Quiz 3- Lec 15-16 Flashcards
list the medial thigh muscles
- pectineus
- adductor brevis
- a. longus
- a. magnus
- gracilis
- obturator externus
where does the saphenous nerve leave the adductor canal?
between sartorius and gracilis;
just above the knee on the medial side
contents of the adductor canal
saphenous nerve
femoral artery
femoral vein
pectineus:
origin/ insertion
o: superior pubic ramus & pectin pubis
i: prox. 1/2 of pectineal line of the femur
* crosses hip; “pecten” means tooth of comb*
pectineus:
action/ innervation
- act: hip flexion and weak hip adduction
- inn: femoral nerve or obturator nerve (or both)
adductor brevis:
origin, insertion
o: body and anterior/ventral surface of inferior pubic ramus
ins: distal part of pectineal line of femur & prox. 1/3 of medial lip of linea aspera
* crosses hip*
adductor brevis:
action, innervation
act: ADDUCTion of hip, and flexion
inn: obturator nerve (anterior, posterior divisons, or both)
adductor longus:
origin, insertion
o: ventral surface of body of pubic, adjacent to pubic tubercle
ins: middle 1/3 of medial lip of linea aspera
adductor longus:
action, innervation
act: ADDUCTION of hip, flexion of hip joint
inn: anterior branch of obturator nerve
gracilis
origin, insertion
o: ventral surface of body of pubis & inferior pubic ramus
ins: tibia (pes anserinus) - posterior to sartorius & superior to semitendinosus
gracilis:
action, innervation
act: ADDUCTS hip, flexes the knee, medially rotates the leg while knee is flexed
inn: anterior division of obturator nerve
adductor magnus:
origin, insertion
- o:
- hamstring part: inferolateral part of ischial tuberosity
- adductor part: ventral surface of ischiopubic ramus
- ins:
- gluteal tuberosity & proximal ¼ of medial lip of linea aspera (minimus part of magnus) &
- distal ¾ of medial lip of linea aspera (adductor part) adductor tubercle via tendon &
- part of medial supracondylar ridge(hamstring part)
adductor magnus:
action, innervation
- act: ADDUCTION of hip, flexion of hip, (adductor part)
- extension of hip w/ hamstrings (hamstring part)
- inn:
- hamstring: tibial nerve
- adductor part: posterior branch of obturator nerve
CC: groin pull
an injury to the muscle tendon unit that produces pain on palpation of the adductor tendons or its insertion on the pubic bone with or without pain during resisted adduction
CC: riders’ bones
localized ossification sometimes seen on the inner aspect of the lower end of the tendon of the adductor muscle of the thigh in horseback riders.
which adductor group muscles are found in the:
anterior layer
- pectineus
- adductor longus
which adductor group muscles are found in:
middle layer
- adductor brevis
- gracilis
which adductor group muscles are found in:
posterior layer
adductor magnus
which adductor muscles are found in the
anterior, middle, and posterior layers
- ANTERIOR
- a. Longus
- Pectineus
- MIDDLE
- a. Brevis
- Gracilis
- POSTERIOR
- a. Magnus
cc: which of the adductor muscles can be transplanted?
gracilis (part of all w/ neurovascular supply) can be transplanted to replace hand muscles &
to replace external anal sphincter muscle (free up distal attachment)
which part of the adductor magnus is the “hamstring part”?
the ischiocondylar part
identify the anterior and posterior divisions of the obturator nerve
- anterior division
- posterior division
course of the internal iliac artery leaving pelvis
leaves pelvis through obturator canal;
terminates by dividing to anterior and posterior branches
anterior branch of internal iliac artery supplies:
medial thigh muscles (adductor group)
posterior branch of internal iliac artery supplies:
- adductor magnus, hamstrings, acetabulum, including a small branch to the head of femur
which artery assists the deep femoral artery in supplying the medial thigh muscles?
the obturator artery
what is the major artery supplying blood to the muscles of the thigh?
deep femoral artery
which muscles are in the posterior compartment of the thigh?
