hip, buttock and thigh Flashcards
buttock and thigh: describe the organisation of the neuromuscular compartments of the buttock and thigh, and explain their innervation and function. Demonstrate the paths of the main blood vessels and nerves of the region
2 functions of anterior compartment of thigh
hip flexors, knee extensors
5 muscles in anterior compartment of thigh
pectineus (flexor and abduction of hip; pubic bone to lateral thigh), ilio-psoas (pelvis; attaches to lesser trachanter of femur; formed by psoas major and iliacus which pass underneath inguinal ligament), (tensor fascia lata), sartotius (inferior and medial, crossing knee joint to attach to medial shaft of tibia; flex knee and abduct thigh), quadriceps femoris (flex knee)
4 muscle heads of quadriceps femoris
rectus femoris (only one to attach across hip joint), vastus medialis, vastus intermedius, vastus lateralis; form ligament which patellar is embedded in (patellar ligament) to anterior tuberosity of tibia
function of medial compartment of thigh
hip adduction
5 muscles in medial compartment of thigh
adductor longus, adductor brevis, adductor magnus (broad attachment along posterior shaft of femur, and then short attachment at adductor tubercle, creating adductor magnus hiatus, used for femoral artery and vein passing from anterior to posterior of knee, before becoming popliteal artery and vein), gracilis, obturator externus; attachments on posterior shaft of femur
2 functions of posterior compartment of thigh (commonly known as hamstrings)
knee flexion, hip extension (except short head of biceps femoris)
3 muscles of posterior compartment of thigh
semimembranosus (flatter strap; stay relatively medial across knee to medial tibia), semitendinosus (rope-like tendon; stay relatively medial across knee to medial tibia), biceps femoris (attach to head of fibula); all come off ischial tuberosity, except biceps femoris, whose short head comes off posterior shaft of femur
what is the femoral triangle (anterior upper part of thigh) outlined by superiorly, medially and laterally
superiorly: inguinal ligament, medially: lateral edge of adductor longus (medial compartment), laterally: medial edge of sartorius (anterior compartment)
contents of femoral triangle from lateral to medial (NAV Y-pants)
femoral nerve, femoral artery, femoral vein
what does the femoral sheath enclose
femoral artery and vein (not nerve)
what does a portion of the femoral sheath form medially
femoral canal
where does the adductor (Hunter’s) canal extend from
extends on medial aspect of thigh from apex of femoral triangle, then travels down underneath sartorius
what does the adductor canal transmit
superficial femoral artery and vein, and saphenous nerve
what forms the adductor canal anteriorly, posteriorly and medially
anteriorly: vastus medialis, posteriorly: adductor longus and magnus, medially: sartorius
main artery supplying region
external iliac artery
where does iliac artery pass from and under
passes from pelvis beneath inguinal ligament
what does external iliac proceed as out of the pelvis
femoral artery
where does the femoral artery lie at the level of the inguinal ligament, and clinical significance
at mid-inguinal point (half-way between ASIS and pubic symphysis), where it is easily palpable
at the mid-inguinal point, what structure is lateral to the femoral artery
femoral nerve
at the mid-inguinal point, what structure is medial to the femoral artery
femoral vein
what is the main branch of the femoral artery to the thigh
profunda femoris artery
what do the femoral artery and profunda femoris branch give off immediately, and what does it supply
circumflex vessels, which supply hip joint
what does the femoral artery proceed as after giving off the profundus femoris artery
superficial femoral artery
what does the superficial femoral artery become at the level of the knee, after passing through the hiatus of adductor magnus
popliteal artery
main superficial vein in thigh
long (great) saphenous vein
where does the long saphenous vein run from to join the deep system
medial border of foot -> passes knee on its medial aspect -> passes
up medial aspect of thigh to join the deep system
where does the long saphenous vein join the deep system
