thigh anatomy Flashcards
medial compartment of thigh
adductor longus/brevis/magnus, gracilis, obturator externus
gracilis
-most medial muscle of thigh
origin: body and inferior pubic ramus
insertion: medial tibia (pes anserinus)
innervation: obturator
action: adducts thigh, medial rotation/flexion of hip, flex knee
adductor longus
origin: inferior pubis
insertion: medial lip of linea aspera
innervation: obturator
action: adduct thigh
adductor brevis
deep to pectineus, adductor longus
origin: pubis body, inferior ramus
insertion: linea aspera
innervation: obturator
action: adduct thigh
adductor magnus (adductor part)
origin: inferior pubic ramus
insertion: linea aspera
innervation: obturator
action: adduct thigh
pes anserinus
SGT FOT, medial
obturator externus
origin: obturator foramen, obturator membrane
insertion: greater trochanter
innervation: obturator
action: external rotation of thigh
adductor canal contents
superficial femoral artery/vein, saphenous nerve, nerve to vastus medialis
adductor canal borders
proximal: apex of femoral triangle
distal: adductor hiatus
lateral: vastus medialis
anterior: vastus medialis/sartorius
medial: sartorius
posterior: adductor longus/magnus
adduct
bring hip toward midline
posterior compartment of thigh
gluteus maximus/medius/minimus, tensor fascia lata, short external rotators (P GOGO Q), hamstrings (semibi)
gluteus maximus
origin: ilium posterior to gluteal line, coccyx, sacrum, PSIS, iliac crest
insertion: IT band
innervation: inferior gluteal
action: extend thigh, external rotation, abduction
gluteus medius
origin: external surface of ilium
insertion: lateral surface of greater trochanter
innervation: superior gluteal
action: abducts and internally rotates thigh
gluteus minimus
origin: external surface of ilium
insertion: anterior surface of greater trochanter
innervation: superior gluteal
action: abducts and internally rotates thigh
tensor fascia lata
origin: ASIS, iliac crest
insertion: IT band/gerdy’s tubercle
innervation: superior gluteal
action: abducts and internally rotates thigh
short external rotators of thigh
P GOGO Q
piriformis, superior gemellus, obturator internus, inferior gemellus, obturator externus (anterior), quadratus femoris
piriformis
origin: anterior surface of sacrum
insertion: greater trochanter
innervation: superior gluteal (branches of S1, S2)
action: externally rotate thigh, abduct flexed thigh
obturator internus
origin: pelvic surface, obturator membrane
insertion: medial surface of greater trochanter
innervation: nerve to obturator internus
action: externally rotate thigh, abduct flexed thigh
superior gemellus
origin: ischial spine
insertion: medial surface of greater trochanter
innervation: nerve to obturator internus
action: externally rotate thigh, abduct flexed thigh
inferior gemellus
origin: ischial tuberosity
insertion: medial surface of greater trochanter
innervation: nerve to quadratus femoris
action: externally rotate thigh, abduct flexed thigh
quadratus femoris
origin: lateral border of ischial tuberosity
insertion: inter-trochanteric crest
innervation: nerve to quadratus femoris
action: externally rotate thigh
hamstrings
semimembranosus, semitendinosus, biceps femoris long head
- extend hip, flex knee
semimembranosus
origin: ischial tuberosity
insertion: medial condyle of tibia
innervation: tibial
action: extend hip, flex knee, internal rotation of flexed leg
semitendinosus
origin: ischial tuberosity
insertion: medial tibial (pes anserinus)
innervation: tibial
action: extend hip, flex knee, internal rotation of flexed leg
biceps femoris long head
origin: ischial tuberosity
insertion: head of fibula
innervation: tibial
action: extend hip, flex knee
biceps femoris short head
origin: linea aspera
insertion: head of fibula
innervation: common peroneal
action: flex knee
greater sciatic foramen borders
greater sciatic notch, sacrospinous ligament, sacrotuberous ligament
greater sciatic foramen contents
