regional gross anatomy spot test 3 Flashcards
(316 cards)
1
Q
what are the 2 peritoneal pouches in females?
A
vesicouteirne pouch - between the uterus and the bladder
rectouteirne pouch - between the uterus and the rectum (aka pouch of Douglas)
2
Q
what is the 1 peritoneal pouch in males?
A
vesicorectal pouch - between the rectum and the bladder
3
Q
describe the inner surface of the bladder
A
folded into rugae which disappear as the bladder fills and the walls stretch
4
Q
what is the urachus?
A
the connective tissue structure that maintains the relationship between the apex of the bladder and. the pubic bone
5
Q
which structures enter / exit at the trigone region?
A
the 2 ureters enter the bladder
the urethra exits the bladder
6
Q
what is the name of the muscular wall of the bladder?
A
the detrusor muscle
7
Q
explain the sphincter formed by the detrusor muscle
A
the detrusor muscle forms an incomplete sphincter at the neck of the bladder called the sphincter vesicae which is composed of smooth muscle
8
Q
explain the control of the sphincter vesicae
A
it is under autonomic control not voluntary control
9
Q
explain the external sphincter of micturation
A
it is in the urogenital diaphragm and is under voluntary control
10
Q
which 2 arteries supply the bladder?
A
the superior vesical artery
they inferior vesical artery
11
Q
where doe the superior vesical artery arise from?
A
the umbilical branch of the anterior division of the internal iliac artery
12
Q
where does the inferior vesical artery arise from?
A
it is a branch of the anterior division of the internal iliac artery
13
Q
explain the venous drainage of the bladder
A
venous drainage is to the vesical plexus and then into the internal iliac veins
14
Q
explain the ANS supply of the bladder
A
the bladder is an internal organ and therefore is supplied by the ANS via the hypogastric plexus
15
Q
where is the main lymphatic drainage of the bladder and the urethra to?
A
internal iliac nodes
16
Q
explain the transition from sigmoid colon to rectum
A
the rectum is an extension of the sigmoid colon as it crosses the third fused sacral vertebrae
17
Q
explain the shape of the rectum
A
the surface of the rectum is in 3 transverse folds and there is a large area called the rectal ampulla between them
18
Q
which levator ani muscle supports the rectum?
A
puborectalis
19
Q
how does puborectalis help maintain continence?
A
it is a sling of muscle that passes around the rectum and when it contracts it bends the wall of the rectum and this makes it more difficult to passs faeces from the rectum to the anal canal
20
Q
explain the 3 rectal arteries that supply the rectum
A
1 superior rectal artery
2 middle rectal arteries (bilateral)
2 inferior rectal arteries (bilateral)
21
Q
where does the superior rectal artery branch from?
A
the inferior mesenteric artery
22
Q
where do the middle rectal arteries branch from?
A
the internal iliac artery
23
Q
where do the inferior rectal arteries branch from?
A
the internal pudendal artery
24
Q
explain how the rectum is a site of portal systemic anastomosis
A
blood from the superior rectum passes to the portal system via the inferior mesenteric vein
blood from the inferior rectum drains into internal iliac vein which is part of systemic system
25
what is the broad ligament?
a fold of peritoneum that covers the uterus and uterine tubes
26
what is the function of the broad ligament?
provide a small degree of support to the uterus
carries the neurovascualr structures of the uterus
27
what are the 3 areas of the broad ligament?
mesovarium
mesosalpinx
mesometrium
28
what is the function of the mesovaarium area of the broad ligament?
holds the ovaries to the posterior surface of the broad ligament
29
what is the function of the mesosalpinx area of the broad ligament?
supports the uterine tube
30
what is the function of the mesometrium area of the broad ligament?
the main part of the broad ligament assoc w/ the body of the uterus
31
explain the dif parts of the uterus
fundus - most superior part
main body - the main middle bit
cervix - main body narrows to form the fundus
vagina - the cervix opens into a muscular tube called the vagina
32
explain the walls of the uterus
they are muscular (myometrium) but lined by endometrium that increases and sheds during each menstrual cycle
33
where is the internal os?
superior to the cervix
34
where is the external os?
at the cervix
35
what are the lateral fornices?
the lateral spaces as the cervix bulges into the vagina
36
what is the arterial supply to the uterus?
the uterine arteries
37
where do the uterine arteries branch from?
the anterior division of the internal iliac arteries.