- biceps femoris
- semitendinosus
- semimebranosus
another name for the posterior compartment muscles?
why?
hamstrings;
these are long skinny muscles; fuse w/ gluteus maximus
which 2 hamstring muscles have a common origin?
biceps femoris & semitendinosus
semitendinosus:
origin/insertion
o: superomedial part of ischial tuberosity w/origin of long head
of biceps femoris
ins: pes anserinus
* crosses hip and knee*
semitendinosus:
action, innervation
act: extends hip and flexes knee; can medially rotate thigh and flexed leg
inn: tibial nerve
semimembranosus (SM):
origin, insertion
- o: as flat tendon from superolateral part of ischial tuberosity (also from sacrotuberous ligament & ischial attachment of adductor magnus)
- ins: widespread, incl:
- groove on medial condyle of tibia (posteriorly)
- medial border of tibia
- fascia covering politeus
- knee joint capsule as oblique popliteal ligament
semimembranosus:
act, inn
action: extends hip, flexes leg, medially rotates thigh and flexed leg
inn: tibial nerve
biceps femoris: which head of muscle crosses both hip and knee?
long head crosses both hip and knee;
short head ONLY crosses knee
biceps femoris:
origin, insertion
- origin
- long head: superomedial part of ischial tuberosity w/ semitendinosus & sacrotuberous ligament
- short head: lateral lip of linea aspera, lateral supracondylar ridge, & lateral intermuscular septum
- insert
- 3 laminae/ layers of insertion:
- *superficial laminae: head of fibula
- deep & intermediate laminae are not important
- 3 laminae/ layers of insertion:
biceps femoris:
action, innervation
- act: long head - extends & laterally rotates hip
- both heads - flex knee and laterally rotate flexed knee
- inn:
- long head - tibial nerve
- short head - common fibular nerve
lumbosacral trunk: assoc. rami
L4/L5
what contributes to SCIATIC NERVE?
Common tibial/peroneal nerve (dorsal/posterior division) &
Tibial (ventral anterior division) w/in same sheath
which division innervates the posterior cutaneous nerve of the thigh?
both posterior and anterior division innervation
which ventral rami are involved in
Sacral Plexus
L4- S4
nerves of the sacral plexus: list
- superior gluteal
- inferior gluteal
- sciatic
- common peroneal
- tibial nerve
- posterior femoral cutaneous
- pudendal
mnemonic for sacral plexus
Sacral innervation could totally prove preposterous
- S: superior gluteal nerve (L4, L5, S1)
- I: inferior gluteal nerve (L5, S1, S2)
- C: common fibular nerve (L4, L5, S1, S2) – sciatic
- T: tibial nerve (L4, L5, S1, S2, S3) – sciatic
- P: posterior femoral cutaneous nerve (S1, S2, S3)
- P: pudendal nerve (S2, S3, S4)
which 2 nerves travel in same sheath to make
sciatic nerve?
- C: common fibular nerve (L4, L5, S1, S2)
- T: tibial nerve (L4, L5, S1, S2, S3)
superior gluteal nerve
ventral rami
S: superior gluteal nerve (L4, L5, S1)
inferior gluteal nerve
ventral rami
I: inferior gluteal nerve (L5, S1, S2)
posterior femoral cutaneous nerve
ventral rami
P: posterior femoral cutaneous nerve (S1, S2, S3)
pudendal nerve
ventral rami
P: pudendal nerve (S2, S3, S4)
posterior compartment muscle and its innervation
- semitendinosus - TIBIAL
- semimembranosus - TIBIAL
- biceps femoris -
- long head - TIBIAL
- short head - COMMON FIBULAR
which nerves innervate the skin of the posterior thigh?
- *POSTERIOR FEMORAL CUTANEOUS
- lateral femoral cutaneous
- medial femoral cutaneous
- obturator nerve
posterior femoral cutaneous nerve:
ventral rami and fibers
- ventral rami of S1-S3
- dorsal division fibers from S2
- ventral division fibers from S2
major arteries supplying the thigh?
- deep femoral artery
- obturator artery
- femoral artery
- lateral circumflex femoral artery
- medial circumflex femoral artery
relationship between deep femoral artery and adductor longus / brevis/ magnus?
deep femoral artery runs DEEP to the adductor longus muscle,
and SUPERFICIAL to adductor brevis and magnus
Relationship of deep femoral artery and perforating arteries to femur and adductor magnus
- the external iliac artery –> becomes the femoral artery when it crosses under the inguinal ligament and enters the femoral triangle.
- Lateral femoral circumflex artery – Wraps round the anterior, lateral side of the femur, supplying some of the muscles on the lateral aspect of the thigh.
- Medial femoral circumflex artery – Wraps round the posterior side of the femur, supplying its neck and head.
- perforating arteries (3-4 arteries): that perforate the adductor magnus, contributing to the supply of the muscles in the medial and posterior thigh
perforating branches of deep femoral artery:
general characteristics
- 4 in number
- all have descending & ascending branches that communicate
- supply: adductors, hamstrings, vastus lateralis, and gluteus maximus
2nd perforating branch of deep femoral artery:
function
provides nutrient artery to the femur
4th perforating branch of deep femoral artery:
function
communicates with muscular branches of popliteal
artery,
providing important collateral pathway
between thigh & leg (in femoral artery occlusion)
