2.5.1. ANAT LAB - Anterior and Medial Thigh Flashcards
What muscle attaches to the ASIS (anterior superior iliac spine)?
Sartorius
What muscle attaches to the AIIS (anterior inferior iliac spine)?
Rectus femoris
Which hip bone contributes to the superior part of the acetabulum?
The ilium
Which hip bone forms the postero-inferior part of the hip bone?
Ischium
Which hip bone forms the anteromedial part of the hip bone?
Which part of the acetabulum does this bone also contribute to?
The pubis bone
Anterior part of the acetabulum
Define “angle of inclination”
What is the average angle in adults (in degrees)?
Angle formed between the neck and shaft of the femur
Average in adults is 126 degrees (and it decreases with age)
Define “angle of declination” (aka the torsion angle)
What is the average angle in males and females?
When viewing the femur superiorly, the angle observed between the long axis of the head/neck of the femur and the transverse axis of the femoral condyles.
The average is 12 degrees in females and 7 degrees in males.
Which joint & artery are we MOST worried about with a fracture of the distal or interior femur, and why??
We are most worried about the knee joint because fractures of the distal/inferior femur can be complicated by the separation of condyles.
We are concerned about hemorrhage of popliteal artery, which could compromise blood supply to the leg
Proximal fractures of the femur are usually due to _____ trauma
Indirect
Which artery is the source of the internal iliac arteries?
Common iliac artery
What areas does the internal iliac artery supply?
It is the principal artery of the pelvis; it supplies most of the blood to the pelvic viscera and some to the musculoskeletal part of the pelvis
It also supplies branches to the gluteal and medial thigh regions, as well as the perineum.
Explain the route of the obturator artery.
It typically arises close to the origin of the umbilical artery; runs anteroinferiorly on the obturator fascia on the lateral wall of the pelvis and passes between the obturator nerve and vein.
What is the largest branch of the posterior division of the internal iliac arter?
What does it supply?
The largest branch is the superior gluteal artery.
It supplies the gluteal muscles of the booty
Describe the general pathway of venous drainage from the lower extremity into the pelvis.
Superficial veins are in the subcutaneous tissue and run independent from named arteries; the deep veins are deep to the deep fascia and accompany all major arteries. Superficial and deep veins have valves, which are more numerous in deep veins.
Describe the general pathway of lymphatic drainage from the lower extremity into the pelvis.
Superficial lymphatic vessels converge on and accompany the saphenous veins and their tributaries → end at the superficial inguinal lymph nodes→ most lymph then directly passes to the external iliac lymph nodes and some passes to the deep inguinal lymph nodes
Define “musculovenous pump”.
Muscular contractions in the limbs function with the venous valves to move blood toward the heart (against gravity)
Femoral triangle:
Superior border
Lateral border
Medial border
Floor (2)
Superior border: Inguinal ligament
Lateral border: medial border of Sartorius
Medial border: lateral border of Adductor Longus
Floor: Iliopsoas and Pectineus muscles
Where is the most common originating site of a femoral hernia?
The anterior abdominal wall
Iliopsoas:
Origin
Insertion
Innervation
Action
Origin: T12-L5 vertebrae; transverse processes of all lumbar
Insertion: Lesser trochanter of femur
Innervation: L1, L2, L3
Action: Stabilizing hip joint and flexing thigh at hip joint
Sartorius:
Origin
Insertion
Innervation
Action
Origin: ASIS
Insertion: Superior part of medial surface of tibia
Innervation: Femoral nerve
Action: Flexes, adducts, and laterally rotates thigh at joint; flexes leg at knee joint
Rectus femoris:
Origin
Insertion
Innervation
Action
Origin: AIIS
Insertion: Base of patella; patellar ligament to tibial tuberosity
Innervation: Femoral nerve
Action: Extend leg at knee joint
What is a “compartment syndrome”?
(HINT: It has to do with increased intra-compartmental pressure within these water-tight osseo-fascial barriers).
How is it relieved?
Such “barriers”, when at normal compartmental pressures, make muscle function extremely efficient. But infections (which cause swelling within this tight space) or bleeding into a compartment can increase the pressure enough to shut off circulation to the limb! This situation is called a “compartment syndrome” and is heralded by pain. It is a surgical emergency, since the pressure builds fast and there is serious risk of tissue necrosis and an amputation may become necessary if this is not corrected immediately.
The pressure must be relieved by cutting into the fascia along the length of the muscle envelope to release the pressure and thus save the limb. It can be done in the field or on the ward to save time.
Pectineus:
Origin
Insertion
Innervation
Action
Origin: Superior ramus of pubis
Insertion: Pectineal line of femur, just inferior to the lesser trochanter
Innervation: Femoral nerve (may also receive a branch from the obturator nerve)
Action: Adducts and flexes thigh; assists with medial rotation of thigh
What are the muscles of the quadriceps femoris?
Rectus femoris
Vastus lateralis
Vastus medialis
Vastus intermedius
