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Clinical Anatomy > Module 9 - Gluteal, Thigh, and Popliteal > Flashcards

Module 9 - Gluteal, Thigh, and Popliteal Flashcards

1
Q

What are the muscles of the gluteal region?

A
  • superior gemellus
  • inferior gemellus
  • gluteus maximus
  • gluteus medius
  • gluteus minimis
  • obturator internus
  • piriformis
  • quadratus femoris
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2
Q

Which gluteal muscles laterally rotate the hip?

A
  • superior gemellus
  • inferior gemellus
  • gluteus maximus
  • obturator internus
  • piriformis
  • quadratus femoris
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3
Q

Which gluteal muscles medially rotate the hip?

A
  • gluteus medias
  • gluteus minimis
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4
Q

What are the OIANs for superior gemellus?

A

origin: external surface spine of ischium via obturator internus tendon

insert: greater trochanter

action: laterally rotates hip

nerve: sacral plexus (L5-S2)

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5
Q

What are the OIANs of inferior gemellus?

A

origin: proximal ischial tuberosity via obturator internus tendon

insert: greater trochanter

action: laterally rotate hip

nerve: sacral plexus (L4-S1)

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6
Q

What are the OIANs of the gluteus maximus?

A

origin: aponeurosis of the erector spinae, sacrum, sacrotuberous ligament and posterior gluteal line (innominate)

insert: greater trochanter, gluteal tuberosity of the femur and IT tract

action: extend and lateral rotate hip

nerve: inferior gluteal nerve (L5-S2)

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7
Q

What are the OIANs of gluteus medius?

A

origin: external iliac surface

insert: oblique ridge on the lateral aspect of the greater trochanter; gluteal aponeurosis

action: abducts and medially rotates hip; keeps the pelvis level when opposite leg is raised off ground

nerve: superior gluteal nerve (L4-S1)

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8
Q

What are the OIANs of the gluteus minimis?

A

origin: external iliac surface and margin of the greater sciatic notch

insert: anterolateral aspect of the greater trochanter

action: abducts & medially rotates hip; and keeps the pelvis level when opposite leg is
raised

nerve: superior gluteal nerve (L4-S1)

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9
Q

What are the OIANs of obturator internus?

A

origin: anterior lateral wall of the pelvis and obturator membrane

insert: medial surface of the greater trochanter

action: laterally rotates hip

nerve: nerve to obturator internus (L5-S2)

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10
Q

What are the OIANs of piriformis?

A

origin: anterolateral sacrum and posterior inferior iliac spine

insert: upper border of the greater trochanter

action: abducts and laterally rotated hip

nerve: nerve to piriformis (S1-2)

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11
Q

What are the OIANs of quadratus femoris?

A

origin: ischial tuberosity

insert: quadrate tubercle of the femur

action: laterally rotates hip

nerve: nerve to quadratus femoris (L4-S1)

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12
Q

What Is the organization of the fascia lata and its thickening, the iliotibial tract?

A
  • deep fascia of the thigh
  • lateral + medial intermuscular septa
  • saphenous opening (great saphenous vein goes through here)

iliotibial tract
- extends from tensor fasciae latae and flutes maximums muscle to proximal lateral tibia
- long dense structure
- tight structure with bursae

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13
Q

What are the compartments of the thigh?

A
  • anterior
  • posterior
    -medial
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14
Q

What separates the compartments of the thigh?

A
  • medial (ant and medial compartments)
  • lateral (ant and post compartments)

no separation between medial and posterior compartments

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15
Q

What are the contents general actions, innervation, and blood supply of the anterior compartment of the thigh?

A
  • femoral n., hip flexors, knee extensors
  • flex hip and extend knee
  • femoral nerve innervation
  • femoral artery
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16
Q

What are the contents general actions, innervation, and blood supply of the posterior compartment of the thigh?

A
  • hip extensors and knee flexors
  • extend thigh and flex knee
  • tibial division of sciatic nerve
  • femoral artery
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17
Q

What are the contents general actions, innervation, and blood supply of the medial compartment of the thigh?

A
  • adductors of thigh
  • adduct thigh and laterally rotate
  • obturator nerve innervation
  • obturator artery supply

*adductor Magnus innervated by tibial division of sciatic (hamstring part)

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18
Q

What are the anterior femoral muscles?

