Hip Region and Thigh Flashcards

1
Q

In anatomy, what are the names given to the top and bottom of the leg?

A

Upper leg = THIGH

Lower leg (knee downwards) = LEG

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2
Q

What does the superficial fascia of the thigh and leg contain?

A

Greater saphenous vein

Lesser saphenous vein

Cutaneous nerves

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3
Q

Where does the greater saphenous vein start?

A

Dorsal-venous arch = where the dorsal veins of the 1st and 5th digit meet

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4
Q

Does the greater saphenous vein run medial or lateral initially?

What structure does it encounter as it does this and where does it travel in relation to this structure?

A

Medially

It travels 1 finger breadth ANTERIOR to the MEDIAL MALLEOULUS

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5
Q

Where does the grater saphenous vein travel after it has passed the medial malleolus?

Explain its route until just before it joins a larger vein.

A

It travels medially along the leg, posteriorly at the knee, back medially along the thigh then travels anteriorly to the front of the thigh

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6
Q

What vein does the greater saphenous join?

What structures does it interact with in the process?

A

The greater saphenous punctures the fascia lata (deep fascia of the thigh) at the saphenous opening

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7
Q

What is the name of the fascial layer that covers the thigh?

A

Fascia lata

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8
Q

What is the name of the fascial layer that covers the back of the knee?

A

Popliteal fascia

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9
Q

What is the name of the fascial layer that covers the leg?

A

Crural fascia

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10
Q

What is the name of the fascial layer that covers the bottom of the foot?

Which bone does this attach to (heel bone)?

A

Plantar fascia

The calcaneous bone

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11
Q

Which nerve follows the path of the greater saphenous vein?

What does this supply?

Which nerve is this a branch of and is this anterior or posterior?

Which structure does this nerve pass through as it travels downwards?

A

Saphenous nerve

It supplies medial leg and foot cutaneously

It is a posterior branch of the femoral nerve

It travels through the adductor canal and adductor hiatus

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12
Q

How many compartments are there in the thigh?

A

3

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13
Q

How many compartments are there in the leg?

A

3

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14
Q

Where is the start of the lesser saphenous vein?

A

At the dorsal-venous arch, same as the greater saphenous vein

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15
Q

Where does the lesser saphenous vein run after it has started?

A

Laterally

It runs inferior and posterior to the lateral malleolus

It then travels posteriorly up the leg

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16
Q

What vein does the lesser saphenous join?

What structures does it interact with in the process?

A

It joins the popliteal nerve

It punctures the popliteal fascia to do this

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17
Q

Which nerve follows the lesser saphenous nerve?

What nerve is this a branch of? (Be specific as to which branches form which nerves)

What does this nerve do?

A

Sural nerve

It is made from a combination of branches of the sciatic nerve branches:

  • tibial nerve
  • common fibular nerve

It supplies the lateral foot and leg cutaneously

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18
Q

What function do the muscles of the anterior compartment of the thigh have?

A

1) extension of the knee

2) flexion of the hip

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19
Q

What function do the muscles of the posterior compartment of the thigh have?

A

1) flexion of the knee

2) extension of the hip

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20
Q

What function do the muscles of the medial compartment of the thigh have?

A

Hip ADDUCTION

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21
Q

What function do the muscles of the anterior compartment of the leg have?

A

1) dorsiflexion of the foot

2) inversion of the foot

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22
Q

What function do the muscles of the posterior compartment of the leg have?

A

1) plantar flexion of the foot

2) inversion of the foot

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23
Q

What function do the muscles of the lateral compartment of the leg have?

A

1) eversion of the foot only

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24
Q

Which two muscles cause foot inversion?

Which compartments are they in?

A

1) tibialis anterior = anterior compartment

2) tibialis posterior = posterior compartment

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25
Q

Which nerve supplies the anterior compartment of the thigh?

What are it’s roots?

A

Femoral nerve

Roots = L2-L4

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26
Q

Which nerve supplies the medial compartment of the thigh?

What are it’s roots?

A

Obturator never

Roots = L2-L4

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27
Q

Which nerve supplies the posterior compartment of the thigh?

What are it’s roots?

A

Sciatic nerve

Roots = L4-S3

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28
Q

Which posterior thigh muscle section is innervated by the common fibular part of the sciatic nerve?

A

The short head of biceps femoris

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29
Q

What are the muscles of the posterior compartment of the thigh?

What are their innervations?

A

Biceps femoris (common fibular part of the sciatic nerve)

Semitendinous (tibial part of the sciatic nerve)

Semimembranous (tibial part of the sciatic nerve)

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30
Q

What are the two divisions of the sciatic nerve?

Which is anterior and which is posterior?

Which compartment does each supply in the leg?

A

1) anterior division = tibial = supplies posterior compartment of leg
2) posterior division = common fibular = supplies anterior and lateral compartment of leg

NB: division orientation = OPPOSITE to the compartment it supplies

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31
Q

Which nerve supplies the sole of the foot?

A

Tibial nerve branch of the sciatic nerve which ends up forming the medial and lateral plantar nerves

32
Q

Which nerve supplies the dorsum of the foot?

A

Common fibular branch of the sciatic nerve

33
Q

What are the 2 divisions of the common fibular nerve and what does each innervate?

What are the nerve roots for each?

A

1) superficial fibular nerve = lateral leg = roots L4-S1

2) deep fibular nerve = anterior leg = roots L4-S1

34
Q

What does the superior gluteal nerve innervate?

What are it’s roots?

A

L4-S1

Gluteus minimus, medius and tensor fascia lata

35
Q

What does the inferior gluteal nerve innervate?

