Exam 1 General Content

1. Inferior epigastric artery
2. Deep circumflex iliac artery
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Terms in this set (175)
Anterior primary rami______________ _____________ rami of L2-S3 divide into posterior & anterior divisions for terminal nervesPosterior division = Femoral & Common fibular (peroneal) Anterior division = Obturator & TibialWhat're the four main terminal nerves of the lumbosacral plexus with their respective divisionsFemoral = L2-L4 Common fibular = L4-S2 Tibial = L4-S3 Obturator = L2-L4What nerve roots contribute to the femoral, common fibular, tibial, and obturator nervesSuperior gluteal nerve (to quadratus femoris/Inferior gemellus) = L4-S1 Inferior gluteal nerve (to obturator internus/superior gemellus) = L5-S2 Posterior femoral cutaneous = S1-S3 Pudendal = S2-S4 Sciatic = L4-S3 "SIPPS"What're the nerves and roots of the sacral plexussacrospinous ligamentligament from ischial spine to lateral region of sacrumsacrotuberous ligamentligament from PSIS to sacral tuberclesInguinal ligament (Poupart)ligament from ASIS to pubic tubercle; from external oblique aponeurosislacunar (Gimbernat's) ligamentattaches lateral to the pubic tubercle and connects the inguinal ligament to the pectineal ligament; forms an archPectineal (Cooper's) ligamentformed from the lacunar ligament fibers, medial and posterior to the femoral canalAnterior wall = External Oblique Aponeurosis Posterior wall = Transversalis fascia Roof = Conjoint tendon Floor = Inguinal ligamentWhat're the boundaries of the inguinal canaldeep inguinal ringentrance to the inguinal canal, opening of transversalis fascia, & lateral to inferior epigastric vesselssuperficial inguinal ringexit of the inguinal canal, opening of exernal oblique aponeurosis, medial to inferior epigastric vesselsobturator internusWhat muscle enters through the lesser sciatic foramenobturator externusWhat muscle is in the same plane as quadratus femoris but deepersacral tuberosityattachment for interosseous sacroiliac ligament; supports sacroiliac jointGluteus maximusWhat muscle inserts posterior to the posterior posterior gluteal linegluteus mediusWhat muscle inserts in between the posterior and anterior gluteal lineGluteus minimusWhat muscle inserts in between the anterior and inferior gluteal lineLinea terminalisincludes arcuate line, pecten pubis, and pubic crest; separates false from true pelvisPubic symphyseal surface (more ridges = younger)What on the pelvis can be used to determine a skeletons ageTrue or Diagonal Conjugate measurementWhat is performed to determine the possibility of childbirth?lunate surfaceC-shaped articular surface of the acetabulumacetabulur fossanon-articular portion of acetabulum but contains a synovial spacePubic tubercle and ASISWhat two structures on the pelvis should be aligned vertically?Fovearegion on femoral head that is not covered by articular cartilage and where ligamentum teres enters the femurAcetabular arteryCarried by ligamentum teresintertrochanteric linebetween both femoral trochanters on the anterior portionintertrochanteric crestbetween both trochanters on the posterior portionTrochanteric fossaFormed by the help of the greater trochanter on the posterior aspectpectineal line → spiral line → medial lip of linea asperaWhat does the lesser trochanter help develop on the posterior aspect of the femuradductor tuberclesuperior to medial epicondyle; attachment for the hamstring portion of adductor magnuspopliteal arteryWhat is the closest structure to the popliteal surface?medial femoral circumflex arteryFirst branch off the deep femoral artery; supplies hip jointmedial and lateral condylesform the patellar surfacePatellalargest sesimoid bone in body; embedded within tendon of quadriceps femorisBase = superior Apex = inferiorWhere is the base and apex in regards to the patellaAnterior = rough surface Posterior smooth surface & contains the keelWhat is the difference between the anterior and posterior portion of the patellakeelportion of patella that articulates with trochlear groove of femurintercondylar tuberclesAttachment sites for cruciate ligaments and horns of meniscusGerdy's tubercleanterolateral prominence that serves as attachment site for IT bandcommon fibular nerveWhat nerve wraps around the neck of the fibulainterosseous ligamentConnects the tibia and fibulaMedial malleolus = Tibia Lateral malleolus = FibulaWhat two processes articulate with the talus and which bones are they found onpes anserinusAttachment for sartorius, gracilis, and semitendonosusLocate the triangular surface (subcutaneous triangular area) Triangle goes right = Right fibulaHow to identify the fibula1. Hindfoot (Rearfoot) = Talus & calcaneus 2. Midfoot = Five remaining tarsal bones 3. Forefoot = Five metatarsals & phalangesWhat're the three functional types of skeletal groupings of the foot w/ their components1. Tarsus = 7 bones 2. Metatarsus = 5 metatarsal bones 