Flashcards in Hip, buttock and thigh Deck (46):
What are the 2 major regions of the lower limb?
Gluteal region (part of the trunk)
Free lower limb (thigh, leg and foot)
What are the 3 parts of the pelvis that fuse during development?
What are the 2 layers of fascia of the lower limb?
Superficial fascia- subcutaneous tissue.
Deep fascia- in the thigh, fascia lata: extends like a stocking beneath the skin from hip to knee.
What is the iliotibial tract?
A lateral thickened area of fascia in the lower limb.
What are the compartments of the lower limb?
Anterior compartment of thigh
Medial compartment of thigh
Posterior compartment of thigh
What muscles are contained within the gluteal region?
Extensors, abductors and external rotators of the hip.
-(Tensor fasciae latae)
Short external (lateral) rotators of the hip:
-The gemelli (sup. and inf.)
What is the main function of the lateral rotator muscles in the gluteal region?
Stabilise the hip joint.
What muscles are contained within the anterior compartment of the thigh?
Hip flexors and knee extensors.
Tensor fasciae latae
What muscles are contained within the medial compartment of the thigh?
What muscles are contained within the posterior compartment of the thigh?
Knee flexors and hip extensors.
What are the borders of the femoral triangle?
Inguinal ligament superiorly
Adductor longus medially
Sartorius (medial border) laterally
What does the femoral triangle contain?
What is the adductor (Hunter's/subsartorial) canal formed by?
Vastus medialis (anteriorly)
Adductor longs and adductor magnus (posteriorly)
What does the adductor canal contain?
What does the greater sciatic foramen contain?
Structures passing from the pelvis to the thigh.
What does the lesser sciatic foramen contain?
Structures passing from the pelvis to the perineum.
What is the significance of the 'safe area' in the lower limb?
Avoid hitting the sciatic nerve (and superior gluteal nerve and vessels) during intramuscular injection.
What does the sciatic nerve supply?
The hamstring muscles
Muscles below the knee
What is the path of the sciatic nerve?
Passes from pelvis to buttock via greater sciatic notch/foramen.
In the buttock, lies in the inferior and medial quadrant.
Passes along posterior aspect of thigh.
Divides into the tibial nerve and the common perineal nerve.
What type of joint is the hip joint?
Synovial ball and socket joint, between head of femur and the acetabulum.
Where does the blood supply of the head of the femur run?
Within the capsule of the hip joint.
What are the 2 possible classifications of hip fractures?
What are the ligaments of the hip joint?
Named in relation to the pelvic bone to which they attach proximally.
Ligament of the head of the femur
What are the possible movements at the hip joint?
Flexion (forward movement)
Extension (backward movement)
What are the possible movements at the knee joint?
Flexion (backward movement)
Extension (forward movement)
What are the possible movements at the ankle joint?
Dorsiflexion (extension, raising the toes)
Plantarflexion (flexion, pointing the toes/lifting the heels)
What does the femur articulate with?
Proximal end (convex head) articulates with hip bones at hip joint (acetabulum)
Distal end (2 condyles) articulates with tibial bone of leg (plateau region, articulation is planar so weight is transferred from the hip down vertically) and patella articulates with distal anterior end of femur.
What type of bone is the patella?
Sesamoid bone, formed within a tendon
What is the most common type of fracture of the femur?
At the femoral neck.
Can also be intertrochanteric.
What is the biggest muscle in the body?
What is the role of gluteus maximus?
Extends the hip.
Involved in flexion of the knee e.g. when running or jumping.
Allows you to sit down gradually.
Where does the majority of the gluteus maximus muscle insert?
Ilio-tibial tract of fascia lata.
Also attaches to gluteal tuberosity.
Small attachment to iliac crest, the rest to sacrum and fascia of the region
What are the attachments of gluteus medius and minimus muscles?
Broad, fibres converge and attach to greater trochanter of femur
Medius is more superficial
What are the functions of gluteus medius and minimus?
Abduction and stabilisation of the hip joint and pelvis- pull femoral head into acetabulum.
Lateral rotation at hip.
What are the attachments of the piriformis muscle?
Sacral region to greater trochanter of femur.
What are the attachments and functions of psoas major and iliacus muscles?
Psoas major comes off lateral bodies of lumbar vertebrae. Its fibres converge and it passes under inguinal ligament to join fibres of iliacus, which has a broad attachment on the internal surface of the plate of the iliac bone. Together they form a short tendon which attaches to the lesser trochanter.
Major flexors of the hip joint.
What are the attachments and functions of the sartorius muscle?
Strap muscle comes off ASIS, crosses anteriorly and inferiorly across knee joint and attaches below the knee. Involved in flexion of hip and knee joints.
Where is the safe area for i.m injection in the lower limb?
Triangle between tubercle of iliac crest and ASIS.
Enters gluteus medius, not maximus- avoid hitting nerves and vessels.
Where does the ligament of the head of femur attach?
Head of femur at the fovea.
What can a fracture at the neck of the femur lead to?
Avascular necrosis of the femoral head due to distal nature of blood supply (lateral and medial circumflex arteries).
What is the path of the femoral artery and vein?
Pass from the anterior compartment to the posterior of the knee (the popliteal fossa) through the hiatus of adductor magnus muscle. After passing posteriorly, become the popliteal artery and vein.
What are the superficial veins of the lower limb?
Long (great) saphenous vein.
Joins the femoral vein at the sapheno-femoral junction.
What are the deep veins of the lower limb?
External iliac vein
Venae comitantes of the profunda femoris artery
What does the femoral nerve supply?
Anterior compartment of thigh.
What does the obturator nerve supply?
Medial (adductor) compartment of thigh.