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Anatomy Exam 2 > Gluteal Region, Posterior Thigh and Leg > Flashcards

Gluteal Region, Posterior Thigh and Leg Flashcards

1
Q

Where is the gluteal region?

A

Posterior to the pelvis from the level of the iliac crests (L4) to the gluteal fold

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2
Q

What is considered the safe zone for IM injects in the gluteal region? Why is this important?

A

superolateral quadrant

avoids sciatic nerve

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3
Q

What are the superficial gluteal muscles?

A

gluteus maximus

gluteus medius

gluteus minimus

Tensor fasciae latae

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4
Q

Insertion for gluteus maximus

A

iliotibial tract and gluteal tuberosity of the femur

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5
Q

Action of gluteus maximus?

A

extend and laterally rotate hip joint (ex. rising from sitting position, climbing stairs)

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6
Q

Innervation of gluteus maximus?

A

inferior gluteal nerve (L5-S2)

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7
Q

Insertion for gluteus medius and minimus?

A

greater trochanter of femur

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8
Q

Action of gluteus medius and minimus?

A

abduct and medially rotate hip joint (keep pelvis level when walking)

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9
Q

Innervation of gluteus medius and minimus?

A

superior gluteal nerve (L5-S1)

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10
Q

Trendelenburg test

A

tests the superior gluteal nerve, if this nerve is injured when pt is asked to stand on that limb, the pelvis tilts toward the unsupported side (positive test)

so injury to R superior gluteal nerve will cause pelvis tilt on the left side

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11
Q

origin and insertion of tensor fasciae latae?

A

origin: ASIS
insertion: iliotibial tract

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12
Q

Action of tensor fasciae latae?

A

tense the fascia lata, improving the efficiency of the other thigh muscles and assisting VR. weekly flex and medially rotate the hip joint

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13
Q

Innervation of the tensor fasciae latae?

A

superior gluteal nerve (L5-S1)

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14
Q

Origin and insertion of deep gluteal muscles?

A

origin: pelvic girdle
insertion: proximal femur

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15
Q

Action rule for deep gluteal muscles?

A

laterally rotate and stabilize the hip joint

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16
Q

Innervation rule for the deep gluteal muscles?

A

small branches of the sacral plexus

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17
Q

What are the deep gluteal muscles?

A

piriformis, superior gemelli, inferior gemelli, obturator internus, quadratus femoris

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18
Q

Obturator externus action?

A

laterally rotates and stabilizes the hip joint

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19
Q

Sciatic nerve

A

L4-S3

exits greater sciatic foramen inferior to piriformis, does not innervate gluteal muscles

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20
Q

The sciatic nerve really consists of 2 nerves, what are they?

A

common fibular nerve and tibial nerve

usually separate in the distal thigh but this can vary (in 12% of ppl the nerves separate as they leave the pelvis, with the common fibular nerve passing through piriformis

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21
Q

What is piriformis syndrome?

A

compression of the sciatic nerve due to hypertrophy or spasm of the piriformis muscle, usually due to excess use of the deep gluteal muscles (e.g. ice skaters, cyclists)

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22
Q

What are the muscles located in the posterior compartment of the thigh?

A

Hamstrings (semitendinosus, semimembranosus, long head of biceps femoris)

short head of biceps femoris

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23
Q

Origin rule for the hamstrings?

A

ischial tuberosity

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24
Q

Action rule for the hamstrings?

A

extend hip joint, flex knee joint

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25
Q

Innervation rule for the hamstrings?

A

tibial nerve (L5-S2)

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26
Q

Origin and insertion for semitendinosus?

A

ischial tuberosity, proximal tibia

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27
Q

Origin and insertion for semimembranosus?

A

ischial tuberosity, proximal tibia (medial, deep to semitendonosus

28
Q

Origin and insertion for long head of biceps femoris

A

ischial tuberosity, proximal fibula

29
Q

origin and insertion for short head of biceps femoris?

A

linea aspera of femur, proximal fibula (via tendon shared with long head)

30
Q

Action of short head of biceps femoris? innervation?

A

knee flexion

common fibular nerve

31
Q

pes anserinus

A

aka goose foot

the tendons of semitendinosus, gracilis and sartorius fuse distally to insert onto the medial aspect of the proximal tibia, forming the pes anserinus

32
Q

pes anserinus bursitis

A

irritation of the bursa underlying the pes anserinus, can cause pain on the medial aspect of the knee

33
Q

Action rule for the lateral compartment of the leg?

A

evert foot, weakly plantarflex ankle joint

34
Q

innervation rules for the lateral compartment of the leg?

A

superficial fibular nerve (L5-S2)

innervates the muscles of the lateral compartment of the leg. Innervates the skin of the anterolateral leg and most of the dorsal foot

35
Q

What are the muscles in the lateral compartment of the leg>

A

fibularis (peroneus) longus, fibularis (peroneus) brevis

36
Q

insertion of fibularis (peroneus) longus

A

tendon passes posterior to lateral malleolus, crosses the sole of the foot and inserts on the base of the 1st metatarsal

37
Q

insertion of fibularis (peroneus) brevis?

