Lower dorsal regions Flashcards
What are the boundaries of the gluteal region?
- sup.: crista iliaca
- inf.: sulcus glutealis
- med.: crista sacralis lateralis
- lat.: perpendicular line from spina iliaca ant. sup.
List the layers of the gluteal region.
- skin
- thick subcutaneous adipose tissue (w/ imp. subcutaneous nn.)
- fascia, lat.: m. tensor fasciae latae
- m. gluteus max.
- conn. tissue w/ nn. + blood vessels
- middle muscle layer
- deep intermuscular space
- deep muscle layer
Which nerves can be found in the adipose tissue of the gluteal region?
Function?
- nn. clunium superiores
- nn. clunium medii
- nn. clunium inferiores
→ sensory innervation of gluteal region
Which muscles contribute to the middle muscle layer in the gluteal region?
- m. gluteus med.
- m. piriformis
- tendon of m. obturator int., flanked by
- mm. gemmeli (together = Austrian flag)
- m. quadratus femoris
Which muscles contribute to the deep muscle layer of the gluteal region?
- m. gluteus min.
- m. obturator ext. (= beneath m. quadratus fem.)
What are the boundaries of foramen ischiadicum majus?
Where does it lead to?
- cran.: iliosacral joint + lig. sacroiliacum ant.
- lat.: incisura ischiadica maj.
- med.: lig. sacrotuberale
- caud.: lig. sacrospinale, spina ischiadica
⇒ leads to lesser pelvis
M. piriformis divides foramen ischiadicum majus into 2 compartments.
Name + contents of upper compartment.
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)
Which a. is also called a. hypogastrica?
a. iliaca int.
M. piriformis divides foramen ischiadicum majus into 2 compartments.
Name + contents of lower compartment.
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)
What are the boundaries of foramen ischiadicum minus?
Where does it lead to?
- cran.: lig. sacrospinale
- caud.: lig. sacrotuberale
⇒ leads to perineum (fossa ischioanalis)
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.
a. circumflexa femoris med.
(from a. femoralis prof., from a. femoralis)
How do the pudendal structures pass through the pelvic diaphragm?
2 names.
How is this structure formed?
a., v. pudenda int. + n. pudendus
→ through canalis pudendalis = Alcock’s canal
formed by fascia of m. obturator int.
Which muscle fibers form m. adductor minimus?
uppermost horizontal fibers of m. adductor magnus
What are the boundaries of the post. femoral region?
- sup.: sulcus glutealis
- inf.: line 3 finger’s breadth above center of midpopliteal sulcus
- med., lat.: lat. + med. edges of thigh
List the layers of the post. femoral region.
- skin
- subcutaneous adipose tissue (subcut. nn. + vv.)
- fascia lata
- flexors of thigh
- conn. tissue layer btw flexors/adductors
- m. adductor magnus which forms the base of this region
List the flexors of the thigh.
Location?
- med.: m. semitendinosus, semimembranosus
- lat.: m. biceps femoris
Which structures can be found in the posterior femoral region?
-
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)
1 - 6
1) septum intermusculare lat.
2) m. biceps femoris
3) n. peroneus comm.
4) n. tibialis
5) m. semitendinosus
6) rr. perforantes a. prof. fem.
7 - 12
7) a. profunda femoris
8) m. semimembranosus
9) m. adductor magnus
10) m. gracilis
11) v. saphena magna
12) m. sartorius
13 - 18
2nd #16 to the right should be #18.
13) lamina vastoadductoria
14) a., v. femoralis
15) m. rectus femoralis
16) femur
17) m. vastus
18) tractus iliotibialis fasciae latae
What are the boundaries of the posterior genicular region?
- sup., inf.: 3 finger’s breadth above and below the midpopliteal groove
- med.: vertical line across epicondylus medialis
- lat.: vertical line across capitulum fibulae
List the layers of the posterior genicular region.
- skin
- subcutaneous adipose tissue
- fascia poplitea
- fossa poplitea
- floor of fossa poplitea
List the boundaries of fossa poplitea.
- sup. medially: m. semitendinosus, -membranosus
- sup. laterally: m. biceps femoris
- inf. med. + lat.: caput med. + lat. of m. gastrocnemius
Which structures form the floor of fossa poplitea?
- lower edge of m. adductor magnus + hiatus tendineus
- popliteal surface of femur
- fibreous capsule of knee joint
- m. popliteus
What is hiatus tendineus?
Another name.
Contents.
adductor hiatus
opening of canalis adductorius in tendineous insertion of m. adductor magnus
→ leads a. + v. femoralis to fossa poplitea
Which structures can be found in the posterior genicular region?
- 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)
Which structures insert in pes anserinus sup.?
- m. gracilis
- m. sartorius
- m. semitendinosus
<u>REMEMBER:</u> 3 > 1, hence 3 mm. inserting in pes anserinus sup. (> inf.)
Which structures insert in pes anserinus inf.?
only m. semimembranosus
What are the boundaries of the posterior crural region?
- sup.: transverse line 3 finger’s breadth below popliteal fold
- inf.: transverse line connecting the malleoli
- med., lat.: perpendicular lines through resp. malleoli
List the layers of the posterior crural region.
