Gluteal Region/Thigh Flashcards
(207 cards)
1
Q
boundaries of gluteal region
A
superior- iliac crest
inferior - gluteal fold
laterally - greater trochanter
medially - intergluteal cleft
*covered by thick layer of fascia
2
Q
greater and lesser sciatic foramina
A
formed by greater and lesser sciatic notches, sacrotuberus,
and sacrospinous II
transmits muscles, nerves, arteries and veins from pelvis to gluteal region and gluteal region to pelvis1
3
Q
hip joint type
A
synovial , ball and socket
4
Q
articulations of hip joint
A
head a femur and acetabulum
5
Q
movements of hip joint
A
flexion/extension , ADD/ABD, MR/LR, circumduction
6
Q
acetabular labrum
A
attached to margin of acetabulum
increases articular area
7
Q
hip extension
A
winds spiraling ll. tightly
pulls femoral head into acetabulum
limits extension
8
Q
hip flexion
A
unwinds spiraling ll.
permits considerable flexion
9
Q
transverse acetabuluar l.
A
continuation of acetabular labrum
bridges acetabular notch
10
Q
most common type of hip dislocation
A
posterior
11
Q
causes of hip dislocation
A
most commonly car accidents
12
Q
limb position when hip dislocation happnes
A
flexed, ADD, and MR
knees strike dash
13
Q
femoral head in hip dislocation
A
head is pushed out of acetabulum
14
Q
limb position after hip dislocation
A
semi flexed and MR
15
Q
sciatic nerve in hip dislocation
A
weakness/paralysis of hamstrings and everything distal to knee
16
Q
sensation loss in dislocation of hip
A
posterolateral leg and much of foot
17
Q
anterior dislocation of hip
A
result from violent injury
limb forced into extension, ABD and LR
18
Q
femoral head in anterior hip dislocation
A
inferior to acetabular margin
19
Q
femoral n. in anterior dislocation of hip
A
weakness/paralysis to sartorius and quadriceps mm
20
Q
sensation in anterior dislocation of hip
A
medial leg and foot
21
Q
what muscles exit the greater sciatic foramen? lesser?win
A
piriformis/ obturator internus m
22
Q
do ligaments of hip wind of unwind with extension?
A
wind
23
Q
what direction of hip dislocation is most common
A
posterior
24
Q
what nerve might be damaged with posterior dislocation of hip? anterior?
A
sciatic/ femoral
25
superficial layer of gluteal muscles
gluteus maximus
gluteus medius
gluteus minimus
tensor fascia latae (located anteriorly but innervated by superior gluteal n)
26
deep layer of gluteal muscles
*lateral rotators
piriformis
gemellus superior
obturator internus
gemellus inferior
obturator externus
quadratus femoris
27
gluteus maxiumus
covers other gluteal muscles
moves superiorly when sitting (sit on ischial tuberosity)
28
actions of gluteus maximus
extension of thigh
LR of thigh
extension of trunk
29
innervation of gluteus maxiumus
inferior gluteal n.
30
gluteus medius
palpable just inferior to iliac crest posteriorly
31
gluteus medius actions
ABD of thigh
MR of thigh
keeps pelvis level when ipsilateral leg is weight bearing and unsupported side is in swing phase
32
gluteus medius innervation
superior gluteal n.
33
gluteus minimus
deep to gluteus medius
has shiny white fan shaped tendon
34
actions of gluteus medius
ABD of thigh
MR of thigh
keeps pelvis level when ipsilateral leg is weight bearing and unsupported side is in swing phase
35
gluteus minimus innervation
superior gluteal n.
36
tensor fascia latae
located more anteriorly
enclosed between layers of fascia lata
37
actions of tensor fascia latae
flexion of thigh
ABD of thigh
MR of thigh
helps knee extend by tensing IT band
38
tensor fascia latae innervation
superior gluteal n.
39
piriformis
has intra and extrapelvic parts
exits greater sciatic foramen
40
piriformis superior and inferior vasculature
pass above and below this muscle respectively
*other contents leaving GSF exit below
41
piriformis actions
LR of extended thigh
ABD of flexed thigh
steadies femoral head
42
innervation of piriformis
ventral rami S1 and S2
43
gemellus superior
*sometimes absent
acts as extrapelvis reinforcement of obturator internus m
44
gemellus superior action
LR of extended thigh
ABD of flexed thigh
steadies femoral head
45
gemellus superior innervation
N. to obturator internus
46
obturator internus
triceps coxae formed by this muscle and gemelli
fills gaps between piriformis and quadratus femoris
incapable of independent action
47
path of obturator internus
leaves pelvis via lesser sciatic foramen
makes 90 degree turn inferior to ishcial spine
48
obturator internus actions
LR of extended thigh
ABD of flexed thigh
steadies femoral head
49
obturator internus innervation
N to obturator internus
50
gemellus inferior
also serves as extrapelvic reinforcement of obturator internus m
51
gemellus inferior actions
LR of extended thigh
ABD of flexed thigh
steadies femoral head
52
gemellus inferior innervation
N. to quadratus femoris
53
obturator externus (not on lab exam)
obturator canal opens superiorly to this
deep in superomedial part of thigh
54
obturator externus path
tendon passes under acetabulum and neck of femur
visible deep to quadratus femoris
55
obturator externus actions
LR of thigh
steadies femorial head
56
innervation of obturator externus
obturator n.
