Anatomy - Gluteal Region and Posterior Thigh

the deep group of the gluteal region does what?

laterally rotate the femur at the hip joint

what is included in the deep group of the gluteal region?

• piriformis

• gemellus superior

• obturator internus 

• gemellus inferior

• obturator externus

• quadratus femoris

the superficial group of the gluteal region does what?

abduct and extend the hip

what is included in the superficial group of the gluteal region?

• gluteus minimus

• gluteus medius

• gluteus maximum

• tensor fasciae latea

tensor fasciae latea does what?

stabilizes the knee in extension

what is the origin of the piriformis?

anterolateral sacrum

what is the insertion of the piriformis?

greater trochanter of femur

what is the action of the piriformis?

lateral rotation and abduction of femur at the hip joing

the piriformis muscle passes through what?

the greater sciatic foramen

the piriformis helps do what?

split the greater sciatic foramen into a superior and inferior region to create a passageway for nerves

what is the origin of the obturator internus?

obturator membrane and adjacent bone of obturator foramen

what is the insertion of the obturator internus?

greater trochanter of femur

what is the action of the obturator internus?

lateral rotation and abduction of the femur at the hip joint

the obturator internus passes through what?

the lesser sciatic foramen

what is the origin of the obturator externus?

anterior surface of obturator membrane and bony parts of obturator foramen

what is the insertion of the obturator externus?

the femur

what is the action of the obturator externus?

thigh external rotation, thigh abduction (from flexed hip); stabilizes head of femur in acetabulum

what is the origin of the gemellus superior?

ischial spine

what is the origin of the gemellus inferior?

ischial tuberosity

what is the insertion of both the gemellus superior and gemellus inferior?

the tendon of the obturator internus

what is the action of both the gemellus superior and gemellus inferior?

lateral rotation and abduction of the femur at the hip joint

what describes the origin of the quadratus femoris?

near ischial tuberosity

the quadratus femoris inserts on what?

the proximal femur

what is the action of quadratus femoris?

lateral rotation of the femur at the hip joint

what is the order of the deep gluteal muscles from superior to inferior?

1. piformis

2. gemellus superior

3. obturator internus

4. gemellus inferior

5. obturator externus

6. quadratus femoris

what is the origin of the gluteus minimus and gluteus medius?

ilium

what is the insertion of the gluteus minimus and gluteus medius?

greater trochanter

what is the action of the gluteus minimus and gluteus medius?

abduction of the lower limb at the hip joint, reduces pelvic drop over the opposite swing limb during walking

what is the innervation of the gluteus minimus and gluteus medius?

superior gluteal nerve

what describes trendelenburg sign?

weak abduction of the hip due to damage of the superior gluteal nerve

what are signs of trendelenburg sign?

• pelvic drop over the swing limb

• patient compensates by moving trunk to the affect side

what is the largest muscle in the body?

gluteus maximus

the gluteus maximus overlies what?

the other gluteal muscles

what describes the origin of the gluteus maximus?

broad origin over the ilium, sacrum, and coccyx

the gluteus maximus inserts into what?

• iliotibial tract

• proximal femur

what is the action of the gluteus maximus?

extension of the flexed thigh at the hip and stabilizes the knee and hip joints

what is the innervation to the gluteus maximus?

inferior gluteal nerve

what is the most anterior (also lateral) of the superficial group of the gluteal region?

tensor fascia latae

what is the origin of the tensor fascia latae?

iliac crest

what is the insertion of the tensor fascia latae?

iliotibial tract

what is the action of the tensor fascia latae?

stabilizes the knee in extension, stabilizes hip joint by holding head of femur in acetabulum 

what is the innervation of tensor fascia latae?

superior gluteal nerve

what is the outer layer of deep fascia in the lower limb?

fascia lata

the fascia lata forms what?

a thick “stocking-like” membrane

what is describes the superior line of attachment of the fascia lata?

starts at inguinal ligament and iliac crest, wraps around the hip bone

what is the fascia lata continuous with inferiorly?

