3 - Zill - Anterior and Medial Thigh Flashcards
What muscles form the walls of the abdomen?
Rectus Abdominis, External Oblique
Inguinal Ligament - Attachment points
What passes under here and in what order?
Thicked fascia of external oblique muscle, ASIS to Pubic Tubercle
(lateral to medial) Femoral:
Nerve
Artery
Vein
Lymph
Iliotibial Tract (IT Band)
What does it receive insertion of?
Thickened later part of fascia lata; extends leg after muscles have extended knee.
Provides lateral stability when standing.
Origin: Ilium
Attachment: Lateral condyle of tibia
Tensor Fascia Lata and Gluteus Maximus insert to IT
Saphenous Opening
Oval shaped defect in deep fascia, allows pasage for Great Saphenous vein
Lateral Side is sharp = Falciform margin
Cutaneous Nerve for Gluteal Region
Posterior Cutaneous Nerve of Thigh
Cutaneous nerve for lateral portion of thigh?
Lateral Femoral Cutaneous Nerve of Thigh
Major Action / Nerve For:
Anterior Compartment
Posterior Compartment
Medial Compartment
Lateral Compartment
Anterior: Knee Extension / Femoral Nerve
Posterior: Knee Flexion / Tibial part of Sciatic Nerve
Medial: Hip ADductors / Obturator Nerve
Lateral: Hip ABductors / Sup. and Inf. Gluteal Nerve
Four Muscles of Quadriceps
Which muscle crosses both hip and knee joints?
Common attachment?
Rectus Femoris (middle, on-top)
Vastus Lateralis (lateral)
Vastus Medialis (medial)
Vastus Intermedius (midd, bottom)
All attach to quadriceps tendon
What is the order of structures from the quads to the patella to tibia?
Quad Muscles
Quadriceps Tendon
Patella
Patellar Tendon
Tibia
What is the mechanical function of the patella?
Increase mechanical advantag of the quadriceps by increasing angle of insertion
What nerves does a patellar tendon reflex test?
L2
L3
L4
(Femoral Nerve)
Hip Pointer
Contusion of muscles at Anterior Superior Iliac Spine (ASIS)
Sartorius actions
Flex hip
Flex knee
ASIS to tibia via Pes Anserinus
Pes Anserinis
Common tendon formed from:
Sartorius
Gracilis
Semitendinosus
Ilippsoas
Thigh flexor - composed of Iliacus and Psoas
Origin: ilium (iliacus), T12-L5 (psoas)
Attachment: Femur
Pectineus
Origin: Pubis
Attachment: Femur
Action: Flex hip
What innervates all anterior compartment muscles?
Femoral Nerve (L2, 3, 4)
What is the action of the muscles of the medial compartment?
How are they innervated?
ADduct thigh
All obturator nerve, except hamstring portion of Adductor Magnus is Tibial Sciatic Nerve
Where do the Adductor Longus and Adductor Brevis insert?
Which is deeper?
Linea Aspera of Femur
Adductor Brevis
Adductor Magnus
What are two parts?
Where to they Originate and Insert?
What is often clinically related to this muscle?
a. Adductor Part
Origin: Pubis / Ischium
Insert: Linea Aspera of Femur
Action: Adduct Thigh
Innervation: Obturator Nerve
b. Hamstring Part
Origin: Ischial Tuberosity
Insert: Adductor Tubercle of Femur (lower)
Action: Extends Thigh
Innervation: Tibial Part of Sciatic Nerve
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Tear or stretch of adductor group at pubis is Pulled Groin
What is a tear or stretch of adductor group muscle(s) called?
Pulled Groin
Gracilis
Origin: Pubis
Insertion: Tibia via Pes Anserinus
Action: ADduct thigh, flex knee
Deep muscle that is difficult to see, which rotates femur laterally?
What does it cover?
Obturator Externus
Obturator Foramen
What innervates all medial compartment muscles?
Obturator nerve (L2, 3, 4)
All except hamstring portion of adductor magnus, which is Tibial Sciatic Nerve
What are the contents of the Femoral Triangle in order from Lateral to Medial?
Femoral:
Nerve
Artery
Vein
Lymphatics
Femoral Sheath
Surrounds femoral artery and vein, not nerve
Continuation of transversalis fascia
Where do lymph vessels of the lower limb pass through to drain to external iliac nodes in abdomen?
Femoral Canal
Femoral Hernia
Femoral Ring is point of weakness in abdominal wall; loop of bowel can protrude into Femoral Canal and become strangulated
Femoral Hernia vs Inguinal Hernia
Femoral = below inguinal ligament
Inguinal = above inguinal ligament
Femoral = closer to femur
When does the External Iliac become the Femoral Artery?
When does the Femoral Artery become the Popliteal Artery?
What route does it travel?
Inguinal Ligament
Adductor Hiatus
Anterior to Posterior due to limb development
What is the pathway of the femoral artery starting from External Iliac?
External Iliac
(Inguinal Ligament)
Femoral Artery
(Adductor Hiatus)
Popliteal Artery
(tibia/fibula)
Anterior Tibial Artery / Posterial Tibial Artery
What are the anastomoses at the joints of the lower extremities?
Hip - Cruciate Anastomosis
Knee - Genicular Anastomosis
What is the primary supplier of blood for the foot?
Posterior Tibial Artery
Profunda Femoris
What does it branch to?
Largest branch of femoral, posterior to femoral triangle
Passes between pectineus and adductor longus
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Branches:
- Medial Femoral Circumflex (femur head)
- Lateral Femoral Circumflex (lateral thigh)
Medial Femoral Circumflex
Primary blood supply to head of femur
If disrupted, femur head can die
Ichemic Necrosis of Head of Femur
What are two sources of blood for femur head?
Can be caused due to falling and fracture of hip, which damages medial femoral circumflex artery
- - -
- Obturator Artery
- Medial femoral circumflex artery
Perforating Arteries
Provide blood to posterior compartment of thigh
Perforate adductor magnus
Where are the curciate anastomosis of the hip found?
Posterior to the joint
Where can you ligate the femoral artery and still have blood supply?
Why?
What blood vessels supply the limb with blood?
Above Profunda Femoris
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Cruciate Anastomosis can maintain blood supply around hip
- -
1. Medial Femoral Circumflex Artery
2. Lateral Femoral Circumflex Artery
3. First Perforating Artery
What is the most common population to experience femoral hernias?
Older females