57
quadratus femoris
inferior to inferior gemellus
sciatic nerve lies over it
may look small depending on how thigh is rotated
58
quadratus femoris actions
LR of thigh
steadies femoral head
59
quadratus femoris innervation
N. to quadratus femoris
60
superior gluteal n. VPR
VPR L4-S1
61
superior gluteal n. innervates
gluteus medius
gluteus minimus
tensor fascia latae
62
inferior gluteal n. VPR
VPR L5- S2
63
inferior gluteal n. innervates
gluteus maximus
64
sciatic n. VPR
VPR L4-S3
65
sciatic n. innervates
nothing in gluteal region
66
what two nerves is the sciatic nerve?
common fibular
tibular
67
N to quadratus femoris VPR
68
N to quadratus femoris VPR
VPR L4-S1
69
N to quadratus femoris innervates
gemellus inferior
quadratus femoris
70
N to obturator internus orgin
VPR L5-S2
71
N to obturator internus innervates
gemellus superior
obturator internus
72
pudendal n. orgin
VPR S2- 4
73
pudendal n. innervates
nothing in gluteal region
leaves GSF and enters LSF
74
injury to superior gluteal n. caused by
pelvic fracture
wound to gluteal region
compression by fetal head
75
injury to superior gluteal n. muscles impaired
gluteus minimus and medius
76
injury to superior gluteal n. sign
Positive Trendelenburg Sign
when asked to stand on one leg pelvis descends on unsupported side
tilts toward undamaged side
indicates mm on supported side are weakened or not fully functional
77
results of injury to superior gluteal n.
gluteal gait - list of body to weakened side; raises pelvis and allows foot room to clear ground
78
cause of injury to sciatic nerve
intragluteal injections
posterior dislocation of hip
79
muscles affected in injury to sciatic nerve
hamstrings
all muscles of leg and foot
* would maintain extension of leg (femoral nerve), rest of leg useless
80
sensory loss in injury to sciatic nerve
all areas below knee (exception medial leg and foot - saphanous n.)
81
sciatica
compression of sciatic nerve or related roots
82
causes of sciatica
piriformis syndrome (muscle pinches
spinal tumors/injections
pregnancy
lumbar herniated discs
lumbar spinal stenosis
83
symptoms of sciatica
may be mild or intense
shooting pain - lower back, gluteal region, thigh, leg and foot
severe symptoms can make walking or standing difficult
84
what muscles of the gluteal regions MR the thigh?
gluteus medius and minumus
85
if your standing on your left leg which gluteus med and min are contracting to keep pelvis level
left side
86
which nerves pass through gluteal region but dont innervate anything
sciatic and pudendal
87
fascia lata
forms IT band laterally
from ilia tubercle to anterolateral tibial tubercle (gerdy's tubercle)
88
fascia latta compartments
3 intermuscular septa which extend centrally to femur
3 compartments - anterior, posterior, medial
89
posterior compartment of thigh muscles
semimembranosus
semitendinosus
biceps femoris
90
joints crossed by muscles of posterior thigh
hip and knee
91
what is the common origin of the muscles of the posterior thigh muscles
ischial tuberosity (pulled hamstring usually happens here)
92
common innervation of posterior compartment of thigh
majority by tibial division of sciatic n. (except short head of biceps femoris)
93
common functions of muscles of posterior compartment of thigh
extension of hip
flexion of leg
94
semitendinosis
"true hamstring" attaches at ischial tuberosity
distal part has cord like tendon (hence name)
95
actions of semitendinosis m
extension of thigh
flexion of leg
MR of leg when knee is flexed
96
innervation of semitendinosis
tibial division of sciatic n.
97
semimembranosus
true hamstring
flattened membranous proximal attachment
98
actions of semimembranosus
extension of thigh
flexion at knee
MR of leg when knee is flexed
99
innervation of semimembranosus
tibial division of sciatic n.
