The Thigh Flashcards
The deep fascia of the thigh
Facia lata
The three compartments of the thigh
Anterior, medial, posterior
The anterior compartment is generally innervated by which nerve?
Femoral nerve
The medial compartment is generally innervated by which nerve?
Obturator nerve
The posterior compartment is generally innervated by which nerve?
Tibial portion of the sciatic nerve
The pectineus muscle has a dual nerve supply. T/F?
T
Obturator nerve and femoral nerve
Actions of the pectineus muscle
Adducts and flexes thigh;
Assists medial rotation of thigh
The chief flexor of the thigh
Iliopsoas muscle
The only muscle attached to the vertebral column, pelvis, and femur
Iliopsoas muscle
Tailor’s muscle
Sartorius
Longest muscle of the body
Sartorius
The sartorius acts across two joints. T/F?
T
Actions of the sartorius
Flexes, abducts (weak) and laterally rotates (weak) thigh;
Flexes knee
None of the actions of the sartorius is strong; therefore it is mainly a synergist, acting with other thigh muscles. T/F?
T
The quadriceps femoris muscles
Rectus femoris, Vastus lateralis, Vastus intermedius, Vastus medialis
The great extensor of the leg
Quadiceps femoris
Structure where the four parts of the quadriceps femoris unite in the distal thigh
Quadriceps tendon
The continuation of the quadriceps tendon in which the patella is embeded
Patellar ligament
The distal attachment of the medial and lateral vastus muscle independent of the patella
Medial and lateral patellar retinacula
The only part of the quardiceps femoris that crosses the hip joint
Rectus femoris muscle
Rectus femoris muscle extends the knee best when the hip is flexed. T/F
F
The ability of the rectus femoris to extend the knee is compromised when the hip is flexed.
Kicking muscle
Rectus femoris
Articularis genu is derived from which muscle
Vastus intermedialis
Structure the articularis genu pulls superiorly during extension of the leg.
Synovial membrane
Which part of the adductor group is innervated by the tibial part of the sciatic nerve?
Hamstring part of the adductor magnus
Most anterior of the adductor group
Adductor longus
The obturator nerve passes through the obturator canal to enter the medial compartment of the thigh. T/F
T
The adductor brevis can be identified by which nerve that divided to run anterior and posterior to it?
Obturator nerve
The anterior and posterior divisions of the obturator nerve in the medial compartment pass anterior and posterior to this muscle
Adductor brevis
Largest, most powerful and most posterior muscle in the adductor group
Adductor magnus
Two parts of the adductor magnus
Adductor part, hamstring part.
In the push-off phase of the gait cycle, the muscles most active is?
Anterior compartment muscles
Muscles with pes anserinus as a common distal tendinous insertion
Gracilis, Sartorius, Semitendinosus
An orthopedic surgeon is about to operate on the lateral side of a patient’s thigh. What structure will he find underneath the skin and the iliotibial tract?
Vastus lateralis
When the patella is traumatically dislocated laterally, which structure is torn?
Medial patellar retinaculum
The common tendinous insertion of semitendinosus, gracilis and sartorius
Pes anserinus
This muscle is innervated by the femoral nerve.
a. gracilis
b. pectineus
c. obturator externus
d. adductor longus
B
The saphenous nerve
a. innervates the pes anserinus tendon
b. innervates the vastus lateralis
c. is the terminal branch of the obturator nerve
d. continuation of the femoral nerve
D
These 2 muscles have distal attachments to the iliotibial tract
a. gluteous medius and minimus
b. rectus femoris and vastus lateralis
c. gluteus maximus and tensor fasciae latae
d. sartorius and gracilis
C
Actions of gracilis
Flexes knee,
Adducts thigh,
Medially rotates leg when knee is flexed
Mara complained of soreness in the medial side of her proximal thigh after several hours of horseback riding. What muscle could have been stretched?
a. biceps fermoris
b. iliopsoas
c. adductor longus
d. tensor fascia latae
C
Godrey joined a sports activity and ran in the 100m sprint. In the process he sustained torn hamstrings. He would feel the pain in the area of the
a. ischial tuberosity
b. greater trochanter
c. anterior knee
d. iliac crest
A
Anteromedial dynamic stabilizer of the knee
Pes anserinus
The anterior compartment of the leg:
a. contains the peroneal artery
b. contains muscles for dorsiflexion
c. is bounded by anterior and posterior interosseous structures
d. contains peroneus brevis in the distal portion
B
Although the adductor muscles are important in many activities, a 70% of reduction of their function results only to a slight to moderate impairment of hip function. T/F
T
Which adductor has an hiatus?
