Leg - Proximal Flashcards
Region name for anterior knee
Genual region
Greater and lesser trochanters
are sites for muscle attachments,
and are separated by the
_______ posteriorly
and ______ anteriorly
intertrochanteric crest; intrerotreric line
Distally, the ____ and ____
epicondyles are the attachment
sites for ligaments of the knee
medial; lateral
Superiorly, it’s base of the patella is
attached to the ____
quadriceps tendon
Inferiorly, its apex of the patella is attached to the
_____
patellar ligament
ligaments that strengthen the hip joint capsule (spiral arrangement)
Iliofemoral*, pubofemoral, and ischiofemoral ligaments
A fibrocartilaginous acetabular labrum attached
to the acetabular rim _____ the joint
deepens
branches of the internal iliac artery that supply the lower limb
○ Superior gluteal artery
○ Inferior gluteal artery
○ Obturator artery
The Obturator artery exits the pelvis anteriorly through the obturator foramen to supply the ____
medial thigh
The femoral artery travels with the _
femoral vein, and femoral nerve
At the adductor hiatus, the femoral artery
becomes the _____
popliteal artery
What two arteries exit through the greater sciatic
foramen to supply the gluteal region
○ Superior gluteal artery
○ Inferior gluteal artery
The branches of the femoral artery that supply
the lower limb
○ Superficial circumflex iliac artery
○ Superficial epigastric artery
○ External pudendal arteries (superficial and deep)
○ Descending genicular artery
deep artery of the thigh
The _____ is the largest branch of the femoral artery and branches off in the proximal thigh
deep artery of the thigh
The popliteal artery is the continuation of
the _____
femoral artery
Anastomosis of the knee includes these vessels
○ Medial superior genicular artery
○ Lateral superior genicular artery
What is the cruciate anastomosis?
○ Medial and lateral circumflex femoral arteries
○ 1st perforating artery
○ Inferior gluteal artery
Follow the drainage of the genicular veins to the IVC
Genicular > popliteal > femoral > external iliac > common iliac > IVC
The medial and lateral circumflex femoral
veins drain into the _____
deep vein of the thigh
Both the superior and inferior gluteal
veins pass through the _____ and empty into the internal iliac vein
greater sciatic foramen
The obturator vein passes through
the the greater sciatic foramen and empties into the _____
internal iliac vein
Superficial veins are located in the ____, and drains to deep venous system and ultimately femoral vein
subcutaneous tissue
Largest superficial vein
Great Saphenous vein
Venous drainage is assisted by
● Presence of valves in the veins
● Pulsing of the accompanying arteries
● Contraction of the surrounding muscles
Nerves of the lumbar plexus
● Iliohypogastric nerve (L1): Skin upper lateral thigh and inguinal region
● Ilioinguinal nerve (L1): Skin upper anterior thigh
● Genitofemoral nerve (L1-2): Skin over upper thigh
● Lateral femoral cutaneous nerve (L2-3): Skin lateral thigh
Nerve that Innervates muscles of the anterior
thigh
Femoral nerve
What nerve Innervates muscles of the medial
compartment
Obturator nerve
Nerves of the sacral plexus
● Superior gluteal nerve (L4-S1): Enters above piriformis muscle, and supplies
abductors of the hip
● Inferior gluteal nerve (L5-S3): Enters inferior to the piriformis muscle, and innervates the gluteus maximus
● Posterior femoral cutaneous nerve of the thigh (L1-S3): Sensory nerve to thigh and posterior perineum
The two nerves diverging from the sciatic nerve
Tibial nerve
Common fibular nerve
Illiopsoas muscle
O: Psoas on spinal column T12-L4; Illiacus on iliac fossa
I: Lesser trochanter of the femur
I: Psoas by lumbar plexus; illiacus by femoral nerve
A: Flexion and external rotation of the hip
Gluteus Maximus
O: sacrum and thoracolumbar
fascia
I: Upper fibers insert into IT tract
(band), and lower fibers to the gluteal
tuberosity.
I: Inferior gluteal nerve
A: Extends and externally rotates the hip.
Gluteus Medius
O: ilium
I: great trochanter of the
femur.
