9/13 Anterior and Medial Thigh - Carter (Completed) Flashcards
What three structures make up the Vulva?
Glans clitoris
Labia majora
Labia Minora
What is the proper name or the groin?
Inguinal region
What is the region behind the knee?
Popliteal region
What structures do the superior horizontal nodes drain? What is an important note about this?
external genitalia
anterior abdominal wall
lateral thigh
perineum
drain the same structures as the tributaries of the femorl vein (external pudendal, superficial circumflex iliac, and superficial epigastric)
What do the vertical lymph nodes of the inguinal region drain?
Skin and superficial fascia
Where do we find/what innervates the medial thigh?
The femoral nerve
What fascia encircles the entire thigh?
Fascia Lata
What is contained within the anterior compartment of the thigh?
Quadriceps femoris
Sartorius
Femur
What is contained within the posterior compartment of the thigh?
Add
What is contained within the lateral compartment of the thigh?
Iliotibial tract/band
Tensor Fascia Lata (muslce)
Which of the four muscles making up the Quadriceps sits deep to one of the anterior muscles?
The vastus intermedius sits deep to the Rectus femoris
What nerve supplies the Quadriceps femoris?
The femoral nerve
What is the origin and attachement of the Sartorius muscle?
O —> Anterior Superior Iliac Spine (ASIS)
(Runs lateral to medial)
I —> proximal tibia
How many joints does the sartorius muscle cross?
Two joints
From medial to lateral what are the structures contained within the femoral sheath? What structure is more medial to the sheath?
Lateral —> N |AVEL| —> Medial
N - Femoral nerve
A - Femoral artery
V - Femoral vein
E - Empty space, represents the femoral canal
L - Femoral lymphatics (within the femoral canal)
Where does the name change from external iliac artery and external iliac vein to femoral artery and femoral vein?
Once they cross the inguinal ligament
What is the femoral ring?
The femoral ring leads into the femoral sheath enclosing the lymphatics portion
What is the deep femoral artery called?
Perfundis femoris artery
How many perforating branches are there for the thigh
4
What are the boundaries of the femoral triangle?
Sartorius Muscle, medial side (lateral boundary)
Adductor longus muscle, lateral border (medial border)
Inguinal ligament (superior border or base)
What are the contents of the femoral triangle
Femoral Sheath (A,V,L)
Femoral Nerve (most lateral)
What forms the floor of the femoral triangle?
Pectineus muscle
Iliopsoas muscle
What two muscles make up the Iliopsoas?
Iliacus
Psoas Major
(Fuse to form a tendon that attaches to lesser trochanter)
What else is the medial compartment of the thigh known as?
The adductor compartment
What is the action and origination of the muscles of the medial compartment? What innervates the muscles of the medial compartment? How many muscles are there within the medial compartment?
O —> anterior aspect of os coxae
A —> adduct & laterally rotate the thigh
I —
Where do the majority of the adductor muscles insert?
On the femur
In addition to adduction what else do the adductor muscles do?
Lateral rotation of the thigh
Where does the gracilis insert?
Ι —> medial proximal tibia
What’s contained within the adductor canal?
1., 2., 3. )Femoral artery, vein, and nerve (femoral nerve continues laterally)
Branches of the femoral nerve:
—> 4.) saphenous nerve (continues medially)
—> 5.) nerve to vastus medialis (lateral to saphenous, but medial to femoral nerve)
6.) descending genicular artery (also saphenous artery)
What nerve could be accidentally damaged when performing surgery on the medial side of the knee?
Saphenous nerve
What two structures pass through adductor hiatus*
Femoral artery
Femoral vein
After the femoral artery and vein leave the femoral triangle what do they enter?
Adductor canal through the adductor hiatus
Which does not transverse the femoral triangle through the femoral sheath? A. Femoral artery B. Femoral lymphatics C. Femoral vein D. Femoral Nerve E. Gracilis
Femoral nerve
What is the only role of vastus medialus, intermedius, and lateralis?
Extension of the leg
What are the deep adductors of the thigh from most superior to most inferior? What innervates all of these muscles?
Pectinous (innervated by femoral nerve)
Adductor brevis
Adductor longus
Adductor Magnus (deep to these other muscles)
Gracilis (most medial)
innervated by the obtrutator nerve (except
Pectinous)
What is contained within the anterior compartment?
Quadriceps femoris
Sartorius
Deep inguinal lymph nodes
Femoral triangle
Femoral sheath (A,V,L)
Femoral Nerve
What tissue makes up the femoral sheath?
Extraperitoneal areolar tissue
What is the origin, insertion, innervation, and action of the rectus femoris? What group does it contribute to?
O –> anterior, inferior Iliac spine
I –> tibial tuberoscity (via patellar tendon/ligament)
N–> femoral nerve
A–> flex thigh | extend leg
Rectus femoris contributes to Quadriceps femoris
What is the origin, insertion, innervation, and action of the vastus lateralis? What group does it contribute to?
O –> shaft of femur
I –> tibial tuberoscity (via patellar tendon/ligament)
N –> femoral Nerve
A –> extend leg
Vastus lateralis contributes to Quadriceps femoris
What is the origin, insertion, innervation, and action of the vastus medialis? What group does it contribute to?