Adductor magnus
Which structures are transmitted by the adductor hiatus?
Femoral artery and vein
Weakest member of the adductor group
Gracilis muscle
A man was injured in his femoral triangle and could no longer extend his knee. What structure was most likely injured?
A. Femoral nerve
B. Obturator nerve
C. Sciatic nerve
A
The femoral artery and vein are transmitted by the adductor hiatus from which structure of the thigh to which structure of the leg?
Adductor canal to popliteal fossa
Lateral border of the femoral triangle
Sartorius muscle
Medial border of the femoral triangle
Adductor longus
Superior border of the femoral triangle
Inguinal ligament
Contents of the femoral triangle
Femoral nerve and femoral sheath with femoral artery, femoral vein, and deep inguinal lymph nodes
Which is found lateral to the adductor canal?
A. Iliotibial tract
B. Vastus medialis
C. Femur
D. Sartorius muscle
B
The largest branch of the lumbar plexus
Femoral nerve
The terminal cutaneous branch of the femoral nerve
Saphenous nerve
The saphenous nerve becomes superficial by passing between the sartorius and gracilis when the femoral vessels transverse the adductor hiatus at the distal end of the canal. T/F
T
The femoral nerve passes thru the muscular compartment of the retro-inguinal space with which structure?
Ilopsoas muscle
Which structures from the femoral sheath
The inferior prolongation of transversalis and iliopsoas fascia from the abdomen
Three compartments of the femoral sheath
Lateral, intermediate, medial
Content of the lateral compartment of the femoral sheath
Femoral artery
Content of the intermediate compartment of the femoral sheath
Femoral vein
Which compartment of the femoral sheath is the femoral canal
Medial
Primary artery of the lower limb
Femoral artery
The femoral artery is the continuation of which artery?
External iliac artery
When does the external iliac artery become the femoral artery?
When it enters the femoral triangle
The femoral vein is the continuation of which vein?
Popliteal vein
The deep femoral vein is formed by the union of which veins?
Perforating veins
What is found posterior to the adductor canal
Adductor longus and adductor magnus
The adductor canal is between which openings?
Femoral triangle and adductor hiatus
The groove that separates the buttocks from each other
Intergluteal clef (natal clef)
The sacroiliac ligament is continuous inferiorly with which ligament?
Sacrotuberous ligament
Which structure extend across the sciatic notch, turning it into a sciatic foramen?
Sacrotuberous ligament
The structure that divides the sciatic foramen into the greater and lesser sciatic foramen
Sacrospinuous ligament
The greater sciatic foramen is the passageway for structures entering or leaving the perineum. T/F
F
It is the passageway for structures entering or leaving the pelvis.
The lesser sciatic foramen is the passageway for structures entering or leaving the pelvis. T/F
F.
It is the passageway for structures entering or leaving the perineum.
The muscles of the superficial layer of the gluteal region all have proximal attachments to the posterolateral surface and margin of the alla of the ilium. T/F
T
The muscles of the deep layer of the gluteal region all have distal attachments on or adjacent to the intertrochanteric crest of the femur. T/F
T
Most superficial gluteal muscle
Gluteus maximus
The largest, heaviest, and most coarsely fibered muscle in the body
Gluteus maximus
You sit on your gluteus maximus. T/F
F
You sit on the fatty fibrous tissue and the ischial bursa that lie between the ischial tuberosity and the skin
Muscle that exits the pelvis through the greater sciatic foramen
Piriformis muscle
Muscles primarily responsible for absorbing jarring shock of heel strike
Quadriceps femoris
The quadriceps femoris contracts eccentrically during walking uphill and climbing stairs. T/F
F
It contracts eccentrically during downhill and descending stairs.