3. Phalanges = 14 toe bones 26 bones in totalWhat're the 3 sections of the foot and how many bones in eachHallux does not have middle phalanx = Only one interphalangeal jointWhat is an important difference between the hallux and other toesall three cuneiformsWhat bones articulate with navicularCuboidWhat bone articulates with calcaneus1. Talus 2. Calcaneus 3. Navicular 4. Medial cuneiform 5. Intermediate cuneiform 6. Lateral cuneiform 7. Cuboid "Transverse City (is) Noted (for) MIchigan's Lovely Cherries"What're the 7 tarsus bonesTalusWhat is the only bone of the foot with no muscle attachmentsKeystone = Talus Consists of: Calcaneus, talus, navicular, 3 cuneiforms, & first 3 metatarsalsWhat bones contribute to the medial longitudinal arch? What is the keystone?Keystone = Cuboid Consists of: Calcaneus, cuboid, 4th & 5th metatarsalsWhat bones contribute to the lateral longitudinal arch? What is the keystone?Consists of: Navicular, 3 cuneiforms, cuboid, & all 5 metatarsalsWhat bones contribute to the transverse arch?digital rayscolumn of bones leading to but not including the phalanges1-3 = Metatarsals and cuneiforms 4-5 = Only metatarsalsWhat're the components of the 5 digital raysfascia latadeep fascia of the thigh that goes around muscle & forms intermuscular septaintermuscular septaseparate the three muscular compartments of the thighlinea asperaWhere the intermuscular septa attaches to the femurcrural fasciaDeep fascia of the legTensor fascia lata and gluteus maximusWhat two muscles form the IT band?saphenous openingspecialization of fascia lata that allows the great saphenous vein to drain into the femoral veinFalciform marginrepresents the superior, lateral, and inferior margin of the saphenous opening; forms crescent shaped edgeCribriform fasciaspreads over the opening (closing) the saphenous opening; also joins at the medial marginfemoral sheathWhat is structure is found within the saphenous opening1. Femoral artery 2. Femoral vein 3. Deep lymph node (Femoral canal)What are the structures within the femoral sheath listed from lateral → medialfemoral ringProximal opening of the femoral canalvena comitantesveins oriented around an artery (typically deep vessels; helps in returning blood to heartGreat saphenous veinsuperficial vein found on the medial side of dorsal venous arch of footsmall saphenous veinsuperficial vein that ascends on the posterior aspect of leg & forms the lateral side of dorsal venous arch of foot1. Superficial external pudendal 2. Superficial epigastric 3. Superficial circumflex iliac 4. Lateral cutaneous vein 5. Accessory saphenous veinsWhat're 5 notable veins the great saphenous vein receives blood from1. Medial femoral cutaneous nerve (IN THIGH) 2. Saphenous nerve (IN LEG)What're the two nerves that travel with the great saphenous veinSural nerveWhat nerve runs with the small saphenous veinperforator veinsconnect superficial veins to deep veins & contain one-way valves; site for varicose veins1. Horizontal group = parallels inferior to inguinal ligament 2. Vertical group = near great saphenous & receives afferent from most of lower extremityWhat're the two groups of superficial inguinal lymph nodes w/ brief definitionNode of Cloquetdeep lymph node within the femoral canalgenitofemoral nerveNerve that provides cutaneous sensation near the saphenous openingAnterior division = Sartorius & pectineus Posterior division = All vastus & rectus femorisWhat muscles are innervated by the anterior and posterior division of the femoral nerveAnterior division = Medial & intermediate femoral cutaneous nerves Posterior division = Saphenous → InfrapatellarWhat sensory nerves are given off by the anterior and posterior division of the femoral nerveInfrapatellar branch of saphenous nervenerve that pierces the sartorius medial to the knee & provides cutaneous innervation over the patella1. Muscular lacuna = Lateral to arch 2. Vascular lacuna = medial to archWhat're the two openings created by iliopectineal arch (Iliopsoas fascia) and there are they located in respect to the archIliopsoas tendon Femoral nerve Lateral femoral cutaneous nerveWhat're the structures contained in the muscular lacunaFemoral sheath & vessels withinWhat're the structures contained in the vascular lacunaMedial border = Lacunar ligament Lateral border = Femoral vein Anterior border = Inguinal ligament Posterior border = Pectineal ligament/muscle & superior rami of pubisWhat're the four borders of the femoral canalBase = Inguinal ligament Medial border = Adductor longus Lateral border = Sartorius Floor (lat → med) = Iliopsoas, pectineus, adductor longus Roof = Fascia lata & cribriform fasciaWhat is the base, medial/lateral border, floor, and roof of femoral triangle1. Femoral Nerve 2. Femoral Artery 3. Femoral Vein 4. Lymphatics "NAVeL"What're the contents of the femoral triangle from lateral → medial1. Hamstrings = Hip extension & knee flexion 2. Rectus femoris = Hip flexion & knee