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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
Q

Function of tensor fascia lata

A

Synergist, supporter, stabiliser of hip and knee movements.

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26
Q

Function of abductors of the hip

A

Keep the pelvis level when walking or standing on one leg.

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27
Q

Where are abductors of the hip found ?

A

Muscles that pass from the pelvis to the femur.

They lie laterally to the sagittal axis of the hip joint.

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28
Q

Test for abductors of the hip

A

Trendelburgh gait / test

Indicative of weakness of abductors.

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29
Q

Where are lateral rotators of the hip located ?

A

Pass from the pelvis to the femur.

Lie close to and posterior to the hip joint.

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30
Q

State the lateral rotators of the hip

A

Piriformis
Superior gemellus
Obturator internus
Inferior gemellus
Quadratus femoris
Obturator externus

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31
Q

Function of the lateral rotators of the hip

A

Stabilise the joint and laterally rotate the femur to keep the foot pointing forwards during walking.

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32
Q

Where do the lateral rotators of the hip insert ?

A

All except the quadratus femoris insert into the trochanteric fossa.

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33
Q

Nerve to piriformis

A

S1-2

Supplies the piriformis muscle

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34
Q

Nerve to obturator internus

A

L5, S1

Supplies the obturator internus and superior gemellus (and obturator externus which is pierced by the obturator nerve)

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35
Q

Nerve to quadratus femoris

A

L5, S1

Supplies the quadratus femoris and inferior gemellus

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36
Q

Location of the sciatic nerve

A

Emerges into the gluteal region, inferior to piriformis (usually)

Midway between the ischial tuberosity and greater trochanter.

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37
Q

What does the sciatic nerve run alongside ?

A

Runs alongside the posterior cutaneous nerve of the thigh.

38
Q

Where can you safely inject in the gluteal region ?

EXAM TYPE Q

A

Intramuscular injection

  • safe area for intramuscular injection is the upper, outer quadrant of the gluteal region
  • away from the sciatic nerve
39
Q

State the location of flexors of the hip

A

Pass from the pelvis to the femur.

Anterior to the transverse axis of the hip joint

40
Q

State the flexors of the hip

A

Iliacus
Psoas major

COLLECTIVELY referred as : Iliopsoas

Sartorius
Rectus femoris

41
Q

Function of Iliopsoas

A

The most powerful flexor of the hip

42
Q

Iliopsoas

A

Iliacus (L2-3)
Psoas Major (L1-3)

43
Q

Sartorius function

A

Flexor of the hip and knee joint

44
Q

Rectus femoris function

A

Flexor of the hip and knee joint

45
Q

Where do iliacus and psoas major pass ?

A

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
Q

What supplies the sartorius and rectus femoris muscle ?

A

The femoral nerve

47
Q

How is the retro-inguinal space divided into muscular and vascular compartments ?

A

The fascia of psoas divides the space

48
Q

How are muscles of the thigh separated ?

A

Separated into 3 compartments by layers of deep fascia.

49
Q

State the compartments of the thigh

A

Medial (Adductor)
Anterior (Extensor)
Posterior (Flexor)

All the compartments are surrounded by thick fascia lata

50
Q

Function of the anterior compartment of the thigh

A

Knee extensors
Hip flexors

51
Q

Function of the posterior compartment of the thigh

A

Knee flexors
Hip extensors

52
Q

Function of the medial compartment of the thigh

A

Hip adductors

53
Q

Nerve supplying the anterior compartment of the thigh

A

Femoral nerve

except iliopsoas

54
Q

Nerve supplying the posterior compartment of the thigh

A

Sciatic nerve

55
Q

Nerve supplying the medial compartment of the thigh

A

Obturator nerve

56
Q

State the muscles of the anterior compartment of the thigh

A

Quadriceps femoris
Sartorius
Iliopsoas
Pectineus

57
Q

How is the function of sartorius different from the other muscles in the anterior compartment of the thigh ?

A

Sartorius muscle FLEXES not EXTENDS the knee

58
Q

Function of deep tendon reflex of the patella

A

Tests the femoral nerve
Spinal segments L3 and L4

59
Q

What is the main extensor of the knee ?

A

Quadratus femoris

  • knee joint stability is hugely dependent upon quadriceps
60
Q

State the heads of quadratus femoris

A

Rectus femoris (acts of hip and knee joint)
Vastus intermedius
Vastus medialis
Vastus lateralis

61
Q

How is the deep tendon reflex of the knee elicited ?