The strongest extensor of the hip
Gluteus maximus
The gluteus maximus functions primarily between the flexed and standing (straight) positions of the thigh, as when rising from the sitting position, straightening from the bending position. T/F
T
Paralysis of the gluteus muscle seriously affect walking on level ground. T/F
F
If you climb stairs and put your hand on your buttock, you will feel the gluteus maximus contract strongly. T/F
T
The gluteus maximus and tensor fascia latae assist in making the extended knee stable. T/F
T
Actions of the gluteus maximus
Extends hip,
Lateral rotation of the thigh
Actions of the gluteus medius
Abducts thigh,
Medial rotation of the thigh
Actions of gluteus minimus
Abducts thigh,
Medial rotation of the thigh
Arterial supply of the gluteus medius
Superior gluteal artery
Arterial supply of the gluteus minimus
Superior gluteal artery
Gluteus medius and gluteus minimus share the same arterial supply. T/F
T
Superior gluteus artery
Innervation of gluteus maximus
Inferior gluteal nerve
Arterial supply of the gluteus maximus
Inferior and superior gluteal arteries
Innervation of gluteus minimus and gluteus medius
Superior gluteal nerve
The tensor fascia latae acts in concert with the ilopsoas and gluteus maximus to flex the thigh. T/F
F
It acts with the ilopsoas and the rectus femoris to flex the thigh.
The tensor fascia latae acts with the gluteus maximus and gluteus medius to abduct and/or medially rotate the thigh. T/F
F
It acts with the gluteus minimus and gluteus medius.
Tensor fascia latae contributes to the stabilization of the knee when the knee is extended fully. T/F
T
When the ilopsoas is paralyzed, the tensor fascia latae hypertrophies to compensate for the paralysis. T/F
T
Tensor fascia latae produces little or if any movement of the leg. T/F
T
Muscle almost filling the greater sciatic foramen
Piriformis muscle
Structure that determines the names of blood vessels and nerves in the gluteal region
Piriformis muscle
Vessels and nerve that emerge superior to the piriformis muscle
Superior gluteal vessels and nerve
Vessels and nerve that emerge inferior to the piriformis muscle
Inferior gluteal vessels and nerve
Muscles that form the triceps coxae
Obturator internus, superior gamelli, inferior gamelli
Action of the obturator externus
Lateral rotation of the thigh
Innervation of the obturator externus
Obturator nerve
Action of tensor fascia latae
Abducts thigh, medial rotation of thigh
Innervation of tensor fascia latae
Superior gluteal nerve
The tensor fascia latae arises from this structure
Iliac crest
The components of triceps coxae are incapable of independent action. T/F
T
Structure that determines the names of the gamelli
Obturator internus muscle
Action of the triceps coxae
Laterally rotates extended thigh,
Abduct flexed thigh
Action of piriformis
Laterally rotates extended thigh,
Abduct flexed thigh
Action of quadratus femoris
Lateral rotator of the thigh
The obturator externus is most effective in laterally rotating the thigh when the hip is flexed. T/F
T
Origin of the piriformis
Anterior surface of sacrum
Nerve accompanying the piriformis muscle through the greater sciatic foramen
Sciatic nerve
Hamstrings
Semitendinosus, semimembranosus, biceps femoris long head
Muscle that exits the perineum through the lesser sciatic foramen
Obturator internus
The superior and inferior gamelli inserts into the ischium. T/F
F
They originate from the ischium:
The superior attaches to the ischial spine
The inferior attaches to the ischial tuberosity
Origin of the quadratus femoris
Ischial tuberosiry.
Short rotators
Superior Gamelli, Inferior gamelli, Quadratus femoris, Piriformis, Obturator internus, Obturator externus
Pectineus originates from the inferior pubic ramus. T/F
F
It originates from the superior pubic ramus.
