Lower dorsal regions

Question 1

What are the boundaries of the gluteal region?

Answer 1

• sup.: crista iliaca
• inf.: sulcus glutealis
• med.: crista sacralis lateralis
• lat.: perpendicular line from spina iliaca ant. sup.

Question 2

List the layers of the gluteal region.

Answer 2

1. skin
2. thick subcutaneous adipose tissue (w/ imp. subcutaneous nn.)
3. fascia, lat.: m. tensor fasciae latae
4. m. gluteus max.
5. conn. tissue w/ nn. + blood vessels
6. middle muscle layer
7. deep intermuscular space
8. deep muscle layer

Question 3

Which nerves can be found in the adipose tissue of the gluteal region?

Function?

Answer 3

• nn. clunium superiores
• nn. clunium medii
• nn. clunium inferiores

→ sensory innervation of gluteal region

Question 4

Which muscles contribute to the middle muscle layer in the gluteal region?

Answer 4

• m. gluteus med.
• m. piriformis
• tendon of m. obturator int., flanked by
• mm. gemmeli (together = Austrian flag)
• m. quadratus femoris

Question 5

Which muscles contribute to the deep muscle layer of the gluteal region?

Answer 5

• m. gluteus min.
• m. obturator ext. (= beneath m. quadratus fem.)

Question 6

What are the boundaries of foramen ischiadicum majus?

Where does it lead to?

Answer 6

• cran.: iliosacral joint + lig. sacroiliacum ant.
• lat.: incisura ischiadica maj.
• med.: lig. sacrotuberale
• caud.: lig. sacrospinale, spina ischiadica

⇒ leads to lesser pelvis

Question 7

M. piriformis divides foramen ischiadicum majus into 2 compartments.

Name + contents of upper compartment.

Answer 7

foramen suprapiriforme
→ VAN

• v. glutealis sup. (from v. iliaca int., from v. cava)
• a. glutealis sup. (from v. iliaca int.)
• n. glutealis sup. (from plexus ischiadicus)

Question 8

Which a. is also called a. hypogastrica?

Answer 8

a. iliaca int.

Question 9

M. piriformis divides foramen ischiadicum majus into 2 compartments.

Name + contents of lower compartment.

Answer 9

foramen infrapiriforme

• n. ischiadicus (from plexus ischiadicus) +
• *a. comitans n. ischiadici** (from a. glutealis inf.)
• n. cutaneus femoralis post. (from plexus sciaticus)
• v., a. pudenda int. (from a., v. iliaca int.)
• n. pudendus (from plexus pudendus)
• v., a. n. glutealis inf. (from a., v. iliaca int., plexus sacralis)

Question 10

What are the boundaries of foramen ischiadicum minus?

Where does it lead to?

Answer 10

• cran.: lig. sacrospinale
• caud.: lig. sacrotuberale

⇒ leads to perineum (fossa ischioanalis)

Question 11

Which vessel can be seen in the gluteal region whose branches

• enter btw m. gemellus inf. - m. quadratus fem.
• enter btw m. quadratus fem. - m. adductor mag.

Answer 11

a. circumflexa femoris med.

(from a. femoralis prof., from a. femoralis)

Question 12

How do the pudendal structures pass through the pelvic diaphragm?

2 names.

How is this structure formed?

Answer 12

a., v. pudenda int. + n. pudendus

→ through canalis pudendalis = Alcock’s canal
formed by fascia of m. obturator int.

Question 13

Which muscle fibers form m. adductor minimus?

Answer 13

uppermost horizontal fibers of m. adductor magnus

Question 14

What are the boundaries of the post. femoral region?

Answer 14

• sup.: sulcus glutealis
• inf.: line 3 finger’s breadth above center of midpopliteal sulcus
• med., lat.: lat. + med. edges of thigh

Question 15

List the layers of the post. femoral region.

Answer 15

1. skin
2. subcutaneous adipose tissue (subcut. nn. + vv.)
3. fascia lata
4. flexors of thigh
5. conn. tissue layer btw flexors/adductors
6. m. adductor magnus which forms the base of this region

Question 16

List the flexors of the thigh.

Location?

