Lower limb + gluteal Flashcards
Entry and exit points between lower limb and abdomen, pelvis and perineum
Gap between inguinal ligament and pelvic bone
Greater sciatic foramen
Obturator canal
Lesser sciatic foramen
Structures passing through gap between pelvic bone and inguinal ligament
Muscles - psoas major, iliacus and pectineus
nerves - femoral and femoral branch of genitofemoral, lateral cutaneous nerve of thigh
vessels - femoral artery and vein
lymphatics
Structures communicating with gluteal region through greater sciatic foramen
muscle - piriformis
nerves - sciatic, superior and inferior gluteal and pudendal nerves
vessels - superior and inferior gluteal arteries and veins, and internal pudendal artery
Obturator foramen
obturator nerve and vessels
Structures between perineum and gluteal region through lesser sciatic foramen
Tendon of obturator internus msucle
Internal pudendal artery and pudendal nerve
Innervation of gluteal region
Superior and inferior gluteal nerves
Innervation of anterior compartment in leg
Deep branch of common fibular nerve
Cutaneous innervation of femoral nerve
skin on anterior thigh, medial side of leg and ankle
Cutaneous innervation of obturator nerve
medial side of thigh
Cutaneous innervation tibial part of sciatic nerve
lateral side of ankle and foot
Cutaneous innervation common fibular part of sciatic nerve
lateral side of leg and dorsum of foot
Innervation of medial compartment of thigh
Obturator nerve (Except pectineus - femoral nerve, and part of adductor magnus by tibial division of sciatic nerve)
Innervation of anterior compartment of thigh
femoral nerve (except tensor fasciae latae which is innervated by superior gluteal nerve)
Innervation of posterior compartment of thigh
tibial part of sciatic nerve
Innervation of Lateral compartment of leg
superficial branch of common fibular nerve
Innervation of posterior compartment of leg
tibial part of sciatic nerve (except short head of biceps femoris - common fibular division of sciatic nerve)
Innervation of sole of foot
TIbial part of sciatic nerve
Ischial tuberosity attachments
Mainly hamstring muscles in posterior thigh
Upper medial - semitendinosus and long head of biceps femoris
Upper lateral - semimembranosus
Lower lateral - adductor magnus
Ischiopubic ramus and pubic bone
Muscles of medial compartment of thigh
Adductor magnus, adductor longus, adductor brevis, pectineus and gracilis
Femoral nerve
L2-L4
Anterior compartment of thigh
Abdomen - iliacus and pectineus
Anterior aspect of thigh, medial aspect of leg and medial side of foot
Genitofemoral nerve
L1, L2
Passes anteroinferiorly through psoas major muscle, crosses under inguinal ligament lateral to femoral artery
Cremasteric reflex
Anterior perineum (anterior scrotum, anterior labia majora)
Obturator nerve
L2 to L4
All muscles in medial compartment of thigh (other than pectineus and part of adductor magnus)
Obturator externus
Skin on medial side of upper thigh
Sciatic nerve
Divides in posterior compartment of thigh
Posterior division L4 to S2 form common fibular part
Anterior division L4 to S3 form tibial part
All muscles in posterior compartment of thigh, and all muscles in the leg
Skin - lateral side of leg and foot
Superior gluteal nerves
L4 to S1
GLuteus medius and minimus
Tensor fasciae latae
Inferior gluteal nerves
L5 to S2
Gluteus maximus
Ilioinguinal nerves
L1
Travels through inguinal canal to exit through superficial inguinal ring
Innervate skin on medial side of upper thigh and adjacent parts of perineum
Femoral artery
Continuation of external iliac artery as it passes under inguinal ligament to enter femoral triangle
Supplies most of thigh and all of leg and foot
Superficial inguinal nodes
Lymph from gluteal region, lower abdominal wall, perineum and superficial regions of lower limb, drains into external iliac nodes
Deep inguinal nodes
medial to femoral vein
Deep lymphatics associated with femoral vessels and from glans penis (or clitoris) in perineum)
Drain into external iliac nodes via vessels that pass along medial side of femoral vein as it passes under the inguinal ligament
Popliteal nodes
receives lymph from superficial vessels, which accompany the small saphenous vein and from deep areas of leg and foot.