Most medial of all thigh muscles
Gracilis
The “landmark” structure in the gluteal area is the
A. gluteus medius
B. piriformis
C. sciatic nerve
D. greater trochanter
B
The femoral artery enters the popliteal area via a gap in the
A. adductor longus
B. adductor brevis
C. adductor magnus
D. gracilis
C
The following structures are inside the femoral sheath,
EXCEPT:
A. femoral artery
B. femoral vein
C. femoral nerve
D. inguinal lymph nodes
C
Arterial pulse can be felt in the
A. inguinal area
B. above the medial femoral condyle
C. behind the lateral malleolus
D. tip of the big toe
A
The gluteus muscles arise from the posterolateral surface of the ischium. T/F
F
They arise from the posterolateral surface of the ilium
Adductors of the thigh
Pectineus, Adductor longus, Adductor brevis, Adductor magnus, Gracilis
Insertion of the ilopsoas muscle
Lesser trochanter
Hip abductors
Gluteus minimus, gluteus medius, Tensor fascia latae
Hip flexors
Sartorius, Iliopsoas, Rectus femoris
Origin of the hamstrings
Ischial tuberosity
Origin of the biceps femoris short head
Linea aspera
Semitendinosus and semimembranosus produce the same action. T/F
T
They extend thigh, flex knee, medially rotate knee
Innervation of the hamstrings
Tibial division of the sciatic nerve
The hamstrings can fully flex the knee while fully flexing the thigh. T/F
F
Each action shortens the hamstrings so they cannot further contract to act fully to produce the other action
A person with paralyzed hamstrings tends to fall forward because the gluteus maximus muscles cannot maintain the necessary muscle tone to stand straight. T/F
T
Hip extensors involved in walking on flat ground
Hamstrings (Semimembranosus, semitendinosus, biceps femoris long head)
Routine stretch exercise can lengthen the hamstings and their tendons. T/F
T
The heads of the biceps femoris insert on this bone
Fibula
Muscle that provides protection for the sciatic nerve after it decends from the gluteal region into the posterior aspect of the thigh
Biceps femoris long head
Innervation of the short head of biceps femoris
Fibular division of the sciatic nerve
A nerve injury may paralyze one head of the biceps femoris, but not necessarily the other head. T/F
T
The heads have different innervations;
Innervation of the skin of the gluteal region
Cluneal nerves ( superior, middle, inferior)
The cluneal nerves are vulnerable to injury when bone is taken from the ilium for grafting. T/F
T
I supplies skin over the iliac crest, between the PSIS, and over the iliac tubercles.
The deep gluteal nerves leave the pelvis through this opening
Greater sciatic foramen
The deep gluteal nerves emerge inferior to the piriformis except for this nerve.
Superior gluteal nerve
Largest nerve in the body
Sciatic nerve
Continuation of the main part of the sacral plexus
Sciatic nerve
Actions of the semitendinosus
Extend thigh, flex knee, medially rotate knee
Actions of the semimembranosus
Extend thigh, flex knee, medially rotate knee
Structures innervated by the superior gluteal nerve
Hip abductors (Gluteus medius, gluteus minimus, Tensor fascia latae)
Structures innervated by the inferior gluteal nerve
Gluteus maximus
Structures innervated by the tibial division of the sciatic nerve
Hamstrings (Semitendinosus, semimembranosus, biceps femoris long head), hamstring part of the adductor magnus
The sciatic nerve is so large that it receives its own artery, which artery is it
Artery to the sciatic nerve (from inferior gluteal artery)
The artery to the sciatic nerve is a branch of this artery
Inferior gluteal artery
The sciatic nerve innervates no structure in the gluteal region. T/F
T
It supplies the posterior thigh muscles, all leg and foot and the skin of most of the leg and foot
Structures innervated by the peroneal division of the sciatic nerve
Short head of biceps femoris
The peroneal and the common fibular nerve are different branches of the sciatic nerve. T/F
F
Peroneal and common fibular nerve are the same. The other branch of the sciatic nerve is the tibial nerve.
The tibial nerve and common fibular nerve usually separate in the distal thigh but may separate higher, as they leave the pelvis. T/F
T
The nerve to the quadratus femoris innervates the quadratus femoris and the inferior gamellus. T/F
T
The nerve to the obturator internus innervates the obturator internus and the superior gamelli. T/F
T
The superior and inferior gamelli have the same innervation. T/F
F
Superior is innervated by the nerve to the obturator internus; inferior is innervated by the nerve to the quadratus femoris
Which cutaneous nerve supplies most skin than the others?
Posterior cutaneous nerve of the thigh
Most medial structure to exit the pelvis through the greater sciatic foramen
Pudendal nerve
The sacral plexus overlies which muscle
Piriformis muscle
The arteries of the gluteal region arise directly or indirectly from the external iliac arteries. T/F
F
They arise from internal iliac arteries.
Largest branch of the internal iliac artery
Superior gluteal artery
The superior gluteal artery leaves the pelvis through this opening
Greater sciatic foramen
The superior gluteal artery passes inferior to the piriformis muscle. T/F
F
It passes superior to the piriformis artery
The superior gluteal artery divides into a superficial and deep branch. The superficial branch supplies ___ while the deep branch supplies ___.
Superficial: gluteus maximus
Deep: gluteus medius, gluteus minimus, tensor fascia latae
The superior gluteal artery anastamoses with which arteries?
