Lower Limb Overview and Gluteal Region

Question 1

What is the deep fascia of the thigh?

Answer 1

• Fascia lata
• Splits to enclose and to provide attachment to tensor fascia lata and gluteus maximus muscle
• Partly attaches to patella
• Forms roof of popliteal fossa
• Continuous with deep fascia of leg (fascia cruris) and further distally with fascia of foot

Question 2

What is the thickened lateral portion of the fascia lata called?

Answer 2

• Iliotibial tract
• Extends from greater trochanter to tibial lateral condyle
• Superiorly connected to tensor fascia lata and gluteus maximus muscle and gluteal aponeurosis

Question 3

What are the compartments of the thigh?

Answer 3

Extensor (innervated by femoral nerve), adductor (innervated by obturator nerve), and flexor (innervated by sciatic (tibial branches) nerve)

Question 4

What are retinacula?

Answer 4

Deep fascial thickenings that support underlying structures, mainly long tendons

Question 5

What are the two superficial veins of the leg?

Answer 5

• Great Saphenous Vein: starts at medial side of dorsal venous arch of foot, drains into femoral vein through gap in fascia lata in the superomedial thigh
• Small Saphenous Vein: starts at lateral side of dorsal venous arch of foot, ends into popliteal vein

Question 6

What are the general fixed locations of perforating veins in the leg?

Answer 6

Medial and lateral ankle, knee, and mid-adductor (thigh)

Question 7

What helps venous return in the leg?

Answer 7

Muscle contractions and arterial pulsation help convey venous blood forward, valves are present to prevent backflow except in the deep veins in the soleus muscle

Question 8

What can cause lower limb varicose veins?

Answer 8

Incompetent valves, congenital absence of valves, or persistently elevated intra-abdominal pressure

Question 9

What innervates the gluteus maximus?

Answer 9

Inferior gluteal nerve (L5-S2)

Question 10

What innervates the gluteus medius?

Answer 10

Superior gluteal nerve (L4-S1)

Question 11

What innervates the gluteus minimus?

Answer 11

Superior gluteal nerve (L4-S1)

Question 12

What innervates the tensor fascia lata?

Answer 12

Superior gluteal nerve (L4-S1)

Question 13

What innervates the piriformis?

Answer 13

Branches of anterior rami of S1-S2

Question 14

What innervates the obturator internus?

Answer 14

Nerve to obturator internus (L5-S2)

Question 15

What innervates the superior gemellus?

Answer 15

Nerve to obturator internus (L5-S2)

Question 16

What innervates the inferior gemellus?

Answer 16

Nerve to quadratus femoris (L4-S1)

Question 17

What innervates the quadratus femoris?

Answer 17

Nerve to quadratus femoris (L4-S1)

Question 18

What nerves provide cutaneous innervation in the gluteal region?

Answer 18

• Superior clunial nerve - posterior rami of L1-3
• Middle clunial nerve - posterior rami of S1-3
• Inferior clunial nerve - recurrent branches of posterior femoral cutaneous nerve (S1-3)

Question 19

What muscles does the superior gluteal nerve supply?

Answer 19

• Gluteus medius, gluteus minimus, tensor fascia lata

Question 20

What does the nerve to quadratus femoris supply?

Answer 20

Hip joint, inferior gemellus, quadratus femoris

Question 21

What does the inferior gluteal nerve supply?

Answer 21

Gluteus maximus

Question 22

What does the nerve to obturator internus supply?

Answer 22

Superior gemellus, obturator internus

Question 23

What does the pudendal nerve supply?

Answer 23

Most of the perineum

Question 24

What does the posterior cutaneous nerve of the thigh/posterior femoral cutaneous nerve supply?

Answer 24

Skin of the buttocks via inferior clunial branches, skin over posterior thigh and calf