Thigh and Gluteal Region Flashcards
Hip bone made of and where is each located
Ilium - superior
Ischium - posterior
Pubis - anterior
Standing arch
Pelvis transmits load from vertebral column to femurs
Joint of standing arch
Acetabulofemoral
Pubic symphysis and function
Links together superior rami of pubic bones
Prevents arches from spreading
Seated arch
Ischial tuberosities bear body weight in seated position
Sacro-iliac joint
synovial
Sacro-iliac ligaments
Pull sacrum into the pelvis
Sacrotuberous and sacrospinous ligaments
prevent the pelvis and sacrum from rotating around the sacro-iliac joint when the weight of the body is bourne by the acetabulum
What parts of pelvis are in same plane and why?
ASIS and pubic symphysis
Forward tilt
Acetabulum
Ball and socket joint of the hip
Acetabular labrum
Firbocartilage around the rim of acetabulum
Ligamentum teres femoris
Triangluar flattened band that attaches to fovea capitis femoris
Attaches to acetabular notch of the pelvis
Ligaments of the hip joint
Thickenings of capsule
Ligamentum teres femoris
Zona orbicularis
Zona orbicularis
Ring of fibers of the capsule that encircle the neck of the femur and help hold femur in place
Gluteal region actions innervation and blood supply
Extenstion, abduction, medial and lateral rotation
Superior and inferior gluteal nerves
Superior and inferior gluteal arteries
Gluteus maximus actions innervation and blood supply
Extends and laterally roates
Inferior gluteal nerve
Sueprior and inferior gluteal arteries
Gluteus medius actions innervation and blood supply
Abducts and medially rotates thigh
Superior gluteal nerve
Superior gluteal artery
Gluteus minimus actions innervation and blood supply
Abducts and medially roates thigh
Superior gluteal nerve
Superior gluteal artery
Hip drop result of
Inability to abduct
Gluteus minimus/medius injury
Another name for hip drop
Tendelenburg Gait
If right gluteus minimus/medius hurt, which hip drops?
Left
Deep gluteal region actions innervation and blood supply
Lateral rotation
Branches of sacral plexus
Superior and inferior gluteal arteries
Triceps coxae
Superior gemellus
Obturator internus
Inferior gemellus
Deep gluteal region important for
Keeping foot swung laterally prior to next heel strike
Lateral rotators
Externally rotate the swinging limb and prevent swinging foot from striking on lateral edge
Internal rotators
Of grounded limb swing contralateral side of pelvis forward
Peritotrochanteric pain associated with
Avulsion of gluteus minimus/medius
Gluteus medius and minimus attach to
Greater trochanter
Compartments of thigh and functions
Anterior - flex thigh and extend leg
Medial - adduct thigh
Posterior - extend thigh and flex leg
Deep fascia of the thigh
fascia lata
What does fascia lata eventually form?
Iliotibial tract
Innervation of anterior thigh
Femoral nerve
Innervation of medial thigh
obturator nerve
Innervation of posterior thigh
Sciatic with some exceptions
Compartment syndrome and what it leads to
Buildup of fluid in tough fascial encasement increases pressure and compresses veins
Ischemia and necrosis
Two muscles that attach to IT tract
Tensor fascia lata
Gluteus maximus
Tightening of IT band function
Steadies trunk and braces the knee of stance foot
Tensor fascia lata (besides IT band function)
Medially rotates lower limb
Iliacus function and innervation
Flexion of the thigh
Femoral nerve
Psoas major function and innervation
Flexion of the thigh
Ventral rami
Iliopsoas made of
and what is function?
Psoas major and iliacus
Bilateral = trunk flexion
Powerful flexion of the thigh
Where does iliopsoas attach?
Lesser trochanter of the femur
Where do iliacus and psoas major merge?