38
what artery does the uterine artery anastamose w/?
the ovarian artery
39
which 3 structures does the ovarian artery supply?
the ovaries
the fundus of the uterus
the uterine tubes
40
explain the region of the uterine tubes
isthmus - narrow section as the uterine tube pierces the wall of the uterus
ampulla - expanded area more laterally than the isthmus
infundibulum - widened end of the ampulla
fimbrae - the most distal part, divided into finger like projections
41
what is the standard position for the uterus?
anteverted and ante flexed
42
what is the muscle that supports the uterus?
pubococcygeus form a sling around the vagina called pubovaginalus
43
what is the arterial supply to the ovaries?
the ovarian artery
44
at what level does the ovarian artery arise from the abdo aorta?
L2
45
where do the ovarian veins drain into?
right side - IVC
left side - left renal vein
46
what carries the ovarian artery and vein?
the suspensory ligament of the ovary
47
which 2 structures does the ligament of the ovary pass between?
the uterus and the ovary
48
which 2 structures does the vagina artery supply?
the distal uterus and the vagina
49
where does the vaginal artery arise from?
either:
uterine artery
direct branch of the anterior division of the internal iliac artery
50
which 2 structures is suppled by the internal pudendal artery?
the distal vagina and perineum
51
which 2 structures carry lymph away from the uterus
the broad ligament and the round ligament
52
what is the vas deferens
a smooth muscle tube that transport sperm from the testis to the ejaculatory duct
53
which 2 structures form the ejaculatory duct?
the vas deferens and the seminal vesicle
54
what are the seminal vesicles?
highly coiled tubes that lie posterior to the bladder in males
55
what is the function of the seminal vesicles?
they secrete the liquid component of hte semen and they support the sperm (they release fructose which acts as an energy source for the sperm)
56
which 2 structures support the prostate gland?
the puboprostatic ligament and the muscles of the pelvic floor
57
which muscle supports the prostate gland
pubococcygeus forms pub prostaticus or levitator prostate
58
where does lymph from the lower part of the bladder, the seminal vesicles, prostate glands and erectile tissues of the penis pass to?
nodes clustered around the internal iliac artery
59
where does lymph from more distal parts of the penis drain to?
deep inguinal nodes
60
where does lymph from the testis drain to?
dollops the arterial supply back to aortic nodes clustered around the root of the testicuar artery
61
where does lymph from the testis drain to?
dollops the arterial supply back to aortic nodes clustered around the root of the testicuar artery
62
what are the borders of the anal triangle?
the ischial tuberosities (base) and the coccyx (apex)
63
what are the spaces either side of the rectum called?
ischiorectal or ischio anal fossae
64
which nerve supplies the external anal sphincter?
the inferior rectal nerve (a branch of the pudendal nerve)
65
what is the main component of the ischial fossa
fat
66
what are the small internal folds of the anal canal called?
anal columns
67
what is the perineal body?
a small dent structure composed of connective tissue that lies at the edge of the urogenital diaphragm to provide attachment to muscles of the perineum ass well a the external anal sphincter
68
what controls releases of faeces from the body?
the external anal sphincter
69
which nerve innervates the external anal sphincter?
the inferior rectal branch of the pudendal nerve (S2-4)
70
what is the pectinate line?
the line at the base of the anal columns which is the landmark for the end of the visceral internal part of the digestive tract ad the start of the parietal body wall structures
71
describe the arterial supply to the wall of the rectum
superior rectal artery
middle rectal artery
inferior rectal artery
72
where does the superior rectal artery arise from?
the inferior mesenteric artery
73
where does the middle rectal artery arise from?
the internal iliac artery
74
where does the inferior rectal artery arise from?
the internal pudendal arteries
75
where does the urogenital triangle sit in relation to the anal triangle?
anterior to the anal triangle
76
where is the urogenital diaphragm found?