deep fascia of leg

the fasica lata laterally thickens into a longitudinal band known as what?

iliotibial tract

the fascia lata splits in the gluteal region to enclose what?

tensor fascia lata muscle anteriorly and gluteus maximus posteriorly

what describes the saphenous opening?

opening in the anterior aspect of the thigh just inferior to the medial end of the inguinal ligament

the saphenous opening allows for what?

saphenous vein to pass from superficial fascia through the deep fascia; allows connection with the femoral vein

what describes the femoral triangle?

wedge-shaped depression formed by muscles in the upper thigh

what is the base of the femoral triangle?

inguinal ligament

what is the medial border of the femoral triangle?

adductor longus

what is the lateral border of the femoral triangle?

sartorius

what are the contents of the femoral triangle?

NAVEL

• femoral nerve, femoral artery, femoral vein, empty spaces, deep lymph nodes

what describes the femoral sheath?

funnel-shaped sleeve of fascia that surrounds the femoral artery, vein, and associated lymphatics within the femoral triangle

each structure within the femoral sheath is what?

individually contained within its own fascial compartment

what is most medial in the femoral sheath?

femoral canal (contains lymphatics and an empty space

what is the superior border of the femoral canal called?

femoral ring

why is the femoral canal clinically relevant?

its the location of femoral hernias

fascia lata completely invests what?

the thigh

intermuscular sepata arranges the muscles of the thigh into what?

3 compartments

the anterior compartment of the thigh is innervated by what?

femoral nerve

the anterior compartment of the thigh contains muscles that do what?

extend the knee

what are the muscles of the anterior compartment of the thigh?

sartorius and 4 “quads” (rectus femoris, vastus lateralis, vastus medialis, and vastus intermedius)

the posterior compartment of the thigh is innervated by what?

sciatic nerve

the posterior compartment of the thigh contains muscles that do what?

extend the thigh at the hip joint and flex the leg at the knee joint

what are the muscles of the posterior compartment of the thigh?

“hamstrings”

• biceps femoris

• semitendinosus

• semimembranosus

the medial compartment of the thigh is innervated by what?

obturator nerve

the medial compartment of the thigh contains muscles that do what?

adduct the thigh at the hip joint

what the muscles of the medial compartment of the thigh?

• gracilis

• pectineus

• adductor longus

• adductor brevis

• adductor magnus

• obturator externus

all of the hamstring muscles cross both the hip and knee joints except for what?

short head of the biceps femoris

what is the most lateral muscle in the posterior compartment of the thigh?

biceps femoris

what describes the long head of the biceps femoris?

origin with the semitendinous muscle at the ischial tuberosity

what describes the short head of the biceps femoris?

origin on the shaft of the femur

the tendon of the biceps femoris inserts into what?

fibular and fibular collateral ligament

what is the action of the biceps femoris?

• extends and laterally rotates thigh at hip join

• laterally rotates leg at knee joint

• flexes leg at knee joint

what is the only hamstring muscle involved in lateral rotation?

biceps femoris

what is medial to the biceps femoris?

semitendinosus

what is the origin of the semitendinosus?

with the long head of biceps femoris at the ischial tuberosity 

what is the insertion of the semitendinosus?

proximal tibia

what is the action of the semitendinosus?

• medially rotates thigh at hip joint and leg at knee joint

• flexes leg at knee joint and extends thigh at hip joint

what is deep to the semitendinosus?

semimembranosus

what is the origin of the semimembranosus?

ischial tuberosity

what is the insertion of the semimembranosus?

tibial condyle

what is the action of the semimembranosus?

• medially rotates thigh at hip joint and leg at knee joint

• flexes leg at knee joint and extends thigh at hip joint

the tendon of the semimembranosus contributes to the formation of what?

ligaments and fascia around knee joint

what describes an avulsion injury (hamstring)?

avulsion of the ischial tuberosity with proximal hamstring origin attachment

what is the weakest element of the proximal hamstring unit in adolescents?

ischial apophysis