Gluteal Region/Thigh

• Narrow passageway in middle third of thigh
• Extends from apex of femoral triangle down to the adductor hiatus in the tendon of the adductor magnus
• Bounded: Anteriorly and laterally by vastus medialis; Posteriorly by adductors longus and magnus; medially by sartorius
• Carries: femoral artery and vein, saphenous nerve, and nerve to vastus medialis

• An opening between the aponeurotic distal attachment of the adductor part of the adductor magnus and the tendinous distal attachment of the hamstring part
• Transmits femoral a. and v. from adductor canal into popliteal fossa

• Bounded superiorly by the inguinal ligament (forms base)
• Bounded inferomedially by the lateral border of the adductor longus
• Bounded inferolaterally by the sartorius
• Contains (lateral to medial): NAVEL
• -femoral Nerve
• -femoral Artery
• -femoral Vein
• -Empty space
• -Lymph nodes

• Proximal Attachment: AIIS and ilium superior to acetabulum
• Distal Attachment: Via quadriceps tendon and independent attachments to base of patella; indirectly via patellar ligament to tibial tuberosity
• Innervation: Femoral n. (L2, L3, L4)
• Main Actions: Extend leg at knee joint; steadies hip joint and helps iliopsoas flex thigh

• Proximal Attachment: Greater trochanter and lateral lip of linea aspera of femur
• Distal Attachment: Via quadriceps tendon and independent attachments to base of patella; indirectly via patellar ligament to tibial tuberosity; tibia and patella via aponeuroses (lateral patella retinacula)
• Innervation: Femoral n. (L2, L3, L4)
• Main Actions: Extend leg at knee joint

• Proximal Attachment: Intertrochanteric line and medial lip of linea aspera of femur
• Distal Attachment: Via quadriceps tendon and independent attachments to base of patella; indirectly via patellar ligament to tibial tuberosity; tibia and patella via aponeuroses (medial patella retinacula)
• Innervation: Femoral n. (L2, L3, L4)
• Main Actions: Extend leg at knee joint; VMO moves patella medially

• Proximal Attachment: Anterior and lateral surfaces of shaft of femur
• Distal Attachment: Via quadriceps tendon and independent attachments to base of patella; indirectly via patellar ligament to tibial tuberosity
• Innervation: Femoral n. (L2, L3, L4)
• Main Actions: Extend leg at knee joint

• Proximal Attachment: ASIS and superior part of notch inferior to it
• Distal Attachment: Superior part of medial surface of tibia
• Innervation: Femoral n. (L2, L3)
• Main Actions: Flexes, ABducts, and laterally rotates thigh at hip joint; flexes leg at knee joint, (medially rotating leg when knee is flexed)

• Proximal Attachment: Superior ramus of pubis
• Distal Attachment: Pectineal line of femur just inferior to lesser trochanter
• Innervation: Femoral n. (L2, L3), may receive branch of obturator nerve
• Main Actions: ADducts and flexes thigh; assists with medial rotation of thigh

• Proximal Attachment: Body and inferior ramus of pubis
• Distal Attachment: Superior part of medial surface of tibia
• Innervation: Obturator n. (L2, L3)
• Main Actions: ADducts thigh; flexes leg; helps rotate leg medially

• Proximal Attachment: Body of pubis inferior to pubic crest
• Distal Attachment: Middle third of linea aspera of femur
• Innervation: Obturator n., branch of anterior division (L2, L3, L4)
• Main Actions: ADducts thigh

• Proximal Attachment: Body and inferior ramus of pubis
• Distal Attachment: Pectineal line and proximal part of linea aspera of femur
• Innervation: Obturator n., branch of anterior division (L2, L3, L4)
• Main Actions: ADducts thigh; to some extent flexes it

• Proximal Attachment: Adductor part: inferior ramus of pubis, ramus of ischium. Hamstring part: ischial tuberosity
• Distal Attachment: Adductor part: gluteal tuberosity, linea aspera, medial supracondylar line. Hamstring part: adductor tubercle of femur
• Innervation: Adductor part: obturator n. (L2, L3, L4), branches of posterior division. Hamstring part: tibial part of sciatic n. (L4)
• Main Actions: ADducts thigh. Adductor part: flexes thigh. Hamstring part: extends thigh

• Proximal Attachment: ASIS; anterior part of iliac crest
• Distal Attachment: IT band which attaches to the lateral condyle of tibia (Gerdy's tubercle)
• Innervation: Superior gluteal n. (L4-S1)
• Main Actions: ABduct and medially rotate thigh; weakly flexes thigh; keep pelvis level when ipsilateral limb is weight-bearing and advance opposite (unsupported) side during its swing phase

• Proximal Attachment: Ilium posterior to posterior gluteal line (PSIS); dorsal surface of sacrum and coccyx; sacrotuberous ligament
• Distal Attachment: Most fibers insert into IT band which inserts on the lateral condyle of tibia; some fibers insert on gluteal tuberosity
• Innervation: Inferior gluteal n. (L5, S1, S2)
• Main Actions: Extends thigh (especially from flexed position) and assists in lateral rotation; steadies thigh and assists in rising from sitting position

• Proximal Attachment: External surface of ilium between anterior and posterior gluteal lines
• Distal Attachment: Lateral surface of greater trochanter of femur
• Innervation: Superior gluteal n. (L5, S1)
• Main Actions: ABduct and medially rotate extended thigh; externally rotates flexed thigh; keep pelvis level when ipsilateral limb is weight-bearing and advance opposite (unsupported) side during its swing phase

