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LOWER LIMB > Exam 4 > Flashcards

Exam 4 Flashcards

1
Q

hip bone

A

• Acetabulum – cup shaped depression articulates with head of femur
o Acetabular fossa - nonarticular fossa
o Lunate surface- peripheral acetabulum is articular portion
o Acetabular notch

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2
Q

ilium

A

• Two portions:
1. Wing (Ala)
External Surface (Dorsum Ilii)
1. Posterior gluteal line
o Shortest
o Gluteus maximus origin posterior to posterior gluteal
2. Anterior gluteal line
o Longest
o Gluteus medius origin between 1 & 2
3. Inferior gluteal line
o Least distinct
o Gluteus minimus origin between 2 & 3
**Rectus Femoris origin btwn inferior gluteal line & margin actebulum
Internal Surface

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3
Q

ilium cont

A 
•	Superior- Iliac Crest 
o	Anterior- Anterior superior iliac spine (ASIS)
o	Posterior- Posterior superior iliac spine (PSIS)
o	External Lip
	Fascia Lata
	Tensor fascia latae
o	Internal Lip
	Iliac fascia 
	Iliacus 
•	Inferior-Arcuate Line
•	Anterior Border
o	Anterior superior iliac spine (ASIS)
	Sartroius 
	Iliacus
	Tensor fasciae latae m 
	Inguinal ligament
o	Anterior INFERIOR iliac spine 
	Iliofemoral ligament
	Straight head rectus femoris 
	Porstion iliacus m 
o	Notch between two spines
o	Groove medial to AIIS for psoas major/iliacus
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4
Q

ilium 3

A 
o	Iliopectineal eminence 
	Site of fusion btwn pubis/ilium medial to groove for iliopsoas
•	Posterior Border
o	Posterior Superior iliac spine (PSIS)
	Sacroiliac ligament 
o	Posterior Inferior iliac spine 
•	Iliac Fossa- concave area 
					Nutrient foramen in its center 
					Iliacus m 
•	Sacroiliac joint
					Posterior to iliac fossa 
					Articulation between sacrum and ilium 
•	Iliac tuberosity- attachment sacroiliac ligaments 
					Poateior to articular area 
2.	Body 
External Surface
				-forms portion acetabulum 
Internal Surface 
	-part wall bony pelvis 
	-Obterator internus takes origin 
•	No ramus 
•	Body joins lateral projection of superior ramus of pubis @ acetabulum 
•	Body/Wing Separated externally margin acetabulum 
		       Internally arcuate line 
•	Greater Sciatic Notch 
o	Both ischium and ilium 
o	Proximally- Inferior to PIIS 
o	Distally- ends ischial spine
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5
Q

ischium

A 
•	Single ramus
•	Body joins lateral projection of superior ramus of pubis @ acetabulum 
•	Strongest/most inferior hip bone 
•	Body
o	External Surface
	Forms part of acetabular fossa 
	Part of lunate surface  
	Ischial Spine 
•	separates greater/lesser sciatic notches 
•	Attachments:
o	Sacrospinalis ligament 
o	Superior gemellus muscle
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6
Q

ischium 2

A

 Ischial tuberosity
• Other attachments:
o Quadratus femoris- lateral tuberosity tear-dropped facet
o Inferior gemellus- superomedial tuberosity
• Quadrilateral Portion: upper part
o Oblique line – separates hamstring origins
 Semimebranosus- upper lateral
 Long head biceps femoris & semitendinosus–below
• Triangular Portion: lower region
o Adductor Magnus
o Sacrotuberous ligament

o Internal Surface
 Obterator Internus attaches

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7
Q

ischium 3

A 
•	Ischial Ramus
o	Directed anteriorly from ischial tuberosity 
o	Joins inferior pubic ramus 
o	External Surface
	Adductor magnus
	Obturator externus
o	Internal Surface 
	Obturator internus 
o	Lateral border
	sharp/thin 
	Forms margin obturator foramen 
o	Medial border
	Perineum attachments
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8
Q

pubis

A 
•	Body
o	Gracilis
o	Adductor Longus
o	Adductor Brevis 
•	Superior Rami
o	Medial to LAteral Portion
	Pubic crest – most medial
	Pubic tubercle- lateral to pubic crest, inguinal ligament attachment 
o	Lateral Portion
	Pectin Pubis – laeral to pubic tubercle
•	Pectineus attaches 
	Iliopectineal line- lateral extension pubic crest
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9
Q

