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Medicine Year 1 - Semester 2 - Part 2 > Lower Limb: Gluteal Region and Thigh > Flashcards

Lower Limb: Gluteal Region and Thigh Flashcards

1
Q

State the gateways to the pelvic girdle

A

Greater sciatic foramen
Lesser sciatic foramen
Obturator space/canal (foramen)
Retro-inguinal space

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2
Q

Greater sciatic foramen

A

Gateway between the pelvis and the gluteal region.

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3
Q

Lesser sciatic foramen

A

Gateway between the gluteal region and the perineum (place where you find external genitalia).

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4
Q

State the contents of the greater sciatic foramen

A

Sciatic nerve

Gluteal neurovascular bundle
(superior and inferior gluteal nerves + arteries etc.)

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5
Q

State the contents of the lesser sciatic foramen

A

Internal pudendal neurovascular bundle

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6
Q

State the contents of the obturator space (canal)

A

Obturator neurovascular bundle

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7
Q

State the contents of the retro-inguinal space

A

Femoral neurovascular bundle

  • Femoral nerve
  • Femoral artery
  • Femoral vein
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8
Q

Describe the gluteal region (buttock)

i.e. how is it bounded

A

Bounded superiorly by the iliac crest and inferiorly by the gluteal fold (fold of the buttock)

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9
Q

What is the gluteal region made up of ?

A

Gluteal muscles and a thick layer of superficial fascia.

  • Extensors, abductors and rotators of the hip joint
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10
Q

State the gluteal muscles

A

Gluteus maximus
Gluteus medius
Gluteus minimus

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11
Q

Extensors of the hip joint

A

Gluteus maximus

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12
Q

Abductors of the hip joint

A

Gluteus medius and minimus

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13
Q

What is the Gluteus Maximus innervated by ?

A

Inferior gluteal nerve

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14
Q

What are Gluteus Medius and Minimus innervated by ?

A

Superior gluteal nerve

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15
Q

KEY function of Gluteus Maximus

A

Prime extensor of the hip
(esp in a flexed position)

  • standing up from sitting position + climbing stairs
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16
Q

Other function of the gluteus maximus

A

Externally rotates and abducts the femur

Extends and locks the knee via the iliotibial tract.

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17
Q

State the insertions of the gluteus maximus muscle

A

Deep fibres: insert on gluteal tuberosity

Superficial fibres: insert on iliotibial tract

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18
Q

Iliotibial tract

A

Thickening of the fascia lata in the thigh region.

Stabilises the lateral aspect of the knee via the gluteus maximus contraction.

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19
Q

Describe the location of gluteus medius and minimus

A

Gluteus medius lies deep to gluteus maximus

Gluteus minimus lies deep to gluteus medius

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20
Q

Where does gluteus medius attach ?

A

Between the anterior and posterior gluteal lines.

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21
Q

Where does gluteus minimus attach ?

A

Between the inferior and anterior gluteal lines.

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22
Q

Where does gluteus maximus attach ?

A

Behind the posterior gluteal line.

Tensor fascia lata and gluteus maximus attach to the iliotibial tract.

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23
Q

Function of the tensor fascia lata and gluteus maximus

A

Aids gluteus medius and minimus in hip abduction.

