femoral regions Flashcards
lower limb includes:
which are responsible for:
Composed of six regions:
Gluteal
Femoral
Knee
Leg
Ankle
Foot
functions:
* Support of body weight
* Locomotion
* Maintain balance
1-limbs are divided into — which are divided into —- by a ——-
2- thigh and gluteal region are —– which encloses —– this is thickened and reinforced by longitudinal fibres forming —–
- segments
- compartments
- thick stocking like membrane
- fascia lata
- large thigh muscles
- iliotibial tract
( check structure )
femoral region:
-The muscles of the thigh are divided into 3 compartments:
- thes walls are formed by —- and the — fascia that attach to the lines aspera of femur
1- anterior
2- medial
3- posterior
- fascia lata and 3 fascia
- intermuscular septa
anterior compartment of the thigh:
- Quadriceps femoris (4)
- Iliopsoas – (Psoas major
and Illiacus) - Sartorius
- has Femoral nerve
( check structure slide 12,13)
—- passes deep to the inguinal ligament
attachement:
1- —– : anterior surface of iliac crest
2- ——: lumbar vertebral column
and discs (T12-L5)
insertion:
action:
- lliopsoas
- illiacus
- posts major
- lesser trochanter
- Flexes thigh at hip (most powerful hip
flexor)
sartorius :
1- attachement:
2- insertion:
3- action:
- has: ——-
1-Anterior superior iliac spine
2-Tibia (inferomedial to tibial tuberosity)
3-Flexes (primarily), abducts & laterally
rotates thigh at hip
Flexes leg at knee
- pes anserinus ( goose foot )
- ( say grace before tea :Sartorius, Gracilis, SemiTendinosus)
tensor fasciae latea:
1- attachement:
2- insertion :
3- action:
4- intervention:
1-Anterior superior iliac spine
2-Iliotibial tract (lateral condyle of the tibia)
3- Flexes, abducts, med rotates thigh at hip , Tenses the fascia lata
4- superior gluteal nerve
-Quadriceps Femoris consists of:
- testing quadriceps by:
- Rectus femoris
- Vastus medialis
- Vastus intermedius
- Vastus lateralis
- testing by:
– Apply one hand to post aspect of
thigh & other slightly superior to
ankle
– Extend leg against practitioner’s
resistance
– Watch for individual leaning
backward & recruiting hip flexors
or exclusively using rectus
femoris
quads femeoris - rectus femoris:
1- attachement:
2- insertion:
3- action:
- Anterior inferior iliac spine
-Quadriceps Femoris Tendon - flexes thigh at hip and extends leg at knee
quads femoris :
2. Vastus Lateralis
3. Vastus Medialis
4. Vastus intermedius
- attachement:
- insertion:
-action:
- femur
- quad femerous tendon
- extends leg at knee
1-
—– injury of knee by direct blow or sudden twist of leg
1- — slips out the normal position in pattellofemoral groove ( intense pain )
2- manual reposition by ——
2-
—– among most common knee injuries usually from hard blow to front of knee
1- nondisplaced fracture:
2- displaced fracture:
- patellar dislocation
- patella
- extending leg or orthopaedic reduction ( – Swelling & impaired mobility
– Rehabilitation 6-16 wks ) - patellar ( kneecap ) fracture
- 4-6 wks immobilization in cast
- surgical treatment followed by
quadriceps strengthening
1-medial compartment of thigh:
2- *Obturator nerve except
Pectineus and ½ Adductor
Magnus
3- Hamstring portion of adductor
magnus is —
- Pectineus
- Gracilis
- Obturator Externus
- Adductor (3)
- Brevis
- Longus
- Magnus
- sciatic n
pectineus :
1- attachment:
2- insertion:
3- action:
- Pectineal line of pubis
- Oblique line of the proximal
femur - adducts and flexes thigh at hip
—— Most Superficial Muscle on Medial Thigh
gracilis:
1-Attachment:
Inferior pubic ramus
2-Insertion:
Proximal shaft of tibia
3-Action:
* Adducts thigh at hip
* Flexes leg at knee
* Medially rotates leg
“Say Grace before Tea”
Sartorius, Gracilis, Semitendinosus
-Pes Anserinus
(“goose foot”)
—— covers Anterior Wall of Pelvis
-Obturator Externus
1-Attachment:
Obturator membrane
2-Insertion:
Trochanteric fossa
3-Action:
* Laterally rotates thigh at
