Anterior and Medial Thigh

Question 1

What is the sartorius?

Answer 1

Anterior compartment of the thigh
Originates from the anterior superior iliac spine and inserts into medial proximal tibia
Action - flexion, abduction, laterally rotate hip
Biarticular muscle - crosses 2 joints (hip and knee)

Question 2

What is the pectineus?

Answer 2

Anterior compartment of inner thigh
Originates at pectineal line of pubis inserts at pectineal line of femur
Dual functions due to its anatomical position - Hip flexion, hip adduction , medial rotation
Can be innervated by 2 diffrent nerves - femoral + obturator nerve

Question 3

What are the 4 heads of the quadriceps femoris and where do they attach ?

Answer 3

Rectus femoris - Anterior inferior iliac spine
Vestus medialis - Intertrochanteric line, linea aspera
Vastus lateralis - Greater trochanter, linea aspera
Vastus intermedius - Anterior femur

Question 4

Where do heads of quadriceps insert and what is their action?

Answer 4

All insert on patella which attaches to the
tibial tuberosity via the patellar ligament.
Action: Extend knee, Rectus Femoris also flexes hip

Question 5

What muscles flex the hip?

Answer 5

Psoas major and Iliacus
Combine to form Iliopsoas
Both insert on lesser trochanter
Iliacus originates at iliac fossa and psoas major at transverse processes, sides of vertebral bodies, and intervertebral discs of T12 to L5 vertebrae

Question 6

What is the femoral triangle?

Answer 6

Borders “SAIL”- Sartorius, Inguinal ligament and Adductor longs
Contents “NAVEL” ;
femoral Nerve
femoral Artery
femoral Vein
Empty space
Lymphatics
AVEL enclosed in femoral sheath

Question 7

Describe the patellar reflex:

Answer 7

Hit patellar ligament with reflex hammer
Impact stretches quadriceps
Sensory nerve stimulated
Kick (knee extension)
Reflex arc occurs
Spinal cord (L2,3,4)
L2,3,4 motor nerves tell quadriceps to contract
L2,3,4 & femoral nerve are functioning

Question 8

What is the reasoning behind myotactic reflex?

Answer 8

Stretch (myotactic) reflex is a
protective mechanism to prevent
overstretching of the muscle

Question 9

What muscles are found in the medial compartment of the lower limb?

Answer 9

Gracilis
Adductor Longus
Aductor Brevis
Adductor Magnus
Obturator externus

Question 10

Describe the gracilis:

Answer 10

Medial compartment of thigh
Originates from inferior ramus and body of the pubis and inserts at the medial surface of the tibia
Function - hip abduction, hip flexion, knee flexion and medial rotation of the knee

Question 11

Describe the obturator externus:

Answer 11

Originates at Obturator membrane and inserts at trochanteric fossa just below greater trochanter
Action: Laterally rotate hip
Formed by L2,3,4 anterior rami
Runs medial to Psoas major
Exits pelvis via obturator canal
Divides into an anterior & posterior branch

Question 12

Describe the Adductor Longus and the Adductor Brevis:

Answer 12

Longus: Pubis (body) → Linea aspera
Brevis: Pubis (body & inf. ramus) → Linea aspera

Question 13

Describe the Adductor Magnus:

Answer 13

Adductor part;
Runs from Ischiopubic ramus → Linea aspera
Action is adduct, flex hip

Hamstring part:
Runs from Ischial tuberosity → Adductor tubercle
Action is to extend hip

Question 14

What is the Subsartorial canal?

Answer 14

Canal between femoral triangle & adductor hiatus, deep to Sartorius
Contains;
Nerve to vastus medialis
Saphenous nerve
Femoral artery
Femoral nerve

Inferiorly canal opens into the Adductor hiatus
Femoral vessels pass through hiatus to enter the
Popliteal fossa posterior to the knee

Question 15

What is the adductor hiatus ?

Answer 15

Gap in the adductor Magnus for nerves and vasculature

Question 16

What is the lumbar plexus?

Answer 16

Plexus of nerves formed by L1- L4 anterior rami
Located posterior to Psoas major muscle

Iliohypogastric Nerve - L1, innervates lower abdominal muscles
Ilioinguinal Nerve - L1, motor supply to part of the abdominal wall muscles
Genitofemoral Nerve - L1,2,
Lateral Femoral Cutaneous Nerve - L2,3
Obturator Nerve (L2, L3, L4)
Femoral Nerve (L2, L3, L4):
Accessory Obturator Nerve (L3, L4)

Question 17

Describe the path of the femoral artery:

Answer 17

Abdominal Aorta divides at L4 level into R & Common Iliac aa
Which divide again into R & L External & Internal Iliac aa
External iliac a runs deep to inguinal lig. & becomes Femoral a
Femoral a runs in adductor canal & passes through adductor hiatus where it changes its name to popliteal artery

Question 18

Describe the path of obturator artery:

Answer 18

Internal iliac a divides into many branches - obturator artery
This exits the pelvis via the obturator canal & foramen
It divides into ant. & post. branches that pass ant. + post. to adductor brevis

Question 19

Describe the femoral vein:

Answer 19

The femoral vein runs alongside the femoral artery and femoral nerve in the femoral triangle
Originates as a continuation of the popliteal vein at the adductor hiatus
Transitions into the external iliac vein as it passes under the inguinal ligament into the pelvis
Receives blood from long saphenous vein