os coxa, femur, anterior, medial, gluteal region Flashcards
os coxa
what are the ligaments of the os coxa
5 of them (think about their locations)
posterior sacro-iliac ligaments
sacrotuberous ligament
iliolumbar ligament
anterior sacro-iliac ligaments
sacrospinous ligament
what is the role of os coxa ligaments?
stabilize pelvis and resist movement
what nerver runs through the lesser sciatic foramen?
pudendal nerve
what nerve runs through the greater and lesser sciatic foramina?
sciatic nerve
os coxa ligaments
where does the iliolumbar ligament originte and attach?
5th lumbar vertebrae to ilium
what are the muscles of the thigh (L-M)
(L) Taylor Swift Is Pretty Alight I Guess (M)
not inlcuding quads
Tensor facia latae, Sartorius, Iliopsoas, pectineus, Adductor longus, Gracilis
(L) Taylor Swift Is Pretty Alight I Guess (M)
helpful tidbits
What landmark can you use to find pectinus muscle?
inguinal ligament
ligaments of thigh
what is a good way to think about naming ligaments?
named after their location 1 to their location 2
adductors
What are the 3 adductor muscles?
superficial to deep
(superficial) adductor longus, adductor brevis, adductor magnus (deep)
What make up the borders of the femoral triangle?
inguinal ligament, adductor longus, sartorius
What are the contents located in the femoral triangle?
NAVeL
femoral nerve, femoral artery, femoral vein, empty space, Lympathic vessels
adductor canal is composed of what structures?
saphenous nerve, femoral vein, femoral artery
What muscles surround the adductor canal?
vastus medialis, sartorius (subsartorial fascia), adductor longus
Where does the femoral artery and vein run out through? what do they turn into?
adductor hiatus - they turn into popliteal artery and vein
what muscles does the obturator nerve innervate? anterior branch and posterior branch
anterior: add long, add brevis, graciliis
posterior: adductor magnus, obturator externus
what muscles does the femoral nerve innervate? all branches
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Anterior division:
-Sartorius
-iliacus
-pectineus
posterior division (Quadriceps femoris):
- rectus femoris
- vastus medialis
- vastus intermedius
- vastus lateralis
when femoral nerve becomes saphenous nerve what does it then innervate?
cutaneous innervation of skin around calf
what muscles make up the hip flexors?
sartorius, iliopsoas (strongest), pectineus, rectus femoris
what is the function of sartorius muscle?
- flex, abduct, laterally rotate thigh at hip joint
- flexes leg at knee joint
what is the function of iliopsoas muscle?
- flex thigh at hip joint
what is the function of pectineus muscle?
- flex and adduct thight at hip joint
may also
- medial rotation of thigh (when in extension and adduction)
- lateral rotation (when flex and abduction) of thigh
what is the function of rectus femoris?
- flex thigh at hip joint
- extend leg at knee joint
all quads femoris extend leg at knee joint
what is the function of adductor magnus (adductor portion, hamstring portion)
adductor portion: flex thigh
hamstring protion: extend thigh
What is the function of gracilis?
- adducts thigh
- flexes leg at knee joint (inserts on pes ancerinus)
- medial rotation of leg
what is the function of tensor fascia latae?
- one is not that intuitive
- abduct the leg
- medially rotate thigh
what is the function of obturator externus?
laterally rotate thigh
iliopsoas receives blood supply from?
multiple arteries
external iliac, iliolumbar, femoral and obturator AA.
what arteries supply pectineus m?
2 arteries
medial femoral circumflex and obturator AA.
what artery supplies sartorius m?
femoral artery
what arteries supply tensor fascia latae?
2 arteries
- lateral circumflex femoral a.
- superior gluteal a.
what arteries supply the obturator externus?
2 arteries
- obturator and medial circumflex femoral aa.
what arteries supply the rectus femoris?
3
- femoral
- deep femoral and or lateral circumflex femoral aa
what arteries supply the vastus lateralis?
2 arteries
- lateral circumflex femoral
- deep femoral aa
what artery supply the vastus intermedius?
deep femoral artery
what arteries supply the vastus medialis?
3 arteries
- femoral
- deep femoral
- descending genicular aa
what arteries supply the adductor longus?
2
- deep femoral and medial circumflex femoral aa.
what artery supplies the adductor brevis?
- deep femoral artery
what artery supplies the gracilis?
