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Anatomy of the limbs > The hip, buttock and thigh part 2 > Flashcards

The hip, buttock and thigh part 2 Flashcards

1
Q

What are the four compartments of this region

A

Gluteal compartment
Anterior compartment of the thigh
Medial compartment of the thigh
Posterior compartment of the thigh

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2
Q

What movements are the muscles of the gluteal region responsible for

A

Extension, abduction and external rotation of the

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3
Q

What are the gluteal muscles

A

Gluteus maximus
Gluteus medius
Gluteus minimus
(tensor fasciae latae – this is neurologically a gluteal muscle (innervated by superior gluteal nerve) but functionally it is more of an anterior compartment muscle)

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4
Q

What are the short external rotators of the hip (found in the gluteal region)

A

Piriformis
Obturator internus
Quadratus femoris
Gemelli (superior and inferior)

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5
Q

Describe the proximal and distal attachments of the gluteus maximus muscle

A

Proximal: Fascia covering gluteus medius, external surface of ilium behind posterior gluteal line, fascia of erector spinae, dorsal surface of lower sacrum, lateral margin of coccyx, external surface of sacrotuberous ligament

Distal: 75% iliotibial tract of fascia lata (posterior aspect) ; 25% gluteal tuberosity of proximal femur

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6
Q

Describe the function and innervation of the gluteus maximus muscle

A

Innervation: Inferior gluteal nerve (L5-S2)

Function: Powerful extensor of flexed femur at hip joint; lateral stabilizer of hip joint and knee joint; laterally rotates and abducts thigh

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7
Q

Describe the attachments of the gluteus medius muscle

A

Proximal: External ilium between anterior/posterior gluteal lines
Distal: Elongate facet on lateral greater trochanter
Crosses laterally over femur

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8
Q

Describe the innervation and function of the gluteus medius muscle

A

Innervation: Superior gluteal nerve (L4-S1)
Function: Abducts femur at hip joint; holds pelvis secure over stance leg and prevents pelvic drop on the opposite swing side during walking; medially rotates thigh

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9
Q

Describe the attachments of the gluteus minimus muscle

A

Proximal: External ilium between anterior/inferior gluteal lines
Distal: Linear facet on anterolateral greater trochanter
Crosses laterally over femur

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10
Q

Describe the innervation and function of the gluteus minimus muscle

A

Same as gluteus medius

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11
Q

Describe the attachments of the tensor fascia latae

A

Proximal: Lateral aspect of crest of ilium between anterior superior iliac spine and tubercle of the crest
Distal: Iliotibial tract of fascia lata

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12
Q

Describe the innervation and function of the tensor fascia latae

A

Innervation: Superior gluteal nerve (L4-S1)
Function: Stabilises the knee in extension.

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13
Q

Describe the attachments of the piriformis

A

Proximal: Anterior surface of sacrum between anterior sacral foramina
Distal: of sacrum between anterior sacral foramina
Medial side of superior border of greater trochanter of femur

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14
Q

Describe the innervation and functions of the piriformis

A

Innervation: Branches from S1 and S2
Function: Laterally rotates the extended femur at hip joint; abducts flexed femur at hip joint

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15
Q

Describe the attachments of the obturator internus

A

Proximal: Anterolateral wall of true pelvis; deep surface of obturator membrane and surrounding bone (essentially the rim of the obturator foramen)
Distal: Medial side of greater trochanter of femur

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16
Q

Describe the innervation and function of the obturator internus

A

Innervation: Nerve to obturator internus (L5-S1)
Function: Laterally rotates the extended femur at hip joint; abducts flexed femur at hip joint

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17
Q

Describe the attachments of the gemelli superior

A

Proximal: External surface of ischial spine
Distal: Along length of superior surface of the obturator internus tendon and into the medial side of greater trochanter of femur with obturator internus tendon