Answer 16

• med.: m. semitendinosus, semimembranosus
• ​lat.: m. biceps femoris

Question 17

Which structures can be found in the posterior femoral region?

Answer 17

• n. ischiadicus (plexus ischiadicus)
  → branches here into n. tibialis + n. peroneus communis
• n. cutaneus femoralis post. (plexus ischiadicus)
• a. perforans prima, sec., tert. (from a. femoralis prof., from a. femoralis)
• Giacomini v. (from v. saphena parva, from v. poplitea)

Question 18

1 - 6

Answer 18

1) septum intermusculare lat.
2) m. biceps femoris
3) n. peroneus comm.
4) n. tibialis
5) m. semitendinosus
6) rr. perforantes a. prof. fem.

Question 19

7 - 12

Answer 19

7) a. profunda femoris
8) m. semimembranosus
9) m. adductor magnus
10) m. gracilis
11) v. saphena magna
12) m. sartorius

Question 20

13 - 18

2nd #16 to the right should be #18.

Answer 20

13) lamina vastoadductoria
14) a., v. femoralis
15) m. rectus femoralis
16) femur
17) m. vastus
18) tractus iliotibialis fasciae latae

Question 21

What are the boundaries of the posterior genicular region?

Answer 21

• sup., inf.: 3 finger’s breadth above and below the midpopliteal groove
• med.: vertical line across epicondylus medialis
• lat.: vertical line across capitulum fibulae

Question 22

List the layers of the posterior genicular region.

Answer 22

1. skin
2. subcutaneous adipose tissue
3. fascia poplitea
4. fossa poplitea
5. floor of fossa poplitea

Question 23

List the boundaries of fossa poplitea.

Answer 23

• sup. medially: m. semitendinosus, -membranosus
• sup. laterally: m. biceps femoris
• inf. med. + lat.: caput med. + lat. of m. gastrocnemius

Question 24

Which structures form the floor of fossa poplitea?

Answer 24

• lower edge of m. adductor magnus + hiatus tendineus
• popliteal surface of femur
• fibreous capsule of knee joint
• m. popliteus

Question 25

What is hiatus tendineus? Another name. Contents.

Answer 25

_adductor hiatus_ opening of canalis adductorius in tendineous insertion of m. adductor magnus → leads **a. + v. femoralis** to fossa poplitea

Question 26

Which structures can be found in the posterior genicular region?

Answer 26

* **a., v. politea** (from a., v. femoralis) * **v. saphena parva** (from v. poplitea) * **n. peroneus communis** (from n. ischiadicus) * **n. tibialis** (from n. ischiadicus) * **n. cutaneus surae lat.** (from n. peroneus comm.) * **n. cutaneus surae med.** (from n. tibialis) * **aa. geniculares sup./inf. med./lat.** (from a. poplitea)

Question 27

Which structures insert in pes anserinus sup.?

Answer 27

* **m. gracilis** * **m. sartorius** * **m. semitendinosus** _{​REMEMBER: 3 > 1, hence 3 mm. inserting in pes anserinus sup. (> inf.)}

Question 28

Which structures insert in pes anserinus inf.?

Answer 28

_only_ **m. semimembranosus**

Question 29

What are the boundaries of the posterior crural region?

Answer 29

* *_sup.:_* transverse line 3 finger's breadth below popliteal fold * *_inf.:_* transverse line connecting the malleoli * *_med., lat.:_* perpendicular lines through resp. malleoli

Question 30

List the layers of the posterior crural region.

Answer 30

1. **skin** 2. subcutaneous conn./adipose **tissue** 3. **lamina superficialis** of fascia cruris 4. **superf. flexor compartment** 5. **lamina profunda** of fascia cruris 6. **deep flexor compartment**

Question 31

Which structures can be found in the subcutaneous layer of the posterior crural region?

Answer 31

**v. saphena parva + n. suralis**

Question 32

Which structures can be found "in" fascia cruris? Explain.

Answer 32

**a., vv. tibialis post., n. tibialis** in duplicature of fascia cruris

Question 33

Which muscles contribute to the superficial flexor compartment?