A
  • iliopsoas (iliacus + psoas major)
  • rectus femoris
  • sartorius
  • tensor fascia latae
  • vastus medialis
  • vastus lateralis
  • vastus intermedius
  • articularis genu
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19
Q

What are the OIANs of articularis genu?

A

origin: distal anterior shaft of femur

insert: proximal portion of synovial membrane of knee joint

action: pulls articular capsule proximally

nerve: femoral nerve (L2-4)

may blend with vests intermedius

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20
Q

What are the OIANs of vastus medialis?

A

origin: intertrochanteric line, spiral line, linea aspera and medial supracondylar line

insert: base and medial border of patella

action: extends leg

nerve: femoral nerve (L2-4)

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21
Q

What are the OIANs of vastus lateralis?

A

origin: intertrochanteric line, greater trochanter, gluteal tuberosity, and Lina aspera

insert: base and lateral border of patella

action: extends knee

nerve: femoral nerve (L2-4)

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22
Q

What are the OIANs of vastus intermedius?

A

origin: anterior aspect of proximal 2/3 of femoral shaft

insert: lateral border of patella

action: extends knee

nerve: femoral nerve (L2-L4)

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23
Q

What are the OIANs of tensor fascia latae?

A

origin: anterior iliac spine and external lip iliac crest

insert: iliotibial tract

action: abducts, flexes, and medially rotates hip and assists in knee extension

nerve: superior gluteal nerve (L4-S1)

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24
Q

What are the OIANs of sartorius?

A

origin: anterior iliac spine

insert: medial aspect of proximal tibia

action: flexes, abducts, and laterally rotates hip, flexes and assists in medial rotation of knee

nerve: femoral nerve (L2-3)

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25
Q

What are the OIANs of rectus femoris?

A

origin: anterior iliac spine and groove superior to acetabulum

insert: base of patella

action: flex hip and extend knee

nerve: femoral nerve (L2-4)

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26
Q

What are the OIANs of iliacus?

A

origin: iliac fossa, iliac crest, sacral ala, and sacroilliac ligaments

insert: lesser trochanter of femur

action: flexes and stabilizes the hip joint

nerve: femoral nerve (L2-4)

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27
Q

What are the OIANs of psoas major?

A

origin: anterior transverse processes, vertebral bodies and discs (T12-L5)

insert: lesser trochanter of femur

action: flexes and stabilizes hip joint

nerve: ventral rami L1-L4 (lumbar plexus)

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28
Q

What is the spinal level innervation of iliopsoas?

A

L1-4

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29
Q

What are the medial femoral muscles?

A
  • adductor brevis
  • adductor longus
  • adductor magnus
  • gracilis
  • pectineus
  • obturator externus
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30
Q

What are the OIANs of obturator externus?

A

origin: rami of the pubis and ischium; external obturator membrane

insert: trochanteric fossa

action: laterally rotates hip

nerve: obturator nerve (L3-4)

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31
Q

What are the OIANs of pectineus?

A

origin: superior pubic ramus

insert: femur between the lesser trochanter and linea aspera (pectineal line)

action: adducts and flexes hip

nerve: femoral and obturator nerve (L2-4)

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32
Q

What are the OIANs of gracilis?

A

origin: body of the pubis and inferior pubic ramus

insert: medial surface of tibia, distal to condyle, proximal to insertion of semitendinosus, lateral to insertion of satorius

action: flexes and medially rotates knee, and adducts hip

nerve: obturator nerve (L2-4)

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33
Q

What are the OIANs of adductor Magnus?

A

origin: inferior pubic ramus, ischial ramus, and tuberosity

insert: gluteal tuberosity, line aspera (adductor part) & medial supracondylar ridge and adductor tubercle of femur (hamstring part)

action: adducts and flexes (adductor part) & extends (hamstring part) hip

nerve: obturator nerve (adductor part L2-4) and tibial division of sciatic nerve (hamstring part L4-S1)

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34
Q

What are the OIANs of adductor longus?

