WHATSAPP SOUND CLIPS PROJECT
16.MAY.2014 FRIDAY
1. Lumbar plexus, upper component of lumbosacral plexus @ the posterior abdominal wall anterior to the
lumbar transverse processes and around the psoas major muscle
2. Lumbar plexus first 4 lumbar spinal nerves anterior rami + a contribution up (T12-subcostal)+ a
contribution down (L5)
3. L4 + L5 anterior rami= Lumbosacral trunk
4. Femoral nerve exists from the lateral side of psoas major, innervates iliacus , then passes under inguinal
ligament and innervates anterior thigh muscles
5. Obutator nerve exists from the medial side of psoas major,passes through the obturator canal and
innervates muscles in the medial thigh
6. Two main nerves of the lumbar plexus femoral and obturator nerves are formed by the L2-L4 anterior
rami
17.MAY.2014 SATURDAY
7. Lumbosacral trunk (L4, L5) is a branch of the lumbar plexus , but passing over the ala of sacrum goes
down in the pelvis and contributes to formation of the sacral plexus
8. Both ilio “iliohypogastric” ve “ilioinguinal” from L1, over/anterior to quadratus lumborum , superior to
iliac crest, innervated abdominal muscles and also skin over the inguinal ve pubic regions
9. Genitofemoral L1-2 pierces psoas major, lateral to common ve external iliac arteries into femoral and
genital branches
10. Lateral cutaneous nerve of the thigh (L2, L3), over iliacus, medial to ASIS passes under the inguinal
ligament, skin over the anterolateral thigh
11. L1 upper branch (ilios), lower branch (genitofemoral) L2,3 and 4 ventral and dorsal branches: from here
femoral and obturator nerves
12. Femoral nerve iliacus, pectineus and flexors of the hip and extensors of the knee: anterior thigh nerve of
quadriceps femoris and sartorius
13. Femoral nerve skin innervastion: anterior and lateral thigh, medial leg and foot
14. Femoral nerve enters the inguinal ligament midpoint @ ASIS and pubic tubercle, fingerbreadth lateral to
the femoral pulse (artery))
15. Saphaneous nerve the biggest cutaneous branch of femoral nerve. Enters the adductor canal.
Saphaneous skin nerve of leg and foot medial side
16. Obturator nerve external oblique, thigh adductor muscles, pectineus (some), adductor longus, magnus,
brevis and gracilis and skin over superior medial thigh
17. Sacral plexus S1-S4 anterior rami+ Lumbosacral trunk (L4 and 5). Lumbosacral trunk is shared by the two
plexuses
18. Sacral plexus @ pelvis posterolateral wall related to anterior aspect of the piriformis, in the lesser pelvis,
main two nerves sciatic and pudendal nerves external to parietal pelvic fascia
19. Most branches of the sacral plexus leave the pelvis through the greater sciatic foramen. Some not only
through here but also through the lesser sciatic foramen.
20. Sacral spinal nerves of the plexus pass out of the anterior sacral foramina and course laterally and
inferiorly on the pelvic wall.
21. L4 ant. ramus some and full L5 ant. rami=lumbosacral goes vertically from abdomenden to pelvic cavity
passing just anterior to sacroiliac joint
22. Each ramus has ventral and dorsal divisons. Peripheric nerves are formed by the union of ventral or
dorsal divisions. S4 ant. ramus has only ventral divison
23. Sacral plexus branches sciatic, gluteal nerves, pudendal nerve: related to perineum. For most greater
sciatic foramen is the gateway into pelvis from the gluteal region. Some stay in pelvis and innervate muscles
there
ASIS: Anterior superior iliac spine
VAN: Under the inguinal ligament in the femoral triangle from medial to lateral the order: Femoral vein, artery,
nerve
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24. Two nerves pass through the greater sciatic foramen+ pass also through the lesser sciatic forman
medially and enter perineum and lateral pelvic wall: the nerve to obturator internus and pudendal nerve
