Posterior Thigh leg foot Flashcards
Where does the gluteal region extend form
The iliac crests (L4) to gluteal fold
What are the superficial gluteal muscles
Gluteus Maximus, medius, minimus, TFL
What innervates the gluteus maximus
Inferior gluteal nerve (L5-S2)
What is the action of gluteus maximus
Extend hip
Laterally rotate hip
What is the action of gluteus medius and minimus
ABduct and medially state hip
Keep pelvis level when standing on leg
What is a positive trendelenburg test result
With a right superior gluteal nerve injury, when the patient stands on the right leg only, pelvis will tilt to unsupported side (left)
What innervates gluteus medius and minimus
Superior gluteal nerve (L5-S1)
What innervates the Tensor fascia latae
Superior gluteal nerve (L5-S1)
What is the action of the TFL
tense the fascia lata
weakly flex and medially rotate hip
What is the origin/insertion rule for the deep gluteal muscles
pelvic girdle to proximal femur
What is the action rule for the deep gluteal muscles
laterally rotate hip stabilize hip
What is the innervation rule for deep gluteal muscles
Branches of the sacral plexus (L4-S4)
What are the deep gluteal muscles
Obturator internus
Piriformis
Superior/inferior gemelli
Quadratus femoris
What is significant about the piriformis
Superior gluteal vessels emerge superior to it
Inferior gluteal vessels emerge inferior to it
What muscle acts similarly to the deep gluteal muscles
Obturator externus in the medial thigh; it laterally rotates and stabilizes the hip
Where does the sciatic nerve usually branch into tibial and common fibular
In the distal thigh
In 12% of people, it branches as soon as it leaves the pelvis and the common fibular passes through piriformis
What is piriformis syndrome
In individuals who are very active, hypertrophy or spasm of piriformis can compress sciatic (or common fibular in 12%)
Where is the best place to administer IM injections
the superolateral gluteal region; to avoid vasculature and nerves
Where does Gluteus max insert
IT tract and gluteal tuberosity of femur (posterior)
Where do gluteus med and min insert
greater trochanter of femur
Where does TFL originate and insert
ASIS to IT tract
What is the action rule for the Hamstrings
Extend hip
Flex knee
What is the innervation rule for the Hamstrings
Tibial nerve (L5-S2)
What is the origin rule for Hamstrings
ischial tuberosity
What are the muscles of the posterior thigh
Semitendinosus
Semimembranosis
Long head of biceps femurs
Short head of biceps femurs (not hamstring)
What is the origin of the short head of biceps femoris
linea aspera
What is the innervation for the short head of biceps femoris
Common Fibular nerve
What is the action of short head of biceps femoris
flex knee
What forms pes anserinus
Tendons of the:
Sartorial
Gracilis
Semitendinosus
What is pes asnerinus bursitis
inflammation of the bursa underlying the Pes, causing medial knee pain
What is the action rule for the lateral leg
Evert foot
weakly plantar flex
What is the innervation rule for the lateral leg
Superficial fibular nerve (L5-S2)
What does the SF fibular nerve innervate
skin of anterolateral leg and most of foot (not flip flop region or lateral pinky)
muscles of lateral leg compartment
What are the muscles of the lateral leg
Fibularis longus
Fibularis brevis
What is the insertion of Fibularis longus
goes behind lateral malleolus, wraps under the foot, attaches to base of 1st metatarsal
What inserts similarly to Fibularis longus
Tibialis anterior- but it crosses medially and attaches to the medial cuneiform and base of 1st metatarsal
Where does fibularis brevis insert
goes behind lateral malleolus and inserts on the tuberosity of 5th metatarsal
What would happen if the common fibular nerve were injured where it wraps around the fibula
SF and deep fibular would be affected, affecting anterior and lateral compartments, losing dorsiflexion, toe extension, and eversion of the foot, and making it difficult to invert. Foot drop
What is the action rule for the posterior leg
Plantar flex ankle
Flex toes
What is the innervation rule for posterior leg compartment
Tibial nerve (L4-S3) which travels between SF and deep muscle groups
What does the tibial nerve innervate
Gives rise to Sural nerve which innervates skin on posterolateral leg and lateral foot
What branches does the Sural nerve receive
Tibial nerve and common fibular nerve branches
What are the superficial posterior leg muscles
Gastrocnemius
Soleus
Plantaris
What is significant about the Plantaris
It is absent in 5-10% of people
Where do muscles of the SF posterior leg insert
calcaneal tuberosity via calcanea tendon (achilles tendon)
What does the calcaneal tendon reflex test
Tibial nerve at S1-S2 levels, mainly S1
If there is a lesion at S1, calcaneal tendon reflex will be absent
What makes up Triceps Surae
Gastrocnemius and Soleus
What are the muscles of the deep posterior leg
Popliteus
Flexor digitorum longus
Flexor hallucis longus
Tibialis posterior
Where does FDL insert
distal phalanges of 2-5 to flex MTP, PIP, and DIP
Where does FHL insert
Distal phalanx of hallux to flee MTP and IP
Where does Tibialis posterior insert
Navicular tuberosity (part of Tom Dick and Harry)
What are action exceptions in the posterior leg
Soles (plantar flex only)
Popliteus (unlock knee from extended position)
Tibialis posterior (plantar flex and invert)
What is the tarsal tunnel
Where Tom Dick and Harry pass under the flexor retinaculum
What passes under the Tarsal tunnel
Tibialis posterior
flexor Digitorum longus
flexor Hallucis longus
posterior tibial Artery/Nerve
What blood supplies the posterior leg
Posterior tibial artery
What blood supplies the posterior thigh
Deep artery of the thigh (also obturator artery)
What supplies the gluteal region
Superior gluteal and inferior gluteal arteries (from internal iliac artery)
What blood supplies the knee
genicular branches of popliteal artery
What blood supplies the anterolateral leg and dorsal foot
Anterior tibial artery