A

Elicited by tapping the patellar ligament

(Patellar tendon, quadriceps tendon)

62
Q

State the boundaries of the femoral triangle

A

Inguinal ligament
Sartorius
Adductor longus

63
Q

What is the femoral triangle ?

A

Area in the anterior thigh

  • Roofs
  • Boundaries
  • Floor
  • Contents
64
Q

State the floor of the femoral triangle

A

Iliopsoas
Pectineus
Adductor longus

65
Q

State the contents of the femoral triangle

A

Femoral Nerve, Artery, Vein

(lateral to medial NAVY)

Femoral nerve above iliopsoas
Femoral sheath : 3 compartments

  • Artery
  • Vein
  • Femoral Canal: lymphatics
66
Q

State the roof of the femoral triangle

A

Fascia lata

67
Q

What is the femoral canal ?

A

A short and conical space between the medial wall of the femoral sheath and the femoral vein

68
Q

What is the femoral sheath ?

A

A continuation of the abdominal transversalis fascia

69
Q

What does the femoral canal contain ?

A

Deep inguinal lymph node

The femoral canal allows the femoral vein to expand.

70
Q

Describe the femoral canal

A

The base of the femoral canal (opening) is the femoral ring.

The femoral ring is a weak area, common location for femoral hernia

71
Q

Common location for femoral hernia

A

The femoral ring - opening of the femoral canal at the abdominal side

72
Q

State some features of the femoral canal

A

Deep inguinal lymph node - cloquet node

Pectineal ligament

Lacunar ligament

Saphenous opening

73
Q

State the location of the posterior muscles of the thigh

A

Muscles that pass from the pelvis to the lower limb.

Posterior to the transverse axis of the hip joint.

74
Q

Function of the posterior compartment muscles of the thigh

A

Extend the thigh
Extend the hip
Flex the knee

75
Q

State the muscles of the posterior compartment of the thigh

A

Ischiocrural (hamstring) muscles

Biceps femoris: 2 heads

Semitendinous
Semimembranosus

76
Q

Location of the ischiocrural (hamstring) muscles

A

Extends between the ischial tuberosity and the leg.

77
Q

Supply to the posterior comp of thigh

A

Sciatic nerve - tibial part

(except the short head of biceps femoris)

78
Q

Origin and insertion of the hamstring muscles

A

ORIGIN: Ischial tuberosity

INSERTION of biceps femoris:
- fibular insertion

INSERTION of semitendinous and semimembranous - tibial insertion

79
Q

State the hamstring muscles

A

Biceps femoris

Semitendinosis
Semimembranosis

80
Q

What does the tibial part of the sciatic nerve innervate ?

A

Long head of biceps femoris

Semitendinosis
Semimembranosis

81
Q

What is the short head of biceps femoris innervated by ?

A

The common peroneal part of the sciatic nerve.

82
Q

State the muscles of the medial compartment of the thigh

A

Adductor magnus
Adductor longus
Adductor brevis

Gracilis

83
Q

State some features of the medial compartment of the thigh

A

All adductors of the hip*

All originate from the pubic body/ramus and insert into the femur*

84
Q

What muscle in the medial compartment of the thigh is not innervated by the obturator nerve ?

A

Adductor Magnus:

  • has a hamstring part from ischial tuberosity, and is 1/2 innervated by the sciatic nerve
85
Q

Adductor magnus

A

Dual nerve supply:

1/2 obturator nerve - adductor part
1/2 sciatic nerve - hamstring part

86
Q

What is the pes anserinus ?

A

Common attachment of sartorius, gracilis and semitendinosus on the tibia.

87
Q

Function of the pes anserinus

A

Adds significant dynamic stability to the medial side of the knee

88
Q

Describe the tendons attaching to pes anserinus

A

Tendons pass posterior to the transverse axis of rotation of the knee

  • flex the knee
89
Q

Length of the adductor canal / hunters canal / SUB sartorial canal

A

Starts at the inferior corner of the femoral triangle

Ends at the adductor hiatus

90
Q

What enters the adductor canal ?

A

Femoral vessels and saphenous nerve

  • Saphenous nerve pierces the anteromedial wall and becomes superficial
  • Femoral vessels enter popliteal fossa through adductor hiatus
91
Q

Boundaries of the adductor canal

A

Vastus medius
(anterolaterally)

Adductor Longus and Magnus
(posteriorly)

Sartorius
(anteromedially)

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

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