberosity, iliotibial tract THIGH fACIA
action: extends and LATERALLY rotates hip, aids in nkee etension via iliotibial tract
Nerve: inferior gluteal L5 S1 S2
Tensor fascia lata
origin: outer surface of anterior iliac crest between tuvercle of the iliac crest ad anterior superior iliac spine
insertion: iliotibial tract (ant surface of lateral condyle of tiia)
action: maintains knee extended (assists gluteus maximums) and abducts thigh
Nerve: superior gluteal nerve L4 5 S1
What runs next to the sciatic nerve?
posterior femoral cutaneous
What is the lubosacral trunk?
L4 and L5
What is the sciatic nerve?
L4 L5 S1 S2 S3
2 nerves in 1 sheath
- tibial portion
- fibula portion
What is origin of pudendal nerve?
S 2 3 4 keeps shit off the floor
What runs with pudendal nerve?
internal pudendal artery
What is the blood supply of the posterior thigh?
perforating branches of the profunda femoris
what are the two innervations of the biceps femoris?
both sciatic
long head = tibial n
short head = common peroneal n
What contributes to the pez anserinus on tibia?
semimembranosus
gracilius
semitendinosus
What tears when you pull a hammy?
1 of 3 main posterior thigh muscles
semimembranosus
biceps femoris
semitendinosus
what is the diamond shaped area behind the knee?
popliteal fossa
has popliteal a and v,
tibial n,
common peroneal n
popliteus m
What is the cruciate anastomosis?
The cruciate anastomsis = circulatory anastomosis in upper thigh
FILM
first perfroating artery of profundea femoris artery
inferior gluteal artery
lateral circumflex femoral artery
medial circumflex femoral artery
if pathway to popliteal artery by going around blocked internal iliac artery or even upper femoral
ie if clot in inguinal ligament n femoral artery
what is tredelenberg sign?
butt opposite gluteus medius weakness droops
superior gluteal nerve injury
pelvis tilts toward unaffected side
weak medius cammot support pelvis lecel when foot on mormal side is lifted off ground
What happens in superficial perineal space with straddle injury?
scapras fascia pouch can fill with urine
Obturator externus
origin bones around medial side of obturator foamen and external surface of obturator membrane
insertion trochanteric fossa of femur via tendon
action rottates thigh laterally
nerve obturator nerve L3 4
Biceps femoris
origin long head = lower medial segment of ischial tuberosity and sacrotuverous lig. Short heqad = lateral lip of linea as pera and proxmial 2/3 of lateral supracondylar ridge and lateral intermusucal septum
insertion lateral side of head of fibula, small slp to lateral tibial condyle
action flexes leg and rotes laterally. long head extends the thigh and rotates laterally
nerve long head = tibial sciatic L5 S1 S2
short head = peroneal divison of sciatic nerve L5 S1 S2
Semitendinosus
origin lower medial segment of ischial tuverosity by tendon with long head of biceps
insertion medial posterior segent of surface of body of tibia distal to medial condyle and deep fascia of leg
action tibial divison of sciatic nerve L5 S1 s2
nerve extends thigh, flees and medially rotates leg
Semimembranosus
origin upper lateral segment of ischial tubverosity
insertion posteromedia area of tibial medial condyle. popliteus mscule facia and posterior aspect of lateral femoral condyle receive slips from major area
action tibial dvision of sciatic L5 S1 S2
nerve extends thigh flexes and rotates medial thigh
rectus femoris
origin anterior endon of origin from anteriorinferior iliac spine reflected tedon of origin from depressoin just superior to acetabular rim
insertion via tendon into base of patella
action extens leg and flexes thigh
nerve femoral nerve L2-4
Vastus lateralis
origin capsule of hip join, femoral tubercle, distal border of greater trocahnter, anterior surface of shaft of femor medail to greater trocahanter, from gluteal tuberosity WIDE
insertion lateral border of patella - blends with quad femoris tendon
action extends leg
nerve femoral L2-4
Vastus medialis
origin lower half o intertrochanteric line, medial lip of linea aspera etc
insertion tendon medial to medial patellar border and quadriceps femoris tendon. expansion of tendon runs to knee joint capsule
action extends leg
nerve femoral L2-4
Vastus intermedius
origin anterior and lateral superior of body and femur. distal half of linea aspera, distal third of lateral intermuscal septum
insertion forms deep segment of etndon of quad femoris
action extends leg
nerve femoral L2-4
Sartorius
origin anterior superior iliac spine and iliac notch just inferior to spoine
insertion ends in tendon that dilates into wide aponeurosis which inserts into media surface of upper tibia. segment of inserting fascia blends with fibers o knee joint capule
action flexes thigh and rotates laterally. flexes and medailly rotates leg
nerve two branches from femoral nerve L2-3
Pectineus
origin pectineal line from puc bone anteriot to pectineal line from fascia that covers muscles anterior
insertion line leading from lesser trochanter to linea aspra
action adducts flexes and rotates the thigh medially
nerve femoral L2-4, accessory obturator L3
Gracilis
origin lower half of anterior surface of symphysis pubica, all of inferior public ramus, part of ramus of ischium
insertion medial surface of body of tibia inferior to tibial condyle
action adducts the thigh flexes the leg and rotates the leg medially
nerve
Adductor longus
origin anterior surface of body of the puis at point where pubic rest joins pubic symphis
insertion medial lip of linea aspera between vastus medialis and adductor magnus
action adducts flexes and rotates thigh medially
nerve obturator, anterior division L3 4
Adductor brevis
origin external surface of inferior public ramus between gracilis and obturator externus m
insertion proximal half o linea aspea and between the lesser trochanter on posterior surface of femur
action adducts flexes and rotates thigh medially
nerve obturator n, anterior division L3 4
Adductor magnus
origin ischial tuverosity, edge of inferior ischial ramus, anterior surface of infeior pubic ramus
insertion along line from greater trochanter to linea aspera and medial epicondylic rdige and adductor tuvercle on the medial femoral condyle
action powerful adductor of thigh superior half rotates thigh medially and flexes it the inferior half extends the thigh and rotates it laterally
nerve obturator nerve, posterior division L3 and sciatic tibial L3 4
