Gross Anatomy Exam 3 Flashcards
6 regions of the lower limb
Gluteal Femoral (thigh) Knee Leg Ankle Foot
Os Coxae
ilium, ischium, pubis, acetabulum
Ilium
ala, iliac crest, iliac tubercle, ASIS, AIIS, PSIS, PIIS, Iliac fossa, body, posterior andterior and inferior gluteal lines, auricular surface, iliac tuberosity
Ischium
body, ramus, ischial tuberosity, ischial spine, lesser sciatic notch, greater sciatic notch
Pubis
body, superior rams, inferior ramus, symphaseal surface, pubic crest, pubic tubercle, pectin pubis
Obturator Foramen
large oval opening in hip bone
surrounded by ischial and pubic rami
closed by obturator membrane creating the obturator canal
Acetabulum
large cup shaped cavity on lateral aspect of hip bone
articulates with femoral head and forms hip joint
Acetabular notch, acetabular fossa, lunate surface
Femur
head with fovea, neck, greater trochanter, lesser trochanter, intertrochanteric line, intertrochanteric crest, quadrate tubercle, trochanteric fossa, shaft, line aspera - medial and lateral lips, gluteal tuberosity, pectineal line, medial and lateral supracondylar lines, medial and lateral femoral condyles, intercondylar fossa, patellar surface, adductor tubercle
Patella
Base, apex and articular surface
Tibia
shin bone, on antero lateral side of leg, articulates with femoral condyle superiorly, and talus inferiorly, fibular laterally, transmits body weight to foot
medial and lateral condyles, superior articular surface, intercondylar eminence, intercndylar tubercles, ant and post intercondylar areas, anterolateral tibial tubercle (Gerdy’s tubercle), tibial tuberosity, fibular articular facet, ant border of tibia, medial surface, medial malleoulus, interosseous border, fibular notch, soleal line, groove for tibialis post tendon, inferior articular surface
Fibula
no function of weight bearing, articulates with tibia and talus
head, neck, shaft, ant interosseus and post borders, medial post and lateral surfaces, lateral malleolus
Tarsals
Talus, calcaneus, Navicular, cuboid, cuneiforms
Talus
no muscular or tendinous attachment, only bone that articulate with leg, divides body weight between calcaneus and forefoot
trochlea body, posterior process, head, neck
Calcaneus
largest, strongest bone in foot
transmits majority of body weight from talus to ground
superior surface, anterior surface, fibular trochlea, sustentaculum tali, calcaneal tuberosity
Navicular
flattened, boat shaped bone
b/w talus and 2 cuniforms
navicular tuberosity
Cuboid
most lateral bone in distal row of tarsals
b/w calcaneus post and 4th and 5th metatarsals anteriorly
tuberosity of cuboid, groove fro tendon of fibularis longus
Cuneiforms
each articulates with navicular posteriorly and base appropriate metatarsals anteriorly
medial (1st) largest
Intermediate (2nd) smallest
lateral (3rd) articulate with cuboid
Metatarsals
make up forefoot, 5 numbered from medial to lateral, 1st is the shortest and 2nd is the longest
base, shaft, head
Phalanges
base shaft and head
Sacroiliac Joint
weight bearing compound joint b/w sacrum and iliac syndesmosis posteriorly b/w tubercles and synovial anteriorly b/w auricular surfaces Ligmaments Anterior scroiliac Interosseous sacroiliac posterior sacroiliac sacrotuberous sacrospinous
Pubic Symphysis
fibrocartilage disk at union of pubic bones in anterior median plane, thicker in females
Ligaments
superior pubic ligament
inferior pubis ligament
Greater Sciatic Foramen
piriformis muscle superior gluteal n.a.v. inferior gluteal n.a.v. internal pudendal a.v. pudendal n. posterior femoral cutaneous n. sciatic n. nerve to obturator internus and quadratus femoris
Lesser Sciatic Foramen
obturator internus tendon
nerve to obturator internus
internal pudendal a.v.
pudendal n.
