Lecture 1: Buttocks And Thigh Flashcards
4 gateways of neurovascular bundles in lower extremities
- Inguinal notch
- Greater sciatic
- Lower sciatic
- Obturator foramen
Superior and inferior boundaries of buttocks
Iliac crest (sup) Fold of buttocks (inf)
Cutaneous innervation of upper medial quadrant of buttocks
Posterior rami of the upper 3 LUMBAR NERVES and upper 3 SACRAL NERVES
Cutaneous innervation of upper lateral quadrant of buttocks
Lateral branches of iliohypogastric
Anterior rami of 12th thoracic nerves
Cutaneous innervation of lower lateral quadrant of buttocks
Lateral cutaneous nerve of the thigh (L2 and L3, anterior rami)
Cutaneous innervation of the lower medial quadrant
Posterior cutaneous nerve of the thigh (S1, S2, S3, anterior rami)
Cutaneous innervation of the skin over the coccyx
Lower sacral and coccygeal nerves
It is a group of lymph nodes where lymph vessels from buttocks drain
Lateral group of superficial inguinal nodes
2 fasciae found in buttocks
Superficial fascia
Deep fascia
The deep fascia of the thigh
Fascia lata
Thickened fascia along the lateral aspect of the thigh
Iliotibial tract
The muscle continuous with the superior border of the iliotibial tract
tensor fascia lata
The highest portion of the lower extremity
Iliac crest
3 bones of the hip bone
Ilium
Ischium
Pubis
- Point where the 3 bones of the hip bone meet
- Fossa where head of femur insert
Acetabulum
The inferior margin of the acetabulum
Acetabular notch
The floor of the acetabulum
Acetabular fossa
The joint formed by sacrum and articular surface of iliac
Sacroiliac joint
Articulation of pubis of the hip inferiorly
Symphysis pubis
6 important landmarks in the iliac ASIS
AIIS PSIS PIIS Iliac tubercle Iliac crest
Largest muscle in the body
Gluteus maximus
Locations of the 3 bursa associated with the gluteus maximus
- Between tendon of insertion and the greater trochanter
- Between tendon of insertion and vastus lateralis
- Overlying the ischial tuberosity
The muscle that is continuous with the iliotibial tract and assist the gluteus maximus in keeping the knee at extended position
Tensor fascia lata
Only muscle that passes through the greater sciatic foramen
Piriformis
Fan-shaped muscle that lies within the pelvis at its origin; muscle netween the gemellus inferior and superior
Obturator foramen
Muscle inferior to gemellus inferior
Quadratus femoris
Components of triceps coxae
Obturator internus
G. Superior
G. Inferior
Action of superficial gluteal muscles
Abductors and extenders
And also medial rotators for all except gluteus maximus, which assist in lateral rotation
These are the four superficial gluteal muscles
Gluteus maximus
Gluteus medius
Gluteus mininmus
Tensor fascia lata
Arterial supply for gluteus medius, tensor fascia lata and gluteus minimus
Superior gluteal artery
Arterial supply for gluteus maximus
Inferior gluteal artery
Action of deep gluteal muscles
Lateral rotators
These are the deep gluteal muscles
Piriformis
Obturator internus
Gemelli inferior and superior
Quadratus femoris
2 ligaments that support the sacroiliac joint
These ligaments prevent rotation of sacrum in the sacroiliac joint.
Sacrotuberous and sacrospinous ligaments
Structures or foramina formed by the sacrotuberous and sacrospinous ligaments
Greater and lesser sciatic foramen
Direction of structures that passes through the greater sciatic foramen
From pelvic to gluteal region
Direction of structures that passes through the lesser sciatic foramen
From gluteal region to perineum
Structures that passes through the lesser sciatic foramen
- Tendon of obturator internus
- Nerve to obturator internus
- Pudendal nerve
- Internal pudendal artery and vein
only nerve passing the greater sciatic foramen above the piriformis muscle
Superior gluteal nerve
Nerves that pass through the greater sciatic foramen below the piriformis
- Inferior gluteal nerves
- Sciatic nerve
- Post femoral cutaneous
- Pudendal nerve
supplies structures in the perineum
Pudendal nerve
Provides the main blood supply to the head of the femur
Trochanteric anastomosis
Components of trochanteric anastomosis
superior gluteal artery
inferior gluteal artery
medial femoral circumflex artery
lateral femoral circumflex artery
it is situated at the level of the lesser trochanter of the femur;
together with the trochanteric anastomosis, provides a connection between the internal iliac and femoral arteries
Cruciate anastomosis
What are the Arteries that take part in the cruciate anastomosis?
