Anatomy dissection 1 (any additional points not mentioned in lecture is here)

Question 1

What does the femoral canal contain (this is located in the femoral triangle)

Answer 1

Contains the deep inguinal lymph nodes

Question 2

What lies within the femoral sheath ? (note the femoral sheath is within the femoral triangle)

Answer 2

Femoral artery and vein - it surrounds the proximal parts of the artery, inferiorly it blends in with the adventitia of these vessels

Question 3

What are the nerve route of the femoral nerve ?

Answer 3

L2-4

Question 4

Describe the route of the femoral nerve in the lower limb

Answer 4

Enters and passes through the femoral triangle lateral to the femoral vessels and gives of articular branches to the hip and knee joints

The terminal cutaneous branch of the femoral nerve is the saphenous nerve which continues, with the femoral artery and vein, through the adductor canal.

Question 5

Where does the saphenous nerve leave the adductor canal ?

Answer 5

Distally by passing between sartorius and gracilis (from the medial compartment)

Question 6

What does the saphenous nerve supply ?

Answer 6

Supplies the fascia and skin of the anteromedial aspects of the knee and leg and the medial aspect of the foot where it accompanies the great saphenous vein.

Question 7

Where do femoral hernias occur and why ?

Answer 7

The femoral canal - due to increased abdominal pressure causing peritoneum to herniate into the canal

Question 8

When thinking about the contents of the femoral triangle what is the most medial and what is the most lateral content ? (not talking about the walls of the femoral triangle)

Answer 8

Most medial is the femoral nerve

Most lateral is the femoral canal (containing deep inguinal lymph nodes and adipose tissue)

Question 9

What are the arteries which supply the majority of the blood to the head of the femur

Answer 9

Medial and lateral circumflex femoral arteries through there retinacular branches

Question 10

What does the medial and lateral circumflex arteries arise from ?

Answer 10

Arise from the profunda femoris

Question 11

This artery can be used an as access route in angiograms, coronary artery stenting, aortic & mitral valve replacements, aortic aneurysm repair, contralateral femoral artery stenting, contralateral uterine artery embolisation etc - what is the artery (hint still talking about lower limb)

Answer 11

Femoral artery

Question 12

Describe the origin and attachments of the inguinal ligament

Answer 12

It runs between the anterior superior iliac spine (ASIS) and the pubic tubercle

Question 13

The inguinal ligament forms a ‘‘gutter’’ - what does the medial half of this gutter contain ?

Answer 13

The inguinal canal (contains the spermatic cord (in males) or the round ligament (in females))

Question 14

The femoral vessels, femoral nerve and the iliopsoas muscle/combined tendon enter/leave the lower limb how ?

Answer 14

By passing deep to the inguinal ligament

Question 15

What is the main function of the anterior muscles of the knee ?

Answer 15

Flex at the hip, extend at the knee

Question 16

What are the major muscles of the anterior compartment of the thigh ?

Answer 16

• Iliopsoas
• Sartorius
• Quadriceps femoris (Rectus femoris, vastus medialis, vastus intermedius, vastus lateralis)

Question 17

Describe the nerve supply to the muscles of the anterior compartment of the thigh

Answer 17

• Iliopsoas - Anterior rami of lumbar spinal nerves
• Sartorius, quadriceps femoris (rectus femoris, vastus medialis, intermedius and lateralis) - femoral nerve

Question 18

Describe what the ‘‘knee jerk’’ is

Answer 18

• A deep tendon reflex by stricking the patellar ligament
• Normally produces a reflex contraction of the quadriceps and slight extension at the knee joint.

Question 19

What does a positive ‘‘knee jerk’’ mean

Answer 19

Confirms the function of the muscle, its nerve supply (femoral nerve: spinal roots L2-L4)

Question 20

What are the muscles of the medial compartment of the thigh referred to as and why?

Answer 20

Referred to as the ‘‘adductors’’ because there function is to adduct the thigh at the hip joint

Question 21

What are the muscles of the medial compartment of the thigh ?

Answer 21

• Gracilis
• ADDuctor longus, brevis and magnus
• Obturator externus

Question 22

What is the nerve supply of the muscles of the medial compartment of the thigh ?

Answer 22

All supplied by the obturator nerve expect the hamstring part of the ADDuctor magnus which is supplied by the tibial nerve

Question 23

What does the obturator nerve, artery and vein enter the medial compartment of the thigh through?

Answer 23

Obturator foramen

Question 24

Where does all lymph in the lower limb untimately drain into ?

Answer 24

The external iliac lymph nodes

Question 25

What is the sensory innervation of the thigh ? (think more cutaneously the other innervations talked about are innervating the muscles)

Answer 25

• The anterior cutaneous nerve of the thigh, which is a branch of the femoral nerve (L2-L4)
• The lateral cutaneous nerve of the thigh, which is a branch of the lumbosacral plexus (L2-3)
• The cutaneous branch of the obturator nerve (L2-4)