A

origin: pubic crest

insert: medial lip linea aspera

action: adducts, medially rotates, and flexes hip

nerve: obturator nerve (L2-4)

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35
Q

What are the OIANs of adductor brevis?

A

origin: inferior pubic ramus

insert: distal 2/3 pectineal line and medial lip linea aspera

action: adducts and flexes hip

nerve: obturator nerve (L2-4)

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36
Q

What are the posterior femoral muscles?

A
  • biceps femoris
  • semimembranosus
  • semitendinosus
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37
Q

What are the OIANs of semitendinosus?

A

origin: ischial tuberosity

insert: proximal, medial tibia

action: extends hip & flexes and medially rotates knee

nerve: tibial division of sciatic nerve (L4-S2)

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38
Q

What are the OIANs of semimembranosus?

A

origin: ischial tuberosity

insert: posterior aspect of the medial tibial condyle

action: extend hip & flexes and medially rotates knee

nerve: tibial division of sciatic nerve (L4-S2)

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39
Q

What are the OIANs of biceps femoris?

A

origin: ischial tuberosity and sacrotuberous ligament (long head); lateral lip of linea aspera and lateral supracondylar line (short head)

insert: lateral side of fibular head

action: flexes and laterally rotates the knee (both) and extends hip (long head only)

nerve: tibial division of sciatic (long head L5- S3) and fibular division of sciatic (short head L5-S2)

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40
Q

What are the boundaries of the femoral triangle?

A
  • inguinal ligament
  • adductor longus muscle
  • sartorius muscle

floor
- iliopsoas
- pectineus

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41
Q

What are the contents of the femoral triangle

A
  • femoral nerve, artery, and vein
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42
Q

What is the arrangement of the femoral artery, nerve, and vein?

A

lateral > medial
- nerve > artery > vein
NAV

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43
Q

What are the boundaries of the greater sciatic formina?

A
  • anterior sacroiliac lig
  • sacrotuberous lig
  • sacrospinous lig
    -greater sciatic notch
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44
Q

What are the contents of the greater sciatic foramina?

A
  • piriformis muscle
  • posterior femoral cutaneous nerve
  • superior gluteal vessels/nerve
  • inferior gluteal vessels/nerve
  • internal pudendal vessels
  • pudendal nerve
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45
Q

What are the boundaries of the lesser sciatic foramina?

A
  • spine of ischium
  • sacrotuberous lig
  • tuberosity of ischium
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46
Q

What are the contents of the lesser sciatic foramina?

A
  • obturator internus
  • internal pudendal vessels
  • pudendal nerve
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47
Q

What is a Trendelenburg gait and what structures are impairs in this condition?

A
  • abnormal gait where hip of leg lifted off the ground drops significantly due to weakness of opposite hip abductor muscles
  • affects superior gluteal nerve (L4-S1)
  • insufficient gluteus medias and minimis activation
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48
Q

What are the important dermatome points of the LE?

A
  • 1st toe = L4
  • 5th toe = S1
  • from top to bottom thigh = L1 > L2 > L3
  • medial shin = L4
  • lateral shin = L5
  • plantar and dorsal foot = L5
  • medial calf = S2
  • lateral calf = S1
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49
Q

What is the path taken by the femoral nerve?

A
  • saphenous branch descends through femoral triangle enters adductor canal, posterior (deep) to inguinal ligament
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50
Q

What is the path taken by the obturator nerve?

A
  • emerges inferior to superior pubic ramus
  • anterior and posterior branch
  • relation to adduction brevis
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51
Q

What is the path taken by the sciatic nerve?

A

between greater trochanter and ischial tuberosity
- splits into common fibular and tibial
- biceps femoris SH = fibular division
- biceps femoris LH = tibial division

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52
Q

What is the path taken by the common fibular nerve?

A
  • originates in sciatic nerve, courses along posterolateral aspect of leg deep to long head of biceps femoris and passes behind proximal fibular head
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53
Q

What is the path of the tibial nerve path?

A
  • originates from sciatic nerve, travels through the posterior compartment of leg, descending between the heads of gratrocnemius
54
Q

What is the path of lymphatic drainage of the lower extremity?

A

superficial inguinal and popliteal > deep inguinal > external iliac > ext iliac and int iliac > common iliac > R or L lumbar trunks > cisterna chyli > thoracic duct > internal jugular vein

55
Q

What is the level of cisterna chyli?

