Gross Anatomy I - Exam 3 - Palmer (Yarbrough)

the lower limb is anchored to the axial skeleton by ______ joint & associated ligaments

sacroiliac joint

what are the 3 transitional areas of the lower limb? (3)

femoral triangle, popliteal fossa, tarsal tunnel

what are the 2 main functions of the lower limb? (2)

support the body weight

locomotion

when standing erect, how does the vertical line pass through the center of gravity at the hip joint?

slightly posterior to the hip joint

when standing erect, the vertical line through the center of gravity is anterior to:

the knees and ankle joints

the knee & hip joints are in _________ when standing; this reduces the amount of energy required to stand

extension

what components help produce a smooth & efficient gait?

pelvic tilt (coronal plane), pelvic rotation (transverse plane), knees toward midline, flexion of the knees

testable image #1! (leg dermatomes)

testable image #2! (peripheral nerves/cutaneous supply)

the pelvis is formed by which 3 bones? (3)

ilium, ischium, pubis

when do the ischium & pubis fuse?

4-8 years old

when does the ilium fuse to the other bones?

11-17 years old

Which features are included in linea terminalis?

pubic crest

pecten pubis

arcuate line

pectineal line

The _________ is where the ilium, pubis &

ischium fuse.

acetabulum

Difference between true pelvis & false pelvis.

False pelvis are the iliac crests and above, whereas true pelvis is the area below the pelvic brim, containing the pelvic cavity, the opening

In anatomical position, the pubic symphysis & the

_________ lie in the same vertical

plane.

anterior superior iliac spine

What makes up the pelvic walls?

sacrum

coccyx

ilium

ischium

pubis

piriformis

obturator internus

sacrospinous ligament

sacrotuberous ligament

What makes up the pelvic outlet?

pubic symphysis

ischiopubic ramus

sacrum

sacrotuberous ligament

coccyx

ischial tuberosity

The adjacent surfaces of the pubic bones are linked by the________.

pubic symphysis

What type of joint is the pubic symphysis?

cartilaginous joint; symphysis

What is present on the pubic symphysis joint's bony surfaces? (only on the bone)

hyaline cartilage

The inguinal ligament is a thickened, reinforced edge of __________

external oblique aponeurosis

The lateral attachment of the inguinal ligament:

anterior superior iliac spine (ASIS)

The medial attachment of the inguinal ligament:

the pubic tubercle

pelvic inlet shape (male pelvis)

heart-shaped

pelvic inlet shape (female pelvis)

circular

subpubic arch (male pelvis)

narrower angle (50-60°)

subpubic arch (female pelvis)

wider angle (80-85°)

ischial spines (male pelvis)

prominent; medially projected

ischial spines (female pelvis)

less prominent; further apart

obturator foramen (male pelvis)

round, smaller

obturator foramen (female pelvis)

oval, larger

iliac crests (male pelvis)

higher; more vertical

iliac crests (female pelvis)

lower; flare outward

The ____________ is a common site for bone

marrow biopsy.

iliac crest

Where does a subcapital happen? risks?

line through femoral head-neck junction;

high risk of necrosis in femoral head

transcervical (femur fracture)

fracture line through mid-portion of femoral neck;

more common in older individuals with osteoporosis;

following low-energy fall (i.e. from standing height)

basicervical (femur fracture)

fracture through base of the femoral neck;

lowest risk of necrosis;

more common in younger individuals;

following high-energy trauma (i.e. fall from a great height)

The hip joint involves articulation between:

head of the femur & the acetabulum (of pelvic bone)

what is the name of the surface of hip joint articulation?

lunate surface

Hip joint classification:

synovial; ball-and-socket

Acetabular labrum: (details)

the rim of the acetabulum is raised slightly by a fibrocartilaginous collar (the acetabular labrum)

Transverse acetabular ligament: (details)

labrum bridges across the acetabular notch

Acetabular foramen: (details)

formed when the transverse acetabular ligament bridges the acetabular notch, allowing nerves and blood vessels to pass into the joint

Ligament of the head of the femur:

aka ligamentum teres

attaches to the: fovea, acetabular fossa, acetabular ligament, margins of the acetabular notch

what does the artery of the ligamentum teres (acetabular branch of obturator artery) supply?

supplies the head of the femur

Artery of ligament of head of the femur supplies blood to the ______

head of the femur

Iliofemoral ligament (characteristics)

anterior, triangular shaped; Y appearance; part of hip joint

Pubofemoral ligament (characteristics)

anteroinferior, triangular shaped; blends with fibrous membrane & deep surface of the iliofemoral ligament

