Anatomy: Anterior and Medial Thigh Flashcards
Anterior compartment of thigh
Femoral Nerve
Extension of knee
Flexion of hip
Medial compartment of thigh
Obturator nerve
Adduction of thigh
Posterior compartment of thigh
Sciatic nerve
Extension of thigh and flexion of knee
deep fascia of thigh, tough layer of fascia that forms sleeve around muscles of thigh
fascia lata
Laterally, fascia lata splits to enclose belly of muscle =
tensor fasciae latae
TFL pulls on thickened portion of fascia lata =
iliotibial tract (IT band) - stabilize knee and weakly rotate hip
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.
Great saphenous vein
Constant location of greater saphenous vein
1 cm in front of medial malleolus (important for ER transfusion)
The great saphenous vein terminates in the __________
femoral vein
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
Femoral Nerve
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.
Obturator nerve
Tensor Fasciae Latae
Anterior iliac crest to tibia via IT band
Superior gluteal nerve
Flex thigh and stabilize knee in extension
Femoral triangle boundaries
Inguinal ligament-superiorly
Adductor longus-medially
Sartorius-laterally
Contents of Femoral Triangle
Femoral Nerve, Femoral Artery and branches, Femoral Vein, inguinal lymph nodes
Femoral nerve spinal cord
L2-4 (posterior divisions)
Femoral artery
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.
Femoral vein
becomes continuous with the external iliac vein posterior to the inguinal ligament.
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.
Femoral sheath
femoral sheath
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.
femoral hernia
Protrusion of an abdominal structure: intestine, fat, mesentery.
through an opening in the abdominal wall.
Lateral to pubic tubercle
Sartorius
Femoral nerve
flexes, abducts and laterally rotates hip joint and flexes and medially rotates knee joint
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.
Adductor canal - holds femoral artery, vein and part of nerve (saphenous)
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.
Saphenous nerve
This avulsion fracture of ______ can result from sudden forceful contraction and TFL
such as in jumping sports
sartorius
Quadriceps Femoris
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
Quadriceps tendon
crosses the knee joint anteriorly, encloses the patella, and inserts as the patellar ligament onto the tibial tuberosity.
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.
Osgood-Schlatter disease
Patellar Tendon Reflex
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
Knee jerk tests _________
L2-L4 (femoral nerve)
2 muscles form floor of femoral triangle
Iliopsoas, Pectineus
Iliopsoas
Femoral Nerve and lumbar plexus
Powerful flexor of hip joint
Pectineus
Femoral nerve (sometimes obturator)
flexes and adducts
Often considered part of adductor compartment
Fibers of the _____ and the _____ muscle fuse in the pelvis to form the iliopsoas , which inserts on the lesser trochanter. Innervation is via _______
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.
Iliopsoas may act as a _____ of the ____ or of the ______, depending on which end of the muscle is fixed. liopsoas also ________ the femur.
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.
Branches of deep femoral artery (2 significant)
Medial circumflex femoral artery
Lateral circumflex femoral artery
(perforating branches)
2 anastomoses around femur
Cruciate (1st perforating, inferior gluteal branches, med/later c. f.)
Trochanteric (Superior gluteal, inferior gluteal, med c.f., lat c.f.)
Obturator nerve spinal cord
L2,3,4 (from lumbar plexus) - anterior divisions
Hamstring part of adductor magnus supplied by
tibial nerve
All adductors of thigh supplied by
Obturator nerve
Medial compartment of thigh muscles
- Gracilis: Gracilis adducts the thigh and flexes the leg – crosses two joints.
- Adductor longus
- Adductor brevis
- Adductor magnus
**Adduct and medially rotate thigh at hip joint
medial femoral circumflex artery deep in the _____ and between _____ and ____.
medial femoral circumflex artery deep in the femoral triangle and between pectineus and psoas.
The anterior branch of the obturator nerve lies on the surface of the ______, deep to ______
The anterior branch of the obturator nerve lies on the surface of the adductor brevis, deep to adductor longus
The posterior branch of the obturator nerve lies deep to the ______ and ______
The posterior branch lies deep to the brevis and pectineus
Adductor magnus supplied by
tibial and obturator nerves
blood supply to medial thigh
obturator artery, branch of internal iliac
What divides a/p obturator nerves?
Adductor brevis
Groin pull
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
Hip reinforced by 3 ligaments:
Iliofemoral
Pubofemoral
Ischiofemoral
Iliofemoral ligament
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.
Pubofemoral ligament
anterior/inferior; prevents overabduction of the hip joint.
Ischiofemoral ligament
posterior; Weakest of three ligaments.
A fracture/traumatic dislocation of the femoral neck can cause
compromise blood supply to head of femur (MCFA, anastomoses) –> avascular necrosis of the femoral head
Fractures of neck of femur
-limb is usually ____ rotated and _____
laterally rotated and shorter
Hip dislocation
congenital (hip dysplasia) or acquired, posterior most common
Limb medially rotated and shorter (psoas)
Femoral hernias pass through the____
femoral canal
Which type of “hip” fracture is most common in elderly, osteoporotic females?
Subcapital (neck) fracture
Which muscle of the quadriceps group acts over both the hip and knee joints?
Rectus Femoris
What ligament of the hip joint contains an important blood supply to the femoral head in children?
Ligament of the head of the femur (round ligament or ligamentum teres)
What structure would lie immediately lateral to a femoral hernia?
Femoral Vein
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?
Iliopsoas