25. Sup. ve inf. gluetal nerves innervate gluteal region, pudendal nerve perineum, sciatic nerve thigh
26. Sciatic nerve largest peripheral nerve.SCIA=L4-S3 combine anterior to piriformis and its lower border.
Passes under piriformis and through the greater sciatic foramenden into the gluteal region; the most lateral
structure in this foramen
27. Sciatic nerve passes through the plane between superficial and deep gluteal muscles and innervates
posterior thigh, entire leg and foot muscles. Besides the joints of all joints of the lower limb
28. Sciatic nerve passes to the thigh under gluteus maximus midway between ischial tuberosity and greater
trochanter. Innervates nothing @ gluteal region .Sensory information: foot and lateral leg
29. Sciatic nerve divides into two branches in the thgih: common fibular (common peroneal) and tibial
nerves .L4-S2 dorsal divisions make the common fibular nerve , whereas L4-S3 ventral divisions carried by
the tibial part
30. Tibial nerve & common fibular nerve loosely bound together in the same connective tissue sheath. They
usually separate in the distal thigh; but sometimes as they leave the pelvis
31. Pudendal nerve S2-S4 main nerve of perineum, chief sensory nerve of external genital region. Most
medial nerve @ greater sciatic foramen
32. Other branches of sacral plexus into gluteal region, pelvic wall & pelvic floor: superior and inferior gluteal
nerves, nerve to obturator internus and superior gemellus
32. Also belonging to sacral plexus: nerve to quadratus femoris and inferior gemellus, nerve to piriformis,
nerves to levator ani
33. Posterior cutaneous nerve of thigh: branch of sacral plexus getting skin sensory information from the
inferior gluteal region, posterior thigh, and upper leg. The nerve that gets the largest area of sensory
information in the body
34. Perforating cutaneous nerve of thigh: other branch of sacral plexus. Its feaure: not through sciatic
foramina but passes through (by piercing),sacrotuberous ligament. Nerve of the skin over the medial aspect
of gluteus maximus
35. And pelvic splanchnic nerves exit from sacral plexus’s S2-S4 spinal nerves. Carry parasympathetic
fibers. Other than in the brain, the parasympathetic system @ this level
36. The small coccygeal plexus: a little contribution from S4, mainly S5 & Co (coccyeal nerve) anterior rami.
Innervates anal triangle @ lower part of perineum
37. Gluteal bölge gövde ve serbest alt eksremite arası geçiş yeri. Pelvis kemiği posterolateralinde ve
femur’un üstteki proximal ucunda yer alır (20 sözcük)
38. Gluteal bölge kasları genellikle femur’a pelvik kemiğe göre abduksiyon, ekstensiyon ve lateral rotasyon
yaptırırlar (14 sözcük)
39. Gluteal bölge ön ve içte greater sciatic foramenle pelvik boşlukla, lesser sciatic formanle de perineumla
iletişim halinde (17 sözcük)
40. Gluteal bölgede: iki yer belirgin arka kısım buttock, ve lateralde kalça eklemi ve greater trochanter
üzerinde yer alan daha az belirgin hip bölgesi (regio coxae) (25 sözcük)
41. Gluteal region is bounded superiorly by the iliac crest, medially by the intergluteal cleft, and inferiorly by
the gluteal fold (L. sulcus glutealis), laterally by a line joining anterior superior iliac spine and greater
troachanter.
42. Gluteal region:superficial fascia full of fat, deep fascia continuous below with the deep fascia, or fascia
lata of the thigh
43. Iliotibial tract: fascia lata thickening on the lateral side of thigh. Iliotibial tract between tubercle of iliac
crest and lateral condyle of tibia. Greater part of gluteus maximus attaches on iliotibial tract
44. Iliotibial tract stabilizes the knee both in extension and in partial flexion, used constantly during walking
and running.
