lecture final Flashcards
Leg Summary
1. Three compartments:
- Three nerves:
a. Anterior – Deep Peroneal Nerve
b. Posterior – Tibial Nerve
c. Lateral – Superficial Peroneal Nerve
Compartments a. Anterior b. Posterior c. Lateral Nerves a. Anterior – Deep Peroneal Nerve b. Posterior – Tibial Nerve c. Lateral – Superficial Peroneal Nerve
Thigh Summary
1. 4 compartments
- Innervated by:
Compartments a. Anterior - Quadriceps b. Posterior -- Hamstrings c. Medial – Adductors d. Lateral (small compartment) – TFL Nerves a. Anterior – Femoral (L2, L3, L4) b. Posterior – Sciatic (L4 - S3) c. Medial – Obturator (L2, L3, L4) d. Lateral – Tensor Fascia Lata – Superior gluteal nerve (L4, L5)
Tibialis posterior
Deep Posterior Compartment of Leg
O: interosseous membrane, posterior surface of tibia inferior to soleal line, and posterior surface of fibula
I: tuberosity of the navicular, cuneiform, and cuboid bones, and bases of 2nd, 3rd, & 4th metatarsal bones
A: plantar flexes and inverts foot
N: tibial nerve (L4 & L5)
Flexor Digitorum longus
Deep Posterior Compartment of Leg
O: medial part of posterior surface of tibia, inferior to soleal line, and by a broad aponeurosis to fibula
I: bases of distal phalanges of lateral 4 digits
A: flexes lateral 4 digits and plantar flexes foot; supports longitudinal arch of foot
N: tibial nerve (S2 & S3)
Flexor hallucis longus
Deep Posterior Compartment of Leg
O: inferior 2/3 of posterior surface of fibula and inferior part of interosseous membrane
I: base of distal phalanx of great toe
A: flexes great toe at all joints and plantar flexes foot; supports longitudinal arch of foot
N: tibial nerve (S2 & S3)
Popliteus
Deep Posterior Compartment of Leg
O: lateral surface of lateral condyle of femur and lateral meniscus
I: posterior surface of tibia, superior to soleal line
A: weakly flexes knee and unlocks it
N: tibial nerve (L4, L5, & S1)
Plantaris
Posterior Compartment of Leg
O: inferior end of lateral supracondylar line of femur and oblique popliteal ligament
I: tendo calcaneus
A: weakly assists the gastrocnemius in plantar flexion and flexing the knee joint
N: tibial nerve (S1 & S2)
Soleus
Posterior Compartment of Leg
O: posterior aspect of head of fibula, superior 1⁄4 of posterior surface of fibula, soleal line, and medial border of tibia
I: posterior surface of calcaneus via tendo calcaneus
A: plantar flexion of foot; steadies leg on foot
N: tibial nerve (S1 & S2)
Gastrocnemius (Lateral and Medial heads)
Posterior Compartment of Leg
O: lateral head – lateral aspect of lateral condyle of femur; medial head – popliteal surface of femur, superior to medial condyle
I: posterior surface of calcaneus via tendo calcaneus
A: plantar flexion of foot; raises heel during walking, and flexes the knee joint
N: tibial nerve (S1 & S2)
Fibularis brevis
**Lateral Compartment of Leg **
O: inferior2/3ofthe lateral surface of the fibula
I: dorsal surface of tuberosity on lateral side of the base of 5th metatarsal bone
A: foot eversion and weak plantar flexion
N: superficial fibular (peroneal) nerve (L5, S1, & S2)
Fibularis Longus
**Lateral Compartment of Leg **
O: head and superior 2/3 of the lateral surface of the fibula
I:base of 1st metatarsal bone and medial cuneiform bone
A: footeversionand weak plantar flexion
N: superficialfibular (peroneal) nerve (L5, S1, & S2)
Fibularis tertius
**Anterior Compartment of Leg **
O: lower 1/3 of the anterior surface of the fibula and the interosseus membrane
I: medialside of the dorsal aspect of the base of the fifth metatarsal bone
A: dorsiflexes the foot; everts the foot
N: deep peroneal nerve (L4, L5)
Extensor Hallucis longus
**Anterior Compartment of Leg **
O: middle half of the anterior surface of the fibula and from the interosseous membrane
I: base of the distal phalanx of the great toe
A: extends the big toe and dorsiflexes the foot; also assists in inversion of the foot
N: deep peroneal nerve (L4,L5)
Extensor digitorum longus
**Anterior Compartment of Leg **
O: upper2/3ofthe anterior surface of the fibula and from the interosseous membrane
I: extensor expansion of the lateral 4 toes
A: extends the toes and dorsiflexes the foot at the ankle joint
N: deep peroneal nerve (L4, L5)
Tibialis Anterior
**Anterior Compartment of Leg **
O: upper half of the lateral surface of tibia and from the interosseous membrane
I: medial cuneiform bone and the adjoining base of the first metatarsal bone
A: dorsiflexes the foot at the ankle joint and inverts the foot at the subtalar and transverse tarsal joints; it assists in holding up the medial longitudinal arch of the foot
N: deep peroneal (fibular) nerve (L4,L5)
Femoral Triangle Boundaries: 1. Superior: 2. Medial: 3. Lateral: 4. Floor: 5. Roof:
- Superior: inguinal ligament
- Medial: adductor longus muscle
- Lateral: sartorius muscle
- Floor: iliopsoas and pectineus mm
- Roof: fascia lata, subcutaneous tissue
Femoral Triangle
Contents: (NAVL from lateral to medial)
- Femoral nerve and branches (Muscular, articular, and cutaneous). Saphenous nerve= terminal cutaneous nerve branch.