- deep femoral a
list the arteries coming off of common iliac artery?
draw if needed
- common iliac a
- iliolumbar a
- internal iliac a
- obturator a
- external iliac a
- lateral circumflex femoral a
- medial circumflex femoral a
- femoral a
- deep femoral a
- descending genicular
- popliteal a
the anterior compartment of the thigh is innervated by what nerve
femoral nerve (L2,3,4)
- special case iliopsoas - receives from anterior rami of lumbar spinal nerves
- tensor fascia latae - receives from superior gluteal n
the medial compartment of the thigh is innervated by what nerve?
obturator N (L,2,3,4)
the except of innervation of anterior compartment is iliopsoas and tensor fascia latae. What are they innervated by?
- iliopsoas is anterior rami of spinal nerves
- TFL is superior gluteal nerve (L4, L5, S1)
how many ossification centers are located on the femur?
5
what is the relevance of the femur shaft being angled medially?
balance
what 2 landmarks creates the angle of inclination of the femur?
long axis of shaft and long axis of head
the femoral sheath has the femoral canal which is made of what contents?
lymph (nothing-no vasculature)
the femoral sheath has 3 compartments from lateral to medial
femoral artery, femoral vein, lymph
muscles
what are the 3 compartments of the thigh muscles?
anterior (extensor)
medial (adductor)
posterior (flexor)
the posterior compartment of the thigh is innervated by what nerve?
sciatic nerve
muscle attachments
what is the insertion site for quadriceps femoris (extensor of knee)
insert on patella, tibia
*innervated by femoral nerve
attachment sites of muscles
what are the different sections of the sciatic nerve?
- common fibular nerve
- tibial nerve
innervation- nerves
what is the anterior (extensor) compartment of thigh innervated by?
femoral n.
nerves
what is the medial (adductor) compartment of thigh innervated by?
obturator n.
nerves
what is the posterior (flexor) compartment of thigh innervated by?
sciatic n.
muscles: medial thigh
adductors of the hip orignate where? insert where?
orignate on os coxa (mostly pubis)
insert on femur
muscles medial thigh
what are the muscles of the medial thigh
adductor longus, adductor brevis, adductor magnus, gracilis, obturator externus
adductor brevis attachments and action
more than 1 action
origin: pubis (body and inferiro ramus)
insertion: femure (pectineal line, linea aspera)
action: adduction and some extension/flexion of hip
adductor longus attachments and action
1 action
origin: pubis (body)
insertion: femur (mid 1/3 of linea aspera)
action: adduction of hip
adductor magnus -2 portions. attachements, action, innervation
adductor part, hamstring part
adductor part:
origin- pubis (inferiro ramus) and ischium (inferior ramus)
inserstion: femur (gluteal tuberostiy, linea aspera, medial supracondylar line
innervation: obturator n
action: adduction of hip, flexion of hip
hamstring part:
origin: ischuim (ischial tuberosity)
insertion: femur (adductor tubercle)
innervation: sciatic nerve (tibial portion)
action: adductor of hip, extension of hip
gracilis muscle O,I,N,A
more than 1 action
origin: pubis (body and inferior ramus)
insertion: tibia
innervation: obturator n
action: adduction of hip; flexion and media lrotation of knee
obturator externus O,I,N,A
origin: external obturator foramen and membrane
insertion: femur (trochanteric fossa)
innervation: obturator nerve
action: lateral rotation, stabilization of hip
describe location of adductor canal (aka subsartorial or hunter canal)
- inferior to apex of femoral triangle
- heads toward aDDuctor hiatus
.what are the boundaries of the adductor canal. What are the contents
anteriroly and laterally: vastus medialis m
posteriorly: adductor longus and magnuss mm
medially: sartorius m.
contents: femroa a and v, saphenous n.
describe the obturator canal and nerve
covered by obturator memebrane
- oval/triangular
- covers obturator foramen: bound of pubic and ischial rami
- superior opening: obturator canal - tends to be more medial and or superior
- obturator a and n pass through
the obturator n at the medial thigh splits into what two branches relative to adductor brevis m?
anterior and posterior branches (one goes in front of brevis one goes behind brevis)
what landmark is used to find femoral artery
inguinal ligament - from external iliac artery
muscles gluteal region
abductor and lateral rotators of the hip orgin and insertion
originate on os coxa
insert on femur
*a few exception
muscles - gluteal region
what is the superficial layer of muscles in gluteal region?
