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MSK Week 5 > 2.5.1. ANAT LAB - Anterior and Medial Thigh > Flashcards

2.5.1. ANAT LAB - Anterior and Medial Thigh Flashcards

1
Q

What muscle attaches to the ASIS (anterior superior iliac spine)?

A

Sartorius

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2
Q

What muscle attaches to the AIIS (anterior inferior iliac spine)?

A

Rectus femoris

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3
Q

Which hip bone contributes to the superior part of the acetabulum?

A

The ilium

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4
Q

Which hip bone forms the postero-inferior part of the hip bone?

A

Ischium

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5
Q

Which hip bone forms the anteromedial part of the hip bone?

Which part of the acetabulum does this bone also contribute to?

A

The pubis bone

Anterior part of the acetabulum

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6
Q

Define “angle of inclination”

What is the average angle in adults (in degrees)?

A

Angle formed between the neck and shaft of the femur

Average in adults is 126 degrees (and it decreases with age)

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7
Q

Define “angle of declination” (aka the torsion angle)

What is the average angle in males and females?

A

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.

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8
Q

Which joint & artery are we MOST worried about with a fracture of the distal or interior femur, and why??

A

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

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9
Q

Proximal fractures of the femur are usually due to _____ trauma

A

Indirect

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10
Q

Which artery is the source of the internal iliac arteries?

A

Common iliac artery

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11
Q

What areas does the internal iliac artery supply?

A

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.

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12
Q

Explain the route of the obturator artery.

A

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.

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13
Q

What is the largest branch of the posterior division of the internal iliac arter?

What does it supply?

A

The largest branch is the superior gluteal artery.

It supplies the gluteal muscles of the booty

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14
Q

Describe the general pathway of venous drainage from the lower extremity into the pelvis.

A

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.

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15
Q

Describe the general pathway of lymphatic drainage from the lower extremity into the pelvis.

A

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

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16
Q

Define “musculovenous pump”.

A

Muscular contractions in the limbs function with the venous valves to move blood toward the heart (against gravity)

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17
Q

Femoral triangle:

Superior border

Lateral border

Medial border

Floor (2)

A

Superior border: Inguinal ligament

Lateral border: medial border of Sartorius

Medial border: lateral border of Adductor Longus

Floor: Iliopsoas and Pectineus muscles

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18
Q

Where is the most common originating site of a femoral hernia?

A

The anterior abdominal wall

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19
Q

Iliopsoas:

Origin

Insertion

Innervation

Action

A

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

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20
Q

Sartorius:

Origin

Insertion

Innervation

Action

A

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

21
Q

Rectus femoris:

Origin

Insertion

Innervation

Action

A

Origin: AIIS

Insertion: Base of patella; patellar ligament to tibial tuberosity

Innervation: Femoral nerve

Action: Extend leg at knee joint

22
Q

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?

A

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.

23
Q

Pectineus:

Origin

Insertion

Innervation

Action

A

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

24
Q

What are the muscles of the quadriceps femoris?

A

Rectus femoris

Vastus lateralis

Vastus medialis

Vastus intermedius

25
Q

Vastus lateralis:

Origin

Insertion

Innervation

Action

A

Origin: Greater trochanter and lateral lip of linea aspera of femur

Insertion: Via quadriceps tendon and attachment to base of patella

Innervation: Femoral nerve

Action: Extend leg at knee joint

26
Q

Vastus medialis:

Origin

Insertion

Innervation

Action

A

Origin: Intertrochanteric line and medial lip of linea aspera of femur

Insertion: Via quadriceps tendon and attachment to base of patella

Innervation: Femoral nerve

Action: Extend leg at knee joint

27
Q

Vastus intermedius:

Origin

Insertion

Innervation

Action

A

Origin: Anterior and lateral surfaces of shaft of femur

Insertion: Via quadriceps tendon and attachment to base of patella

Innervation: Femoral nerve

Action: Extend leg at knee joint

28
Q

Adductor longus:

Origin

Insertion

Innervation

Action

A

Origin: Body of pubis inferior to pubic crest

Insertion: Middle third of linea aspera of femur

Innervation: Obturator nerve

Action: Adducts thigh

29
Q

Adductor brevis:

