Posterior hip, thigh and knee Flashcards
bony landmarks on the Tibia
- M/L condyle
- M/L plateau
- Intercondylar area
- articular facet for head of fibula
- tibial tuberosity
- Gerdy tubercle
- interosseous border
- M malleolus
- fibular noth
- articular surface for talus
bony landmarks of fibula
- head
- interosseous boder
- L malleolus
- articular surface for talus
Knee joint articulations
- femorotibial
2. femoropatellar
medial femorotibial articulation
medial condyle of femur to medial condyle of tibia
lateral femorotibial articulation
lateral condyle femur to lateral condyle tibia
T/F: the patella normally articulates with the tibia
FALSE, not unless something bad happens
Knee joint capsule
- strong capsule
- open posterior for popliteus tendon
- intrapellar/alar synovial folds
purpose of intrapatellar/alar synovial folds
divides knee joint into M/L articulations
Knee extracapsular ligaments
- patellar ligament
- M/L patellar retinacula
- fibular (lateral) collateral
- tibial (medial) collateral
role of collateral ligaments
relaxed when knee is flexed and taught when knee is extended.
limit hyperextension and rotation
what does the fibular collateral ligament limit?
adduction
what does the tibial collateral ligament limit?
abduction
Knee intracapsular ligaments
- Cruciate ligmanets
2. Menisci
what are the cruciate ligaments
ACL and PCL, crisscross within intercondylar space of joint capsule
what do the cruciate ligaments limit?
Medial rotation at knee and keep femur and tibia aligned during Flx/Ext
what are the menisci?
fibrocartilage wedges that act as cushions and create a lip to the shallow sockets of the tibia
name the menisci ligmanets
- coronary ligaments
- transverse ligament
- M/L meniscus
coronary ligament role
attach menisci to ridge of tibial condyle
transverse ligament role
interconnects ant surface of the M/L menisci across the intercondylar space
which meniscus has more mobility?
lateral
movements of the knee joint?
- Flx/Ext
2. M/L rotation (gliding)
Suprapatellar bursa
extension of the joint capsule between M/L edges of patella and femur; and between the quad tendon and the femur
what moves the suprapatellar bursa?
articualris genus (derived from vastus intermedius)
What is the Q angle?
angle between axis of femur and tibia. Purpose is to move legs more toward central axis of the body
Varus = ______
decreased Q angle
Valgus = ________
increased Q angle
what occurs when the knees are “locked”
knee is fully extended.
femur medially rotates into the tibia to lock the knee
what unlocks the knee before flexion?
popliteus laterally rotates femur
Muscles in the superficial gluteal layer
- Gluteus Maximus
- Gluteus medius
- Gluteus minimus
- Tensor fascia lata (TFL)
prox attachment gluteus maximus
ilium, sacrum, coccyx
distal attachment gluteus maximus deep
femur/gluteal tuberosity
distal attachment gluteus maximus superficial
IT band/Gerdy tubercle
Gluteus maximus innervation
inferior gluteal nerve (L5, S1, 2)
Gluteus maximus action
Hip Ext, ER, ABD when synergist w/TFL
Gluteus medius prox attachment
ilium/ala
Gluteus medius distal attachment
femur/greater trochanter
Gluteus medius innervation
superior gluteal nerve (L5, S1)
Gluteus medius action
primarily ABD hip
Gluteus minimus prox attachment
ilium/ala
Gluteus minimus distal attachment
femur/greater trochanter
Gluteus minimus innervation
superior gluteal nerve (L5, S1)
Gluteus minimus action
primarily ABD hip
Tensor fascia lata prox attachment
ilium/ASIS & crest
Tensor fascia lata distal attachment
IT band/Gerdy tubercle
Tensor fascia lata innervation
superior gluteal nerve (L5, S1)
Tensor fascia lata action
Hip flx, ER, ABD in synergy with glut max
Muscle in deep gluteal layer
- piriformis
- obturator internus
- S/I gemelli
- quadratus femoris
- obturator externus
piriformis prox attachment
sacrum
piriformis distal attachment
femur/greater trochanter
piriformis innervation
lumbosacral plexus (S1, 2)
piriformis action
hip ER, ABD
obturator internus prox attachment
deep surface obturator membrane
obturator internus distal attachment
femur/greater trochanter
obturator internus innervation
lumbosacral plexus (L5, S1)
obturator internus action
Hip ER, ABD
S/I gemelli prox attachment
hip/ischial spine and tuberosity
S/I gemelli distal attachment
greater trochanter
S/I gemelli innervation
lumbosacral plexus (L5, S1)
S/I gemelli action
hip ER and ABD
quadratus femoris prox attachment
hip/ischial tuberosity
quadratus femoris distal attachment
femur/intertrochanteric
quadratus femoris innervation
lumbosacral plexus (L5, S1)
quadratus femoris action
Hip ER
Obturator externus prox attachment
external surface obturator membrane
obturator externus distal attachment
greater trochanter
obturator externus innervation
obturator nerve (L3, 4)
obturator externus action
Hip ER and ABD of femur
Nerves branching from sacral plexus and passing through greater sciatic foramen
- Superior gluteal
- interior gluteal
- nerve to obturator internus
- nerve to quadratus femoris
- posterior branches of ventral rami S1 and S2 to piriformis
- clunial nerves, S/M/I cutaneous innervations
Arteries of gluteal region
- Internal Iliac
- superior gluteal artery
- inferior gluteal artery
- obturator artery
Veins of gluteal region
- internal ilia veins
- superior gluteal vein
- inferior gluteal vein
- obturator vein
Posterior thigh muscles
- Semitendinosis
- Semimembranosis
- Biceps femoris
Semitendinosis prox attachment
hip/ischial tuberosity
semitendinosis distal attachment
pes anserinus
semitendinosis innervation
tibial nerve (L5, S1, 2)
semitendinosis action
- hip - Ext, IR
2. knee - flex
prox attachment biceps femoris long head
hip/ischial tuberosity
distal attachment biceps femoris long head
tibia/lateral plateau/fibula
innervation biceps femoris long head
tibial nerve (L5, S1, 2)
biceps femoris long head action
- hip - extend, ER
2. knee - flex
prox attachment biceps femoris short head
femur/linea aspira
distal attachment biceps femoris short head
tibia/lateral plateau/ fibula
biceps femoris short head innervation
fibular nerve (L5, S1, 2)
biceps femoris short head actions
knee - flex, ER
Nerves of the posterior thigh
- sciatic nerve
2. posterior cutaneous nerve
branches of sciatic nerve
- tibial branch
2. fibularbranch
tibial nerve destination
anterior division to flexors
fibular nerve destination
posterior division to extensors
Blood vessels of the posterior thigh
- Deep artery
2. Deep vein