Quiz 4: Lectures 12-14 Flashcards

1
Q

Which of the following nerves does not originate from the sacral plexus?

A

Obturator nerve

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2
Q

Which nerves run below the piriformis in the greater sciatic foramen?

A

Sciatic nerve, inferior gluteal nerve, pudendal nerve

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3
Q

The femoral nerve originates from which nerve roots?

A

L2-L4

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4
Q

Which of the following ligaments restrict hip extension?

  • iliofemoral ligament
  • pubofemoral ligament
  • ischiofemoral ligament
A

All of them restrict hip extension

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5
Q

Which of the following arteries do not supply blood to the femoral head or neck?

  • acetabular branch of the obturator artery
  • perforating branches of the deep femoral artery
  • lateral circumflex femoral artery
  • medial circumflex femoral artery
A

Perforating branches of the deep femoral artery

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6
Q

The distal attachment of the glute med is the…?

A

Greater trochanter

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7
Q

Which of the following is not an action of the TFL?

  • hip flexion
  • hip abduction
  • hip external rotation
  • hip internal rotation
A

Hip external rotation

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8
Q

Where does the femoral nerve originate?

A

L2-L4 nerve roots of lumbar plexus

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9
Q

Which nerve provides motor innervation to the anterior compartment of the thigh?

A

Femoral nerve

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10
Q

What are the 6 major nerves of the lumbar plexus?

A
  • iliohypogastric
  • ilioinguinal
  • genitofemoral
  • lateral femoral cutaneous
  • obturator
  • femoral
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11
Q

Where does the iliohypogastric nerve originate in the lumbar plexus?

A

L1

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12
Q

Where does the ilioinguinal nerve originate in the lumbar plexus?

A

L1

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13
Q

Where does the genitofemoral nerve originate in the lumbar plexus?

A

L1-L2

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14
Q

Where does the lateral femoral cutaneous nerve originate in the lumbar plexus?

A

L2-L3

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15
Q

Where does the obturator nerve originate in the lumbar plexus?

A

L2-L4

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16
Q

Where does the femoral nerve originate in the lumbar plexus?

A

L2-L4

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17
Q

The iliohypogastric nerve provides motor innervation to which deep muscles?

A

Internal Oblique and Transverse Abdominis

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18
Q

Where does the iliohypogastric provide sensory innervation to?

A

Abdominal skin above the pubis and upper lateral thigh

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19
Q

Which muscles attach to the thoracolumbar fascia?

A

Internal oblique and transverse abdominis

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20
Q

The ilioinguinal nerve provides motor innervation to which deep muscles?

A

Internal oblique and transverse abdominis

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21
Q

Where does the ilioinguinal nerve provide sensory innervation to?

A

Upper medial thigh

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22
Q

T or F? The genitofemoral nerve provides sensory and motor innervation?

A

True

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23
Q

The femoral branch of the genitofemoral nerve provides sensory innervation to where?

A

Upper anterior thigh

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24
Q

The genital branch of the genitofemoral nerve provides motor innervation to _______________ and sensory innervation to _____________ and ______________

A
  1. cremaster muscle
  2. scrotum and mons pubis
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25
Q

The lateral femoral cutaneous nerve provides sensory innervation to…

A

Lateral thigh

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26
Q

T or F? The femoral nerve is the largest branch of the lumbar plexus?

A

True

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27
Q

The femoral nerve provides motor innervation to where?

A

anterior compartment of the thigh (hip flexors and knee extensors)

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28
Q

The obturator nerve provides motor innervation to where?

A

Medial compartment (hip adductors)

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29
Q

The femoral nerve provides sensory innervation to where?

A

anterior thigh and medial leg

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30
Q

The obturator nerve provides sensory innervation to where?

A

Medial lower thigh

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31
Q

Which nerve goes through the psoas major?

A

Genitofemoral nerve

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32
Q

What are the 4 primary nerves of the sacral plexus?

A

Superior gluteal nerve, inferior gluteal nerve, posterior femoral cutaneous nerve, pudendal nerve

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33
Q

Which sacral plexus nerve originates from L4-S1?

A

Superior gluteal nerve

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34
Q

Which sacral plexus nerve originates from L5-S2?

A

Inferior gluteal nerve

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35
Q

Which sacral plexus nerve originates from S1-S3?

A

posterior femoral cutaneous nerve

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36
Q

Which sacral plexus nerve originates from S2-S4?

A

Pudendal nerve

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37
Q

The superior gluteal nerve provides motor innervation to the?

A

Glute med, glute min, and TFL

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38
Q

The posterior femoral cutaneous nerve provides sensory innervation to the?

A

back and medial side of the thigh, popliteal fossa, and the upper part of the back of the leg

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39
Q

The inferior gluteal nerve provides motor innervation to the?

