MUSCLES OF THE LOWER EXTREMITY REMEMBER!

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1 MUSCLES OF THE LOWER EXTREMITY REMEMBER! GLUTEAL REGION AND MUSCLES ON THE ANTERIOR SIDE OF THE PELVIS - ATTACH THE LOWER EXTREMITY TO PELVIC GIRDLE THIGH - HIP TO THE KNEE LEG - KNEE TO THE ANKLE FOOT - DISTAL TO THE ANKLE

2 ANTERIOR MUSCLES CROSSING THE HIP MUSCLES OF THE ANTERIOR COMPARTMENT OF THE THIGH MUSCLES OF THE MEDIAL COMPARTMENT OF THE THIGH

3 ANTERIOR MUSCLES ORIGINATING ON THE PELVIS WHICH CROSS THE HIP JOINT 1. ILIOPSOAS (ILIACUS AND PSOAS MAJOR) 2. SARTORIUS

4 ILIOPSOAS COMPOSED OF TWO MUSCLES - ILIACUS AND PSOAS MAJOR ILIACUS FROM THE ILIAC FOSSA; PSOAS MAJOR FROM T12 AND THE LUMBAR VERTEBRAE EXITS THE PELVIS DEEP TO THE INGUINAL LIGAMENT INSERTS INTO THE LESSER TROCHANTER CHIEF FLEXOR OF THE THIGH OR TRUNK INGUINAL LIGAMENT

5 SARTORIUS MOST SUPERFICIAL IN THE ANTERIOR THIGH PASSES OBLIQUELY FROM LATERAL TO MEDIAL ACROSS THIGH INSERTS AS PART OF THE PES ANSERINUS LONGEST MUSCLE IN THE BODY FLEXES AND LATERALLY ROTATES THIGH AND FLEXES LEG; CROSSES 2 JOINTS

6 THIGH CONSISTS OF 3 COMPARTMENTS- 1. ANTERIOR 2. MEDIAL 3. POSTERIOR EACH HAVING A SPECIFIC ACTION EACH INNERVATED BY A SPECIFIC NERVE EACH GROUP SEPARATED BY FASCIAL WALLS FORMED BY THE DEEP FASCIA OF THE THIGH

7 ANTERIOR COMPARTMENT MUSCLES OF THE THIGH 1. RECTUS FEMORIS (ALSO CROSSES THE HIP JOINT) 2. VASTUS LATERALIS 3. VASTUS MEDIALIS 4. VASTUS INTERMEDIUS 5. TENSOR FASCIA LATAE

8 ANTERIOR COMPARTMENT MUSCLES* - QUADRICEPS ALL INNERVATED BY THE FEMORAL NERVE RECTUS FEMORIS VASTUS LATERALIS VASTUS MEDIALIS VASTUS INTERMEDIUS ALL 4 UNITE TO FORM THE QUADRICEPS TENDON WHICH CONTAINS THE PATELLA FROM THE PATELLA TO THE TIBIAL TUBEROSITY IS THE PATELLAR LIGAMENT

9 RECTUS FEMORIS THE KICKING MUSCLE - EXTENDS THE LEG ALSO CROSSES THE HIP JOINT SO CAN FLEX THE THIGH

10 VASTUS LATERALIS THE VASTUS MUSCLES ARE VERY LARGE (VAST) COVER THE ENTIRE ANTERIOR SURFACE OF THE FEMUR VASTUS LATERALIS IS THE LARGEST COMPONENT LOCATED ON THE LATERAL SIDE OF THE THIGH

11 VASTUS MEDIALIS COVERS THE MEDIAL SUFACE OF THE FEMUR FORMS A TEAR DROP SHAPED BULGE JUST ABOVE THE KNEE

12 VASTUS INTERMEDIUS LIES DEEP TO THE RECTUS FEMORIS LOOKS VERY TENDINOUS NOT MUSCULAR

13

14 ILIACUS PSOAS MAJOR SARTORIUS RECTUS FEMORIS VASTUS LATERALIS VASTUS MEDIALIS

15 ANTERIOR COMPARTMENT INNERVATED BY THE FEMORAL NERVE MOST IMPORTANT FOR EXTENDING THE LEG; MINOR FLEXION OF THE THIGH

16 TENSOR FASCIA LATAE* LIES ON THE LATERAL SIDE OF THE HIP AND UPPER THIGH INSERTS INTO THE ILIOTIBIAL BAND/TRACT FLEXES THE THIGH WITH THE ILIOPSOAS MEDIALLY ROTATES AND ABDUCTS THE THIGH WITH OTHER MUSCLES ILIOTIBIAL BAND *SUPERIOR GLUTEAL NERVE