Ischiofemoral ligament (characteristics)

reinforces the posterior aspect of the fibrous membrane

Which structures primarily provide blood supply to the hip joint? (6)

obturator artery

medial femoral circumflex artery

lateral femoral circumflex artery

superior gluteal artery

inferior gluteal artery

first perforating branch of the deep artery of the thigh

Which structures primarily provide nerve supply to the hip joint? (4)

femoral nerve

obturator nerve

superior gluteal nerve

nerve to the quadratus femoris

Greater sciatic foramen superior to piriformis (gateway contents)

superior gluteal nerve, artery, & vein

Greater sciatic

foramen inferior to

piriformis (gateway contents)

sciatic nerve

inferior gluteal nerve, artery, and vein

pudendal nerve

internal pudendal artery & vein

posterior femoral cutaneous nerve

nerve to obturator internus

nerve to quadratus femoris

lesser sciatic foramen (gateway contents)

obturator internus muscle

pudendal nerve

internal pudendal artery & vein

obturator canal (gateway contents)

obturator nerve

obturator artery & vein

gap between inguinal ligament & pelvic bone (gateway contents)

psoas major

iliacus

pectineus

femoral artery & vein

femoral nerve

femoral branch of genitofemoral nerve

lateral cutaneous nerve of the thigh

lymphatics

The lumbar plexus is formed by the anterior rami of spinal nerves:

L1-L4 (most of L4)

The lumbosacral trunk is formed by:

L4/L5 (the rest of L4)

The lumbosacral trunk joins with the anterior rami of

________________________ to form the sacral plexus.

S1-S3

testable image #3 (lumbar plexus)

Iliohypogastric nerve (spinal segments, motor/sensory)

L1

motor: muscles of abdominal wall

sensory: posterolateral gluteal skin & skin in pubic region

Iliohypogastric nerve (spinal segment)

L1

Iliohypogastric nerve (motor innervation)

muscles of the abdominal wall

Iliohypogastric nerve (sensory innervation)

posterolateral gluteal skin

skin in pubic region

Ilioinguinal nerve (spinal segments, motor/sensory)

L1

motor: muscles of the abdominal wall

sensory: skin in the anterior medial part of the upper thigh

Ilioinguinal nerve (spinal segment)

L1

ilioinguinal nerve (motor innervation)

muscles of the abdominal wall

Ilio-inguinal nerve (sensory innervation)

skin in the anterior medial part of the upper thigh

ilioinguinal nerve passes through ___________

inguinal canal; leaves the abdominal wall through the superficial inguinal ring

iliohypogastric nerve & ilioinguinal nerve arise as a single trunk from _________

the anterior ramus of L1

genitofemoral nerve (spinal segment, motor/sensory)

L1, L2

motor: genital branch-cremaster muscle in males

sensory: femoral branch -> skin of upper anterior thigh

genital branch -> genital region

genitofemoral nerve (spinal segment)

L1, L2

genitofemoral nerve (motor innervation)

genital branch: cremaster muscle in males

genitofemoral nerve (sensory innervation)

femoral branch: skin of upper anterior thigh

genital branch: genital region

lateral cutaneous nerve of the thigh (spinal segment, motor/sensory)

L2, L3

no motor

sensory: skin over the anterolateral thigh; parietal peritoneum in iliac fossa

lateral cutaneous nerve of the thigh (spinal segments)

L2, L3

lateral cutaneous nerve of the thigh (motor innervation)

none

lateral cutaneous nerve of the thigh (sensory innervation)

skin over the anterolateral thigh; parietal peritoneum in iliac fossa

Femoral nerve (spinal segment, motor/sensory)

L2-L4

motor: all muscles in anterior compartment of the thigh; gives rise to branches that supply iliacus & pectineus

sensory: skin over the anterior thigh, anteromedial knee, medial side of the leg, medial side of the foot

Femoral nerve (spinal segment)

L2-L4

Femoral nerve (motor)

motor: all muscles in anterior compartment of the thigh; gives rise to branches that supply iliacus & pectineus

Femoral nerve (sensory)

sensory: skin over the anterior thigh, anteromedial knee, medial side of the leg, medial side of the foot

Obturator nerve (spinal segment, motor/sensory)

L2-L4

motor: all muscles in the medial compartment of the thigh (except pectineus & part of adductor magnus); obturator externus

sensory: skin over upper medial aspect of the thigh

Obturator nerve (spinal segment)

L2-L4

Obturator nerve (motor)

all muscles in the medial compartment of the thigh (except pectineus & part of adductor magnus); obturator externus

Obturator nerve (sensory)

skin over upper medial aspect of the thigh

testable image #4! (sacral plexus)

Superior gluteal nerve (spinal segment, motor/sensory)

L4-S1

motor: gluteus medius, gluteus minimus, tensor fascia latae

sensory: none

Superior gluteal nerve (spinal segment)

L4-S1

Superior gluteal nerve (motor innervation)

motor: gluteus medius, gluteus minimus, tensor fascia latae

Superior gluteal nerve (sensory innervation)

sensory: none

Inferior gluteal nerve (spinal segment, motor/sensory)

L5-S2

motor: gluteus maximus

sensory: none

Inferior gluteal nerve (spinal segment)

L5-S2

Inferior gluteal nerve (motor innervation)

motor: gluteus maximus

Inferior gluteal nerve (sensory innveration)

sensory: none

Nerve to the piriformis (spinal segment, motor/sensory)

S1-S2

motor: piriformis

sensory: none

Nerve to the piriformis (spinal segment)

S1-S2

Nerve to the piriformis (motor innervation)

piriformis

Nerve to the piriformis (sensory innervation)

none