Quiz 2- Lec 11-12 Flashcards

1
Q

anterior hip muscles:

list

A
  1. psoas minor (absent in 40-50% of cases)
  2. iliacus
  3. psoas major (iliacus + psoas major = iliopsoas)
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2
Q

which anterior hip muscle is absent 40-50% of the time?

A

psoas minor

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3
Q

psoas major: origin & insertion

A
  • o:
    • ventral fibers from IV discs and vertebral bodies (T12-L5);
    • dorsal fibers from inferior edges of transverse processes of L1-L5
  • ins: all fibers converge into single muscle belly and thru combined tendon w/ iliacus into LESSER TROCHANTER
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4
Q

psoas major: innervation

A

L1-L3

(twigs from ventral rami)

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5
Q

psoas major: action

A
  • *major hip flexor
  • side-bending
  • pelvic stabilization during gait;
  • other actions are considered (lat. rotation of flexed hip & active during sit-ups & leg raises – hip flexion component)
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6
Q

iliacus: origin and insertion

A
  • o: iliac fossa, internal lip of iliac crest, lateral part of pelvic surface of sacrum, ventral sacroiliac and iliolumbar ligaments
  • i: thru combined tendon w/ psoas major into lesser trochanter and femoral shaft distal to lesser trochanter
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7
Q

iliacus: innervation

A
  • *L2-L3

(fibers/twigs from ventral rami); diff’t from psoas major

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8
Q

iliacus: action

A
  • *major hip flexor
  • pelvic stabilization during gait;
  • other actions are considered (lat. rotation of flexed hip & active during sit-ups & leg raises – hip flexion component)

*NOT side-bending (but psoas major incl. this)

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9
Q

psoas minor: origin & insertion

A
  • o: (anterior to major) from T12 & L1 vertebral bodies and disc
  • i: iliopubic eminence (where pubis and ilium meet)
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10
Q

psoas minor: innervation

A

L1

(twig from ventral ramus)

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11
Q

psoas minor: action

A
  • weak trunk flexion (controversial)
  • & NO ACTION AT HIP; does not cross hip joint!
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12
Q

which muscles provide stability to hip joint anteriorly?

A

psoas major and iliacus muscles

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13
Q

identify:

  1. hip joint capsule
  2. iliopectineal bursa
A
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14
Q

identify where the following movements occur:

  1. trunk flexion
  2. hip flexion
  3. external (lateral) rotation
A
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15
Q

describe the blood supply to the lower limb?

A
  1. aorta
  2. common iliac
  3. external iliac
  4. femoral (after crossing deep to inguinal)
  5. internal iliac artery and branches
  6. superficial circumflex iliac
  7. deep circumflex iliac
  8. inguinal ligament
  9. femoral artery
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16
Q

where does SUPERIOR GLUTEAL ARTERY leave the pelvis?

A

through L4/5 and S1

*L4/L5 is lumbosacral trunk

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17
Q

where does INFERIOR GLUTEAL ARTERY leave the pelvis?

A

through S3/S4

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18
Q

where does OBTURATOR ARTERY leave the pelvis?

A
  • originates from anterior division of internal iliac artery
  • travels along the obturator fascia of the pelvic sidewall, between the obturator nerve and vein, to reach the obturator foramen
  • leaves pelvis through OBTURATOR CANAL
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19
Q

contents of obturator canal

A
  • connects the pelvis to the thigh
  • contents: obturator artery, obturator vein, and obturator nerve all travel through the canal.
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20
Q

*internal pudendal artery: course

A
  • exits the pelvic cavity through the greater sciatic foramen, inferior to the piriformis muscle, to enter the gluteal region.
  • It then curves around the sacrospinous ligament to enter the perineum through the lesser sciatic foramen.
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21
Q

4 gateways to lower extremity from abdomiopelvic cavity

A

“LOGS”

  1. Lesser sciatic foramen
  2. Obturator canal
  3. Greater sciatic foramen
  4. Subinguinal space
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22
Q

identify the following:

A
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23
Q

subinguinal space: contents

A
  • femoral vessels & nerve, lymphatics,
  • Iliopsoas & pectineus muscles
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24
Q

obturator canal: contents

A

obturator vessels (artery and vein) and obturator nerve

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25
Q

greater sciatic foramen: contents

A
  • superior and inferior gluteal vessels & nerves
  • sciatic nerve, pudendal nerve,
  • internal pudendal vessels,
  • posterior cutaneous nerve of the thigh,
  • nerves to the small lateral rotators of the thigh,
  • tendon of piriformis
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26
Q

lesser sciatic foramen: contents

A
  • pudendal nerve and internal pudendal vessels
  • tendon of obturator internus,
  • nerve to obturator internus
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27
Q

vertebral levels involved in lumbar plexus (per Dr. Washburn)

A

(T12), L1-L4

*subcostal nerve should be included

28
Q

sacral plexus: vertebral levels

A

L4-S4

29
Q

which nerves are called “border nerves” (in lumbar plexus)

A
  1. iliohypogastric
  2. ilioinguinal
  3. genitofemoral
30
Q

mnemonic for LUMBAR PLEXUS

(dr. washburn’s extended cut)

A

Summers, I twice get laid on fridays- Awesome!!

