Muscles of the Thigh Flashcards
Gluteus Maximus m. Origin
- Ilium posterior to posterior gluteal line
- Dorsal surface of sacrum
- Sacrotuberous ligament
Gluteus Maximus m. Insertion
- IT band
- Gluteal tuberosity
Gluteus Maximus m. Action
- Extension
- Lateral rotation
- Rising from seated position
Gluteus Maximus m. Innervation (Nerve and Artery)
- N: Inferior gluteal N (L5-S2)
- A: Superior and Inferior Gluteal A
Gluteus Medius m. Origin
-External ilium b/t ant. and post. gluteal lines
Gluteus Medius m. Insertion
Lateral surface of greater trochanter
Gluteus Medius m. Action
- Abduct
- Medially rotate thigh
Gluteus Medius m. Innervation (Nerve and Artery)
- N: Superior gluteal N
- A: Superior gluteal A.
Gluteus Minimus m. Origin
External ilium b/t anterior and inferior gluteal lines
Gluteus Minimus m. Insertion
Anterior surface of greater trochanter
Gluteus Minimus m. Action
Abduct and medially rotate thigh
Gluteus Minimus m. Innervation (Nerve and Artery)
- N: Superior gluteal n (L5, S1)
- A: Superior gluteal A
Tensor Fascia Lata m. Origin
ASIS, anterior iliac crest
Tensor Fascia Lata m. Insertion
IT Tract
Lateral epicondyle of tibia
Tensor Fascia Lata m. Action
Abduct
medially rotate thigh
flex thigh
maintain extended leg
Tensor Fascia Lata m. Innervation (Nerve and Artery)
- N: Superior gluteal N (L5, S1)
- A: Lateral circumflex A.
Which muscles abduct and medially rotate the thigh?
- Gluteus medius m.
- Gluteus Minimus m.
- Tensor Fascia Latae m.
Which groups laterally rotate and extend/abduct the thigh?
- Piriformis m.
- Obturator Internus m.
- Superior Gemelli m.
- Inferior Gemelli m.
- Quadratus Femoris m.
Which muscles attach to the greater trochanter?
- Piriformis m. (superior)
- Gluteus medius m. (Lateral)
- Gluteus minimus m. (anterior)
- Obturator externus m. (posterior)
- Obturator internus m.
- Superior Gemellus m (medial)
- Inferior Gemellus m (medial)
Piriformis m. Origin
- Anterior surface of sacrum
- Sacrotuberous ligament
Piriformis m. Insertion
Superior border of greater trochanter of femur
Piriformis m. Action
- Laterally rotate extended thigh
- Abduct flexed thigh
- Stabilize femoral head in acetabulum
Piriformis m. Innervation
- N to Pisiformis (Ventral Rami S1,2)
- Inferior gluteal A.
Obturator internus m. Origin
Pelvic surface of obturator membrane
Obturator internus m. Insertion
Medial surface of greater trochanter of femur
Obturator internus m. Action
Laterally rotate extended thigh
Abduct flexed thigh
Obturator internus m. Innervation
- N to Obturator Internus (L5, S1)
- Inferior gluteal A.
What structure passes through the lesser sciatic foramen?
Tendon of Obturator Internus
P: Pudendal N (enters perineum)
I: Internal Pudendal A
N: N. to Obturator Internus
Superior and Inferior Gemelli m. Origin
Superior: Ischial spine
Inferior: Ischial tuberosity
Superior and Inferior Gemelli m. Insertion
Medial surface of greater trochanter of femur
Superior and Inferior Gemelli m. Action
- Laterally rotate extended thigh
- Abduct flexed thigh
Superior and Inferior Gemelli m. Innervation
Superior N: N to obturator Internus
Inferior N: N to Quadratus femoris (L5,S1)
Artery (both): Inferior Gluteal a.
Quadratus Femoris m. Origin
Lateral border of ischial tuberosity
Quadratus Femoris m. Insertion
intertrochanteric crest on femur
Quadratus Femoris m. Action
Laterally rotate thigh
Quadratus Femoris m. Innervation
- N: N. to Quadratus femoris (L5,S1)
- A: Medial circumflex femoral a. and inferior gluteal a
Piriformis Syndrome
- Pathology of Piriformis (spasm, tightening, other pathology), causing irritation of sciatic N.
