Anterior and Medial Thigh Flashcards
Tributaries of the great saphenous vein
External pudendal
Superficial circumflex iliac
Superficial epigastric
Superficial inguinal lymph nodes super/inferior groups
Superior/horizontal- drains anterior abdominal wall inferior to umbilicus, penis, scrotum, vulva, lower vagina and anal canal, lateral thigh
Inferior/vertical- drains superficial tissue of lower extremity except dorsolateral foot and posterior calf- drained by popliteal lymph nodes
Pathology involved with superficial inguinal lymph nodes
Sexually transmitted infections
Medial foot/leg cellulitis
Skin cancer
Lateral femoral cutaneous nerve
Sensory anterior and lateral thigh
Obturator nerve
Sensory medial thigh
Motor- obturator externus, adductor longus/brevis (anterior division), gracilis, adductor magnus (adductor part, posterior division)
May give branch to pectineus
Femoral branch of genitofemoral nerve
Sensory- scrotum/labia majora/medial thigh
Motor- cremaster muscle
Meralgia parasthetica
Gun belt palsy
Impingement of lateral femoral cutaneous nerve
Tingling/numbness later thigh
Can occur in anyone who wears a heavy belt or something that impinges inguinal region (cops, construction worker, pregnancy or obesity)
Iliotibial tract IT band
Fibers of the fascia lata of vertical orientation
Aponeuroses of gluteus maximus and tensor fascia lata
Inserts into Gerdys tubercle- anterolateral tubercle of the tibia
Anterior compartment muscles of the thigh include
Extensor compartment (flexors of hip, extensors of knee) Psoas major Iliacus Sartorius (longest muscle of body) Quadriceps femoris Rectus femoris Vastus lateralis/intermedius/medialis Articularis genu
Quadriceps femoris
Extensors of knee, composed of:
Rectus femoris (also flexes hip)
Vastus lateralis
Vastus intermedialis
Vastus medialis (also stabilizes patella)
All 4 aponeurosis of these muscles insert on patella
Flexors of hip from anterior compartment
Sartorius- also abducts/laterally rotates hip and flexes/medially rotates knee
Iliopsoas (psoas major and iliacus)
Pectineus- also stabilizes patella
Iliacus muscle OINA
O-Anterior/superior iliac fossa, ala of sacrum
I- lesser trochanter of femur
N- Femoral nerve
A- flex thigh and stabilize acetabulofemoral joint
Psoas major OINA
O- Transverse processes of lumbar vertebrae
I- lesser trochanter
N- Anterior rami of L1-3
A- Flex vertebral column, trunk and thigh-when used with iliacus
Rectus femoris OINA
O- straight head- anteroinferior iliac spine
reflected head- ilium above acetabulum
I- patella/tibial tuberosity via patellar ligament
N- femoral nerve
A- Extend leg at knee, assist iliopsoas in thigh flexion (crosses two joints)
Vastus lateralis OINA
O- greater trochanter of femur
I- Lateral patella, tibial tuberosity via patellar ligament
N- femoral nerve
A- extend leg
Vastus intermedialis OINA
O- anterior/lateral surface of femoral body
I- base of patella, tibial tuberosity via patellar ligament
N- femoral nerve
A- extend leg
Vastus medialis OINA
O- Intertrochanteric line of femur
I- tibial tuberosity via patellar ligament
N- femoral nerve
A- extend leg
Sartorius OINA
O- anterior/superior iliac spine
I- Medial aspect of proximal tibia
N- femoral nerve
A- flex, abduct, laterally rotate thigh and flex knee
Pes anserinus
Insertion point for the tendons of sartorius, gracilus, semitendinosus muscles
Articularis genu OINA
O- anterior surface of distal femur
I- articular capsule of knee
N- femoral nerve
A- Tighten knee capsule during extension of leg
(this is the only muscle seen under a reflected vastus intermedius)
Femoral nerve supplies what muscle
4 muscles of anterior compartment Iliacus Quadriceps femoris Sartorius Pectineus
Posterior retinacular arteries and Acetabular branch of obturator artery
Posterior retinacular- supply head neck of femur, branch from medial femoral circumflex artery
Acetabular branch- Provides blood supply to ligament of head of femur
Can originate from medial femoral circumflex artery if not from the obturator
These are associated with avascular necrosis of hip joint
Medial compartment of the thigh contains
Pectineus
Adductor longus/brevis/magnus
Gracilis
These are adductors of the hip
Gracilis OINA
O- body of pubis
I- medial surface of tibia inferior to tuberosity, b/w insertion of sartorius and semitendinosus
N- Anterior division of obturator nerve
A- adduct thigh, assist medial thigh rotation, flex leg
(only muscle in medial group to cross 2 joints)
Pectineus OINA
O- superior pubic ramus
I- pectineal line of femur
N- femoral nerve
A- Adduct and flex thigh
Adductor longus OINA
O- body of pubic ramus inferior to pubic crest
I- middle third of linea aspera
N- anterior division of obturator nerve
A- adduct thigh
Adductor brevis OINA
O- body and inferior pubic ramus
I- pectineal line and proximal linea aspera
N- anterior division of obturator nerve
A- Adduct thigh, assist in flexion
Adductor magnus OINA
O- ischiopubic ramus and ischial tuberosity
I- pectineal line of femur
N- upper fibers- posterior division obturator nerve
lower fibers- tibial division sciatic nerve
A- whole muscle- adduct thigh
hamstring side helps extend leg
Obturator externus OINA
O- external surface and surrounding margins of obturator membrane (pubis and ischium)
I- Passes posterior to neck of femur to attach at trochanteric fossa
N- anterior division of obturator nerve
A- lateral rotator of thigh, holds head of femur in acetabulum
Hunters canal
Narrow conical tunnel located in thigh, runs from apex of femoral triangle to adductor hiatus (gap b/w adductor and hamstring attachments of the adductor magnus) also known as adductors canal
Boundaries of hunters canal
Anteromedial- sartorius
Lateral- vastus medialis
Posterior- adductor longus and magnus
Contents of adductor canal
Femoral artery and vein
Saphenous artery and nerve
Nerve to vastus medialis
What exits the adductor canal posteriorly
Femoral artery and vein exit through adductor hiatus to become popliteal artery and vein
Saphenous nerve and artery do not exit through adductor hiatus, they pierce the adductor magnus
Groin pull
Strain/stretching of proximal attachments of anteromedial thigh muscles
i.e. adductor and flexor muscular attachment points (inguinal region at the junction of thigh and trunk)