at the urogenital triangle - the urogenital diaphragm fills the urogenital triangle
77
explain the continuation of the abdo wall fascia into the pelvis
scraps fascia is called collet fascia and continues into the labia in females or scrotum in males
78
explain the 3 layers of the urogenital diaphragm
superior layer - comprised of fascia and blends w/ the perineal body
middle layer - contains the voluntary sphincter that controls urination (sphincter urethrae) and deep transverse perineal muscles
inferior layer - most superficial and contains a layer of fascia called the perineal membrane
79
where is the superficial perineal pouch?
in between the inferior layer of the urogenital diaphragm (perineal membrane) and the skin
80
where is the deep perineal pouch?
lies anteriorly between the fascial layers of the urogenital pouch
81
what are the 3. structures that pass through the deep perineal pouch in both sexes?
urethra
branches of the internal pudendal artery
pudendal nerve
82
what is the additional structure that passes through the deep perineal pouch in males?
bulbourethral glands
83
what is the function of bulbourethral glands?
add fluid to the urethra
84
what are the 2 additional structures that pass through the deep perineal pouch in females?
the vagina
small glands assoc w/ the vagina
85
where do the reproductive structures in both sexes lie?
in the superficial perineal pouch
86
what are the 4 structures of the superficial perineal pouch?
small muscles
pieces of erectile tissue
the nerves and vessels that supply the erectile tissue
the urethra
87
what nerve supplies the muscles in the urogenital pouch?
perineal branches of the pudendal nerve
88
where do the small skeletal muscles lie in the urogenital triangle and what is their function?
the overlie the erectile tissues of the perineum and help maintain erection of the tissue by impending venous return, keeping blood inside the erectile tissue
89
which muscle overlies the crura?
ischiocavernosus
90
which muscle overlies the bulb of the penis in males and the bulb of the vestibule in females?
bulbospongiosus
91
explain the distribution of the bulbospongiosus muscle in males and females
females - runs on either side of the vagina (because the bulb of the vestibule is in 2 parts, one on either side of the vagina)
males - meet in the midline and surround the bulb of the penis
92
what is the erectile tissue that lies next to the ischiopubic rami?
the crura
93
in females what do the crura continue as?
continue to form the body of the clitoris
94
in males what do the crura continue as?
continue into the penis as the corpus cavernous
95
what does the bulb of the penis continue as?
the corpus spongiosum which will also form the glans penis
96
what are the 3 blocks of erectile tissue in the penis?
2 corpus cavernous
1 corpus spongiosum
97
explain the arrangement of the 3 blocks of erectile tissue in the penis
there are 2 blocks of corpus cavernousum on either side with 1 block of corpus spongiosum at the bottom and in the middle
98
where in relation to the erectile tissue does the urethra lie?
w/n the corpus spongiosum
99
what are the 4 parts of the male urethra?
pre prostatic part
prostatic part
membranous part
penile (spongy part)
100
where is the pre prostatic part of the male urethra found?
between the trigone area and the prostate gland
101
where is the prostatic part of the male urethra found?
passing through the prostate gland where it is joined by the ejaculatory ducts
102
where is the membranous part of the male urethra found?
passing through the urogenital diaphragm
103
where is the penile (spongy) part of the male urethra found?
passing through the corpus spongiosum to open at the glans of the penis
104
what nerve provides sensory innervation to the penis and scrotum?
the pudendal nerve
105
what nerve provides sensory innervation to the clitoris?
the pudendal nerve
106
what nerve roots make up the sacral plexus?
L4-S5
107
what is the nerve root value of the sciatic nerve?
L4-S3
108
explain the innervation of the sciatic nerve
supplies the posterior compartment of the thigh (hamstring muscles) and then divides into its terminal branches which supply all the muscles of the leg adn the foot
109
what are the nerve root values of the superior gluteal nerve?
L4, L5, S1
110
explain the innervation of the superior gluteal nerve
innervates gluteus medius and minimus
111
what are the nerve root values of the inferior gluteal nerve
L5, S1, S2
112
explain the innervation of the inferior gluteal nerve
innervates gluteus maximus
113
where does the sciatic nerve pass through?
the sciatic foramen immediately above piriformis
114
which nerve supplies obturator interns muscle?
nerve to obturator internus
115
nerve to obturator internus is a direct branch from where?