- Shooting pain down thigh and back of leg
Which arteries are involved in the cruciate anastomosis?
- Inferior gluteal a.
- Medial circumflex a.
- Lateral circumflex a.
- First perforating branch of the Profundus Femoris a.
What can damage or lesion to the Superior Gluteal N cause? What muscles does it innervate? What is the pathology called and what does it present as?
- Trendelenburg Sign (Duchenne’s Limp)
- Denervation or weakness of Gluteus Medius and Minimus m.
- Issues with medially rotating thigh, so your foot drags as you walk and pelvis drips on side opposite to injury
What 7 nerve structures pass through the greater sciatic foramen?
- Sciatic N
- Superior Gluteal N.
- Inferior Gluteal N.
- Pudendal N
- Posterior Femoral Cutaneous N.
- N. to Quadratus Femoris
- N to Obturator Internus
What 5 structures pass through the lesser sciatic foramen?
- Tendon of Obturator Internus
2/3. Internal Pudendal A and V - Pudendal N
- N. to obturator Internus
What 3 vessel structures pass through the greater sciatic foramen?
- Superior Gluteal A and V
- Inferior Gluteal A and V
- Internal Pudendal A and V
What muscle passes through the greater sciatic foramen?
Piriformis m
What structures pass through both the greater and lesser sciatic foramen?
- Pudendal N
- N to Obturator Internus
- Internal Pudendal A and V
What muscles are in the floor of the femoral triangle?
- Iliacus m.
- Psoas major m.
- Pectineus m. (medially)
What does the roof of the femoral triangle consist of? (If you were looking from a superior view)
- Fascia lata (root of femoral triangle)
- Cribriform fascia (only in femoral triangle, surrounds NAVEL)
- Subcutaneous tissue (fat)
- Skin
What is the muscular component of the retroinguinal space?
Iliopsoas and femoral N
What is the vascular component of the retroinguinal space?
- Femoral A and V
- Lymph vessels draining the deep inguinal node (located in femoral canal)
What 8 muscles are supplied by the femoral N?
- Iliacus
- Quadriceps Femoris: rectus femoris, vastus lateralis, vastus intermedius, vastus medialis
- Articularis Genu
- Sartorius
- Pectineus
What part of the skin does the femoral cutaneous N supply?
Anterior thigh and part of the medial thigh
-As the Saphenous N: medial aspect of lower leg and ankle
What is found in the femoral sheath?
Femoral A, V, and lymph node
What is found in the femoral canal?
Lymphatics (medial to femoral V.)
How would one locate the femoral artery for a pulse?
Halfway between the inguinal ligament (runs between anterior superior iliac spine to the pubic tubercle), then down roughly 3 cm
What is the femoral ring and why is it important?
Superior opening of the femoral canal, within the femoral sheath
-Lymph vessels go through here
Whats the difference between a Femoral Hernia vs. Inguinal Hernia?
Femoral Hernia:
- Women>Men
- Intestinal loop thru femoral ring
- Below and lateral to pubic tubercle
Inguinal Hernia
- Men>Women
- Above and Medial to pubic tubercle
- NOT through femoral canal/ring
- Male (tissue could potentially perforate scrotum.
What is the path of the Great Saphenous V, distal to proximal?
- Dorsum of foot
- Medial side of leg
- Medial thigh
- Through saphenous hiatus
- Joint of femoral v.
What is the principle artery of the thigh?
Deep femoral a.
What are the tributaries of the great saphenous v?
- External pudendal v.
- Superficial circumflex iliac v.
- Superficial epigastric v.
Obturator Externus m. Origin
Margin of obturator foramen and obturator membrane
Obturator Externus m. Insertion
Trochanteric fossa of femur
Obturator Externus m. Action
- Laterally rotate thigh
- Stabilize femoral head in acetabulum
Obturator Externus m. Innervation
Obturator N.
Psoas Major m. Origin
Transverse process of L1-5
Psoas Major m. Insertion
Lesser trochanter
Psoas Major m. Action
- Laterally flex vertebral column
- Balances and flexes trunk
- Flex thigh when acting with iliacus
Psoas Major m. Innervation
Lumbar Plexus L1-3
Iliacus m. Origin
- Superior iliac fossa
- Sacral ala
- Anterior sacroiliac l.
