Anterior and Medial Thigh Flashcards
What are the two thigh fascia layers?
Superficial and Deep
What is in the superficial thigh fascia?
It’s deep to the dermis and contains fat, cutaneous nerves and veins
What is in the deep thigh fascia?
It’s called Fascia Lata, is dense connective tissue and located between the superficial fascia and thigh muscles
Where does the Greater Saphenous Vein start?
It’s found in the superficial fascia and begins at the medial end of the dorsal venous arch.
- anterior to the medial malleolus
- posterior to the medial femoral condyle
What is the longest vein in the body?
The Greater Saphenous Vein
Where does the Greater Saphenous Vein run?
Superolaterally to the Saphenous opening
- frequently communicates with the accessory Saphenous vein
- terminates into the Femoral vein
How many valves are in the Greater Saphenous Vein?
10-12 flaps of endothelium
More in the leg than thigh
Located inferiorly to perforating veins
What are the three main Venous Tributaries near the termination of the Greater Saphenous Vein?
Superficial Circumflex Iliac
Superficial Epigastric
External Pudendal
What can the Greater Saphenous Vein be used for?
To administer blood, electrolytes, drugs and for coronary bypass surgery
What is a Saphenous cutdown and what can it result in?
It’s an incision made anterior to medial malleolus to harvest part of the vein. It can result in pain along the medial border of the foot from the Saphenous nerve.
Where do most cutaneous thigh nerves derive from?
Lumbar and Sacral Plexuses
What is the Lumbar Plexus formed from?
L1-L4 Ventral Rami within Psoas major
What are the two largest and most important branches of the Lumbar Plexus?
Obturator nerve L2-L4, medial thigh
Femoral nerve L2-L4, front of leg
Spinal Roots of Obturator nerve?
L2-L4
Spinal Roots of Femoral Nerve?
L2-L4
What does the Sacral Plexus consist of?
It consists of the lumbosacral trunk, descending part of L4/L5 and S1-S4 ventral rami
What are the two main nerves of the Sacral Plexus?
Sciatic nerve and Pudendal nerve
Name the 6 anterior cutaneous nerves of the thigh
Lateral cutaneous branch of the sub costal nerve- T12
Femoral branches of the genitofemoral nerve-L1 and L2
Ilioinguinal nerve-L1
Lateral Femoral cutaneous nerve- L2/L3
Anterior(intermediate and medial) cutaneous branches of the femoral nerve- L2-L4
Cutaneous branch of the obturator nerve- L2
What is the greater Saphenous also called (heart as well)
Fossa Ovalis
What is the Falciform Margin?
backwards “C”. Sharply curved free margin of the Saphenous opening in the Fascia Lata. It forms the superior, inferior, and lateral boundaries of the Saphenous opening.
Also called Margo falciformis
Where is the Saphenous opening?
Just inferior to the inguinal ligament, where the greater Saphenous vein reaches the Femoral Vein
What is the Cribriform Fascia?
Medial margin of Saphenous Opening, its a thin sieve-like layer of connective tissue
What is a Distinct Feature of the Fascia Lata?
It thickens laterally and is called iliotibial tract
Where is the Iliotibial Tract found?
Goes from Iliac Tubercle to “Gerdy’s tubercle” on the lateral tibial condyle
What is the Fascia Lata made up of?
Reinforced by tendinous fibers from TFL and G Max
What does Fascia Lata do?
Acts to stabilize the hip and knee
What do the Medial thigh muscles do?
ADDuction
Innervated by Obturator nerve
What do the Anterior thigh muscles do?
Extension
Innervated by the Femoral nerve
What are the three sections of thigh muscles?
Anterior, Medial and Posterior
What are the Anterior Thigh Muscles? Hip Flexors and Knee Extensors
Pectineus
Sartorius
Iliopsoas- P. Major, P. Minor and Iliacus
Quadriceps Femoris- Rectus Femoris, Vastus Lateralus, V. Medialis, V. Intermedius
Tensor Fascia Latae
Attachments for Pectineus?
P: Superior Ramus of Pubis
D. Pectineal line of Femur, just below the lesser trochanter
Innervation for Pectineus?
