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MSK anatomy > Muscles Of The Gluteal Region And Thigh And Neurovascular Supply Of The Thigh > Flashcards

Muscles Of The Gluteal Region And Thigh And Neurovascular Supply Of The Thigh Flashcards

1
Q

2 groups of muscles in gluteal region

A

Superficial
Deep

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2
Q

Superficial gluteal muscles

A

Gluteus maximus
Gluteus medius
Gluteus minimus
Tensor fascia latae

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3
Q

Number of superficial gluteal muscles

A

4

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4
Q

Proximal Attachments of gluteus maximus

A

Most posterior parts of the posterior surface of the ilium
Sacrotuberous ligament
Sacrum

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5
Q

Distal attachments of the gluteus maximus

A

Iliotibial band
Gluteal tuberosity

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6
Q

Function of gluteal maximus

A

Extensor of the hip
- Important for standing from a sitting position
External rotator of the hip
Stabilises knee joint- as inserts into Iliotibial tract

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7
Q

Attachments of the gluteus medius and gluteus minimus

A

Posterior ilium
Greater trochanter

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8
Q

Function of gluteus medius and gluteus minimus

A

Abduction of hip
Internal rotation of hip

Important role in normal gait- contraction and hold the pelvis level when walking

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9
Q

Attachments of the tensor fascia latae

A

ASIS
Iliotibial band

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10
Q

Function of tensor fascia latae

A

Tenses the fascia lata and Iliotibial band- stabilising the knee when extended
Weak hip flexor

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11
Q

Fascia lata

A

A thick fascia that envelopes the muscles of the thigh from the iliac crest proximally to the tibia distally

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12
Q

Which nerves innervate the superficial gluteal muscles

A

Gluteal nerves which leave the sacral plexus via the greater sciatic foramen

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13
Q

Which nerve innervates the gluteus maximus

A

Inferior gluteal nerve

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14
Q

Which nerve innervates the gluteus medius, gluteus minimus and tensor fascia latae

A

Superior gluteal nerve

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15
Q

Function of deep gluteal muscles

A

Stabilise and laterally rotate the hip

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16
Q

Number of deep gluteal muscles

A

5

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17
Q

Deep gluteal muscles

A

Piriformis
Superior and inferior gemelli
Obturator internus
Quadratus femoris

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18
Q

What do all deep gluteal muscles insert into or close to

A

Greater trochanetr

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19
Q

Path of piriformis muscle

A

Attaches to anterior surface of sacrum
Passes through greater sciatic foramen
Inserts on greater trochanter

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20
Q

Over which muscle do the nerves of the sacral plexus pass

A

Piriformis

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21
Q

Where does the sciatic nerve emerge

A

Below inferior border of Piriformis in gluteal region

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22
Q

What do the superior and inferior gemelli and quadratus femoris arise from

A

Ischium

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23
Q

What does the obturator internus arise from

A

Obturator membrane

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24
Q

What does the tendon of the obturator internus pass through

A

Lesser sciatic foramen

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25
Q

Number of muscles in anterior thigh

A

7

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26
Q

What are the muscles of the anterior thigh innervated by

A

Femoral nerve

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27
Q

Which spinal nerves are the femoral nerve derived from

A

L2-L4

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28
Q

Muscles of the anterior thigh

A

Quadriceps femoris- 4 muscles
Sartorius
Iliopsoas
Pectineus

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29
Q

Function of quadriceps femoris

A

Primary Extensor of the knee

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30
Q

Muscles of quadriceps femoris

A

Rectus femoris
Vastus lateralis
Vastus medialis
Vastus intermedius

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31
Q

Quadriceps tendon

A

Convergence of all 4 quadriceps femoris muscles
Runs over patella to insert into the tibial tube rosary via the patellar ligament

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32
Q

Rectus femoris

A

Lies in midline of anterior thigh
Attaches to AIIS

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33
Q

Function of rectus femoris

A

Flexion of hip
Extension of knee

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34
Q

Vastus lateralis

A

Lies lateral to rectus femoris
Attaches to linea aspera on posterior aspect of femoral shaft