  1. subcostal
  2. iliohypogastric
  3. ilioinguinal
  4. genitofemoral
  5. lateral femoral cutaneous
  6. femoral
  7. obturator
  8. accessory obturator
31
Q

which nerves receive ventral rami from POSTERIOR/DORSAL DIVISION FIBERS

A
  1. lateral femoral cutaneous nerve of thigh
  2. muscular branches to psoas & iliacus muscle
  3. FEMORAL NERVE
32
Q

which nerves receive ventral rami from ANTERIOR/VENTRAL DIVISION FIBERS?

A
  1. accessory obturator nerve(often absent)
  2. *OBTURATOR NERVE
33
Q

which nerve is innervated by:

T12, L1

A

ILIOHYPOGASTRIC

34
Q

which nerve is innervated by:

T12

A

SUBCOSTAL

35
Q

which nerve is innervated by:

L1

A

ILIOINGUINAL

36
Q

which nerve is innervated by:

L1, L2

A

GENITOFEMORAL

37
Q

which nerve is innervated by:

L2, L3

A

LATERAL FEMORAL CUTANEOUS

38
Q

which nerve is innervated by:

L2, L3, L4

(DORSAL/POSTERIOR DIVISION)

A

FEMORAL

39
Q

which nerve is innervated by:

L2, L3, L4

(VENTRAL/ANTERIOR DIVISION)

A

OBTURATOR

40
Q

which nerve is innervated by:

L3, L4

(DORSAL/POSTERIOR DIVISION)

A

ACCESSORY OBTURATOR, though this is often absent

41
Q

identify the nerves in the image below:

pink arrow

A

iliohypogastric

42
Q

identify the nerves in the image below:

orange arrow

A

ilioinguinal

43
Q

identify the nerves in the image below:

green arrow

A

lateral femoral cutaneous

44
Q

identify the nerves in the image below:

blue arrow

A

obturator

45
Q

identify the nerves in the image below:

purple arrow

A

lumbosacral trunk

46
Q

identify the dermatomes on the map

A
47
Q

where is L3 dermatome?

A

above knee; anteromedially

48
Q

where is S1 dermatome?

A

over lateral aspect of foot, posterior heel, and skin over Achille’s/posteior calf

49
Q

where is the L5 dermatome?

A

lateral aspect of calf, and medial aspect of foot, esp BIG TOE

50
Q

what are the 2 layers of the superficial fascia?

A
  1. superficial fatty (Camper’s fascia)
  2. deep membranous (Scarpa’s fascia)
51
Q

what layer of superficial fascia is called “Camper’s” Fascia?

A

superficial fatty fascia

52
Q

what layer of superficial fascia is called “Scarpa’s” Fascia?

A

deep membranous fascia

53
Q

fatty Camper’s fascia (abdomen) is continous with what fascia of the thigh?

A

the fatty superficial fasica of the thigh

54
Q

is the membranous superficial (Scarpa’s) fascia of the abdomen continuous with the deep fascia of the thigh?

A

NO, it is not continuous w/ deep fascia (aka fascia lata) of the thigh

55
Q

where does the membranous superficial (Scarpa’s) fascia of abdomen attach?

A

to the deep fascia of the thigh, 1 finger’s breadth INFERIOR to the inguinal ligament

56
Q

which layer of superficial fascia (subcuntaneous tissue) of the abdomen is CONTINUOUS with the thigh?

A

superficial fatty (Camper’s) fascia

57
Q

which layers contribute to walls of the femoral sheath?

A
  1. transversalis fascia
  2. iliac fascia
58
Q

what layers are SUPERFICIAL to the peritoneum?

A

extraperitoneal fascia (endoabdominal fasica),

which incl. transversalis fascia and iliac fascia

59
Q

peritoneum

A
  • the serous membrane forming the lining of the abdominal cavity
  • covers most of the intra-abdominal (or coelomic) organs
  • composed of a layer of mesothelium supported by a thin layer of connective tissue
  • this peritoneal lining of the cavity supports many of the abdominal organs and serves as a conduit for their blood vessels, lymphatic vessels, and nerves.
60
Q

femoral sheath: composed of which layers

A

formed by a prolongation downward, behind the inguinal ligament, of:

  • the abdominal fascia
  • the transverse fascia being continued down in front of the femoral vessels, &
  • the iliac fascia behind them
61
Q

in which space is the femoral sheath found?

A

contained w/in femoral triangle

62
Q

femoral canal: contents

A

femoral artery, vein, lymph node

(Femoral VAL)

63
Q

where is the femoral nerve found?

A

travels with the iliopsoas; encased by the fascia iliaca

64
Q

femoral canal: define

A

anatomical compartment, located in the anterior thigh.

It is the smallest and most medial part of the femoral sheath

65
Q

what are the 3 compartments of the FEMORAL SHEATH?

A
  • LATERAL - femoral branch of genitofemoral nerve & femoral artery
  • INTERMEDIATE - femoral vein
  • MEDIAL - lymphatics and lymph node of “Cloquet”
66
Q

what passes under the inguinal ligament?

A

“PIP Fem NAV”

  • Psoas major
  • iliacus
  • pectineus
  • Femoral nerve, artery, and vein