Exam 4 Flashcards
Boundaries of femoral triangle
Superior: inguinal ligament
Lateral: Sartorius
Medial: adductor longus
Femoral triangle clinically important because:
- Hernias common
2. Arterial pressure point
Contents of femoral triangle
Femoral nerve
Femoral sheath (femoral artery+ vein)
Inguinal lymph nodes
Femoral sheath function
Allows femoral artery and vein to glide deep to inguinal ligament during movements of hip joint
Femoral sheath compartments
- Lateral: femoral artery
- Intermediate: femoral vein
- Medial: femoral canal
Femoral canal function
Allows femoral vein to expand when there is increased venous return from lower extremity
Femoral canal is ___ in females
Wider
Femoral ring
Opening in roof of femoral canal
Femoral hernia
Protrusion of abdominal viscera through femoral ring into femoral canal
may become strangulated
Main arterial supply of lower extremity
Femoral artery
Femoral artery is a continuation of
External iliac artery
Femoral artery passes through adductor hiatus to become
Popliteal artery
Branches of femoral artery
- Superficial branches
- Femoral Profundus
- Lateral and Medial Circumflex
- Perforating arteries
- Descending genicular artery
Superficial branches of femoral artery supply:
Proximal anterior thigh region
Superficial branches of femoral artery…
Superficial circumflex iliac
Superficial epigastric
Superficial pudendal
First major branch of femoral artery
Femoral profundus
First branches off femoral profundus
Lateral and Medial circumflex arteries
Lateral and medial circumflex arteries supply
Muscles on lateral and medial aspect of thigh
Main blood supply to neck and head of femur
Perforating arteries supply
Muscles and skin on posterior aspect of thigh
Descending genicular artery supplies
Knee and medial aspect of leg
Femoral vein passes through adductor Magnus as a continuation of ___
Popliteal vein
As the femoral vein leaves femoral triangle and enters pelvis it becomes __
External iliac vein
Femoral vein receives tributaries from
Femoral profundus vein
Great saphenous vein
Popliteal lymph nodes associated with
Popliteal vein in popliteal fossa
Adductor canal located in
Medial aspect of thigh
Adductor canal provides passageway for
Femoral artery
Femoral vein
Saphenous nerve
Superior and inferior gluteal arteries are branches of
Internal iliac artery
Superior gluteal artery supplies
Gluteus Maximus
Gluteus Medius and minimus
Tensor Fascia Lata
Inferior gluteal artery supplies
Gluteus Maximus
Obturator Internus
Quadratus Femoris
Posterior thigh muscles
Boundaries of popliteal fossa
Lateral: biceps Femoris + lateral head of gastrocnemius
Medial: semimembranosus + semitendinosus + medial head of gastrocnemius
Roof: deep Fascia and skin
Floor: popliteal surface of femur, posterior extrinsic ligaments of knee joint + popliteus
Contents of popliteal fossa
Popliteal artery and vein Lesser saphenous vein Common fibular nerve Tibial nerve Posterior femoral cutaneous nerve Popliteal lymph nodes
Deepest neuromuscular structure of popliteal fossa
Popliteal artery
Genicular branches of popliteal artery form …
Genicular anastomosis at the back of the knee
Genicular anastomosis provides
Collateral circulation to leg during full flexion at knee joint
Popliteal artery terminates into
Anterior and posterior tibial arteries
Popliteal aneurysm
Abnormal dilation of artery which causes swelling and pain in popliteal fossa
Arterial embolism could result in
Loss of blood to leg and foot
Articulating surfaces of hip joint
Head of femur
Acetabulum of pelvis
Acetabular labrum
Deepens cavity of acetabulum
Transverse acetabular ligament
Part of acetabular labrum that bridges acetabular notch
Hip joint classified as
Ball and socket
Capsular ligament of hip joint
Strong, loose ligament that permits free movement at joint
cannot maintain integrity of joint alone
Iliofemoral ligament reinforces capsular ligament ___ and ____
Anteriorly
Inferiorly
Strongest ligament in body is
Iliofemoral ligament
Iliofemoral ligament attaches to ____ superiorly and ___ inferiorly
Anterior inferior iliac spine
Intertrochanteric line
When bending backward, ____ prevent body from falling backward
Anterior hip and abdominal muscles
When bending forward, ___ prevent body from falling forward
Gluteal, hamstring, and spinal muscles
Iliofemoral ligament is ___ and acts like ___
Extrinsic
Rope
Nerve supply of iliofemoral ligament
Femoral
Obturator
Sciatic
Pubofemoral ligament attaches to ___ superiorly and ___ inferiorly
Superior ramus of pubis
Intertrochanteric line
Pubofemoral ligament prevents __ at joint
Abduction
Pubofemoral ligament is __ and acts like ___
Extrinsic
Rope
Ischiofemoral ligament runs from ___ superiorly and ___ inferiorly
Body of ischium
Neck and greater trochanter of femur
Ischiofemoral ligament prevents ___ and __ at joint
Hyperextension
Abduction
Ischiofemoral ligament is __ and acts like ___
Extrinsic
Rope
Transverse acetabular ligament is ___ and converts acetabular notch into tunnel
Intrinsic
Capitis Femoris ligament is a weak ____
Intrinsic ligament
Developmental Dysplasia more common in
Females (8X more common)
Majority of infants with developmental dysphasia were in
