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Anatomy

Lower Limb

Question 160 of 180

A 23 year old woman is brought to the Emergency Department after falling from a ride at an amusement park. Imaging has shown trauma to the sartorius, iliopsoas and pectineus muscles. These muscles all act together to produce which of the following movements:

Answer:

The sartorius, iliopsoas and pectineus muscles are all flexors of the thigh at the hip joint.

Anterior Thigh Muscles

The sartorius, iliacus, psoas major and pectineus (in addition to the rectus femoris of the quadriceps femoris muscle) are all flexors of the thigh at the hip joint.

Table: Function and Innervation of the Anterior Thigh Muscles

Muscle Function Innervation
Sartorius Flexion, abduction and lateral rotation at hip and flexion at knee Femoral nerve
Iliacus Flexion and lateral rotation at hip Femoral nerve
Psoas major Flexion and lateral rotation at hip Anterior rami L1 – L3
Pectineus Adduction and flexion at hip Femoral nerve

Sartorius

The sartorius is innervated by the femoral nerve. It acts to flex the thigh at the hip joint and flex the leg at the knee joint. It also abducts the thigh and rotates it laterally, as when resting the foot on the opposite knee when sitting.

Iliopsoas

The iliacus and psoas major muscles originate as separate muscles but insert by a common tendon onto the femur and together are referred to as the iliopsoas muscle, which is a powerful flexor of the thigh at the hip joint and also contributes to lateral rotation of the thigh at the hip joint. The iliacus is innervated by the femoral nerve. The psoas major is innervated by the anterior rami of spinal nerves L1 - L3.

Pectineus

The pectineus is innervated by the femoral nerve. It acts to adduct and flex the thigh at the hip joint.

Modified by FRCEM Success. Original by Henry Vandyke Carter [Public domain], via Wikimedia Commons

Anterior Thigh Muscles: Pectineus (green), Sartorius (blue), Iliacus (red), Psoas major (yellow). (Image modified by FRCEM Success. Original by Henry Vandyke Carter [Public domain], via Wikimedia Commons)

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  • Biochemistry
  • Blood Gases
  • Haematology
Biochemistry Normal Value
Sodium 135 – 145 mmol/l
Potassium 3.0 – 4.5 mmol/l
Urea 2.5 – 7.5 mmol/l
Glucose 3.5 – 5.0 mmol/l
Creatinine 35 – 135 μmol/l
Alanine Aminotransferase (ALT) 5 – 35 U/l
Gamma-glutamyl Transferase (GGT) < 65 U/l
Alkaline Phosphatase (ALP) 30 – 135 U/l
Aspartate Aminotransferase (AST) < 40 U/l
Total Protein 60 – 80 g/l
Albumin 35 – 50 g/l
Globulin 2.4 – 3.5 g/dl
Amylase < 70 U/l
Total Bilirubin 3 – 17 μmol/l
Calcium 2.1 – 2.5 mmol/l
Chloride 95 – 105 mmol/l
Phosphate 0.8 – 1.4 mmol/l
Haematology Normal Value
Haemoglobin 11.5 – 16.6 g/dl
White Blood Cells 4.0 – 11.0 x 109/l
Platelets 150 – 450 x 109/l
MCV 80 – 96 fl
MCHC 32 – 36 g/dl
Neutrophils 2.0 – 7.5 x 109/l
Lymphocytes 1.5 – 4.0 x 109/l
Monocytes 0.3 – 1.0 x 109/l
Eosinophils 0.1 – 0.5 x 109/l
Basophils < 0.2 x 109/l
Reticulocytes < 2%
Haematocrit 0.35 – 0.49
Red Cell Distribution Width 11 – 15%
Blood Gases Normal Value
pH 7.35 – 7.45
pO2 11 – 14 kPa
pCO2 4.5 – 6.0 kPa
Base Excess -2 – +2 mmol/l
Bicarbonate 24 – 30 mmol/l
Lactate < 2 mmol/l

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