extension 3. Gastrocnemius = Knee flexion & plantarflexionWhat're the three TJM muscles discussed with their actionsiliopsoas muscleWhat muscle is the most powerful flexor of the thigh (hip)PactineusMuscle in same plane as iliopsoas muscle but sometimes considered apart of the medial compartmentsubinguinal spacegap between the inguinal ligament (anterior) & the pelvic bone (posterior)1. Muscles: Psoas major, iliacus, pectineus 2. Nerves: Lateral femoral cutaneous & femoral branch of genitofemoral 3. Contents of Femoral sheathWhat structures pass through the subinguinal spaceadductor hiatusopening in the adductor magnus that transmits the femoral vessels into the popliteal vesselsdescending genicular arteryThe termination (most inferior branch) of the femoral artery1. Sub-sartorial 2. Hunter's canalWhat're the 2 other names synonymous to adductor's canalAt apex of femoral triangleWhere does the adductor canal beginAnteriolateral = Vastus medialis Posterior = Adductor longus & magnus Medial = Sartorius Roof = SartoriusWhat're the boundaries of the adductors canalFemoral artery & vein Saphenous nerve Nerve to vastus medialisWhat're the contents of the adductors canalprofunda (deep) femoral arterylargest branch of the femoral artery and is the major source of blood supply to the thigh1. Medial circumflex femoral artery 2. Lateral circumflex femoral artery 3. Perforating arteriesWhat're the three branches given off by the profunda (deep) femoral artery (in order)1. Lateral circumflex femoral artery 2. Medial circumflex femoral artery (more important)What arteries are the two main blood suppliers to the hip joint1. Ascending branch = supplies gluteal region 2. Transverse branch = winds around femur; cruciate anastomosis 3. Descending branch = genicular anastomosesWhat're the three branches of the lateral circumflex femoral artery and what do they supply1. Transverse branch = Cruciate anastomosis 2. Ascending branch = Joins inferior gluteal arteryWhat're the two branches of the medial circumflex femoral artery and what do they supply4th perforating arteryThe termination (most inferior branch) of the profunda (deep) femoral arteryAdductor magnusWhat muscle does the perforating branches of profunda femoral artery pass throughALL THREE COMPARTMENTS; especially the posterior compartmentWhat compartment does the perforating branches of the profunda femoral artery supply1. Descending genicular 2. Descending branch of lateral circumflex femoralWhat're the two branches of the femoral artery that go to the knee1. Superior medial genicular 2. Superior lateral genicular 3. Middle genicular 4. Inferior medial genicular 5. Inferior lateral genicularWhat're the five branches of the popliteal artery that go to the kneeMiddle genicular artery goes inside knee jointWhich branch of popliteal to the knee does not contribute to the genicular anastamoses1. Posterior tibial recurrent 2. Anterior tibial recurrentWhat're the two branches of the tibial artery that go to the kneeNear lesser trochanterWhere is the cruciate anastomosis located1. First perforating of deep femoral 2. Inferior gluteal 3. Lateral circumflex femoral (transverse) 4. Medial circumflex femoral (transverse) "FILM"What arteries contribute to the cruciate anastomosisProvide alternate blood flow to lower limb if there is external iliac blockageWhat is the function of the cruciate anastomosisAt trochanteric fossaWhere is the trochanteric anastomoses located1. Descending superior gluteal 2. Inferior gluteal 3. Lateral circumflex femoral (ascending) 4. Medial circumflex femoral (ascending)What arteries contribute to the trochanteric anastomosisPectineusWhat muscle could be innervated by both femoral and obturator nervetibial nerveWhat nerve innervates the hamstring portion of adductor magnusMedial intermuscular septumWhat intermuscular septum separates the anterior and medial compartment of the thighPosterior intermuscular septumWhat intermuscular septum separates the posterior and medial compartment of the thighlateral intermuscular septumWhat intermuscular septum separates the anterior and posterior compartment of the thighadductor minimusHorizontal seperation of adductor magnus creates ______________ _________________.1. Adductor longus 2. Adductor brevis 3. Gracilis 4. SkinWhat is innervated by the anterior division of obturator nerve1. Obturator externus 2. Adductor brevis 3. Adductor portion of adductor magnusWhat is innervated by the posterior division of obturator nerveAnterior branch = On top of brevis Posterior branch = On top of magnus, behind brevisWhere is the anterior and posterior branch of obturator nerve located in regards to adductor brevisposterior retinacular arteriesBranches of the medial circumflex femoral artery that supply the head, neck and subsynovial portion of the femurPosterior branchWhat branch of obturator artery gives off the acetabular arteryAcetabulumformed by all three pelvic bones, contains