A: Lower limb muscles, blood vessels, nerves

Question 1

Sartorius (origin, insertion, action, nerve supply)

Answer 1

• Anterior superior iliac spine
• Upper part of medial surface tibia
• Flexes hip, flexes knee
• Femoral nerve

Question 2

Iliacus (iliopsoas) (origin, insertion, action, nerve supply)

Answer 2

• Iliac fossa
• Runs into thigh posterior to inguinal ligament. With psoas major it inserts into lesser trochanter of femur.
• Flexes hip
• Lumbar plexis (lies within psoas major)

Question 3

Psoas major - part of iliopsoas (origin, insertion, action, nerve supply)

Answer 3

• Transverse process, bodies & intervertebral discs of T12-L5
• Runs into the thigh posterior to inguinal ligament. Inserts into lesser trochanter of femur with iliacus
• Flexes hip, forward + lateral flexion of lumbar spine
• Lumbar plexus

Question 4

Rectus femoris (origin, insertion, action, nerve supply)

Answer 4

• Hip bone
• Quadriceps tendon into patella and into tibial tuberosity via patellar tendon
• Extension of knee, flexion at hip
• Femoral nerve

Question 5

Vastus lateralis (origin, insertion, action, nerve supply)

Answer 5

• Posterolateral aspect of shaft of femur
• Quadriceps tendon into patella and into tibial tuberosity via patellar tendon
• Extension of knee
• Femoral nerve

Question 6

Vastus medialis

Answer 6

• Posteromedial aspect of shaft of femur
• Quadriceps tendon into patella and into tibial tuberosity via patellar tendon
• Extension of knee
• Femoral nerve

Question 7

Vastus intermedius

Answer 7

• Anterior aspect of the shaft of the femur
• Quadriceps tendon into patella and into tibial tuberosity via patellar ligament
• Extension of knee
• Femoral nerve

Question 8

Adductor magnus

Answer 8

• Adductor part: ischiopubic ramus. Hamstring part: Ischial tuberosity
• Entire length of linea aspera, adductor tubercle of femur
• Adduction at hip, medial rotation at hip
• Adductor part: obturator nerve. Hamstring part: sciatic nerve

Question 9

Adductor longus

Answer 9

• Body of pubic bone
• Middle 1/3 of linea aspera of femur
• Adduction at hip, medial rotation at hip
• Obturator nerve

Question 10

Adductor brevis

Answer 10

• inferior pubic ramus
• upper 1/3 linea aspera of femur
• Adduction at hip, medial rotation at hip
• Obturator nerve

Question 11

Gracilis

Answer 11

• Inferior pubic ramus
• Medial surface of upper part of tibia
• Adduction at hip, flexion at knee
• Obturator nerve

Question 12

Pectineus

Answer 12

• Superior pubic ramus
• upper end of shaft of femur
• Flexion + adduction of hip
• Femoral nerve

Question 13

Obturator externus

Answer 13

• External surface of obturator membrane + adjacent bone
• Passes posteriorly + laterally around neck of femur to insert into trochantric fossa of femur
• Lateral rotation at hip joint, stabilizes hip joint
• Obturator nerve

Question 14

Boundaries of femoral triangle

Answer 14

Inguinal ligament = superior
Sartorius = lateral
Medial border of adductor longus = medial

Question 15

Floor of femoral triangle

Answer 15

Iliopsoas, pectineus, adductor longus muscles.

Question 16

Contents of femoral triangle from lateral to medial

Answer 16

Femoral nerve
Femoral sheath containing femoral artery, vein and femoral canal (with lymph nodes).

Question 17

What is the thickening of fascia on the lateral side of leg called?

Answer 17

Iliotibial tract

Question 18

What is the thickening of fascia on the lateral side of leg called?

Answer 18

Iliotibial tract

Question 19

Boundaries of femoral ring

Answer 19

Medial = lacunar ligament
Lateral = femoral vein
Anterior = inguinal ligament
Posterior = pectineus muscle

Question 20

Lumbar plexus

Answer 20

Anterior rami of L1-L3 and a part of L4.

Question 21

What does the saphenous nerve innervate?

Answer 21

Skin on anterior and medial aspect of leg + medial side of foot.

Question 22

What does the obturator nerve innervate?

Answer 22

• All muscles of medial compartment except hamstring part of adductor magnus (sciatic) and pectineus (femoral)
• Obturator externus
• Hip + knee joints –> can cause referred pain (pain felt in a cutaneous site innervated by same segment of brain stem.
• Skin on medial side of upper thigh –> can cause referred pain from pelvic inflammation

Question 23

What can compression of lateral cutaneous nerve of thigh cause?

Answer 23

Meralgia paresthetica –> tingling, numbness + burning pain on outer thigh.

Question 24

Anastomosis around hip joint

Answer 24

Alternative circulating if artery is obstructed. Involves branches of inferior gluteal artery, medial + lateral circumflex femoral artery + 1st perforating branch of deep femoral artery.

Question 25

Superficial inguinal LN

Answer 25

Receive lymph drainage from entire lower limb.
Horizontal group: drain anterior abdominal wall below umbilicus + perineum.
Vertical group: Drain lower limb.

Question 26

Deep inguinal LN

Answer 26

Receive drainage from deep tissues of lower limb.

Question 27

Vascular supply to hip joint

Answer 27

Medial + lateral circumflex femoral branches of femoral artery. Medial is main blood supply.

Question 28

Avascular necrosis

Answer 28

If femoral head is fractured, there man be inadequate blood supply through acetabular branch of obturator artery.