100
biceps femoris heads
long head-crosses hip and knee
short head( most lateral) - crosses knee
101
biceps femoris long head
only long head is true hamstring
covers sciatic nerve
102
biceps femoris actions
extension of thigh - long head only
flexion of leg - both heads
LR of leg when knee is flexed - both
103
biceps femoris innervations
long head- tibial division of sciatic n.
short head - common fibular division of sciatic nerve
104
hamstring injuries common in
those that kick or run hard
inadequate warm up
105
most common torn in hamstring
semimembranosus
106
causes of hamstring injuries
violent muscular extension may tear proximal part of hamstrings from ischial tuberosity
107
what could result in avulsion of ischial tuberosity
forcible flexion of hip with knee extended (proximal part of biceps femoris and semitendinosis)
108
hamstring injury damage
bruising(contained by fascia lata) and tearing of muscle
109
innervation of posterior compartment of thigh
sciatic and post femoral cutaneous
110
sciatic nerve origin
VPR L4-S3
111
sciatic nerve divisions
tibial - L4-S3; semibranosus, semitendinous, long head of biceps femoris and hamstring portion of adductor magnus
common fibular - L4 -S2: supplies short head of biceps femoris
112
posterior femoral cutaneous n origin
VPR S1- S3
113
posterior femoral cutaneous n, innervates
skin over posterior thigh and popliteal fossa
114
posterior femoral cutaneous n. AKA
posterior cutaneous nerve of thigh
115
the it band is a thickening of what fascia
fascia lata
116
what actions would be affected by avulsion of ischial tuberosity
extension of thigh
flexion of knee
117
where is sciatic nerve located?
deep to biceps femoris long head
118
anterior compartment of thigh muscles
pectineus
iliospsoas
sartorius
quadriceps femoris
119
pectineus
between ant and post compartments of thigh
forms part of floor of femoral triangle
120
actions of pectineus
ADD of thigh
flexion of thigh
121
innervation of pectineus
femoral n.
may receive branch from obturator n.
122
iliopsoas
chief flexor of thigh
forms part of floor of femoral triangle
123
iliopsoas composition
ilicaus and psoas major
124
iliopsoas actions
flexion of thigh or trunk
stabilize hip joint
125
iliopsoas innervations
iliacus - femoral n.
psoas major -VPR L1 - L3
126
sartorius m.
tailors muscle
forms border of femoral triangle
127
sartorius m. joints crossed
hip and knee
128
sartorius m. permits
crossed knee flexion
129
sartorius m. actions
ABD of thigh
LR of thigh
flexion of thigh
flexion of leg
MR of leg when knee is flexed
130
pes anserinus
gooses foot
3 muscles from 3 compartments insert here
131
rectus femoris joints crossed
hip and knee
132
rectus femoris actions
flexion of thigh
extension of leg (limited when thigh is flexed)
steadies hip joint
133
rectus femoris innervation
femoral n.
134
vastus muscles joints crossed
just knee
135
vastus muscles
vastus lateralis, vastus intermedius,vastus medialis
136
vastus muscles action
extension of leg
137
vastus muscles innervation
femoral n.
138
vastus lateralis
deep to IT band
139
vastus intermedius
deep to rectus femoris
140
vastus medialis
forms part of adductor canal
141
medial compartment of thigh muscles
adductor longus
adductor brevis
adductor magnus
gracilis
obturator externus
142
medial compartment of thigh common innervation
obturator n.
143
medial compartment of thigh common function
ADD of thigh
144
adductor longus
most anterior of adductors
forms border of femoral triangle
covers anterior aspects of adductor brevis and magnus
145
adductor longus action
ADD of thigh
146
adductor longus innervation
obturator n.
147
adductor brevis
deep to adductor longus
2 division of obturator n pass anterior and posterior to this muscle
148
adductor brevis actions
ADD of thigh
limited flexion of thigh
149
adductor brevis innervation
obturator nerve
150
adductor magnus
largest most powerful and most posterior of ADD group
151
adductor magnus parts
adductor - horizantal
hamstring-vertical
152
adductor magnus actions
ADD of thigh
adductor part - flexes thigh
hamstring part - extends thigh
153
adductor magnus innervation
adductor part - obturator n.
hamstring part - tibial division of sciatic n.