Inferior gluteal artery
Medial femoral circumflex artery
Lateral femoral circumflex artery
First perforating artery
A superficial fascia that extend into the thigh and continues down over the lower limb without interruption
Fatty layer of superficial fascia
A gap in the fascia in friont of the thigh just below the inguinal ligament. It is where the femoral vein and saphenous vein diverge
Fossa ovalis or saphenous opening
The lower lateral margin of the saphenous opening which lies anterior to the femoral vessels
Falciform margin
Loose connective tissue in the saphenous opening
Cribriform fascia
The longest vein
Saphenous vein
Saphenous vein starts at the ———
Foot
The first segment of great saphenous vein drains at the ——
Median dorsal venous arch
What vessel is found superficial to median malleolus?
Great saphenous
What are the 3 tributaries of the great saphenous vein in the saphenous opening?
Superficial circumflex iliac vein
Superficial epigastric vein
Superficial external pudendal vein
What vessel is used for venous cutdown and coronary bypass surgery?
Great saphenous vein
What are the two main groups of lymph nodes in the lower limb?
Deep and superficial
Horizontal group of superficial inguinal nodes receive lymph vessels from what areas?
- Anterior wall below the umbilicus
- Back portion below the iliac crest, buttocks
- External genitalia
- Urethra
- Lower half of anal canal
Vertical group of superficial inguinal nodes receive lymph vessels from what areas?
- Lower limbs
The inguinal group which is under the deep fascia.
It lies along the medial side of femoral vein.
It passes through the femoral canal to join the nodes along the exterior iliac vessels.
Deep inguinal nodes
Three fascial compartments of the thigh.
Medial
Anterior
Posterior
A structure that divides the thigh into three compartments.
Linea aspera
Longest muscle of the thigh
Sartorius
Most superficial muscle of the anterior thigh
Sartorius
A muscle in the thigh that covers the femoral artery.
Sartorius
Strongest flexor of the thigh
Iliopsoas
An important antigravity postural muscles for erect posture
Iliopsoas
Biggest muscle of the body
Quadriceps femoris group
Which is stronger, hamstring or quadriceps?
Quadriceps
Arterial supply of anterior thigh.
Femoral artery
Nerve supply of anterior thigh
Femoral nerve
Femoral artery starts at ——- and ends at ——-, to become ———artery.
Inguinal ligament
Adductor hiatus
Popliteal
The 6 branches of femoral artery
Superficial circumflex iliac artery
Superficial epigastric (supplies region of umbilicus)
Superficial external pudendal artery
Deep external pudendal artery
Profunda femoris (largest branch)
Descending genicular artery (most distal)
Femoral vein becomes ——- vein after passing through the ———-.
Popliteal vein
adductor hiatus
The largest branch of lumbar plexus which supplies anterior thigh muscles
Femoral nerve
- not included in the femoral sheath
- passes laterally from psoas muscle and then downward between psoas and iliacus muscle
3 borders of femoral triangle
Inguinal ligament (at the superior) Adductor longus (at the medial side) Sartorius (at the lateral side)
Floor of the femoral triangle
Iliopsoas
Pectineus
Adductor longus
Roof of the femoral triangle
Fascia lata
Contents of the femoral triangle
NAVEL
Femoral sheath is continuous above with ——- fascia in the abdominal wall.
Transversalis fascia
Upper opening of femoral canal.
Femoral ring
A condensation of extraperitoneal tissue that closes the femoral canal
Femoral septum
Contents of femoral canal
Fatty connective tissue
Lymph vessels from deep inguinal nodes
Node of cloquet
Other name for adductor canal
Subsartorial canal (because it is under the sartorius muscle)
Boundaries of the adductor canal.
Roof: sartorius
Floor: add longus and magnus
Lateral: vastus medialis
———- do not pass through the adductor hiatus
Nerves
Annopening in the tendon of adductor magnus
Adductor hiatus
Weakest, most medial, long slender muscle in the medial compartment of the thigh.
Gracilis
Triangular muscle that has both adductor and hamstring part.
Adductor magnus
A large artery that branch out laterally from femoral artery
Profunda femoris
A branch of internal iliac artery
Obturator artery
Two nerves that run medially from the psoas muscle
Obturator nerve and genitofemoral nerve
Blood supply of the medial thigh
Profunda femoris ( its perforating branch supplies the posterior compartment) and obturator artery
Nerve supply of medial thigh
Obturator nerve
Criteria for hamstring muscles
Origin in ischial tuberosity
Insertion in either fibula or tibia
Nerve supply must be from tibial portion of sciatic nerve
Posterior thigh muscle that is not part of the hamstring muscle
Biceps femoris short head
Nerve supply of biceps femoris short head
Common peroneal branch of sciatic nerve
Boundaries of the popliteal fossa
Semitendosus semi membranosus
Biceps femoris
Heads of gastrocnemius
Contents of popliteal fossa
Popliteal artery and vein
Tibial nerve
Common peroneal nerve
