Anatomy: Anterior and Medial Thigh

Question 1

Anterior compartment of thigh

Answer 1

Femoral Nerve
Extension of knee
Flexion of hip

Question 2

Medial compartment of thigh

Answer 2

Obturator nerve

Adduction of thigh

Question 3

Posterior compartment of thigh

Answer 3

Sciatic nerve

Extension of thigh and flexion of knee

Question 4

deep fascia of thigh, tough layer of fascia that forms sleeve around muscles of thigh

Answer 4

fascia lata

Question 5

Laterally, fascia lata splits to enclose belly of muscle =

Answer 5

tensor fasciae latae

Question 6

TFL pulls on thickened portion of fascia lata =

Answer 6

iliotibial tract (IT band) - stabilize knee and weakly rotate hip

Question 7

The______, which begins at the medial end of the dorsal venous arch of the foot and ascends obliquely, terminates in the femoral vein by passing through saphenous opening in the fascia lata.

Answer 7

Great saphenous vein

Question 8

Constant location of greater saphenous vein

Answer 8

1 cm in front of medial malleolus (important for ER transfusion)

Question 9

The great saphenous vein terminates in the __________

Answer 9

femoral vein

Question 10

is the largest branch of the lumbar plexus (consists of ventral rami of T12, L1, L2, L3, 1/2 L4)
supplies the muscles of the anterior compartment

Answer 10

Femoral Nerve

Question 11

Innervates all of the adductors of the thigh (medial compartment) are supplied by this nerve. The hamstring part of the adductor magnus is supplied by the sciatic nerve.

Answer 11

Obturator nerve

Question 12

Tensor Fasciae Latae

Answer 12

Anterior iliac crest to tibia via IT band
Superior gluteal nerve
Flex thigh and stabilize knee in extension

Question 13

Femoral triangle boundaries

Answer 13

Inguinal ligament-superiorly
Adductor longus-medially
Sartorius-laterally

Question 14

Contents of Femoral Triangle

Answer 14

Femoral Nerve, Femoral Artery and branches, Femoral Vein, inguinal lymph nodes

Question 15

Femoral nerve spinal cord

Answer 15

L2-4 (posterior divisions)

Question 16

Femoral artery

Answer 16

provides the chief arterial supply to lower limb; is a continuation of external iliac artery above the inguinal ligament and becomes continuous with the popliteal artery as it courses through the Adductor canal and passes through the Adductor hiatus (an intermuscular cleft in the adductor magnus muscle) into the popliteal fossa posteriorly.

Question 17

Femoral vein

Answer 17

becomes continuous with the external iliac vein posterior to the inguinal ligament.

Question 18

prolongation of the deep abdominal fascia surrounding the femoral vessels proximally. It allows the vessels to glide beneath the inguinal ligament during hip flexion. The sheath is divided into 3 compartments:
Lateral – contains the femoral artery
Intermediate–contains the femoral vein
Medial—named the femoral canal, is mostly empty except for a small amount of fat, loose connective tissue, and sometimes a few lymph nodes.

Answer 18

Femoral sheath

Question 19

femoral sheath

Answer 19

prolongation of deep abdominal fascia surrounding the femoral vessels proximally. It allows the vessels to glide beneath the inguinal ligament during hip flexion. The sheath is divided into 3 compartments:
Lateral – contains the femoral artery
Intermediate–contains the femoral vein
Medial—named the femoral canal, is mostly empty except for a small amount of fat, loose connective tissue, and sometimes a few lymph nodes.

Question 20

femoral hernia

Answer 20

Protrusion of an abdominal structure: intestine, fat, mesentery.
through an opening in the abdominal wall.
Lateral to pubic tubercle

Question 21

Sartorius

Answer 21

Femoral nerve

flexes, abducts and laterally rotates hip joint and flexes and medially rotates knee joint

Question 22

an intermuscular passageway by which the neurovascular bundle of the thigh traverses the middle third of the thigh. Sartorius forms the roof of the canal and adductor longus the floor.

Answer 22

Adductor canal - holds femoral artery, vein and part of nerve (saphenous)

Question 23

The _______________ is the longest cutaneous branch of the femoral nerve. It descends on the anterior thigh toward the medial side of the knee, behind sartorius. It the pierces the fascia lata between the tendons of sartorius and gracilis and becomes cutaneous, supplying the medial leg to the medial side of the foot, accompanied by the great saphenous vein.

Answer 23

Saphenous nerve

Question 24

This avulsion fracture of ______ can result from sudden forceful contraction and TFL
such as in jumping sports

