Hip and thigh region

Question 1

What is contained in the superficial fascia?

Answer 1

cutaneous nerves

greater and lesser saphenous vein

Question 2

Where is the fascia lata?

Answer 2

deep fascia over the gluteal region and thigh

Question 3

What is the root and function of the superior gluteal nerve?

Answer 3

• L4, L5, S1

- motor to gluteus minimus and medius and tensor fascia lata

Question 4

What is the root and function of the inferior gluteal nerve?

Answer 4

• L5, S1, S2

- motor to gluteus maximus

Question 5

What is the root and function of the femoral nerve?

Answer 5

• L2-4
• sensory = anteriomedial thigh, medial leg and foot
• motor = anterior thigh muscles

Question 6

What is the course of the femoral nerve?

Answer 6

passes inferiorly thorugh psoas major
underneath inguinal ligament
divides into anterior and posterior

Question 7

What is the root and function of the obturator nerve?

Answer 7

• L2-4
• motor = medial compartment of thigh
• sensory = medial thigh

Question 8

What is the course of the obturator nerve?

Answer 8

through psoas major
exits thigh through obturator canal
divides into anterior and posterior

Question 9

What is the root and function of the tibial nerve?

Answer 9

root = L4-S3
motor = posterior compartment of leg
sensory = posterio-lateral leg, lateral foot and sole

Question 10

What does the sciatic nerve branch into?

Answer 10

tibial nerve and common fibular/peroneal nerve

- branches at the popliteal fossa

Question 11

What is the root and function of the common fibular / peroneal nerve?

Answer 11

root = L4-S2
motor = short head of biceps femoris, lateran and anterior compartments of leg 
sensory = upper lateral and lower posterolateral skin of leg, dorsum of foot

Question 12

What does the common fibular nerve terminate into?

Answer 12

superficial fibular and deep fibular nerves

Question 13

What is the main artery of the lower limb?

Answer 13

femoral artery

- branches from external iliac at the inguinal ligament

Question 14

What is the profunda femoris artery?

Answer 14

a branch of the femoral nerve at the femoral triangle

Question 15

What are the 3 branches of the profunda femoris artery?

Answer 15

Perforating branches - supply posterior and medial muscles

Lateral femoral circumflex artery - supplies lateral muscles

Medial femoral circumflex artery - supples head and neck of femur

Question 16

What artery supplies the head and neck of femur?

Answer 16

medial femoral circumflex

Question 17

When does the femoral artery become the popliteal artery

Answer 17

when it reaches the adductor hiatus

Question 18

Where do the arteries supplying the gluteal region enter?

Answer 18

the greater sciatic foramen

Question 19

What does the popliteal artery branch into?

Answer 19

anterior tibial artery -> dorsalis pedis artery

tibioperoneal trunk -> posterior tibial artery + fibular artery

Question 20

What are the major pulse point of the lower limb?

Answer 20

femoral, popliteal, posterior tibial, dorsalis pedis

Question 21

What is the articulation site of the hip joint?

Answer 21

acetabulum and head of the femur

Question 22

What is the normal angle of inclination for the femur?

Answer 22

125
< 125 = coxa vara
> 125 = coxa valga

Question 23

What are the ligaments supporting the hip joint?

Answer 23

• iliofemoral ligament (y-shaped)
• pubofemoral ligament (triangular)
• ischiofemoral (spiral)

Question 24

What is the neurovasculature of the hip joint?

Answer 24

• medial circumflex & femoral arteries

- sciatic, femoral and obturator nerves

Question 25

What factors stabilise the hip joint?

Answer 25

ligaments, acetabulum, acetabular labrum

Question 26

What direction is the majority of hip joints?

Answer 26

posterior

Question 27

What enters through the greater sciatic foramen?

Answer 27

sciatic and gluteal nerves/arteries

Question 28

What are the features of gluteus maximus?

Answer 28

- main hip extensor - attaches to posterior surface of pelvis and iliotibial band - innervated by inferior gluteal nerve

Question 29

What is the attachment, innervation and actions of gluteus medius?

Answer 29

``` attachments = surface of ilium & greater trochanter action = abduction and medial rotation of leg innervation = superior gluteal nerve ```

Question 30

What is the attachment, innervation and action of gluteus minimus?

Answer 30

``` attachment = ilium + greater trochanter of femur action = abduction and medial rotation, stabilises pelvis innervation = superior gluteal nerve ```

Question 31

What is Trendelenburg's sign?

Answer 31

- damage to the superior gluteal nerve - results in wasting of gluteus medius and minimus - observed by pelvic drop

Question 32

What are the deep muscles of the gluteal region?

Answer 32

- piniformis - obturator internus - superior gemelli - inferior gemelli - quadratus femoris

Question 33

What is the function of the deep muscles of the gluteal region?

Answer 33

lateral rotation

Question 34

Where do the nerves in the gluteal region run?

Answer 34

either side of the piriformis muscle

Question 35

Where are IM injections given to avoid the sciatic nerve?

Answer 35

upper lateral quadrant

Question 36

What is a sign that an IM injection has damaged the sciatic nerve?

Answer 36

foot drop

Question 37

What is the path of the sciatic nerve in the gluteal region?

Answer 37

- emerges inferior to piriformis - crosses the deep gluteal muscles posteriorly - enters the posterior thigh

Question 38

What is the innervation of the anterior compartment of the thigh?

Answer 38

femoral nerve

Question 39

What is the function of the anterior compartment of the thigh?

Answer 39

extends the leg at the knee joint

Question 40

What muscles make up the anterior compartment of the thigh?

Answer 40

1. quadriceps femoris (4) 2. sartorius (long and thin) 3. pectineus (flat)

Question 41

What is the innervation of the medial compartment of the thigh?

Answer 41

obturator nerve

Question 42

What is the function of the medial compartment of the thigh?

Answer 42

hip adduction

Question 43

What muscles make up the medial compartment of the thigh?

Answer 43

1. adductor magnus 2. adductor longus 3. adductor brevis 4. obturator externus 5. gracialis

Question 44

What is the innervation of the posterior compartment of the thigh?

Answer 44

sciatic nerve

Question 45

What is the function of the posterior compartment of the thigh?

Answer 45

extend at hip, flex at knee | = hamstrings

Question 46

What muscles make up the posterior compartment of the thigh (hamstrings)?

Answer 46

1. biceps femoris 2. semiteninosus 3. semimembranous

Question 47

What are the borders of the femoral triangle?

Answer 47

``` superior = inguinal ligament lateral = sartorius muscle medial = adductor longus roof = fascia lata base = pectineus muscle ```

Question 48

What are the contents of the femoral triangle?

Answer 48

femoral nerve, artery and vein femoral canal containing lymphs - order = NAVEL

Question 49

What are the borders of the politeal fossa?

Answer 49

(diamond shaped) superomedial = semimembranous superolateral = biceps femoris inferomedial = medial head of gastrocnemius inferolateral = lateral head of gastrocnemius

Question 50

What are the contents of the popliteal fossa from medial to lateral?

Answer 50

popliteal artery popliteal vein tibial nerve common fibular nerve

Question 51

What is Baker's cyst?

Answer 51

swelling in the popliteal fossa | - caused by inflammation of semimembranous bursa

Question 52

What is Perthe's disease?

Answer 52

abnormal development of the head of femur (mushroom head) | - causes collapse