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Gross Anatomy - Snell's > Lower limb: Glutes, Thigh, and Knee > Flashcards

Lower limb: Glutes, Thigh, and Knee Flashcards

1
Q

What are the functions of the lower limb

A

(1) support body weight
(2) produce locomotion
(3) produce stability as foundation for standing, walking, and running

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2
Q

Lower limb divisions:

from superior > inferior

A

(superior > inferior)

gluteal region > thigh > popliteal fossa > leg > ankle > foot

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3
Q

Why are llimbs divided into compartments

A

to define muscles that perform group functions with their own distinct nerve and blood supply

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4
Q

What bone forms the lower limb girdle that attaches the lower limbes to the vertebral column

A

os coxae

topographically and functionally the equivalent of the upper limb clavicle and scapula

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5
Q

The os coxae bones (ilium, ischium, pubis) meet one another at the acetabulum via what structure?

A

triradiate cartilage

(Y-shaped)

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6
Q

Os coxae articulations

A
  • posteriorly to the sacrum via sacroiliac joint
  • anteriorly to one another via symphysis pubis

The os coxae forms the anterolateral walls of the pelvis

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7
Q

Ilium structures

A

1) iliac crest
2) anterosuperior iliac spine
3) posterosuperior iliac spine
4) iliac tubercle - notch at the middle-posterior part of iliac crest; 2 in. behind the ASIS
5) anteroinferior iliac spine
6) posteroinferior iliac spine
7) iliac fossa
8) greater sciatic notch

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8
Q

Ischium structures

A

1) body
2) ramus
3) ischial spine (posterior part)
4) ischial tuberosity

The ischial spine intervenes between the greater and lesser sciatic notches - it becomes the greater and lesser sciatic foramina by the presence of the sacrospinous and sacrotuberous ligaments

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9
Q

Pubis Structures

A

The pubis is divided into: body, superior ramus, & inferior ramus

1) pubic crest
2) pubic tubercle

  • The pubis connects with each other at the symphysis pubis
  • it connects with all 3 bones at the acetabulum
  • it joins with the ischium to form the obturator foramen
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10
Q

Anatomical tilt of the pelvis

A
  • pelvic surface of the symphysis pubis faces upward and backward
  • anterior surface of the sacrum is directed forward and downward

The front of the symphysis pubis and the anterosuperior iliac spine lie in the same vertical plane

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11
Q

Important muscle attachments to os coxae 1

Memorize

A
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12
Q

Important muscle attachments to os coxae 2

Memorize

A
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13
Q

Femur articulations

A
  • superiorly with the acetabulum to form the hip joint
  • inferiorly with the tibia and patella to form the knee joint
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14
Q

What is the fovea capitis

A

a small depression at the center of the head of the femur

for the attachment of the ligament of the head

Importance: part of the blood supply to the head of the femur from the obturator artery is conveyed along the ligament of the head and enters the bone at the fovea

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15
Q

What is the normal angle of the femur neck with the long axis
1) in adults
2) in children

A

1) 125 degrees
2) 160 degrees

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16
Q

At the femur, the greater and lesser trochanters are connected by:
(1) anteriorly
(2) posteriorly

A

(1) intertrochanteric line
(2) intertrochanteric crest

The intertrochanteric line is where the iliofemoral ligament attaches

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17
Q

Posterior ridge at the shaft of the femur

A

linea aspera

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18
Q

A flat, triangular area on the posterior surface of the distal shaft of the femur

A

popliteal surface

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19
Q

Important structures and muscle attachments of the femur

Memorize

A
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20
Q

The largest sesamoid bone

A

patella

triangular bone - apex lies inferiorly

It develops within the tendon of the quadriceps femoris muscle in front of the knee joint

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21
Q

Relations of the patella

A
  • inferiorly, the apex is connected to the tuberosity of the tibia by the ligamentum patellae
  • posterior articulation with the condyles of the femur
  • anteriorly separated with the skin by the prepatellar bursa
  • upper, lateral, and medial margins give attachment to the quadriceps femoris muscle
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22
Q

Largest muscle in the body

A

Gluteus maximus

also the 2nd most powerful muscle next to the maseter

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23
Q

Cutaneous nerve supply of the lower limb

A
  • Upper Medial: posterior rami of L1-3 and S1-3
  • Upper Lateral: lateral branches of the anterior rami of the iliohypogastric (L1) and T12
  • Lower Lateral: lateral cutaneous nerve of the thigh (anterior rami of L2-3)
  • Lower Medial: posterior cutaneous nerve of the thigh (anterior rami of S1-3)
  • Skin over the coccyx in the floor of the cleft between the buttocks: lower sacral and coccygeal nerves
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24
Q