Iliacus m. Insertion
- Lesser trochanter
- Femoral shaft
- Psoas Major t.
Iliacus m. Action
- Flex thigh
- Stabilize hip joint
Iliacus m. Innervation
Femoral N
Sartorius m. Origin
Anterior Superior Iliac Spine (ASIS)
Sartorius m. Insertion
Medial aspect of proximal tibia (part of pes anserine)
Sartorius m. Action
- Flex, aBduct, laterally rotate thigh
- Flex leg at knee
- Medially rotate knee when flexed
Sartorius m. Innervation
Femoral N
Rectus Femoris m. Origin
Anterior inferior iliac spine
Rectus Femoris m. Insertion
- Common tendinous (quadriceps tendon)
- Independent attachments to base of patella
- Indirectly via patellar ligament to tibial tuberosity
Rectus Femoris m. Action
- Extend leg at knee
- Assist iliopsoas m. in thigh flexion
Rectus Femoris m. Innervation
Femoral N
Vastus Lateralis m. Origin
- Greater trochanter
- Lateral lip of linea aspera
Vastus Lateralis m. Insertion
- Common tendinous (quadriceps tendon)
- Independent attachments to base of patella
- Indirectly via patellar ligament to tibial tuberosity
- tibia and patella via aponeuroses (lateral patellar retinacula)
Vastus Lateralis m. Action
Extend leg at knee
Vastus Lateralis m. Innervation
Femoral N
Vastus Intermedius m. Origin
Anterior and lateral surface of femur body
Vastus Intermedius m. Insertion
- Common tendinous (quadriceps tendon)
- Independent attachments to base of patella
- Indirectly via patellar ligament to tibial tuberosity
Vastus Intermedius m. Action
Extend leg at knee
Vastus Intermedius m. Innervation
Femoral N
Vastus Medialis m. Origin
- Intertrochanteric line
- Medial lip of linea aspera
Vastus Medialis m. Insertion
- Common tendinous (quadriceps tendon)
- Independent attachments to base of patella
- Indirectly via patellar ligament to tibial tuberosity
- Tibia and patella via aponeuroses (medial patellar retinacula)
Vastus Medialis m. Action
Extend leg at knee
Vastus Medialis m. Innervation
Femoral n.
Articularis Genu m. Origin
Anterior surface of distal femur
Articularis Genu m. Insertion
Articular capsule of knee
Articularis Genu m. Action
Tightens capsule of knee during leg extension
Articularis Genu m. Innervation
Femoral n.
What are the muscles of the anterior thigh?
- Iliacus m.
- Psoas Major m.
- Sartorius m.
- Rectus Femoris m.
- Vastus Lateralis m.
- Vastus Intermedius m.
- Vastus Medialis m.
- Articularis Genu m.
What are the muscles of the Medial Thigh?
- Pectineus m.
- Adductor longus m.
- Adductor Brevis m.
- Adductor Magnus m.
- Gracilis m.
What are the muscles of the posterior thigh?
- Biceps Femoris (long head, short head)
- Semitendinosus m.
- Semimembranosus m.
What are the muscles of the anterior leg?
- Tibialis anterior m.
- Extensor Hallucis Longus m.
- Extensor Digitorum Longus m.
- Fibularis Tertius m.
What are the muscles of the lateral leg?
- Fibularis Longus m.
2. Fibularis Brevis m.
What are the muscles of the superficial posterior Leg?
- Gastrocnemius m. (lateral & medial head)
- Soleus m.
- Plantaris m.
What are the muscles of the deep posterior leg?
- Popliteus m.
- Tibialis Posterior m.
- Flexor Hallucis longus m.
- Flexor Digitorum Longus m.
What are the extensor muscles of the foot?
- Extensor digitorum brevis m.
2. Extensor Hallucis Brevis m.
What are the layer 1 muscles of the foot?
- ABductor Hallucis m.
- Flexor Digitorum Brevis m.
- ABductor Digiti Minimi m.
What are the layer 2 muscles and tendons of the foot?