A

Glute max

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40
Q

Which nerve provides sensory and motor innervation to the perineum region?

A

Pudendal

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41
Q

Which nerve loops around the sacrospinous ligament and passes through both the greater and lesser sciatic foramen?

A

Pudendal nerve

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42
Q

The sciatic nerve branches off into which two nerves?

A

Tibial nerve (medial) and fibular/peroneal nerve (lateral)

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43
Q

The sciatic nerve provides motor innervation to the?

A
  • posterior compartment of thigh (hamstrings)
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44
Q

Which nerve innervates the tibialis anterior?

A

deep peroneal nerve

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45
Q

Which nerve innervates the peroneus longus?

A

superficial peroneal nerve

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46
Q

Which nerve innervates the tibialis posterior?

A

tibial nerve

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47
Q

The sciatic nerve provides sensory innervation to the?

A

Foot and the lateral side of leg

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48
Q

Which nerve provides sensory innervation to the medial lower leg?

A

Saphenous nerve

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49
Q

What are the 6 hip external rotators?

A

(PGOGOQ)
- Piriformis
- Superior Gemellus
- Obturator Internus
- Inferior Gemellus
- Obturator Externus
- Quadratus Femoris

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50
Q

T or F? All of the sacral plexus nerves go through the greater sciatic foramen

A

True

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51
Q

What is the only sacral plexus nerve that goes superior to the piriformis?

A

superior gluteal nerve

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52
Q

Which nerve provides sensory innervation to the glutes?

A

Cluneal nerves (superior, medial, inferior)

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53
Q
  1. The internal iliac artery goes to the…
  2. The external iliac artery goes to the…
A
  1. pelvis
  2. down the lower extremity
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54
Q

The external iliac artery turns into the __________ artery after it passes the inguinal ligament

A

femoral

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55
Q

The femoral artery becomes the ___________ artery at the knee

A

Popliteal artery

56
Q

The popliteal artery becomes the __________________________ artery to supply the leg

A

anterior/posterior tibial artery and peroneal artery

57
Q

What are the three major branches of the internal iliac artery that supply the hip and gluteal region?

A
  • Obturator artery (supplies hip region)
  • Superior gluteal artery (supplies the gluteal region)
  • Inferior gluteal artery (supplies the gluteal region)
58
Q

Patients who have meralgia paresthetica feel tingling, numbness, and burning pain on the outer side of the thigh. This disease is caused by entrapment of a nerve. Which nerve would this most likely be?

A

Lateral femoral cutaneous

59
Q

Stretching is often used to treat meralgia paresthetica. Which muscle should you most likely stretch?

A

Psoas Major

60
Q

Stretching is often used to treat meralgia paresthetica. Which muscle should you most likely stretch?

A

Psoas Major

61
Q

Name the layers of a synovial joint from outer to inner

A

Capsule, synovial membrane, synovial fluid, articular cartilage (lines the head of bones)

62
Q

Where does the rectus femoris originate?

A

AIIS

63
Q

Which structures attach to the ASIS?

A

Inguinal ligament, sartorius, (TFL maybe?)

64
Q

Which structure divides the greater and lesser sciatic foramen?

A

Sacrospinous ligament

65
Q

T or F? All of the adductor muscles attach to the superior and/or inferior pubic ramus

A

True

66
Q

Where are the 2 pectineal lines?

A

Femur and superior pubic ramus

67
Q

Which ligament attaches the fovea of the femoral head to the acetabulum

A

Ligamentum teres

68
Q

Describe the acetabular labrum

A
  • stabilizes the hip joint
  • deepens acetabulum by 30%
  • creates negative intra-articular pressure
  • poor vasculature (will not heal well if damaged)
69
Q

Which structures pass through the greater sciatic foramen?

A

Gluteal vessels/nerves, sciatic nerve, pudendal nerve

70
Q

Which structures pass through the lesser sciatic foramen?

A

Pudendal nerve

71
Q

Which structure passes through the obturator canal?

A

Obturator nerve

72
Q

All of the sacral plexus nerves go through which structure?

A

Greater sciatic foramen

73
Q

What is the strongest, and 2nd strongest bone in the body?

A

Femur, tibia

74
Q

Which muscles attach to the greater trochanter?

A
  • glute min (anterior trochanter)
  • glute med (lateral trochanter)
  • piriformis (superior trochanter)
  • obturator internus (medial/posterior)
  • superior and inferior gamelli
75
Q

What is the function of the intertrochanteric line?

A

Provide attachment to iliofemoral ligament

76
Q

Which muscle inserts on the lesser trochanter?

A

Iliopsoas

77
Q

What is the pectineal line? Which muscles attach to it?

A

Base of the lesser trochanter

Pectineus

78
Q

Wich muscles attach to the linea aspera?