Inguinal ligament
Aterior compartment of thigh actions innervation and blood supply
Flexion of thigh and extension of leg
Femoral nerve
Deep femoral artery and femoral artery
Sartorius actions innervation
Flex, abduct, laterally rotates the thigh
Flexes the leg
Femoral nerve
Quadricpes femoris function and muscles that make it up
Extends the knee Rectus femoris Vastus lateralis Vastus medialis Vastus intermedius All attach to quad tendon
Rectus femoris attaches to
AIIS
and patellar tendon
Vastus medialis obliquus important for
Patellar alignment
Tendon of quadriceps renamed at
Patellar to patellar ligament
Patellar ligament attaches to
tibial tuberosity
Charlie horse
Ofen of rectus femoris
Cramping of individual muscle
Medial compartment of thigh actions innervation and blood supply
Adduction of thigh
Obturator nerve
Deep femoral and obturator
Pectineus
Innervated by femoral nerve
Adductor magnus
Anterior and posterior fibers
Anterior - adduct via obturator
Posterior - extend via tibial division of sciatic
Gracilis
Flexes and medially rotates leg
Obturator externus
Laterally rotates thigh
Muscles of medial compartmnet
Pectineus
Adductor longus/brevis/magnus
Gracilis
Obturator externus
What passes through adductor hiatus?
Femoral artery
Groin pull result of
Strain of adductor muscles
Femoral triangle borders
Sup - inguinal ligament Lateral - sartorius Medial - addutor longus Floor - iliopsoas and pectineus Roof - fascia lata
Femoral triangle continuous with
Adductor canal where femoral artery travels through
Contents of femoral sheath
Femoral artery
Femoral vein
Deep inguinal lymph nodes
NOT FEMORAL NERVE
Inguinal ligament acts as a
flexor retinaculum of the femoral sheath
Structures passing under the inguinal ligament into the femoral triangle from lateral to medial
Femoral nerve Femoral artery Femoral vein Empty space Lymphatic vessel NAVEL
Site of entry for femoral hernia
Femoral ring that is opening to femoral canal
Posterior compartment of the thigh actions innervation and blood supply
Extension of thigh and flexion of leg
Sciatic (tibial division to all…except for fibular division to short head of bicep femoris)
Deep femoral and inferior gluteal arteries
Semitendinosus
Medially rotates flexed leg
Semimembranous
Medially rotates flexed leg
Biceps femoris
Laterally roates a flexed leg
Short head of biceps femoris does not
Extend the thigh
All posterior muscles of thigh attach at ischial tuberosity except for
bicep femoris short head
Lateral and medial popliteal fossa boundaries
Semimembranosus - medial
Long head of bicep femoris - lateral
Pes anserinus attachments and function
Sartorius Gracilius Semitendinosus Some Gibbons STutter Stabilizes medial side fo the knee
Increased risk of hamstring tear if
Quads much stronger than hamstrings
Lumbar plexus levels and nerves produced
L1-L4
Obturator and femoral nerve
Innervates anterior and medial parts of thigh
Sacral plexus levels and nerves produced
L4-S3
Tibial and common fibular (from sciatic)
GLuteal region, posterior compartment of thigh, all leg compartments, and foot
L4-L5
Lumbosacral trunk
L1,2,3 give rise to
Purely sensory cutaneous nerves
L2,3,4 give rise to
Obturator and femoral that have both motor and sensor y
L4-S3 give rise to
Sciatic of both motor and sensor y
S2-S4 give rise to
Preganglionic parasympathetics (pelvic splanchnics)
Pudendal
Levator ani
Lumbar plexus
Roots lie in psoas major
Motor innervation not below knee but some cutaneous
Femoral nerve
L2,3,4
Not in femoral sheath but near artery
Innervates anterior compartment of thigh and pectineus, iliacus
Obturator nerve
Innervates medial compartment of the thigh
Saphenous nerve
Sensory innervation coming from lumbar plexus
Sacral plexus
Roots through greater sciatic foramen
Mostly gluteal, posterior thigh, and all of leg and foot
Formed from L4-S3
S1-S3 of sacral plexus
Ventral rami have anterior and posterior division
Anterior (flexors)
Posterior (extensors)
Long saphenous vein reaches femoral vein at
Saphenous hiatus
Which saphenous vein on front and back
Great/long on front
Short on back
Arteries of the thigh
Aorta—common iliac—–External and internal iliac
Extneral —-lateral and medial circumflex femoral and also femoral
Cruciate anastamosis
Multiple ways to get blood to hip
Inferior gluteal
Medial and lateral femoral circumflex, and first perforating of deep femoral