Lymph drainage of the gluteal region

A

Superficial inguinal nodes - lateral group

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25
Q

What is the composition of the iliotibial tract (iliotibial band)

A

Thickening of the fascia lata (deep fascia of the thigh) on the lateral surface of the thigh

Attahced above to the iliac tubercle (of the iliac crest) and below to the lateral condyle of the tibia

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26
Q

Forms a sheath for the tensor fasciae latae muscle and receives the greater part of the insertion of the gluteus maximus

A

Iliotibial tract

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27
Q

Function of the sacrotuberous and sacrospinous ligaments

A

To stabilize the sacrum and prevent its rotation at the sacroiliac joint

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28
Q

Connects the back of the sacrum to the ischial tuberosity

A

sacrotuberous ligament

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29
Q

Connects the back of the sacrum to the spine of the ischium

A

sacrospinous ligament

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30
Q

Lymph nodes of the lower limb

A
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31
Q

The greater sciatic foramen provides an exit from the pelvis into the gluteal region

What structures exit the greater sciatic foramen:

A

1) piriformis muscle
2) sciatic nerve
3) posterior cutaneous nerve of the thigh
4) gluteal nerves (superior & inferior)
5) gluteal vessels (superior & inferior)
6) nerves to the obturator internus
7) nerves to the quadratus femoris
8) pudendal nerve
9) internal pudendal vessels

“vessels” - artery & vein

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32
Q

The lesser sciatic foramina provides and entrance to the perineum from the gluteal region

What structures pass through the lesser sciatic notch?

A

1) tendon of the obturator internus muscle
2) nerve to the obturator internus
3) pudendal nerve
4) internal pudendal vessels

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33
Q

What muscle assists the gluteus maximus in maintaining the knee in extended positon?

A

Tensor fasciae latae

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34
Q

What muscle separates the superior gluteal nerves and vessels from the inferior gluteal nerves and vessels?

A

Piriformis muscle

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35
Q

Gluteal Region Muscles

Memorize

A
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36
Q

Sciatic Nerve composition

A

consists of the tibial and common fibular (peroneal) nerves bounded together by fascia

L4-5 and S1-3

The sciatic nerve gives no branches in the gluteal region

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37
Q

Gluteal Region Nerves

Memorize

A
  • sciatic nerve
  • posterior cutaneous nerve of the thigh
  • superior gluteal nerve
  • inferior gluteal nerve
  • nerve to the quadratus femoris
  • pudendal nerve
  • nerve to the obturator internus
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38
Q

Supplies the skin in the popliteal fossa

A

Posterior Cutaneous Nerve of the Thigh

Branches:
(1) gluteal branches - skin over the lower medial quadrant of the buttock

(2) perineal branch - skin of the back of the scrotum or labium majus

(3) cutaneous branches - to the back of the thigh and the upper part of the leg

39
Q

The superior gluteal nerve supplies the

A
  • gluteus medius
  • gluteus minimus
  • tensor fasciae latae
40
Q

What muscle does the inferior gluteal nerve supply

A

Gluteus maximus muscle

41
Q

What muscle/s does the nerve to the quadratus femoris supply?

A
  • quadratus femoris
  • inferior gemellus
42
Q

What structures crosses the ischial spine with the internal pudendal artery and renters the pelvis through the lesser sciatic foramen

A
  • pudendal nerve
  • nerve to obturator internus
43
Q

What structures does the pudendal nerve supply?

A

structures in the perineum

44
Q

What structures does the nerve to the obturator internus supply?

A

the obturator internus muscle on its pelvic surface

45
Q

What are the primary vessels supplying the gluteal region?

A
  • superior gluteal artery
  • inferior gluteal artery

Blood supply to the gluteal region is composed of the: (1) superior gluteal artery, (2) inferior gluteal artery, (3) Trochanteric anastamosis, (4) Cruciate anastamosis

46
Q

It divides into branches that distribute throughout the gluteal region but its primary flow is in the fascial space between the gluteus medius and minimus muscles

A

Superior gluteal artery

Enters the gluteal region through the upper part of the greater sciatic foramen above the piriformis

47
Q

Its major supply is to the glutes maximus muscle

A

Inferior gluteal artery

Enters the gluteal region through the lower part of the greater sciatic foramen, below the piriformis

48
Q

Provides the main blood supply to the head of the femur ()

What are its branches?

A

Trochanteric Anastamosis

Branches:
1) superior gluteal artery
2) inferior gluteal artery
3) medial femoral circumflex artery
4) lateral femoral circumflex artery

49
Q

What provides a collateral connection between the internal iliac and femoral arteries?