A
  • L2 vertebrae
56
Q

What does the popliteal lymph node drain?

A
  • drain knee and deep tissues of leg and foot
57
Q

What does the deep inguinal lymph node drain?

A
  • drain deep tissues of the thigh, popliteal nodes, and superficial inguinal nodes
58
Q

What does the superficial inguinal lymph node drain?

A
  • drain superficial structures inferior to umbilicus except for the anus and glans of the clitoris or penis
59
Q

What do the right and left lumbar trunks drain?

A
  • drain lateral aortic lymph nodes, carrying all lymphatic drainage from lower extremity
60
Q

What vessels supply blood to the head and neck of the femur and how does this change with age?

A
  • children = obturator artery
  • adults = medial circumflex artery
61
Q

What happens to the femur head and neck supply if there is a dislocation early in life?

A
  • interrupt acetabular br of the obturator artery
  • if later re-injured, avascular necrosis can develop
62
Q

What is the femoral sheath and its contents?

A
  • continuation of the plaices and transversalis fascia inferior to the inguinal ligament
  • contains femoral nerve, artery, and vein
63
Q

What are the locations you take femoral pulse?

A
  • below inguinal ligament , midway between pubic symphysis and anterior superior iliac spine
64
Q

What are the primary motions that occur at the knee?

A
  • flexion/extension
    rotation of tibia one femur during extension/flexion
65
Q

What are the primary motions that occur at the hip?

A
  • flexion/extension
  • abduction/adduction
  • circumduction
  • rotation
66
Q

What are the ligaments of the pelvic girdle?

A
  • sacrotuberous
  • sacrospinous
  • fibrous joint capsule
  • iliofemoral
  • pubofemoral
  • ischiofemoral
  • ligamentum teres (head of femur)
  • transverse acetabular
67
Q

What are the attachments of the transverse acetabular ligament?

A
  • interconnects margins of acetabular notch
68
Q

What are the attachments of the ligamentum teres?

A
  • fovea of femoral head to acetabular notch
69
Q

What are the attachments of the ischiofemoral ligament?

A
  • ischium posterior to acetabulum to the greater trochanter and iliofemoral ligament
70
Q

What are the attachments and function of the pubofemoral ligament?

A
  • from iliopubic eminence and superior pubic ramus to fibrous capsule
  • limits femoral abduction
71
Q

What are the attachments and function of the iliofemoral ligament?

A
  • anterior iliac spine to the intertrochanteric line of the femur
  • limit extension of thigh at hip
72
Q

What are the attachments of the fibrous joint capsule of the hip?

A
  • margin of the acetabulum to the neck, intertrochanteric line, and intertrochanteric crest of the femur
73
Q

What are the attachments of the sacrospinous ligament?

A
  • ischial spine to lateral margin of sacrum
74
Q

What are the attachments of the sacrotuberous ligament?

A
  • posterior iliac spine and lateral margin of the sacrum to the ischial tuberosity
75
Q

What are the ligaments of the knee?

A
  • fibrous capsule of the knee
  • tibial (medial) collateral
  • fibular (lateral) collateral
  • anterior cruciate
  • posterior cruciate
  • patellar ligament
76
Q

What are the attachments of the fibrous capsule of the knee?

A
  • margins of the femoral condyles to the margins of the tibial condyles
77
Q

What are the attachments and function of the tibial (medial) collateral ligament?

A
  • medial epicodyle of the femur to the medial condyle and shaft of the tibia
  • prevent abduction of tibia (genu valgus)
78
Q

What are the attachments and functions of the fibular (lateral) collateral ligament?

A
  • lateral epicondyle of the femur to the head of the fibula
  • prevent adduction of tibia (genu varus)
79
Q

What are the attachments and function of the anterior cruciate ligament?

A
  • medial part of the anterior intercondylar area of the tibia to the posterior part of the medial surface of the lateral condyle of the femur
  • prevents posterior displacement of the femur on the tibia and hyperextension of the knee
80
Q

What are the attachments and functions of the posterior cruciate ligament?