Answer 33

* **triceps surae** (2 heads of m. gastrocnemius + m. soleus) * **m. plantaris** (= freshmen's nerve)

Question 34

Which muscles contribute to the deep flexor compartment? List from medial to lateral.

Answer 34

from medial to lateral * **m. flexor digitorum long.** * **m. tibialis post.** * **m. flexor hallucis long.**

Question 35

Which structures can be found in the posterior crural region?

Answer 35

* **v. saphena parva** (from v. poplitea) * **n. cutaneus surae lat.** (from n. peroneus comm.) * **n. cutaneus surae med.** (from n. tibialis) * **n. suralis** (from previous 2) * **n. tibialis** (from n. ischiadicus) * **a. tibialis post.** (from a. poplitea) * **vv. tibialis post.** * **a. fibularis** (from a. tibialis post.) * **n. canalis musculoperonei** (from n. tibialis)

Question 36

What is canalis musculoperoneus? Contents?

Answer 36

canal btw m. tibialis post. + m. flexor hallucis long./fibula → contains **a. fibularis** + **n. canalis musculoperonei**

Question 37

Which structures form chiasma crurale?

Answer 37

tendon of **m. flexor digitorum long.** (superficially) + tendon of **m. tibialis post.**

Question 38

#1 - 6 #2 = #6

Answer 38

1) a. fibularis 2) m. soleus 3) lamina profunda fasciae cruris 4) m. flexor hallucis longus 5) m. tibialis post. 6) m. soleus

Question 39

#7 - 12 #8 refers to 2 structures.

Answer 39

7) m. gastrocnemius 8) v. saphena parva + n. suralis 9) n. tibialis 10) a. tibialis post. 11) v. saphena magna 12) m. flexor digitorum long.

Question 40

#13 - 18 #15 refers to 2 structures.

Answer 40

13) tibia 14) membrana interossea 15) a. tibialis ant. + n. peroneus prof. 16) m. tibialis ant. 17) m. extensor hallucis long. 18) m. extensor digitorum long.

Question 41

#19 - 23

Answer 41

19) septum intermusculare ant. 20) n. peroneus superficialis 21) mm. peronei 22) fibula 23) septum intermusculare post.

Question 42

What are the boundaries of the lateral malleolar region?

Answer 42

* *_sup.:_* transverse line 1 finger's breadth above level of malleolus lat. * *_inf.:_* lateral edge of sole of foot * *_ant._**_:_* line drawn along ant. border of fibula as far as top of malleolus lat., continued as arched line to tuberosity of fifth metacarpal * *_post.:_* midline of leg

Question 43

List the layers of the lateral malleolar region.

Answer 43

1. **skin** 2. subcutaneous conn. **tissue** 3. 2 ligamentous parts of fascia cruris: * *retinaculum peroneorum sup. + inf.** 4. tendons of **m. peroneus brev.** (ant.) **+ long.** (post.) together in a common synovial sheath

Question 44

Which structures can be found in the lateral malleolar region?

Answer 44

* **v. saphena parva** (behind malleolus lat.) * **n. suralis** * **a. malleolaris post. lat.** (from a. fibularis) * **rr. calcaneales lat.** (from a. fibularis)

Question 45

What are the boundaries of the sole of the foot?

Answer 45

* *_ant.:_* skin folds at base of toes * *_post., med., lat.:_* edges of sole and heel

Question 46

List the layers of the sole of the foot (8). Only refer to eminentia plantaris intermedia.

Answer 46

1. **skin** 2. subcutaneous adipose **tissue** 3. **aponeurosis plantae** 4. **m. flexor digitorum brevis** 5. **tendons** of m. flexor digitorum long., m. quadratus plantae, mm. lumbricales 6. **deep conn. tissue** space 7. *back:* plantar surface + ligg. of tarsal bones * front:* m. adductor hallucis + mm. interossei 8. **tendon of m. peroneus long.**

Question 47

Which structure forms aponeurosis plantae?

Answer 47

strong triangular part of **fascia plantaris**

Question 48

What is special about the tendon of m. peroneus longus?

Answer 48

passes in own groove **on os cuboideum surrounded by lig. plantare longum**

Question 49

Which structures can be found in the sole of the foot?