- gluteus maximus, medius, minimus mm
- tensor facia latae (TFL
muscles - gluteal region
what is the deep layer of musles in gluteal region
- piriformis m
- obturator internus m
- superior and inferior gemelli mm
- quadratus femoris m
gluteal region
gluteus maximus O,I,N,A
origin: os coxa (ilium), sacrum, coccyx, sacrotuberous ligament
insertion: IT band (into lateral condule of tibia), femur (gluteal tuberosity)
innervation: inferior gluteal n
action: extension of hip; assists in lateral rotaiton, rising from sitting position
*only gluteal muscle (out of the 3) innervted by inferior gluteal n
gluteal region
gluteus medius O,I,N,A
deep to maximus superficial to minimus
origin: os coxa (ilium)
insertion: femure (greater trochanter)
innervation: superiro gluteal n
action: ABduction and medial rotation of hip
gluteal region
gluteus minimus m O,I,N,A
origin: os coxa (ilium)
insertion: femur (greater trochanter)
innervation: superior gluteal n
action: ABduction and media lrotaiton of hip
gluteal region
TFL muscle O,I,N,A
origin:os coxa (ASIS; iliac crest)
insesrstion: IT band
innervation: superior gluteal n
action: aBduction and medial rotation of hip
Arteries of anterior thigh
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Descending genicular artery
Profunda femoris rtery
Superficial epigastric
Superficial circumflex iliac
Superficial External Pudendal Deep external pudendal arteries
through which structure does the superior gluteal artery exit the pelvis?
greater sciatic foramen (superior to piriformis muscle)
what muscles are supplied by the deep branch of the superior gluteal artery?
gluteus medius, gluteus minimus, TFL muscles
which artery supplies the gluteus maximus, obturator internus adn quadratus femoris muscles?
inferior gluteal artery
what percentage of the population has the tibial enrve passing through the piriformis muscle?
12%
0.5% have it running on top of the piriformis
what is the innervation of the gluteus maximus muscle?
inferior gluteal nerve
name the origins of the gluteus maximus muscle
os coxa (ilium), sacrum, coccyx, sacrotuberous ligament
what is teh insertion of the piriformis muscle?
femur (greater trochanter)
what nerve innervates the superior gemellus muscle?
nerve to obturator internus
what bursae is present at birth?
trochanteric bursa
describe the anatomical course of the femoral artery in the thigh
through femoral triangle -> adductor canal -> ends at adductor hiatus in the posterior knee where it becomes the popliteal artery
which artery branches from the internal iliac artery and supplies the medial thigh?
obturator artery
what is the origin and insertion of the obutartor internus muscle?
O: internal surface of the obturator foramen and membrane
I: femur (trochanteric fossa)
what nerve innervates teh quadratus femoris muscle?
n to quadratus femoris
Which artery passes through the lesser sciatic foramen into the perineum but does not supply the gluteal region?
internal pudendal artery
which nerve runs laterally between teh gluteus medius and minimus muscles?
superior gluteal nerve
what is the origin of the inferior gemellus muscle?
ischial tuberosity of the os coxa
Which muscle originates on the ischial spine and is innervated by the nerve to obturator internus?
superior gemellus muscle
name the artery that passes posteriorly on the medial aspect of the femur, supplying the thigh via its branches?
deep artery of the thigh (profunda femoris artery)
What is the course of the nerve to obturator internus?
through the greater sciatic foramen -> around the ischial spine -> through less sciatic foramen
Which deep gluteal muscle has a square shape and inserts on the quadrate tubercle of the femur?
quadratus femoris muscle
label this entire cross section
which artery anastomoses with both the superior gluteal and medial circumflex femoral arteries?
inferior gluteal artery
what is the relationship of the inferior gluteal artery to the sciatic nerve as it passes inferior to the piriformis?
the inferior gluteal artery passes medial to the sciatic nerve
name the lower limb dermatomes
what structures can be found in the medial compartment, intermediate compartmen of the femoral sheath?
medial: lymph, fat
intermediate: femoral v.
What is fascia lata?
strong fascial sheath which envelops the thigh like a sleeve
fascia lata
which septa is strongest?
lateral - goes to TFL
cross sections
label
- gluteus maximus
- gluteus medius
- gluteus minimus
- piriformis
cross sections
label
- femur
- linea aspera
- rectus femoris
- vastus intermedius
- sartorius
- gracilis
- adductor magnus
- vastus medialis
- vastus lateralis
