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MSK Dissections > Femoral Triangle, Anterior and Medial Thigh > Flashcards

Femoral Triangle, Anterior and Medial Thigh Flashcards

1
Q

What are the borders of the femoral triangle?

A 
Superiorly = inguinal ligament
Laterally = sartorius
Medially = adductor longus
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2
Q

What forms the floor of the femoral triangle?

A

Formed by iliopsoas laterally and pectineus medially

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3
Q

What are the contents of the femoral triangle (from lateral to medial)

A

Femoral nerve, femoral artery, femoral vein and femoral canal (lymphatics)

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4
Q

What does the femoral canal contain?

A

Deep inguinal lymph nodes and adipose tissue (where femoral hernias form)

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5
Q

What is contained within the femoral sheath?

A

The femoral artery and vein

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6
Q

What is the femoral sheath?

A

Short tube of transversalis and iliopsoas fascia from the abdominal wall which surrounds most proximal parts of the femoral artery and vein, blends inferiorly with the adventitia of these vessels

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7
Q

Where is the femoral nerve in relation to the femoral sheath?

A

Outside and lateral to the sheath

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8
Q

What is the femoral nerve?

A

L2-L4, formed in lumbar plexus

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9
Q

Where do the saphenous (sensory) branches of the femoral nerve leave via?

A

Leave adductor canal distally by passing between sartorius and gracilis

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10
Q

Where do the saphenous branches of the femoral nerve innervate?

A

Supply fascia and skin of anteromedial aspects of knee and leg, and medial aspect of the foot where it accompanies the great saphenous vein

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11
Q

What is a femoral hernia, and what can cause it?

A

Can present as painful lump in the groin; increased abdominal pressure causes peritoneum to herniate into canal

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12
Q

What aspect of the femoral sheath does the femoral canal form?

A

Forms most medial part

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13
Q

Where do deep inguinal lymph nodes run from?

A

Run in a chain from the femoral canal to the femoral vein

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14
Q

Where do the medial and lateral circumflex arteries supply?

A

Supply majority of blood to the head of the femur through their retinacular branches

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15
Q

Where do the retinacular branches of the medial and lateral circumflex arteries pass?

A

Pass superiorly in relation to the femoral neck and capsule of hip joint

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16
Q

How are the medial and lateral circumflex arteries named?

A

According to the aspect of the profundal femoris artery from which they emerge

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17
Q

What can the femoral pulse be used to locate?

A

The femoral vein and nerve, which can be used for cannulation and nerve block respectively

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18
Q

What is the femoral pulse?

A

The pulsation of the femoral artery

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19
Q

What processes can the femoral artery be used for?

A

Angiograms, coronary artery stenting, aortic/mitral valve replacements, AA repair

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20
Q

Where is the inguinal ligament?

A

Inferior border of external oblique aponeurosis, runs between ASIS and pubic tubercle (forms a gutter)

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21
Q

What is in the medial half of the inguinal ligament?

A

The inguinal canal

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22
Q

Where can the inguinal ligament be palpated?

A

At the junction between the external oblique aponeurosis and the deep fascia of the thigh (the fascia lata)

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23
Q

What structures pass deep to the inguinal canal to enter/leave the lower limb?

A

Femoral vessels, nerve and iliopsoas muscle/combined tendon all pass deep to the inguinal ligament in the retroinguinal space

24
Q

What are the proximal attachments of the iliopsoas?

A

Iliac fossa (iliacus), lumbar transverse process/IV discs (psoas major)

25
Q

What muscles make up the anterior compartment of the thigh?

A

Iliopsoas, sartorius, quadriceps femoris

26
Q

What is the distal attachment and nerve supply of the iliopsoas?

A

Attaches distally to the lesser trochanter of the femur; supplied by the anterior rami of lumbar spinal nerves

27
Q

What action does the iliopsoas perform?

A

Flexion at the hip

28
Q

What are the proximal and distal attachments of the sartorius?

A 
Proximal = ASIS
Distal = medial surface of proximal tibia (via pes anserinus)
29
Q

What nerve supplies the sartorius, and what action does the muscle perform?

A

Supplied by femoral nerve; performs flexion at hip

30
Q

What are the four muscles that make up the quadriceps femoris?

