ANA-LEC: Thigh and Knee Flashcards

1
Q

superficial fascia vs deep fascia

A

superficial: has fatty layer then membranous layer that attaches to fascia lata @ inguinal ligament

deep: anterior attaches to pelvis nd inguinal lig; lateral becomes it band
- saphenous opening: gap below inguinal lig; transmits great saphenous vein
- falciform margin: lower lat border of saph opening

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2
Q

what covers the saph opening

A

cribriform fascia

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3
Q

superficial vs deep inguinal lymph nodes

A

sficial:
- horizontal: abdominal wall level of umbilicus and below iliac creast
- vertical: posterior aspect running through saph vein

deep: along femoral vein in femoral canal

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4
Q

what are the muscles of the anterior compartment

A

sartorius, iliacus, psoas, pectineus, quadriceps, femoris

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5
Q

blood and nerve supply of anterior compartment

A

femoral artery/nerve

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6
Q

what are the branches of femoral nerve

A

ant: medial and intermediate cutaneous; muscular branch
post: saphenous; muscular branches of rectus femoris

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7
Q

what is the cutaneous supply of the thigh

A

Lateral cutaneous nerve (L2-3) – supplies lateral aspect of thigh and knee

Genitofemoral nerve (femoral branch L1-2) – anterior below inguinal ligament

Ilioinguinal nerve (L1) – penis, scrotum or clitoris/labia majora

Medial cutaneous nerve branch of femoral n (L2,3,4) medial aspect of thigh

Intermediate cutaneous nerve (obturator n) –anterior of thigh

Posterior cutaneous nerve of thigh

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8
Q

sartorius

A

Sartorius – longest muscle in the body

  • Strap shape
  • ASIS to medial tibia;
  • flex knee and hip; abduct and lateral rotation of thigh; medial rotation of knee
  • Innervated by femoral nerve
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9
Q

what are the contents of femoral sheath

A

lat: femoral artery
intermediate: femoral vein
medial: lymph vessels and femoral canal

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10
Q

where is the femoral triangle located

A

upper third of the anterior medial part of thigh below inguinal ligament

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11
Q

what are the boundaries of the femoral triangle

A

sup: inguinal lig
lat: sartorius
med: adductor longus
floor: iliopsoas, pectineus, adductor longus
roof: skin and fascia of thigh

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12
Q

what are the contents of the femoral triangle

A
  • femoral nerve and branches,
  • femoral sheath, femoral artery and branches,
  • femoral vein and tributaries
  • deep inguinal nodes
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13
Q

walls of subsartorial canal

A

Anteromedial wall – formed by the sartorius muscle and fascia

Posterior wall – adductor longus and magnus

Lateral wall – vastus medialis

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14
Q

location of subsartorial canal

A

medial aspect of the middle third of the thigh deep to the sartorius muscle

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15
Q

contents of sabsartorial canal

A

Terminal part of the femoral artery

Femoral vein

Deep lymph vessels

Saphenous nerve, nerve to vastus medialis and terminal part of the obturator nerve

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16
Q

muscles of the medial compartment

A

gracilis, adductor longus/brevis/magnus, obturator externus

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17
Q

blood and nerve supply of medial compartment

A

profunda femoris, obturator artery

obturator nerve

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18
Q

anterior div of obturator nerve

A

The anterior division

  • gives muscular branches to the gracilis, adductor brevis, and adductor longus, and occasionally to the pectineus
  • gives articular branches to the hip joint and terminates as a small nerve that supplies the femoral artery
  • supplies the skin on the medial side of the thigh.
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19
Q

posterior div of obturator nerve

A

Posterior division

  • Descends through the opening in the adductor magnus to supply the knee joint
  • muscular branches to the obturator externus, to the adductor part of the adductor magnus, and occasionally to the adductor brevis
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20
Q

muscles of posterior compartment

A

hamstrings, adductor magnus

21
Q

blood and nerves of posterior compartment

A

profunda femoris artery

sciatic nerve

22
Q

what are the branches of sciatic nerve

A

BRANCHES

Tibial nerve, a terminal branch of the sciatic nerve enters the popliteal fossa.

Common peroneal nerve, a terminal branch of the sciatic nerve enters the popliteal fossa on the lateral side of the tibial nerve

23
Q

what does the tibial nerve supply

A

Cutaneous: The sural nerve supply the skin of the calf and the back of the leg & skin along the lateral border of the foot and the lateral side of the little toe.

Muscular branches supply both heads of the gastrocnemius, plantaris, soleus, and popliteus

Articular branches supply the knee joint.