pubis cont

A 
•	Inferior rami
o	 fused to ischial ramus > ischiopubic ramus
o	Directed posterolateral from pubic symphysis 
o	Adductor compartment attachments:
	Gracilis
	Adductor brevis
	Adductor magnus
	Obturator externus
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10
Q

sacrum

A

• Five fused sacral vertebrae
• Base: superior, articulates 5th lumbar vertebra
o ALAE – large triangle areas
 Lateral
 Support Psoas major & lumbosacral trunks
 Anterior ¾ each ala = Costal process
 Posterior ¼ each= Transverse process
• Apex: inferior end, articulates w/ coccyx
• Vertebral canal: dorsal, ventral rootlest of spinal nerves

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11
Q

sacrum 2

A 
•	Surfaces
o	Anterior “pelvic surface”
	Iliacus origin- superolateral 
	Piriformis orgin – segments 1-4
o	Posterior
	Convex 
	Narrower
	Middle Sacral Crest- midline longitudinal ridge 
•	Rudimentary spinous processes of sacral vertebrae
	Sacral grooves
•	Laminae of vertebrae 
•	Between middle sacral crest & articular crest… longitudinal ridge of articular processes
	Posterior Sacral Foramina
•	Lateral to articular crests 
o	Lateral x2
	Broad superior, thin inferior
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12
Q

sacrum 3

A

 Auricular surface
• covered hyaline cartilage
• articulates with ilium at sacroiliac joint
 Sacral Tuberosity
• Posterior to auricular suface
• 3 depressions for dorsal sacroiliac ligament
 Thin Inferior
o Gluteus Maximus
o Sacrospinous
o Sacrotuberous
• Ossifcation
o Primary center & 2 epiphyseal plates: body each sacral vertebra
o 2 ossifcation centers: each vertebral arch
o 2 epiphyseal plates: each lateral seface
o 1 ossifcation center: lateral portion each upper 3 vertebrae

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13
Q

coccyx

A 
•	4 verebrae (can range 3-5)
•	No laminae, pedicles, spinous processes
•	Lateral Processes
o	Sacrotuberous lig
o	sacrospinous lig
o	Gluteus Maximus 
•	Anterior surface- concave
o	Sacrococcygela ligament attached 
•	Posterior Surface
o	Cocygeal Cornua- large pair of superior articular processes 
•	Ossifcation:
o	1st    1-4y
o	2nd    5-10y
o	3rd    10-15y
o	4th    15-20y
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14
Q

hip joint

A 
•	Ball/Socket 
•	Acetabulum 
o	Articular/nonarticular regions
o	1/5 pubis- medial
o	2/5 ischium – lateral 
o	Ilium- superior 
•	Acetabular Fossa
o	Deepest, nonarticulating 
o	Primarily ischium 
•	Lunate Surface
o	Aricualr surface
o	Cartilage covered 
o	Acetabular labrum¬- attaches to lateral margin & synovial membrane 
	deepens acetabulum 
	Fibrocartilagnious ring 
o	Acetabular Notch- lunate incomplete inferiorly 
	Cont w/ fossa 
	Transverse acetabular ligament –bridges notch 
•	Foramen for blood vessels to supply joint
•	Head of Femur
o	Direction superior/medial 
o	Surface covered articular cartilage – thicker above supporting weight 
	Exception: rough depression center = fovia captiis femoris 
•	Ligament capitus femoris attaches
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15
Q

hip joint 2

A

• Ligaments:
1. Articular Capsule
• Strong, loose around joint
• Attach: margins acetabulum few mm from labrum
o Lateralarlly to medial side of greater trochanter
o Anteriorly intertrochanteric line
o Posterirly 1 cm above intertrochanteric crest
o Fibers over neck of femur > acetabular rim
• Inferioly- blends transvers acetabular ligament
• THICK anterior/superior for greater R area
• Thin posterior/inferior
• Distally become zona orbicularis
• Proximally become iliofemorla, pubofemoral, ischiofemoral
2. Acetabular Labrum
• Triangular
• Fibrocartilaginous
• Deepens cavity
• Blends transverse acetabular at acetabular notch
• Helps hold head femur in acetabulum

