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JAFFY Anatomy > S2 - Lower Limb (thigh) > Flashcards

S2 - Lower Limb (thigh) Flashcards

1
Q

describe the arterial supply of the head of the femur and when could this be compromised?

A
  • lateral and medial circumflex a. give off ascending branches (retinacular branches)
  • obturator artery runs thru ligamentum teres
  • if NOF is fractured this could be damaged
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2
Q

describe the arterial supply of the thigh

A

NOT INCLUDED IN DIAGRAM: INTERNAL PUDENDAL a. branches off posterior division of internal iliac artery

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3
Q

describe the arterial supply of the gluteal region

A
  • superior gluteal artery leaves greater sciatic foramen superior to piriformis, supplies superficial glutes maximus, medius, minimus and TFL
  • inferior gluteal artery leaves greater sciatic foramen inferior to piriformis, supplies quadratus femoris, obturator internus, deep glutes maximus, long head of biceps femoris
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4
Q

what does the obturator artery supply?

A
  • medial compartment of thigh (adductors): adductor magnus, brevis, longus, obturator externus, gracilis
  • head of femur and hip joint
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5
Q

what do the femoral and popliteal arteries supply?

A
  • femoral: anterior thigh
  • popliteal: knee joint
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6
Q

which nerve runs lateral to the femoral triangle? and what does it supply?

A
  • lateral femoral cutaneous nerve
  • sensory only: anterolateral thigh
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7
Q

main nerves that supply the thigh

A
  • femoral: extensors/quads (anterior)
  • obturator: adductors (medial)
  • sciatic (tibial): flexors/hamstrings (posterior) - EXCEPT short head of biceps femoris which is common peroneal
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8
Q

femoral nerve:
- what roots is it made up of
- motor innervation
- sensory innervation
- where does it run anatomically

A
  • roots: L2, L3, L4
  • motor: iliacus, pectineus, sartorius, quadriceps
  • sensory: anteromedial surface of thigh + medial surfaces of leg and foot (saphenous nerve)
  • course: runs under the midpoint of inguinal ligament, lateral to femoral artery
  • terminates and becomes saphenous nerve (sensory only) just inferior to the pelvis > runs medially down the entire leg
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9
Q

obturator nerve:
- what roots is it made up of
- motor innervation
- sensory innervation
- where does it run anatomically

A
  • roots: L2, L3, L4
  • motor: obturator externus, adductor magnus, adductor brevis, adductor longus, gracilis
  • sensory: medial surface of thigh
  • course: runs thru obturator foramen, splits into anterior and posterior div., continues medially down leg
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10
Q

sciatic nerve:
- what roots is it made up of
- motor innervation
- sensory innervation
- where does it run anatomically

A
  • roots: L4-S3
  • motor: none directly (branches supply posterior thigh and all of leg)
  • sensory: none directly (the branches do tho)
  • runs thru greater sciatic foramen near long head of biceps femoris, bifurcates into common fibular nerve (deep + superficial) and tibial nerve in popliteal fossa > tibial nerve branches into lateral and medial plantar nerves
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11
Q

what issues will present if there is a problem with the obturator and femoral nerves?

A
  • femoral: knee extension and hip flexion
  • obturator: hip adduction
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12
Q

which plexus are the femoral, obturator, gluteal and sciatic nerves from?

A
  • femoral and obturator: lumbar
  • gluteal and sciatic: lumbosacral
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13
Q

what muscles does the superior and inferior gluteal nerve supply?

A
  • superior: gluteus medius, gluteus minimus, tensor fascia latae
  • inferior: gluteus maximus
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14
Q

how are the roots of the lumbosacral plexus named?
- how does a herniated disc damage the nerve?

A
  • after the vertebra above it
  • e.g. L5 root has the L5 vertebra above it
  • a herniated disc will damage the nerve BELOW it
  • e.g. a damaged L4-L5 disc will damage the root/s below it
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15
Q

how to determine whether sciatic nerve has been impinged @ piriformis or at the spinal cord?

