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Lower Extremities
Anatomy
| Question | Answer |
|---|---|
| Gluteal Muscles | Tensor Fasciae Latae, Gluteus Maximus, Gluteus Medius, Gluteus Minimus, Piriformis, Superior gemellus, Obturator internus, Inferior gemellus, Quadratus femoris |
| Muscles of Anterior Thigh | Hip Flexors, Quadriceps Femoris, Sartorius |
| Muscles of Hip Flexors | Iliopsoas |
| Muscles of Quadriceps Femoris | Vastus Intermedius, Vastus Medialis, Vastus Lateralis, Rectus Femoris |
| Muscles of Medial Thigh | Obturator externus, Pectineus, Gracilis, Adductor Longus, Adductor Brevis, Adductor Magnus (adductor part) |
| Muscles of Posterior Thigh | Hamstrings (Adductor Magnus (hamstring part), Semimembranosis, Semitendinosus, Biceps Femoris) |
| Foramina of the Pelvis | Gap below inguinal ligament; Greater & Lesser sciatic foramina; Obturator canal |
| Movements of the hip | Flexion/ extension; Abduction/ adduction; Internal/ external rotation; Circumduction |
| Compartments of the Lower Extremity: thigh | Anterior, medial, & posterior compartments; fascia lata, intermuscular septa |
| Compartments of the Lower Extremity: leg | Anterior, lateral, & posterior compartments; deep fascia, intermuscular septa, interosseous membrane |
| Superficial Veins of thigh | Superficial to deep fascia; Great saphenous v. Small saphenous v. |
| Varicose veins: MOA | Malfunction of valves in perforating veins; allows blood to flow back via veins, blood backs up |
| Lymphatics: route of drainage from Gr saphenous vein | Great saphenous vein -> superficial inguinal nodes -> external iliac nodes |
| Lymphatics: route of drainage from Small saphenous vein | Small saphenous v. -> popliteal nodes -> superifical and deep inguinal nodes -> external iliac nodes |
| Lymphatics: route of drainage from Femoral vein | Femoral vein -> deep inguinal nodes -> external iliac nodes |
| LumboSacral Plexus: Major branches: | Femoral nerve (L2-L4); Obturator nerve (L2-L4); Gluteal nerves (L4-S2); Sciatic nerve (L4-S3) |
| Significance of orientation of hip joint ligaments | Ligaments oriented in spiral fashion -> causes ligaments to become taut with hip extension (reduces energy required to maintain standing position) |
| Borders of femoral triangle | Base (inguinal ligament); medial margin (adductor muscles); lateral margin (sartorius) |
| Branches of the femoral artery | Deep a. of thigh; medial circumflex femoral a.; lateral circumflex femoral a.; perforating arteries |
| Only artery branching directly from femoral artery | Deep artery of thigh (other branches come off the deep a. of thigh) |
| Femoral Nerve gives off cutaneous branches to: | Ant. Thigh; anteromedial knee; medial leg; medial foot |
| Obturator Artery & Nerve run through: | Obturator canal of obturator membrane (not in femoral triangle) |
| Obturator nerve innervates: | All muscles in medial compartment of thigh (except pectineus) and skin over medial thigh |
| Gluteal muscles, in order (sup to inf) | Piriformis, Superior gemellus, Obturator internus, Inferior gemellus, Quadratus femoris |
| Gluteal muscles innervated by: | Superior & inferior gluteal nerves (gluteus muscles and tensor fascia lata); all other gluteal nerves: directly from branches of sacral plexus |
| Posterior thigh muscles: attachment at knee | Biceps femoris on lateral side; Semitendinosus & semimembranosus on medial side |
| Something cute about gluteal nerves: | No cutaneous innervation from gluteal nerves; cutaneous innervation only directly from sacral plexus |
| What pass thru gap below inguinal ligament? | Iliac a. & v.; iliopsoas mx |
| What pass thru greater sciatic foramen? | Piriformis mx, sciatic n. |
| What pass thru lesser sciatic foramen? | Obturator internis mx |
| Obturator canal is formed by: | ischium & pubis |
| What pass thru obturator canal? | Obturator a. & nerve |
| Obturator foramen is bordered by: | Obturator externis & internis muscles |
| Movements of the knee | Flexion/ extension (also slight rotation) |
| Movements of the foot | Dorsiflexion/ plantarflexion; Inversion/ eversion |
| Fascia in thigh = | fascia lata |
| Fascia lata is anchored: | superiorly to iliac crest and inguinal ligament |
| Fascia lata thickens laterally to form: | iliotibial tract |
| Fascia in leg = | deep fascia of leg |
| Deep fascia of leg: continuous superiorly with: | fascia lata |