hip
* Stabilises femur in
acetabulum
Adductor Brevis and Longus:
Adductor Brevis
1-Attachment:
Body of pubis and inferior
pubic ramus
2-Insertion:
Proximal femur and upper 1/3
of linea aspera
Adductor Longus
1-Attachment:
Body of pubis
2-Insertion:
½ way down the femur
—- large triangular muscle
Adductor Magnus
Attachment:
* Ischiopubic ramus
* Ischial tuberosity
Insertion:
Gluteal tuberosity, linea aspera,
medial supracondylar line and
adductor tubercle
actions of thigh muscle:
1- anterior:
2- medial compartment;
2- posterior compartment
1-
Flexion of thigh at the hip
Extension of leg at the knee
2- adduction of thigh and hip
femoral triangle:
- boundaries ( think SAIL )
1- —- : medial border of (s)aritours
2- —-: medial border of (a)dductor longus
3—-: (l)inguinal (l)ligament
- lateral
-medial
-superior
femoral traingle:
1- floor:
2- roof:
3- content:
1- floor:
– Iliopsoas (laterally)
– Pectineus & adductor longus
(medially)
2- fascia lata
3- navel from lateral —> medial
* Terminal part of femoral Nerve
* Femoral Artery
* Femoral Vein
* Empty space
* Lymphatics
( all are from femoral sheath and empty space and lymphatics are from the femoral canal and the femoral sheath )
—– funnel shaped fascial tube behind inguinal ligament
1- femoral nerve is —- and — within fennoral sheath
2- —– permeates roof the triangle to drain femoral vein
3- The apex of the triangle is continuous inferiorly with a —-
- femoral sheath
- lateral and not contained
- great saphenous vein
- fascial canal - adductor canal
the femoral canal contains —- allows —- and entrance is —
1- contains lymphatic embedded in loose fatty connective tissue
2- allows for expansion of femoral vein
3- entrance is femoral ring
—- is the opening into the femoral canal from the abdominal cavity and the boundaries include:
- femoral ring
- boundaries are:
- Anterior: inguinal ligament
- Lateral: femoral vein
- Medial: lacunar ligament
- Posterior: pectineal ligament
( check structure pls)
—- protrusion of abdominal contents
through the femoral ring into the
femoral canal
clinical diagnosis include:
- femoral hernia
- swelling below and lateral to pubic tubercle
( check lower limb blood supply slide 39)
thigh - blood supply:
1- —- supplies very little in thigh itself
2- the thigh is mainly supplied by —–
- femoral artery from external iliac artery
- branched of femoral artery ( profound femoris artery by which profound means deep) and it rises:
- Medial circumflex femoral artery
- Lateral circumflex femoral artery
- Perforating branches (~ 4) that pass
through adductor magnus to supply
back of thigh
thigh - blood supply:
1- —– deep femoral ( profound femoris ) artery
2- —- obturator artery
- anterior compartment
- medial compartment
lower limb - venous drainage
1- —> superficial
2- —> deep
1- great saphenous
2- femoral vein
—– is a serious clinical condition which is the complication in pulmonary occlusion (caused by DVT travelling through circulatory system & entering
pulmonary circulation), can result in
cardiopulmonary arrest
— that prevents circulation from continuoing leads to — in preipheral tissue
- presence of clot in deep and large vein will lead to:
1- deep venous thrombosis
2- clot
3-swelling
4- lower extremities and may propagate into femoral veins
varicose veins of legs:
— prevents blood from flowing backward , the return of venous blood from lower limbs to heart requires —
— leaflets of valves no longer meet properly , by which the blood can accumulate in —–
- most common in —- w – when standing ( great saphenous vein )
- various veins are — and lead to —
- treated by:
- valves
- pump ( think gravity )
- varicous
- superficial vein
- superficial veins of legs
- Hugh pressure
- painful , lead to leg swelling , thick skin and ulceration
- treatment: vein obliteration, support
stockings, elevating legs, exercise
