Lower Extremity Flashcards
What type of joint is the hip joint?
Synovial, ball and socket
What is the strongest ligament in the body?
Iliofemoral ligament (holds femur in place)
What movement of the hip joint has the most range?
Flexion (135deg)
Which is the largest muscle compartment in the thigh?
Anterior compartment
What commonly causes “numb bum” syndrome?
Damage to the superior cluneal nerves (arising from dorsal rami of L1, L2, & L3) often from skin incision for harvesting bone from iliac crests. Leads to sensory loss to skin of gluteal region
What are the (3) superficial muscles of the gluteal region?
Gluteus maximus
Gluteus medius
Gluteus minimus
Gluteus maximus origin (proximal)
Outer surface of ilium, adjacent posterior surface of sacrum and coccyx
Gluteus maximus insertion (distal)
Iliotibeal tract of fascia lata, gluteal tuberosity of femur
Gluteus maximus actions
Extends and laterally rotates hip joint
Gluteus maximus nerve supply
Inferior gluteal nerve (L5, S1, S2)
Gluteus medius origin (proximal)
Outer surface of ilium inferior to iliac crest
Gluteus medius insertion (distal)
Lateral surface of greater trochanter
Gluteus medius actions
Abducts femur at hip joint and medially rotates thigh
Gluteus medius nerve supply
Superior gluteal nerve (L4, L5, S1)
Gluteus minimus origin (proximal)
Outer surface of ilium between middle and inferior gluteal lines
Gluteus minimus insertion (distal)
Anterior surface of greater trochater
Gluteus minimus actions
Abducts femur at hip joint and medially rotates thigh
Gluteus minimus nerve supply
Superior gluteal nerve (L4, L5, S1)
Tensor fasciae latae origin (proximal)
Anterior superior iliac spine (ASIS) and outer edge of iliac crest
Tensor fasciae latae insertion (distal)
Iliotibial tract of upper part of thigh
Tensor fasciae latae actions
Flexes, medially rotates, and abducts thigh
Tensor fasciae latae nerve supply
Superior gluteal nerve (L4, L5, S1)
What are the (6) short lateral rotators of the thigh?
Piriformis Obturator internus Obturator externus Gemellus superior Gemellus inferior Quadratus femoris
Piriformis origin (proximal)
Internal surface of sacrum
Piriformis insertion (distal)
Upper border of greater trochanter
Piriformis actions
Laterally rotates thigh
Piriformis nerve supply
S1 & S2 from sacral plexus
What is found immediately deep to the piriformis?
Sciatic nerve
Gemellus superior origin (proximal)
Spine of ischium
Gemellus superior insertion (distal)
Upper border of greater trochanter
Gemellus superior actions
Laterally rotates thigh
Gemellus inferior origin (proximal)
Ischial tuberosity (inferior to spine)
Gemellus inferior insertion (distal)
Upper border of greater trochanter
Gemellus inferior actions
Laterally rotates thigh
Obturator internus origin (proximal)
Pelvic surface of obturator membrane and surrounding bone
Obturator internus actions
Laterally rotates thigh
Obturator externus origin (proximal)
Outer surface of superior and inferior rami of pubis and ramus of ischium surrounding obturator foramen
Obturator externus insertion (distal)
Trochanteric fossa of femur
Obturator externus actions
Laterally rotates thigh
Obturator externus nerve supply
Obturator nerve (L2, L3, L4)
Quadratus femoris origin (proximal)
Ischial tuberosity
Quadratus femoris insertion (distal)
Below intertrochanteric crest
Quadratus femoris actions
Laterally rotates thigh
What are the 4 hamstring muscles?
Biceps femoris
Semitendiosus
Semimembranosus
Adductor magnus
Which hamstring muscle is innervated by the common peroneal (lateral) component, as opposed to the tibial component, of the sciatic nerve?
