ANA-LEC: Thigh and Knee Flashcards
superficial fascia vs deep fascia
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
what covers the saph opening
cribriform fascia
superficial vs deep inguinal lymph nodes
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
what are the muscles of the anterior compartment
sartorius, iliacus, psoas, pectineus, quadriceps, femoris
blood and nerve supply of anterior compartment
femoral artery/nerve
what are the branches of femoral nerve
ant: medial and intermediate cutaneous; muscular branch
post: saphenous; muscular branches of rectus femoris
what is the cutaneous supply of the thigh
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
sartorius
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
what are the contents of femoral sheath
lat: femoral artery
intermediate: femoral vein
medial: lymph vessels and femoral canal
where is the femoral triangle located
upper third of the anterior medial part of thigh below inguinal ligament
what are the boundaries of the femoral triangle
sup: inguinal lig
lat: sartorius
med: adductor longus
floor: iliopsoas, pectineus, adductor longus
roof: skin and fascia of thigh
what are the contents of the femoral triangle
- femoral nerve and branches,
- femoral sheath, femoral artery and branches,
- femoral vein and tributaries
- deep inguinal nodes
walls of subsartorial canal
Anteromedial wall – formed by the sartorius muscle and fascia
Posterior wall – adductor longus and magnus
Lateral wall – vastus medialis
location of subsartorial canal
medial aspect of the middle third of the thigh deep to the sartorius muscle
contents of sabsartorial canal
Terminal part of the femoral artery
Femoral vein
Deep lymph vessels
Saphenous nerve, nerve to vastus medialis and terminal part of the obturator nerve
muscles of the medial compartment
gracilis, adductor longus/brevis/magnus, obturator externus
blood and nerve supply of medial compartment
profunda femoris, obturator artery
obturator nerve
anterior div of obturator nerve
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.
posterior div of obturator nerve
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
muscles of posterior compartment
hamstrings, adductor magnus
blood and nerves of posterior compartment
profunda femoris artery
sciatic nerve
what are the branches of sciatic nerve
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
what does the tibial nerve supply
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.
supply of fibular nerve
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
deep peroneal vs superficial peroneal
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
describe the knee joint
tibio-femoral; hinge but has some deg of rotation
Between patella and patellar surface of femur
patella-femoral; plane
Stability of the joint depends on
Strength and actions of the surrounding muscles
Ligaments that connect the femur and tibia
knee flexion
hamstring; limited by contact of calf and thigh
knee rotation
Rotation – when knee is flexed
Medial rotation – popliteus, semitendinosus, semimembranosus, check by cruciates ligament
Lateral rotation – biceps femoris, checked by collateral ligament
knee extension
Extension – quadriceps – limited by cruciate and collateral ligaments
describe the capsule
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
what are the extracapsular lig
pattelar, lateral collat, medial collat, fibular collat, oblique popliteal
Patellar ligament
Patellar ligament – distal part of the quadriceps tendon
lateral collat
Fibular collateral ligament (lateral collateral ligament) – rounded, cordlike strong ligament
- Prevents excessive adduction
medial collat
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.
oblique popliteal
Oblique popliteal ligament – expansion of the semimembranosus that strengthens the fibrous capsule posteriorly
inercapsular lig
acl, pcl, med/lat meniscus
acl
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
pcl
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
lat meniscus
Lateral meniscus – circular and smaller and more freely movable than medial
med miniscus
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
what is the unhappy triad of o’donoghue
med meniscus, acl, mcl
what are the pes anserine mucles
sartorius, gracilis, semitendinosus
suprapatella bursa
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
prepatella bursa
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
infrapatella bursa
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
politeal bursa
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
The semimembranosus bursa
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
