Lower Extremity 1 Flashcards
Iliofemoral Ligament (Y-Ligament)
largest ligament of hip, anterior, resists extension (especially standing)
Pubofemoral Ligament
anterior inferior- resists abduction
ischiofemoral ligament
posterior, resists extension and medial rotation
Ligamentum teres
attaches to foves capitis of femur head
provides pathway for acetabular branch of obturator artery
Hip Flexors
iliopsas
rectus femoris
sartorius
Hip Adduction
pectineus adductor longus adductor brevis adductor magnus gracilis
Hip Abduction
gluteus minimus
gluteus medius
TFL
Hip Extension
gluteus maximus
biceps femoris (long head)
medial hamstrings
-semimembranosus
-semitendinosusExternal Rotation of Hip
piriformis superior gemellus obtrurator internus inferior gemellus quadratus femoris obturator externus
gluteus maximus
biceps femoris
sartorius
Internal Rotation of Hip
gluteus minimus
gluteus medius
TFL
medial hamstrings
-semimembranosus
-semitendinosus6 Lateral Rotators
piriformis superior gemellus obturator internus inferior gemellus quadratus femoris obturator externus
Psoas Major
P = T12-L5 vertebrae and discs; transverse processes of all lumbar vertebrae D = lesser trochanter N = ventral rami of lumbar nerves (L1,L2, L3 A = flex thigh at hip, also can have influence on posture of pelvis in weight bearing
Psoas Minor
P = T12-L5 vertebrae and discs D = Pectineal line, iliopectineal eminence via iliopectineal arch N = Ventral rami of lumbar nerves (L1 and L2) A = maybe some stability in pelvis but no direct influence on hip motion
Illiacus
P = iliac crest, iliac fossa, ala of sacrum, and anterior SI ligaments D = tendon of psoas major, lesser trochanter and femur distal to it N = Femoral N (L2, L3) A = flex thigh at hip, also can have influence on posture of pelvis in weight bearing
Tensor of Fasciae Latae
P = ASIS and anterior part of iliac crest D = iliotibial tract that attaches to lateral tibial condyle N = Superior gluteal N (L4 and L5) A = Abducts, medially (internally) rotates and flexes thigh; helps to kept knee extended; steadies trunk on thigh
Sartorius
P = ASIS and superior part of notch inferior to it D = superior part of medial surface of tibia N = Femoral N (L2 and L3) A = Flexes, abducts, and laterally (externally) rotates thigh at hip; flexes leg at knee joint,
Rectus Femoris
P = AIIS and ilium superior to acetabulum D = Base of patella and by ligament to tibial tuberosity N = Femoral (L2, L3, and L4) A = extends knee joint; also slightly flexes the hip
Vastus Lateralis
P = Greater trochanter and latral lip of linea aspera of femur D = Base of patella and by ligament to tibial tuberosity N = Femoral (L2, L3, and L4) A = extends knee joint
Vastus Medialis
P = Intertrochanteric line and medial lip of linea aspera of femur D = Base of patella and by ligament to tibial tuberosity N = Femoral (L2, L3, and L4) A = extends knee joint
Vastus Intermedius
P = Anterior and lateral surfaces of body of femur D = Base of patella and by ligament to tibial tuberosity N = Femoral (L2, L3, and L4) A = extends knee joint
Contents of the Femoral Triangle
Femoral Vein Femoral Artery Femoral Nerve Profunda femoris artery profunda femoris vein inguinal lymph nodes
Boundaries of Adductor Canal
Anterior & Laterally–> vastus medialis
Posterior–> adductor longus and adductor magnus
Medial–> sartorius
Contents of Adductor Canal
femoral artery
femoral vein
saphenous nerve
nerve to vastus medialis
Femoral Artery
in adductor canal, enters posterior knee region known as popliteal fossa
provides blood supply to leg/foot
Deep Femoral Artery
major artery that suppplys thigh
Lateral Femoral Circumflex
provide blood to hip
Medial femoral circumflex
provide blood to hip
Great Saphenous Vein
ascends along medial legs–>drains into femoral vein
Small Saphenous Vein
ascends along posterior leg and drains into popliteal vein in popliteal fossa
Pectineus
P = superior ramus of pubis D = pectineal line of femur, just inferior to lesser trochanter N = femoral N (L2 and L3; may receive branch from obturator N A = adducts and flexes thigh; assists with medial rotation
Adductor Longus
P = body of pubis inferior to public crest D = middle 1/3 of linear aspera of femur N = obturator N, branch of ant division (L2, L3, and L4) A = adducts thigh
