lower limb Flashcards
lumbar plexus content
femoral (L2-L4)
obturator (L2-L4)
sciatic nerve - lumbosacral trunk (L4-L5)+sacral nerves (S1-S3)
root of nerves of lumbar plexus from pelvis to lower limb
femoral - subingual space
obturator - obturator canal
sciatic nerve - greater sciatic foramen
superficial veins at sciatic hiatus
superficial epigastric
superficial circumflex iliac
accessory saphenous
greater saphenous
cutaneous nerves of the lower limb
lateral thigh:
lateral cutaneous T12
lateral cutaneous nerve of thigh L2-L3
anterior thigh:
femoral branch of genitofemoral L1-L2
medial thigh:
ilioinguinal L1
cutaneous branch of obturator L2-L4
all:
anterior cutaneous branch of femoral L2-L4
boundaries of the femoral triangle
roof: fasciae latae cribiform fascia subcutaneous tissue skin
base:
inguinal ligament
lateral:
sartorious
medial:
adductor longus
floor:
iliopsoas
pectineus
content of femoral triangle
femoral nerve, artery, vein and lymph (NAVL)
femoral sheath composition and what it does
transversalis and iliopsoas fascia
adventitia of femoral vessels
what is the space medially within the femoral sheath
femoral canal
contains fat and lymphatics
muscles of the anterior compartment of the leg
iliacus
psoas major
pectineus
sartoriuous
quadriceps: rectus femoris vastus lateralis vastus medialis vastus intermedius
role of muscles of anterior compartment and which muscles do extra
extend knee (quadriceps)
flex hip (all other)
pectineus - adducts hip and assists in medial rotation
sartorious - abducts, laterally rotates and flexes knee
rectus femoris - flexes hip
pectineus attachment
superior ramus of pubis to pectineal line of femur
sartorious attachment
anterior superior iliac spine to superior medial tibia
rectus femoris attachment
AIIS and ilium above acetabulum to quadriceps tendon then tibial tuberosity via patellar ligament
vastus lateralis attachment
greater trochanter to quadriceps tendon then tibial tuberosity via patellar ligament
vastus medialis attachment
intertrochanteric line to quadriceps tendon then tibial tuberosity via patellar ligament
vastus intermedius attachment
anterior and lateral shaft of femur to to quadriceps tendon then tibial tuberosity via patellar ligament
what nerve is found deep to the inguinal ligament
femoral nerve
branches of the femoral nerve
muscular
articular
cutaneous - saphenous is terminal
root values for the anterior muscle compartment:
iliacus, *pectineus and sartorious
psoas major
quadriceps
femoral (L2-L3) *sometimes obturator
anterior rami (L1-L3)
femoral (L2-L4)
muscles of medial compartment of the leg
gracilis adductor longus adductor brevis adductor magnus obturator externus
role of muscles of the medial compartment and which muscles do extra
hip adductors
gracilis - flexes knee
adductor brevis - may assist flexion
obturator externus DOES NOT ADDUCT - laterally rotates thigh
root values for medial compartment muscles:
gracilis
adductor longus, braves and *magnus
obturator externus
obturator (L2-L3)
obturator (L2-L4) *also sciatic (L4)
obturator (L3-L4)
obturator nerve branches
anterior and posterior division
muscular branches
(anterior is cutaneous to middle)
location of the adductor canal
starts at apex of femoral canal to adductor hiatus
under distal sartorious
boundaries of adductor canal
sartorious
vastus medialis
adductor longus
what passes through the adductor canal
femoral vessels (veins and arteries) and the saphenous nerve (between sartorious and gracilis)
arterial supply to the anterior and medial thigh
femoral artery from the external iliac (eventually becoming popliteal through the adductor hiatus)
profunda femoris is a branch
obturator artery from the internal iliac
posterior and anterior branches
where does profunda femoris branch off and what branches does it have
deep to adductor longus
3-4 perforating branches through adductor magnus
medial (posterior) and lateral (anterior) circumflex branches (they join anteriorly and with inferior gluteal to form cruciate anastomosis)
what do the posterior and anterior branches of the obturator artery supply
anterior - muscles of medial compartment
posterior - muscles attached to ischial tuberosity
gracilis attachment
body and inferior ramus of pubis to superior medial surface of tibia
adductor longus attachment
body of pubis to medial 1/3 linea aspera
adductor brevis attachment
body and inferior rams of pubis to pectineal line and proximal linea aspera
adductor magnus attachment
pubic ramus and ischial tuberosity to linea aspera, medial supracondylar line and adductor tubercle
obturator externus attachment
margin of obturator foramen and membrane to trochanteric fossa
long axis of shaft of femur crosses the long axis of head and neck (wider hips = narrower)
angle of inclination
neck angle slightly anteriorly
angle of anteversion
lines at inferior posterior section of femur
supracondylar lines
Muscles of gluteal region (8)
gluteus maximus piriformis obturator internus gemelli quadratus femoris gluteus medius gluteus minimus tensor fasciae latae
the lateral rotators of the hip and any other action they preform
*gluteus maximus - extends hip piriformis obturator internus gemelli quadratus femoris
the medial rotators of the hip
gluteus medius and gluteus minimus
muscle has the role of support
tensor fasciae latae
what muscles are innervated by superior gluteal nerve (L4-S1)
gluteus medius
gluteus minimus
tensor fasciae latae
innervation of the gluteus maximus
inferior gluteal nerve (L5-S2)
innervation of the gemelli
superior - obturator internus (L5-S1)
inferior - quadratus femoris (L5-S1)
gluteus maximus attachment
sacrum, sacrotuberous ligament and ilium to iliotibial tract (3/4) and gluteal tuberosity (1/4)
gluteus medius attachment
ilium between posterior and anterior gluteal lines to greater trochanter of femur
gluteus minimus attachment
ilium between anterior and inferior gluteal lines to greater trochanter of femur
gemelli attachments
superior - ischial spine to tendon of obturator internus (greater trochanter of fossa)
inferior - ischial tuberosity to tendon of obturator internus
tensor fasciae latae attachments
anterior iliac crest and ASIS to iliotibial tract