4.1 - Upper Leg

Question 1

Answer 1

Question 2

Answer 2

Question 3

Answer 3

Question 4

Answer 4

Question 5

Answer 5

Question 6

Answer 6

Question 7

Answer 7

Question 8

Answer 8

Question 9

Answer 9

Question 10

Answer 10

Question 11

Answer 11

Question 12

Answer 12

Question 13

Answer 13

Question 14

Answer 14

Question 15

Answer 15

Question 16

Answer 16

Question 17

Answer 17

Question 18

Answer 18

Question 19

List the medial thigh muscles, and outline their actions and innervations

Answer 19

• Action: Adduct hip joint
• Innervation: Obturator nerve (don’t worry about exceptions)
• Muscles: Adductor Magnus, Pectineus, Adductor Longus, Adductor Brevis, and Gracilis

Question 20

List the anterior thigh muscles, and outline their actions and innervations

Answer 20

• Includes: Quadriceps Femoris (Vastus Lateralis, Vastus Intermedius, Vastus Medialis, and Rectus Femoris)
• Action: Flex Hip – Extend Knee
  
  • Rectus Femoris: Flex Hip and Extend Knee
  • Vastus Muscles: Extend Knee
• Innervation: Femoral nerve
• Muscles: Medial Thigh Adductor Muscles, Vastus Lateralis, Vastus Intermedius, Vastus Medialis, Rectus Femoris, and Satorius

Question 21

List the posterior thigh muscles, and outline their actions and innervations

Answer 21

• Includes: Hamstrings (Biceps Femoris, Semitendinosus, and Semimembranosus)
• Action: Extend hip – Flex knee
• Innervation: Sciatic nerve
• Muscles: Biceps Femoris, Semitendinosus, and Semimembranosus

Question 22

What is the fascia lata? Where is it and what is it also called?

Answer 22

• Fascia Lata- Deep Fascia forming the roof over the femoral triangle
  
  • Directly beneath skin and superficial fascia
  • Like a stocking wrapping around the muscles, arteries, and deep veins of the thigh
  • Beneath Superficial Veins
    
    • E.g. Great Saphenous Vein
      
      • Originates in the dorsal venous arch- a venous system at the top of the foot
        à Comes up medial side of the sural/calf and thigh
        à Moves through hole in proximal deep fascia
        à Empties into femoral vein (deep vein)
  • Beneath an array of Superficial Lymph Nodes

Question 23

What is the femoral triangle? What is it bordered by?

Answer 23

• Femoral Triangle-
  
  • The entry point of the femoral nerve, femoral artery, femoral vein into the lower limb
  • An upside-down wedge-shaped depression formed by muscles in the upper thigh allowing passage of nerves and blood vessels
• Base- Inguinal Ligament
  
  • Attaches from anterosuperior iliac spine à Pubic tubercle
• Medial Border- Adductor longus
  
  • Muscle in medial compartment of thigh
  • Pubis à middle third of the femur shaft
• Lateral Border- Sartorius
  
  • Muscle in anterior compartment of thigh
  • Anterosuperior iliac spine à diagonally across thigh à Medial side of tibial tuberosity. The only anterior thigh muscle that isn’t a quadriceps femoris muscle
• Floor-
  
  • Medial Floor- Pectineus
    
    • Muscle in medial compartment of thigh
  • Lateral Floor- Iliopsoas
    
    • A combination of the psoas major (flexor of lumbar spine and hip) and illiacus muscles
      
      • Two abdominal muscles which combine and cross the anterior of the hip to attach to lesser trochanter of the femur
• Roof- Fascia Lata
  
  • Layer of fascia
• Apex- Points inferiorly and continues with an adductor canal which descends medially down the thigh and then moves posteriorly through the adductor hiatus in the adductor magnus muscle

Question 24

Outline the passage of the femoral nerve, femoral artery, and femoral vein down the thigh?

Answer 24

• Femoral nerve, femoral artery and femoral vein enter the lower limb by passing under the inguinal ligament (base of femoral triangle) into the femoral triangle
• Femoral nerve then branches off within the anterior thigh and some thigh skin, then ends
• Femoral artery and femoral vein continue inferiorly down the femoral triangle à then leave the femoral triangle at the apex by travelling under sartorius through the adductor canal / subsartorial canal à then travel posteriorly through the adductor hiatus of the adductor magnus to reach the back of the knee à at which point they become the popliteal artery and popliteal vein which supply the posterior lower leg

Question 25

Outline the sciatic nerve? What does it innervate and outline it’s movement down the leg.

Answer 25

• Innervates Posterior Thigh
• Two nerves held together by fascia
  
  • Common peroneal nerve
  • Tibial nerve
• Enters through pelvis into posterior lower limb
  à Moves inferiorly deep to the biceps femoris long head down the posterior thigh
  à At the top of the popliteal fossa, divides into Common Peroneal Nerve and Tibial Nerve
• Largest nerve in the body

Question 26

Where can the popliteal artery and popliteal vein be found? Where do they originate from?

Answer 26

• Originate as the femoral artery and femoral vein in the anterior thigh
  à Which reach the popliteal region by passing through the adductor hiatus in the adductor magnus muscle
  à At which point they become the popliteal artery and popliteal vein
• Travel alongside the tibial nerve