15. Spaces Flashcards
Borders of the Femoral canal
- Anterior: inguinal ligament + fascia lata
- Medial: fascia of pectineus muscle
- Lateral: femoral vein
* The femoral canal is not a real canal. It is called a canal only if a hernia occurs.
Contents of the Femoral canal
- lymph vessels & lymph nodes (Rosenmuller’s, Cloquet’s, Deep inguinal lymph nodes)
The Femoral canal is the medial compartment of femoral sheath
→ femoral canal opens inferiorly to (1)____ and superiorly to abdominal cavity at (2)____ (here clinically is important as a site of femoral hernia)
- saphenous hiatus
- the femoral ring
Borders of Femoral ring
- Superior: inguinal lig of Poupart
- Inferior: pubic periosteum, Cooper’s lig
- Lateral: femoral vein
- Medial: lacunar lig of Gimbernat (this ligament connects the inguinal ligament to the pectineal ligament)
Femoral ring is the entrance to (1)____ through which bowel can enter and cause (2)___
- the femoral canal
- a femoral hernia.
Saphenous hiatus
→ an oval opening in the superomedial part of (1)____, lies 3–4 cm inferolateral to (2)____
- the fascia lata
- the pubic tubercle.
Saphenous hiatus
→ it is the external opening of ____
femoral canal.
Contents of saphenous hiatus
The greater saphenous vein pass through this hiatus and after it joins to the femoral vein.
Borders of Subinguinal hiatus
- Superior: inguinal lig
- inferior:
- liopubic eminence
- body and sup.ramus of pubis
- pubic tubercle.
What are the 3 compartments of subinguinal hiatus from lateral to medial sides?
- Lacuna musculonervosa
- Lacuna vasorum
- Lacuna lymphatica
Contents of Lacuna musculonervosa
- femoral nerve
- iliopsoas muscle.
Contents of lacuna vasorum
- femoral artery
- femoral vein
- genito-femoral nerve.
Contents of lacuna lymphatica
it is common site of herniation and contains lymph nodes.
The borders of the Femoral triangle (Scarpa’striangle)
Superior: inguinal lig of Poupart
Lateral: Sartorius muscle
Medial: Adductor longus muscle
Floor and Roof of Femoral triangle (Scarpa’striangle)
- Its floor is provided laterally by iliopsoas & medialy by pectineus muscle
- The roof is formed by fascia lata
Contents of Femoral triangle (Scarpa’striangle)
Contains (from med to lat):
- Femoral canal
- Femoral vein
- Femoral artery
- Femoral nerve (branch of lumbar plexus)
The femoral artery gives a branch called as ____
deep femoral artery
The femoral artery gives a branch called as deep femoral artery, that gives 3 branches which are
1) Medial circumflex femoral artery (together with the obturator artery, supplying the adductors).
2) Lateral circumflex femoral artery (supplying the extensors of the thigh).
3) Perforating branches (supplying the flexors of the thigh).
The femoral artery gives a branch called as deep femoral artery, that gives 3 branches which are
1) Medial circumflex femoral artery (together with the obturator artery, supplying _____).
2) Lateral circumflex femoral artery (supplying ____).
3) Perforating branches (supplying____).
- the adductors
- the extensors of the thigh
- the flexors of the thigh
The femoral artery gives a branch called as deep femoral artery, that gives 3 branches, including
1) Medial circumflex femoral artery (together with ___ (artery?), supplying the adductors)
the obturator artery
Borders of Adductor canal/ Subsartorial canal/ Hunter’s canal
Anterior: vasto-adductorial membrane & Sartorius muscle.
Lateral: vastus medialis muscle
Medial: Adductor longus & magnus muscle
Pathway of saphenous nerve:
it emerges behind the aponeurotic covering of adductor canal
→ it descends vertically along the medial side of the knee and pierces ____ between the tendons of sartorius and gracilis muscles, then it becomes subcutaneous.
the vasto-adductorial membrane
Contents of Adductor canal/ Subsartorial canal/ Hunter’s canal
Femoral artery
Femoral vein
Saphenous nerve ( it is the largest cutaneous branch of femoral nerve ).
Adductor canal/ Subsartorial canal/ Hunter’s canal
→ This canal is an aponeuretic canal which is about 10 cm length located deep to the middle third of ___ (which muscle?)
Sartorius muscle.
Adductor canal/ Subsartorial canal/ Hunter’s canal
→ This canal provides an intermuscular passage through which the femoral vessels pass to reach _____ (Space?)
the popliteal fossa.
Adductor canal/ Subsartorial canal/ Hunter’s canal
→ This canal starts from inferior angle of (1)___ and later on ends in (2)_____
- femoral triangle (proximally)
- the adductor hiatus (distally).