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16
Q

hip joint 3

A
  1. Transverse Acetabular
  2. Zona Orbicularis
    • DISTAL part of articular capsule become this
    • Around neck fo femur
  3. Iliofemoral
    • longest, widest, strongest
    • inverted Y
    o stem: ilium immed below AIIS
    o Base 1: anterior part greater trochanter
     Often called Iliotrochanteric ligament
    o Base 2: intertrochanteric line
    • Anterior joint
    • Transversed by: articular branch deep branch medial femoral circumflex
  4. Pubofemoral
    • Not well developed
    • Anterior to iliofemoral
    • Origin:
    o obturator crest
    o superior ramus of pubis (anterior iliopectineal eminence)
    • direction inferiorlateral
    • Attach: Neck of femur
    • Blend w/ iliofemoral
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17
Q

hip joint 4

A
  1. Ischiofemoral
    • Triangular
    • Posterior capsule
    • Origin:
    o Posterior body ischium
    o Inferior acetabulum
    • Dreiction superior lateral in spiral course
    • Attach:
    o Posterosuperior part neck fo femur below greater trochanter
    • Below this ligament the capsule of hip is thin
  2. Ligament capitus femoris
    • 4 cm long
    • Btwn head femur & acetabulum
    • Intracapsular
    • Enclosed by tub- like extension of synovial membrane
    • Proximal (3 bands)
    o 2 lateral bands: fixed to margins acetabular notch
    o Medial band blends transverse acetabular ligament
    • Distal:
    o Fovea capitus on femur
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18
Q

hip joint 4

A

• Synovial Membrane- inner surface of articular capsule
o Acetabulum corsses over transverse acetabular ligament to acetabular fossa
o Tubal reflexion around ligamentum capitus femoris

•	Nerve to hip joint: 
o	Femoral
o	Obturator 
o	Accessory obturator
o	Inferior gluteal nerves 
•	Blood vessels to hip joint:
o	Medial/lateral femoral circumflex
o	Superior/inferior gluteal 
o	Obterator 
o	1st perforating 
**HEAVY LIGAMENTS AVASCULAR
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19
Q

sacroiliac joint

A 
•	Synovial joint 
•	Auricular sacrum & ilium at 1st 3 sacral vertebrae 
•	Lined by cartilage 
•	Narrow joint cavity surrounded by articular capsule 
•	Ligaments
1.	Anterior Sacroiliac
•	Ventrolateral surface sacrum to margins of auricular suface of ilium 
2.	Posterior Sacroiliac
•	Strong 
•	2 sets fibers: 
o	Deep/Short Fibers
	Origin: tuberosity of ilium & PIIS
	Passes inferomedially
	Attach: posterolateral sacrum
o	Superical/Long Fibers
	Oblique 
	Origin: PSIS 
	Attach: 3rd tubercle of sacrum 
	Blends sacrotuberous ligament 
3.	Interosseous
•	Strong fibers unite 2 articular bones
•	Blend posterior sacroiliac lig
•	Suspend sacrum between 2 iliac bones
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20
Q

psoas major m

A

Origin:
• transverse process lumbar vertebrae
• intervertebral discs last thoracic/all lumbar vertebrae
• tendinous arches (allow passage lumbar A/V
**Deep to inguinal ligament
Insertion:
• lesser trochanter femuer medial to iliacus
• bursa spearats tendon from pubis & hip joint capsule
Nerve: L2/L3
Function: Flex hip & lumbar spine

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21
Q

psoas minor m

A 
Inconstant muscle
	Anterior to Psoas major
	Origin: 
•	T12 & L1 vertebrae & intervertebral disc 
Insertion:
•	Iliopecitneal eminence
•	Iliac fascia 
Nerve: L1
Function: Flex lumbar spine
22
Q

iliacus m

A 
Origin: 
•	Upper 2/3 iliac fossa 
•	iliac crest to ASIS/AIIS
•	 superolateral Ala
•	Sacroiliac lig 
•	Iliolumbar lig 
**Tapers to tendon on lateral side psoas major m 
Insertion:
•	Base lesser trochanter femur 
Nerve: femoral
Function: Flex hip
23
Q

iliacus minor m

A

Iliacus Minor- detached part iliacus occasionaly present
O: ASIS
I: Intertrochanteric line femur or iliofemoral lig

24
Q

fascia of gluteal region

A

Subcut fascia: cont thigh/back layers: superficial fatty layer/ deep membranous layer
Deep fascia: Cont fascia lata
Fascia lata divides around gluteus maximus
Tendon gluteus maximus ends in IT band
Gluteal aponeruosis = vertical fibers between iliac crest and superior gluteus maximus

