Anterior and Medial Thigh

Question 1

What does the external iliac artery become, and what does it become after that? What does that artery branch into?

Answer 1

External iliac artery -> femoral artery -> popliteal artery

branches into anterior and posterior tibial artery

Question 2

Where does the great saphenous vein ascend? Where does the small saphenous vein ascend?**

Answer 2

The great saphenous vein ascends anterior to the medial malleolus
The small saphenous vein ascends posterior to the lateral malleolus

Question 3

Which side of the thigh does the saphenous vein pass? What vein does it pass into?

Answer 3

Passes up the medial side of the thigh

Emites into femoral vein after entering the saphenous opening of the fascia lata

Question 4

What are varicose veins? How does blood continue to pass upwards in this case?

Answer 4

Varicose veins are those with incompetent valves

Blood still goes up due to perforating veins that the saphenous vein communicates to the deep veins through

Question 5

What vein does the small saphenous vein drain into behind the knee?*

Answer 5

Popliteal vein

Question 6

How do the small saphenous and great saphenous veins communicate with the deep veins?

Answer 6

Via the perforating veins

Question 7

Describe the 2 groups of lymph nodes with respect to the fascia lata.

Answer 7

Superficial nodes lie above the fascia lata

Deep nodes lie along medial side of femoral vein deep to fascia lata

Question 8

Where do the superficial inguinal nodes receive lymph from?

Answer 8

• Anterior and posterior surfaces of trunk below umbilicus
• perineum including lower half of anal canal, vagina, and all external genitalia (except testes! which drain into lumbar nodes)
• Superficial lymph vessels of lower limbs

Question 9

Which lymph nodes do the ovaries and testes drain into?

Answer 9

Lumbar nodes (para-aortic nodes

Question 10

Where do the deep inguinal nodes receive lymph from?

Answer 10

• receive lymph from superficial nodes

- from deep structures of lower limb

Question 11

What do the efferent vessels from deep inguinal nodes drain into?

Answer 11

Drain into the external iliac nodes

Question 12

What side of the thigh is the fascia lata thickened, and what does it form?

Answer 12

Fascia lata is thickened on the lateral aspect to form the iliotibial tract (or IT band)
runs from iliac tubercle to lateral condyle of tibia

Question 13

What insertions do the iliotibial tract receive?

Answer 13

isertions from the tensor fascia latae and greater part of gluteus maximus

Question 14

What are the 3 muscular compartments formed by the fascia lata?

Answer 14

Anterior
Medial
Posterior

Question 15

What creates the saphenous opening, and what does it transmit?

Answer 15

Is a gap in deep fascia (fascia lata) in anterior thigh

transmits great saphenous vein and lymph vessels

Question 16

What are the 5 muscles of the anterior compartment of the thigh? What is the nerve and blood supply?**

Answer 16

Sartorius
Ilacus
Psoas major
Quadriceps femoris
Pectineus

Supplied by femoral nerve and femoral artery

Question 17

What compartment in the thigh is the sartorius muscle, what is its nerve supply, and what is its action?

Answer 17

In the anterior compartment of the thigh
supplied by femoral nerve
Flexes and laterally rotates the femur at hip joint
-flexes and medially rotates leg at knee joint (creates tailor’s position hence muscle name of ‘tailor’s muscle’)

Question 18

What are the 4 quadriceps femoris muscles? What are they all supplied by, and what is their group action?

Answer 18

1. rectus femoris
2. vastus medialis
3. vastus lateralis
4. vastus intermedius
   all supplied by femoral nerve
   group action is to extend leg at knee joint. they are all important supports for the knee joint
   -rectus femoris also flexes femur at hip joint

Question 19

What helps to form and strengthen the capsule of the knee joint?

Answer 19

The patellar retinacula

these are expansions of the vastus medialis and vastus lateralis portions of the quadriceps tendon

Question 20

What do the iliacus and psoas form, where do they combine, what is the nerve supply for each, and what is their group function?

Answer 20

Iliacus and psoas form the iliopsoas, which meet in a common tendon on the lesser trochanter of the femur
psoas is supplied by ventral rami L2-L4
iliacus is supplied by femoral nerve (note L2-L4 ventral rami become femoral nerve)
together is the chief flexor of the femur at the hip joint, flexes the vertebral column when sitting up from supine position, stabilizes column in sitting position

Question 21

What compartment of the thigh is the pectineus in what is its nerve supply, and what is its action?

Answer 21

pectineus is in the anterior compartment of the thigh
supplied by the femoral nerve (sometimes receives branch of obturator nerve which is the nerve of adductors)
flexes and adducts femur at hip joint

Question 22

What muscles are contained in the medial compartment of the thigh? What is their nerve and blood supply?