Pathway of saphenous nerve:
it emerges behind the aponeurotic covering of adductor canal
→ it descends vertically along the medial side of the knee and pierces the vasto-adductorial membrane between ___ (2 muscles), then it becomes subcutaneous.
the tendons of sartorius and gracilis muscles
What is Adductor hiatus?
the opening between the tendon of adductor magnus muscle and femur, marking the distal end of adductor canal.
= Adductor hiatus
→ It allows the passage of the femoral vessels from the adductor canal to ____
the popliteal fossa
Borders of Adductor hiatus
→ It allows the passage of the femoral vessels from the adductor canal to ____
Adductor magnus muscle + tendon & the body of the femur
Contents of Adductor hiatus
Femoral artery & vein,
(but when these vessels pass from adductor hiatus and enter to the popliteal fossa ,their name change to popliteal artery and vein.)
Borders of popliteal fossa
- Superomedial:
- Tendons of Semimembranosus & Semitendinosus muscle.
- inferiomedial and lateral:
- Medial & lateral heads of the Gastrocnemius muscle.
The base of popliteal fossa is made by __ (3)
- Popliteal surface of femur
- Posterior part of knee joint capsule
- Popliteus muscle
Contents of popliteal fossa from superficial to deep (2 nn., 1 a., 1 m.)
- Tibial nerve (gives medial sural nerve)
- Common fibular (peroneal) nerve (gives lateral sural nerve)
- Lesser saphenous vein
- Popliteal vein
- Popliteal artery
- Popliteus muscle
Borders of Greater sciatic foramen
- Superior & anteriorly: Greater sciatic notch (posterior border of the hip bone)
- Inferiorly: Sacrospinous lig
from inside of greater sciatic foramen a muscle will emerge which is called piriformis muscle and it divides the foramen into: ___
- Suprapiriformis hiatus
- Infrapiriformis hiatus
piriformis muscle originates from front of middle 3 sacral foramina, and it inserts to the (1)___
→ The piriformis muscle is innervated by (2)_____
- Greater trochanter of femur.
- sciatic nerve.
Contents of Suprapiriformis hiatus? (1 a., 1v., 1 n.)
- Sup. gluteal art
- Sup. gluteal vein
- Sup. gluteal nerve (branch of sacral plexus)
Contents of Infrapiriformis hiatus? (2 aa., 2 vv., 4 nn.)
- Inf. gluteal art
- Inf. gluteal vein
- Inf. gluteal nerve (branch of sacral plexus)
- Internal pudendal art
- Internal pudendal vein
- Pudendal nerve (branch of sacral plexus)
-
Sciatic nerve
(branch of sacral plexus) -
Post. femoral cutaneous nerve
(branch of sacral plexus)
Border of Lesser sciatic foramen?
- Anterior: Sacrospinus lig+Lesser sciatic notch
- Posterior: Sacrotuberous lig
Contents of Lesser sciatic foramen? (1 a., 1 v., 1 n., 1 tendon)
- Internal pudendal art
- Internal pudendal vein
- Pudendal nerve
- Tendon of obturator internus
Obturator canal is a tunnel which is formed in _____
the obturator foramen.
Contents of Obturator canal
- Obturator art
- Obturator vein
- Obturator nerve (branch of lumbar plexus)
What is Pes anserinus (superficial)? List the muscles from anterior to posterior
the area where we can see insertion of conjoined tendons of 3 muscles.
→ The 3 muscles are: (from anterior to posterior)
- Sartorius muscle
- Gracilis muscle
- Semitendinosus muscle
What is Pes anserinus (deep)? List the muscle
The site of the insertion of only one muscle tendon in the same area but locates more deeply.
→ The muscle is: Semimembranosus muscle
Where is Medial retromalleolar region?
It is located behind the medial malleolus.
→ Its boundaries:
Superior: one finger’s breadth above the medial malleolus.
Inferior: The medial edge of the sole of the foot.
Contents of Medial retromalleolar region?
- *Posterior tibial artery **
- * **
- *Posterior tibial veins ( 2 veins) **
- * **
- *Tibial nerve **
- * **
- *Tendons from anterior to posterior: **
- * **
- *Tibialis posterior muscle** (in front)
- *Flexor digitorum longus muscle** (Middle)
- *Flexor hallucis longus muscles** (behind)
What is Lateral retromalleolar region?
It is placed behind the lateral malleolus .
→ Its boundaries:
Superior: A transverse line one finger’s breadth above the level of the lateral malleolus.
Inferior: The lateral edge of the sole of the foot.
Contents of Lateral retromalleolar region
- Tendons of peroneus brevis muscle & peroneus longus muscle
- Lesser saphenous vein
- Sural nerve
