Area on the medial tibial condyle. 3 muscles insert here. 1. Semitendonosus 2. Gracilis 3. Sartoris All flex the knee and medially rotate the leg.

Anterior and Medial Thigh Flashcards by Claire Clifton

Pectineus

O: pectineal line of superior pubic ramus

I: pectineal line of femur (below lesser trochanter)

A: flexion of thigh; adduction of thigh; assists in rotation of thigh.

N: femoral nerve and sometimes obturator n.

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PSOAS MAJOR

O: bodies and transverse processes of TV12-LV5; intervertebral disc.

I: lesser trochanter

A: flexion of thigh/flexion of vertebral column.

N: L1-L3

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Iliacus

O: iliac fossa

I: lesser trochanter

A: flex thigh

N: femoral nerve

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iliopsoas

Iliacus + psoas major

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Sartorius

O: ASIS

I: superior-anterior portion of medial tibial condyle (Pes anserinus)

A: flexion, abduction, lateral rotation of thigh; flexion of knee, medial rotation of leg

N: femoral nerve

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Pes Anerinus

Area on the medial tibial condyle.

3 muscles insert here.

Semitendonosus
Gracilis
Sartoris

All flex the knee and medially rotate the leg.

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Rectus femoris

O: straight head – AIIS

reflected head – anterior acetabulum

I: tibial tuberosity via patellar ligament

A: flexion of thigh, extension of leg

N: femoral nerve

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Vastus lateralis

O: anterolateral surface of the femur

I: tibial tuberosity via patellar ligament

A:extension of leg

N:femoral nerve

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Vastus medialis

O:anteromedial surface of the femur

I: tibial tuberosity via patellar ligament

A: extension of leg

N: femoral nerve

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Vastus medialis obliquus

Distal fibers and insertion of vests medals. Maintains lateral tracking of the patella.

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Vastus intermedius

O: anterior surface of the femur

I: tibial tuberosity via patellar ligament

A: extension of leg

N: femoral nerve

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Articularis genu

O:anteroinferior surface of the femur

I: suprapatellar bursa of knee synovial joint

A: prevent suprapatellar bursa from getting impinged between the femur and patella during flexion and extension.

N: femoral nerve

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Gracilis

O:pubic body

I: medial tibial condyle (pes anserinus)

A: adduction of thigh; flexion of knee and medial rotation of the tibia.

N: obturator nerve (anterior division)

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Adductor longus

O:pubic body and inferior pubic ramus

I:middle portion of medial lip of linea aspera

A: adduction of thigh; assists with rotation of thigh.

N: obturator n (anterior division)

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Adductor brevis

O:pubic body and inferior pubic ramus

I:superior portion of medial lip of linea aspera

A: adduction of thigh; assists with rotation of thigh.

N: obturator n (anterior division)

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Adductor magnus

O: ischiopubic ramus; ischial tuberosity

I: Anterior, adductor portion: medial lip of linea aspera

Posterior, hamstrings portion: adductor tubercle

A:: entire muscle adducts thigh;

anterior portion flexes thigh;

posterior portion extends thigh.

N: Anterior, adductor portion: posterior division of obturator n

Posterior, hamstring portion: tibial component of sciatic n

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Adductor hiatus

split in the tendon of the adductor magnus

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Obturator externus

O:external surface of obturator foramen and obturator fascia

I: trochanteric fossa of femur

A:: lateral rotation of thigh

N: obturator n (posterior division)

Boundries of the femoral triangle

Superior: Inguinal Ligament

Inferior/lateral: Sartorius Medial: Adductor Longus

Floor: Iliopsoas and pectinus

Roof: Fascia lata and cribiform fascia

Apex: where sartorius meets adductor longs

Contents of Femoral Triangle

NAVL

Femoral N

Femoral A

Femoral V

Deep Lymphatics and the femoral canal

Femoral Ring

Opening of the abdomen into the femoral canal. Hernia’s can push through here

Boundaries of the femoral ring

Medial : Lacunar ligament

Lateral: Femoral Vein

Floor: Superior pubic ramus (pectenius)