L5-S1
116
what nerve supplies piriformis muscle?
nerve to piriformis
117
nerve to piriformis is a direct branch from where?
S1, S2
118
what innervates levator ani?
the nerve to levator ani and the pudendal nerve
119
how does the pudendal nerve control continence?
the pudendal nerve supplies both the external (voluntary) sphincters of the urethra and anal canal and it is important in the maintenance of continence
120
what are the nerve root of the pudendal nerve?
S2-4
121
explain the course of the pudendal nerve
it passes through the greater sciatic foramen, around the ischial spine and then through the lesser sciatic foramen to reach the anal triangle and then the perineum
122
where is the superior hypogastric plexus found?
at the bifurcation of the aorta into the common iliac arteries
123
what kind of autonomic nerves are fond in the superior hypogastric nerve plexus?
sympathetic only
124
what kind of autonomic nerves are found in the inferior hypogastric plexus?
both parasympathetic and sympathetic
125
what is the main arterial supply to the pelvis?
the internal iliac artery
126
where does the aorta divide into the common iliac?
L4
127
what does the common iliac artery divide into?
internal and external iliac arteries
128
where does the external iliac artery supply?
the lower limb
129
where does the internal iliac artery supply?
the pelvis
130
which is the first branch of the anterior division of the internal iliac artery?
umbilical artery
131
explain the course of the umbilical artery
ends as a piece of connective tissue but gives at least 2 arteries to supply the bladder - the superior vesical arteries
132
explain the course of the obturator artery
passes through the obturator foramen into the medial compartment of the thigh
133
which artery usually replaces the inferior vescial artery in females?
the vaginal or the uterine artery
134
other than the rectum which additional structure does the middle rectal artery supply in males?
the prostate gland
135
which 2 arteries from the anterior division of the internal iliac arteries pass through the greater sciatic foramen?
the internal pudendal artery
the inferior gluteal artery
136
where does the internal pudendal artery supply?
the perineum
137
which structures are supplied by the inferior vesical artery in males?
the prostate
the seminal vesicles
ductus deferens
138
where do the testicular arteries arise from?
the abdominal aorta at L2
139
which artery supplies the inferior bladder in females and why?
the uterine artery or the vaginal artery because the the inferior rectal artery is absent in females
140
where does the ovarian artery come from?
direct branch from the abdo aorta at L2
141
what are the branches of the anterior division of the internal iliac artery?
umbilical artery
obturator artery
uterine artery (females) / inferior vesical artery (males)
middle rectal
inferior gluteal
internal pudendal
142
what are the branches of the posterior division of the internal iliac artery?
iliolumbar artery
lateral sacral artery
superior gluteal region
remember:
P - posterior division
I - iliolumbar artery
L - lateral sacral artery
S - superior gluteal artery
143
where does the iliolumbar artery supply?
posterior part of the abdo wall
144
where does the lateral sacral artery supply
contributes blood to the vertebral canal
145
where does the superior gluteal artery supply?
part of the gluteal region
146
where is the main venous drainage of the pelvis to?
the internal iliac veins
147
what turns the greater and lesser sciatic notch into foramen?
the presence of ligaments
148
which structures cover the obturator foramen?
obturator internus
obturator externsus
obturator membrane
149
how do obturator nerves and vessels pass through the obturator foramen when its covered by the structures?
the structures are pierced by the obturator nerves and vessels
150
what is the bony landmark for the pudendal nerve?
the ischial spine
151
what is the site of the hip joint
the acetabulum
152
what type of joint is the hip joint
synovial ball and socket
153
what type of joint is the pubic symphysis?
secondary cartilaginous
154
what type of joint is the lumbosacral joint
secondary cartilaginous
155
how many vertebrae is the sacrum formed from?