A
  • if @ spinal cord: compressed before the branching of the dorsal/ventral ramus > therefore you get referred pain and muscle spasms in the back muscles
  • if @ piriformis: pain/weakness only occurs in the leg > not referred to the back
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16
Q

impacts of a damaged superior gluteal nerve

A
  • weakness of gluteus medius, gluteus minimus, tensor fascia latae
  • their job is to contract to allow the other leg to come through when you take a step
  • downwards tilted pelvis
  • pendular gait: swinging leg around to walk instead of putting it straight through
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17
Q

what is the component in green?
- what are its contents?

A
  • obturator foramen
  • filled by obturator membrane
  • contains obturator a., v. and n.
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18
Q

name the deep gluteal muscles and how are they innervated?

A
  • piriformis
  • superior gemellus
  • obturator internus
  • inferior gemellus
  • quadratus femoris
  • GEM THIEF - each muscle gets their own nerve but the gemelli steal the nerve from the one below
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19
Q

what is A?
- what is its origin and insertion?
- what is its innervation?
- what movement can it do?

A
  • piriformis (‘pear shaped)
  • origin: inside of sacrum > passes thru greater sciatic foramen and divides it into 2 parts
  • insertion: greater trochanter
  • innervation: piriformis nerve
  • movement: hip abduction + external rotation
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20
Q

what is B?
- what is its origin and insertion?
- what is its innervation?
- what movement can it do?

A
  • obturator internus (deep to obturator externus)
  • origin: inferior margin of superior pubic ramus
  • insertion: greater trochanter
  • innervation: obturatus internus nerve
  • movement: abduction and external rotation
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21
Q

what is C?
- what is its origin and insertion?
- what is its innervation?
- what movement can it do?

A
  • gemellus superior
  • origin: ischium
  • insertion: greater trochanter
  • innervation: obturator internus nerve
  • movement: hip abduction + external rotation
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22
Q

what is D?
- what is its origin and insertion?
- what is its innervation?
- what movement can it do?

A
  • gemellus inferior
  • origin: ischium
  • insertion: greater trochanter
  • innervation: quadratus femoris nerve
  • movement: hip abduction + external rotation
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23
Q

what is E?
- what is its origin and insertion?
- what is its innervation?
- what movement can it do?

A
  • quadratus femoris
  • origin: ischial tuberosity
  • insertion: intertrochanteric crest
  • innervation: quadratus femoris nerve
  • movement: hip external rotation and extension
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24
Q

name the superficial gluteal muscles

A
  • tensor fascia latae
  • gluteus medius
  • gluteus maximus
  • gluteus minimus
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25
Q

what is A?
- what is its origin and insertion?
- what is its innervation?
- what movement can it do?

A
  • gluteus maximus
  • origin: many
  • insertion: gluteal tuberosity
  • innervation: inferior gluteal nerve
  • movement: hip extension and external rotation, also knee extension (via IT band)
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26
Q

what are B and C?
- what is its origin and insertion?
- what is its innervation?
- what movement can it do?

A
  • B = gluteus medius, C= gluteus minimus
  • origin: gluteal fossa and gluteal line
  • insertion: greater trochanter
  • innervation: superior gluteal nerve
  • movement: hip abduction and internal rotation
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27
Q

what is D?
- what is its origin and insertion?
- what is its innervation?
- what is its function?

A
  • tensor fasciae latae
  • origin: anterior iliac crest
  • insertion: iliotibial tract
  • innervation: superior gluteal nerve
  • function: hip abduction + internal rotation
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28
Q

name the muscles in the anterior thigh

A
  • psoas major + minor
  • iliacus
  • pectineus
  • sartorius
  • quadriceps
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29
Q

what is A?
- what is its origin and insertion?
- what is its innervation?
- what movement can it do?

A
  • iliacus
  • origin: iliac crest
  • insertion: lesser trochanter
  • innervation: femoral nerve
  • movement: hip flexion
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30
Q

what is B?
- what is its origin and insertion?
- what is its innervation?
- what movement can it do?