45. Superficial gluteal group of larger muscles: 3. Starting with gluteus (maximus, medius and minimus).
Mainly abduct and extend the hip. Hip and thigh work together just like shoulder and arm
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46. Deep gluteal muscles: Lateral rotation of thigh at the hip joint. Piriformis, obturator internus, gemellus
superior, gemellus inferior, and quadratus femoris (obturator externus @ medial thigh)
47. Another gluteal muscle: tensor fasciae latae stabilizes the knee in extension by acting on iliotibial tract
48. Many of the important nerves in the gluteal region are in the plane between the superficial and deep
groups of muscles
49. Gluteus maximus: largest muscle in the body, superficial in the gluteal region, poweful extensor of flexed
thigh at the hip joint. via iliotibial tract, stabilizes the knee and hip joints.
50. Gluteus maximus laterally rotates and abducts thigh; steadies thigh and assists in rising from sitting
position Nerve: Inferior gluteal nerve
51. Gluteus medius & minimus: abduct and medially rotate thigh, keep pelvis level when ipsilateral limb is
weight-bearing and advance opposite (unsupported) side during its swing phase. Nerve: Superior gluteal
nerve. Also nerve of tensor fascia lataee.
52. Piriformis: most superior of deep gluteal muscles. Lateral rotation and abduction of thigh, L5-S2 nerve to
piriformis. A landmark muscle
53. Nerve to quadratus femoris: Unlike others lies anterior to the plane of deep gluteal muscles. Nerve of
Quadratus femoris and inf. gemellus muscle up
54. Nerve to obturator internus: Nerve of obturator internus of course and of superior gemellus up. Passes
through lesser sciatic foramen
55. Superior and inferior gluteal arteries branches of internal iliac artery. The gluteal veins are tributaries of
the internal iliac veins that drain blood from the gluteal region
19.MAY.2014 MONDAY
56. Femoral region=thigh; region of free lower limb between gluteal, abdominal, and perineal regions
proximally and the knee region distally.
57. Femoral region: anteriorly, separated from the abdominal wall by the inguinal ligament; posteriorly,
from the gluteal region by gluteal fold superficially, by inferior margins of the gluteus maximus and
quadratus femoris on deeper planes.
58. Posteriorly thigh continous with gluteal region; major structure passing through= sciatic nerve. Medially
between thigh and pelvic cavity through the obturator canal: structures passing through this canal:
obturator nerve and associated vessels
59. Anteriorly thigh communicates with abdominal cavity through aperture between inguinal ligament and
pelvic bone. Major structures passing through here: iliopsoas, pectineus, VAN (femoral vein, artery, nerve),
lymphatic vessels
60. Vessels and nerves passing between the thigh and leg pass through the popliteal fossa posterior to the
knee joint.
61. Deep fascia of thigh (fascia lata) attached to the pelvis and the inguinal ligament. Saphenous
hiatus(opening) in the fascia lata just below the inguinal ligament. Great saphenous vein through hiatus
saphenus to drain into femoral vein.
62. Anterior compartment of thigh muscles: mainly extend the leg at the knee joint (Femoral nerve);Medial
compartment: adduct the thigh at the hip joint (obturator nerve); posterior: extend the thigh at the hip joint
and flex the leg at the knee joint (sciatic nerve) FOS
63. Femoral triangle: Major artery, vein and lymphatic channels enter thigh anterior to pelvic bone here
inferior to inguinal ligament. Inguinal ligament between ASIS & pubic tubercle
64. Inguinal ligament formed by the most inferior part of the aponeourosis of the external oblique muscle
65. Anterior thigh muscles: sartorius and the four large quadriceps femoris muscles (rectus femoris, vastus
lateralis, vastus medialis, and vastus intermedius) + iliopsoas: chief flexor of thigh
66. Sartorius: Longest muscle of the body. Act both on hip and knee joints. Flexes hip and participates in
flexion of knee. weakly abducts thigh and laterally rotates it. Cross-legged sitting position.
67. Quadriceps femoris: great extensor of the leg. rectus femoris assists flexion of the thigh. vastus muscles
stabilize the position of the patella during knee joint movement.