25
Q

gluteus maximus m

A 
Origin: 
•	Posterior gluteal line ilium 
•	Posterior surface coccyx 
•	Aponeurosis sacrospinalis m 
•	Sacrotuberous lig
•	Gluteal aponeurosis (covering m body)
Insertion:
•	IT band- proximal/superifical fibers
•	Gluteal tuberosity- deep fibers

**3 bursae on deep surface
o Greater trochanter- LARGEST
o Ischial tuberosity- most commonly missing
o Btwn tendon gluteus maximus & vastus lateralis
Nerve: inferior gluteal n
Function: Extend, lateral rotate, abduct thigh

26
Q

gluteus medius m

A 
Posterior ½ covered gluteus maximus
	Anterior ½ covered gluteal aponuerosis 
	Origin: 
•	Outer ilium btwn iliac crest & posterior gluteal line posteriorly 
•	Anterior gluteal line anteriorly 
Insertion:
•	Oblique bony ridge greater trochanter (laterally)
Nerve: superior gluteal n
Function: 
•	Abduct thigh 
•	Medially rotate extended hip 
•	Anterior fibers: flex/medial rotate hip 
•	Posterior portion: lateral rotate hip 
•	STABILIZE PELVIS IN MOVEMENT
27
Q

gluteus minimus m

A 
Deep gluteus medius 
	Between medius and minimus = superior gluteal n/ deep superior gluteal vessels 
	Anterior ½ covered gluteal aponuerosis 
	Origin: 
•	Outer ilium btwn anterior & inferior gluteal line 
•	Greater sciatic notch
Insertion:
•	Anterior greater trochanter 
**Bursa- btwn tendon & greater trochanter 
Nerve: superior gluteal n
Function: 
•	Abduct hip 
•	Medially rotate extended hip 
•	Weak hip flexor 
•	STABILIZES PELVIS DURING MOTION
28
Q

tensor fascia latae

A 
Enclosed upper fibers Iliotibial band  
	Origin: 
•	Anterior iliac crest near ASIS 
Insertion:
•	Iliotibial tract just distal to level greater trochanter 
o	IT attaches inferior lateral tibial condyle/forms part knee capsule 
Nerve: superior gluteal n
Function: 
•	Medially rotate hip 
•	Hip flexor
29
Q

piriformis

A 
Origin: 
•	Anterior Sacrum btwn 1-4 sacral foramina 
**Through Greater sciatic foramen 
Insertion:
•	Supieror greater trochanger posterior to obeterator internus/gemelli 
Nerve: S1 or S1/S2
Function: 
•	Lateral rotator 
•	Abductor of flexed hip 
•	Assist hip extension
30
Q

obturator internus m

A 
Origin: 
•	Superior/inferior pubic rami
•	Ischial ramus
•	Ilial/ischial wall of true pelvis
•	Obturator membrane
**Through lesser sciatic foramen > right angle over bone btwn spine/tuberosity of ischium 
	BURSA HERE 
**Tendon gest fibesr from gemelli m 
**2nd bursa btwn hip joint capsule/ tendon
Insertion:
•	medial greater trochanger anterior to trochanteric fossa  
Nerve: N to obturator Internus (L5-S1/S2)
Function: 
•	Lateral rotator 
•	Abductor of flexed hip 
•	hip extension
31
Q

superior gemellus m

A 
Origin: 
•	outer surface ischial spine 
**partial fusion obeterato internus tnedon
Insertion:
•	medial greater trochanter
Nerve: n obturator internus 
Function: 
•	Lateral rotator hip
32
Q

inferior gemellus m

A 
Origin: 
•	Superomedial ischial tuberosity 
**partial fusion obeterato internus tnedon
Insertion:
•	medial greater trochanter
Nerve: n quadratus femoris  
Function: 
•	Lateral rotator hip
33
Q

quadratus femoris

A 
(Between inferior gemellus & adductor magnus)
	Origin: 
•	Lateral edge ischial tuberosity
Insertion:
•	Quadrate tubercle femur
Nerve: n quadratus femoris  (L4-S1)
Function: 
•	Lateral rotator hip 
•	Adducts hip
34
Q