A
  • psoas minor
  • origin: T12-L1
  • insertion: iliopectineal eminence and pecten pubis
  • innervation: anterior rami
  • movement: assists flexion of vertebral column
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31
Q

what is C?
- what is its origin and insertion?
- what is its innervation?
- what movement can it do?

A
  • psoas major
  • origin: lumbar vertebrae
  • insertion: lesser trochanter
  • innervation: anterior rami of L1-L3
  • movement: hip flexion + external rotation
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32
Q

what is A?
- what is its origin and insertion?
- what is its innervation?
- what movements is it responsible for?

A
  • sartorius
  • origin: anterior superior iliac spine (ASIS)
  • insertion: gooses foot (tibia)
  • innervation: femoral nerve
  • movement: hip flexion, abduction, external rotation, knee flexion (tailor’s muscle b/c tailors sit cross legged)
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33
Q

what is B?
- what is its origin and insertion?
- what is its innervation?
- what movements is it responsible for?

A
  • pectineus (anterior)
  • origin: superior pubic ramus
  • insertion: pectineal line (right below lesser trochanter)
  • innervation: femoral nerve
  • movement: hip adduction + flexion
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34
Q
  • what is C?
  • what is its origin and insertion?
  • what is its innervation?
  • what movements is it responsible for
A
  • vastus intermedius (anterior)
  • origin: femur
  • insertion: tibia
  • innervation: femoral nerve
  • movements: hip flexion and knee extension
35
Q
  • what is B?
  • what is its origin and insertion?
  • what is its innervation?
  • what movements is it responsible for
A
  • vastus lateralis
  • origin: lateral linea aspera
  • insertion: tibia
  • innervation: femoral nerve
  • movements: hip flexion and knee extension
36
Q
  • what is A?
  • what is its origin and insertion?
  • what is its innervation?
  • what movements is it responsible for
A
  • rectus femoris
  • origin: ilium (one head proximal to acetabulum and one head anterior inferior iliac spine)
  • insertion: tibia
  • innervation: femoral nerve
  • movements: hip flexion and knee extension
37
Q
  • what is D?
  • what is its origin and insertion?
  • what is its innervation?
  • what movements is it responsible for
A
  • vastus medialis
  • origin: medial linea aspera
  • insertion: tibia
  • innervation: femoral nerve
  • movements: hip flexion and knee extension
38
Q

name the muscles in the medial compartment of the thigh

A
  • obturator externus
  • adductor brevis + longus
  • gracilis
  • adductor magnus
39
Q

what is the muscle in red?
- what is its origin and insertion?
- what is its innervation?
- what movement is it responsible for?

A
  • obturator externus
  • origin: ischiopubic ramus and obturator membrane
  • insertion: greater trochanter (posterior to femur)
  • innervation: posterior branch of obturator nerve
  • movement: hip external rotation + adduction
40
Q

what is A?
- what is its origin and insertion?
- what is its innervation?
- what movement can it do?

A
  • adductor brevis (medial)
  • origin: body pubis
  • insertion: linea aspera
  • innervation: anterior branch of obturator nerve
  • movement: hip adduction
41
Q

what is B?
- what is its origin and insertion?
- what is its innervation?
- what movement can it do?

A
  • adductor longus (medial)
  • origin: body of pubis (medial to brevis)
  • insertion: linea aspera
  • innervation: anterior branch of obturator nerve
  • movement: hip adduction
42
Q

what is C?
- what is its origin and insertion?
- what is its innervation?
- what movement can it do?

A
  • gracilis (most medial)
  • origin: pubis
  • insertion: tibia
  • innervation: anterior branch of obturator nerve
  • movement: hip adduction and flexion + internal rotation of knee
43
Q

what is D?
- what is its origin and insertion?
- what is its innervation?
- what movement can it do?

