anterior pelvic gidle and thigh

pectineal area

= around the anus

perineum area

= from the anus to scrotum to vulva

femoral triangle boundaries

lateral: sartorius

medial: adductor longus

superior: inguinal ligament

what runs through the femoral triangle

NAVL → femoral nerve, artery, vein and lymph nodes

popliteal fossa boundaries

superior-lateral = biceps femoris

superior-medial = semitendinosis and semimebranosis

inferior = gastrocnemius head (medial and lateral)

popliteal fossa contents

popliteal artery and vein, tibial nerve

largest sesamoid bone in the body

patella

function of LE bones

• locomotion

• support

• carry weight of the entire body

• muscular attachments

knee joint: femur and tibia

hinge joint

knee joint: femur and patella

plane joint

joint between proximal tibia and fibula

plane, gliding

distal tibia and fibula joint

fibrous (syndesmosis)

• slightly moveable

• injury here known as “high ankle sprain”

ankle joint: tibia/fibula + talus

hinge, uniaxial, synovial

intertarsal and tarsal-metatarsal joint

plane, synovial

metatarsal-phalanges joint

condyloid, synovial

interphalangeal joint

hinge, uniaxial

pubic symphysis

midline amphiarthrotic joint covered with hyaline cartilage and contains a disc and ligaments → rotation and translation

sacrospinous ligament

connects the sacrum → ischial spine

separates the greater and lesser sciatic notches and helps to create the greater and lesser sciatic foramen

sacrotuberous ligament

sacrum → ischial tuberosity

closes off lesser sciatic notch

greater sciatic foramen

passageway for piriformis muscle

greater sciatic notch

the sacrospinous ligament converts the notch into the greater sciatic foramen

what’s superior to the piriformis

superior gluteal artery and nerve

lesser sciatic foramen

the pudendal nerve and vessels

iliolumbar ligament

connects TP of L5 to ilia → strengthens the joint between S1 and L5

sacroiliac ligament

• connects sacrum → ilium

• strengthens articulation of sacrum to ilia for transference of weight

iliofemoral ligament

• STRONGEST!! prevents hyperextension of the hip joint

• runs from the ASIS to acetabular rim and intertrochanteric line

• = Y ligament of Bigalow

pubofemoral ligament

• limits abduction and prevents hyperextension

• runs from the femur → pubic bone at the obturator crest

ischiofemoral ligament

• WEAKEST of the 3… prevents hyperextension (tightens with hyperextension, unwinds in hip flexion)

• ischial portion of the acetabular rim to femoral neck

transfer of weight

1. weight transmitted centrally down vertebral column

2. divided and directed laterally towards the sacrum and ilia

3. portions of ilia transmit weight towards femur

4. pubic rami form a strut to brace the arch

who is the largest, longest, strongest bone in the body

femur! 13-300% of bodyweight transmitted through femoral head to acetabulum and then directed to SI joint and pubic symphysis

patella alta

• patella lies proximal in relationship to trochlea in patellar groove (riding high)

• = attenuated patella

patella baja

• patella lies distal in the trochlea in patellar groove (riding low)

• post op/trauma condition causing knee pain

lumbar plexus

• arrises from L1-L4

• lies within the psoas major muscle

• mostly anterior structures

sacral plexus

• arises from spinal nerves L4-S4

• lies caudal to the lumbar plexus

• mostly posterior structures

nerves of the lumbar plexus

• femoral nerve

• obturator

• lateral femoral cutaneous

• genitofemoral

• ilioinguinal

• iliohypogastric

femoral nerve

• L2-L4

• quads, pectineus, iliacus, sartorius, anterior thigh skin

obturator nerve

• L2-L4

• adductors: adductor magnus, adductor brevis, adductor longus, obturator externus, skin of medial thigh

lateral femoral cutaneous nerve

• L2-L3

• lateral skin of the thigh

genitofemoral nerve

• L1-L2

• genitals and medial thigh skin

ilioinguinal nerve

• transverse abdominus, internal oblique, genitals

iliohypogastric nerve

• transverse abdominus, skin

sacral plexus nerves

• superior gluteal

• common fibular/peroneal

• tibial

• inferior gluteal

• posterior femoral cutaneous

• pudendal

which nerves form sciatic nerve

common fibular/peroneal and tibial nerve

superior gluteal nerve

• L4-S1

• TFL, glut med/min

common fibular/peroneal nerve

• L4-S2

• lateral leg compartment, tibialis anterior, toe extensors

tibial nerve

• L4-S3

• posterior leg, foot

inferior gluteal nerve

• L5-S2

• gluteus maximus

posterior femoral cutaneous nerve

• S1-3

• posterior thigh skin

pudendal nerve

• S2-4

• genitals, levator ani muscles

• continence

wherre does abdominal aorta split into common iliac

at the top of the pelvis at the lower lumbar spinal region

internal iliac artery

supplies pelvic organs

external iliac arteries

supplies lower limb

when does external iliac artery become femoral nerve

when it passes under the inguinal ligament

who does internal iliac artery branch into

1. cranial and caudal gluteals (superior and inferior)

2. internal pudendal

3. obturatory

what does femoral artery branch into

1. deep femoral artery

2. popliteal artery

3. anterior and posterior tibial

lateral and medial circumflex arteries

wraps around the head of the femur, supplies head of the femur

adductor hiatus

opening of adductor magnus for the femoral artery to pass through

superficial veins of the LE

• dorsal venous arch (foot)

• great saphenous (empties into femoral)

• small saphenous (empties into popliteal)