Unit 2 lec 2 Flashcards
The common iliac artery (from the abdominal aorta) divides into the ____ and ____ ____ arteries.
external and internal iliac arteries
The internal iliac artery splits into the ____ and _____ _____
anterior and posterior trunks
the external iliac artery continues into the ___ as the ____ _____.
thigh as the femoral artery
The posterior trunk essentially becomes the _____ ____ ______ (it exits from anterior side of pelvis above the piriformis)
superior gluteal artery
the anterior trunk becomes the ____ _____ _____ (exits from anterior side below the piriformis)
inferior gluteal artery
the inferior gluteal artery and superior gluteal artery give branches that supply muscles of :
the hip, the hip joint, and the skin overlying the sacrum and the buttocks.
The posterior abdominal wall is formed by
a. the five lumbar vertebrae and associated intervertebral discs in the midline
b. laterally and superiorly by the 12th rib
c. inferiorly by the upper part of the pelvis and a set of 3 or 4 muscles
The following muscles line the posterior abdominal wall:
a. the psoas major,
b. the iliacus
c. the quadratus lumborum. d. d. Often, a fourth muscle, the psoas minor (missing in 40% of the population) can be found.
endoabdominal or transversalis fascia
A loose, areolar connective tissue lines 4 muscles of posterior abdominal wall and the entire internal surface of the abdominal wall
- its derived from transversus abdomens muscle (outermost layer)
endoabdominal (or transversalis fascia) is continuous with the _____ in the pelvis and is usually invested with fat (_____)
endopelvic fascia in the pelvis and is usually invested with fat (preperitoneal fat).
the lumbar plexus is formed on top of ______ ____ and posterior to ________
anterior to quadratus lumborum
posterior to psoas major
lumbar plexus
ventral primary rami: L1-L4, contribution from T12 VPR 50% of the time
Gray rami communicates (i.e. sympathetic postganglionics) from the sympathetic trunk enter
all 5 roots (T12 to L4)
white rami communicates (sympathetic preganglionics) to the _____ through only
the sympathetic trunk through only T12-L2
the lumbar plexus forms within the
psoas major and emerges from the lateral, anterior and medial borders of that muscle
NOTE: In about 9% of the cases, the ________ nerve exists.
accessory obturator nerve
NOTE the lumbar plexus is divided into ________ ( ____ ____ ____ and _____ ____) and _____ divisions (_____ ____ and ____ ____)
posterior (lateral femoral cutaneous and femoral nerve) and anterior divisions (obturator and accessory nerves).
if accessory obturator nerve isn’t there the ____ nerve takes over
femoral
the _______ brings the VPR from L4 and L5 into the sacral plexus
lumbosacral trunk
the sacral plexus
L4-S4
all nerves are derived from anterior and posterior divisions (branches)
This sacral plexus lies anteriorly to the _____ muscle, on the posterior pelvic wall. It is covered by the _____ _____.
piriformis muscle
end-pelvic fascia
A number of branches from the sacral plexus pass to the lower limb through the
greater sciatic foramen
sympathetic nervous system of lumbosacral plexus
T1-L2
parasympathetic system of lumbosacral plexus
S2-S4
Thigh defines
lower hip to the knee
the leg defines
the knee to the ankle
the layers of the thigh going outside to in (superficial to deep):
*Note- these layers are subcutaneous tissue
- superficial fatty layer
- deep membranous layer
- fascia latae (aka the deep investing layer)
when the fascia latae is condensed laterally it forms the
IT band
A dermatome represents an area of skin supplied by a ____ _____ ____ regardless of the cutaneous nerves distributed to the same area. These areas are important because they can be tested for ___ and ____ and are related to a specific spinal cord levels.
specific spinal nerve
touch and temperature
the 5 muscles of the anterior compartments of the thigh
- sartorius;
- iliacus;
- psoas major;
- pectineus;
- quadriceps femoris (4 heads).
the 5 muscles of the medial compartment of the thigh (think the sides of the thigh)
- gracilis
- adductor longus
- adductor brevis
- adductor magnus (oblique fibers)
- obturator externus
B. There are 4 muscles that comprise the posterior compartment of the thigh:
This compartment runs from the buttock to the posterior aspect of the knee and is separated from the extensor compartment by the lateral intermuscular septum.
- biceps femoris
- semitendinosus
- semimembranosus
- adductor magnus (vertical fibers)
the posterior compartment of the thigh is also referred to as
the hamstring muscles
The Femoral Triangle is a triangular depression below the _____ _____. Its boundaries are:
- superiorly - ____
- medially - ____
- laterally - ____
inguinal ligament
- superiorly- the inguinal ligament
- medially- medial aspect of the adductor longus
- laterally- medial margin of sartorius
The floor of the femoral triangle is gutter-like and is formed by (lateral to medial) the ___, ____, ____ and ____. The roof is formed by skin and fascia
the iliacus
psoas major
pectineus
adductor longus
the contents of the femoral triangle:
lacunar ligament- helps hold these in place
NAVEL (lateral to medial) Nerve (femoral) Artery (femoral) Vein (femoral) Empty space Lymphatics
The adductor or subsartorial canal is a triangular aponeurotic tunnel in the middle third of the thigh. It extends from the apex of the femoral triangle to the opening of the adductor magnus. The contents of this canal are:
the femoral artery and vein
the deep lymphatic vessels saphenous nerve
and nerve to vastus medialis (from the femoral nerve).
the great saphenous vein drains the ___ ____ ___, passes anterior to the MEDIAL malleolus, runs on the MEDIAL side of the leg and then posterior to the MEDIAL condyles of the tibia and femur, ends on the MEDIAL aspect of the thigh in the ___ ____ (after passing through the saphenous hiatus in the deep fascia
drains the dorsal venous arch
ends in the femoral vein
The 2 superficial veins of lower limb are the
great and small(lesser) saphenous veins and their tributaries
the small saphenous vein
takes blood off the lateral aspect of the foot, up the POSTERIOR aspect of the LEG, and dumps the blood into the popliteal vein (back of knee
anterior compartment of thigh muscles all do
extension
medial compartment of the thigh
think adductors
inguinal ligament
runs down from external abdominal oblique muscle
femoral hernia
a loop of ? bowl ? might get pulled down into femoral ring and then it herniates.
adductor canal is found
just a little distal to the femoral triangle
anterior compartment of the thigh is innervated by
THE FEMORAL NERVE
- with the exception of the pectineus (9% of the time it is the accessory obturator nerve, not the femoral nerve)
- the exception THE PSOAS MAJOR bc it comes right off of VPR L2-L4
The medial compartment of the thigh is innervated by
THE OBTURATOR NERVE
oblique fibers of adductor Magnus = obturator nerve
posterior compartment of the hamstring is innervated by the
THE SCIATIC NERVE
(this includes vertical fibers of adductor Magnus)
exception - bicep femoral short head = common perineal nerve
what innervates the tensor fascia latae?
the superior gluteal nerve
the terminal branch of the femoral nerve?
the saphenous nerve!
it gives sensory to the medial side of foot and leg
the femoral nerve passes deep to the
inguinal ligament
the opturator nerve passes through the
opturator canal
the opturator nerve splits around the
abductor brevis
into ant and post branches
the anterior branch of the opurator n supplies the
adductor muscles
EXCEPTIONS:
post branch supplies opturator externus
post branch supplies adductor Magnus