5 fused vertebrae
156
how do sacral nerves exit the vertebral column to supply structures w/in the pelvis and lower limb?
through the sacral foramina
157
what are the 2 large ligaments that attach to the sacrum?
the sacrotuberous ligament
the sacrospinous ligament
158
where does the sacrospinous ligament pass to / from?
from the sacrum to the ischial spine
159
where does the sacrotuberous ligament pass to / from?
from the sacrum to the ischial tuberosity
160
what forms the posterior borders of the greater and lesser sciatic foramen?
the sacrotubeous and sacrospinous ligaments
161
what forms the inguinal ligament?
aponeurosis of external oblique rolling over itself
162
what are the 3 differences of the female pelvis?
the pubic angle ar the pubic symphysis is wider
the ischial spines do not protrude into the pelvic cavity as much
the sacrum is flatter compared to that of a male
163
what is the classic shape of the pelvic inlet
gynecoid
164
what muscle covers the external surface of the obturator foramen?
obturator externus
165
what is the innervation of obturator intenrus?
nerve to obturator Inverness directly from the sacral plexus (L5, S1)
166
what is the composition of the pelvic floor?
levator ani anteriorly
coccygeus posteriorly
167
where does coccygeus pass to / from?
fro the ischial spine to the coccyx and the lower part of the sacrum
168
levator ani is divided into which 2 parts?
pubococcygeus - more medial fibres
iliococcygeus - more lateral fibres
169
in males which 2 structures does pubococcygeus wrap around?
the rectum (puborectalis)
the prostate gland (puboprostaticus)
170
in females which 2 structures does pubococcygues wrap around?
the rectum (puborectalis)
the vagina (pubovaginalis)
171
iliococcygues fills the space between which 2 muscles?
pubococcygeus and coccygeus
172
where does iliococcygues attach?
to the thickened fascia above obturator internus (this line is called the tendinous arch of levator ani)
173
the lumbosacral trunk carries fibres from which spinal levels?
L4-S3
174
where is the femoral nerve derived from?
posterior divisions of L2, L3 and L4 anterior rami
175
where is the obturator nerve derived from?
anterior divisions of L2, L3 and L4 anterior rami
176
which 2 nerves are derived from L2, L3 and L4 nerve roots?
femoral and obturator nerves
177
what are the 2 main veins in the lower limb?
the great saphenous vein and the short / small saphenous vein
178
where does the great saphenous vein run from / to and where does it empty?
runs from the dorsum of the foot and up to the anterolateral thigh
empties into the femoral vein
179
where does the short saphenous vein run from / to and where does it empty?
runs from the foot to the leg (does not go into the thigh)
empties into the popliteal vein
180
what is the name of the deep fascia in the leg?
crural fascia
181
what is the name of the deep fascia in the thigh?
fascia latae
182
what is the iliotibial tract?
thickenings of the fascia latae on the lateral side
183
what is the function of the iliotibial tract?
to support the femur on the on the tibia when standing
184
what is the defect in the fascia latae called and what occurs here?
the saphenous hiatus
here the great saphenous vein is diving down towards the femoral vein
185
what covers the defect in the fascia latae (the saphenous hiatus)?
cribriform fascia
186
what are the boundaries of the femoral triangle?
base: inguinal ligament
lateral border: sartorius muscle
medial border: adductor longus muscle
floor: iliopsoas laterally and pectineus medially
187
what are the contents of the femoral triangle from lateral to medial?
N - femoral nerve
A - femoral artery
V - femoral vein
L - lymphaticxs
188
which structure of the femoral triangle is not included within the femoral sheath?
the femoral nerve
189
what is the femoral canal?
located within the femoral sheath and contains fat and lymphatic vessels
190
what are the 2 functions of the anterior compartment of the thigh?
hip flexion
knee extension
191
what is the function of the medial compartment of the thigh?
hip adduction
192
what is the function of the posterior compartment of the thigh?
hip extension
knee flexion
193
what is the small indentation on the head of the femur called?
the fovea
194
what connects the greater and lesser trochanters of the femur on the anterior surface?
intertrochanteric line
195
what connects the greater and lesser trochanters of the femur on the posterior surface?
intertrochanteric crest
196
what is the bony ridge down the midline of the posterior side of the femur called?
linea aspera
197
what is the ridge that extends proximally from the line aspera towards the lesser trochanter called?
the pectineal line
198
what are the 2 ridges that the linea aspera splits into distally called?
the supracondylar lines
199
what are the notches above the condyles called?
epicondyles
200
what are the 4 hip flexor muscles of the anterior compartment?
iliacus
psoas major
pectineus
sartorius
201
what muscle group males up the knee extensors of the anterior compartment?
quadriceps
202
what are the 4 heads of quadriceps?
rectus femoris
vastus medialis
vastus lateralis
vastus intermedius
203
what innervates pectineus muscle?
femoral nerve (L2,L3)
204
where is the proximal attachment of sartorius?
