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Flashcards in Glute and Thigh Deck (84):
1

regions and corresponding bones of the LE

thigh - femur
leg - tibia and fibula
foot - tarsal bones
hip - coxal bone, femur
knee - patella, femur, tibia
ankle (talocrural) - tibia, fibula, talus

2

tarsal bones (9)

calcaneus
talus
navicular
cuboid
medial (first) cuneiform
intermediate (second) cuneiform
lateral (third) cuneiform
metatarsal bones
phalanges

3

coxal bone components

ilium
ischium
pubis

4

femur components

head
neck
body
greater trochanter
lesser trochanter
intertrochanteric line
intertrochanteric crest
gluteal tuberosity
spiral line
pectineal line
linea aspera
medial and lateral condyles
intercondylar notch (fossa)
adductor tubercle
medial and lateral epicondyles
ligament of head of femur

5

intertrochanteric line
-location
-function

anterior
attachment of ligaments that support hip joint

6

intertrochanteric crest
-location
-function

posterior
attachment of muscles

7

spiral line
-location

medial lip of linea aspera

8

pectineal line
-location

continuation of intertrochanteric line

9

linea aspera
-splits to form...
-categorization function

splits to form medial and lateral supracondylar lines
divides thigh into compartments

10

ligament of head of femur
-location
-held in place by...
-function

attached to inferior portion of acetabulum
held in place by transverse acetabular ligament
allows insertion of vasculature of head of femur

11

fracture of the neck of the femur
-primary culprit
-primary determinant of healing

culprit
-aging
determinant
-blood supply

12

patella
-what type of bone?
-points of interest
-location of points

sesamoid bone
apex
-points inferiorly
base
-superiorly

13

tibia
-points of interest

medial and lateral condyles
medial and lateral tibial plateaus
intercondylar eminence
tibial tuberosity (attachment of patellar ligament)
medial malleolus
fibula rnotch
shaft or body
interosseus border (lateral)
soleal line, vertical line
popliteal area

14

hip joint
-motions allowed
-points of interest

motions
-flexion-extension
-abduction-adduction
-medial-lateral rotation
-circumduction
acetabular labrum
fibrous capsule

15

acetabular labrum
-composed of what type of tissue
-function

fibrocartilage
deepens the acetabular fossa

16

fibrous capsule
-ligaments
-additional part
-ligament origin and attachment

ligaments
-iliofemoral ligament ("Y" ligament)
--static stabilizer for upright posture
-ischiofemoral ligament
-pubofemoral ligament
-circular part of each ligament forms an orbicular (circular) part
origin
-acetabular rim
attachments
-intertrochanteric line (iliofemoral and pubofemoral)
-neck of the femur medial to base of greater trochanter

17

ligament of head of the femur origin and attachment

from acetabular wall and transverse acetabular ligament to the pit in the head of the femur

18

hip joint blood supply
-from which arteries
-how do they provide blood to the femur?

blood supply from articular arteries off of the medial and lateral femoral circumflex arteries
-they anastosome (I think this means that they branch and interconnect a lot) around and through the head with an artery in the ligament of the head of the femur

19

avascular necrosis
-what
-how

deterioration of the head of the femur following a compromise in the blood supply
causes
-age
-broken hip (Bo Jackson)

20

knee joint
-type of joint
-permits which actions

hinge type synovial joint permitting some rotation
permits
-flexion and extension of the leg
-rotation of the leg when fixed

21

when knee is fully extended and "locked"
-relation between femur and tibia
-how do you unlock?

femur is medially rotated on the tibia
to unlock
-popliteus muscle laterally rotates the femur (tibia fixed due to standing)

22

knee intrinsic capsular ligament (external ligaments of the knee)

lateral and medial collateral ligaments
patellar ligament
oblique popliteal ligament
arcuate popliteal ligament

23

oblique popliteal ligament
-portion of...

portion of the tendon of semimembranosus that supports the posterior part of the joint capsule

24

arcuate popliteal ligament
-what is it?

branched ligament
from head of fibula to the intercondylar space of the thigh and lateral epicondyle of the femur

25

internal ligaments of the knee

anterior and posterior cruciate ligaments
medial and lateral collateral menisci (not really ligaments but seemed like a good place to put them)

26

how is the knee joint supplied with blood?

genicular arteries from an anastomotic circulation around it

27

gluteal region
-superior and inferior boundaries
-marked superficially by..

superiorly bounded by iliac crest
inferiorly bounded by inferior border of gluteus maximus
marked superficially (surface anatomy) by gluteal sulcus

28

lateral surface of ilium
-marked by limits of...
-how do these mark it
-what do we call these "marks"

marked by limits of the origins of the named gluteal muscles (maximus, medius, minimus)
these muscle attachments leave small elevation or roughened surface on the bone
knows as the posterior, anterior, and inferior gluteal lines
more likely to be seen or real bone than models

29

obturatur internus
-originates where and with what muscle?