17 TENSOR FASCIA LATAE - MUSCLE LOCATED ON THE LATERAL SIDE OF THE HIP ILIOTIBIAL BAND - CONNECTIVE TISSUE BAND, THE TENSOR FASCIA LATA INSERTS INTO THIS BAND ILIOTIBIAL BAND - INSERTS ONTO THE LATERAL TIBIA (GERDY S TUBERCLE)

18

19 TENSOR FASCIA LATAE ILIOTIBIAL TRACT VASTUS LATERALIS

20 MEDIAL COMPARTMENT MUSCLES OF THE THIGH 1. ADDUCTOR MAGNUS 2. ADDUCTOR LONGUS 3. ADDUCTOR BREVIS 4. PECTINEUS 5. GRACILIS *REMEMBER THAT COMPARTMENTS ARE USUALLY INNERVATED BY ONE NERVE AND HAVE ONE PRIMARY ACTION

21 MEDIAL COMPARTMENT OF THE THIGH ADDUCTORS OF THE THIGH (STABILIZE THE THIGH DURING FLEXION AND EXTENSION) ORIGINATE FROM THE PELVIS INNERVATED BY THE OBTURATOR NERVE A GROIN INJURY OR PULLED GROIN INVOLVES THESE MUSCLES

22 ADDUCTOR MAGNUS* LARGEST ADDUCTOR MOST DEEPLY LOCATED ATTACH TO THE LINEA ASPERA MOST MEDIAL FIBERS ATTACH TO THE ADDUCTOR TUBERCLE; THESE FIBERS ALSO EXTEND THE THIGH *OBTURATOR AND TIBIAL NERVE

23 ADDUCTOR LONGUS MOST ANTERIOR MUSCLE OF THE ADDUCTOR GROUP ARISES INFERIOR TO THE PUBIC TUBERCLE NARROW TRIANGLE SHAPED

24 ADDUCTOR BREVIS DEEP TO ADDUCTOR LONGUS THINNER AND SMALLER THAN ADDUCTOR LONGUS OBTURTOR NERVE DIVIDED INTO AN ANTERIOR AND POSTERIOR DIVISION ON EITHER SIDE OF THIS MUSCLE

25 PECTINEUS LOCATED MORE ANTERIORLY THAN THE OTHER ADDUCTORS; CAN FLEX AND ADDUCT THE THIGH LATERAL TO THE ADDUCTOR LONGUS AND MEDIAL TO THE ILIOPSOAS INNERVATION BY THE FEMORAL NERVE (MAY ALSO RECEIVE THE OBTURATOR NERVE)

26 GRACILIS LONG THIN MUSCLE, MAY BE CONFUSED WITH SARTORIUS LIES ALONG THE MEDIAL THIGH ONLY ADDUCTOR TO CROSS THE KNEE ALSO FLEXES THE LEG WILL FORM THE PES ANSERINUS ON THE MEDIAL SIDE OF THE TIBIAL WITH THE SARTORIUS AND THE SEMITENDINOSUS PES ANSERINUS

27 PES ANSERINUS: 3 TENDONS INSERTING ON THE MEDIAL TIBIA

28

29 PECTINEUS ILIOPSOAS ADDUCTOR LONGUS GRACILIS

30 FEMORAL TRIANGLE: AREA ON THE ANTERIOR SURFACE OF THE THIGH LATERAL BORDER - SARTORIUS MEDIAL BORDER - ADDUCTOR LONGUS SUPERIOR BORDER - INGUINAL LIGAMENT FLOOR (POSTERIOR WALL) - PECTINEUS, ILIOPSOAS, ADDUCTOR LONGUS FEMORAL NERVE, ARTERY AND VEIN LIE INSIDE TRIANGLE FEMORAL TRIANGLE

31 FEMORAL TRIANGLE: CONTENTS - FEMORAL NERVE, ARTERY AND VEIN (NAVEL)

32 MUSCLES OF THE GLUTEAL REGION AND POSTERIOR THIGH

33 MUSCLES OF THE GLUTEAL REGION AND THE POSTERIOR THIGH GLUTEAL REGION ON POSTERIOR SIDE OF PELVIS: EXTENDS, ABDUCTS, MEDIAL AND LATERAL ROTATION OF THE THIGH POSTERIOR THIGH: MUSCLES KNOWN AS HAMSTRINGS, EXTEND THE THIGH AND FLEX THE LEG

34 GLUTEAL MUSCLES: GLUTEUS MAXIMUS GLUTEUS MEDIUS GLUTEUS MINIMUS LATERAL ROTATORS OF THE THIGH: PIRIFORMIS OBTURATOR INTERNUS SUPERIOR AND INFERIOR GEMELLI OBTURATOR EXTERNUS QUADRATUS FEMORIS