ASIS of the ilium
205
where is the distal attachment of sartorius?
superior part of the medial surface of the tibia
206
what innervates sartorius?
femoral nerve (L2,L3)
207
what is the most superficial component of quadriceps?
rectus femoris
208
where do the vastus components of quadriceps lie?
vastus lateralis - lateral side of the thigh
vastus medialis - medial side of the thigh
vastus intermedius - deep to rectus femoris
209
explain the distal attachment of quadriceps muscle?
all 4 components of quadriceps unite to form a single distal attachment at the quadriceps tendon which surrounds the patella and then continues below the patella as the patellar ligament
210
what levels of the spinal cord form the femoral nerve?
L2, L3 and L4
211
explain the course of the femoral nerve
it crosses over the surface of the ilium running on the surface of iliacus muscle. it then passes deep to the inguinal ligament, just medial to ASIS and then runs on the tendon of the iliopsoas muscle
212
what are the types of branches of the femoral nerve and what do they innervate?
muscular branches - innervate the muscles of the anterior thigh
articular branches - sensory branches to the hip and knee
cutaneous branches - sensory innervation to the anteromedial aspect of the knee
213
what is the terminal branch of the femoral nerve?
the saphenous nerve
214
what does the saphenous nerve innervate?
travels down to pass on the medial side of the knee joint giving cutaneous innervation to the skin covering the anteromedial aspect of the knee and the leg and foot
215
what is the function of the medial compartment of the thigh?
hip adduction
216
what are the 4 hip adductor muscles?
gracilis
adductor longus
adductor brevis
adductor magnus
217
what muscle is part of the adductor compartment but does not produce adduction of the hip?
obturator externus
218
what is the nerve to the medial compartment?
the obturator nerve (L2, L3, L4)
219
explain the innervation of adductor magnus
primarily innervated by the obturator nerve (L2, L3 and L4) but the hamstring part is innervated by the sciatic nerve
220
explain the course of the obturator nerve
it travels distally running along the lateral wall of the pelvis and then passes through the obturator canal to access medial compartment of the thigh
in medial compartment it divides into anterior and posterior branches
221
where does the anterior branch of the obturator nerve?
on the anterior surface of adductor brevis
222
where does the posterior branch of the obturator nerve lie?
deep to adductor brevis
223
the anterior branch of the obturator nerve gives branches to which muscles?
adductor brevis
adductor longus
gracilis
224
the posterior division of the obturator nerve gives branches to which muscles?
adductor magnus
obturator externus
225
where is the adductor canal?
in the distal part of the thigh in between the anterior and medial compartments of the thigh
226
what travels in the adductor canal?
femoral vessels and the saphenous nerve
227
the femoral artery is a continuation of which artery?
external iliac artery
228
where does profunda femoris branch off?
the femoral artery
229
which muscle does profunda femoris travels deep to?
adductor longus
230
explain the arteries that wrap around the shaft of the femur
profunda femoris gives medial and lateral circumflex femoral branches which wrap around the shaft of the femur
231
where does the obturator artery arise from?
the internal iliac artery
232
which compartment does the anterior division of the obturator artery supply?
medial compartment
233
which compartment foes the posterior branch of the obturator artery supply?
the posterior compartment
234
where is the cruciate anastomosis?
posterior to the proximal end of the femur
235
what vessels are involved in the cruciate anastomosis?
medial and lateral circumflex femoral arteries
a branch from the first perforating artery from the proufunda femoris
contribution from inferior gluteal artery
236
where does the iliac crest run from / to ?
from ASIS to PSIS
237
what is the arcuate line?
the ridge that runs along the medial surface of the ilium towards the pubis
238
the pectineal line is an important site of muscle attachment for which muscles?