A
  • adductor magnus (medial)
  • origin: ischiopubic ramus
  • insertion: gluteal tuberosity
  • innervation: obturator nerve (adductor part) and tibial nerve (hamstring part)
  • movement: hip adduction
44
Q

adductor hiatus

A
  • hole created by adductor Magnus to allow blood vessels to travel from anterior thigh to posterior leg
45
Q

name the muscles in the posterior compartment of the thigh)

A
  • hamstrings
  • semimembranosus
  • semitendinosus
  • biceps femoris
46
Q

what is A?
- what is its origin and insertion?
- what is its innervation?
- what movements is it responsible for

A
  • semimembranosus (posterior)
  • origin: ischial tuberosity
  • insertion: medial knee (proximal to tendinosus)
  • innervation: sciatic n. (tibial)
  • movement: hip extension, knee flexion
47
Q

what is B?
- what is its origin and insertion?
- what is its innervation?
- what movements is it responsible for

A
  • semitendinosus (posterior)
  • origin: ischial tuberosity
  • insertion: medial knee (distal to membranosus)
  • innervation: sciatic n. (tibial)
  • movement: hip extension, knee flexion
48
Q

what is C?
- what is its origin and insertion?
- what is its innervation?
- what movements is it responsible for

A
  • biceps femoris (posterior)
  • origin: ischial tuberosity + femur
  • insertion: head of fibula
  • innervation: long head = tibial n. (medial) and short head = common fibular n. (lateral)
  • movement: hip extension, knee flexion
49
Q

how does knee extension occur

A
  • rectus femoris
  • vastus intermedius
  • vastus lateralis
  • vastus medialis (last 20˚)
50
Q

what are A, B, C, D?

A
  • A = iliac crest
  • B = anterior superior iliac spine (ASIS)
  • C = superior pubic ramus (black line is the pectineal line)
  • D = pubic tubercle
51
Q

what are E, F, G, H?

A
  • E = inferior pubic ramus
  • F = inferior ischial (ischiopubic) ramus
  • G = ischial ramus
  • H = ischial tuberosity
52
Q

what are I, J, K, L?

A
  • I = lesser sciatic notch
  • J = ischial spine
  • K = greater sciatic notch
  • L = posterior inferior iliac spine (PIIS)
53
Q

what are M, N, O, P?

A
  • M = anterior inferior iliac spine (AIIS)
  • N = posterior superior iliac spine (PSIS)
  • O = pubic body
  • P = superior ischial ramus
54
Q

what are A, B, C, D, E?

A
  • A = greater trochanter
  • B = inter-trochanteric line
  • C = head of femur (contains a little dip in the middle called the fovea)
  • D = lesser trochanter
  • E = inter-trochanteric crest
55
Q

what are F, G, H, I?

A
  • F = gluteal tuberosity
  • G = linea aspera (has a medial + lateral lip)
  • H = anatomical neck of femur
  • I = surgical neck of femur
56
Q

what are 3 ligaments in the pelvis?
- what are their function?

A
  • sacrotuberous ligament: from sacrum to ischial tuberosity
  • sacrospinous ligament: from sacrum to ischial spine
  • inguinal ligament
  • fix sacrum in place
  • sacrotuberous and sacrospinous ligaments form greater and lesser sciatic foramina (holes)
57
Q

acetabular labrum

A
  • thickened fibrocartilage which deepens the acetabulum
58
Q

ligaments of the hip joint

A
  • iliofemoral (looks like a Y - anterior) - extracapsular
  • pubofemoral - extracapsular (anterior)
  • ischiofemoral (posterior) - extracapsular
  • ligament of the head of the femur (ligamentum teres - intracapsular)
  • transverse acetabular ligament
59
Q

when is the hip joint at its most and least stable?

A
  • most: extension, adduction and internal rotation (makes the ligaments tighter)
  • least (posterior dislocation): flexion @ hip/knee, adduction and internal rotation (b/c laxes the ligaments)
60
Q

what position of the leg would show a NOF fracture?

A
  • shortened, externally rotated, abducted
61
Q

what are A, B, C, D, E?

A
  • A = external iliac a.
  • B = femoral a.
  • C = profunda femoris a.
  • D = medial circumflex a.
  • E = lateral circumflex a.
62
Q

describe the borders of the femoral triangle

A
  • superior: inguinal ligament
  • medial: adductor longus
  • lateral: sartorius
  • A = ASIS
  • C = pubic tubercle
63
Q

what is contained in the femoral triangle?

