Lecture 7: Gluteal Region & Thigh Flashcards
What is the lower limb held in place by?
Pelvic girdle
Bones of thigh and leg
Ossa Coxae
Femur
Patella
Tibia
Fibula
What type of joint is the hip?
Ball and socket
The hip jt is more stable than the shoulder - so, it is __________ mobile than shoulder
less
What does the hip joint receive its stability from?
- Bony architecture
- Ligaments
The hip joint capsule is strengthened by what 3 ligaments?
- Iliogemoral ligament
- Pubofemoral ligament
- Ischiofemoral ligament
Is the ligament to the head of the femur strong?
Not really
What does the artery to the head of the femur do?
Provides some (minimal) blood to head of femur
Where does most blood flow to the head and neck of the femur come from?
Medial + Lateral Circumflex Aa.
Hip dislocations are when the lower limb is _________________ rotated and appears __________.
Medially rotated
appears shorter
What is the classic characteristic of congenital hip dislocation?
Patient can’t ABDuct thigh
Congenital hip dislocation treatment
Harness or surgery
Acquired hip dislocation typically occurs when…
Thigh is flexed, adducted, and medially rotated
The femurs dislocate ___________ by rupturing through the capsule in an acquired hip dislocation
posteriorly
What nerve is most likely to be injured in an acquired hip dislocation?
Sciatic N
What makes up the lumbosacral plexus?
Anterior rami of L1-S4
What does the lumbosacral plexus innervate?
Lower limb, lower abdominal wall, pelvis/perineum
The lumbrosacral plexus consists of
-Lumbar plexus (L1-L4)
-Sacral plexus (L4-S4)
What N innervates anterior thigh muscles, skin on anterior & inferomedial thigh?
Femoral N
What N innervates medial thigh muscles, skin on upper medial thigh
Obturator N
What are the main nerves of the sacral plexus?
-Superior gluteal
-Inferior gluteal
-Sciatic [tibial, common fibular]
What N innervates adductors (Glut. med., glut. min., & TFL)
Superior gluteal N
What N innervates the gluteus maximus (primary extensor of thigh/hip)
Inferior gluteal N
What does the sciatic N split into?
Tibial N + Common Fibular N
What N innervates flexors of lower limb?
Tibial N
What N innervates extensors of leg?
Common fibular N
Describe the cutaneous innervation of the gluteal region.
Mixture of posterior and anterior rami
Gluteal regions muscles are innervated by ________________ rami.
Anterior
List the lateral rotators of the thigh [gluteal muscles, other]
Piriformis
Superior gemellus
Obturator internus
Inferior gemellus
Quadratus femoris
What makes up the sciatic N?
Anterior Rami L4-S3
Where would you give a gluteal intramuscular injection?
Upper lateral quadrant of buttock
Can you think of any NON-gluteal causes for sciatic?
Herniated disc
What are the boarders of the femoral triangle?
Base: inguinal ligament
Lateral border” sartorius muscle
Medial border: adductor longus
What are the contents of the femoral triangle?
Femoral NAVL
What is the femoral sheath?
Dense CT that covers the vessels and lymphatics.
Does the femoral sheath cover N?
NO
The femoral sheath divides into compartments. List them.
- Lateral (Artery)
- Intermediate (Vein)
- Medial (Lymphatics, Areolar CT, Fat)
AVL (no N)
Where do femoral hernias occur?
Femoral canal
What is the deep fascia of the thigh?
Fascia Lata
What is the IT Tract?
Thickening of the fascia lata on lateral side of thigh
What is the anterior thigh sompartmetn?
Hip flexors, extensors of knee
Medial compartment of thigh
ADDuctors of hip
Posterior compartment of thigh
Extensors of hip, flexors of knee
Lateral compartment of thigh
ABDuctor of hip
What is the blood supply to the posterior compartment of the thigh?
Deep Femoral A
The posterior compartment of the thigh innervation
Tibial division of sciatic nerve
Anterior compartment innervation
Femoral N
Medial thigh compartment innervation
Obturator N
Posterior thigh compartment innervation
Sciatic N
Posterior compartment muscles
Semitendinosus
Semimembranosus
Biceps Femoris, Long Head
Biceps Femoris, Short Head
Innervation of biceps femoris short head
Common fibular division
Only muscle in lateral compartment of thigh
TFL
TFL Innervation
Superior gluteal N
TFL action
ABDucts thigh
Anterior compartment of thigh - innervation, action, blood supply
Flexors of hip joint + Knee extensors
Innervation: Femoral N
Blood supply: femoral A
Anterior compartment muscles
Ilioposoas
Quadriceps Femoris
Rectus femoris, vastus lateralis, vastus intermedius, vastus medialis
sartorius
Medical compartment of thigh action
ADDuctors of thigh/hip
Medial compartment of thigh innervation
Obturator N (all but 2)
Medial compartment of thigh blood supply
Deep femoral A and obturator A
Medial thigh compartment muscles
Pectineus
Gracilis
Adductor Longus + Brevis
Adductor Magnus
Obturator externus
The thigh is primarily supplied by waht artery and its branches?
femoral artery
Venous drainage of the thigh
Femoral Vein
Great Saphenous Vein