at the sapheno-femoral junction
where does the long saphenous vein join the deep system having pierced the fascia of the thigh
femoral triangle
what does the valve at the sapheno-femoral junction do
prevents blood passing from deep to superficial system
in what condition is valve at sapheno-femoral junction often faulty or incompetent
varicose veins
what do the deep veins of the thigh flow into, and where
popliteal vein at level of knee
what does the popliteal vein run alongside, and what does it form
runs alongside popliteal and femoral arteries to form femoral vein
in the groin, where does the femoral vein lie in relation to the femoral artery
medial
what does the femoral vein pass under to form the external iliac vein
inguinal ligament
where does the femoral vein receive the long saphenous vein at
sapheno-femoral junction
what does the femoral vein receive proximally to receiving the long saphenous vein
venae comitantes of profunda femoris artery
what does lymph flow with
superficial and deep venous systems
what does the superficial lymph system run with
long and short saphenous veins
location of lymph nodes of superficial lymph system, and name
in groin, called superficial inguinal lymph nodes
what do the inguinal lymph nodes drain into
deep inguinal lymph nodes and external iliac lymph nodes
what does the deep system of lymphatic drainage drain alongside, and where does it drain to
deep veins to deep inguinal lymph nodes
what do the deep inguinal lymph nodes drain into
external iliac lymph nodes
what spinal levels are knee extensors in general supplied by
L3,4
what spinal levels are knee flexors in general supplied by
L5, S1
what is the nerve of the anterior compartment of the thigh
femoral nerve
what is the femoral nerve supplying the anterior compartment of the thigh derived from
posterior divisions of the lumbar plexus (L2,3,4)
what is the nerve of the medial compartment of the thigh
obturator nerve
what is the obturator nerve supplying the medial compartment of the thigh derived from
anterior divisions of the lumbar plexus (L2,3,4)
what is the nerve of the posterior compartment of the thigh (and all muscles of legs and foot))
sciatic nerve
what is the sciatic nerve supplying the posterior compartment of the thigh derived from
lumbo-sacral plexus (L3,4,5 S1,2)
what are the nerves of the gluteal compartment
superior and inferior gluteal nerves
where is the superior gluteal nerve derived from
L4,5 S1
where is the inferior gluteal nerve derived from
L5 S1,2
what does the superior gluteal nerve supply
gluteus medius, gluteus minimus
what does the inferior gluteal nerve supply
gluteus maximus
what is the dermatomal supply of the anterior area of the thigh (L3 to the knee, L4 to the floor)
T12, L1,2,3
what is the dermatomal supply of the posterior area of the thigh
S1,2,3
what is the dermatomal supply of the buttock
S2-4
what plexus supplies the sensory peripheral supply to the buttock and thigh
lumbo-sacral plexus
what nerve supplying sensory peripheral supply to buttock and thigh originates at T12
subcostal nerve
what nerves supplying sensory peripheral supply to buttock and thigh originate at L1
ilio-hypogastric nerve, ilio-inguinal nerve
what nerve supplying sensory peripheral supply to buttock and thigh originates at L1 and L2
genito-femoral nerve
what nerve supplying sensory peripheral supply to buttock and thigh originates at L2 and L3
lateral cutaneous nerve of thigh
what nerves supplying sensory peripheral supply to buttock and thigh originate at L2, L3 and L4
sensory branches of femoral nerve, sensory branches of obturator nerve
what nerve supplying sensory peripheral supply to buttock and thigh originates at S2 and S3
posterior cutaneous nerve of thigh
what nerve supplying sensory peripheral supply to buttock and thigh originates at L2,3,4
saphenous nerve (terminal branch of femoral nerve)
what nerves supplying sensory peripheral supply to buttock and thigh originate at L1-S3
buttock nerves derived from sacral plexus
femur bone type
long
what is femur hemispherical head covered with
hyelin cartilage
patellar bone type
sesamoid
most commonn fracture of femur
fracture of femoral neck
other common fracture of femur
intertrochanteric fracture