acetabular rim with an acetabular notch inferiortransverse acetabular ligamentcompletes the acetabular notch and creates the acetabular foramentrabeculaewithin spongy bone, arranged in direction of forces passing through the femoral head/neckCalcarextra thick cortical bone that resists bending forces in the femoral neckCapsule, acetabular fossa, fovea, transverse acetabular ligament (non-articulating surfaces)What parts of the hip joint does synovial membrane lineintertrochanteric line (posterior)Where does the hip joint capsule insertretinaculaeformed by capsule fibers & synovial lining; enclose blood vessels surrounding femoral neckZona Orbicularis (Angular Ligament)within capsule wall, runs around the femoral neck1. Iliofemoral ligament (most important) 2. Ischiofemoral ligament 3. Pubofemoral ligament Function: Limit extension of the thigh!!!What're the three extracapsular ligaments and what are their main functions1. Transverse acetabular ligament 2. Ligamentum teres capitis femorisWhat're the two intracapsular ligamentsIliofemoral ligament (Ligament of Bigelow)strongest ligament in the body; runs from AIIS to intertrochanteric lineIschiofemoral ligamentweakest of the extrinsic ligament; runs from ischial body to superolateral femoral neckPubofemoral ligamentligament that runs from iliopectineal eminence to intertrochanteric line of femurSciatic is lateral Posterior femoral cutaneous nerve is medialWhere is the sciatic positioned in relation to the posterior femoral cutaneous nerve after exiting infrapiriform foramen1. Obturator internus 2. Nerve to obturator internus 3. Internal pudendal vessels 4. Pudendal nerveWhat structures pass through the lesser sciatic foramenInfromedial quadrantWhat gluteal quadrant possesses the sciatic, piriformis, and both sciatic foramenPosterior sacroiliac ligamentcontinuous with sacrotuberous ligament & supports sacroiliac joint1. Superior cluneal = Dorsal rami (L1-L3) 2. Medial cluneal = Dorsal rami (S1-S3) 3. Inferior cluneal = Branch of posterior femoral cutaneous (ventral rami)What're the three sets of cluneal nerves with their originCluneal nervesNerves responsible for cutaneous innervation over gluteal regionIliac Tubercle (Tuberculum)widest point of the iliac crest, anterior & posterior to the ASIS and lies at the level of the L5 spinous processtranstubercular planetransverse plane that runs through both right and left iliac tuberclesuperior gluteal arterybranch of posterior trunk of internal iliac artery; supplies all 3 gluteal muscles & tensor fascia latainferior gluteal arterybranch of anterior trunk of internal iliac artery; suplies gluteus maximus & hamstrings1. Piriformis 2. Gamellus superior 3. Obturator internus 4. Gamellus inferior 5. Obturator externus 6. Gluteus Maximus 7. Quadratus femoris "Play Golf Or Go On Good Quaaludes"List the external (lateral) rotators of the hip1. Gluteus medius 2. Gluteus minimusWhat're the two internal (medial) rotators of the hiparcuate lineWhat structure receives force of body weight from the sacroiliac joint and transmits it to the acetabuluminterosseous sacroiliac ligamentvery strong ligament that attaches to the iliac tuberosity and sacral tuberosity and supports the sacroiliac jointNutationanterior end of sacrum dips down, coxal end moves upwards; increases pelvic outletCounternutationanterior end of sacrum lifts up, coxal end down; increases pelvic inletTibial nerve = Medial Common fibular = LateralWhere are the tibial and common fibular located in respect to one another in the thighSemitendonosus & membranosus = Medial Biceps femoris (long and short head) = LateralWhich hamstring muscles are medial? Which are lateral?long head of biceps femorisWhat structure protects the sciatic nerve & continues to protect the common fibular after the divisionSuperolaterally = Biceps femoris Superomedially = Semimembranosus & tendonosus Inferomedially = Medial head of gastrocnemius Inferolaterally = Lateral head of gastrocnemius and plantaris muscle Floor (Anterior wall) = Femur, knee joint capsule, fascia of popliteus muscle Roof (Posterior wall) = Superficial part of deep fasciaWhat're the boundaries of the popliteal fossaposterior femoral cutaneous nerveWhat nerve innervates the skin over the popliteal region1. Termination of lesser saphenous vein 2. Tibial and common fibular nerve 3. Popliteal vein and arteryWhat're the contents of the popliteal fossaTibial gives off medial sural cutaneous nerve Common fibular gives off lateral sural cutaneous, which gives off communicating branch Medial sural cutaneous + communicating branch = Sural nerveExplain the formation of the sural nervearcuate popliteal ligamentCreates an opening for the popitues muscle into the knee jointpopliteus muscleUnlocks the knee from full extension; initiates flexionExtend (lock) = Femur rotated medially Flex (unlock) = Femur rotated laterallyWhich direction does the femur rotate to extend (lock) or flex (unlock) the knee