A
  • posterior intercondylar area of the tibia to the lateral surface of the medial condyle of the femur
  • prevents anterior displacement of the femur on tibia
81
Q

What are the attachments and function of the patellar ligament?

A
  • apex of the patella to the tibial tuberosity
  • resists knee flexion
82
Q

What are the capsular ligaments of the hip?

A
  • iliofemoral (strong enough to hold entire body weight
  • pubofemoral (anterior)
  • ischiofemoral (posterior)
  • all will be taught in extension/limit extension
83
Q

What are the capsular ligaments of the knee?

A
  • MCL/TCL
  • LCL/FCL
84
Q

What are the joints of the pelvic girdle and hip?

A
  • sacroiliac
  • pubic symphysis
  • hip
85
Q

What is the synovial joint classification of the sacroiliac joint?

A
  • plane
86
Q

What is the synovial classification of the hip joint?

A
  • ball and socket
87
Q

What are the joints of the knee?

A
  • tibiofemoral
  • patellofemoral
  • proximal tibiofibular
88
Q

What is the synovial classification of the tibiofemorl joint?

A
  • bi condylar
89
Q

What is the synovial classification of the proximal tibiofibular joint?

A
  • plane
90
Q

What are the identifying features of the medial and lateral menisci?

A

medial
- larger
- C shape
- attached to MCL

lateral
- smaller
- O shape

91
Q

What are the injuries of the meniscus?

A
  • bucket handle
  • radial tear
92
Q

What are the strictly sensory branches of the lumbar plexus?

A
  • femoral (L1-2)
  • lateral cutaneous nerve of the thigh (L2-3)
93
Q

What nerves belong to the anterior division of the sacral plexus?

A
  • branches to levator ani
  • pudendal nerve
  • posterior cutaneous nerve of the thigh
  • tibial division/tibial nerve of sciatic
94
Q

What nerves belong to the posterior division of the sacral plexus?

A
  • superior gluteal
  • inferior gluteal
  • nerve to piriformis
  • perforating cutaneous
  • fibular division/ common fibular nerve of sciatic
95
Q

What is the most common mechanism of injury for hip dislocation and what structure is most affected?

A
  • motor vehicle accident
  • injure sciatic nerve
96
Q

What are the weak points of the pelvis?

A
  • weakest: between pubis and ischium
  • superior pubic ramus
  • inferior pubic ramus
97
Q

What is a double ring and single ring fracture?

A

double
- between pubis and ischium
- superior pubic ramus fracture

single
- inferior pubic ramus fracture

98
Q

What is normal angle of inclination and what are the indications of coxa vara and valgum?

A
  • 125 deg
  • coxa vara = <125 deg inclination, leads to genu valgum
  • coxa valgum = >125 deg inclination, leads to genus varam
99
Q

what is the normal angle of torsion?

A
  • 8 to 15 deg
100
Q

What is retrovesion and anterversion?

A
  • anterversion = pigeon toed
  • retroversion = duck feet
101
Q

What are the boundaries of the popliteal fossa?

A
  • popliteal surface of femur
  • joint capsule of knee
  • popliteus muscle and its fascia
102
Q

What are the contents of the popliteal fossa?

A

superficial to deep
- tibial nerve
- popliteal vein
- popliteal artery

103
Q

What muscles offer knee support?

A
  • sartorius
  • gracilis
  • semitendinosus

(goose’s foot)

104
Q

What are the boundaries of the gluteal region?

A
  • inferior = gluteal fold
  • lateral = line joining greater trochanter and ASIS
  • superior = iliac crest
  • medial = midline of body
105
Q

What is the subpubic angle of men and women?

A
  • men = 50-80 deg
  • women = 90 deg (iliac flare)
106
Q

What are the bones of the pelvic girdle?

A
  • inominate (pubis, ilium, ischium)
  • sacrum
  • coccyx
107
Q

What is the stage of fusion for the ischiopubic ramus?

A
  • starts to fuse @ 7-8 yrs old
  • fully fuses @ 15-25 yrs old
108
Q

What is the function of quadratus lumborum branch of the lumbar plexus?

A
  • sensory, postganlionic symp, and motor innervation of quadratus lumborum muscle
109
Q

What is the function of the psoas branch of the lumbar plexus?