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35
Q

Vastus medialis

A

Lies medial to rectus femoris
Attaches to linea aspera

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36
Q

Vastus intermedius

A

Lies deep to rectus femoris
Attaches to anterior aspect of femoral shaft

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37
Q

Sartorius location

A

Superficially in anterior thigh
Attaches to ASID and twists across thigh to insert on medial aspect of proximal tibia

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38
Q

Function of sartorius muscle

A

Flexion and external rotation of hip joint
Flexion of knee

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39
Q

Iliopsoas location

A

Proximal in anterior thigh
Psoas major and iliacus converge via a common tendon onto the lesser trochanter of the femur

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40
Q

Which 2 muscles form the ilipsoas

A

Psoas major
Iliacus

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41
Q

Function of ilipsoas

A

Primary Flexor of hip joint

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42
Q

What innervated the psoas major

A

Branched of L1-L3 spinal nerves

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43
Q

What innervates the iliacus muscle

A

Femoral nerve

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44
Q

What is the primary flexor of the hip joint

A

Ilipsoas

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45
Q

Pectineus location

A

In proximal anterior thigh medial to ilipsoas
Attaches proximally to superior pubic ramus and distally in femur (just inferior to lesser trochanter)

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46
Q

Function of pectineus

A

Flexes and adducts the hip joint

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47
Q

Number of muscles in the medial thigh

A

5

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48
Q

Which nerve innervates the muscles of the medial thigh

A

Obturator nerve

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49
Q

Which spinal nerves form the obturator nerve

A

L2-L4

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50
Q

Primary action of the medial thigh muscles

A

Adductors of the hip

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51
Q

Muscles of the medial thigh

A

Adductor brevis
Adductor longus
Adductor Magnus
Gracilis
Obturator externus

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52
Q

Which 2 muscles does the Obturator nerve lie between

A

Adductor brevis and adductor longus

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53
Q

Attachments of the adductor brevis and adductor longus

A

Pubic bone
Linea aspera

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54
Q

2 parts of adductor Magnus

A

Adductor part
Hamstring part

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55
Q

Adductor part of adductor Magnus

A

Attaches to inferior pubic ramus and linea aspera
Acts as an adductor
Innervated by Obturator nerve

56
Q

Hamstring part of adductor Magnus

A

Attaches to ischia’s tuberosity and adductor tubercle
Acts as an extensor of the hip

57
Q

Hamstring part of adductor Magnus function

A

Extensor of hip

58
Q

Hamstring part of adductor Magnus innervation

A

Tibial part of sciatic nerve

59
Q

Adductor hiatus

A

Gap formed between the distal attachments of the 2 parts of the adductor magnus

60
Q

What travels through the adductor hiatus

A

Femoral artery and vein to enter posterior thigh

61
Q

Gracilis location

A

Most medial muscle
Attaches to pubic bone and medial aspect of tibia

62
Q

Gracilis function

A

Weak adductor and flexor of hip
Weak flexor of knee

63
Q

Obturator externus location

A

Attached to external surface of Obturator membrane and inserts in femur near greater trochanter