• Proximal Attachment: External surface of ilium between anterior and inferior gluteal lines
• Distal Attachment: Anterior surface of greater trochanter of femur
• Innervation: Superior gluteal n. (L5, S1)
• Main Actions: ABduct and medially rotate extended thigh; externally rotates flexed thigh; keep pelvis level when ipsilateral limb is weight-bearing and advance opposite (unsupported) side during its swing phase

• Proximal Attachment: Anterior surface of sacrum; sacrotuberous ligament
• Distal Attachment: Superior border of greater trochanter of femur
• Innervation: Branches of anterior rami of S1, S2
• Main Actions: Laterally rotate extended thigh and ABduct flexed thigh; steady femoral head in acetabulum

• Proximal Attachment: Ischial spine
• Distal Attachment: Medial surface of of greater trochanter of femur
• Innervation: Nerve to obturator internus (L5, S2)
• Main Actions: Laterally rotate extended thigh and ABduct flexed thigh; steady femoral head in acetabulum

• Prxoimal Attachment: Ischial tuberosity
• Distal Attachment: Medial surface of greater trochanter of femur
• Innervation: Nerve to quadratus femoris (L4, L5, S1)
• Main Actions: Laterally rotate extended thigh and ABduct flexed thigh; steady femoral head in acetabulum

• Proximal Attachment: Pelvic surface of obturator membrane and surrounding bones
• Distal attachment: Medial surace of greater trochanter of femur
• Innervations: Nerve to obturator internus (L5-S2)
• Main Actions: Laterally rotate extended thigh and ABduct flexed thigh; steady femoral head in acetabulum

• Proximal Attachment: External margins of obturator foramen and obturator membrane
• Distal Attachment: Trochanteric fossa of femur
• Innervation: Obturator n. (L3, L4)
• Main Actions: Laterally rotates and ADducts thigh; steadies head of femur in acetabulum

• Proximal Attachment: Lateral border of ischial tuberosity
• Distal Attachment: Quadrate tubercle on intertrochanteric crest of femur and area inferior to it
• Innervation: Nerver to quadratus femoris (L4, S1)
• Main Actions: Laterally rotates thigh; steadies femoral head in acetabulum

• Proximal Attachment: Ischial tuberosity
• Distal Attachment: Posterior part of medial condyle of tibia; reflected attachment forms oblique popliteal ligament (to lateral femoral condyle)
• Innervation: Tibial division of sciatic nerve (L5, S1, S2)
• Main Actions: Extend thigh; flex leg and rotate it medially when knee is flexed; when thigh and leg are flexed, can extend trunk

• Proximal Attachment: Ischial tuberosity
• Distal Attachment: Medial surface of superior part of tibia
• Innervation: Tibial division of sciatic nerve (L5, S1, S2)
• Main Actions: Extend thigh; flex leg and rotate it medially when knee is flexed; when thigh and leg are flexed, can extend trunk

• Proximal Attachment: Long head: Ischial tuberosity. Short head: Lateral lip of linea aspera and lateral supracondylar line of femur
• Distal Attachment: Lateral side of head of fibula; tendon is split at this site by fibular colateral ligament of knee
• Innervation: Long head: tibial division of sciatic nerve (L5, S1, S2). Short head: Common fibular division of sciatic nerve (L5, S1, S2)
• Main Actions: Flexes leg and rotates is laterally when knee is flexed; extends thigh

• Iliopsoas
• Sartorius
• Tensor Fasciae Latae
• Rectus Femoris
• Pectinues
• Adductor Longus
• Adductor Brevis
• Adductor Magnus - anterior to part
• Gracilis

• Semitendinosus
• Semimembranosus
• Biceps Femoris - Long head
• Adductor Magnus - posterior part
• Gluteus Maximus

• Gluteus Medius
• Gluteus Minimus
• Tensor Fasciae Latae

• Adductor Longus
• Adductor Brevis
• Adductor Magnus
• Pectineus
• Gracilis
• Obturator Externus

• Piriformis
• Superior Gemellus
• Obturator Internus
• Inferior Gemellus
• Obturator Externus
• Quadratus Femoris
• Gluteus Maximus

(P GO GO Q Glut Max)

• Gluteus Medius - anterior part
• Gluteus Minimus - anterior part
• Tensor Fasciae Latae

• Goes from dorsum of foot, wraps up behind knee, and then follows sartorius up to femoral triangle where it goes through the saphenous opening (in fascia) and into femoral v.
• Drains: anything superficial in area

Comes up posterolateral side of lower leg, between heads of gastrocnemeus, and into back of knee to join popliteal v.

• Roots: Femoral n. from lumbar plexus (L3, L4)
• Innervates: skin of medial lower leg and foot

Contains: popliteal a. (genicular branches); popliteal v.; small saphenous v.; sciatic n. (tibial n., common peroneal n. and sural n.)

• Roots: Sacral plexus (S1, S2, S3)
• Innervates: skin of posterior thigh and skin over popliteal fossa

• Roots: Tibial and common peroneal nn. (S1, S2)
• Innervates: skin of posterior lateral leg and lateral margin of foot

• Roots: sacral plexus (L4-S3)
• Innervates: muscles of poterior compartment of thigh

• Roots: Sacral plexus (L4-S1)
• Innervates: gluteus medius, gluteus minimus, TFL

• Roots: Sacral plexus (L5-S2)
• Innervates: gluteus maximus

• Roots: Sacral plexus (L4-S1)
• Innervates: hip joint, inferior gemellus, quadratus femoris

• Roots: Sacral plexus (S2-S4)
• Innervates: perineum

• Roots: Sacral plexus (L5-S2)
• Innervates: superior gemellus, obturator internus