The short head of biceps femoris
Biceps femoris origin (proximal)
Long head: Ischial tuberosity
Short head: linea aspera
Biceps femoris insertion (distal)
Lateral aspect of the head of fibula
Biceps femoris actions
Flexes at knee joint
Long head extends thigh
Laterally rotates leg when knee is flexed
Biceps femoris nerve supply
Long head: tibial part of sciatic nerve
Short head: common peroneal (fibular) art of sciatic nerve
Semitendinosus origin (proximal)
Ischial tuberosity
Semitendinosus insertion (distal)
Medial surface of shaft of tibia
Semitendinosus actions
Extends thigh at hip, flexes leg, medially rotates leg when knee is flexed
Semitendinosus nerve supply
Tibial portion of sciatic nerve
Is the semimembranosus deep or superficial to the semitendinosus?
Semimembranosus is deep to semitendinosus
Semimembranosus origin (proximal)
Ischial tuberosity
Semimembranosus insertion (distal)
Posterior part of medial condyle of tibia
Semimembranosus actions
Extends thigh at hip, flexes leg, medially rotates leg when knee is flexed
Semimembranosus nerve supply
Tibial portion of sciatic nerve
Adductor magnus origin (proximal)
Inferior ramus of pubis (adductor part)
And ischial tuberosity (hamstring part)
Adductor magnus insertion (distal)
Linea aspera, adductor tubercle of femur
Adductor magnus actions
Adducts thigh at hip
Assists in extension of thigh (hamstring part)
Adductor magnus nerve supply
Obturator nerve (L2, L3, L4)
What roots make up the sciatic nerve?
L4, L5, S1, S2, S3
What roots make up the femoral nerve?
L2, L3, L4
What roots make up the obturator nerve?
L2, L3, L4
What roots make up the superior gluteal nerve?
L4, L5, S1
What roots make up the inferior gluteal nerve?
L5, S1, S2
What roots make up the posterior cutaneous nerve of thigh?
S1, S2, S3
What roots make up the pudendal nerve?
S2, S3, S4
What is the order of the branches of the lumbrosacral plexus?
Sciatic (L4-S3) Femoral (L2–L4) Obturator (L2-L4) Superior gluteal (L4-S1) Inferior gluteal (L5-S2) Posterior cutaneous (S1-S3) Pudendal (S2-S4)
What is the superior medial border of the popliteal fossa?
Semitendinosus
What is the superior lateral border of the popliteal fossa?
Biceps femoris (long head)
What is the inferior borders of the popliteal fossa? (Medial and lateral)
Gastronemius, medial and lateral heads
What innervates the flexors (anterior compartment) of the thigh?
Femoral nerve
What innervates the adductors (medial compartment) of the thigh?
Obturator nerve
What innervates the extensors of the thigh?
Sciatic nerve
What innervates most of the abductors of the thigh?
Gluteal nerve
Psoas major origin (proximal)
Transverse processes and bodies of L1-L5 vertebrae
Psoas major insertion (distal)
Merges with iliacus and inserts as iliopsoas into the lesser trochanter of femur
Psoas major actions
Flexes thigh at hip
Flexes vertebral column (bending forward)
Psoas major nerve supply
L2, L3
Iliacus origin (proximal)
Iliac fossa
Iliacus insertion (distal)
Merges with soas major and inserts as iliopsoas into lesser trochanter of femur
Iliacus actions
Flexes thigh at hip
Iliacus nerve supply
L2, L3
Sartorius origin (proximal)
Anterior superior iliac spine (ASIS)
Sartorius insertion (distal)
Medial surface of proximal tibia
Sartorius actions
Flexes, abducts and laterally rotates thigh a hip
Flexes leg at knee
Medially rotates leg with flexed knee
Sartorius nerve supply
Femoral nerve (L2, L3, L4)
What are the (4) quadriceps femoris?
Rectus femoris
Vastus lateralis
Vastus medialis
Vastus intermedius
Rectus femoris origin (proximal)
Anterior inferior iliac spine (AIIS)
Rectus femoris insertion (distal)
Patella via quadriceps tendon
Tibial tuberosity via patellar ligament
Rectus femoris actions
Extends leg at knee
Flexes high at hip
Rectus femoris nerve supply
Femoral nerve (L2, L3, L4)
Vastus lateralis origin (proximal)
Greater trochanter, intertrochanteric line, linea aspera of femur