A
  • FEMORAL SHEATH CONTAINS EVERYTHING EXCEPT FEMORAL N. (saphenous branch)
  • lateral: femoral a.
  • intermediate: femoral v. (great saphenous v.)
  • medial: femoral canal (contains lymphatics and empty space which allows for expansion of the femoral v.)
  • femoral n. is NOT in the femoral sheath
  • NAVEL (nerve, artery, vein, empty space, lymphatics - from lateral to medial)
64
Q

which muscles make the floor of the femoral triangle?

A
  • iliopsoas
  • pectineus
  • adductor longus
65
Q

important lines in a femur x-ray

A
  • semicircle from lesser trochanter to pubic tubercle
  • angle @ which NOF interacts w/ hip joint = approx 120-130˚
  • straight vertical line from greater trochanter and horizontal line from top of greater trochanter to middle of humeral head = 90 degrees
66
Q

impact of detaching head of humerus from neck

A
  • external rotation
  • shortened limb due to muscle spasm
  • slight knee flexion
67
Q

primary vs secondary hip abductors

A
  • primary: gluteus minimus, tensor fascia latae,
  • secondary: gluteus maximus, sartorius, piriformis
68
Q

general rule for thigh innervation

A
  • anterior compartment = femoral n.
  • medial compartment = obturator n.
  • posterior compartment = sciatic n.
69
Q

major terminal branches of the lumbosacral plexus and their spinal roots

A
  • femoral nerve: L2-L4
  • obturator nerve: L2-L4
  • superior gluteal: L4-S1
  • inferior gluteal: L5-S2
  • sciatic nerve: L4- S3
70
Q

what is sciatica?

A
  • impingement to sciatic nerve e.g. by herniated disc or piriformis syndrome
  • Sx: pain, tingling, numbness radiating down the leg
  • test: elevate an extended leg
71
Q

which structures are in the adductor canal?

A
  • femoral vein
  • femoral artery
  • saphenous nerve
72
Q

how to tell the diff b/n medial and lateral circumflex femoral artery

A
  • medial circumflex = posterior
  • lateral circumflex = anterior
73
Q

intracapsular NOF fractures

A
  • subcapital
  • cervical
  • basal
  • all have potential to cause avascular necrosis b/c bone can lose blood supply
74
Q

extracapsular NOF fractures

A
  • intertrochanteric (pertrochanteric)
  • fractures of the greater/lesser trochanter
75
Q

what movement is limited in hip osteoarthritis

A
  • limited internal rotation
76
Q

Hilton’s law

A
  • a muscle that causes movement of a particular joint will have its nerve innervate the joint and some skin over the joint
77
Q

describe the significance of the piriformis

A
  • runs thru greater sciatic foramen
  • divides it into a supra and infra portion
  • supra: superior gluteal a. and n.
  • infra: pudendal a. and n., inferior gluteal a. and n., sciatic n.
78
Q

walking cycle

A

STANCE PHASE (60%)
- heel strike (glutes, quads, anterior leg)
- support (quads, everters, inverters, glutes medius and minimus)
- toe-off (hamstrings, quads, posterior leg)
SWING PHASE (40%)
- leg lift (iliopsoas, rectus femoris, hamstrings, anterior leg)
- swing (iliopsoas, rectus femoris, quads, anterior leg)

79
Q

in the gluteal region, where is the bursa located?

A
  • overlies greater trochanter, between glutes medius and maximus
80
Q

which nerves innervate the hip joint

A
  • femoral
  • sciatic
  • obturator
  • superior gluteal
81
Q

femoral vs inguinal hernia

A
  • femoral: protrusion of intestine into femoral triangle
  • inguinal: protrusion of intestine into inguinal canal
82
Q

what nerve provides sensation to the posterior thigh

A
  • posterior cutaneous nerve of the thigh
83
Q

where does the common fibular nerve run?

A
  • lateral to neck of fibula

JAFFY Anatomy (14 decks)

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