What are its branches?

A

Cruciate Anastamosis

Branches:
1) inferior gluteal artery
2) medial femoral circumflex artery
3) lateral femoral circumflex artery
4) first perforating artery
5) branch of the profunda artery

50
Q

The proximal segment of the lower limb (from hip to the knee)

A

Thigh

51
Q

What is the location of the saphenous opening - gap in the deep fascia

A
  • in the front of the thigh just below the inguinal ligament
  • 1.5 in below and lateral to the pubic tubercle

It is filles with loose connective tissue called the cribiform fascia

52
Q

What is transmitted in the saphenous opening?

A

1) great saphenous vein
2) small branches of the femoral artery
3) lymph vessels

53
Q

Lower lateral border of the saphenous opening

A

falciform margin

lies anterior to the femoral vessels

54
Q

Cutaneous nerves of the thigh

A

1) lateral cutaneous nerve of the thigh (L2-3): skin of the lower lateral quadrant of the buttock

2) femoral branch of the genitofemoral nerve (L1-2): cremaster mucle (genitobranch)

3) ilioinguinal nerve (L1): skin of the root of the penis and adjacent scrotum

4) medial cutaneous nerve of the thigh (Branch of the femoral nerve, L2-4): medial aspect of the thigh; joins the patellar plexus

5) intermediate cutaneous nerve of the thigh (Branch of the femoral nerve): anterior aspect of the thigh; joins the patellar plexus

6) anterior division of the obturator nerve: skin on the medial aspect of the thigh

7) patellar plexus: front of the knee

8) posterior cutaneous nerve of the thigh (S1-3): posterior thigh and upper part of the leg

55
Q

The patellar plexus is formed by the terminal branches of ()

A

1) lateral, intermediate, and medial cutaneous nerve of the thigh
2) infrapatellar branch of the saphenous nerve

56
Q

What forms the superficial veins of the leg?

A

great & small saphenous veins and their tributaries

57
Q

What vessels drain the medial side of the leg

from the dorsal venous arch of the foot upwards medially

A

Great saphenous vein

Joins the femoral vein at the saphenous opening

58
Q

What accompanies the saphenous nerve in the superficial fascia over the medial side of the leg

A

great saphenous vein

59
Q

Connect the great saphenous vein with the deep veins along the medial side of the calf

A

perforating veins

60
Q

Name the 3 tributaries received by the great sphenous vein

A

1) superficial circumflex iliac vein
2) superficial epigastric vein
3) superficial external pudendal vein

additional vein known as the accessory vein

61
Q

Superficial Inguinal Lymph Nodes

Lie at the superficial fascia below the inguinal ligament

A

Horizontal group:
1) medial members - receive vessels from the ant. abdominal wall below the level of the umbilicus which includes the urethra, external genitalia, and lower half of the anal canal
2) lateral membres - receive vessels from the back below the level of the iliac crests

Vertical group - receive lymph vessels from the back of the thigh

62
Q

Deep inguinal lymph node
Receive lymph from?

Located beneath the deep fascia and lie along the medial side of the femoral vein

A

1) from the superficial inguinal nodes
2) from the deep structures of the lower limb

63
Q

The thigh is divided into how many compartments?

A

3 compartments:

1) anterior fascial compartment
2) medial fascial compartment
3) posterior fascial compartment

64
Q

Thigh

Anterior Fascial Compartment Contents

Muscles, Blood Supply, Nerve Supply

A

Muscles: sartorius, iliopsoas, pectineus, ans quadriceps femoris

Blood Supply: Femoral Artery
Nerve Supply: Femoral Nerve

65
Q

Muscels of the Thigh - Anterior Fascial Compartment

Memorize

A
66
Q

The Iliopsoas muscle is formed by

A

iliacus and psoas major muscles of the abdomen that merge together at the thigh

67
Q

The quadratus femoris muscle is formed by

A

1) rectus femoris
2) vastus intermedius
3) vastus lateralis
4) vastus medialis

powerful extensor of the knee joint

It inserts into the patella and attaches to the tibial tuberosity vila the ligamentum patellae (patellar ligament)

68
Q

The retinacula which join the capsule of the knee for strengthening, is composed of

A

fibers of the vastus lateralis and vastus medialis

69
Q

The only component of the quadriceps that crosses the hip joint - flexes the hip in addition to extending the knee

A

rectus femoris

70
Q

Triangular depression situated in the upper part of the medial aspect of the thigh - below the inguinal ligament