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18
Q

Describe the innervation and function of the gemelli superior

A

Same as obturator internus

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19
Q

Describe the attachments of the gemelli inferior

A

proximal: upper aspect of ischial tuberosity
distal: Along length of inferior surface of the obturator internus tendon and into the medial side of greater trochanter of femur with obturator internus tendon

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20
Q

Describe the innervation and function of the gemelli inferior

A

Innervation: Nerve to quadratus femoris (L5-S1)
Function: Laterally rotates the extended femur at hip joint; abducts flexed femur at hip joint

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21
Q

Describe the attachments of the quadratus femoris

A

Proximal: Lateral aspect of the ischium just anterior to the ischial tuberosity
Distal: Quadrate tubercle on intertrochanteric crest of the proximal femur

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22
Q

Describe the innervation and function of the quadratus femoris

A

Innervation: same as gemelli inferior
Function: Laterally rotates femur at hip joint

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23
Q

Why is the piriformis an important landmark

A

In addition to its action on the hip joint, the piriformis is an important landmark because it divides the greater sciatic foramen into two regions, one above and one below the piriformis. Vessels and nerves pass between the pelvis and gluteal region by passing through the greater sciatic foramen either above or below the piriformis.

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24
Q

What is a key function of the short external rotators of the hip

A

Deep muscles of gluteal compartment
Hold head of femur into acetabulum to stabilise the hip joint
Similar to the rotator cuff muscles.

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25
Q

Which compartment is the tensor fascia latae in

A

Neurologically it is more like a gluteal compartment muscle because it is innervated by the superior gluteal nerve
In terms of action, it is a flexor of the hip so it functions more like an anterior compartment muscle

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26
Q

Which muscles are in the anterior compartment of the thigh

A 
Tensor fasciae latae 
Pectineus 
Ilio-psoas 
Sartorius 
Quadriceps (rectus femoris, vastus medialis, vastus intermedius, vastus lateralis)
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27
Q

What movements are the anterior muscles of the thigh responsible for

A

Hip Flexors and Knee Extensors

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28
Q

Describe the attachments of the psoas major muscle

A

Proximal: Posterior abdominal wall (lumbar transverse processes, intervertebral discs, and adjacent bodies from TXII to LV and tendinous arches between these points)
Distal: Lesser trochanter of femur

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29
Q

Describe the innervation and function of the psoas major muscle

A

Innervation: Anterior rami (L1-L3)
Function: Flexes the thigh at the hip joint

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30
Q

Describe the attachments of the iliacus

A

Proximal: Posterior abdominal wall (iliac fossa)
Distal: Lesser trochanter of femur

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31
Q

Describe the innervation and function of the iliacus

A

Innervation: Femoral nerve (L2-4)

Function; Flexor of the thigh at the hip joint

32
Q

Describe the attachments of the vastus medialis

A

Proximal: Femur—medial part of intertrochanteric line, pectineal line, medial lip of the linea aspera, medial supracondylar line
Distal: Quadriceps femoris tendon and medial border of patella

33
Q

Describe the attachments of the vastus intermedius

A

proximal: Femur—upper two-thirds of anterior and lateral surfaces
Distal: Quadriceps femoris tendon, lateral margin of patella, and lateral condyle of tibia

34
Q

Describe the attachments of the vastus lateralis

A

proximal: Femur—lateral part of intertrochanteric line, margin of greater trochanter, lateral margin of gluteal tuberosity, lateral lip of the linea aspera
distal: Quadriceps femoris tendon and lateral margin of patella

35
Q

Describe the attachments of the rectus femoris

A

proximal: Straight head: AIIS
Reflected head: ilium (superior to acetabulum)
distal: quadriceps femoris tendon

36
Q

What are all the quadricep muscles innervated by

A

the femoral nerve (L2-L4)

37
Q

What is the function for all the quadricep muscles except for the rectus femoris

A

To extend the leg at the knee joint
The rectus femoris also does this but also flexes the thigh at the hip joint.
Also stabilise the position of the patella during knee movement