I: superior gluteal nerve
A: abduct and stabilize the hip
tensor fasciae latae
O: anterior superior iliac spine
I: IT tract
I: superior gluteal nerve
A: abducts the hip, and aids in flexion, and internal rotation of the hip.
______ is the tough band of tissue that
encloses the muscles of the thigh.
Fascia Lata
_____ is inflammation and tendonitis along
the IT tract.
Iliotibial band syndrome
gluteus minimus
O: ilium
I: greater trochanter of the femur
I: superior gluteal nerve
A: Anteriorly the muscle flexes and, internal rotates the hip. Posteriorly it acts on extension and external rotation of the hip
Piriformis
O: sacrum
I: greater trochanter of the femur
I: sacral plexus
A: Action of external rotation, abduction, and extension.
Obturator Internus
O: inner surface of the obturator membrane
I: medial surface greater trochanter.
I: branches of the sacral plexus
A: externally rotate and adduct the hip
Quadratus femoris
O: lateral border of the ischial tuberosity
I: intertrochanteric crest of the femur
I: branches of the sacral plexus
A: externally rotate and adduct the hip joint
Gemeli
O: has two origins, the superior on the ischial spine and inferior to ischial tuberosity.
I: obturator internus tendon.
I: branches of the sacral plexus
A: externally rotate and adduct the hip
Sartorius
O: ASIS
I: medial aspect of the tibial tuberosity.
I: Femoral nerve
A: hip flexion, abduction, external rotation.
Quadriceps Femoris - 4 parts (& what is their innervation and insertion?)
Rectus femoris
Vastus medialis
Vastus lateralis
Vastus intermedius
*all innervated by the femoral nerve, and all
insert into the tibial tuberosity
Rectus Femoris
O: anterior inferior iliac spine.
A: hip flexion and knee extension.
Vastus medialis
O: linea aspera
I: medial aspect of the tibial tuberosity.
A: knee extension.
Vastus lateralis
O: linea aspera and greater trochanter
I: lateral aspect of the tibial tuberosity
A: is knee extension.
Vastus intermedius
O: femoral shaft
A: knee extension.
Medial compartment muscles
Pectineus
Adductor longus
Adductor brevis
Gracilis
Obturator externus
Adductor magnus
Anterior compartment muscles
Sartorius
Quadriceps femoris (4 parts)
Posterior compartment muscles
Biceps femoris
Semimembranosus
Semitendinosus
Borders of the femoral triangle
○ Inguinal ligament – superiorly
○ Adductor longus – medially
○ Sartorius muscle – laterally
Pectineus
O: pecten pubis
I: pectineal line of the femur.
I: femoral and obturator nerves.
A: adduction, external rotation and to stabilize the pelvis
Adductor longus
O: superior pubic rami
I: medial femur
I: Obturator nerve
A: hip adduction and flexion up to 70 degrees.
Adductor brevis
O: inferior pubic rami
I: Femur
I: Obturator Nerve
A: hip adduction and flexion up to 70
degrees.
Gracilis
O: inferior pubic rami
I: medial aspect of the tibial tuberosity.
I: Obturator nerve
A: hip adduction and flexion, with
some knee flexion and internal rotation
Obturator externus
O: outer surface of obturator membrane
I: trochanteric fossa of the femur.
I: Obturator nerve
A: hip adduction, external rotation, and
stabilization of the the hip.
Adductor magnus
O: inferior pubic rami, ischial ramus and tuberosity
I: medial femoral linea spine to the adductor tubercle.
I: deep by obturator nerve and superficial by tibial nerves
A: adduction, extension, slight flexion, and stabilization of the hip.
Biceps femoris (long and short head)
Long Head
O: ischial tuberosity and sacrotuberous ligament.
I: head of the fibula.
I: Tibial nerve
A: hip extension and knee
flexion and external rotation.
Short head
O: lateral aspect of the linea aspera.
I: head of the fibula
I: common fibular nerve
A: knee flexion and external rotation.
Semimembranosus
O: ischial tuberosity
I: medial tibial condyle.
I: tibial nerve
A: extension and stabilization of the hip. Flexion and internal rotation of the knee.
Semitendinosus
O: ischial tuberosity and sacrotuberous
ligament.
I: medial tibial tuberosity of the pes anserinus.
I: tibial nerve
A: extension and stabilization of the hip.
Flexion and internal rotation of the knee.