- Femoral sheath and contents:
a. Femoral artery and several of its terminal branches
b. Femoral vein and its proximal tributaries (e.g. the great saphenous and deep femoral veins)
c. Deep inguinal lymph nodes and associated lymphatic vessels.
Biceps femoris (long head and short head)
**Posterior Compartment (Hamstrings) of Thigh **
O: long head – ischial tuberosity; short head: linea aspera and lateral supracondylar line of femur
I: lateral side of head of fibula; tendon is split at this site by fibular collateral ligament of the knee
A: flexes leg and rotates it laterally when knee is flexed; extends thigh
N: long head - tibial division of sciatic nerve (L5, S1, & S2); short head – common fibular (peroneal) division of sciatic nerve (L5, S1, & S2)
Semimembranosus
**Posterior Compartment (Hamstrings) of Thigh **
O: ischial tuberosity
I: posterior part of medial condyle of tibia; reflected attachment forms oblique popliteal ligament (to the lateral femoral condyle)
A: extend thigh; flex leg and rotate it medially when knee is flexed
N: tibial division of sciatic nerve (L5, S1, & S2)
Semitendinousus
**Posterior Compartment (Hamstrings) of Thigh **
O: ischial tuberosity
I: medial surface of superior part of tibia
A: extend thigh; flex leg and rotate it medially when knee is flexed
N: tibial division of sciatic nerve (L5, S1, & S2)
Obturator externus
**Medial Compartment of Thigh **
O: margins of obturator foramen and outer surface of obturator membrane
I: trochanteric fossa of the femur
A: laterally rotates the thigh; steadies head of femur in acetabulum
N: obturator nerve (L3 & L4)
Gracilis
**Medial Compartment of Thigh **
O: body and inferior ramus of pubis
I: superior part of medial surface of tibia
A: adducts thigh, flexes leg, and helps rotate it medially
N: obturator nerve (L2 & L3)
Adductor Magnus
**Medial Compartment of Thigh **
O: adductor part – inferior ramus of pubis, ramus of the ischium; hamstrings part: ischial tuberosity
I: adductor part – gluteal tuberosity, linea aspera, medial supracondylar line; hamstrings part: adductor tubercle
A: adducts thigh
N: obturator nerve, posterior division (L2, L3, & L4); tibial division of sciatic nerve (L4)
Adductor brevis
**Medial Compartment of Thigh **
O: body and inferior ramus of pubis
I: pectineal line and proximal part of linea aspera
A: adducts the thigh and to some extent flexes it
N: obturator nerve, branch of anterior division (L2, L3, & L4)
Adductor Longus
**Medial Compartment of Thigh **
O: body of pubis inferior to pubic crest
I: middle third of linea aspera
A: adducts the thigh
N: obturator nerve, branch of anterior division (L2, L3, & L4)
Tensor Fascia Lata (can be seen as lateral compartment)
** Lateral Compartment of the Thigh**
O: ASIS and anterior part of iliac crest
I: iliotibial tract that attaches to the lateral condyle of the tibia
A: primarily flexes the thigh; also abducts, medially rotates thigh; helps to keep knee extended; steadies trunk on thigh
N: superior gluteal nerve (L4 & L5)
Articularis Genu (derivative of vastus intermedius)
**Anterior Compartment of Thigh **
O: inferior part of anterior aspect of femur
I: synovial membrane of the knee joint and wall of the suprapatellar bursa
A: pulls the synovial capsule superiorly during extension of the leg, thereby preventing folds of the capsule being compressed between the femur and the patella within the knee joint
N:Femoral nerve (L2, L3, & L4)
What Muscles make up the quadriceps?
rectus femoris, vastus lateralis, vastus medialis, and vastus intermedius make up the quadriceps.