A

tendon passes posterior to the lateral malleolus to insert on the tuberosity of the 5th metatarsal

38
Q

What muscles will be affected if the common fibular nerve is injured?

A

the muscles of the anterior and lateral compartment of the leg and the dorsal foot. Pt will have drop foot due to loss of dorsiflexion and toe extension. Eversion will also be affected.

One invertor will be affected (tibialis anterior) but tibialis posterior will be intact as it is innervated by the tibial nerve

39
Q

Action rules for the posterior compartment of the leg?

A

plantarflex ankle joint, flex toes

40
Q

Innervation rule for the posterior compartment of the leg?

A

tibial nerve (L4-S3) medial branch of the sciatic nerve, travels between the superficial and deep muscle groups of the posterior leg

inverts posterior leg muscles and skin on the posterolateral aspect of the leg and lateral foot (via sural nerve which also receives contributions from the common fibular n.)

41
Q

What are the muscles of the superficial group of the posterior compartment of the leg? Where do they insert?

A

gastrocnemius, soleus, plantaris

onto the calcaneal tuberosity via calcaneal (achilles) tendon

42
Q

What does the calcaneal tendon reflex test?

A

the tibial nerve and spinal levels S1-S2

43
Q

What is triceps surae?

A

gastrocnemius + soleus

44
Q

Gastrocnemius, actions?

A

made up of medial and lateral head, flex knee joint and plantar flex ankle joint

45
Q

Action of soleus?

A

plantarflex ankle joint

46
Q

Action of plantaris?

A

absent in 5-10% of ppl

weakly flex knee joint, plantar flex ankle joint

47
Q

What are the muscles in the deep group of the posterior compartment of the leg?

A

popliteus, flexor digitorum longus, flexor hallucis longus, tibialis posterior

48
Q

Action of popliteus?

A

unlocks the knee from extended position, rotates femur laterally

49
Q

Insertion of flexor digitorium longus?

A

tendon travels posterior to medial malleolus of tibia in tarsal tunnel, divides into 4 tendons to insert of distal phalanges (digits 2-5)

50
Q

Action of flexor digitorium longus?

A

flex digits 2-5 (MTP, PIP and DIP joints), plantar flex ankle joint

51
Q

Insertion of flexor hallucis longus?

A

tendon travels posterior to medial malleolus of tibia in tarsal tunnel and inserts on distal phalanx of hallux

52
Q

Action of flexor hallucis longus?

A

flex hallux, weakly plantar flex ankle joint

53
Q

Insertion of tibialis posterior?

A

tendon travels posterior to medial malleolus of tibia in tarsal tunnel and inserts primarily on the navicular tuberosity

54
Q

Action of tibialis posterior?

A

plantar flex at ankle joint, invert foot

55
Q

What is held within the tarsal tunnel?

A

Tom Dick ANd Harry (from anterior to posterior)

  • Tibialis Posterior
  • Flexor digitorium longus
  • posterior tibial artery/vein, tibial nerve
  • Flexor hallucis longus
56
Q

What makes up the roof of the tarsal tunnel?

A

flexor retinaculum

57
Q

What are the arteries in the gluteal region? What do they arise from?

A

superior gluteal artery (exits sciatic foramen superior to piriformis)

inferior gluteal artery (exits sciatic foramen inferior to piriformis)

arise from internal iliac artery

have veins that accompany them with same names, drain into internal iliac vein

58
Q

What artery supplies the posterior thigh?

A

deep artery of the thigh and obturator artery

59
Q

What vein drains the posterior thigh?

A

deep vein of the thigh

60
Q

What does the femoral artery become as it passes through the adductor hiatus?

A

the popliteal artery

61
Q

What is the name for the branches of the popliteal artery that form anastomoses around the knee?

A

geniular branches

62
Q

What are the branches of the popliteal artery?

A

geniular branches, anterior tibial artery, posterior tibial artery (gives off fibular artery)

63
Q

How does the anterior tibial artery emerge? What does it supply?

A

passes through gap in superior part of the interosseous membrane

supplies the anterolateral leg and dorsal foot

64
Q

Where does the posterior tibial artery travel? What does it supply?

A

travels with tibial nerve between the superficial and deep muscle groups, supplies posterior leg.

65
Q

What arteries does the posterior tibial artery give off? what do they supply?

A

fibular artery- posterolateral leg
-gives off lateral malleolar and calcaneal branches

Gives off medial malleolar and calcaneal branches which anastomose with those given off by the fibular artery

66
Q

Where can you palpate the posterior tibial pulse?

A

posterior to the medial malleolus (within tarsal tunnel)

67
Q

What are the deep veins of the posterior and lateral leg

A

they parallel the arteries:

popliteal vein

anterior tibial vein

posterior tibial vein
-fibular vein

Anatomy Exam 2 (10 decks)

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