LE: Muscles Flashcards
What are the muscles of the gluteal region?
Gluteus maximus Gluteus medius Gluteus minimus Tensor fasciae latae Piriformis Obturator internus Superior gemelius Inferior gemelius Quadratus femoris
- Is a membranous, deep fascia covering muscles of the thigh and forms the lateral and medial intermuscular septa by its inward extension to the femur.
- Is attached to the pubic symphysis, pubic crest, pubic rami, ischial tuberosity, inguinal and sacrotuberous ligaments, and the sacrum and coccyx.
Fascia Lata
- Is a thick lateral portion of the fascia lata.
- Provides insertion for the gluteus maximus and tensor fasciae latae muscles.
- Helps form the fibrous capsule of the knee joint and is important in maintaining posture and locomotion.
Iliotibial Tract
What is the unique structure that pass through lesser sciatic foramen?
obturator internus tendon
What structures exit through both lesser and grater sciatic foramen?
pudendal nerve,
internal pudendal vessels,
nerve to the obturator internus
What structures exit through the lesser sciatic foramen?
tendon of the obturator internus,
nerve to the obturator internus,
internal pudendal vessels and pudendal nerve
What structures exit through greater sciatic foramen?
piriformis muscle,
superior and inferior gluteal vessels and nerves,
internal pudendal vessels and pudendal nerve,
sciatic nerve,
posterior femoral cutaneous nerve,
nerves to the obturator internus and quadratus femoris muscles
It extends from the ischial spine to the lower sacrum and coccyx. It converts the greater sciatic notch into greater sciatic foramen.
Sacrospinous ligament
It extends from the ischial tuberosity to the posterior iliac spines, lower sacrum and coccyx. Together with the sacrospinous ligament, it converts the lesser sciatic notch into the lesser sciatic foramen.
Sacrotuberous ligament
It is a waddling gait characterized by the pelvis falling (or drooping) toward the unaffected side when the opposite leg is raised at each step. It results from paralysis of the gluteus medius muscle, which normally functions to stabilize the pelvis when the opposite foot is off the ground.
Gluteal gait (gluteus medius limp)
Where is the common site for intramuscular injection of medications to avoid injury to the underlying sciatic nerve and other neurovascular structures?
superior lateral quad rant of the gluteal region
What are the posterior muscles of thigh?
Semitendinosus
Semimembranosus
Biceps femoris
What are the anterior muscles of the thigh?
Iliacus Sartorius Rectus femoris Vastus medialis Vastus lateralis Vastus intermedius
It may result from forcible flexion of the hip with the knee extended.
Avulsion of the ischial tuberosity (the origin of the hamstrings)
These are very painful and common in persons who are involved in running, jumping, and quick-start sports.
Hamstring injuries or strains (pulled or torn hamstrings)
It is seen in a fracture of the femoral neck, dislocated hip joint (head of femur), or weakness and paralysis of the gluteus medius (abductor). If the right gluteus medius muscle is paralyzed, the left side (sound side) of the pelvis falls (sags) instead of rising, normally, the pelvis rises.
Positive Trendelenburg sign
Pain in the lower back and hip that radiates down the back of the thigh and into the lower back.
Sciatica
It is a condition in which the piriformis muscle irritates and places pressure on the sciatic nerve, causing pain in the buttocks and referring pain along the course of the sciatic nerve.
Piriformis syndrome
Borders of Femoral triangle
Superior: inguinal ligament
Lateral: sartorius muscle
Medial: adductor longus muscle
Floor and roof of Femoral triangle
Floor: iliopsoas, pectineus, adductor longus muscles
Roof: Fascia lata, cribriform fascia
order of structures in the femoral triangle (in the canal)
femoral NAVeL
lateral to medial order of femoral canal contents
NAVy
Where is pulsation of femoral artery felt?
inferior to the midpoint of inguinal ligament
Abdominal opening of femoral canal
femoral ring
Boundaries of femoral ring
Anterior: inguinal ligament
Lateral: femoral vein
Medial: lacunar ligament
Posterior: pectineal ligament
- Lies medial to the femoral vein in the femoral sheath.
- Contains fat, areolar connective tissue, and lymph nodes and vessels.
- Transmits lymphatics from the lower limb and perineum to the peritoneal cavity.
Femoral canal
Is a potential weak area and a site of femoral herniation, which occurs most frequently in women because of the greater width of the superior pubic ramus of the female pelvis
Femoral canal
- Is formed by a prolongation of the transversalis and iliac fasciae in the thigh.
- Reaches the level of the proximal end of the saphenous opening with its distal end.
Femoral sheath
Lateral, intermediate, and medial compartment of femoral sheat
Lateral: Femoral artery
Intermediate: Femoral vein
Medial: Femoral canal
Femoral sheath contents
- femoral artery and vein,
- femoral branch of the genitofemoral nerve,
- femoral canal. (The femoral nerve lies outside the femoral sheath, lateral to the femoral artery.