Vastus intermedius (Quadriceps)
**Anterior Compartment of Thigh **
O: anterior and lateral surfaces of body of femur
I: base of patella and by patellar ligament to tibial tuberosity
A: extend leg at knee joint
N: femoral nerve (L2, L3, & L4)
Vastus Medialis (Quadriceps)
**Anterior Compartment of Thigh **
O: intertrochanteric line and medial lip of linea aspera of femur
I: base of patella and by patellar ligament to tibial tuberosity
A: extend leg at knee joint
N: femoral nerve (L2, L3,& L4)
– This muscle has two portions: longus (VML) & oblique (VMO)
Vastus lateralis (Quadriceps)
**Anterior Compartment of Thigh **
O: greater trochanter and lateral lip of linea aspera
I: base of patella and by patellar ligament to tibial tuberosity
A: extend leg at knee joint
N: femoral nerve (L2, L3, & L4)
Rectus femoris (Quadriceps)
**Anterior Compartment of Thigh **
O: AIIS and ilium superior to acetabulum
I: base of patella and by patellar ligament to tibial tuberosity
A: extend leg at knee joint; also steadies hip joint and helps iliopsoas to flex thigh
N: femoral nerve (L2, L3, & L4
Sartorius
**Anterior Compartment of Thigh **
O: ASIS and superior part of notch inferior to it
I: superior part of medial surface of tibia
A: flexes, abducts, and laterally rotates thigh at hip joint; flexes leg at knee joint
N: femoral nerve (L2 & L3)
Iliacus
**Anterior Compartment of Thigh **
O: iliac crest, iliac fossa, ala of sacrum, anterior SI ligaments
I: tendon of psoas major, lesser trochanter, and femur distal to it
A: flexing thigh at hip joint and stabilizing it
N: femoral nerve (L2 & L3)
Psoas Minor
**Anterior Compartment of Thigh **
O: sides of T12-L1 vertebrae and disc in between
I: pectineal line, iliopectineal eminence
A: may assist in flexion of trunk; of minor importance
N: ventral rami of lumbar nerves (L1& L2)
Psoas Major
**Anterior Compartment of Thigh **
O: sides of T12-L5 vertebrae and discs in between; TPs of all lumbar vertebrae
I: lesser trochanter of femur
A: flexing thigh at hip joint and stabilizing it
N: ventral rami of lumbar nerves (L1, L2, & L3)
Pectineus
**Anterior Compartment of Thigh **
O: superior ramus of pubis
I: pectineal line of femur
A: adducts and flexes the thigh; assists with Medial rotation of the thigh
N: femoral nerve (L2 & L3)
Sensory to the right Butt Cheek
Superior Lateral- VR- Iliohypogastric (L1)
Inferior Lateral- VR- Lateral Femoral cutaneous (L2,3)
Superior Medial- DR- superior cluneal(L1,2,3) and Middle Cluneal (S1,2,3)
Inferior Medial- VR- Posterior femoral cutaneous (S1,S2,S3 aka inferior cluneal)
Gluteus Maximus
O- Posterior illiac crest, posterior surface of the sacrum, coccyx, sacrotuberous ligament
I- Illiotibial tract, gluteal tuberosity of femur
A- extension at hip joint, laterally rotates hip,
N- Inferior Gluteal nerve (L5, S1, S2)
B- sup. and inf. gluteal a.a.
Gluteus Medius
O- gluteal surface of the ilium
I- lateral aspect of the greater trochanter
A- abducts and medially rotates at hip joint
N- superior Gluteal nerve (L5, S1)
B- Superior Gluteal a.a.
Gluteus Minimus
O- Gluteal surface of illium I- anterior aspect of greater trochanter A- abducts and medially rotates at hip joint N- superior gluteal nerve (L5, S1) B- Superior gluteal a.a.
Piriformis
O- anterior surface of the sacrum
I- superior aspect of greater trochanter
A- abducts thigh in flexion, lateral rotation in extension
N- sacral plexus (VR S1, S2) nerve to the piriformis
B- superior and inferior gluteal a.a. and internal pudendal a.a.
Quadratus Femoris
O- ischial tuberosity
I- quadrate tubercle on intratrochanteric crest
A- lateral rotation of the thigh
N- nerve to the quadratus femoris (L5, S1)
B- Inferior gluteal a.a.
Obturator Internus
O- obturator membrane and inferior surface of obturator foramen
I- medial surface of the greater trochanter
A- Lateral rotation of extended thigh, abducts flexed thigh
N- nerve to the obturator internus (L5, S1)
B-obturator a.a.
Superior and inferior Gemellus
O- superior- ischial spine
inferior- Ischial tuberosity
I- medial aspect of greater trochanter
A- lateraly rotates extended thigh, abducts flexed thigh
N-sup.-nerve to obturator internus (L5 S1)
inf.- nerve to quadratus femoris (L5 S1)
B- Inferior Gluteal a.a.
Tensor Fascia Latte (TFL)
O- Illiac crest posterior to ASIS
I- Iliotibial tract (IT band)
A- fexes the hip, medially rotates hip, abduxts hip
N- Superior Gluteal (L4, 5, S1)
B- lateral circumflex femoral artery, superior gluteal artery
Anterior compartment of thigh is all innervates by femoral nerve except
Psoas major and minor, VR of lumbar nerves L123
TFL is considered anterior compartment of thigh but has a different nerve
Superior gluteal L45
Medial compartment of thigh is innervated by obturator nerve except
Adductor Magnus which has posterior division of obturator nerve and tibial division of the sciatic, making it a composite muscle
Posterior compartment of thigh is innervated by the tibial division of the sciatic except
Short head of the biceps femoris which is innervated by common fibular (peroneal) division of sciatic L5 S1,2