Answer 22

Gracilus
Adductor longus
Adductor brevis
Adductor magus
Obturator externus

supplied by profunda femoris artery and obturator artery
nerve supply is the obturator nerve

Question 23

What compartment of the thigh is the gracilus, what is its nerve supply, and what is its action?

Answer 23

In the medial compartment
supplied by obturator nerve
adducts the femur at the hip joint, flexes leg at knee joint

Question 24

What compartment of the thigh is the adductor longus, what is its nerve supply, and what is its action?

Answer 24

In the medial compartment
supplied by obturator nerve
adducts and flexes the femur at hip joint

Question 25

What compartment of the thigh is the adductor brevis, what is its nerve supply, and what is its action?

Answer 25

medial compartment
supplied by obturator nerve
adducts and flexes femur at hip joint

Question 26

What compartment of the thigh is the adductor magnus, what are the 2 portions, what is each portion supplied by, and what are each of the actions?

Answer 26

Medial compartment
-has an adductor portion and a hamstring portion
-adductor is supplied by obturator nerve
-hamstring is supplied by tibial division of sciatic nerve
-adductor adducts and flexes femur at hip joint
-hamstring extends the femur at the hip joint
=note that all hamstring parts have an attachment to the ischial tuberosity

Question 27

What compartment is the obturator externus in, what is its nerve supply, and what is its action?

Answer 27

In the medial compartment
supplied by obturator nerve
laterally rotates the femur at the hip joint

Question 28

What are the contents of the femoral triangle, what lateral to medial?

Answer 28

Femoral nerve
Femoral sheath
Deep inguinal lymph nodes (are in the femoral sheath)

Question 29

What is enclosed in the femoral sheath? What are the 3 compartments of the femoral sheath created by septa?

Answer 29

Femoral vessels and lymphatics are contained below the inguinal canal
The most lateral compartment holds the femoral artery
Middle holds the femoral vein
most medial compartment holds the femoral canal

Question 30

What is enclosed in the femoral canal?

Answer 30

Fat
All efferent vessels from deep inguinal lymph nodes
One deep inguinal lymph node

Question 31

Where is a femoral hernia? What about an inguinal hernia?

Answer 31

• it is a protrusion of abdominal contents through the femoral canal
• Inguinal hernia is above the pubic tubercle, while a femoral hernia is below and lateral to the pubic tubercle
• The sac of femoral hernia passes out femoral canal below inguinal ligament onto the thigh

Question 32

Where is the adductor canal, and what is contained in it?

Answer 32

Adductor canal begins at apex of femoral triangle and ends at the adductor hiatus. is deep to sartorius muscle
Contains:
-the femoral vessels
-saphenous nerve (terminal branch of femoral nerve)
-nerve to vastus medialis

Question 33

What does the adductor canal end as, and where do its contents go from there? What name change happens there?

Answer 33

Adductor canal ends at the adductor hiatus
Vessels pass through the hiatus into the popliteal fossa behind knee
femoral vessels are now called popliteal vessels

Question 34

What ventral rami is the femoral nerve derived from, and how does it enter the thigh?

Answer 34

Derived from ventral rami of L2, L3, and L4
Passes deep to the inguinal ligament and ***lateral to the femoral sheath (so the femoral nerve is not contained in femoral sheath)

Question 35

What is the terminal branch of the femoral nerve?

Answer 35

Saphenous nerve is the terminal branch of femoral nerve

Question 36

What ventral rami is the obturator nerve derived from, and behind what muscle does the obturator nerve emerge into the thigh?

Answer 36

Derived from L2, L3, and L4
Both the anterior and posterior branches emerge into thigh behind the pectineus muscle and in front of or through the obturator externus

Question 37

Behind what does the femoral artery enter the thigh?

Answer 37

Enters thigh behind the inguinal ligament as a direct continuation of the external iliac artery

Question 38

What does the femoral artery lie between once it enters the thigh?

Answer 38

Lies midway between the anterior superior iliac spine and the symphysis pubis

Question 39

What artery does the femoral artery give off within the femoral triangle?

Answer 39

Gives off the deep femoral artery (profunda femoris)

Question 40

What is the profunda femoris a branch of, and what are its 3 main branches?

Answer 40

Profunda femoris is a branch of the femoral artery
gives off:
-lateral circumflex femoral artery
-medial circumflex femoral artery
-four perforating arteries which supply hamstring

Question 41

What do the perforating arteries of the profunda femoris supply?

Answer 41

Enter the posterior compartment of the thigh and are the chief blood supply to this compartment
-note: 4th perforating artery is a direct continuation of the profunda femoris