Answer 49

* **a. plantaris med.**, **lat.** (from a. tibialis post.) * **n. plantaris med.**, **lat.** (from n. tibialis) * **arcus plantaris** * **nn. digitales plantares communes** (from nn. plnatares med./lat.) **+ nn. digitales plantares proper** * **aa. digitales plantares communes + aa. digitales plantares propriae** _{NOTE: analoy to hand}

Question 50

Which structures form arcus plantaris? Origin of ... ?

Answer 50

**a. plantaris lat.** + branch of **a. dorsalis pedis** (from a. tibialis ant.) → origin of aa. metatarsales plantares

Question 51

List the tarsals from medial to lateral.

Answer 51

* *med.:* **os cuneiforme med. + intermed. + lat.** * *behind them:* **os navicularis** * *lat.:* **os** **cuboideum**

Question 52

Which septa can be found in the sole of the foot? Origin + insertion. What is their function?

Answer 52

2 intermuscular septa originate from **fascia plantaris** * **​**septum interm. med. → **first metatarsus** * septum interm. lat. → **fifth metatarsus** ⇒ divide foot into 3 compartments

Question 53

What are the names of the 3 compartments of the foot?

Answer 53

* **eminentia plantaris med.** = corr. to thenar * **eminentia plantaris intermedia** * **eminintae plantaris lat.** = corr. to hypothenar

Question 54

Which mm. contribute to eminentia plantaris med.?

Answer 54

* *_med.:_* **m. abductor hallucis** * *_middle:_* **m. flexor hallucis brevis** * *_deeply lat.:_* **m. adductor hallucis****,** caput obliquum/transversum __NOTE:_ _{in comparison to hand: opponens missing}

Question 55

Which structure can be found btw the 2 heads of m. flexor hallucis brevis in the sole of the foot?

Answer 55

tendon of **m. hallucis longus**

Question 56

Which mm. contribute to eminentia plantaris lat.?

Answer 56

* *_lat.:_* **m. abductor digiti minimi** * *_next to it:_* **m. opponens digiti minimi** * *_med.:_* **m. flexor digiti minimi** _{NOTE: in comparison to hand: adductor missing}

Question 57

Which structures form the chiasma plantaris?

Answer 57

tendon of **m. flexor digitorum long.** (superficially) + tendon of **m. flexor hallucis long.**

Question 58

What are the boundaries of the lumbar region?

Answer 58

* *_sup.:_* horizontal line connecting angulus scapulae inf. + plica axillaris post. * *_inf.:_* crista iliaca * *_med.:_* midline of trunk * *_lat.:_* perpendicular lines along midaxillary line

Question 59

List the layers of the lumbar region.

Answer 59

1. *_​_***skin** 2. m. latissimus dorsi + **fascia thoracolumbalis** 3. m. erector spinae, m. obliquus abdominis int., m. transversus abdominis 4. m. quadratus lumborum

Question 60

Which structures can be found in the lumbar region?

Answer 60

**rr. posteriores** of nn. spinales

Question 61

What are the boundaries of Petit's triangle? Content. Clinical relevance?

Answer 61

* *_sup.:_* m. latissimus dorsi * *_lat.:_* m. obliquus ext. abdominis * *_inf.:_* crista iliaca * *_floor:_* m. obliquus int. abdominis → contains a. lumbalis (from aorta abdominalis) ⇒ site of **lumbar hernia** (rare!)

Question 62

Describe the structure of fascia thoracolumbalis. "Content"?

Answer 62

lamina superficialis + profunda → in btw **m. erector spinae**

Question 63

#1 - 7

Answer 63

1) m. obliquus ext. abdominis 2) m. latissimus dorsi 3) m. quadratus lumborum 4) rr. dorsales a. lumbalis 5) fascia thoracolumbalis lamina superficialis 6) r. spinalis 7) m. erector spinae

Question 64

#8 - 13

Answer 64

8) m. psoas major 9) aorta abdominalis 10) a. lumbalis 11) fascia thoracolumbalis lamina profunda 12) m. transversus abdominis 13) m. obliquus int. abdominis