obturator externus m

A 
*Covers outer suface anterior pelvic wall 
	Origin: 
•	Ischium/Pubis surrounding medial margin obturator foramen/membrane 
Insertion:
•	Trochanteric fossa femur 
Nerve: posterior division obturator n 
Function: 
•	Lateral rotator hip 
•	Adducts hip
35
Q

lumbar plexus

A
  • Anterior primary rami L1-L3, part of L4, some T12
  • Posterior/in psoas major
  • T12/L1 forms
36
Q

iliiohypogastric n

A

 iliohypogastric(T12/L1)
• cranial end of lateral psoas major
• crosses quadratus lumborum, passes iliac crest, enters intneral surface of transversus abdominis & internal oblique
• Lateral cutaneous branches – posterior gluteal area
• Anterior cutaneous branches – hypogastric region
• Muscle branches: transversus abdominis & internal oblique

37
Q

ilioinguinal n

A

 Ilioinguinal (L1)
• Lateral border psoas major
• Caudal to iliohypogastric
• Parallel w/ iliohypogastric across quadratus lumborum to iliac crest, pierces trasnversus abdominis
• Communication w/ iliohypogastric: btwn transversus abdominis & internal oblique
• w/ sperm cord through superifical inguinal ring
• TO: Medial thigh, root of penis, anterior scrotum

38
Q

genitofemoral n

A

 genitofemoral (L1, L2)
• passes through Psoas major to ventral surface
• genital branch: joins spermatic cord/round ligament
o lateral scrotum & adjacent thigh
• femoral branch
o lateral to genital branch
o deep to inguinal ligament in lateral femoral sheath
o skin over anterior thigh

39
Q

Anterior

L2, L3, L4

A 
	obturator (L2,3,4)
•	medial to psoas major
•	enters pelvis under iliac vessels
•	exitsthrough obturator canal 
	 accessory obturator (L3,L4)
•	Present 10%
•	Medial psoas 
•	Leaves pelvis: passing superior to pubic ramus 
•	Deep to pectineus in thigh > m branch
•	Hip joint articular branch
40
Q

posterior

L2, L3, L4

A

o Posterior:
 Femoral (L2,3,4)
• Through psoas major
• Distal between psoas major & iliacus
• Leaves pelvis deep to inguinal ligament
• Lateral femoral artery
 lateral femoral cutaneous (L2,L3)
• Middle/lateral border psoas major
• Over iliacus
• To ASIS
• Inferior inguinal ligament
• Over Sartorius
• Anterior branch- skin over lateral/anterior thigh
• Posterior branch – skin lateral thigh from greater trochanter distally to mid-thigh

41
Q

sacral plexus

A

• Lumbosacral trunk: pats L4, L5-S3, part S4
• Medial to piriformis
• Converge at greater sciatic foramen
• All branches EXCEPT S4 branch into anterior/posterior divisions
***L4= Nervus furcalis > divided ino two plexuses
• ANTERIOR DIVISION
o N to quadratus femoris/inferior gemellus (L4-S1)
 Greater sciatic foramen, ventral to sciatic n
 Articular branch to hip joint
o N to obturator internus/superior gemellus (L5-S2)
 greater sciatic foramen
 reenters through lesser sciatic foramen to bturator internus

42
Q

sacral plexus 2

A 
•	POSTERIOR DIVISION
o	N to piriformis (S2 or S1/S2)
o	Superior gluteal (L4-S1)
	Greater sciatic foramen superior to piriformis
	Superior branch to gluteus minimus 
	Inferior branch to gluteus medius/minimus, tensor fascia latae 
o	Inferior gluteal (L5-S2)
	Greater sciatic foramen 
	Inferior piriformis 
	Supplies gluteus maximus
43
Q

sciatic

A

• SCIATIC
o Largest n in body, largest branch sacral plexus
o Anterior division: L4-S3
o Posterior divison L4-S2
o Supplies: posterior leg M, all M leg, foot, skin foot most skin leg, all joints in LE
o Greater sciatic formane inferior to piriformis
o Cranial end: rests posterior ischium btwn ischial tuberosity & greater trochanter of femur
o Crosses obturator internus tendon, gemelli m, quadratus femoris
o Accompanied: posterior femoral cutaneous, inferior gluteal A
o Articular branches to hip joint
o 1 antaomic n

