Femoral Region Flashcards
What are the boundaries of the femoral triangle?
- superior – inguinal ligament
- medially – adductor longus
- laterally –sartorius
- floor – iliopsoas and pectineus
- roof – deep fascia (fascia lata)
What are the contents of the femoral triangle?
Femoral Nerve
Femoral Artery
Femoral Vein
Lymphatics
The femoral _____1_____ are enveloped by the femoral sheath. The sheath does not envelop the ____2____, which lies outside and lateral to the sheath.
1) artery and vein
2) femoral nerve
What roots is the femoral nerve from? Where is it formed
Spinal roots- L2,3 and 4 formed in the lumbar plexus.
Where does the saphenous nerve branch from? Where does it go? What does it supply?
The femoral nerve
leaves adductor canal distally by passing between sartorius and gracilis (from the medial compartment)
supplies the fascia and skin of the anteromedial aspects of the knee and leg and the medial aspect of the foot where it accompanies the great saphenous vein.
What is the femoral canal?
passageway by which femoral structures exit from the abdomen into the upper thigh
What does the femoral canal contain?
only contains the deep inguinal lymph nodes and adipose tissue, and forms the most medial part of the femoral sheath.
The deep inguinal lymph nodes run in a chain in the femoral canal medial to the femoral vein.
What arteries supply the majority of blood to the head of the femur?
The medial and lateral circumflex femoral arteries supply the majority of blood to the head of the femur through their retinacular branches
Name four muscle groups of the anterior compartment of the thigh?
pectineus, iliopsoas (joined muscle of psoas and iliacus), sartorius and quadriceps femurus (four muscles)
What are the muscles of anterior compartment of the thigh supplied by?
Femoral nerve (L2, 3 and 4) Except psoas major (L1,2 and 3)
Proximal and distal attachments of ilipsoas muscle? Action?
Proximal: iliac fossa (iliacus) and lumbar transverse processes/IV discs (psoas major)
Distal: lesser trochanter of the femur
Flexion at the hip
Proximal and distal attachments of sartorius muscle? Action?
Proximal: ASIS
Distal: Medial surface of proximal tibia (via pes anserinus)
Flexion at the hip and knee
Four muscles of the quadriceps femoris group?
Rectus femoris
Vastus Lateralis
Vastus Intermedius
Vastus medius
Proximal and distal attachments of all the quadriceps? Action?
Proximal: Rectus femoris is from ASIS , the other three from the shaft of the femur.
Distal: All Patella (via quadriceps tendon) then tibial tuberosity (via patellar tendon/ligament)
Extension of the knee (and weak flexion of the hip for rectus femoris)
Main actions of the anterior compartment of the thigh?
Flexors of the thigh and leg extensors
Main function of the medial compartment of the thigh?
Adductors of the thigh
What are the muscles of the medial compartment of the thigh?
gracilis and adductors brevis, longus & magnus, and obturator externus
Proximal and distal attachments of gracilis? Action?
Proximal: inferior pubic ramus
Distal: Superiomedial aspect of the tibia
Adduction of the thigh
Proximal and distal attachments of the adductor muscles? Action?
- Proximal attachments: Pubis, ischiopubic ramus or the ischial tuberosity (“hamstring” part of adductor magnus)
- Distal attachments: Posterior surface of the shaft of the femur along the linea aspera, or the adductor tubercle of the femur (“hamstring” part of adductor magnus)
Adduction of the thigh
Origin and insertion of obturator externus? Action
Insertion: trochanteric fossa of femur Actions: adduct thigh, Laterally rotates thigh
Origin: obturator foramen
Adduction of the thigh
The muscles of the medial compartment of the thigh are all innervated by the ______1_______ except for the _____2________ which is supplied by the ____3_____
1) obturator nerve (L2-4)
2) “hamstring part” of adductor magnus,
3) tibial nerve
The obturator nerve, artery and vein enter the medial compartment of thigh via the ______1_________. The nerve then divides into anterior and posterior branches at the upper border of ____2_____. The anterior branch can be located between ______3______in the superior part of the medial compartment.
1) obturator foramen of the hip bone
2) adductor brevis
3) adductors longus (anteriorly) and brevis (posteriorly)
Describe sensory innervation of the thigh
The anterior cutaneous nerve of the thigh, which is a branch of the femoral nerve (L2-L4) The lateral cutaneous nerve of the thigh, which is a branch of the lumbosacral plexus (L2-3) The cutaneous branch of the obturator nerve (L2-4).
What does all lymph from the lower limb ultimately drain into?
external iliac nodes
The posterior compartment of the thigh is made up of what group of muscles?
The hamstrings
What three muscles make up the hamstring group?
Semitendinosus, semimembranosus and bicep femoris (this has a short head and a long head)
What three features do all hamstring muscles share?
- Proximal attachment to the ischial tuberosity deep to gluteus maximus
- Distal attachment to the bones of the leg (thus they span and act on two joints, producing extension at the hip joint and flexion at the knee joint)
- Innervation by the tibial division of the sciatic nerve
Action of the hamstrings?
extensors of thigh & flexors of leg
What hamstring is not a true hamstring? Why?
short head of bicep femoris as it does not come from the ischial tuberosity and does not cross the hip joint and supplied by common fibular branch not tibia
Semitendinous (long tendon) proximal and distal attachments?
Proximal: ischial tuberosity
Distal: Medial surface of superior part of tibia
Semimembranous (shiny membrane) proximal and distal attachments?
Proximal: Ischial tuberosity
Distal: Posterior part of medial condyle of tibia.
Biceps femoris proximal and distal attachments?
Proximal: long head attaches to ischial tuberosity but short head attaches to the line aspera and lateral supracondylar line of femur
Distal: Lateral side of head of fibula. Tendon is split at this site by fibular collateral ligament of the knee.
What is the acetabular labrum? What does it do?
ring of cartilage that surrounds the acetabulum of the hip, increases the depth of the acetabulum
The hip joint has three ligaments which spiral from the pelvis to the head of the femur, what are they?
iliofemoral
pubofemoral
ischiofemoral
Moving anterior to posterior give order of adducts muscles?
Adductor longus, adductor brevis, adductor magnus
How to tell semimebranosus from semitendonosus?
Semimebranosus is wider flatter and deeper, the semitendonosus is on top and lies over middle. They both curve round to attach to medial part of leg.