Adductor Brevis
P = body and inferior ramus of pubis D = pectineal line and proximal part of linea aspera of femur N = Obturator N (L2, L3, and L4) branch of ant division A = adducts thigh and some flexion as well
Adductor Mangus
P = adductor part: inferior ramus of pubis, ramus of ischium; hamstring part: ischial tuberosity
D = adductor part: gluteal tuberosity, linea aspera, medial supracondylar line; Hamstrings part;adductor tubercle of femur
N = adductor part: obturator N (L2, L3, and L4), branches of posterior division ; Hamstrings part: tibial part of sciatic nerve (L4)
A = adducts thigh; adductor part: flexes thigh, Hamstrings part extends thigh
Distal attachment forms an arch known as adductor hiatus (femoral artery & vein pass posterior through the hiatus)
Gracilis
P = body of inferior ramus of pubis D = superior part of medial surface of tibia N = Obturator N (L2 and L3) A = adducts thigh, flexes leg, and helps to rotate leg medially
Obturator Externus
P = margins of obturator foramen and obturator membrane D = trochanteric fossa of femur N = Obturator N (L3 and L4) A = laterally rotates thigh; steadies head of femur in acetabulum
Sciatic Nerve
tibial and common fibular components, exits pelivs through greater sciatic foreman, descends down the posterior thigh
Superior Gluteal nerve
exits through greater sciatic foramen superior to piriformis
motor–> gluteus medius, gluteus minimus and TFL
Inferior Gluteal
exits through sciatic foramen inferior to piriformis
motor supply–>gluteus maximus
Nerve to obturator internus
supplies obturator unternus and superior gamellus
Nerve to quadratus femoris
supplies quadratus femoris and inferior gemellus
Pudendal nerve
pass through greater sciatic foramen–> SUPPLIES NO STRUCTURE IN GLUTEAL REGION
supplies perineal muscles
Biceps Femoris (long head)
P = Ischial tuberosity D = lateral side of head of fibula; tendon is split by fibular collateral knee ligament N = tibial division of sciatic N (L5, S1, S2) A = Flexes leg and rotates it laterally when knee flexed; extends thigh at hip joint
Biceps Femoris (short head)
P = Linear aspera and lateral supracondylar line of femur D = lateral side of head of fibula; tendon is split by fibular collateral knee ligament N = Common fibular (peroneal) division of sciatic N (L5, S1, S2) A = Flexes leg and rotates it laterally (IT DOES NOT HAVE A DIRECT EFFECT ON THE HIP)
Semitendinosus
P = Ischial tuberosity D = Medial surface of superior part of tibia N = Tibial division of sciatic N (L5, S1, S2) A = Extend thigh; flex leg and rotate it medially with knee flexed
Semimembranosus
P = Ischial tuberosity D = Posterior part of medial tibial condyle; reflective attachment forms oblique popliteal ligament (to lateral femoral condyle) N = Tibial division of sciatic N (L5, S1, S2) A = Extend thigh; flex leg and rotate it medially with knee flexed
Popliteal Fossa Boundaries
Superolaterally–> biceps femoris
Superomedially–> semimembransosus and semitendinosus
Inferiorly–> 2 heads of the gastrocnemius
Roof–> skin and fascia
Floor–> popliteal surface of the femur, oblique popliteal ligament, expansion of the semimbransous tendon, popliteus fascia
Contents of popliteal fossa
popliteal artery
popliteal vein
small saphenous vein
tibial and common fibular nerves
Menisci
fibrocartilage disks that deepen joint surface and reduce shock, provide proprioceptive feedback
medial meniscus
lateral mensicus
MCL (medial collateral ligaments)
Attachments–> medial epicondyle to medial tibia plateau
resist valgus stress (a blow or force going from lateral through medial)
LCL (lateral collateral ligaments)
Attachments: lateral epicondyle to head of fibula
NO attachmen with joint capsule or lateral meniscus
Function–>resist varsus stress (force going from medial through lateral knee)
ACL (anterior cruciate ligament)
Attachment–> anterior tibia to posterior lateral femoral condyle
Function–> resist anterior translation of the tibia on the femur (injuries=forced hyper extension)
PCL (posterior cruciate ligament)
Attachment–>posterior tibia to inner aspect of medial femoral condyle
Function–> resist posterior translation of the tibia on the femur
