Blue Boxes - Anterior & Medial Thigh Flashcards
This is the term for bleeding from ruptured capillaries and infiltration of blood into the muscles, tendons, and other soft tissues.
Contusion
This is the term for a contusion of the Iliac Crest (usually where Sartorius M. attaches to ASIS).
Hip pointer
This is the term for the cramping of an individual thigh muscle due to ischemia or contusion and rupture of blood vessels (hematoma).
Charley horse
What is the most common sight of thigh hematoma?
Quadriceps – Usually Tendon of Rectus Femoris M.
The Transversalis Fascia (on internal abdominal wall) combines with the Psoas Fascia to form a fascial covering for the Psoas Major M. going into the thigh. A pyogenic infection (pus forming) can occur in the abdomen and into the fascia forming an _________.
Abscess
***Usually from TB or Crohn’s Disease
A psoas abscess should always be considered when edema occurs in the proximal part of the thigh. However, the abscess is often mistaken for…
Indirect or direct hernia
Enlargement of Inguinal LNs
Saphenous varix
People with paralysis of the Quadriceps cannot (FLEX/EXTEND) the leg against resistance.
Extend
How do people with paralysis of the Quadriceps walk?
With a forward lean and press on the distal thigh as heel hits ground to prevent inadvertent knee flexion
This is a common knee injury for marathon runners and presents in softening of the articular cartilage of the patella.
Chondromalacia Patellae (“Runner’s Knee”)
Chondromalacia Patellae is often a result of what?
Quadriceps imbalance
A direct blow or a sudden contraction of the quadriceps of the patella may fracture it into two or more pieces. This type of fracture is called…
Transverse patellar fractures
In a transverse patellar fracture, how are the fragments usually pulled apart?
Proximal fragment pulled superiorly with quadriceps tendon
Distal fragment remains with patellar ligament
The patella ossifies during age 3-6, frequently from different ossification centers. They usually coalesce and form a single bone, but can remain separate. How can we examine the patella in a patient and know it’s an ossification abnormality and not a patellar fracture?
By examining diagnostic images bilaterally. Ossification abnormalities are almost always bilateral.
In a patellar tendon reflex, if it’s normal what should contract?
Quadriceps
The patellar tendon reflex tests what nerves?
Femoral N. (L2-L4)
***Afferent impulses from spindles travel to the L2-L4 spinal segments and an efferent signal is passed to the quads
This muscle is a relatively weak adductor, so it is often transplanted with its nerve and blood vessels as a muscle replacement in the hand or for the external anal sphincter.
Gracilis M.
What occurs in a groin injury?
Strain, stretching, and probably some tearing of the proximal attachments of the anteromedial thigh muscles
***Usually flexor and adductor thigh muscles
Injury to this muscle often occurs in sports that require fast acceleration, deceleration, and changes in direction. It can also occur in horseback riders and produce pain (“Rider’s strain”).
Adductor Longus M.
Ossification sometimes occurs in the tendons of the Adductor Longus M. of horseback riders because they are actively adducting their thighs to keep from falling off the horse. The ossified tendons are sometimes wrongly called…
Rider’s bones
With a person laying in a supine position, the Femoral pulse can be felt where?
Between the ASIS and the Pubic Symphysis
T/F. Cannulation happens just inferiorly to the Inguinal Ligament and a catheter is inserted into the Femoral A. and eventually reaches the aorta to the left ventricle (for left cards angiology).
True
What is the sight for compression of the Femoral A. (in cases of laceration)?
Press posteriorly against the Superior Pubic Ramus, Psoas Major M., and Femoral head
The Femoral A. is superficial and more susceptible to laceration. It is often lacerated in conjunction with the Femoral V., and in some cases an ________ ________ occurs as a result of communication between the injured vessels.
Arteriovenous shunt
If the Femoral A. is ligated, how can the leg still get blood?
Via the Cruciate Anastomosis
Why should we never use the term “superficial” for the Femoral A. and V. (as opposed to its “deep” counterpart)?
Because it could be potentially lethal, considering they are not in subcutaneous tissue and actually lie deep. Pulmonary emboli originate in deep veins, and calling the Femoral V. “superficial” could cause an acute thrombosis to be overlooked.
This is the term for the localized dilation of the terminal part of the Great Saphenous V. It may cause edema of the femoral triangle and can be confused with a psoas abscess.
Saphenous Varix
What is the differing thing between a psoas abscess and saphenous varix that should be considered?
When varicose veins are present in other parts of the lower limb, a varix should be considered!
The Femoral V. is not palpable, but can be found how?
By finding the femoral pulse inferior to the Inguinal L., because the A. is directly lateral to the V.
At the level of finding the femoral pulse, it’s important to note that the Femoral V. has no tributaries at this level except the Great Saphenous V. When is it important to differentiate between these two veins?
During a varicose vein operation, you want to make sure you don’t tie off the Femoral V. by mistake
The cannulation of the Femoral V. is used for (RIGHT/LEFT) cardiac angiology. A catheter is inserted and passes superiorly to the inferior vena cava and into the atrium.
Right
***Remember, left cardiac angiology uses the Femoral A.
Describe a femoral hernia and what it’s bound by.
Small intestine pops through the femoral ring and into the femoral canal.
It’s bound by the Femoral V. laterally and the Lacunar Ligament medially
Are femoral hernias more common in males or females? Why?
Females because they have a wider pelvis and smaller inguinal canals and rings
An enlarged pubic branch of the Inferior Epigastric A. either takes the place of the ________ or it joins it as an accessory in 20 percent of people.
Obturator A.
This accessory or replaced Obturator A. could be involved in strangulated femoral hernias due to its position close to or on the femoral ring. What does this lead to?
Small intestine necrosis