Drain into deep and superficial inguinal nodes
Saphenous opening
Formed by free medial edge of fascia lata as it descends from inguinal ligament and spirals around lateral side of GSV and medially under femoral vein
Femoral triangle
superiorly inguinal ligament
medial - adductor longus
lateral - sartorius
Floor - medially pectineus and adductor magnus, laterally iliopsoas
Apex of femoral triangle
Continuous with adductor canal which descends medially through aperture in adductor magnus to open into popliteal fossa behind knee
COntents of femoral triangle
Femoral nerve, artery and vein and lymphatic vessels
Femoral sheath
Continuous superiorly with transversalis fascia and iliac fascia of abdomen
Contain femoral artery, vein and lymphatics.
Femoral nerve not contained in sheath.
Piriformis
Origin: Anterior surface of sacrum
Insertion: medial side of greater trochanter of femur
Innervation: S1 to S2
Function: laterally rotates extended femur, abducts flexed femur at hip joint
Obturator internus
Origin: deep surface of obturator membrane
Insertion: medial side of greater trochanter
Nerve: nerve to obturator internus L5, S1
Functon: laterally rotates extended femur, abducts flexed femur at hip joint
Gemellus superior
Origin: external surface of ischial spine
INsertion: medial side of GT
Nerve: nerve to obturator internus L5, S1
Function: laterally rotates extended femur, abducts flexed femur at hip joint
Gemellus inferior
Origin: upper aspect of ischial tuberosity
Insertion: medial side of GT
Nerve: nerve to quadratus femoris L5, S1
Function: laterally rotates extended femur, abducts flexed femur at hip joint
Quadratus femoris
Origin: lateral aspect of ischium
Insertion: quadratus tubercle on intertrochanteric crest on proximal femur
Nerve: nerve to quadratus femoris L5, S1
Function: laterally rotates femur
Gluteus minimus
Origin: External surface of ilium
Insertion: anterolateral aspect of GT
nerve: superior gluteal nerve L4 to S1
Function: abducts femur
Gluteus medius
Origin: External surface of ilium
Insertion: lateral surface of GT
Nerve: superior gluteal nrve L4 to S1
Function: abducts femur
Gluteus maximus
Origin: LARGE
Insertion: Posterior aspect of iliotibial tract and gluteal tuberosity of proximal femur
Nerve: inferior gluteal nerve L5 to S2
Function: Extensor of flexed femur. Lateral stabilizer of hip joint and knee joint
Tensor fasicae latae
Origin: lateral aspect of iliac crest between ASIS and tubercle of crest
Insertion: iliotibial tract
Nerve: superior gluteal nerve L4 to S1
Function: Stabilises knee in extension
Nerves passing through greater sciatic foramen
7 nerves superior gluteal nerve sciatic nerve inferior gluteal nerve nerve to quadratus femoris nerve to obturator nerve pudendal nerve posterior cutaneous nerve of thigh (perforating cutaneous pierces sacrotuberous ligament)
Superior gluteal nerve
Only one that passes above piriformis
Travels in between gluteus medius and minimus, and terminates by supplying TFL
sciatic nerve
Passes beneath piriformis, descends between deep and superficial group of gluteal muscles
nerve to quadratus femoris
only nerve anterior to plane of deep muscle
supplies small branch to inferior gemelli
nerve to obturator internus
Enters gluteal region beneath piriformis between posterior cuteanous nerve of thigh and pudendal nerve
Posterior cutaneous nerve of thigh
Inferior to piriformis and immediately medial to sciatic nerve.
Inferior gluteal artery
Supplies posterior thigh and anastomoses with perforating branches of femoral artery. Also supplies a branch to sciatic nerve
Superior gluteal artery
Divides into superficial (deep surface of glut max) and deep (between gluteus medius and minimus).
Contributes to hip joint.
Anastomose with lateral and medial femoral circumflex arteries from deep femoral in thigh and with inferior gluteal artery
Lymphatics in gluteal region
Internal iliac nodes