O –> shaft of femur
I –> tibial tuberoscity (via patellar tendon/ligament)
N –> femoral nerve
A –> extend leg
Vastus medialis contributes to Quadriceps femoris
What is the origin, insertion, innervation, and action of the Vastus intermedius? What group does it contribute to?
O –> Shaft of femur
I –> tibial tuberoscity (via patellar tendon/ligament)
N –> femoral nerve
A –> extend leg
Vastus intermedius contributes to Quadriceps femoris
What is the origin, insertion, innervation, and action of the sartorius (seat-belt)?
O –> anterior, superior Iliac spine
I –> medial surface of tibia
N –> femoral nerve
A:
- Flexes thigh
- Flexes leg
- Abducts hip
- Laterally rotates hip
What are the three compartments of the femoral sheath?
Lateral compartment - femoral artery
Middle compartment - femoral vein
Medial compartment (femoral canal) - lymph/lymphatic vessels
What is the femoral ring?
the femoral ring leads into the femoral canal (lymphatics of femoral triangle). Small intestines may protrude through the ring into the canal causing hernias
women are 3x more likely to have a hernia
due to differences in hip bones
What are the branches of the femoral artery as they enter the hip
External iliac becomes the femoral artery
femoral artery branches into:
- external pudendal
- superficial circumflex iliac
- superficial epigastric
- profunda femoris
What does the external pudendal artery supply and the external pudendal vein drain?
supplies the penis and scrotum in males
vulva (labia majora/minora, glans clitoris) in females
lower half of anal canal in both
What does the superficial circumflex iliac artery supply?
supplies the lateral thigh
What does the superficial epigastric artery supply?
supplies the anterior abdominal wall inferior to the umbilicus
What are the branches of the profunda femoris? What do they supply?
lateral and medial circumflex branches
- hip joint and gluteal region
four perforating arteries
- posterior and medial compartments of the thigh
What are tributaries to the femoral vein?
great saphenous vein
- ) external pudendal veins
- ) superficial circumflex iliac
- ) superficial epigastric
What do the deep inguinal nodes (deep femoral nodes) drain? Where are they located?
located medial and inferior to the femoral vein
penile urethra
glans penis
glans clitoris
What structures do the inferior vertical nodes drain?
skin/superficial fascia of thigh and leg
Identify all of the veins of the upper thigh. Access photos.
A.) Superficial epigastric vein
B.) Superficial circumflex iliac vein
C.) Deep Circumflex Iliac
E.) superficial external pudendal vein
F.) Great Saphenous vein
G.) Deep external pudendal vein
H.) Circumflex femoral lateral
I.) Femoral vein
J.) Profunda femoris (deep femoral) vein
Generally, what are all the nerves of the thigh?
femoral cutaneous nerve (medial, intermediate, lateral)
Ilioinguinal nerve
Genitofemoral nerve (branch of the femoral)
Obturator nerve (branch of the femoral)
What is the name of the septa that divides the thigh into three muscular compartments?
Fascia Lata
What is the orientation of all of the fibers of the Fascia lata? What is the exception?
all of the fibers move horizontally
EXCEPT, the lateral surface and proximal tibia where the fibers are vertical (Iliotibial tract)
What is the vasculature supply for the medial compartment?
Obturator arteries
Profunda femoris arteries
What is the origin, insertion, innervation, supply, and action for the Gracilis? What compartment is the muscle located in?
O —> body/inferior ramus of pubis
I -—> medial surface of tibia (inferior to tibial tuberosity)
N —> obturator nerve
S —> obturator artery
A —> cross 2 joints, flexes leg, abducts thigh
What is the origin, insertion, innervation and supply for the Pectineus? What compartment is the muscle located in?
O —> pecten pubis, superior ramus of pubis
I —
What is the origin, insertion, supply, innervation, and action for the Adductor longus? What compartment is the muscle located in?
O —> pecten pubis, superior ramus of pubis
I —
What is the origin, insertion, supply, innervation, and action for the Adductor brevis? What compartment is the muscle located in?
O —> body/inferior ramus of pubis
I —
What is the origin, insertion, supply, innervation, and action for the Adductor magnus? What compartment is the muscle located in?
Origin:
(Hamstring portion)—> Ischial tuberoscity
(Adductor portion) —> ischiopubic ramus
Insertion:
(Hamstring portion) —> adductor tubercle of femur
(Adductor portion) —> gluteal tubercle, linea aspera
S —> deep femoral artery (profundus femoris)
N —>
(hamstring portion) —> tibial nerve
(adductor portion) —
What is the origin, insertion, supply, innervation, and action for the Obturator externus? What compartment is the muscle located in?
O —> external surface of obturator membrane, surrounding margin of pubis and ischium
I —
What are the borders of the adductor canal?
Vastus medialis - lateral wall
Adductor longus & adductor magnus - medial wall
Sartorius - roof
What happens to the saphenous artery (descending genicular) and nerve after entering the adductor canal?
They become cutaneous and head to the medial knee and then medial side of the foot