Breech position
Majority of children with developmental dysphasia have
Ligamentous laxity- causes hip to become unstable and slip out of position
If not corrected, developmental dysphasia may lead to
Pain, abnormal gait, femoral anteversion, unequal leg length, osteoarthritis, contracture of hip muscle
Posterior dislocations of hip
More common
May compromise sciatic nerve
Femoral head ends on ilium
Anterior dislocation
May compromise Obturator nerve
Head of femur ends up in obturator Foramen
Largest and most superficial joint in body
Knee joint
Articulation of knee joint
Femur
Tibia
Patella
Articulating surfaces of tibial condyles
Lateral and medial tibial plateaus
Joint between femur and tibia is
Ginglymus (hinge)
Joints between patella and femur is
Plane gliding
Nerve supply of knee joint
Femoral
Obturator
Common fibular
Tibial nerve
Subcutaneous prepatellar Bursae
Lies between patella and skin
Subcutaneous infrapatellar Bursae
Lies between tibial tubercle and skin
Deep infrapatellar Bursae
Between ligamentum patella and tibial tubercle
Suprapatellar Bursae
Lies between femur and common tendon of insertion of quads
Ligamentum patella function
Help maintain alignment of patella relative to articular surface of femur
Ligamentum patella runs from
Apex to patella to tibial tubercle
Collateral ligaments of knee contribute to
Stability when standing
Lateral collateral ligament attached to ___ proximally and ___ distally
Lateral epicondyle of femur
Head of fibula
Lateral collateral ligament function
Wall and prevents lateral movement of joint
Medial collateral ligament function
Wall and prevents medial movements at joint
Medial collateral ligament attaches to ___ proximally and ____ distally
Medial epicondyle of femur
Medial side of tibia, just below medial condyle
Oblique and arcuate popliteal ligaments both function to
Prevent hyperextension of knee joint (functions as wall)
Stabilize posterior aspect of joint
Main bonds between femur and tibia
Cruciate ligaments
Anterior cruciate ligament runs from ___ to ____
Lateral condyle of femur
Anterior intercondylar area of tibia
ACL prevents
Anterior displacement of tibia under femur
Functions like rope
____ cruciate ligament is weaker
Anterior
Posterior cruciate ligament runs from __ to ___
Medial condyle of femur
Posterior intercondylar area of tibia
PCL prevents
Posterior displacement of tibia under femur
Functions like rope
Menisci have well developed blood supply from birth to
18 months of age
Central portions of adult meniscus are
Avascular
Main function of menisci
Deepen articulating surface
Shock absorber
Mechanoreceptor to increase positional sense of knee joint
Medial meniscus adheres to
Tibial collateral ligament
__ is C shaped
Medial meniscus
___ is less mobile on surface of tibia
Medial meniscus
___ is more freely movable on surface of tibia
Lateral meniscus
Lateral meniscus is ___ in shape
Circular
Lateral meniscus is __ than medial meniscus
Smaller
Coronary ligaments help hold ___ in place
Menisci
When fully extended, knee “locks” due to
Lateral rotation of tibia
To “unlock” the knee, the ___ must contract to rotate tibia ___
Popliteus
Medially
Prepatellar (housemaid’s) bursitis
Friction between skin and patella
Direct blow/ falling on flexed knee
Subcutaneous infrapatellar bursitis
Excessive friction between skin and tibial tubercle
Common in roofers, clergymen
Suprapatellar bursitis
Bacteria from abrasion or penetrating wound
May spread to knee joint cavity
Unhappy triad
Blow to lateral aspect of joint while in weight bearing position
Can cause damage to medial collateral, ACL, and medial meniscus
Most commonly injured ligament of knee joint
Medial collateral
If large parts of medial meniscus are removed, ___ can result
Osteoarthritis
___ meniscus is more vulnerable to injury
Medial
ACL damaged in sports with
Twisting or jumping
ACL damage symptoms
Hear “pop” and then feel like knee as “given out”
Positive anterior drawer test
Tibia can be pulled excessively forward under femur after ACL damage
Positive posterior drawer test
Tibia can be pulled excessively backward under femur due to damage to PCL
Function of tibia
Weight bearing
Tibia articulates with
Condyles of femur and head of fibula and with talus and distal end of fibula
___ ossification centers of tibia
4
(1 primary)
(3 secondary)
3 secondary ossification centers of tibia
Proximal end
Distal end
Tibial tuberosity
Ossification of tibia
- Shaft
- Proximal end
- Distal end
- Tibial tuberosity
- Distal end fuses
- Proximal end fuses
Osgood-Schlatter’s Disease
Disruption of epiphyseal plate of tibial tuberosity that occurs around puberty in active adolescents
Apophyses
Secondary ossification center that develops with growth
Osgood-schlatter’s disease is example of
Apophyseal injury
Function of fibula
Give attachment to muscles
__ ossification centers of fibula
3
1 primary- shaft
(2 secondary - distal and proximal ends)
Ossification of femur order
- Shaft
- Distal end
- Proximal end
- Proximal end fuses
- Distal end fuses
Bumper fracture
Compound fractures of tibia due to direct trauma
Fractures of fibula may damage
Common fibular nerve