Hip Joint
designed for stability over wide range of movement, synovial joint
connects pelvic girdle and lower limb, ball and socket b/w head of femur and acetabulum
femoral head covered with articular cartilage and acetabulum
acetabulum labrum
permits flex/ext, MR/LR, ABD/ADD and circumduction
Ligaments of Hip Joint
transverse acetabular ligament orbicular zone ischiofemoral ligament iliofemoral ligament pubofemoral ligament ligamentum capitis femoris
superior gluteal artery
from internal iliac artery anastamoses with inferior gluteal and medial femoral circumflex arteries participates in trochanteric anastamosis superficial branch deep branch
inferior gluteal artery
from internal iliac artery
anastamoses with superior gluteal artery
participates in cruciate anastamosis
Internal pudendal artery
from internal iliac artery
passes thru gluteal region between sacrotuberous ad sacrospinous ligaments
does not supply anything in gluteal region
Profunda Femoris artery
from femoral artery
medial femoral circuflex artery
lateral femoral circumflex artery - ascending, transverse and descending branch
perforating arteries - usually 4 of them the 1st participates in anastamoses with inferior gluteal artery and cruciate anastamosis
Gluteal Veins
tributaries of internal iliac vein
accompany corresponding arteries
communicate with tributaries of femoral vein, provide alternative route for blood from lower limbic femoral vein is occluded or ligated
Cruciate Anastamosis
important for keeping lower limb viable
stenosis, damage or blockage of the external iliac or femoral arteries could cause series issues
provides connection between internal iliac arteries and femoral arteries - via profunda femurs artery
Involves the following arteries
inferior gluteal artery
medial femoral circumflex artery
lateral femoral circumflex artery ascending and transverse
1st perforating artery of profunda femoris
Superior Gluteal nerve
from VPR L4-S1
supplies gluteus medis, minims and tensor fascia lata
Inferior Gluteal nerve
from VPR L5-S2
supplies gluteal maximus muscle
Sciatic Nerve
from VPR L4-S3
does not supply anything in the gluteal region
Nerve to Obturator Femoris
from VPR L4-S1
supplies quadratus femurs and inferior gamellus muscles
Nerve to Obturator Internus
from VPR L5-S2
supplies obturatr interns and superior gemellus muscles
Pudendal Nerve
from VPR S2-4
does not supply anything in gluteal region
Clunial Nerve
superior from DPR of L1-3, supplies superior buttock
middle from DPR S1-3, supply skin over sacrum and adjacent buttock
inferior from posterior cutaneous nerve of thigh
Lumbosacral Plexus
consists of VPR from L1-L4 with inconsistent contributions from T12
formed within psoas major muscle
each receives postsynaptic sympathetics via tray rami communicantes`
Iliohyopgastric and ilioinguinal nerves
VPR of L1
innervate the abdominal wall muscle and L1 derma tom anteriorly
Lateral Femoral Cutaneous Nerve
VPR of L2-3
enters thigh deep to inguinal ligament and medial in ASIS
sensory to anterolateral skin of thigh
Femoral Nerve
Posterior divisions of VPR of L2-4
passes deep to inguinal ligament and then to anterior thigh
innervates the hip flexors and knee extensors, sensory to anterior and medial thigh and anteromedial leg and foot
Genitofemoral Nerve
VPR of L1-L2
genital branch passes through deep inguinal ring
sensory to anterolateral skin of scrotum/labia majora, motor to the cremaster muscle
femoral branch passes along external iliac artery, sensory innervation over femoral triangle
Obturator Nerve
anterior divisions VPR or L2-4
motor to medial thigh muscles and sensory to medial thigh above knee
Lumbosacral Trunk
VPR L4-5
participates with S1-S4 in forming the sacral plexus
Sacral Plexus of Nerves
composed of VPR of S1-S4 and lumbosacral trunk
all branches except those to pelvic diaphragm leave pelvis via greater sciatic foramen above or below pelvis
all branches receive tray rami commincans from sympathetic trunk
Superior Gluteal Nerve
posterior divisions VPR L4-S1
enters gluteal region via greater sciatic foramen
sensory to hip and motor to gluteus medius, minimus and tensor fascia lata
Inferior Gluteal Nerve
posterior divisions VPR L5-S2
enters the gluteal region via the greater sciatic foramen
sensory to hip and motor to gluteus maximus muscle
Posterior Femoral Cutaneous Nerve
anterior and posterior divisions of VPR S1-3
sensory to skin of upper thigh, lateral perineum, inferior buttock, posterior thigh and popliteal fossa
Sciatic nerve
anterior and posterior divisions of VPR L4-S3
located midway b/ ischial tuberosity and greater trochanter in gluteal region
composed of two division: tibial (anterior div) and common fibular (posterior div)
sensory to hip, knee, ankle and all foot joints, posterior and anteriolateral leg, skin of foot
motor to hamstrings, hamstring portions of adductor magnus and all leg and foot muscles
Pudendal Nerve
anterior divisions of VPR S2-4
exits pelvis via greater sciatic foramen below piriformis muscle b/w sacrotuberour and sacrospinous ligaments
enters perineum via lesser sciatic forament
sensory to perineal skin, penis and clitoris
motor to perineal muscles, pelivc diaphragm and external anal sphincter
Nerve to Quadriceps Femoris
anterior divisions of VPR L4-S1
enters gluteal region via greater sciatic nerve
sensory to hip and motor to quadratus femoris and inferior gemellus
Nerve to Obturator Internus
posterior divisions of VPR L5-S2
exits pelvis via greater sciatic foramen and enter pelvis via lesser sciatic foramen
sensory to hip and motor to superior gemellus and obturator internus muscles
Fascia Lata
continuous superiorly with: anteriorly with the inguinal ligament pubic arch body of pubis and pubic tubercle, posteriorly and lateral with iliac crest, and posterior medial with sacrum coccyx sacrotuberous ligament and ischial tuberosity ischopubic ramu
conituous inferiorly with: exposed parts of bone around knee, popliteal fascia, deep fascia of leg inferior to the knee
Thickens laterally to form Iliotibial band:
-shared aponeurosis of tensor fascia lat a and glutes maximus
-from iliac tubercle to anterolateral tubercle of tibia (gerdy’s tubercle)