- skin
- subcutaneous conn./adipose tissue
- lamina superficialis of fascia cruris
- superf. flexor compartment
- lamina profunda of fascia cruris
- deep flexor compartment
Which structures can be found in the subcutaneous layer of the posterior crural region?
v. saphena parva + n. suralis
Which structures can be found “in” fascia cruris?
Explain.
a., vv. tibialis post., n. tibialis in duplicature of fascia cruris
Which muscles contribute to the superficial flexor compartment?
- triceps surae (2 heads of m. gastrocnemius + m. soleus)
- m. plantaris (= freshmen’s nerve)
Which muscles contribute to the deep flexor compartment?
List from medial to lateral.
from medial to lateral
- m. flexor digitorum long.
- m. tibialis post.
- m. flexor hallucis long.
Which structures can be found in the posterior crural region?
- 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)
What is canalis musculoperoneus?
Contents?
canal btw m. tibialis post. + m. flexor hallucis long./fibula
→ contains a. fibularis + n. canalis musculoperonei
Which structures form chiasma crurale?
tendon of m. flexor digitorum long. (superficially)
+
tendon of m. tibialis post.
1 - 6
1) a. fibularis
2) m. soleus
3) lamina profunda fasciae cruris
4) m. flexor hallucis longus
5) m. tibialis post.
6) m. soleus
7 - 12
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.
13 - 18
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.
19 - 23
19) septum intermusculare ant.
20) n. peroneus superficialis
21) mm. peronei
22) fibula
23) septum intermusculare post.
What are the boundaries of the lateral malleolar region?
- 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
List the layers of the lateral malleolar region.
- skin
- subcutaneous conn. tissue
- 2 ligamentous parts of fascia cruris:
* *retinaculum peroneorum sup. + inf.** - tendons of m. peroneus brev. (ant.) + long. (post.) together in a common synovial sheath
Which structures can be found in the lateral malleolar region?
- v. saphena parva (behind malleolus lat.)
- n. suralis
- a. malleolaris post. lat. (from a. fibularis)
- rr. calcaneales lat. (from a. fibularis)
What are the boundaries of the sole of the foot?
- ant.: skin folds at base of toes
- post., med., lat.: edges of sole and heel
List the layers of the sole of the foot (8).
Only refer to eminentia plantaris intermedia.
- skin
- subcutaneous adipose tissue
- aponeurosis plantae
- m. flexor digitorum brevis
- tendons of m. flexor digitorum long., m. quadratus plantae, mm. lumbricales
- deep conn. tissue space
-
back: plantar surface + ligg. of tarsal bones
* front:* m. adductor hallucis + mm. interossei - tendon of m. peroneus long.
Which structure forms aponeurosis plantae?
strong triangular part of fascia plantaris
What is special about the tendon of m. peroneus longus?
passes in own groove on os cuboideum surrounded by lig. plantare longum
Which structures can be found in the sole of the foot?
- 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
<u>NOTE:</u> analoy to hand
Which structures form arcus plantaris?
Origin of … ?
a. plantaris lat. + branch of a. dorsalis pedis (from a. tibialis ant.)
→ origin of aa. metatarsales plantares
List the tarsals from medial to lateral.
- med.: os cuneiforme med. + intermed. + lat.
- behind them: os navicularis
- lat.: os cuboideum
Which septa can be found in the sole of the foot?
Origin + insertion.
What is their function?
2 intermuscular septa originate from fascia plantaris
- septum interm. med. → first metatarsus
- septum interm. lat. → fifth metatarsus
⇒ divide foot into 3 compartments
What are the names of the 3 compartments of the foot?
- eminentia plantaris med. = corr. to thenar
- eminentia plantaris intermedia
- eminintae plantaris lat. = corr. to hypothenar
Which mm. contribute to eminentia plantaris med.?
- med.: m. abductor hallucis
- middle: m. flexor hallucis brevis
- deeply lat.: m. adductor hallucis, caput obliquum/transversum
NOTE: in comparison to hand: <u>opponens missing</u>
Which structure can be found btw the 2 heads of m. flexor hallucis brevis in the sole of the foot?
tendon of m. hallucis longus
Which mm. contribute to eminentia plantaris lat.?
- lat.: m. abductor digiti minimi
- next to it: m. opponens digiti minimi
- med.: m. flexor digiti minimi
<u>NOTE:</u> in comparison to hand: <u>adductor</u> missing
Which structures form the chiasma plantaris?
tendon of m. flexor digitorum long. (superficially)
+
tendon of m. flexor hallucis long.
What are the boundaries of the lumbar region?
- sup.: horizontal line connecting angulus scapulae inf. + plica axillaris post.
- inf.: crista iliaca
- med.: midline of trunk
- lat.: perpendicular lines along midaxillary line
List the layers of the lumbar region.
- skin
- m. latissimus dorsi + fascia thoracolumbalis
- m. erector spinae, m. obliquus abdominis int., m. transversus abdominis
- m. quadratus lumborum
Which structures can be found in the lumbar region?
rr. posteriores of nn. spinales
What are the boundaries of Petit’s triangle?
Content.
Clinical relevance?
- 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!)
Describe the structure of fascia thoracolumbalis.
“Content”?
lamina superficialis + profunda
→ in btw m. erector spinae
1 - 7
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
8 - 13
8) m. psoas major
9) aorta abdominalis
10) a. lumbalis
11) fascia thoracolumbalis lamina profunda
12) m. transversus abdominis
13) m. obliquus int. abdominis