64
Q

Function of Obturator externus

A

Stabilises and laterally rotates the hip

65
Q

Number of muscles in posterior thigh

A

4

66
Q

Muscles in posterior thigh

A

Semimembranosus
Semitendinosus
Biceps femoris
Hamstring part of adductor magnus

67
Q

Which muscles form the hamstrings

A

Semimembranosus
Semitendinosus
Long head of biceps femoris

68
Q

What do the hamstrings attach to

A

Ischial tuberosity proximally

69
Q

Function of the hamstrings muscles

A

Extend the hip
Flex the knee

70
Q

What innervates the hamstrings muscles

A

Tibial part of the sciatic nerve

71
Q

What does the Semimembranosus and Semitendinosus insert into

A

Medial aspect of proximal tibia

72
Q

What does the long head of the biceps femoris insert into

A

Forms a common tendon with the short head and inserts onto head of the fibula

73
Q

What does short head of the biceps femoris arise from

A

Linea aspera

74
Q

What innervates the short head of biceps femoris

A

Common fibular part of sciatic nerve

75
Q

Function of short head of biceps femoris

A

Flexes the knee

76
Q

What does the hamstring part of adductor magnus arise from

A

Ischial tuberosity

77
Q

What does the hamstring part of the adductor magnus insert onto

A

Adductor tubercle of the femur

78
Q

Function of the hamstring part of the adductor magnus

A

Extends the hip

79
Q

Biceps femoris

A

Short head and long head

80
Q

Femoral triangle

A

Region of the proximal anterior thigh

81
Q

Lateral border of the femoral triangle

A

Medial border of the sartorius

82
Q

Medial border of the femoral triangle border of the femoral triangle

A

Lateral border of adductor longus

83
Q

Superior border of the femoral triangle

A

Inguinal ligament

84
Q

Apex of the femoral triangle

A

Distal
Where sartorius and adductor longus meet

85
Q

Floor of the femoral triangle

A

Ilipsoas laterally
Pectineus medially

86
Q

Contents of the femoral triangle

A

Femoral artery
Femoral vein
Femoral nerve
Lymknatics

87
Q

Tributary into the femoral vein

A

Superficial vein- great saphenous vein

88
Q

Location of femoral nerve

A

Travels deep to the inguinal ligament to enter the anterior thigh

89
Q

Order of contents of femoral triangle from lateral to medial

NAVaL

A

Nerve
Artery
vein
Lymphatics

90
Q

What are the superior and inferior gluteal arteries branches of

A

Internal iliac artery

91
Q

What is the femoral artery a branch of

A

External iliac artery

92
Q

What is the Obturator artery a branch of

A

Internal iliac artery

93
Q

Branches of the femoral artery

A

Profunda femoris
Popliteal artery

94
Q

What does the femoral artery become

A

Popliteal artery

95
Q

Path of femoral artery

A

It travels deep to the inguinal ligament to enter the proximal anterior thigh. It is located relatively superficially here and can be palpated. It gives off a large branch called the profunda femoris (deep artery of the thigh) which travels deep into the thigh and supplies it. The femoral artery continues distally, traverses the adductor hiatus, and enters the distal part of the posterior thigh where it becomes the popliteal artery.

96
Q

Path of Obturator artery

A

It travels through the obturator canal into the medial compartment of the thigh. It anastomoses with branches from the femoral artery.

97
Q

Which 2 arteries of the thigh anastomose

A

Femoral and obturator

98
Q

Which arteries supply the hamstring muscles

A

3/4 perforating arteries that arise from the profunda femoris

99
Q

Path of perforating arteries

A

travel through small apertures in the adductor magnus to reach the posterior compartment.

100
Q

Veins of the thigh

A

Superior and inferior gluteal veins
Popliteal vein—> femoral vein
Great saphenous vein
Obturator vein

101
Q

Which veins drain into the internal iliac vein

A

Obturator
Superior and inferior gluteal

102
Q

Path of femoral vein

A

Medial to femoral artery in proximal thigh

103
Q

How does the popliteal vein enter the anterior thigh

A

Via the adductor hiatus

104
Q

What does the femoral vein receive blood from in the femoral triangle

A

Great saphenous vein

105
Q

Which vein becomes the external iliac vein

A

Femoral vein after travelling under the inguinal ligament

106
Q

Which nerve innervates the skin over the leg

A

Saphenous nerve

107
Q

What is the saphenous nerve a branch of

A

Femoral nerve

108
Q

Obturator nerve

A

travels along the lateral wall of the pelvis and exits through the obturator canal. It emerges onto the superficial surface of adductor brevis and gives rise to branches that innervate the medial compartment muscles and skin over the medial thigh.

109
Q

Sciatic nerve

A

leaves the pelvis via the greater sciatic foramen and enters the gluteal region inferior to the lower border of piriformis. The nerve is really composed of two separate nerves bound together – the tibial nerve and the common fibular nerve.

110
Q

Which nerves form the sciatic nerve

A

Tibial nerve
Common fibular nerve

111
Q

Tibial nerve innervates

A

Muscles of posterior thigh and posterior leg

112
Q

Common fibular nerve innervates

A

Muscles of anterior and lateral leg

113
Q

Which spinal nerves form the sciatic nerve

A

L4-S3

114
Q

Neurovascular access

A

The femoral artery can be accessed in the femoral triangle. This is very commonly undertaken for angiography. The femoral vein is medial to the femoral artery. Using knowledge of anatomy and surface landmarks, in emergency situations, it can be easily accessed for blood samples if they cannot be obtained from peripheral veins.

