Hip, Gluteal Region, & Thigh Flashcards
Functions of the lower extremities
Weight support
Locomotion
Maintain balance
3 bones of the pelvis
Ilium
Ischium
Pubis
Hip socket
Acetabulum
Name of the hip joint
Coxal joint
Articulate surface of acetabulum
Lunate surface
C-shaped cartilage around the acetabulum
Acetabular labrum
These two things enclose the acetabular joint
Acetabular labrum
Transverse acetabular ligament
Connects head of the femur to acetabulum
Round ligament
Round ligament carries which vessel to the femoral head?
A branch of the obturator nerve
What would happen if you damaged the branch of the obturator nerve to the femoral head?
Avascular necrosis - no other supply to the femoral head
Connects AIIS to intertrochanteric line; prevents hyperextension of the hip
Iliofemoral ligament
Connects the ischial part of the acetabular rim to the femoral neck
Ischiofemoral ligament
Connects the pubic bone to the joint capsule and iliofemoral ligament; prevents overabduction
Pubofemoral ligament
What 3 ligaments spiral to become taut with hip extension to keep the femoral head in the acetabulum?
Iliofemoral ligament
Pubofemoral ligament
Ischiofemoral ligament
Subcutaneous tissue deep to the skin that contains loose connective tissue, fat, cutaneous nerves, veins, lymphatics
Superficial fascia
Deep fascia of the leg contains which important structures?
Iliotibial tract
Fascia lata
What are the 3 components of the leg separates by?
Intermuscular septa
What are the superficial veins of the lower limb and where are they located?
Great saphenous vein (medial)
Small saphenous vein (posterior)
Where to the great and small saphenous veins drain into?
Femoral vein
What dermatomes correspond to the anterior and medial part of the limb?
L1-L5
What dermatomes correspond to the posterior aspect of the limb?
S1 & S2
What are the hip flexors?
Iliopsoas
Pectineus
Sartorius
What are the knee extensors?
Quadriceps femoris
Origin of iliopsoas
Iliac fossa
Lumbar vertebrae
Insertion of iliopsoas
Lesser trochanter of femur
Origin of sartorius
ASIS (anterior superior iliac spine)
Insertion of sartorius
Medial tibia
Actions of sartorius
Flex, abduct, and laterally rotate hip
Flex knee
Origin of pectineus
Superior ramus of pubis
Insertion of pectineus
Pectineus line of femur
Action of pectineus
Hip adduction, flexion, and medial rotation
What are the knee extensors?
Quadriceps femoris:
Rectus femoris
Vastus lateralis
Vastus medialis
Vastus intermedius
The patellar tendon reflex tests which nerve and spinal levels?
Femoral
L2-L4
What nerve innervates the anterior thigh muscles?
Femoral nerve
What nerve innervates the medial thigh muscles? What are the exceptions?
Obturator nerve
Adductor magnus - tibial nerve
What are the muscles of the medial compartment?
Adductor longus Adductor brevis Adductor magnus Gracilis Obturator externus
What are the muscles of the posterior compartment?
Biceps femoris
Semitendinosus
Semimembranosus
What are the muscles of the anterior compartment?
Sartorius Rectus femoris Vastus lateralis Vastus medialis Vastus intermedius Pectineus Iliopsoas
Origin of adductor muscles
Ischial tuberosity
Insertion of adductor muscles
Femoral shaft
What is the role of the adductor hiatus?
Transmits femoral artery/vein from anterior to posterior
What nerve innervates the posterior thigh muscles? What are the exceptions?
Tibial division of the sciatic nerve
Short head of biceps femoris - common fibular nerve
What is a clinical use for the gracilis?
Gracilis transplant - its a small, thin muscles that can be removed without much notice; used to replace damaged muscles elsewhere
Common area of hernias
Femoral triangle
What are the boundaries of the femoral triangle?
Inguinal ligament (superior) Sartorius (lateral) Adductor longus (medial)
What passes through the femoral triangle?
NAVL:
Femoral nerve
Femoral artery
Femoral vein
Lymphatics
What does the femoral sheath enclose?
Femoral artery, femoral vein, and lymphatics
NOT the femoral nerve
What happens if you press on the pubis?
Compression of the femoral artery
What is the level of the iliac crests?
L4/L5
What are the two pelvic ligaments that convert the sciatic notches into foramina?
Sacrotuberous ligament
Sacrospinous ligament
Action of pectineus
Flexion of hip
Adduction of hip
What muscle “locks” your hips?