Inferior gluteal artery and medial circumflex femoral artery
The inferior gluteal artery leaves the pelvis through this opening
Greater sciatic foramen
Muscles supplied by the inferior gluteal arteries
Gluteus maximus, obturator internus, quadratus femoris, superior part of hamstrings
Before birth, the artery of the sciatic nerve is the part of the inferior gluteal artery continuous with which artery?
Popliteal artery
The internal pudendal artery arises from which artery?
Internal iliac artery
The internal pudendal artery supplies the gluteal region. T/F
F
It supplies external genitalis and muscles in the peroneal regions, but not the gluteal region.
The internal pudendal artery enters the gluteal region through the greater sciatic foramen superior to the piriformis. T/F
F
It enters inferior to the piriformis.
The internal pudendal artery leaves the gluteal region immediately by crossing which structure to enter the lesser sciatic foramen?
Ischial spine/ sacrospinous ligament
The perforating arteries perforate the aponeurotic part of which muscle to enter the posterior compartment?
Adductor magnus
Muscles supplied by the perforating arteries
Majority (centra portions) of the hamstrings, vastus lateralis
After giving off branches in the posterior compartment, the perforating arteries pierce this structure to enter the anterior compartment
Lateral intermuscular septum
The gluteal veins drain into which major vein?
Internal iliac veins
The gluteal veins communicate with tributaries of which vein, thereby providing alternative routes for the return of blood from the lower limb if this vein is occluded or has to be ligated?
Femoral vein
The perforating veins drain into which vein?
Deep vein of the thigh
Perforating veins usually communicate inferiorly with which vein?
Popliteal vein
Perforating veins usually commmunicate superiorly with which vein?
Inferior gluteal vein
The sciatic nerve stretches when the thigh is flexed and the knee is extended. T/F
T
The sciatic nerve stretches when the thigh is extended and the knee is flexed. T/F
F
When the thigh is extended and knee is flexed, the sciatic nerve is relaxed.
The pes anserinus muscles are arranged in this manner posteriorly to anteriorly;
a) Sartorius - Gracilis - Semitendinosus b) Gracilis - Sartorius - Semitendinosus c) Semitendinosus - Gracilis - Sartorius d) Sartorius - Semitendinosus - Gracilis
C
Which structure is not found in the adductor canal?
a. nerve to vastus medialis
b. femoral artery
c. femoral vein
d. lateral femoral cutaneous nerve
D
Which muscle keeps the femur horizontal with the pelvic girdle when the weight of the body is placed on one leg
a. glueuts medius and minimus
b. hamstrings
c. adductor longus
d. iliopsoas
A
After horseback riding, patient complains of pain in the medial side of thigh, what nerve can be affected? A. medial cutaneous femoral B. obturator C. pudendal D. sciatic
B
Which is responsible for the sensation of the outer, upper quadrant of the gluteal region? A. inferior gluteal nerve B. superior gluteal nerve C. lateral femoral cutaneous nerve D. cluneal nerves
D
. What is true about the sciatic nerve? A. exits from the superior border of the piriformis B. innervates gluteus maximus C. has a peroneal and tibial division D. innervates the piriformis
C
What covers the adductor canal? A. Sartorius B. adductor magnus C. adductor longus D. inguinal ligament
A
Which passes thru the adductor canal?
A. femoral artery, femoral vein, saphenous nerve
B. femoral artery, femoral vein
C. femoral artery, femoral vein, femoral nerve
D. femoral artery, femoral vein, lesser saphenous vein
C
Which of the following is not included in the femoral sheath? A. deep inguinal nodes B. superficial inguinal nodes C. femoral artery D. femoral vein
B
Muscles innervated by the obturator nerve
Obturator externus, medial compartment muscles (except adductor magnus hamstrings part)
Muscles innervated by the femoral nerve
Sartorius, quadriceps femoris, pectineus, iliacus
The obturator nerve is lateral the psoas major tendon. T/F
F
It is medial the tendon
The femoral nerve is medial the psoas major tendon. T/F
F
It is lateral the tendon
Origin of vastus lateralis
Lateral side of linea aspera,
greater trochanter
Origin of vastus medialis
Medial side of linea aspera,
Intertrochanteric line
Origin of the straight part of the rectus femoris
Anterior inferior iliac spine
When standing up from a chair, the muscle most active is the: A. Gluteus maximus B. Gluteus minimus C. Gluteus medius D. Quadriceps femoris
C