Answer 24

sartorius

Question 25

Quadriceps Femoris

Answer 25

``` Femoral nerve Femor Extensor of leg 1. Rectus femoris (flexes hip and extends knee) -AIIS 2. Vastus lateralis 3. Vastus intermedius 4. Vastus medialis *Vasti on shaft of femus All insert onto quadriceps tendon --> tibial tuberosity ```

Question 26

Quadriceps tendon

Answer 26

crosses the knee joint anteriorly, encloses the patella, and inserts as the patellar ligament onto the tibial tuberosity.

Question 27

pain in the area of the tibial tuberosity where the patellar ligament attaches; an epiphysitis of the tuberosity. Usually occurs in adolescents (10-15, growth spurt) and is aggravated by activities like running, jumping, squatting and kneeling. Risk factors include excess weight and overzealous activity.

Answer 27

Osgood-Schlatter disease

Question 28

Patellar Tendon Reflex

Answer 28

knee jerk; patient sits on a table with their legs dangling. A firm strike on the patellar ligament with a reflex hammer usually causes the leg to extend. If the reflex is normal, a hand on the person’s quadriceps should feel the muscle contract. This tendon reflex tests the integrity of the femoral nerve and the L2-L4 spinal cord segments

Question 29

Knee jerk tests _________

Answer 29

L2-L4 (femoral nerve)

Question 30

2 muscles form floor of femoral triangle

Answer 30

Iliopsoas, Pectineus

Question 31

Iliopsoas

Answer 31

Femoral Nerve and lumbar plexus | Powerful flexor of hip joint

Question 32

Pectineus

Answer 32

Femoral nerve (sometimes obturator) flexes and adducts Often considered part of adductor compartment

Question 33

Fibers of the _____ and the _____ muscle fuse in the pelvis to form the iliopsoas , which inserts on the lesser trochanter. Innervation is via _______

Answer 33

Fibers of the iliacus and the psoas muscle fuse in the pelvis to form the iliopsoas , which inserts on the lesser trochanter. Innervation is via ventral rami of L1-L3.

Question 34

Iliopsoas may act as a _____ of the ____ or of the ______, depending on which end of the muscle is fixed. liopsoas also ________ the femur.

Answer 34

Iliopsoas may act as a flexor of the hip or of the vertebral column, depending on which end of the muscle is fixed. liopsoas also internally rotates the femur.

Question 35

Branches of deep femoral artery (2 significant)

Answer 35

Medial circumflex femoral artery Lateral circumflex femoral artery (perforating branches)

Question 36

2 anastomoses around femur

Answer 36

Cruciate (1st perforating, inferior gluteal branches, med/later c. f.) Trochanteric (Superior gluteal, inferior gluteal, med c.f., lat c.f.)

Question 37

Obturator nerve spinal cord

Answer 37

L2,3,4 (from lumbar plexus) - anterior divisions

Question 38

Hamstring part of adductor magnus supplied by

Answer 38

tibial nerve

Question 39

All adductors of thigh supplied by

Answer 39

Obturator nerve

Question 40

Medial compartment of thigh muscles

Answer 40

1. Gracilis: Gracilis adducts the thigh and flexes the leg – crosses two joints. 2. Adductor longus 3. Adductor brevis 4. Adductor magnus **Adduct and medially rotate thigh at hip joint

Question 41

medial femoral circumflex artery deep in the _____ and between _____ and ____.

Answer 41

medial femoral circumflex artery deep in the femoral triangle and between pectineus and psoas.

Question 42

The anterior branch of the obturator nerve lies on the surface of the ______, deep to ______

Answer 42

The anterior branch of the obturator nerve lies on the surface of the adductor brevis, deep to adductor longus

Question 43

The posterior branch of the obturator nerve lies deep to the ______ and ______

Answer 43

The posterior branch lies deep to the brevis and pectineus

Question 44

Adductor magnus supplied by

Answer 44

tibial and obturator nerves

Question 45

blood supply to medial thigh

Answer 45

obturator artery, branch of internal iliac

Question 46

What divides a/p obturator nerves?

Answer 46

Adductor brevis

Question 47

Groin pull

Answer 47

strain, stretching and possibly tearing of the proximal attachments of the adductor muscles of the thigh (and sometimes flexors). Groin injuries usually occur in sports that require quick starts such as short-distance racing

Question 48

Hip reinforced by 3 ligaments:

Answer 48

Iliofemoral Pubofemoral Ischiofemoral

Question 49

Iliofemoral ligament

Answer 49

most important; prevents overextension of joint; anterior; prevents hyperextension of hip joint – strongest ligament in the body. In quiet standing position, most of the body’s weight and pressure rests on the iliofemoral ligament. Iliofemoral ligament attaches to AIIS and acetabular labrum superiorly and the intertrochanteric line distally.

Question 50

Pubofemoral ligament

Answer 50

anterior/inferior; prevents overabduction of the hip joint.

Question 51

Ischiofemoral ligament

Answer 51

posterior; Weakest of three ligaments.

Question 52

A fracture/traumatic dislocation of the femoral neck can cause

Answer 52

compromise blood supply to head of femur (MCFA, anastomoses) --> avascular necrosis of the femoral head

Question 53

Fractures of neck of femur | -limb is usually ____ rotated and _____

Answer 53

laterally rotated and shorter

Question 54

Hip dislocation

Answer 54

congenital (hip dysplasia) or acquired, posterior most common Limb medially rotated and shorter (psoas)

Question 55

Femoral hernias pass through the____

Answer 55

femoral canal

Question 56

Which type of "hip" fracture is most common in elderly, osteoporotic females?

Answer 56

Subcapital (neck) fracture

Question 57

Which muscle of the quadriceps group acts over both the hip and knee joints?

Answer 57

Rectus Femoris

Question 58

What ligament of the hip joint contains an important blood supply to the femoral head in children?

Answer 58

Ligament of the head of the femur (round ligament or ligamentum teres)

Question 59

What structure would lie immediately lateral to a femoral hernia?

Answer 59

Femoral Vein

Question 60

A 22-year-old college football player was injured during a game. X-rays reveal an avulsion of the lesser trochanter of the femur. Severe reflex contraction of which of the following muscles would most likely cause this injury?

Answer 60

Iliopsoas