Tensor fascia lata
Action of adductor longus
Adduction of hip
Flexion of hip
Action of adductor magnus
Anterior head: adduction/flexion of hip
Posterior head: adduction/extension of hip
Action of adductor brevis
Adduction of hip
Flexion of hip
Action of pectineus
Adduction of hip
Flexion of hip
Origin of gluteus maximus
Posterior sacrum
Posterior ilium
Insertion of gluteus maximus
IT band
Gluteal tuberosity of femur
Blood supply of gluteus maximus
Inferior gluteal artery
Superior gluteal artery
Nerve supply of gluteus maximus
Inferior gluteal nerve
Action of gluteus maximus
Extension of hip
External rotation of extended hip
Action of tensor fascia lata
Stabilizes extended knee
Flexion of hip
ABduction of hip
Internal rotation of hip
Nerve supply of tensor fascia lata
Superior gluteal nerve
Blood supply of tensor fascia lata
Superior gluteal artery
Origin of tensor fascia lata
Anterior iliac crest
Insertion or tensor fascia lata
IT band
Origin of gluteus medius
Ilium
Iliac crest
Insertion of gluteus medius
Greater trochanter of femur
Origin of gluteus minimus
Ilium
Insertion of gluteus minimus
Greater trochanter of femur
Blood supply of gluteus minimus
Superior gluteal artery
Blood supply of gluteus medius
Superior gluteal artery
Nerve supply of gluteus medius
Superior gluteal nerve
Nerve supply of gluteus minimus
Superior gluteal nerve
Action of gluteus medius
ABduction of hip
Internal rotation of hip
Action of gluteus minimus
ABduction of hip
Internal rotation of hip
A positive trendenlenburg sign indicates a lesion of what?
The superior gluteal nerve on the contralateral side
What are the lateral rotators of the thigh?
Piriformis Superior gemellus Inferior gemellus Obturator internus Quadratus femoris
Origin of piriformis
Sacrotuberous ligament
Insertion of piriformis
Greater trochanter of femur
Action of piriformis
External rotation of hip
Blood supply of piriformis
Superior and inferior gluteal arteries
Nerve supply of piriformis
Superior and inferior gluteal nerves
Origin of superior gemellus
Ischial spine
Insertion of superior gemellus
Trochanteric fossa
Origin of obturator internus
Pubis and obturator membrane
Insertion of obturator internus
Trochanteric fossa of femur
Origin of inferior gemellus
Ischial tuberosity
Insertion of inferior gemellus
Trochanteric fossa
Origin of quadratus femoris
Ischial tuberosity
Insertion of quadratus femoris
Intertrochanteric crest
What are the 3 gluteal bursae?
Trochanteric bursa
Ischial bursa
Gluteofemoral bursa
What comes out superiorly to piriformis? Inferiorly?
Superiorly: superior gluteal artery/vein
Inferiorly: inferior gluteal artery/vein, sciatic nerve
Best site for intramuscular injections?
Upper lateral quadrant; avoids major vessels/nerves
What are the muscles of the posterior compartment?
Hamstrings: Semitendinosus Semimembranosus Biceps femoris long head Biceps femoris short head
What are the functions of the muscles in the posterior compartment?
Hip extensors, knee flexors
Origin of semitendinosus
Ischial tuberosity
Origin of semimembranosus
Ischial tuberosity
Origin of biceps femoris short head
Lines aspera
Origin of biceps femoris long head
Ischial tuberosity
Insertion of semimembranosus
Posterior medial tibial condyle
Insertion of semitendinosus
Proximal medial tibial shaft via pes anserinus
Insertion of biceps femoris
Lateral aspect of head of fibula
Lateral condyle of tibia
Innervation of semitendinosus
Tibial division of sciatic nerve
Innervation of semimembranosus
Tibial division of sciatic nerve
Innervation of biceps femoris long head
Tibial division of sciatic nerve
Innervation of biceps femoris short head
Common fibular division of the sciatic nerve
What are the major branches of the lumbosacral plexus and their nerve roots? What part of the thigh/hip do they innervate?
Femoral nerve: L2-L4 (anterior thigh)
Obturator nerve: L2-L4 (medial thigh)
Gluteal nerve: L4-S2 (gluteal region)
Sciatic nerve: L4-S3 (posterior thigh, leg, foot)
What motor and sensory innervation does the sciatic nerve provide?
Motor: posterior thigh, leg, foot
Sensory: skin of lateral leg and all of foot
What passes through the greater sciatic foramen?
Sciatic nerve, under the piriformis
Where do the lymphatics of the leg dump into?
Femoral triangle
Blood supply of gracilis
Femoral profunda artery
Nerve supply of gracilis
Obturator nerve
Action of gracilis
ADDuction of hip
Flexion of knee
Internal rotation of flexed knee