38
Q

Describe the attachments of the sartorius

A

Proximal: ASIS
Distal: Medial tibia just inferomedial to tibial tuberosity

39
Q

Describe the innervation and function of the sartorius

A

Innervation: Femoral nerve (L2,L3)
Function: Flexes the thigh at the hip joint and flexes the leg at the knee joint
Also abducts the thigh and rotates it laterally, as when resting the foot on the opposite knee when sitting

40
Q

What is the most powerful flexor of the hip and describe how this muscle is formed

A

Ilio-psoas
Psoas major attaches to the lateral parts of the lumbar vertebrae and T12 and Iliacus attaches to the iliac fossa and crest
The two muscles then come together to form a common tendon that attaches to the lesser trochanter
Pass under inguinal ligament along their course

41
Q

Describe the arrangement of the quadriceps muscles

A

The two heads of the rectus femoris unite to form an elongate muscle belly, which lies anterior to the vastus intermedius muscle and between the vastus lateralis and vastus medialis muscles, to which it is attached on either side. At the distal end, the rectus femoris muscle converges on the quadriceps femoris tendon and inserts on the base of the patella

42
Q

What is the patellar ligament

A

The patellar ligament is functionally the continuation of the quadriceps femoris tendon below the patella and is attached above to the apex and margins of the patella and below to the tibial tuberosity (Fig. 6.58). The more superficial fibers of the quadriceps femoris tendon and the patellar ligament are continuous over the anterior surface of the patella, and lateral and medial fibers are continuous with the ligament beside the margins of the patella.

43
Q

What is the pes anserinus

A

The sartorius, gracilis, and semitendinosus muscles attach to the tibia in a three-pronged pattern on the tibia, so their combined tendons of insertion are often termed the pes anserinus (Latin for “goose foot”).

44
Q

What does a tap on the patellar ligament with a tendon hammer test

A

Spinal reflex of L3 and L4 (femoral nerve)

45
Q

Describe the articularis genus

A

A tiny muscle (articularis genus) originates from the femur just inferior to the origin of the vastus intermedius and inserts into the suprapatellar bursa associated with the knee joint (Fig. 6.58). This articular muscle, which is often part of the vastus intermedius muscle, pulls the bursa away from the knee joint during extension

46
Q

Which is the only part of the quadriceps femoris that crosses the hip joint

A

The rectus femoris

47
Q

What movement are the muscles in the medial compartment of the thigh responsible for

A

Adduction of the hip

48
Q

What are the muscles of the medial compartment of the thigh

A 
Obturator externus 
Gracilis 
Adductor brevis 
Adductor longus 
Adductor magnus
49
Q

Describe the attachments of the gracilis

A

Proximal: A line on the external surfaces of the body of the pubis, the inferior pubic ramus, and the ramus of the ischium
Distal: Medial surface of proximal shaft of tibia

50
Q

Describe the innervation and function of the gracilis

A

Innervation: Obturator nerve (L2,L3)
Function: Adducts thigh at hip joint and flexes leg at knee joint.

51
Q

Describe the attachments of the obturator externus

A

Proximal: External surface of obturator membrane and adjacent bone
Distal: Trochanteric fossa

52
Q

Describe the innervation and function of the obturator externus

A

Innervation: Obturator nerve (L3-4)- posterior division
Function: Laterally rotates thigh at hip joint

53
Q

Describe the attachments of the adductor longus muscle and its innervation

A

Proximal; External surface of body of pubis (triangular depression inferior to pubic crest and lateral to pubic symphysis)
Distal: Linea aspera on middle one-third of shaft of femur
Innervation: Obturator nerve (L2-4)- anterior division

54
Q

Describe the attachments of the adductor brevis muscle and its innervation

A

Proximal; External surface of body of pubis and inferior pubic ramus
Distal: Posterior surface of proximal femur and upper one-third of linea aspera
Innervation; Obturator nerve (L2,L3)

55
Q

Describe the attachments of the adductor magnus

A

Proximal: Adductor part: ischiopubic ramus
Hamstring part: ischial tuberosity

Distal: Adductor part: Posterior surface of proximal femur, linea aspera, medial supracondylar line
Hamstring part: Adductor tubercle and supracondylar line

Innervation; Adductor part: Obturator nerve L2-L4)

Hamstring part: Sciatic nerve (tibial division) (L2, L3, L4)

56
Q

What are the functions of the adductor brevis, longus and magnus muscles

A

Adduct the hip and medially rotate the thigh at the hip.