- Begins at the apex of the femoral triangle and ends at the adductor hiatus (hiatus tendineus).
- Lies between the adductor magnus and longus muscles and the vastus medialis muscle, and is covered by the sartorius muscle and fascia.
Adductor canal
Adductor canal contents
- femoral vessels,
- saphenous nerve,
- nerve to the vastus medialis,
- descending genicular artery.
- Is the aperture in the tendon of insertion of the adductor magnus.
- Allows the passage of the femoral vessels into the popliteal fossa.
Adductor Hiatus (Hiatus Tendineus)
- Is an oval gap in the fascia lata below the inguinal ligament that is covered by the cribriform fascia, which is a part of the superficial fascia of the thigh.
- Provides a pathway for the greater saphenous vein.
Saphenous Opening (Saphenous Hiatus) or Fossa Ovalis
It is a strain, stretching, or tearing of the origin of the flexor and adductor of the thigh and often occurs in sports that require quick starts such as a 100-m dash and football.
Groin injury or pulled groin
It is a reflex twitch of the triceps surae (i.e., the medial and lateral heads of the gastrocnemius and the soleus muscles) induced by tapping the tendo calcaneus. It causes plantar flexion of the foot and tests its reflex center in the L5 to S1 or S1 to S2 segments of the spinal cord. Both afferent and efferent limbs of the reflex arc are carried in the tibial nerve.
Ankle-jerk (Achilles) reflex
It occurs when the patellar ligament is tapped, resulting in a sudden contraction of the quadriceps femoris. It tests the L2 to L4 spinal (femoral) nerves by activating muscle spindle in the quadriceps. Both afferent and efferent impulses are transmitted in the femoral nerve.
Knee-jerk (patellar) reflex
It is a sense of restless unpleasant discomfort inside the legs when sitting or lying down, accompanied by an irresistible urge to move the legs. Movement like walking brings temporary relief, but it is worse at rest and in the evening or at night. Its cause is unknown (idiopathic).
Restless legs syndrome
It is a condition of limping caused by ischemia of the muscles in the lower limbs, chiefly the calf muscles, and is seen in occlusive peripheral arterial diseases particu larly in the popliteal artery and its branches. The main symptom is leg pain that occurs during walking and intensifies until walking is impossible, but the pain is relieved by rest
Intermittent claudication
It is a sudden, involuntary, painful contraction of muscles of the lower limb. It is caused by muscle fatigue from prolonged sitting, overexertion, dehydration, and de pletion or imbalance of salt and minerals (electrolytes) as well as a poor blood supply to leg muscles. It occurs most commonly in the calf muscle, hamstrings, and quadriceps. The cramp goes away within a few minutes, or it can be treated by a gentle stretch and massage of the cramped muscle, pain relievers, and muscle relaxers.
Muscle cramp (“charley horse”)
It is a painful condition caused by swollen muscles in the anterior compartment of the leg along the shin bone (tibia), particularly the tibialis anterior muscle, following athletic overexertion. It may be a mild form of the anterior compartment syndrome.
Shin splint
It is an ischemic necrosis of the muscles of the anterior compartment of the leg, resulting from compression of the anterior tibial artery and its branches by swollen muscles following excessive exertion. It is accompanied by extreme tenderness and pain on the anterolateral aspect of the leg.
Anterior tibial compartment syndrome
Is the combined tendinous expansions of the sartorius, gracilis, and semitendinosus muscles at the medial border of the tuberosity of the tibia. It may be used for surgical repair of the anterior cruciate ligament of the knee joint.
Pes Anserinus
Floor of popliteal fossa
femur
oblique popliteal ligament
popliteus muscle
Boundaries of popliteal fossa
Superomedially: semitendinosus and semimembranosus muscles
Superolaterally: biceps muscle
Inferolaterally: lateral head of the gastrocnemius and plantaris muscles
inferomedially: medial head of gastrocnemius muscle
It may occur in horseback riders and produce pain because the riders adduct their thighs to keep from falling from the animal.
Muscle strains of the adductor longus
It is a relatively weak member of the adductor group of muscles, and thus surgeons often transplant this muscle or part of it, with nerve and blood vessels, to replace a damaged muscle in the hand. The proximal muscle attachments are in the inguinal region or groin.
Gracilis
It is more common in women than in men, passes through the femoral ring and canal, and lies lateral and inferior to the pubic tubercle and deep and inferior to the inguinal ligament; its sac is formed by the parietal peritoneum. Strangulation of a femoral hernia may occur because of the sharp, stiff boundaries of the femoral ring, and the strangula tion interferes with the blood supply to the herniated intestine, resulting in death of the tissues.
Femoral hernia