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24
Q

Innervation of tensor fascia lata

A

Superior gluteal nerve

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25
Function of tensor fascia lata
Synergist, supporter, stabiliser of hip and knee movements.
26
Function of abductors of the hip
Keep the pelvis level when walking or standing on one leg.
27
Where are abductors of the hip found ?
Muscles that pass from the pelvis to the femur. They lie laterally to the sagittal axis of the hip joint.
28
Test for abductors of the hip
Trendelburgh gait / test Indicative of weakness of abductors.
29
Where are lateral rotators of the hip located ?
Pass from the pelvis to the femur. Lie close to and posterior to the hip joint.
30
State the lateral rotators of the hip
Piriformis Superior gemellus Obturator internus Inferior gemellus Quadratus femoris Obturator externus
31
Function of the lateral rotators of the hip
Stabilise the joint and laterally rotate the femur to keep the foot pointing forwards during walking.
32
Where do the lateral rotators of the hip insert ?
All except the quadratus femoris insert into the trochanteric fossa.
33
Nerve to piriformis
S1-2 Supplies the piriformis muscle
34
Nerve to obturator internus
L5, S1 Supplies the obturator internus and superior gemellus (and obturator externus which is pierced by the obturator nerve)
35
Nerve to quadratus femoris
L5, S1 Supplies the quadratus femoris and inferior gemellus
36
Location of the sciatic nerve
Emerges into the gluteal region, inferior to piriformis (usually) Midway between the ischial tuberosity and greater trochanter.
37
What does the sciatic nerve run alongside ?
Runs alongside the posterior cutaneous nerve of the thigh.
38
Where can you safely inject in the gluteal region ? | EXAM TYPE Q
Intramuscular injection - safe area for intramuscular injection is the upper, outer quadrant of the gluteal region - away from the sciatic nerve
39
State the location of flexors of the hip
Pass from the pelvis to the femur. Anterior to the transverse axis of the hip joint
40
State the flexors of the hip
Iliacus Psoas major COLLECTIVELY referred as : Iliopsoas Sartorius Rectus femoris
41
Function of Iliopsoas
The most powerful flexor of the hip
42
Iliopsoas
Iliacus (L2-3) Psoas Major (L1-3)
43
Sartorius function
Flexor of the hip and knee joint
44
Rectus femoris function
Flexor of the hip and knee joint
45
Where do iliacus and psoas major pass ?
Pass through the retro-inguinal space into the femoral region. - fascia of psoas divides the space into muscular and vascular compartments - iliopsoas and femoral nerve pass through the muscular compartment
46
What supplies the sartorius and rectus femoris muscle ?
The femoral nerve
47
How is the retro-inguinal space divided into muscular and vascular compartments ?
The fascia of psoas divides the space
48
How are muscles of the thigh separated ?
Separated into 3 compartments by layers of deep fascia.
49
State the compartments of the thigh
Medial (Adductor) Anterior (Extensor) Posterior (Flexor) All the compartments are surrounded by thick fascia lata
50
Function of the anterior compartment of the thigh
Knee extensors Hip flexors
51
Function of the posterior compartment of the thigh
Knee flexors Hip extensors
52
Function of the medial compartment of the thigh
Hip adductors
53
Nerve supplying the anterior compartment of the thigh
Femoral nerve except iliopsoas
54
Nerve supplying the posterior compartment of the thigh
Sciatic nerve
55
Nerve supplying the medial compartment of the thigh
Obturator nerve
56
State the muscles of the anterior compartment of the thigh
Quadriceps femoris Sartorius Iliopsoas Pectineus
57
How is the function of sartorius different from the other muscles in the anterior compartment of the thigh ?
Sartorius muscle FLEXES not EXTENDS the knee
58
Function of deep tendon reflex of the patella
Tests the femoral nerve Spinal segments L3 and L4
59
What is the main extensor of the knee ?
Quadratus femoris - knee joint stability is hugely dependent upon quadriceps
60
State the heads of quadratus femoris
Rectus femoris (acts of hip and knee joint) Vastus intermedius Vastus medialis Vastus lateralis
61
How is the deep tendon reflex of the knee elicited ?
Elicited by tapping the patellar ligament (Patellar tendon, quadriceps tendon)
62
State the boundaries of the femoral triangle
Inguinal ligament Sartorius Adductor longus
63
What is the femoral triangle ?
Area in the anterior thigh - Roofs - Boundaries - Floor - Contents
64
State the floor of the femoral triangle
Iliopsoas Pectineus Adductor longus
65
State the contents of the femoral triangle
Femoral Nerve, Artery, Vein (lateral to medial NAVY) Femoral nerve above iliopsoas Femoral sheath : 3 compartments - Artery - Vein - Femoral Canal: lymphatics
66
State the roof of the femoral triangle
Fascia lata
67
What is the femoral canal ?
A short and conical space between the medial wall of the femoral sheath and the femoral vein
68
What is the femoral sheath ?
A continuation of the abdominal transversalis fascia
69
What does the femoral canal contain ?
Deep inguinal lymph node The femoral canal allows the femoral vein to expand.
70
Describe the femoral canal
The base of the femoral canal (opening) is the femoral ring. The femoral ring is a weak area, common location for femoral hernia
71
Common location for femoral hernia
The femoral ring - opening of the femoral canal at the abdominal side
72
State some features of the femoral canal
Deep inguinal lymph node - cloquet node Pectineal ligament Lacunar ligament Saphenous opening
73
State the location of the posterior muscles of the thigh
Muscles that pass from the pelvis to the lower limb. Posterior to the transverse axis of the hip joint.
74
Function of the posterior compartment muscles of the thigh
Extend the thigh Extend the hip Flex the knee
75
State the muscles of the posterior compartment of the thigh
Ischiocrural (hamstring) muscles Biceps femoris: 2 heads Semitendinous Semimembranosus
76
Location of the ischiocrural (hamstring) muscles
Extends between the ischial tuberosity and the leg.
77
Supply to the posterior comp of thigh
Sciatic nerve - tibial part (except the short head of biceps femoris)
78
Origin and insertion of the hamstring muscles
ORIGIN: Ischial tuberosity INSERTION of biceps femoris: - fibular insertion INSERTION of semitendinous and semimembranous - tibial insertion
79
State the hamstring muscles
Biceps femoris Semitendinosis Semimembranosis
80
What does the tibial part of the sciatic nerve innervate ?
Long head of biceps femoris Semitendinosis Semimembranosis
81
What is the short head of biceps femoris innervated by ?
The common peroneal part of the sciatic nerve.
82
State the muscles of the medial compartment of the thigh
Adductor magnus Adductor longus Adductor brevis Gracilis
83
State some features of the medial compartment of the thigh
All adductors of the hip* All originate from the pubic body/ramus and insert into the femur*
84
What muscle in the medial compartment of the thigh is not innervated by the obturator nerve ?
Adductor Magnus: - has a hamstring part from ischial tuberosity, and is 1/2 innervated by the sciatic nerve
85
Adductor magnus
Dual nerve supply: 1/2 obturator nerve - adductor part 1/2 sciatic nerve - hamstring part
86
What is the pes anserinus ?
Common attachment of sartorius, gracilis and semitendinosus on the tibia.
87
Function of the pes anserinus
Adds significant dynamic stability to the medial side of the knee
88
Describe the tendons attaching to pes anserinus
Tendons pass posterior to the transverse axis of rotation of the knee - flex the knee
89
Length of the adductor canal / hunters canal / SUB sartorial canal
Starts at the inferior corner of the femoral triangle Ends at the adductor hiatus
90
What enters the adductor canal ?
Femoral vessels and saphenous nerve - Saphenous nerve pierces the anteromedial wall and becomes superficial - Femoral vessels enter popliteal fossa through adductor hiatus
91
Boundaries of the adductor canal
Vastus medius (anterolaterally) Adductor Longus and Magnus (posteriorly) Sartorius (anteromedially)

Medicine Year 1 - Semester 2 - Part 2 (53 decks)

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