44
Q

sciatic 2

A

o 2 physiologic n in 1 connective sheath
 Tibial (anterior L4-S3)
 Common peroneal (posterior L4-S2)
o Posterior femoral cutaneous (S2, S3A or S1/S2P)
o Skin gluteal region, posterior thigh, perineum, upper leg
o Gluteal branches
 Inferior cluneal – lateral gluteus maximus
o Perineal branches
o Medial to proximal thigh, perineum, scortum, base penis/labia majora
o Femoral branches
o Skin posterior/medial thigh & popliteal fossa
o Sural branches
o skin distal popliteal fossa
Coccygeal Plexus
• part S4, S5, coccygeal anterior rami

45
Q

common iliac a 1

A 
o	common iliac artery
o	splits between L5-S1 
o	external iliac
	larger terminal branch 
	medial border psoas major 
	intervertebral disc to inguinal ligament
	deep to ligament btwn symphysis pubis & ASIS 
	Crossed by:
•	Ureter
•	Ovarian A/V
•	Gential branch genitofemoral n
•	Deep circumflex iliac v
•	Ductus deferens
•	Round ligament 
	Inferior epigastric
•	Ascends superior/medial subperitoneal tissues 
o	Through transversalis fascia 
o	Btwn rectus abdominis & posterior rectus sheath
•	Forms lateral umbilical fold 
•	Anastomoses w/ branches superior epigastric a above umbilicus
46
Q

common iliac a 2

A 
	Deep circumflex iliac 
•	Opposite origin inferior epigastric on medial side 
•	Lateral deep to inguinal ligament 
•	Ascends toward ASIS 
o	
	Femoral Artery
o	Superifical external pudendal 
o	Deep external pudendal 
	Distal to superifical branch 
	Medially across pectinues/adductor longus 
	Anastomoses internal puedendal artery
o	Profunda femoris 
	2-5 cm distal to inguinal lig
	Largest branch of femoral 
	From lateral aspect femoral 
	Spirals posteriorinferior then to medial 
	Lateral femoral circumflex
•	Goes form rectus femoris & sartorius
•	Ascending branch
o	Superior deep to fascia lata 
o	Enter fibrous capsule as retinacular branches 
o	Anastamose:
	medial femoral circumflex 
	superior gluteal
	deep circumflex iliac
47
Q

profunda femoris a cont

A

 Medial femoral circumflex
• MOST IMPORTANT ADULTS FOR NECK FO FEMUR
• 25% comes off femoral
• Disappear btwn pectineus & psoas
• Enter fibrous capsule as retinacular branches
• Acetabular branches: opposite acetabular notch
o Enters with acetabular branch of obturator
o Supplies fat in acetabular fossa & around round ligament to head of femur
• Anastamose:
o Lateral femoral circumflex

48
Q

internal iliac

A

 supply viscera, walls pelvis
 Obturator Artery
• Joines obturator n lateral wall pelvis to enter obturator canal
o Foveolar branch – w/ ligament head of femur, supplies head femur
 NEED FOR KIDS! –during ossification
 Adults doesn’t matter

49
Q

veins

A

o Internal Iliac Vein
 Superior gluteal’
• Above piriformis
• Greater sciatic foramen
 Inferior gluteal
• Anastomose medial femoral circumflex & 1st perforating
• Greater sciatic foramen inferior to piriformis

50
Q

superficial inguinal nodes

A 
o	lop-sided T
o	stem T parallels great saphenous 
	known as Inferior group 
	foot, le, thigh, perineum 
	4-6 nodes
o	cross T parallels inguinal ligament 
	Known as superior group 
	Superifical, lateral protion gluteal region, anterior abdominal wall
	5-7 nodes 
	Pass primarily to external iliac nodes within false pelvis 
	Some go deep inguinal lymph nodes
51
Q

deep inguinal nodes

A

o 1-3 nodes
o Within femoral sheath
o Medial to femoral vein
o Lowest/ most constant node belwo termination great saphenous vein in femoral vein
o Intermediate node: most variable, midway along length femoral canal
o Uppermost: near femoral ring, superior femoral canal – cloquet or node of Rosenmuller
o Vessles from: femoral, deep femoral, perineum, superirfical inguinal nodes
o Efferent go to external iliac

52
Q

nodes cont

A 
External iliac nodes
o	Above pelvic brim 
o	Afferent-from inguinal nodes
o	Efferent- merge to common iliac
	Internal iliac nodes
o	Within pelvis
o	Afferent- pelvic organs, deeper gluteal regions 
o	Coruse with superior/inferior gluteal bv
o	Efferent- common iliac

LOWER LIMB (4 decks)

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