A

Rectus femoris, vastus lateralis, vastus intermedius, vastus medius

31
Q

What are the proximal attachments of the muscles which make up the quadriceps femoris?

A

Rectus femoris = ASIS

Vastus lateralis, intermedius and medius = shaft of femur

32
Q

What is the distal attachment of the quadriceps femoris?

A

Patella (via quadriceps tendon) then tibial tuberosity (via patellar ligament/tendon), same attachment for all four muscles

33
Q

What action does the quadriceps femoris perform?

A

Extension of the knee (and weak flexion of the hip for rectus femoris)

34
Q

Which nerve supplies the quadriceps femoris?

A

The femoral nerve

35
Q

What is the knee jerk reflex?

A

Deep tendon reflex elicited by striking the patellar ligament with a tendon hammer to suggest a sudden stretch of the quadriceps muscle

36
Q

What is a normal result of the knee jerk reflex?

A

Reflex contraction of the quadriceps and slight extension at the knee joint

37
Q

What does a positive test result of the knee jerk reflex show?

A

Functions of the muscle, its nerve supply (femoral nerve, spinal roots L2-4), the spinal cord connections and descending controls from the brain which normally act to prevent unwanted recurrent reflexes from occurring during normal functioning

38
Q

Why are muscles of the medial compartment called the adductor group?

A

Their action is to adduct the thigh at the hip joint

39
Q

What are the muscles of the medial compartment?

A

Gracilis, adductor brevis, adductor longus, adductor magnus

40
Q

What are the different parts of the adductor magnus?

A

Hamstring part and adductor part

41
Q

What are some features of the gracilis?

A

Most medial muscle of group, thin strap-like muscle descending along the medial aspect of the thigh

42
Q

Which is the only muscle of the medial aspect of the thigh to cross the knee in addition to the hip?

A

The gracilis (weak flexor of knee)

43
Q

Where does the gracilis insert into?

A

Superomedial aspect of the tibia

44
Q

Where are the adductors brevis and longus located?

A

Anterior to the adductor magnus, adductor brevis lies superior to the adductor longus

45
Q

What are the proximal attachments of the muscles of the medial thigh?

A

Pubis, ischiopubic ramus or ischial tuberosity(hamstring part of adductor magnus)

46
Q

What are the distal attachments of the muscles of the medial thigh?

A

Posterior surface of the shaft of the femur along the linea aspera, adductor tubercle of femur (hamstring part of adductor magnus)

47
Q

What nerve innervates the muscles of the medial thigh?

A

All muscles innervated by the obturator nerve (L2-4) except the hamstring part of the adductor magnus (innervated by tibial nerve)

48
Q

Where do the obturator vessel and nerve enter the medial compartment of the thigh?

A

Via the obturator foramen of the hip joint

49
Q

Where does the obturator nerve divide into its posterior and anterior branches?

A

Once inside the medial compartment of the thigh at the upper border of the adductor brevis

50
Q

Where is the anterior branch of the obturator nerve located?

A

Between adductors brevis (anteriorly) and longus (posteriorly) in the superior part of the medial compartment of the thigh

51
Q

What nerves provide sensory innervation to the thigh?

A

Anterior cutaneous nerve of the thigh = branch of femoral nerve (L2-4)
Lateral cutaneous nerve of the thigh = branch of the lumbosacral plexus (L2-3)
Cutaneous branch of the obturator nerve (L2-4)

52
Q

What does lymph drainage tend to follow?

A

Venous drainage

53
Q

Where does lymph from superficial structures (e.g skin, superficial fascia) follow?

A

The great and small saphenous veins

54
Q

Where does lymph following the great saphenous vein drain into?

A

Superficial inguinal lymph nodes located in the superficial fascia around the vein, then from there mostly drains into external iliac nodes and some to deep inguinal nodes

55
Q

Where does lymph following the small saphenous vein drain into?

A

Popliteal lymph nodes located in the popliteal fossa, then from there drains into deep inguinal nodes and finally into the external iliac nodes

56
Q

Where are the deep inguinal nodes located?

A

Deep to the deep fascia of the thigh (fascia lata) medial to the femoral vein

57
Q

Where does all lymph from the lower limb ultimately drain into?

A

The external iliac nodes

MSK Dissections (11 decks)

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