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68. Medial compartment of thigh contains six muscles (gracilis, pectineus, adductor longus, adductor brevis,
adductor magnus), obturator externus. All innervated by obturator nerve:except pectineus by femoral nerve
(partly obturator), hamstring part of adductor magnus by sciatic nerve,
69. Adductor longus/magnus adduction of the thigh, its medial rotation.Pectineus addition to these two
fxns; flexion of the thigh, adductor brevis adduction of the thigh
70. Gracilis an exception: only adductor/medial thigh muscle crossing knee: Adducts thigh; flexes leg; helps
rotate leg medially
20.MAY.2014 TUESDAY
71. Hamstring muscles: All posterior thigh muscles except short head of biceps femoris. Biceps femoris long
head, semitendinosus, semimembranosus: Tibial nerve, origin: ischial tuberosity, extensors of hip, flexors of
knee/leg
72.Gracilis, sartorius, semitendinosus tendons attach on medial surface of superior tibia and form pes
anserinus. GS TS . Stabilizes medial part of knee, iliotibial band lateral part of knee.
73. External iliac artery after passing under inguinal ligament becomes femoral artery. Branches: Superficial
circumflex iliac artery, superficial epigastric artery, superficial & deep external pudendal arter, a. profunda
femoris, descending genicular artery
74. Superficial veins of the thigh and leg: dorsal venous arch on dorsum of the foot: medially originating from
here great saphenous vein:drains into femoral vein, originating from lateral side of the arch: small
saphaneous vein drains into popliteal vein
75. Thigh sensory innervation: lateral sides of the thigh and the knee (lateral cutaneous nerve of thigh),
anterior: intermediate;medial medial cutaneous nerve of thigh; these two of the femoral nerve; posterior
(post. cutaneous nerve of thigh
76. Femoral triangle: superiorly inguinal ligament, medially adductor longus medial margin, laterally
sartorius. @ the triangle: femoral vein, artery, nerve, femoral sheath ve deep inguinal lymph nodes
77. Femoral sheath encloses femoral artery and vein, also femoral canal most medially. Medial to the canal
lacunar ligament, superiorly inguinal ligament, posteriorly pelvic bone. Here is where the femoral hernia
ocur. Weak
78. Adductor canal: Hunter canal: @ mid 1/3 of thigh, under sartorius. Through the canal saphaneous nerve,
nerve to vastus medialis, obturator nerve terminal branches, femoral artery and vein , deep lymph vessels
pass
79. Adductor canal bordered anteriorly and laterally vastus medialis, posteriorly adductor longus/magnus
and anterior wall sartorius. Finishes as adductor hiatus formed by tendons of adductor magnus
80. Popliteal fossa: biceps femoris superolateral border, semimembranosus superomedial border,
inferomedial and inferolateral borders gastrocnemius medial and lateral heads. Femoral artery leaves the
adductor canal and becomes popliteal artery
81. In the Popliteal fossa: small saphaneous vein, popliteal artery/vein, tibial/common fibular nerves, post.
cutaneous nerve of thigh, popliteal lymph nodes and vessels
82. Sciatic nerve over the popliteal fossa (1/3 lower thigh) divides into tibial and common fibular nerves.
Tibial nerve goes vertically down in the popliteal fossa and exits from margin of plantaris and runs in the
posterior leg compartment
83. Common fibular nerve by the medial border of biceps femoris tendon, @ lateral part of popliteal fossa,
swings around the fibular neck and enters the lateral leg compartment
84. Popliteal artery branches: 4 arteries; superior and inferior (med./lat.) genicular arteries. Lateral to
midline of the leg divides into anterior and posterior tibial arteries
85. Leg (L. regio cruris) part between knee and ankle joint. Deep fascia=crural fascia. 2 intermuscular
septum and interosseus membrane divides the leg into 3: lateral, anterior and medial compartments
86. Antriorly thickening of deep fascia= superior extensor retinaculum passes from fibula to tibia proximal to
malleoli, inf. extensor retinaculum Y shaped band attaching to calcaneus
87. Laterally sup. and inf. peroneal retinaculum between calcaneus and lat. malleoulu, holding the tendons
of peroneus muscles. Flexor retinaculum between calcaneus medial surface and medial malleolus 88.