A

Adductor longus, brevis, and magnus

79
Q

Where is the gluteal tuberosity?

A

At the base of the greater trochanter

80
Q

What is the gluteal tuberosity? Which muscle attaches to it?

A

Lateral lip of linea aspera / base of greater trochanter

Gluteus Maximus

81
Q

Which muscle inserts on the intertrochanteric crest and quadrate tubercle?

A

Quadratus femoris

82
Q

What is the angle of inclination?

A

The angle between the axis of femoral head/neck and the long axis of femur

Frontal plane angle: 125 degrees

83
Q

If the angle of inclination is greater than 125 degrees, it is referred to as…

A

Coxa valga

84
Q

If the angle of inclination is less than 125 degrees, it is referred to as…

A

Coxa vara

85
Q

What is the femoral anteversion angle? What is a normal angle?

A

An angle between the femoral head/neck and a horizontal line in the transverse plane

15 degrees

86
Q

What type of capsule is the hip capsule?

A

Fibrous capsule
- synovial lining

87
Q

Where does the hip capsule attach?

A

Proximal attachment: acetabulum
Distal anterior: intertrochanteric line
Distal posterior: intertrochanteric crest

88
Q

Which of the 4 hip ligaments connects the fovea of the femur to the acetabulum, and carries a branch of the obturator artery?

A

ligamentum teres

89
Q

Explain the iliofemoral ligament

A
  • known as the “Y” ligament
  • proximally attaches to AIIS, distally attaches to intertrochanteric line
  • resists extension and external rotation
  • STRONGEST LIGAMENT IN THE BODY
90
Q

Explain the pubofemoral ligament

A
  • Proximally attaches to superior pubic ramus, dismally attaches to intertrochanteric line
  • resists extension/abduction
  • distally blends with iliofemoral ligament and joint capsule
91
Q

Explain the ischiofemoral ligament

A
  • located on the posterior part of the hip joint
  • proximally attaches to ischium
  • distally attaches to the intertrochanteric line
  • resists internal rotation and extension
92
Q

Which 3 arteries supply blood to the hip joint?

A
  • medial circumflex femoral artery
  • lateral circumflex femoral artery
  • acetabular branch of obturator artery
93
Q

What are the two main branches off the external iliac artery?

A
  • profunda femoris artery
  • femoral artery
94
Q

What is another term for profunda femoris artery?

A

Deep femoral artery

95
Q

Which nerves provide sensation to the glutes

A
  • Superior cluneal nerves (L1-L3)
  • Lateral cluneal nerves (L1)
  • Medial cluneal nerves (S1-S3)
  • Inferior cluneal nerves (via posterior femoral cutaneous nerve)
96
Q

Which nerve comes off T12?

A

Subcostal nerve

97
Q

Which nerves come off of the lumbar plexus?

A

I, I Get Lunch On Fridays

  • Iliohypogastric (L1)
  • Ilioinguinal (L1)
  • Genitofemoral (L1, L2)
  • Lateral femoral cutaneous nerve (L2,L3)
  • Femoral nerve (L2, L3, L4)
  • Obturator nerve (L2, L3, L4)
98
Q

T or F? The majority of the nerve innervation to the gluteal region comes from the lumbar plexus

A

False, sacral plexus

99
Q

Which nerve inner area the glute med, glute min, and TFL?

A

Superior gluteal nerve

100
Q

Which nerve supplies the glute max?

A

Inferior gluteal nerve

101
Q

Which nerves innervate the small external rotators? What is the one exception?

A

Sacral plexus nerves

Exception: obturator nerve innervates the obturator externus

102
Q

Which vessels supply/drain the deep glute muscles (min and med), and superficial glute muscles (glute max)?

A

Superior gluteal artery/vein

103
Q

Which vessels supply/drain the glute max and external rotators (except obturator externus and quadratics femoris)

A

Inferior gluteal artery/vein

104
Q

Which artery supplies the obturator externus?

A

Obturator artery

105
Q

Which artery supplies the quadratic femoris?

A

Medial circumflex artery

106
Q

What is the strongest ligament in the body?

A

Iliofemoral ligament

107
Q

What is the origin and insertion of the glute max? Action? Innervation? Blood supply?

A

Origin: posterior ilium, sacrum, sacrotuberous ligament

Insertion: gluteal tuberosity and iliotibial tract (IT band)

Action: hip extension and external rotation

Innervation: inferior gluteal nerve (L5-S2)

Blood supply: superior and inferior gluteal arteries

108
Q

Where does the IT band originate and insert?

A

Origin: Iliac crest
Insertion: Gerdy’s tubercle

109
Q

What is “snapping hip”

A

A snap in the hip whenever it goes into flexion and/or extension

110
Q

Although the IT band doesn’t stretch, how could you lengthen it and treat IT band syndrome?