the adductor muscles of the medial thigh
the vasti muscles that contribute to quadriceps
239
what are the 5 lateral rotators of the gluteal region?
gluteus maximus
piriformis
obturator internus
gemelli
quadratus femoris
240
what are the medial rotators and abductors of the gluteal region?
gluteus medius
gluteus maximus
241
where do the fibres of gluteus maximus insert?
most muscle fibres (3/4) insert into the iliotibial tract
the deeper 1/4 of the fibres attach onto the gluteal tuberosity of the femur
242
what are the 2 functions of gluteus maximus?
extension of the hip joint - primary function
lateral rotation - can assist in lateral rotation due to the orientation of the fibres
243
what is the innervation of gluteus maximus?
the inferior gluteal nerve (L5, S1, S2)
244
where do fibres from tensor fascia latae insert?
into the iliotibial tract
245
what is the function of tensor fascia latae?
support the femur on the tibia when standing
246
what innervates tensor fascia latae?
the superior gluteal nerve (L4, L5, S1)
247
what is the function of gluteus medius?
abduction and medial rotation of the hip
248
what nerve innervates gluteus medius?
superior gluteal nerve (L4, L5, S1)
249
what is the function of gluteus minimus?
abduction and medial rotation of the hip
250
what nerve innervates gluteus medius?
superior gluteal nerve (l4, L5, S1)
251
explain the course of piriformis muscle?
it begins in the pelvic cavity w/ the proximal attachment on the anterior surface of the sacrum and sacrotuberous ligament it then passes through the greater sciatic foramen to enter the gluteal region and its distal attachment is on the greater trochanter of the femur
252
what is the function of piriformis?
laterally rotate the hip
253
what is the innervation of piriformis?
the anterior rami of S1, S2
254
what is the function of obturator internus?
lateral rotation of the hip
255
what nerve innervates obturator internus?
nerve to obturator internus (L5, S1)
256
what are the gemelli?
two small muscles closely assoc w/ obturator intenrus (one either side)
257
where is the proximal attachment of the superior gemellus?
ischial spine
258
where is the proximal attachment of the inferior gemellus?
ischial tuberosity
259
where do the gemelli insert?
blend w/ the obturator tendon and insert w/ it on the medial side of the greater trochanter
260
what innervates the superior gemellus?
nerve to obturator internus
261
what innervates the inferior gemellus?
nerve to quadratus femoris
262
where does quadratus femoris run from / to?
from the ischial tuberosity to the quadrate tubercle of the intertrochanteric crest
263
what is the function of quadratus femoris?
laterally rotate the hip
264
what innervates quadratus femoris?
nerve to quadratus femoris (L5, S1)
265
what is the function of quadratus externus?
lateral rotation of the hip
266
explain why obturator externus is seen in the gluteal region despite being a medial compartment muscle
the tendon of obturator extenrus can be seen in the gluteal region
267
explain why obturator externus is seen in the gluteal region despite being a medial compartment muscle
the tendon of obturator extenrus can be seen in the gluteal region
268
what nerve innervates obturator externus and explain why
the obturator nerve (L3, L4) because it is a medial compartment muscle and the obturator nerve is the nerve t o the medial compartment
269
what nerve innervates obturator externus and explain why
the obturator nerve (L3, L4) because it is a medial compartment muscle and the obturator nerve is the nerve t o the medial compartment
270
explain the course of the sciatic nerve
forms w/in the pelvic cavity and then exits via the greater sciatic foramen and enters the gluteal region just inferior to piriformis then passes through the gluteal region
it does not supply anything in the gluteal region
271
what are he 2 branches of the sciatic nerve?
tibial nerve
common peroneal nerve
272
where does the tibial nerve emerge from?
always deep to piriformis
273
where does the common peroneal nerve emerge from?
variable - can emerge above, below or through piriformis
274
the posterior cutaneous nerve of the thigh caries fibres from which spinal levels?
