Hip, Gluteal Region, and Thigh Flashcards
Functions of the lower extremity
weight support
locomotion
maintain balance
regions of the lower extremity
gluteal thigh/femoral knee leg ankle foot
Movements of the lower extremity
flexion and extension
abduction and adduction
internal and external rotation
circumduction
Bones of the hip and thigh
ilium
ischium
pubis
acetabulum
Landmarks of the hip and thigh
ASIS AIIS ischial spine pubic tubercle ischial tuberosity greater sciatic notch obturator foramen
Femoral landmarks
greater trochanter lesser trochanter femoral head gluteal tuberosity adductor tubercle femoral condyles
Joints of the hip and thigh
sacroiliac
hip (coxal)
What kind of joint is the hip?
ball and socket synovial joint
How many degrees of freedom does the hip joint have?
six degrees of freedom
How is weight transmitted in the hip joint?
through the femoral head and neck
acetabular labrum
c-shaped cartilage and transverse acetabular ligament =encloses joint
Round ligament of head of femur
carries branch of obturator artery to femoral head
Ligament of the hip joint
iliofemoral ligament
Ischiofemoral ligament
Pubofemoral ligament
iliofemoral ligament
prevents hyperextension
AIIS to interochanteric line
Ischiofemoral ligament
ischial part of the acetabular rim to femoral neck
pubofemoral ligament
prevents overabduction
pubic bone to joint capsule and iliofemoral ligament
The three hip joint ligaments spiral to do what?
To become taut with hip extension and keep femoral head in the acetabulum
What is superficial fascia?
subcutaneous tissue that is deep to skin –> loose connective tissue with cutaneous nerves, veins, and lymphatics
Deep fascia
also known as fascia lata
thickens to form iliotibial tract
What separates the compartments of the thigh?
inter muscular septa
venous drainage of the lower limb
superficial
medial - great saphenous vein
posterior - small saphenous vein
Where do the veins of the lower limb drain?
femoral vein
Anterior and medial limb dermatomes
L1-L5
Posterior limb dermatomes
S1 and S2
What is the exception for dermatome overlap?
Except at the axial line where adjacent dermatomes are discontinuous spinal levels
What are the anterior thigh muscles?
hip flexors and knee extensors
Hip flexors
pectineus
sartorius
iliopsoas
Knee extensions
Quadriceps femoris
iliopsoas
iliac fossa/lumbar verts –> lesser trochanter
combo of the iliacus and psoas major
Sartorius
Flexes, abducts, laterally rotates hip, flex knee (cross legged position)
ASIS –> medial tibia
Pectineus
hip abduction. flexion, medial rotation
quadriceps femoris muscles (4)
rectus femoris
vastus intermedius
vastus lateralis
vastus medialis
Innervation of the quadriceps femoris
femoral nerve (L2-L4)
Patellar tendon reflex
tap patellar ligament = deep tendon reflex
Medial thigh muscles
Adductor longus Adductor brevis Adductor magnus Obturator internus Gracilis
Innervation of the medial thigh muscles
obturator nerve except for adductor magnus which is also innervated by the sciatic nerve
Adductor hiatus
Transmits the femoral artery and vein from the anterior to posterior knee
Gracilis transplant
the gracilis is small and thin and can be removed without much notice
it is used to replace damaged muscles everywhere
What are the boundaries of the femoral triangle?
superior - inguinal ligament
lateral - sartorius
medial - adductor longus
Describe the femoral triangle lateral to medial
NAVL –> nerve, artery, vein, lymphatics
Femoral nerve, femoral artery, femoral vein, lymphatics
Function of the femoral sheath
encloses artery, vein, and lymph
Clinical important of the femoral triangle
femoral hernia and femoral pulse
Femoral hernia
femoral ring is weak and susceptible to hernia
Femoral pulse
inferior to midpoint of the inguinal ligament
Surface anatomy of the gluteal region
buttocks, thigh, and hip
Level of iliac crests
L4-L5
Pelvic ligaments
Sacrotuberous
Sacrospinous
conversion of sciatic notches to foramina
Gluteus maximus innervation
inferior gluteal nerve
Action of gluteus maximus
extension of the thigh
tensor fascia lata
flexes thigh
tenses IT band and supports thigh
innervation of the tensor fascia lata
superior gluteal nerve
gluteus medius and minimus
abduction and adduction
innervation of the gluteus medius and minimus
superior gluteal nerve
A patient has a right superior gluteal nerve injury. During standing on the right leg?
the pelvis will tilt towards the left; tilt to the opposite side of the weakness
Positive Trendenlenburg Sign
superior gluteal nerve lesion
Action of the deep gluteal muscle
lateral rotation of thigh
hip joint stabilization
Innervation of the deep gluteal muscles
sacral plexus
L5-S2
innervation of the piriformis
nerve to the piriformis
obturator internus and gemelli
superior gemellus
obturator internus
inferior gemellus
trochanteric fossa
What is a bursa?
membranous sac containing the capillary layer of synovial fluid
function of bursa
reduces friction and permits free movement
gluteal bursa
ischial bursa
trochanteric bursa
gluteofemoral bursa
source of the gluteal arteries
internal iliac artery
site of intramuscular injections
upper quadrant
Posterior thigh muscles
Semitendinosus
Semimembranosus
Biceps femoris (long head)
Short head of biceps femoris
Function of the posterior thigh muscles
extend hip joint and flex knee
innervation of the posterior thigh muscles
tibial branch of sciatic n.
fibular branch of sciatic n.
describe the lumbosacral plexus
Ventral rami of L1-S3
lumbar plexus L1-L4
Sacral L4-S3
What are the major branches of the lumbosacral plexus?
Femoral n. (L2-L4)
Obturator n. (L2-L4)
Gluteal nn. (L4-S2)
Sciatic n. (L4-S3)
pathway of sciatic n.
greater sciatic foramen inferior to piriformis muscle through posterior compartment of thigh
the sciatic n splits into?
tibial and common fibular nerves in posterior thigh
Superficial lymph drainage
superficial inguinal nodes! external iliac nodes
Deep lymph drainage
deep inguinal lymph nodes ! external iliac
gluteal lymph
gluteal nodes ! iliac nodes ! lumbar nodes