A

Stretch the muscles attached to it (glute max and TFL)

111
Q

Where does the TFL originate and insert? Action? Innervation? Blood supply?

A

Origin: ASIS

Insertion: IT band (iliotibial tract)

Action: hip abduction, flexion, and internal rotation

Innervation: superior gluteal nerve (L4-S1)

Blood supply: superior gluteal artery, lateral circumflex femoral artery

112
Q

Where does the glute med originate and insert? Action? Innervation? Blood supply?

A

Origin: between anterior and posterior gluteal lines

Insertion: greater trochanter (lateral)

Action: abduction, internal rotation, external rotation

Innervation: superior gluteal nerve (L4-S1)

Blood supply: superior gluteal artery

113
Q

Where does the glute min originate and insert? Action? Innervation? Blood supply?

A

Origin: between anterior and posterior gluteal lines

Insertion: greater trochanter (anterior)

Action: abduction, internal rotation, external rotation

Innervation: superior gluteal nerve (L4-S1)

Blood supply: superior gluteal artery

114
Q

What is trendelenburg?

A

When hip drop occurs contralateral to the affected glute med

115
Q

Where does the piriformis originate and insert? Action? Innervation? Blood supply?

A

Origin: anterior-lateral surface of sacrum

Insertion: greater trochanter

Action: hip external rotation

Innervation: nerve to piriformis (S1-S2)

Blood supply: inferior and superior gluteal artery

116
Q

What is the origin and insertion of the gemellus superior?

A

Origin: ischial spine

Insertion: greater trochanter

Action: hip external rotation

Innervation: nerve to obturator internus (L5-S2)

Blood supply: inferior gluteal artery

117
Q

Where does the obturator internus originate and insert? Action? Innervation? Blood supply?

A

Origin: obturator membrane

Insertion: greater trochanter

Action: hip external rotation

Innervation: nerve to obturator internus (L5-S2)

Blood supply: inferior gluteal artery

118
Q

Where does the gemellus inferior originate and insert? Action? Innervation? Blood supply?

A

Origin: ischial tuberosity

Insertion: greater trochanter

Action: hip external rotation

Innervation: nerve to quadratus femoris (L4-S1)

Blood supply: inferior gluteal artery

119
Q

Where does the quadratus femoris originate and insert? Action? Innervation? Blood supply?

A

Origin: ischial tuberosity (lateral edge)

Insertion: intertrochanteric crest

Action: hip external rotation

Innervation: nerve to quadratus femoris (L4-S1)

Blood supply: medial circumflex femoral artery

120
Q

Where does the obturator externus originate and insert? Action? Innervation? Blood supply?

A

Origin: obturator membrane

Insertion: trochanteric fossa of femur

Action: hip external rotation

Innervation: obturator nerve (L2-L4)

Blood supply: obturator artery

121
Q

Where does the superior cluneal nerve come from?

A

Dorsal rami of L1-L3

122
Q

Where does the medial cluneal nerve come from?

A

Dorsal rami of S1-S3

123
Q

Where does the inferior cluneal nerve come from?

A

Posterior femoral cutaneous nerve (S1-S3)

124
Q

Where is a safe place to perform a gluteal injection?

A

Superior lateral glute

125
Q

What are the dermatomes in the gluteal region like?

A
  • Primarily S2 and S1 dermatome
  • looks like a dart board
  • S5 is innermost layer, S1 is outermost
126
Q

Which muscle attaches to the AIIS?

A

Rectus femoris

127
Q

Which muscle attaches to the ASIS?

A

Sartorius, inguinal ligament

128
Q

Which structures go through the greater sciatic foramen?

A
  • piriformis
  • sciatic nerve
  • inferior gluteal nerve
  • posterior cutaneous nerve
  • internal pudendal artery
  • superior gluteal nerve
  • inferior gluteal artery
129
Q

Which structures go through the lesser sciatic foramen?

A
  • internal pudendal artery/vein
  • pudendal nerve
  • nerve to obturator internus
130
Q

What are the proximal and distal attachments of the femoral capsule?

A

Proximal: acetabulum

Distal: lesser trochanter of line and crest

131
Q

Which artery supplies the obturator externus?

A

Obturator artery

132
Q

Which artery supplies the quadratus femoris?

A

Medial circumflex artery

133
Q

The lumbar and sacral plexus divide at which vertebral level?

A

L4

134
Q

❗️How to distinguish between posterior and anterior femur?

A

Intertrochanteric line is anterior

Intertrochanteric crest and linea aspera are posterior

135
Q

❗️How to distinguish between posterior and anterior femur?

A

Intertrochanteric line is anterior

Intertrochanteric crest and linea aspera are posterior