A

Femoral Triangle

71
Q

Boundaries of the femoral triangle

A
  • superiorly: inguinal ligament
  • laterally: sartorius muscle
  • medially: adductor longus muscle
  • floor: gutter shaped and formed from the lateral to medial by the iliopsoas, pectineus, and adductor longus
  • roof: skin and fasciae of the thigh
72
Q

Major contents of the femoral triangle:

A

1) femoral nerve and its terminal branches
2) femoral sheath
3) femoral artery and its branches
4) femoral vein and its tributaries
5) deep inguinal lymp nodes

73
Q

An intermuscular cleft situated on the medial aspect of the middle third of the thigh deep to the sartorius muscle

A

Adductor (Subsartorial) Canal

begins above at the apex of the femoral triangle and ends below at the opening in the adductor magnus (adductor hiatus)

74
Q

Enumerate the walls of the adductor (subsartorial) canal

A
  • anteromedial wall: sartorius muscle and fascia
  • posterior wall: adductor longus and magnus
  • lateral wall: vastus medialis
75
Q

Adductor canal contents:

A

1) terminal part of the femorl artery
2) femoral vein
3) deep lymph vessels
4) saphenous nerve
5) nerve to the vastus medialis
6) terminal part of the obturator nerve

76
Q

The three compartments of the femoral sheath

A

1) lateral - contains the femoral artery
2) intermediate - contains the femoral vein
3) medial - contains the lymph vessels

Fascial sheath is a downward protusion of the fascial lining in the abdominal walls into the thigh
- Anterior is continuous with the transversalis fascia
- Posterior wall is continous with the fascia iliaca

77
Q

Femoral canal

A

Termed for the small medial compartment of the lymph vessels in the femoral sheath

The opening is termed the femoral ring and the femoral septum plugs the opening

78
Q

Potentially weak area in the abdominal wall

A

the femoral canal

79
Q

Potentially weak area in the abdominal wall

A

the femoral canal

The only part where the femoral sheath does not adhere to the wall of the vessel it contains

80
Q

A protrusion of peritoneum forced down the femoral canal and pushes the femoral septum

A

Femoral hernia

81
Q

Relations of the femoral ring:

A
  • anteriorly: inguinal ligament
  • posteriorly: superior ramus of the pubis
  • medially: lacunar ligament
  • laterally: femoral vein
82
Q

Blood supply and drainage of the anterior compartment of the thigh

A

femoral artery and femoral vein

83
Q

The femoral artery becomes the popliteal artery at what level?

A

through the opening of the adductor magnus muscle (adductor hiatus) at the popliteal space

84
Q

What structure is medial to the the femoral artery (1) and lateral to the femoral artery (2)

A

(1) femoral vein
(2) femoral nerve

85
Q

Branches of the femoral artery

A

1) superficial circumflex iliac artery
2) superficial epigastric artery
3) superficial external pudendal artery
4) deep external pudendal artery
5) profunda femoris artery > medial and lateral femoral circumflex arteries, 4 perforating arteries
6) descending genicular artery

86
Q

Supplies the skin of the scrotum

A

superficial & deep external pudendal artery

87
Q

The descending genicular artery supplies what structure?

A

knee joint

88
Q

(True/False)

The femoral nerve does not enter the thigh within the femoral sheath

A

True

89
Q

Branches of the Femoral Nerve (L2 - 4)

Memorize

A
90
Q

Thigh

Medial Fascial Compartment

Muscles, Blood supply, Nerve supply

A

Muscles: gracilis, adductor longus, adductor brevis, adductor magnus, and obturator externus

Blood supply: profunda femoris artery and obturator artery

Nerve Supply: obturator nerve

91
Q

Muscles of the Medial Compartment of the Thigh

Memorize

A
92
Q

Thigh

Posterior Fascial Compartment Contents

Muscles, Blood SUpply, Nerve Supply

A

Muscles: Biceps femoris, semitendinosus, semimembranosus, small part of the adductor magnus

Blood Supply: branches of the profunda femoris
Nerve Supply: sciatic nerve

93
Q

Muscles of the Posterior Thigh Compartment

Memorize

A
94
Q

The popliteal fossa is a diamond-shaped intermuscular space at the back of the knee

What are its boundaries?

A
  • Laterally-superior: biceps femoris
  • laterally-inferior: head of the gastrocnemius & plantaris
  • Medially-superior: semimembranous and semitendinous
  • Medially-inferior: medial head of the gastrocnemius
  • Anterior wall (floor): femur, capsule fo the knee joint, and the popliteus muscle
  • Roof: skin, superficial fascia, deep fascia

Gross Anatomy - Snell's (35 decks)

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