Origin

Insertion

Innervation

Action

A

Origin: Body and inferior ramus of pubis

Insertion: Pectineal line and proximal part of linea aspera of femur

Innervation: Obturator nerve

Action: Adducts thigh

30
Q

Adductor magnus:

Origin (2)

Insertion (2)

Innervation (2)

Actions

A

Origin: Adductor part - inferior ramus of pubis, ramus of ischium

Hamstrings part - ischial tuberosity

Insertion: Adductor part - gluteal tuberosity, linea aspera, medial supercondylar line

Hamstrings part - adductor tubercle of femur

Innervation: Adductor part - obturator nerve

Hamstrings part - tibial part of sciatic nerve

Actions: Adducts thigh; Adductor part - flexes thigh; Hamstrings part - extends thigh

31
Q

Gracilis:

Origin

Insertion

Innervation

Action

A

Origin: Body and inferior ramus of pubis

Insertion: Superior part of medial surface of tibia

Innervation: Obturator nerve

Action: Adducts thigh; flexes leg; helps rotate leg medially

32
Q

Obturator externus:

Origin

Insertion

Innervation

Action

A

Origin: Margins of obturator foramen and obturator membrane

Insertion: Trochanteric fossa of femur

Innervation: Obturator nerve

Action: Laterally rotates thigh; steadies head of femur in acetabulum

33
Q

What is the adductor canal?

What is another name for it?

A

It is a long, narrow passageway in the middle third of the thigh; extends from the apex of the femoral triangle to the adductor hiatus

It is also known as Hunter’s canal

34
Q

Where is the adductor hiatus located?

A

In the tendon of the adductor magnus

35
Q

What are the contents of the adductor canal? (4)

A

Femoral artery

Femoral vein

Saphenous nerve

Nerve to vastus medialis

36
Q

What artery is the main blood supplier to the femoral head?

A

The medial femoral circumflex artery

37
Q

Identify the following:

A
  1. Femoral nerve
  2. Lateral component of femoral sheath
  3. Medial component of femoral sheath (femoral canal)

The components of the femoral sheath (from lateral to medial) are:

N - Femoral nerve (OUTSIDE the sheath)

A - Femoral artery

V - Femoral vein

L - lymphatics

38
Q

Identify the following:

A
  1. Deep femoral artery (Profunda Femoral artery)
  2. Lateral circumflex femoral artery
  3. Medial circumflex femoral artery
  4. Femoral artery
39
Q

Identify the following:

A
  1. Sartorius muscle
  2. Adductor longus muscle
  3. Gracilis
40
Q

Identify the following:

A
  1. Tensor fascia lata muscle
  2. Iliotibial tract
41
Q

Identify the following:

A
  1. Vastus medialis
  2. Rectus femoris
  3. Vastus lateralis
  4. Patellar tendon/ligament
42
Q

Identify the following:

A
  1. Vastus intermedius
  2. Vastus lateralis
  3. Vastus medialis
  4. Rectus femoris (distal stump) - the rectus femoris has been reflected so that the vastus intermedius can be seen
43
Q

Identify the following:

A
  1. Gracilis
  2. Adductor longus
  3. Sartorius
  4. Rectus femoris
44
Q

Identify the following:

A
  1. Pectineus
  2. Adductor brevis
  3. Adductor magnus
  4. Adductor longus
45
Q

Identify the following:

A
  1. Iliopsoas
  2. Sartorius (cut edge)
  3. Femoral and profunda femoral arteries
46
Q

Identify the following:

A
  1. Pubic tubercle
47
Q

Identify the following:

A
  1. Anterior inferior iliac spine (AIIS)
  2. Anterior superior iliac spine (ASIS)
48
Q

Identify the following:

A
  1. Head of femur
  2. Greater trochanter
  3. Lesser trochanter
  4. Fovea of head
  5. Medial epicondyle
  6. Lateral epicondyle
49
Q

Identify the following:

A
  1. Linea aspera
  2. Fovea of head
  3. Lateral condyle
  4. Medial condyle

MSK Week 5 (7 decks)

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