24
Q

supply of fibular nerve

A

Cutaneous branches

sural communicating branch runs downward and joins the sural nerve lateral cutaneous nerve of the calf supplies the skin on the lateral side of the back of the leg

Muscular branch to the short head of the biceps femoris muscle, which arises high up in the popliteal fossa

Divides at the neck of the fibula into 2 branches:

deep peroneal nerve Superficial peroneal nerve

25
Q

deep peroneal vs superficial peroneal

A

deep:

Muscular branches to the tibialis anterior, the extensor digitorum longus, the peroneus tertius, and the extensorm hallucis longus

Articular branch to the

ankle joint

sficial:

Muscular branches to the peroneus longus and brevis

Cutaneous: Medial and lateral branches are distributedto the skin on the lower part of the front of the leg and the dorsum of the foot. In addition, branches supply the dorsal surfaces of the skin of all the toes, except the adjacent sides of the first and second toes and the lateral side of the little toe

26
Q

describe the knee joint

A

tibio-femoral; hinge but has some deg of rotation

27
Q

Between patella and patellar surface of femur

A

patella-femoral; plane

28
Q

Stability of the joint depends on

A

Strength and actions of the surrounding muscles
Ligaments that connect the femur and tibia

29
Q

knee flexion

A

hamstring; limited by contact of calf and thigh

30
Q

knee rotation

A

Rotation – when knee is flexed

Medial rotation – popliteus, semitendinosus, semimembranosus, check by cruciates ligament

Lateral rotation – biceps femoris, checked by collateral ligament

31
Q

knee extension

A

Extension – quadriceps – limited by cruciate and collateral ligaments

32
Q

describe the capsule

A

Absent in front but forms a pouch beneath the quadriceps tendon forming a bursa (suprapatellar bursa)

Lateral and medial sides are reinformed by tendons of vastus lateralis and medialis

-Oblique popliteal ligament strengthens capsule posteriorly

33
Q

what are the extracapsular lig

A

pattelar, lateral collat, medial collat, fibular collat, oblique popliteal

34
Q

Patellar ligament

A

Patellar ligament – distal part of the quadriceps tendon

35
Q

lateral collat

A

Fibular collateral ligament (lateral collateral ligament) – rounded, cordlike strong ligament

  • Prevents excessive adduction
36
Q

medial collat

A

Tibial collateral ligament (medial collateral ligament) – strong flat band that extends from medial condyle to the medial of tibia deep part is attached to the medial mensicus prevents excessive abduction of the knee.

37
Q

oblique popliteal

A

Oblique popliteal ligament – expansion of the semimembranosus that strengthens the fibrous capsule posteriorly

38
Q

inercapsular lig

A

acl, pcl, med/lat meniscus

39
Q

acl

A

Anterior cruciate – weaker than posterior cruciate

poor blood supply slack when knee is flexed and taut when extended prevents posterior displacement of femur (or anterior displacement of tibia over femur) and hyperextension of knee
Provides rotational (tortional) stability

40
Q

pcl

A

Posterior cruciate ligament

Stronger is tight when knee is flexed prevents anterior displacement of femur on the tibia or posterior displacement of the tibia on the femur helps prevent hyperflexion during weight bearing flexed knee, PCL is the main stabilizing factor for femur

41
Q

lat meniscus

A

Lateral meniscus – circular and smaller and more freely movable than medial

42
Q

med miniscus

A

Medial meniscus

C shape and broader anterior end is attached to anterior intercondylar area of tibia, anterior to attachment of ACL; posterior end attached to posterior intercondylar area is firmly attached to the deep surface of tibial collateral ligament

43
Q

what is the unhappy triad of o’donoghue

A

med meniscus, acl, mcl

44
Q

what are the pes anserine mucles

A

sartorius, gracilis, semitendinosus

45
Q

suprapatella bursa

A

Beneath the quadriceps muscle, above the patella Communicates with knee joint is held in position by the attachment of a small portion of the vastus intermedius muscle, called the articularis genus muscle

46
Q

prepatella bursa

A

prepatellar bursa lies in the subcutaneous tissue between the skin and the front of the lower half of the patella and the upper part of the ligamentum patellae

47
Q

infrapatella bursa

A

superficial infrapatellar bursa lies in the subcutaneous tissue between the skin and the front of the lower part of the ligamentum patellae

The deep infrapatellar bursa lies between the ligamentum patellae and the tibia

48
Q

politeal bursa

A

The popliteal bursa is found in association with the tendon of the popliteus and communicates with the joint cavity Found downward on the deep surface of the tendon of the popliteus

49
Q

The semimembranosus bursa

A

is found related to the insertion of the semimembranosus muscle

between the medial head of the gastrocnemius and the medial femoral condyle and the semimembranosus tendon ommunicate with the joint cavity