115
Q

Fascia iliaca compartment block

A

This is a commonly performed procedure in the emergency department where a relatively large volume (around 30-40ml) of local anaesthetic is injected, usually under ultrasound guidance, just underneath the fascia of the iliacus muscle near the femoral triangle. In this ‘compartment’, there are several nerves that carry pain sensation from the around the neck of the femur, including the femoral and obturator nerves, so it is performed to provide analgesia (pain relief) to patients that have sustained a neck of femur fracture. Care must be taken not to accidentally inject the anaesthetic into an artery or vein.

116
Q

Femoral hernia

A

Similar to an inguinal hernia, this is an abnormal protrusion of intestine into the upper anterior thigh. It is more common in females. The intestine passes deep to the inguinal ligament and causes a lump to appear just distal to the inguinal region. Strangulation of the herniated intestine leads to ischaemia and infarction of the tissue.

117
Q

Obturator nerve irritation

A

Along its course on the lateral wall of the pelvis, the obturator nerve runs close to the ovary. Ovarian pathology, such as a cyst, may irritate the nerve. This typically results in sensory abnormalities (tingling, itching or pain) in the medial thigh.

118
Q

Gluteal IM injection

A

Gluteus maximus is a common site for intramuscular injection, but the sciatic nerve must be avoided. Given the position of the nerve deep to the gluteal muscles, the only safe place to give an injection is into the upper outer quadrant of the buttock to safely avoid the sciatic nerve.

119
Q

Sciatica

A

This term is in common use and describes pain that is felt in the posterior thigh and leg due to compression of nerve roots that contribute to the sciatic nerve (L4 - S3). Most commonly it is the result of a prolapsed (‘slipped’) intervertebral disc between L5 and S1.

120
Q
  1. Which muscles are the primary abductors of the hip joint? Explain why abduction is important for normal gait.
A

Gluteus medius and gluteus minimus
Abductors contract to hold pelvis level and prevent tilt

121
Q
  1. Which muscles attach to the ischial tuberosity?
A

Semimembranosus
Semitendinosus
Long head of biceps femoris
Hamstring part of adductor magnus

122
Q
  1. Which arteries supply the gluteal region? What larger vessel do they arise from?
A

Superior and inferior gluteal arteries
- internal iliac

123
Q
  1. Which vessel supplies the posterior compartment of the thigh?
A

Perforating arteries that arise from the profunda femoris

124
Q
  1. What is the surface marking of the femoral artery?
A

Just below the inguinal ligament at the point halfway between the pubic tubercle and ASIS

125
Q
  1. How do the femoral artery, vein and nerve lie relative to each other in the femoral triangle?
A

NAV lateral to medial

126
Q
  1. Which compartment and muscles are supplied by the femoral nerve? What is the general action of this muscle group?
A

Anterior - quadriceps femoris, sartorius, iliopsoas and pectineus
-primary flexors of hip and extensors of knee

127
Q
  1. Which regions of skin in the lower limb are innervated by the femoral nerve?
A

Anterior thigh and anteromedial leg (via saphenous nerve)

128
Q
  1. What forms the adductor hiatus and what passes through it?
A

Aperture formed between the attachments of the 2 parts of the adductor magnus to femur
-femoral artery and vein

129
Q
  1. Describe the course of the obturator nerve.
A

o The nerve is composed of fibres from the L2-L4 spinal nerves.
o It descends into the pelvis and courses along the lateral wall of the pelvis with the obturator artery and vein.
o It travels through the obturator foramen.
o It travels between adductor brevis and longus. It gives rise to branches that innervate the medial thigh muscles and the skin of the medial thigh.

130
Q

What artery supplies the posterior thigh compartment

A

Profunda femoris (branch of femoral)

131
Q

What artery supplies the medial thigh compartment

A

Obturator

132
Q

What artery supplies the anterior thigh compartment

A

Femoral

133
Q

What artery supplies the gluteal compartment

A

Superior and inferior gluteal (branch of internal iliac)

134
Q

Primary hip flexors

A

Iliacus
Psoas major

135
Q

Which muscles insert into lesser trochanter of femur

A

Iliacus
Psoas major

MSK anatomy (13 decks)

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