Femoral Nerve ( sometimes also Obturator)
Functions of Pectineus?
Adduct and flex hip joint, assist with medial rotation
Blood supply for Pectineus?
Medial Femoral Circumflex Artery
Attachments for Sartorius?
P: ASIS, Superior part of notch inferior to it
D: Superior part of medial surface of tibia
Innervation of Sartorius?
Femoral Nerve
L2 and L3
Functions of Sartorius?
Flex, ABduct, lateral hip rotation, flex knee
Blood supply of Sartorius?
Lateral Femoral Circumflex Artery
What are the muscles of Iliopsoas?
Psoas Major, Iliacus, and Psoas Minor
Attachments for Psoas Major?
P: sides of T12-L5 vertebrae and the discs between them
Transverse processes of all lumbar vertebrae
D: Lesser Trochanter of the Femur
Innervation of Psoas Major?
Anterior Rami of Lumbar nerves L1-L3
Functions of Psoas Major?
Flex hip, and controls deviation of trunk during standing
Blood supply of Psoas Major?
Subcostal artery, Lumbar aa
Iliacus attachments?
P: Iliac fossa and Iliac crest, ala of sacrum
D: Lesser trochanter of femur
Innervation of Iliacus?
Femoral Nerve
Functions of Iliacus?
Flex hip, and controls deviation of trunk during standing
Blood supply of Iliacus?
Subcostal artery and Lumbar aa
Why is Psoas Minor weird?
Only 50-60% of people have it, and its usually only present on one side
What are the muscles of Quadriceps Femoris?
Vastus Lateralis, Vastus Intermedius, Rectus Femoris, Vastus Medialis
What is the innervation of Quadriceps Femoris?
Femoral Nerve
What are the functions of Quadriceps Femoris?
Extend the knee joint
What is the Blood supply of Quadriceps Femoris?
Lateral femoral circumflex artery
Attachments for Vastus Lateralis?
Greater trochanter and lateral lip of the lines aspera
Wide aponeurosis at the distal femur and attaches to the base of the patella via the common quadriceps tendon
Attachment for Vastus Intermedius?
Anterior and lateral surfaces of shaft of femur
Common quadriceps tendon at the base of patella
Attachment for Rectus Femoris?
ASIS and ilium superior to acetabulum
Common quadriceps tendon at the base of patella
Extend knee joint, stabilize hip joint, and help iliopsoas flex hip
Attachment for Vastus Medialis?
Intertrochanteric line and medial lip of Linda aspera
Common quadriceps tendon at the base of patella
What us the innervation of Tensor Fasciae Latae?
Superior gluteal nerve, L4, L5, S1
What are the Attachments of Tensor Fasciae Latae?
ASIS and anterior external Iliac crest
Lateral tibial condyle via iliotibial tract- Gerdy’s tubercle
What does the Patellar Tendon Reflex test?
Test the integrity of femoral nerve, L2-L4
What is the mechanism of the Patellar Tendon Reflex test?
AFFÉRENT fibers of muscle spindles in the quadriceps sends impulses to the spinal cord
EFFERENT impulses are transmitted back to the the quadriceps, resulting in a jerk-like extension of the leg
What are the medial thigh muscles?
Adductor Longus, Adductor Brevis Pectineus Gracilis Adductor Magnus Obturator externus
What is the Femoral Triangle?
Subfacial space-triangular depression along the superomedial 1/3 thigh
What are the Boundaries of the Femoral Triangle?
Floor- Pectineus and Iliopsoas
Roof- fascia lata
What’s in the Femoral Triangle?
Femoral Nerve, branches
Femoral Artery, branches
Femoral Vein, tributaries
Inguinal Lymph Nodes
What is the Femoral Nerve?
Largest branch of the Lumbar Plexus, supplies most anterior thigh muscles, knee and hip joint
Where does the Femoral Nerve go?
Enters thigh just lateral to midpoint of inguinal ligament-lateral to femoral arteries
Terminal branch of Femoral Nerve is the Saphenous Nerve
What is the chief arterial supply to the lower limb?
Femoral Artery