within pelvic cavity with piriformis

30

piriformis
-originates where
-how does it leave pelvis
-where does it insert?

originates on
-pelvic side of the sacrum
-associated ligaments
-ilium at edge of the greater sciatic notch
leaves pelvis in an anterolateral direction through the greater sciatic foramen
insert on the greater trochanter of the femur

31

obturator internus
-originates...
-exits...
-inserts...

originates
-within limits of the pelvis
-bony surfaces of the ischium and ilium surrounding the obturator foramen
-obturator membrane
exits
-somewhat posteriorly below the sacrospinous ligament through the less sciatic foramen (notch)
inserts on the medial surface of the greater trochanter after bending anterolaterally after moving through lesser sciatic foramen

32

obturator internus tendon
-protected by

protected by a bursa as it swings around the bony edge of the ischium

33

obturator foramen
-partially covered by ____ with a small opening called___

obturator membrane
obturator canal

34

obturator externus
-originates...

on external side of the obturator membrane
adjacent rami of the ischium and pubic bones

35

piriformis
-separates...

separates the exiting of the superior and inferior gluteal nerve and artery from the pelvis

36

sciatic nerve
-exits where
-"usual" orientation relative to piriformis
-what are other configurations

exits the pelvis through the greater sciatic notch in relation to the piriformis
"usual" orientation
-comes out inferior to piriformis
other configurations
-split around or through piriformis

37

glute muscle action and walking
-medius and minimus

gluteus medius and minimus extremely important in walking
-to take step with right foot, thigh and leg of the left side must be fixed
-allows elevation of the right leg and foot on the opposite side
-achieved by having these muscles tilt and stabilize pelvis, so hip doesn't sag on the right side when its support is removed
-this allows opposite foot to clear the ground

38

if pelvis sags during walking
-name
-causes
-how do patients compensate?

Trendelenberg's sign
causes
-neuromuscular damage to the superior gluteal nerves and/or the muscles
-broken bone so that muscles don't have a fixed point from which to pull
compensation
-patients walk with a lurching gait

39

plexuses in general
-formed from

formed from primary ventral rami of spinal nerves

40

primary ventral rami
-divide into...
-plexus is formed by...
-what type of nerves are ventral rami?

divide into a dorsal and ventral division
plexus is formed by the dividing and mixing of individual spinal nerves into the formation of peripheral nerves
ventral rami are mixed nerves
-contain both sensory and motor axons

41

sacral plexus
-created by...
-form...
-also gives rise to...

created by dorsal division of the ventral rami of L4, L5-S2
form the common peroneal part of the sciatic nerve
also gives rise to
-superior and inferior gluteal nerves

42

superior and inferior gluteal nerves
-function

innervate three named gluteus muscles and the piriformis

43

superior and inferior gluteal nerves
-leave the pelvis via...
-ventral divisions give rise to...

via greater sciatic foramen
ventral divisions give rise to
-tibial part of the sciatic nerve
-nerves of the obturator internus and quadratus femoris

44

damage to the sciatic nerve in the gluteal region results in...

affects ability to
-extend and abduct the thigh
-flex the leg
-dorsiflex the foot (foot drop)

45

sacral plexus nerve divisions also give rise to...

the pudendal nerve
-seen in gluteal region

46

pudenal nerve
-function

carries sensory information and autonomic fibers to and from genital region

47

lumbar plexus
-which nerves?

collections of dorsal and ventral divisions of ventral rami of spinal nerves (T12), L1-L5

48

femoral nerve created by

dorsal division of ventral rami of L2-L4

49

obturatur nerve created by

ventral divisions of ventral rami of L2-L4

50

lumbosacral trunk created by

dorsal division of L4 and L5

51

superior and inferior gluteal arteries
-branches off of...
-travel where and with what?

branches off of the internal iliac artery
travel into the gluteal region with superior and inferior gluteal nerves

52

superior gluteal artery vascular distribution

provides blood for all named gluteal muscles

53

inferior gluteal vascular distribution

provides blood to
-gluteus maximus
-other small muscles of the gluteal region

54

superior gluteal and inferior gluteal arteries participate in...

anastomotic circulation

55

anastomotic circulation of superior and inferior gluteal arteries formed between
-termed the

these two arteries
medial and lateral circumflex femoral arteries
first branch of the profunda femoris artery (deep femoral artery)
termed the
-cruciate anastomosis of the thigh

56

anastomotic circulation of thigh supported by...
-this is a branch of the...

artery that is following the ligament to the head of the femur
-branch of the obturator artery

57

branches of cruciate anastomosis send...

retinacular vessels along the neck of the femur

58

cruciate anastomosis compromise
-cause
-result

cause
-aging common
result
-difficulty in repair of fractures of the neck of the femur
-bone maintenance and repair process is marginal at best, and the neck or head of the femur begins to deteriorate
-this is known as avascular necrosis