- 1st-4th Lumbrical ms (between tendon of flexor digitorum longus m)
- Flexor digitorum longus tendon
- Quadratus Plantae M. (attach to tendon of flexor digitorum longus)
- Flexor hallucis longus tendon
What are the layer 3 muscles of the foot?
- Flexor Hallucis Brevis m.
- Flexor Digiti Minimi Brevis m
- Adductor Hallucis m. (oblique and transverse head)
What are the layer 4 muscles of the foot (deepest)?
- Plantar interossei m. (1st-3rd)
2. Dorsal interossei m (1st-4th)
Pectineus m. Origin
Superior pubic ramus
Pectineus m. Insertion
Pectineal line of femur
Pectineus m. Action
- Adduct and flex thigh
- medially rotate flexed knee
Pectineus m. Innervation
Femoral n.
Adductor longus m. Origin
Body of pubis inferior to pubic crest
Adductor longus m. Insertion
Middle 1/3 of linea aspera
Adductor longus m. Action
Adduct thigh
Adductor longus m. Innervation
Anterior division of obturator N.
Adductor brevis m. Origin
Body and inferior pubic ramus
Adductor brevis m. Insertion
Pectineal line and proximal linea aspera
Adductor brevis m. Action
- Adduct thigh
- Assist in thigh flexion
Adductor brevis m. Innervation
Anterior division of Obturator N.
Adductor Magnus m. Origin
- Ischiopubic ramus
- Ischial tuberosity
Adductor Magnus m. Insertion
- Gluteal tuberosity
- Linea aspera
- Medial supracondylar line
- Adductor tubercle
Adductor Magnus m. Action
- Whole muscle: adduct thigh
- Upper fiber: flex thigh
- Lower fiber: extend thigh
Adductor Magnus m. Innervation
- Upper fiber: posterior division of obturator n.
- Lower fiber: tibial division sciatic n.
Gracilis m. Origin
Inferior pubic ramus and body of pubis
Gracilis m. Insertion
Medial aspect of tibial head
Gracilis m. Action
- Adduct thigh
- Assist in medial leg rotation @ knee
- Flex leg
Gracilis m. Innervation
Anterior division of obturator n.
Biceps Femoris, long head m. Origin
Ischial tuberosity
Biceps Femoris, long head m. Insertion
Lateral aspect of fibular head
Biceps Femoris, long head m. Action
- Flex and laterally rotate leg when flexed (both)
- Extend thigh
Biceps Femoris, long head m. Innervation
Tibial division of sciatic n.
Biceps Femoris, short head m. Origin
Linea aspera and lateral supracondylar line
Biceps Femoris, short head m. Insertion
lateral aspect of fibular head
Biceps Femoris, short head m. Action
Flex and laterally rotate leg
Biceps Femoris, short head m. Innervation
common fibular division of sciatic n
Semitendinosus m. Origin and insertion
Ischial tuberosity and inserts on Medial aspect of tibia head (pes anserinus)
Semitendinosus m. Innervation
tibial N (L4-S3)
Semitendinosus m. Action
- Extend thigh
- Flex and medially rotate leg when flexed
Semimembranosis m. Origin
Ischial tuberosity
Semimembranosis m. Insertion
Posterior aspect of medial tibial condyle
Semimembranosis m. Action
- Extend thigh
- Flex and medially rotate leg when flexed
Semimembranosis m. Innervation
Tibial division of sciatic n.
Which vascular supply is commonly used in a CABG? Why?
Great Saphenous Vein (superficial)
- longest and largest superficial vein in the body
- contains a higher % of muscular and elastic fibers
- vein lies primarily in the subQ tissue so it’s easy to harvest
Describe the pathway of an indirect inguinal hernia
- Hernial sac descends through the femoral canal within the femoral sheath, pushing the femoral septum before it.
- Exits the lower end of the canal, it expands to form a large globular swelling in the thigh deep to the deep fascia (femoral hernia)
Describe the pathway and appearance of a direct inguinal hernia
hernial sac that bulged anteriorly through the posterior wall of the inguinal canal, producing the swelling in the upper thigh (superior to inguinal l.)
Where does lymph from the appendix flow?
superior mesenteric nodes