S1, S2, S3
275
where does the posterior cutaneous nerve of the thigh innervate?
primarily supplies the skin covering the posterior thigh
also gives a number of branches that supply the skin of the inferior half of the bum - these are the inferior clunial nerves
276
what supplies the upper half of the bum with cutaneous innervation?
the superior clunial nerves
277
explain the hip joint
the hip joint is made up of hte small rounded head of hte femur covered by hyaline cartilage which sits w/in the deep socket of the acetabulum
278
what is the distribution of the articular surface in the acetabulum?
horseshoe
279
where is the capsule found on the hip bone?
closely following the margins of the articular surface
280
where is the capsule found on the femur?
attaches around the junction of the neck of the femur
281
where does the iliofemoral ligament run from / to ?
from ASIS on the hip bone to the intertrochanteric line anteriorly
282
what does the iliofemoral ligament limit?
extension of the hip
lateral rotation of the hip
adduction (upper band)
abduction (lower band)
283
where does the pubofemoral ligament run from / to?
from the iliopubofemoral eminence to attach on the intertrochanteric line
284
what does the pubofemoral ligament limit?
extension
lateral rotation
abduction
285
where does the ischiofemoral ligament run from / to?
from the acetabulum to the greater trochanter
286
what does the ischiofemoral ligament limit?
medial rotation
adduction
extension
287
why do all ligaments limit extension but none limit flexion?
because hip flexion brings the thigh close to the trunk and so the trunk itself limits flexion and so there are no ligaments needed to limit flexion
288
the artery of the head of the femur is a branch from where?
the obturator artery
289
where does the artery of the head of the femur travel?
in the ligament of the head of the femur w/in the joint space
290
explain the importance of the artery of the head of the femur throughout life
it is esp important in developemnt but less important later in life
291
apart from the artery to the head of the femur what other vessels supply the hip joint?
branches from the medial and lateral circumflex femoral arteries which come from the profunda femoris artery
292
what is the single group of muscles in the posterior thigh?
the hamstring muscles
293
what are the 3 muscles in the hamstring group
294
what are the 3 muscles in the hamstring group
semitendinosus
semimembranosus
biceps femoris
295
wha tis the function of the hamstring group (posterior thigh)?
extension of the hip
flexion of the knee
296
where is semitendinosus located?
on the medial aspect of the posterior compartment
297
how does semitendinosus differ from semimembranosus visually?
semitendinosus - long rope like tendon
semimembranosus - shiny membranous appearance
298
what nerve innervates semitendinosus and semimembranosus?
tibial division of the sciatic nerve (L5, S1, S2)
299
what is the common proximal attachment for all true hamstring muscles?
the ischial tuberosity
300
where does the long head of biceps femoris proximally attach?
ischial tuberosity (same as all other hamstring muscles)
301
where does the short head of biceps femoris attach proximally?
on the linea aspera and the lateral supracondylar line of the shaft of the femur
302
explain the distal insertion of biceps femoris
the two heads unit distally to insert on the head of the fibula
303
what nerve innervates the long head of biceps femoris?
the tibial division o the sciatic nerve (L5, S1, S2)
same as all other hamstring muscles
304
what nerve innervates the short head of biceps femoris?
the common peronal division of the sciatic nerve (L5, S1, S2)
305
what is the function of the muscles of the posterior compartment
extend the hip joint
flex the knee joint
306
what muscle produces lateral rotation of the knee?
biceps femoris
307
which 4 muscles produce medial rotation of the knee?
semimembranosus
semitendinosus
gracilis
sartorius
308
where does the sciatic nerve divide into common peroneal and tibial branches?
occur anywhere along the length but usually occurs as the nerve enters the popliteal fossa
309
what forms the roof of the popliteal fossa?
deeep fascia
310
which 2 structures pierce the deep fascia of the popliteal fossa?
short saphenous vein
sural nerve
311
where does the short saphenous vein empty?
into the popliteal vein at the popliteal fossa
312
which 4 structures pass through the popliteal fossa?
popliteal artery
popliteal vein
tibial nerve
common perineal nerve
313
where in the popliteal fossa are the tibial nerve and common peroneal nerve found?
tibial nerve - closer to the midline
common peroneal nerve - wraps around laterally
314
which artery supplies the cruciate ligaments?
the middle genicualr artery
315
which artery supplies the cruciate ligaments?
the middle genicualr artery
316
when does the femoral artery become the popliteal artery?
when it passes through the adductor hiatus