59

internal pudendal artery
-branch off of...
-where does it travel?
-function

branch off of the internal iliac artery
leaves the pelvis via the greater sciatic foramen and then re-enters via the lesser sciatic foramen
-loops around the ischial spine, underneath the sacrotuberous ligament
function
-gives blood to the external genitalia and deep muscles of the pelvis and gluteal region

60

fascia lata
-what
-how is it attached?
-lateral side of fascia lata

dense connective tissue sheath that forms the deep fascia of the thigh
attached in a ring fashion to much of the pelvis and invests the thigh muscles
lateral side
-thicked as the iliotibial band (tract)

61

IT band
-what inserts into it
-purpose of this insertion

TFL and gluteus maximus insert into and tight it
aid in stabilization of pelvis

62

superficial veins of thigh
-seen where?

seen overlying the dense connective tissue (fascia lata)
run in the subcutaneous space

63

deep veins
-located where?

run along with paired named arteries

64

how are superficial and deep veins connected?

by valved interconnections

65

deep veins of the thigh and leg contain...

valves that help in the prevention of pooling of blood in the lower extremities

66

what happens if this venous system breaks down?

blood pools in peripheral veins
leads to vericose veins

67

3 important veins

great saphenous vein
lesser saphenous vein
femoral vein

68

great saphenous
-saphenous opening
-what is a common use of this vein

saphenous opening
-area in fascia lata that allows great saphenous vein to dump into femoral vein
great saphenous commonly used in cardiac bypass surgery

69

arteries of the thigh and popliteal fossa

-external iliac artery becomes femoral artery after passing inguinal ligament
-deep femoral artery (profundis femoris)
-perforating branches
-lateral and medial circumflex femoral arteries
-descending branch of lateral circumflex femoral arteries
-descending genicular branch
-popliteal artery (femoral artery after it passes through adductor canal)
-superior - medial and lateral - and inferior - medial and lateral - genicular arteries
-anterior tibial artery
-posterior tibial artery
-peroneal artery

70

branches of internal iliac artery that reach the thigh

superior and inferior gluteal artery
obturator artery (adductor region)

71

nerves of thigh and popliteal fossa

femoral
sciatic
obturator
ilioinguinal
genitofemoral

72

femoral nerve
-formed from
-innervates...

formed from lumbar plexis
-dorsal divisions of L2-L4
innervates
-anterior thigh muscles
-cutaneous innervation of anterior and medial sides of leg

73

saphenous nerve
-location

enters femoral triangle with femoral nerve
travels with femoral artery through adductor canal

74

obturator nerve
-formed from...

formed from ventral divisions of L2-L4

75

femoral triangle
-clinical significance and location of this
-boundaries

can palpate femoral pulse in this region
location
-2-3 cm inferior to inguinal ligament
boundaries
-superior (base) - inguinal ligament
-medial - lateral border of adductor longus
-lateral - medial border of sartorius
-floor - bodies of pectineus and iliopsoas

76

femoral triangle
-contents

contents
-femoral artery, nerve, vein
-profunda femoris artery - chief after of thigh
-lymph nodes

77

femoral triangle
-important contents from lateral to medial

femoral nerve
femoral artery
femoral vein
femoral canal

78

femoral sheath
-what is it?

extension of abdominal transversalis fascia and iliac fascia that encases all of the contents of the femoral triangle for 4 cm, except the femoral and saphenous nerves

79

femoral sheath compartments
-purpose of compartments

3 compartments
-for femoral artery, vein, and canal

80

femoral canal
-contents
-function
-superior border
-covered by
-what happens if ruptured?

contents
-empty with few lymph nodes and vessels
function
-allows for venous expansion of vein during times of high venous return
superior border
-femoral ring
covered by a weak covering of abdominal peritoneum
if ruptured
-small intestine can bulge into and/or become strangulated (different than inguinal hernia)

81

adductor canal
-location
-purpose
-where does it end?
-boundaries

tunnel beneath the sartorius
carries
-femoral artery and vein
-saphenous nerve
ends at the adductor hiatus in adductor magnus
boundaries
-lateral - vastus medialis
-posteromedial - adductor longus and magnus
-anterior - sartorius
-roof - sartorius and subsartorial fascia

82

popliteal fossa
-location and appearance
-boundaries

diamond shaped area at the posterior aspect of the knee
boundaries
-superolateral: biceps femoris
-superomedial: semitendinosus and semimembranosus
-inferomedial and inferolateral: medial and lateral heads of gastrocnemius
-floor: next slide
-roof: skin and fascia

83

floor of popliteal fossa

popliteal surfaces of femur and tibia
oblique popliteal ligament
part of the semimembranosus tendon
popliteus fascia

84

popliteal fossa contents

popliteal artery and genicular anastomosis
popliteal vein
tibial nerve
-branch of sciatic nerve usually branches at/near superior point of popliteal fossa
common peroneal nerve - other branch of sciatic nerve