A
  • sensory, postganlionic symp, and motor innervation of the psoas muscle
110
Q

What are the functions of the lateral cutaneous nerve?

A

L2-3
- sensory and postganglionic sympathetic innervation of the skin overlying the lateral aspect of the thigh

111
Q

What are the functions of the saphenous nerve branch of the femoral nerve?

A

L2-4
- sensory and postganlionic sympathetic innervation of the skin overlying the medial aspect of the leg

112
Q

What are the functions of the muscular branches of the femoral nerve?

A

L2-4
- sensory, postganlionic sympathetic, and motor innervation of the iliacus, pectineus, sartorius, rectus femoris, vastus lateralis, vastus medialis, and vastus intermedius muscles

113
Q

What are the functions of the obturator nerve?

A

L2-4
- sensory, postganglionic symp, and motor innervation of the gracilis, adductor brevis, adductor longus, adductor Magnus, and obturator externus muscles

114
Q

What are the functions of the nerve to piriformis branch of the sacral plexus?

A

S1-2
- sensory, postganlionic symp, and motor innervation of the piriformis muscle

115
Q

What are the functions of the nerve to quadratus femoris branch of the sacral plexus?

A

L4-5, S1
- sensory, postganglionic symp, and motor innervation of the quadratus femoris and inferior gemellus muscles

116
Q

What are the functions of the nerve to obturator internus branch of the sacral plexus?

A

L5,S1-2
- sensory, postganglionic symp, and motor innervation of the obturator internus and superior gemellus muscles

117
Q

What are the sensory branches of the sacral plexus?

A
  • perforating cutaneous and posterior cutaneous nerve of the thigh
118
Q

What is the function of the perforating cutaneous nerve?

A

S2-3
- sensory, postganglionic symp innervation of the medial part of buttock

119
Q

What are the function of the posterior cutaneous nerve of the thigh?

A

S1-3
- sensory, postganglionic symp innervation of buttock and uppermost medial and posterior surfaces of thigh

120
Q

What are the functions of the superior gluteal nerve?

A

L4-5, S1
- sensory, postganglionic symp, and motor innervation of the gluteus medius, gluteus minimus, and tensor fasciae latae muscles

121
Q

What are the functions of the inferior gluteal nerve?

A

L5, S1-2
- sensory, postganglionic symp, and motor innervation of the gluteus maximus muscle

122
Q

What are the functions of the musclar branches of the tibial division of the sciatic nerve?

A
  • sensory, postganglionic sympathetic and motor innervation of semimembranosus, semitendinosus, biceps femoris (LH) and adductor magnus muscles
123
Q

What is the function of the sural nerve branch of the tibial nerve?

A
  • sensory and postganglionic symp innervation of skin overlying lateral aspect of leg and foot
124
Q

What are the functions of the muscular branches of the tibial nerve?

A
  • sensory, postganglionic symp, and motor innervation of the gastrocnemius, soleus, planteris, popliteus, tibialis posterior, flexor digitorum longus, and flexor hallucis longus muscles
125
Q

What are the functions of the medial plantar nerve branch of the tibial nerve?

A
  • sensory, postganglionic symp, and motor innervation of the medial muscles of the planter surface of the foot
126
Q

What are the functions of the lateral plantar nerve branch of the tibial nerve?

A
  • sensory, postganglionic symp, and motor innervation of the lateral muscles of the plantar surface of the foot
127
Q

What are the functions of the muscular branches of the fibular division of the sciatic nerve?

A
  • sensory, postganlionic symp, and motor innervation of the biceps femoris short head
128
Q

What are the functions of the lateral sural nerve branch of the common fibular nerve?

A
  • sensory and postganlionic symp innervation of the skin overlying lateral aspect of leg
129
Q

What are the functions of the deep fibular nerve?

A
  • sensory, postganglionic symp, and motor innervation of the tibialis anterior, extensor hallucis longus, extensor digitorum longus, and fibulas tertius muscles
130
Q

What are the functions of the superficial fibular nerve branch of the common fibular nerve?

A
  • sensory, postganglionic symp, and motor innervation of the fibularis longus and brevis muscles

Clinical Anatomy (12 decks)

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