35 GLUTEUS MAXIMUS MOST SUPERFICIAL OF THE GLUTEAL MUSCLES FIBERS SLOPE INFERIORLY AND LATERALLY AT 45º INSERTS INTO ILIOTIBIAL BAND MAJOR EXTENSOR OF THE THIGH AND LATERAL ROTATOR

36 GLUTEUS MEDIUS AND MINIMUS* ABDUCT THE THIGH AND ROTATE IT MEDIALLY *ESSENTIAL ROLE IN LOCOMOTION: PREVENTS THE UNSUPPORTED LIMB FROM DRAGGING ON THE GROUND BY KEEPING THE PELVIS LEVEL RIGHT LIMB UNSUPPORTED, LEFT MUSCLES CONTRACT TO TILT THE PELVIS

37 WHEN THE WEIGHT IS SUPPORTED BY ONE FOOT, THE MUSCLES (GLUTEUS MEDIUS AND MINIMUS) OF THAT SAME SIDE HOLD THE PELVIS SO THAT THE PELVIS WILL NOT SAG ON THE SIDE OF THE UNSUPPORTED LIMB. WHEN THE GLUTEUS MEDIUS AND MINIMUS ARE INACTIVE OWING TO INJURY OF THE SUPERIOR GLUTEAL NERVE, THE SUPPORTING AND STEADING ACTION OF THESE MUSCLES IS LOST AND THE PELVIS FALLS TO THE SIDE OF THE RAISED OR UNSUPPORTED LIMB. THIS IS THE TRENDELENBERG SIGN.

38 LATERAL ROTATORS OF THE THIGH - 6 MUSCLES DEEP TO GLUTEUS MAXIMUS ALL INSERT ON OR NEAR THE GREATER TROCHANTER

39 PIRIFORMIS TRIANGLE SHAPED ALL OTHER ROTATORS ARE LOCATED INFERIOR TO THE PIRIFORMIS SCIATIC NERVE EXITS INFERIOR KEY MUSCLE IN LOCATING OTHER STRUCTURES SCIATIC NERVE

40 LOCATION OF SCIATIC NERVE

41 OBTURATOR INTERNUS WHITE TENDON IN THE GLUTEAL REGION MUSCLE LOCATED INSIDE THE PELVIS ORIGINATES OFF THE SACRUM THE GEMELLUS SUPERIOR AND INFERIOR BORDER OBTURATOR INTERNUS

42 QUATRATUS FEMORIS THICK SQUARE- SHAPED MUSCLE LOCATED INFERIOR TO THE GEMELLUS INFERIOR STRONG LATERAL ROTATOR OF THE THIGH

43

44 GLUTEUS MAXIMUS GLUTEUS MEDIUS PIRIFORMIS SUPERIOR GEMELLUS OBTURATOR INTERNUS QUADARTUS FEMORIS GEMELLUS INFERIOR

45 INTRAGLUTEAL INJECTIONS SAFE AREA SAFE IN THE UPPER LATERAL QUADRANT

46 THE POSTERIOR THIGH HAS 3 MUSCLES COLLECTIVELY CALLED THE HAMSTRINGS BICEPS FEMORIS SEMITENDINOSUS SEMIMEMBRANOSUS THEY ARE THE EXTENSORS OF THE THIGH AND THE FLEXORS OF THE LEG INNERVATION - SCIATIC NERVE; SHORT HEAD OF BICEPS BY COMMON FIBULAR NERVE

47 BICEPS FEMORIS LATERALLY LOCATED TWO HEADS LONG AND SHORT LONG HEAD CROSSES THE HIP AND THE KNEE JOINT SHORT HEAD ONLY CROSSES THE KNEE JOINT, LIES DEEP TO LONG HEAD

48 SEMITENDINOSUS MEDIALLY LOCATED IN THE THIGH LONG CORD-LIKE TENDON INSERTS ON THE MEDIALLY SIDE OF THE KNEE ALONG WITH THE GRACILIS AND THE SARTORIUS AS THE PES ANSERINUS PES ANSERINUS

49 SEMIMEMBRANOSUS LIES DEEP THE THE SEMITENDINOSUS THICKER MUSCLE HAS A WIDE FLAT MEMBRANOUS INSERTION, THAT EXTENDS TO THE POSTERIOR SIDE OF THE KNEE

50

51 GLUTEUS MEDIUS GLUTEUS MINIMUS PIRIFORMIS SEMITENDINOSUS BICEPS FEMORIS SEMIMEMBRANOUS

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