05.46 Thigh II Flashcards
- What is the role of the deep fascia?
Prevents bulging of muscles
- What is the deep fascia made of? And what is it between? Where is it strongerst?
Dense layer of connective tissue between the muscles of the thigh and the superficial fascia
Very strong on anterior and lateral thigh
- What is the iliotibial tract (band)?
A lateral thickening of the Deep Fascia
- What is the deep fascia/fascia lata attached to superiorly and inferiorly?
Inguinal Ligament
Parts of hip bone (Pubic bone, iliac crest, Ischial tuberosity)
Sacrum and coccyx
Scarpa’s fascia and the sacrotuberous ligament
Inferiorly at the knee joint is continuous with the crural fascia
- What are the fascia lata’s three septas/compartments?
Lateral intermuscular septa
Medial intermuscular septa
Posterior intermuscular septa
- What action does the anterior compartment perform? What is the nerve? What are the muscles in the anterior compartment?
Flex hip and extends knee
Femoral Nerve
Sartorius Rectus femoris Vastus lateralis Vastus medialis Vastus intermedius Articularis genu Psoas major Iliacus Tensor fascia latae
- Give the attachment points of the Sartorius muscle
ASIS – superior medial surface of tibia
- Where does the rectus femoris attach?
AIIS – patella
- Where does the vastus lateralis attach?
Linea aspera – patella
- Where does the vastus medialis attach?
Linea aspera – patella
- Where does the vastus intermedius attach?
Femur body – patella
- Where does the articularis genu attach?
Anterior femur – synovial membrane of knee
- Where does the psoas major attach?
Lumbar vertebrae – lesser trochanter
- Where does the iliacus attach?
Iliac crest and fossa – lesser trochanter of femur
- Where does the tensor fascia latae attach?
ASIS - iliotibial tract
- What kind of action does the medial compartment of muscles perform? What is the nerve of this compartment? Give the muscles that make up the medial compartment.
Adductor group
Obturator nerve
- Pectineus:
- Adductor longus:
- Adductor brevis
- Adductor magnus:
- Gracilis:
- Obturator externus
- What does the pectineus attach to? Innervation?
Superior ramus of pubis – pectineal line of femur
Femoral and obturator nerves
- What does the adductor longus attach to?
Body of pubic bone – linea aspera
- Attachment for adductor brevis?
Inferior ramus of pubic bone – linea aspera
- Attachment for adductor longus?
Body of pubic bone – linea aspera
- What are the two parts of the adductor magnus? Give each’s attachment points and nerves
Adductor part: Ischiopubic ramus – linea aspera
Obturator nerve
Hamstring part: Ischial tuberosity – adductor tubercle of femus
Tibial nerve
- What is the attachment for the Gracilis muscle?
Inferior ramus of pubis – superior part of medial surface of tibia
- What are the attachments of the obturator externus?
Margins of obturator foramen/membrane – trochanteric fossa of femur
- What kinds of muscles does the posterior compartment have? What action? Nerve of compartment?
Hamstring muscles (except the short head of biceps femoris) Act on two joints – extend hip and flex knee Tibial nerve
- What are the attachments for the biceps femoris? Nerve?
Long head: Ischial tuberosity – Fibular head
Innervated by tibial nerve
Short head: Linea aspera – Fibular head
Innervated by the common peroneal nerve
- What are the attachment points of the semitendinosus?
Ischial tuberosity – medial surface of upper tibia
- What are the attachments points of the semimembranosus?
Ischial tuberosity – medial tibial condyle
28. Give the following boundaries of the femoral triangle Superior Medial Lateral Base Apex Roof Floor
Superior - inguinal ligament
Medial - medial border of adductor longus
Lateral - medial border of Sartorius
Base – inguinal ligament
Apex - where the sartorius crosses the adductor longus
Roof - fascia lata
Floor - iliopsoas and pectineus muscles
- Give the contents of the femoral triangle
femoral artery and branches femoral vein and branches femoral nerve and branches lymphatic vessels and nodes Femoral sheath
- What is the femoral sheath and what compartment does it contain?
It is a funnel-shaped fascial tube
Lateral
Intermediate
Medial – femoral canal
- Femoral hernias usually start where?
Femoral ring
- Where does the adductor canal extend to? (aka subsartorial/Hunter’s canal)
Extend from the apex of the femoral triangle to the adductor hiatus in the adductor
- What are the boundaries of the adductor canal?
Anteromedial – Sartorius
Lateral - vastus medialis
Posterior - adductor longus and magnus
- What are the contents of the adductor canal?
Femoral artery and vein
Saphenous nerve
Nerve to vastus medialis
- What lumbar levels is the femoral nerve and how does it size compare to other branches of the lumbar plexus? What does it travel under to enter? How is it unlike the femoral artery and vein? Position to femoral artery?
Femoral nerve (L2,L3,L4)
Is the largest branch of lumbar plexus
Travels under the inguinal ligament to enter the femoral triangle
Unlike femoral artery/vein, is not enclosed by the femoral sheath
Lies lateral to the femoral artery
- What are the sensory branches of the femoral nerve?
Medial femoral cutaneous nerve
Intermediate femoral cutaneous nerve
Saphenous nerve
- What does the saphenous nerve travel through and what does it innervate?
Adductor canal
Innervate skin of leg and foot
- What muscles does the femoral nerve provide motor branches to? What is the exceptional muscle that receives nerves from both femoral and another nerve? Name it and the other nerve
Sartorius
Quadriceps femoris
Articularis genu
Pectineus
Pectineus –also innervated by branch of obturator nerve
- The obturator nerve divides into what divisions in the obturator foramen? Where are these divisions located between?
Anterior division
Located between adductor longus and brevis
Posterior division
Located between adductor brevis and magnus
- What do the two divisions of the obturator nerve innervate?
Anterior Adductor longus Gracilis Adductor brevis Pectineus (partly) Posterior Obturator externus adductor brevis adductor magnus
- The femoral artery is a continuation of? How does it enter the thigh and what is its position in relation to the femoral vein?
Continuation of external iliac artery
Enter thigh by passing below the inguinal ligament, lateral to the femoral vein
- What are the branches of the femoral artery in the thigh?
Superficial circumflex iliac Superficial epigastric Superficial and deep external pudendal Lateral femoral circumflex Medial femoral circumflex Profunda femoris
- What arteries compose the cruciate anastomosis?
1st perforating a
Medial femoral circumflex a
Lateral femoral circumflex a
Inferior gluteal a
- What is the obturator artery a branch of?
Internal iliac a
- What does the popliteal fossa contain and where is it?
Fat filled
Diamond space at the back of the knee
- What are boundaries of the popliteal fossa?
Inferomedial and inferolateral –gastrocnemius muscle
Superolateral –biceps femoris
Superomedial –semimembranosus tendon
Floor –popliteal surface of femur and posterior knee ligaments
- What are the contents of the popliteal fossa?
End of small saphenous vein Popliteal vessels and branches Tibial and common peroneal nerves Posterior cutaneous nerve of thigh Popliteal lymph nodes and vessels