154
adductor hiatus
opening between parts of adductor magnus
transmits femoral a./ v. to and from adductor canal, to and from popliteal fossa
155
gracilis joints crossed
hip and knee
156
gracilis actions
ADD of thigh
flexion of leg
MR of leg
157
gracilis innervation
obturator n
158
groin pull indivduals affected
quick starts
hockey, baseball, sprinting
159
groin pull types of injuries
strains
stretching and tearing of proximal attachments in medial thigh
160
muscles involved in groin pull
adductor muscles
most commonly adductor longus
161
femoral a path
direct continuation of external iliac a. distal to inguinal ligament
passes through femoral triangle lateral to femoral
162
one of 4 places to take pulse
femoral a,
163
femoral a. branches
profunda femoris (deep a of thigh)- supplies perforating aa. to posterior thigh
164
termination of femoral a.
becomes politeal a. as traverse adductor hiatus
165
femoral v.
continuation of popliteal v. as it goes through adductor hiatus
166
great saphenous v.
greatest tributary
167
great saphenous v. path
arises from medial aspect of dorsal venous arch of foot
ascends ant to medial maleolus
passes posterior at medial femoral condyle
found in subcutaneous tissue of medial thigh
traverses saphenous opening (hiatus)
drains into femoral v
168
saphenous vein grafts uses
CABG (used to bypass blocked arteries)
veins are inverted as to not block blood flow
readily accesible
usable lengths to be harvested
walls contain higher number of muscular and elastic fibers
169
femoral n. origin
posterior division of VPR L2-4
located in femoral triangle lateral to femoral a.
170
femoral cauda equina
collective term for numerous branches of femoral n.
171
femoral n. innervates
anterior compartment of thigh
sensory to anterior thigh and anteromedial leg
172
femoral n. branches
saphenous n. - runs in adductor canal
- bypasses adductor hiatus
- doesn't supply anything in thigh
173
obturator n. origin
anterior division of VPRL2- 4
174
obturator n. exits pelvis via
obturator canal
175
obturator n. innervates
adductor compartment mm.
obturator externus
adductor part of adductor magnus
sensory:skin of medial thigh just above knee
176
lateral femoral cutaneous n.
VPR L2-3
supplies skin of anterior and lateral thigh
177
femoral branch of genitofemoral n,
VPR L1-2
supplies skin over lateral femoral triangle
178
ilioinguinal n.
VPR L1
supplies skin of inguinal region
179
injury to femoral n. causes
pelvis fracture
psoas absess
gunshot of penetrating wound
180
injury to femoral n. muscles affected
anterior compartment of thigh
181
injury to femoral n. sensory loss
anterior and parts of medial thigh
anteriomedial leg and foot (saphenous n.)
182
injury to femoral n. function affected
weakened flexion of hip
loss of leg extension
diffculty walking up stairs/ uphill (person will push into thigh to force knee into extension)
183
which quadriceps femoris cross hip and knee
rectus femoris
184
what medial thigh muscle crosses hip and knee
gracilis
185
where is adductor hiatus
inferior portion of adductor magus
contains femoral a./v. become popliteal a./v on when through
186
femoral triangle borders
superior- inguinal ligament
medial border- adductor longus
lateral border -sartorius
floor - pectineus, ilospsoas
roof -skin/fascia
187
femoral triangle contents
femoral N -> A-> V
188
retro inguinal space
deep to inguinal ligament
189
2 compartments formed by iliopectenal arch
from inguinal l. to iliopubic eminence
190
retro inguinal space lateral compartment
outside femoral sheath
ilispsoas and femoral n. (femoral n does not sit in femoral sheath - outside)
191
retro inguinal space medial compartment
encloses femoral sheath
femoral a.
femoral v.
femoral canal - deep inguinal lymph nodes/vessels
192
area of lymphatics in femoral sheath is weak so
site for hernias
193
femoral seath
funnel shaped fascial tube
terminates inferiorly by blending with adventitia of femoral vessels
enclosed proximal parts of femoral vessels and makes femoral canal medial to them
194
femoral sheath compartments
lateral - femoral a.
intermediate - femoral v.
medial - femoral canal - lymph nodes
195
femoral canal location
between medial edge of femoral canal and femoral v.
extends to level of saphenous opening
196
purpose of femoral canal
allows for venous expansion
temporary stasis
increases venous return from lower limb
197
contents of femoral canal
loose connective tissue and lymphatic
198
base of femoral canal
femoral ring(small opening at proximal end of canal)
199
adductor hiatus
opening between distal attachements of 2 adductor magnus parts
200
location of adductor hiatus
lateral and superior to adductor tubercle
201
contents of adductor hiatus
Femoral a.v. to/from adductor canal to/from popliteal fossa
does NOT contain saphenous vein
202
femoral hernias more common in
females (wider pelvis)
203
femoral hernias
protrusion of abdominal viscera through femoral ring (passes through femoral canal
204
location of mass of femoral hernias
femoral triangle and inferolateral to pubic tubercle
205
femoral hernias boundaries
femoral v. laterally, lacunar l. medially, inguinal l. superiorly
206
how can femoral hernias enlarge
pass through saphenous hiatus into thigh
207
risk of femoral hernias
strangulation (necrotic)