Roof: Inguinal Ligament

Femoral Canal

A space for deep lymph nodes and room for the femoral vein to extend

Adductor Canal Contents

femoral artery, and vein (exit via the adductor hiatus)

saphenous nerve,

the nerve to vastus medialis

the descending genicular a. (fr. femoral)

which do not exit through the adductor hiatus

Adductor Canal Boundries

**Anertiolateral:** Vastus Medialis **Anteriomedial**: Sartorius and vasoadductor membrane **Floor**: Aduuctor longus and magnus

Femoral Nerve cord segments

L2, L3, L4 Vental Rami

Femoral Nerve Function

Flexion at the Hip Extension of the Knee

Femoral Nerve Course

Originates in the abdomen and descends into the pelvis in between lilacs and the lateral border of posts major. It then passes behind the inguinal ligament and then goes into the thigh in the lateral portion of the femoral triangle

Femoral Nerve Innervations

All Anterior Compartment Muscles Illiacus Sartorius Rectus Femoris Vastus Muscles Articularis Genu Pectinus Sensory Innervation to the knee

Femoral Nerve Cutaneous Branches

Anterior (medial and intermediate) cutaneous nerves of the thigh

Saphenous Nerve

Cutaneous Branch of Femoral Nerve L4 Sensation to medial leg and medial foot

Saphenous Nerve Course

Enters the adductor canal, pierces the vastoadductor membrane Runs medial to the knee and along the medial leg to the foot.

Femoral Artery Course

a. Passes posterior to the inguinal ligament at its midpoint b. Through femoral triangle between femoral v and femoral n. c. Continues through adductor canal and into popliteal fossa then becomes popliteal a. d. Within the adductor hiatus, the femoral artery moves from being lateral to the femoral vein to being anterior.

Illiotibial Tract

1. Lateral thickening of fascial late 2. Shared aopneurosis for tensor fascia lata and gluteus maximus 3. Extends from iliac tubercle and crest to Gerdy's tubercle 4. Stabilizes the extended knee

Fascia Lata

1. Deep fascia of thigh 2. Invests thigh tightly, like a sleeve 3. Plays an important role in the musculovenous pump

Thigh Compartments

Deep invaginations of the fascia lata separate the thigh into 3 compartments a. Medial b. Anterior c. Posterior

Saphenous opening

1. Hiatus in fascia lata inferior to medial inguinal ligament 2. 4 cm inferolateral to pubic tubercle 3. Falciform magin – curved lateral margin

Cribriform fascia

Fatty, loose connective tissue which covers the saphenous opening allows for passage of lymphatics and the great saphenous vein.

Great saphenous vein

Superficial Drainage of the lower limb a. Formed from dorsal venous arch of foot b. Ascends anterior to medial malleolus, posterior to medial epicondyle of femur, pierces through cribriform fascia to enter femoral vein.

Lesser (small) saphenous vein

Superficial Drainage of the lower limb a. Formed from dorsal venous arch of foot b. Ascends posterior to lateral malleolus, courses along midline of posterior leg, enters popliteal vein.

Deep Venous Drainage of the Lower Limb

Parallel arteries (venae comitantes) Usually paired

Superficial Lymphatic Drainage of the Lower Limb

1. Accompany saphenous veins 2. Great saphenous lymph drain mostly to superficial inguinal lymph nodes. 3. Small saphenous lymph drain mostly to popliteal lymph nodes.

Deep Lymphatic Drainage of the Lower Limb

1. Accompany deep veins 2. Drain mostly to popliteal and deep inguinal lymph nodes.

Cutaneous Innervation of Lower Limb

Supplied by the L1-S2 dermatomes. Spiraling, “barber pole” fashion of dermatomes is due to limb rotation during development.