Anteromedial thigh Flashcards
The fascia Lata
Is a thickening of the deep fascia covering the thigh and separating the muscle compartments.
Attachment points of the fascia lata are
Superiorly: Pubic tubercle, pubis and inguinal ligament
laterally: Iliac crest
Posteriorly: sacrum, coccyx and ischial tuberosity
What consists of the illiotibial band?
The blending of the fascia lata with the tendon of the ‘tensor fascia lata muscle’
Where does the illiotibial band attach to?
The lateral aspect of the tibia
What is the one deficiency of the fascia lata, and what passes through this?
The Saphenous opening, for which the great saphenous vein passes through to meet the femoral vein.
Which of the intermuscular septa (that form thigh compatrments with the fascia lata) is the strongest and therefore easiest to find?
The lateral intermuscular septum
Why is the Tensor Fascia Lata muscle considered a gluteal muscle
Because its embryonic origin is in the gluteal region
What are the 8 Anterior compartment muscles of the thigh?
Vastus Lateralis Vastus intermedius Vastus Medialis Rectus Femoris Sartorius pectineus* (partially) Psoas Major iliacus
What consists of the iliopsoas and what is the common attachment point of this?
Iliacus and psoas major. These muscles both insert as the lesser trochanter of the femur
Where do the Iliopsoas muscles originate from?
Iliacus= iliac fossa and lateral sacrum
Psoas Major= lumbar vertebrae
Where does the tensor of the fascia lata originate?
ASIS and iliac crest
Where does the Sartorius muscle insert and originate from?
Origin= ASIS Insertion= superior medial tibia (pes anserinus)
what is the function of the iliopsoas muscle?
To FLEX and EXTERNALLY ROTATE the thigh
What constitutes the Quadriceps Femoris?
Rectus Femoris
Vastus lateralis, medialis and intermedius
what is the common insertion of the quadriceps femoris?
Superior Patella
What is the common action of the quadriceps femoris, and what is the exception?
Extends leg via knee
Rectus Femoris also flexes the thigh at the hip joint
Where does the vastus lateralis originate?
The greater trochanter and linea aspera
Where does the vastus medialis originate?
Intertrochanteric line, medial intermuscularsepta
Where does the vastus intermedialis originate?
sup 2/3 femoral shaft
lateral intermuscular septa
Why is the pectinius muscle considered both an anterior and medial muscle?
Because it is innervated by both the femoral and obturator nerve. It flexes the thigh as well as adducting it.
What constitutes the femoral triangle
The femoral nerve, vein and artery as well as lymphatics
The borders of the femoral triangle are made up of
Lateral: Sartorius
Medial: Adductor longus
superiorly: Inguinal ligament
Floor: iliopsoas, adductor longus and pectinius
Roof: subcutaneous tissue, skin and fascia lata
The femoral SHEATH contains
The femoral vein, artery and lymphatics. NOT the femoral nerve
The femoral canal is…. and how is this important clinically?
A compartment of the femoral sheath that contains lymphatics. What can occur is the abdominal contents can herniate into the femoral canal “femoral Hernia”
What is the order of the femoral triangle lateral > medial
Nerve, artery, vein, lymphatics
How would you perform a femoral nerve block?
Find the femoral artery (via pulse). inject just LATERALLY to the artery. This is better then using lots of medication.
What are the five medial thigh muscles and what is their nerve innervation
Adductor Longus Adductor Brevis Adductor Magnus* (both med and post) Gracilis Obturator externus *pectinius
Nerve: obturator (L2-L4)
What is another name for Adductor canal and why?
Subsartorial Canal as it occurs deep to the middle third of sartorius
What are the boundaries of the adductor canal?
Medial: Sartorius Lateral: Vastus medialus Posterior: Adductor Longus and magnus Inlet: Apex of femoral triangle outlet: adductor hiatus (adductor magnus muscle
What are the actions of the sartorius muscle
Flexes, abducts, externally rotates thigh, flexes leg
What is the origin of Rectus Femoris straight head?
AIIS
What is the origin of Rectus Femoris reflected head?
superior acetabular rim
what is the general order for BOTH the aterial and venous femoral vessels?
Aorta-common iliac artery-external iliac artery- femoral artery
Inferior vena cava-common iliac vein-external iliac vein- femoral vein
What is the structural boundary that defines the femoral vessels?
Inguinal ligament
Where do both Gracilis and adductor longus originate from?
Body of pubis
Where do both adductor longus, brevis and magnus insert to? And where are the extra insertion points for the broad adductor magnus muscle?
Linea Aspera.
Extra points are medial supra condylar ridge and adductor tubercle.
The adductor magnus originates from two point on the pelvis, what are these and which part belongs to which group?
Adductor: Inferior pubic ramis
Hamstrings: Ischial tuberosity
What are the common movements of the Adductor muscles and gracilis?
Adducts and flexes thigh
What makes adductor magnus special in regards to movement?
Due to it’s broadness/curvature, it can both flex and extend the thigh using different fibres
Where does gracilis insert and what does that mean about it’s movement
Insertion: superior medial tibia.
Therefore it can adduct/flex thigh AND internally rotate leg
Where is the femoral nerve formed and how?
From L2-4 and is formed within psoas major
What does the femoral nerve supply and where does it go?
Supplies flexors of the hip and extensors of the knee in the ant compartment. The terminal branch descends medially and becomes the saphenous nerve (cutaneous).
What are the cutaneous branches of the femoral nerve and what do they supply?
Anterior Cutaneous nerve of thigh: anterior thigh
Saphenous Nerve: Medial aspect of leg
What is the purpose of the tensor of the fascia lata?
Abducts and stabilizes thigh
What are the contents of the adductor canal?
femoral artery and vein, saphenous nerve and nerve to vastus medialis
O/I of Pectineus
O: superior pubic ramus
I: inferior to lesser trochanter
