Anatomy Flashcards
What makes up the borders, roof and floor of the femoral triangle?
Superior border - inguinal ligament
Medial border - lateral border of the adductor longus
Lateral border - medial border of the sartorius
Floor - iliopsoas and pectineus
Roof - deep fascia (fascia lata)
Describe the contents of the femoral triangle.
Which structure here is NOT included in the femoral sheath? What is the only structure in the femoral canal?
From lateral to medial:
Nerve (not included in the femoral sheath)
Artery
Vein
Lymphatics (only structure found in the femoral canal, along with adipose tissue. Forms the most medial part of the femoral sheath)
Describe the lymph drainage of the lower limb
System of superficial lymphatics follow the great and small saphenous veins. Drain to the superficial inguinal lymph nodes, and then on to the external iliac lymph nodes. (Lymph draining alongside the small saphenous vein drains deep with the vein into the popliteal lymph nodes.)
The deep lymphatics follow the deep veins (e.g. anterior and posterior tibial veins, fibular vein, popliteal vein, profunda femoris, femoral veins). All lymph following the deep veins drains into the popliteal lymph nodes.
Anterior compartment of the thigh (not including quadriceps) - muscles and corresponding attachments
Iliopsoas (psoas major and iliacus)
- Origins - iliac fossa (iliacus) and lumbar spine (psoas major)
- Insertions - lesser trochanter of the femur
- Actions - flexion of lower limb at hip joint and assists in lateral rotation
- Innervations - psoas major is L1-L3 anterior rami, iliacus is femoral nerve (L2-L4)
Sartorius
- Origins - ASIS
- Insertions - superior medial surface of the tibia
- Actions - flexor, abductor and lateral rotator of hip, and flexor of knee
- Innervations - femoral nerve (L2-L4)
Pectineus
- Origins - pectineal line on the anterior surface of the pelvis
- Insertions - pectineal line on the posterior surface of the femur
- Actions - adduction and flexion at the hip
- Innervations - femoral nerve
Quadriceps femoris - muscles, attachments, actions and innervations
Rectus femoris
- Origins - ilium, just superior to the acetabulum
- Insertions - attaches to the patella via the quadriceps femoris tendon
- Actions - only muscle of the quadriceps to cross both the hip and knee. Flexes hip, extends knee
- Innervations - femoral nerve
Vastus lateralis
- Origins - greater trochanter and the lateral lip of the linea aspera
- Insertions - patella via the quadriceps tendon
- Actions - extends knee and stabilises patella
- Innervations - femoral nerve
Vastus medialis
- Origins - the intertrochantic line and the medial lip of the linea aspera
- Insertions - quadriceps tendon
- Actions - extends knee and stabilises patella
- Innervations - femoral nerve
Vastus intermedius
- Origins - anterolateral femur
- Insertions - quadriceps tendon
- Actions - extends knee and stabilises patella
- Innervations - femoral nerve
Muscles in the adductor (medial) compartment of the thigh, along with attachments, actions and nerve innervations
Adductor longus
- Origin - pubic bone
- Insertion - linea aspera, middle 1/3rd
- Action - adduction and flexion of hip
- Innervation - obturator nerve, anterior branch
Adductor brevis
- Origin - anterior surface of the inferior ramus, and body of the pubis
- Insertion - lesser trochanter and linea aspera
- Action - adduction of hip
- Innervation - obturator nerve
Adductor magnus
- Origin - pubis, tuberosity of the ischium
- Insertion - linea aspera and adductor tubercle of femur
- Action - adduction of hip, as well as flexion (adductor portion) and extension (hamstring portion)
- Innervation - obturator nerve, posterior branch. Also tibial nerve
Gracillis
- Origin - ischiopubic ramus
- Insertion - tibia
- Action - flexes, medially rotates and adducts hip
- Innervation - anterior branch of obturator nerve
(Obturator externus)
- Origin - obturator foramen
- Insertion - trochanteric fossa of femur
- Action - adduct and laterally rotate thigh
- Innervation - obturator nerve, posterior branch
Describe the route of the obturator nerve and artery into the medial compartment of the thigh
Obturator artery arises from the internal iliac artery and travels along the lateral pelvic wall with the obturator nerve and vein. It exits the pelvis through the obturator canal
The Obturator nerve arises from the ventral rami of spinal nerves L2-L4 and supplies the muscles of the medial thigh, as well as the skin of the distal medial thigh. Also exits the pelvis through the obturator canal and splits to give off the anterior and posterior branches
Describe the blood supply to the head of the femur.
What structure does the artery to the head of the femur pass through?
External iliac artery > Femoral artery > Profunda femoris > medial and lateral circumflex arteries, which give off retinacular arteries
Head of the femur is also supplied by the artery to head of femur, which is usually a branch of the obturator artery. This passes through the ligamentum teres
Which three nerves supply sensory innervation to the thigh?
- anterior cutaneous nerve of the thigh, branch of the femoral nerve (L2-L4)
- lateral cuteaneous nerve of the thigh, branch of the lumbosacral plexus (L2-3)
- cutaneous branch of the obturator nerve (L2-L4)
What two important foramina allow nerves to enter/exit the perineum?
What ligaments form these two foramina?
Greater sciatic foramen
Lesser sciatic foramen
Formed by the sacrotuberous and sacrospinous ligaments
What muscles are contained in the superficial muscle group of the gluteal region?
What is their nerve innervation?
- Gluteus maximus
- Gluteus medius
- Gluteus minimus
- Tensor fascia latae
Innervated by the gluteal nerves - glut. max. is innervated by the inferior gluteal nerve, all the others are innervated by the superior gluteal nerve
What muscles are contained in the deep muscle group of the gluteal region?
What is their nerve innervation?
From top to bottom…
- Piriformis
- Superior gemelli
- Obturator internis
- Inferior gemelli
- Quadratus femoris
All innervated by nerves from the sacral plexus
What is the function of the superficial gluteal muscles?
Extension, abduction and medial rotation of the thigh
What is the function of the deep gluteal muscles?
Stabilisers of the hip and lateral rotation of the thigh
What nerve roots does the sciatic nerve come off of?
What does it supply?
L4-S3
Supplies the posterior thigh, all leg and foot muscles and most of the skin via the tibial and common fibular branches
What does the posterior cutaneous nerve of the thigh supply?
Skin over the posterior thigh, the popliteal fossa, the lateral perineum and the upper medial thigh
What muscle does the sciatic nerve usually exit the pelvis inferiorly to?
Where is it in relation to other structures exiting the greater sciatic foramen?
Usually exits inferiorly to the piriformis
Usually the most lateral structure exiting the greater sciatic foramen
Which structure within the femoral triangle is NOT in the femoral sheath?
The femoral nerve
(Remember - NAVEL for contents of femoral triangle, from lateral to medial)
