Hip and thigh region Flashcards
What is contained in the superficial fascia?
cutaneous nerves
greater and lesser saphenous vein
Where is the fascia lata?
deep fascia over the gluteal region and thigh
What is the root and function of the superior gluteal nerve?
- L4, L5, S1
- motor to gluteus minimus and medius and tensor fascia lata
What is the root and function of the inferior gluteal nerve?
- L5, S1, S2
- motor to gluteus maximus
What is the root and function of the femoral nerve?
- L2-4
- sensory = anteriomedial thigh, medial leg and foot
- motor = anterior thigh muscles
What is the course of the femoral nerve?
passes inferiorly thorugh psoas major
underneath inguinal ligament
divides into anterior and posterior
What is the root and function of the obturator nerve?
- L2-4
- motor = medial compartment of thigh
- sensory = medial thigh
What is the course of the obturator nerve?
through psoas major
exits thigh through obturator canal
divides into anterior and posterior
What is the root and function of the tibial nerve?
root = L4-S3 motor = posterior compartment of leg sensory = posterio-lateral leg, lateral foot and sole
What does the sciatic nerve branch into?
tibial nerve and common fibular/peroneal nerve
- branches at the popliteal fossa
What is the root and function of the common fibular / peroneal nerve?
root = L4-S2 motor = short head of biceps femoris, lateran and anterior compartments of leg sensory = upper lateral and lower posterolateral skin of leg, dorsum of foot
What does the common fibular nerve terminate into?
superficial fibular and deep fibular nerves
What is the main artery of the lower limb?
femoral artery
- branches from external iliac at the inguinal ligament
What is the profunda femoris artery?
a branch of the femoral nerve at the femoral triangle
What are the 3 branches of the profunda femoris artery?
Perforating branches - supply posterior and medial muscles
Lateral femoral circumflex artery - supplies lateral muscles
Medial femoral circumflex artery - supples head and neck of femur
What artery supplies the head and neck of femur?
medial femoral circumflex
When does the femoral artery become the popliteal artery
when it reaches the adductor hiatus
Where do the arteries supplying the gluteal region enter?
the greater sciatic foramen
What does the popliteal artery branch into?
anterior tibial artery -> dorsalis pedis artery
tibioperoneal trunk -> posterior tibial artery + fibular artery
What are the major pulse point of the lower limb?
femoral, popliteal, posterior tibial, dorsalis pedis
What is the articulation site of the hip joint?
acetabulum and head of the femur
What is the normal angle of inclination for the femur?
125
< 125 = coxa vara
> 125 = coxa valga
What are the ligaments supporting the hip joint?
- iliofemoral ligament (y-shaped)
- pubofemoral ligament (triangular)
- ischiofemoral (spiral)
What is the neurovasculature of the hip joint?
- medial circumflex & femoral arteries
- sciatic, femoral and obturator nerves
What factors stabilise the hip joint?
ligaments, acetabulum, acetabular labrum
What direction is the majority of hip joints?
posterior
What enters through the greater sciatic foramen?
sciatic and gluteal nerves/arteries
What are the features of gluteus maximus?
- main hip extensor
- attaches to posterior surface of pelvis and iliotibial band
- innervated by inferior gluteal nerve
What is the attachment, innervation and actions of gluteus medius?
attachments = surface of ilium & greater trochanter action = abduction and medial rotation of leg innervation = superior gluteal nerve
What is the attachment, innervation and action of gluteus minimus?
attachment = ilium + greater trochanter of femur action = abduction and medial rotation, stabilises pelvis innervation = superior gluteal nerve
What is Trendelenburg’s sign?
- damage to the superior gluteal nerve
- results in wasting of gluteus medius and minimus
- observed by pelvic drop
What are the deep muscles of the gluteal region?
- piniformis
- obturator internus
- superior gemelli
- inferior gemelli
- quadratus femoris
What is the function of the deep muscles of the gluteal region?
lateral rotation
Where do the nerves in the gluteal region run?
either side of the piriformis muscle
Where are IM injections given to avoid the sciatic nerve?
upper lateral quadrant
What is a sign that an IM injection has damaged the sciatic nerve?
foot drop
What is the path of the sciatic nerve in the gluteal region?
- emerges inferior to piriformis
- crosses the deep gluteal muscles posteriorly
- enters the posterior thigh
What is the innervation of the anterior compartment of the thigh?
femoral nerve
What is the function of the anterior compartment of the thigh?
extends the leg at the knee joint
What muscles make up the anterior compartment of the thigh?
- quadriceps femoris (4)
- sartorius (long and thin)
- pectineus (flat)
What is the innervation of the medial compartment of the thigh?
obturator nerve
What is the function of the medial compartment of the thigh?
hip adduction
What muscles make up the medial compartment of the thigh?
- adductor magnus
- adductor longus
- adductor brevis
- obturator externus
- gracialis
What is the innervation of the posterior compartment of the thigh?
sciatic nerve
What is the function of the posterior compartment of the thigh?
extend at hip, flex at knee
= hamstrings
What muscles make up the posterior compartment of the thigh (hamstrings)?
- biceps femoris
- semiteninosus
- semimembranous
What are the borders of the femoral triangle?
superior = inguinal ligament lateral = sartorius muscle medial = adductor longus roof = fascia lata base = pectineus muscle
What are the contents of the femoral triangle?
femoral nerve, artery and vein
femoral canal containing lymphs
- order = NAVEL
What are the borders of the politeal fossa?
(diamond shaped)
superomedial = semimembranous
superolateral = biceps femoris
inferomedial = medial head of gastrocnemius
inferolateral = lateral head of gastrocnemius
What are the contents of the popliteal fossa from medial to lateral?
popliteal artery
popliteal vein
tibial nerve
common fibular nerve
What is Baker’s cyst?
swelling in the popliteal fossa
- caused by inflammation of semimembranous bursa
What is Perthe’s disease?
abnormal development of the head of femur (mushroom head)
- causes collapse