57
Q

Describe the attachments of the pectineus (anterior compartment)

A

Proximal: Pectineal line (pecten pubis) and adjacent bone of pelvis
Distal: Oblique line extending from base of lesser trochanter to linea aspera on posterior surface of proximal femur

58
Q

Describe the innervation and function of the pectineus

A

innervation: femoral nerve (L2,L3)

Function; Adducts and flexes thigh at hip joint.

59
Q

What is the gracilis sandwiched between

A

The tendon of the sartorius in front

Tendon of semitendinosus behind

60
Q

What does the pectineus pass under along its course

A

The inguinal ligament

61
Q

What happens to the fibres of the adductor longus muscle as it descends posterolaterally

A

They expand

62
Q

What is important to remember about the adductor brevis

A

It is a triangular muscle attached at its apex to the body of the pubis and inferior pubic ramus just superior to the origin of the gracilis muscle (Fig. 6.60). The muscle is attached by its expanded base via an aponeurosis to a vertical line extending from lateral to the insertion of the pectineus into the upper aspect of the linea aspera lateral to the attachment of the adductor longus.

63
Q

Describe the adductor hiatus

A

A large circular gap inferiorly between the hamstring and adductor parts of the muscle is the adductor hiatus (Fig. 6.61), which allows the femoral artery and associated veins to pass between the adductor canal on the anteromedial aspect of the thigh and the popliteal fossa posterior to the knee.

64
Q

What movements are the muscles in the posterior compartment of the thigh responsible for

A

Knee Flexors and Hip Extensors

“The Hamstrings”

65
Q

Which muscles make up the posterior compartment of the thigh

A

Semitendinosus
Semimembranosus
Biceps femoris

66
Q

Describe the attachments of the biceps femoris

A

Proximal: Long head—inferomedial part of the upper area of the ischial tuberosity; short head—lateral lip of linea aspera

Distal: Head of fibula

67
Q

What is the function of the biceps femoris

A

Flexes leg at knee joint; extends and laterally rotates thigh at hip joint and laterally rotates leg at knee joint

68
Q

Describe the attachments of the semitendinosus

A

proximal; inferomedial part of the upper area of the ischial tuberosity
distal; Medial surface of proximal tibia

69
Q

Describe the attachments of the semimembranosus

A

Proximal: Superolateral impression on ischial tuberosity
Distal: Groove and adjacent bone on medial and posterior surface of medial tibial condyle

70
Q

What are the functions of the semitendinosus and semimembranosus

A

Flexes leg at knee joint and extends thigh at hip joint; medially rotates thigh at hip joint and leg at knee joint

71
Q

What are the posterior compartment muscles of the thigh all innervated by

A

Sciatic nerve (L5-S2)

72
Q

What does the tendon of the biceps femoris blend with

A

Extensions from the tendon blend with the fibular collateral ligament and with ligaments associated with the lateral side of the knee joint.

73
Q

When can the biceps femoris laterally rotate the leg at the knee joint

A

When the knee is partly flexed

74
Q

What do expansions from the semimembranosus tendon contribute to

A

Expansions from the tendon also insert into and contribute to the formation of ligaments and fascia around the knee joint.

75
Q

What is the distal attachment of the ilio-tibial tract

A

Gerdy tubercle (lateral side of proximal tibia)

Anatomy of the limbs (11 decks)

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