7 nerves: sciatic, superior gluteal, inferior gluteal, pudendal, posterior femoral cutaneous, nerve to quadratus femoris, nerve to obturator internus
3 arteries: superior gluteal, inferior gluteal, internal pudendal
1 muscle: piriformis
lesser sciatic foramen borders
superior: sacrospinous ligament
inferior: sacrotuberous ligament
lesser sciatic foramen contents
tendon: obturator internus
internal pudendal artery/vein
pudendal nerve
anterior thigh compartment
pectineus, iliopsoas, sartorius, quadriceps femoris, articularis genu
psoas abscess
fever, abdominal pain, elevated WBC, pain with hip extension, resisted flexion
quadriceps femoris muscles
rectus femoris, vastus medialis/intermedius/lateralis
rectus femoris
origin: direct head - AIIS, indirect head - acetabulum/hip joint
insertion: superior pole of patella
innervation: femoral
action: hip flexion, knee extension
vastus lateralis
origin: gluteal tuberosity, greater trochanter, linea aspera
insertion: quadriceps tendon
innervation: femoral
action: knee extension
vastus intermedius
origin: femoral shaft
insertion: quadriceps tendon
innervation: femoral
action: knee extension
vastus medialis
origin: femoral shift
insertion: patella tendon, quadriceps tendon
innervation: femoral
action: knee extension
articularis genu
origin: anterior distal femur
insertion: suprapatellar bursa
innervation: femoral
action: draw suprapatellar bursa proximal during knee extension
quad tendon rupture
fail during eccentric contraction
requires surgery
associated with systemic diseases
patellar reflex
force to patellar tendon –> stretch tendon which stretches quad tendon
- quads reflexively contract
inguinal ligament
extend from pubic tubercle to ASIS
cortical bone
dense/compact
cancellous bone
spongy, more turnover
what cells make up bone
osteocytes, osteoblasts, osteoclasts
what makes up extracellular matrix
organic (35%): collagen type 1 (90%)
inorganic (65%): hydroxyapatite
endochondral bone formation
process where growing cartilage is replaced by bone to form growing skeleton
periosteal arteries
at periphery of bone
metaphyseal and epiphyseal arteries
supply ends of bones
femoral triangle contents
laterial-medial NAVEL
femoral nerve, femoral artery, femoral vein, lymphatics
femoral triangle borders
inguinal ligament (superiorly), adductor longus (medially), sartorius (laterally), iliopsoas/pectineus (floor)
illiacus and psoas
origin: iliac fossa
insertion: lesser trochanter
innervation: femoral
action: flex hip
sartorius
origin: ASIS
insertion: medial tibia (pes anserinus)
innervation: femoral
action: flex and externally rotate hip
pectineus
origin: superior pubic rami
insertion: posterior to lesser trochanter
innervation: femoral
action: flex and adduct thigh
how does femoral nerve terminate
saphenous
hemiarthroplasty
half joint replacement, replace femoral head, leaves acetabulum untouched
- lower dislocation risk
blood supply to femoral head
medial femoral circumflex artery
femoral neck stress fracture
common in runners, females
- compression on interior surface
- tension on superior surface
- can go on to complete fracture with displacement
hip labral tear
- labrum goes around acetabulum to enhance stability around femoral head
- no acute injury, sharp groin pain
- CAM: bump on femoral neck abuts labrum
- Pincer: overgrown acetabulum abuts femoral neck
- MRI with arthrogram
- diagnose with position of flexion, internal rotation, and adduction
treatment: PT, arthroscopy if severe
hip dislocation
high energy injury, posterior more common (easy to injure PCL)
- present with shortened, internally rotated limb
treatment: reduction (pull leg into place)
proximal hamstring avulsion fracture
forced extension of flexed knee during deceleration
diagnosis: palpable defect in tendon, bruising, pain/weakness with flexion
treatment: surgery
quadriceps tendon tear
forced flexion of knee
diagnosis: large hemoarthrosis, palpable defect in tendon superior to patella, unable to extend knee