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Anterior leg muscles: tibialis anterior, extensor digitorum longus and hallucis, fibularis tertius. Dorsiflexion.
Nerve: Deep peroneal nerve. Tibialis ant. and tibialis post. @ post. leg together= inversion of the ankle/foot
89. Lateral leg muscles: Peroneus longus and brevis, wekaly plantarflex the ankle and eversion. Nerve:
Superficial peroneal nerve
90. Posterior leg superficial muscles: Gastrocnemius; medial & lateral heads, below soleus, common tendon
Aschilles tendon, plantaris @ superiorly and on the lateral side. Plantarflex the ankle.. Gastrocnemius when
knee extended, soleus in any position
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21.MAY.2014 WEDNESDAY
91. Posterior deep leg muscles: Popliteu weak flexio of the knee and unlocks the extended knee and starts its flexion.
Flexor digitorum longus: Flexion of the 4 toes, hallucis of the big toe, tibialis posterior in the middle:
overlying tibial nerve and posterior tibial artery
92. Nerve of all the posterior leg muscles: Tibial nerve. Flexor hallucis longus @ side of little toe, supports
the medial longitudinal arch of the foot, whereas longus all the longutidinal arches; both also plantarflexion
93. Popliteal artery passes through gastrocnemius/soleus, with tibial nerve aside through two heads of
soleus. Divides into two branches. Posterior tibial artery branches: Circumflex fibular artery, fibular artery,
nutrient artery of tibia (larges nutrient artery)
94. Deep fascia divides the foot into 5 compartments: lateral sole, medial sole, central sole, interosseus
compartment, dorsal compartment. Plantar aponeurosis formed by the thickening of deep fascia of the sole
of the foot
95. Two muscles @ dorsum of the foot: extensor digitorum brevis and hallucis brevis. Nerve: Deep peroneal
nerve, @ sole of the foot muscles are in 4 layers
96. Sole-1st layer: Abductor hallucis & digiti minimi, in the middle flexor digitorum brevis, 2nd layer:
quadratus plantae, lumbricals, 3rd: flexor hallucis & digiti minimi brevis, adductor hallucis, 4th:
dorsal/plantar interossei
97. Tarsal Tunnel is under flexor retinaculum; from anterior to posterior passing: tendon tibialis post./flexor
digitorum longus, post. tibial artery, tibial nerve, flexor hallucis longus tendon (MMANbigtoe)
98. Post. tibial artery pulse is taken under flexor retinaculum midway between medial malleolous and
calcaneous
99. Tibial nerve, after passing through the Tunnel divides into lateral and medial plantar nerves. Lateral
plantar the maim motor muscle of the sole of the foot. Medial: abductor hallucis, flexor digitorum and
hallucis brevis, 1. lumbrical muscles
100. Ant. tibial artery passes between the two malleoli and becomes dorsalis pedis artery. Deep plantar
artery a branch of ant. tibial artery joins the lateral plantar artery; branch of post. tibial artery and forms the,
deep plantar arch of foot.
101. Sensory innervtion of the dorsum of the foot: Superficial peroneal nerve except web space between 1.2. toes, that space by deep peroneal, medial leg until the 1. Metatarsal and medial side of the sole of the
foot by saphaneous nerve
102. 3.5 medial toes, more than 2/3 of sole skin nerve medial plantar nerve, just like median nerve in the
hand, 1.5 toes, 1/3 sole by lateral plantar nerve
103. Dorsalis pedis branches: lateral & medial tarsal branches, arcuate artery, deep plantar artery, 1.dorsal
metacarpal artery, other 4 of them from arcuate
104. From the deep plantar arch: a digital branch to the lateral side of little toe, 4 plantar metatarsal
arteries, 3 perforating arteries. Other branch of post. tibial artery medial plantar artery; a superficial branch
from this artery joins with plantar metatarsal arterleries
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