| Small saphenous v. is analogous to: | basilic v. |
| Small saphenous v. runs up & joins: | popliteal v. |
| Gr saphenous v. joins femoral v. after traveling thru: | saphenous ring in fascia lata |
| Veins communicating btw deep & superficial veins of legs = | perforating veins |
| Lymphatics of legs follow: | venous system |
| LumboSacral Plexus = Ventral rami of: | L1-S3 |
| Femoral nerve (L2-L4) innervates: | Anterior thigh |
| Obturator nerve (L2-L4) innervates: | Medial thigh |
| Gluteal nerves (L4-S2) innervate: | Gluteal muscles |
| Sciatic nerve (L4-S3) innervates: | Posterior thigh, leg, foot |
| Sciatic nerve splits into: | Tibial nerve; common fibular (peroneal) nerve |
| Hip joint includes: | Acetabular labrum; Round ligament; Synovial membrane |
| Acetabular labrum assoc with ____ ligament | Transverse acetabular ligament |
| Round ligament of hip = | ligamentum teres (ligament of femoral head) |
| Round ligament of hip: attaches where? | inside acetabulum |
| Ligaments surrounding hip joint | Pubofemoral, Iliofemoral, & ischiofemoral ligaments |
| Most common hip fracture: | femoral neck fracture |
| Types of hip fractures | Pelvic fractures; femoral neck fracture; avascular necrosis of femoral head |
| Hip dislocation: Types | posterior hip dislocation; hip dysplasia |
| Danger of posterior hip dislocation: | may impinge sciatic nerve |
| Quads: which lies deep to the others? | Vastus intermedius |
| Quads: crossing what | Rectus femoris crosses hip & knee; other quads cross knee only |
| Pes anserinus = tendons of 3 muscles = | Sartorius, semitendinosus, gracilis |
| Femoral Triangle: between: | anterior and medial compartments |
| Femoral Triangle contains: | Femoral nerve, artery, vein, lymphatics (NAVL) |
| Femoral Triangle: analogous to: | axilla |
| Femoral hernia: location | Medial to femoral vein; can emerge through saphenous opening |
| Femoral hernia: prevalence | Occurs more frequently in females |
| Femoral Artery is continuous proximally with: | external iliac a. |
| Femoral Artery becomes: | femoral artery after passing inguinal ligament |
| Femoral Artery runs in: | adductor canal (partly covered by sartorius mx) |
| Femoral Artery passes thru: | adductor hiatus (in adductor magnus m.) and becomes popliteal artery |
| Location of femoral pulse | halfway btw ASIS & pubic tubercle |
| Femoral veins run with: | arteries and share their names |
| Femoral Nerve = lateral to: | femoral artery |
| Muscles that help prevent pelvic tilt (drop) | Gluteal muscles |
| Actions of gluteal muscles | to laterally rotate hip and extend femur |
| Hamstring part of adductor magnus crosses: | Does not cross knee |
| Posterior thigh muscles cross: | Semitend, semimem, & biceps femoris cross hip & knee |
| Lumbar plexus innervates: | Ant. thigh (hip flexors); Ant. thigh (knee extensors); Medial thigh (adductors) |
| Sacral plexus innervates: | Gluteal muscles; Posterior thigh (hamstrings) |
| Iliopsoas innervated by: | femoral n. (lumbar plexus) |
| Quads innervated by: | femoral n. |
| Sartorius innervated by: | femoral n. |
| Obturator externus innervated by: | obturator n. |
| Mx of medial thigh, sometimes included in anterior thigh: | pectineus |
| Pectineus mx innervated by: | femoral n. |
| Medial thigh mx innervation: | mostly obturator n. (exceptions: pectineus, hamstring part of adductor magnus) |
| Femoral Nerve innervates: | all anterior thigh muscles (and pectineus) |
| Gluteal muscles: innervation from: | branches of sacral plexus |
| Innervation of gluteal muscles and TFL: | gluteal nerves |
| Posterior thigh muscles: innervation | tibial part of sciatic nerve |
| Sciatic nerve: motor innervation: | muscles of posterior thigh, all muscles of leg & foot |
| Sciatic nerve: cutaneous innervation: | to skin of lateral leg &foot, sole of foot, & dorsum of foot |
| Sciatic nerve: exits: | greater sciatic foramen inferior to piriformis muscle |
| Sciatic nerve runs through: | posterior compartment of thigh & into popliteal fossa |
| Sciatic n. splits into: | tibial & common fibular nerves in posterior thigh |
| 12% of sciatic n. passes thru: | piriformis mx |
| 12% of what nerve passes thru piriformis mx? | sciatic n. |
| Fn of Round ligament of hip: | Carries branch of obturator artery to femoral head |
Created by:
Abarnard
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