Femoral Triangle and Anterior Thigh Flashcards
Name the bony parts of the pelvis
Know how to find the following important landmarks
- anterior superior iliac spine
- pubic tubercle
- pubic symphysis
- inguinal ligament
How to know where muscles attach on a bone?
It will be raised and bumpy
Find the following important landmarks on the femur
- Head
- Neck
- Attachment for Piriformis
- Greater Trochanter
- Lesser Trochanter
- intertrochanteric line
- Attachment for gluteus minimus
- Attachment for gluteus medius
- Fovea
- pectineal line
- linea aspira
- Gluteal tuberosity
Where are the areas of transition in the lower limb (where vessels change names)?
The femoral triangle, the popliteal fossa, and the tarsal tunnel
Find these ‘gaps’ in the pelvis and know their borders
- Greater/Lesser Sciatic foramen
- below the inguinal canal
- Obturator Foramen
- Pelvic inlet
- Pelvic Outlet
Describe the path of the femoral artery
Abdominal aorta - common iliac artery- external iliac artery - femoral artery
What are the boundaries of the femoral triangle?
What are the roots of the femoral nerve?
L2,3,4
What passes through the femoral triangle?
lateral - NAVAL - medial
- femoral nerve
- femoral artery
- femoral vein
- ‘a gap’
- lacunar ligament
Femoral ring is closed by?
a femoral septum
What are the ligaments of the femoral ring?
Inguinal ligament
lacunar ligament
pectineal ligament
Where does the femoral artery pass in relation to the inguinal ligement?
It passes deep to the inguinal ligament at the mid-inguinal point
Follow the path of the femoral artery after it passes under the inguinal ligament
passes deep to the inguinal ligament - then gives off the profunda femoris laterally - passes deep to sartorius - through the adductor canal (aka subsartorial/hunters etc)
Describe the arteries of the Profundus Femoris (deep artery of the thigh)
After laterally exiting the femoral artery it gives off
- medial circumflex femoral artery
- Lateral circumflex femoral artery
- First, second and third perforating arteries
where does the profunda femoris arise?
What are it’s branches?
It arises 4 cm below the inguinal ligament from the lateral side of the femoral artery
Gives off medial/lateral circumflex arteries and perforating branches
What structures are within the femoral sheath below the inguinal ligament?
Everything except the Femoral Nerve
What branches come from the femoral nerve and what does it supply?
The femoral nerve gives off cutaneous branches +saphenous nerve
the femoral nerve supplies quadriceps
Lumbar plexus
- What are it’s spinal origins?
- What major branches does it give?
T12- L4
Superiorly
- iliohypgastric nerve (T12,L1)
- ilio-inguinal nerve (T12, L1)
- genitofemoral nerve (T12, L1,2)
- lateral femoral cutaneous nerve (L2,3)
- femoral nerve (L2,3,4)
- obturator nerve (L2,3,4)
inferior
What is Meralgia Paresthetica?
Meralgia Paresthetica is a condition where the Lateral cutaneous nerve of the thigh (which passes medially to ASIS) is entraped (potentially by tight jeans) causes pain in the outside of the thigh.
Describe attachments of the Sartorius muscle and it’s action/significance
The sartorius muscle attaches from the ASIS to the medial tibial
It flexes the hip, the knee, and laterally rotates the femur
The sartorius muscle makes up the lateral boundary of the femoral triangle!
Name the four quadricep muscles and their attachments
Vastus Lateralis: greater trochanter of femur to the tibial tuberosity
Vastus Medialis : medial lip of linea aspira to the tibial tuberosity
Vastus intermedius: intertrochanteric line to the tibial tuberosity
Rectus femoris: AIIS to the tibial tuberosity
What nerve supplies the quadriceps?
the femoral nerve (L2,3,4)
What are the contents of the subsartorial/hunter canal?
Femoral Artery, Femoral Vein, Saphenous Nerve, nerve to vastus medialis
What are the two veins in the thigh?
femoral vein = deep (under the fascia)
Saphenous vein = superficial
Describe the path of the saphenous vein
starts around the dorsal venous arch and passes anteriorly to the medial maleolus - travels up the leg and a hands breadth behind the patella, then it drains through the fascia lata (through the saphenous ring) and into the femoral vein.
Where does the saphenous vein drain into the femoral vein?
through the saphenous ring just 4 cm below and lateral to the pubic tubercle
Describe the lymphatic drainage of the lower limb
Lymphatic nodes
- Inguinal nodes (superficial, sub-inguinal superficial and deep sub-inguinal) - found in femoral triangle
- popliteal nodes - found in the popliteal fossa - recieve lymph from the lateral superficial vessels
What is Shenton’s Line?
The line following the superior pubic ramus and the neck of the femur - seen on Xray and used to diagnose a fracutre of the hip
Describe the dermatomes of the leg
What is a femoral hernia
Where does it occur
Who is it most common in?
Femoral hernia is due to bowel pushing into the superficial femoral ring-
presents as a lump situated inferolaterally to the pubic tubercle.
More common in women due to wider bony pelvis
*clinically this is challenging b/c the femoral canal is a tight space and not extendible which can compress the hernia and it’s blood supply causing a strangulated hernia.
How would you test the femoral nerve?
Sensory: touch inner thigh - compare both sides
motor: ask the to extend knee against pressure
