Anterior and Medial Thigh Flashcards
femoral triangle
passage of femoral nerve, artery and vein from abdomen to thigh
femoral artery become popliteal artery when..
passes thru adductor hiatus, goes behind the knee
popliteal artery branches
anterior and posterior tibial arteries
branches of anterior and posterior tibial arteries
anterior- dorsal pedal
posterior- plantar arteries
fascia layers of lower limb
superficial fascia- contains nerves, supericial vessels, lymphatics
deep- very strong wapping limb like a sleeve
-thigh called fascia lata
leg called crural fascia
iliotibial band- location, contributions, insertion
thick lateral portion of fascia lata, has contributions from aponeuroses of gluteus maximus and tensor fascia lata
inserts into gerdys tubercle- lateral condyle of tibia
TFL
Tensor Fascia Lata
abductor of hip and flexor of hip
innervated by superior gluteal nerve (L4,5 and S1)
compartments of thigh
arise from 3 intermuscular septum from fascia lata
anterior- hip flexors and knee extensors
medial- hip adductors
posterior
2 main superficial veins of lower limb
great saphenous- ascends up leg, enters femoral vein thru saphenous hiatus in fascia lata
small saphenous- pierces deep fascia behind knee, enters popliteal vein
location of many deep inguinal nodes
beside femoral vein w/i femoral canal, just medial
deep inguinal nodes drain into…
external iliac nodes
two groups of anterior thigh muscle, innervation
hip flexors- pass anterior to hip joint
knee etensors- pass anterior to knee joint (quadriceps)
innervated mostly by femoral nerve (TFL by gluteal nerve)
iliopsoas muscle
fusion of psoas major and ilacus
chief hip flexor, helps w/ lateral rotation
insert into lesser trochanter of femur
leg presentation w/ hip fracture
femur is shortened and laterally rotated- iliopsoas is in spasm when femur is fractured superior to lesser trochanter
etiologies of psoas abscess
close proxiimity to organs like appendix and colon, can spread
also rich vascular supply, can have hematogenous infection
clin pres of psoas abscess
fever, low back pain, hip thigh pain
psoas sign- pain on extension of hip
present in fetal position
was more common when TB was prevalnet
4 heads of quad
rectus femoris-middle superficial
vastus medialis
vastus lateralis
vastus intermedius- middle deep
quad insertion, nerve roots, fn
insert into quad tendon, contains patella and continues as patallar tendon and inserts into tibial nerve
femoral nerve from L2,3,4 (kick the garbage out the door)
quad that is most susceptible to tear
rectus femoris- crosses hip and knee joints
femoral nerve roots and fn, branches
L2,3,4, goes beneath inguinal ligament
quad, sartorius, pectineus muscles
several anterior femoral cutaneous branches
terminates as saphenous nerve, cutenous to medial lower leg and foot
osgood schlatter disease
stress from powerful quad inflames the not fully develops tibial tuberosity
self limiting b/w 1-3 yrs
5 medial thigh muslces and fn, innervation
adductor longus adductor brevis adductor magnus gracilis obturator externus
adduct the hip
obturator nerve for the most part
origin and insertion of major hip adductors
longus, brevis, magnus from pubis to posterior femur
adductor magnus segments, contents
largest, most powerful medial thigh muscle
3 parts- minmus, adductor in middle, hamstring (attaches to adductor tubercle of femur, innervated by sciatic nerve)
adductor hiatus secures and protects femoral artery and vein
clincial importance of femoral artery thru adductor hiatus
common spot for atherosclerosis
pectineus
flex and adduct hip- innervated by femoral and/or obturator
gracilis
long thin adductor- used for muscle grafts
sartorius
long thing muscle abducts, externally rotates, flexes hip
gracilis and sartorius insertions
into pes anserinus on medial tibial condyle (along w/ semitendinosus)
four major lower limb gateways
obturator canal
under inguinal ligament
greater sciatic foramen
lesser sciatic foramen
obturator canal contents
obturator nerve (divides into anteriro and posterior branches) and vessels supplying medial thigh compartment
2 parts of inguinal ligament gap
muscular lacuna laterally
vascular lacuna medially
divided by iliopectineal arch
muscular lacuna contents
iliopsoas
lateral femoral cutaneous nerve, femoral nerve
vascular lacuna contents
femoral artery and vein
femoral branch of genitofemoral nerve
lymphatics
borders of femoral triangle
superior- inguinal ligament
medial- adductor longus
lateral- sartorius
contents of femoral triangle lateral to medial
femoral nerve
femoral artery
femoral vein
venous near the penis
femoral sheath also
femoral sheath contents
funnel shaped fascial tube under inguinal ligament
encloses proximal femoral vessels and femoral canal, NOT femoral nerve
3 compartments of femoral sheath
lateral- femoral artery
intermediate- femoral vein
medial- femoral canal w/ deep lymphatic nodes
top of femoral canal is..
femoral ring
lacunar ligmanet
adjacent to femoral canal, under constant tension
define femoral hernia
protrusion of adbodminal viscera thru femoral ring into femoral canal
complication of femoral hernia
can enlarge and pass thru saphenous hiatus into subq tissues
can be strangulated by lacunar ligament, causing necrosis
surgical emrgency
population more susceptible to femoral hernia
females
adductor canal location and contents
femoral artery and vein exit femoral triangle into adducotr canal
middle third of thigh under sartorius, extends from apex of triangle to adductor hiatus
contains femoral artery and vein, saphenous nerve, nerve to vastus medialis
femoral artery branches
deep femoral artery (profunda) thru femoral triangle
circumflex supply proximal femur/head
perforating branches pierce adductor magnus and supply posterior compartment
superficial femoral artery continues down adductor canal
popliteal artery via adductor hiatus
cutaneous inneration of thigh- 4 nerves
lateral femoral cutaneous- superior lateral thigh
femoral- anterior cutanous branches innervate skin of thigh
saphenous- sensation along medial leg and then foot
obturaror- small cutanous branch that innervates skin of medial thigh