What are it’s roots?

A

Gluteus maximus

L5-S2

36
Q

What is the pathway of the common fibular nerve distal to the knee?

A

Around the neck of the fibula

37
Q

Which artery branches from the aorta to supply the lower leg?

What artery does this eventually become and when?

A

External iliac

Femoral artery after it bypasses under the inguinal ligament

38
Q

What is the largest branch of the femoral artery?

A

Profunda femoris

39
Q

What is another name for the common fibular nerve?

A

Common peroneal

40
Q

Which thigh compartments does the profunda femoris supply?

A

Medial and posterior thigh

41
Q

What are the boarders of the femoral triangle?

A

Superior boarder = inguinal ligament

Lateral boarder = medial part of sartorius muscle

Medial boarder = adductor longus

Floor = adductor longus

42
Q

When does the femoral artery become the popliteal artery?

A

Once it penetrates Adductor Magnus through the adductor hiatus

43
Q

Where does the gluteal region blood supply arise from?

A

Branches of the INTERNAL iliac arteries

44
Q

Where dels the hip joint get its arterial supply from?

A

Branches of the profunda femoris

45
Q

Which artery supplies the anterior thigh compartment?

A

Femoral

46
Q

Explain the route the femoral artery takes to become the popliteal artery.

A

Travels in anterior compartment, anterior to posterior of femur bone, pierces adductor hiatus in the adductor Magnus muscle (found in the medial compartment)

47
Q

What does the popliteal artery branch into?

A

1) anterior tibial artery

2) posterior tibial artery

48
Q

Explain the course of he anterior tibial artery.

A

Popliteal artery is posterior to knee

Branches to form anterior tibial

Anterior tibial travels posterior to anterior BETWEEN fibula and tibia

Eventfully forms dorsalis pedis artery (pulse point)

49
Q

What does the posterior tibial artery further divide into?

A

1) peroneal artery

2) plantar arteries

50
Q

Name 4 pulse points of the lower limbs.

A

1) femoral
2) popliteal
3) posterior tibial
4) dorsalis pedis

51
Q

What is the vein supply mirroring in the lower limb?

A

The arterial supply

52
Q

Where are the only lymphatic nodes in the lower limb?

A

Deep nodes in the popliteal fascia

53
Q

Which nodes in the thigh region does the whole lower limb drain to?

What else drains here?

A

Superficial inguinal nodes

Anterior abdomen
Genitals
Lower back
Gluteal region

54
Q

What are the 2 types of lymphatic drainage vessels?

What structures does each follow?

A

1) deep lymphatic drainage (follows arteries)

2) superficial lymphatic drainage (follows great saphenous vein)

55
Q

How common are anterior and posterior hip dislocations?

A

Posterior = 9/10

Anterior = 1/10

56
Q

What position would the lower limb be in for each type of hip dislocation?

A

Posterior dislocation
= hip flexion
= adduction
= internal rotation

Anterior dislocation
= mild hip flexion
= abduction
= external rotation

57
Q

What is a normal hip join flexion range?

What limits this?

A

Unlimited, limited only but soft tissues

58
Q

What is a normal hip join extension range?

What limits this?

A

20 degrees limited by ligaments

59
Q

What is a normal hip joint abduction range?

A

60 degrees

60
Q

What is a normal hip joint adduction range?

A

30 degrees

61
Q

What is the main arterial supply to the inside of the capsule of the hip joint?

What may damage to this this cause? (And therefore require thinking about during hip fractures)

A

Medial femoral circumflex artery (a profunda femoris branch)

Avascular necrosis of the femoral head/neck

62
Q

What are the trochanters of the femur used for?

A

Muscle attachment

63
Q

Which muscle inserts to the lesser trochanter?

A

Iliopsoas

64
Q

Which muscle inserts to the quadratic tubercle?

A

Quadratus femoris

65
Q

What is the normal angle of the axis of the femur between the neck and shaft?

What is this angle called?

A

125 degrees

Angle of inclination

66
Q

What is an abnormally low angle of inclination called?

Who may you see this in?

A

Coxa vara

Elderly

67
Q

What is an abnormally high angle of inclination called?

Who may you see this in?

A

Coxa vaga

Children

68
Q

What is the angle of anteversion/declination/torsion?

What is a normal angle?

A

The angle the neck is at compared to the centre of the femur

It is usually 15 degrees forwards

69
Q

What is the femoral shaft angle/an atomic axis of the femur?

Why is this needed?

A

The angle between the distal and proximal ends of the femur caused by the neck pushing the femur away from the hip, usually about 6 degrees, to keep the weight of the body held by the distal femur

70
Q

Which ligament fills the gap of the inferior part of the acetabulum?

A

Transverse acetabular ligament

71
Q

Which ligament attaches the acetabulum to the femoral head?

What is the name of the notch in the femoral head to which this ligament attaches?

Which artery travels with this and what is it a branch of?

A

Ligament of the head of the femur

Fovea

The acetabular branch of the obturator artery (with the obturator being a branch of the internal iliac artery)

72
Q

What 3 ligaments strengthen the hip joint capsule?

Which is the strongest?

A

1) pubofemoral
2) iliofemoral (strongest = biggest bone) - Y shape
3) ishiofemoral

73
Q

Which line can you look at on an X-ray to see if a dislocation or displaces fracture may be present?

A

Shenton’s line

74
Q

Where is worst for femoral fractures for poor salvageability of the head of the femur?

A

In the capsule = vessels will not survive = avascular necrosis

75
Q

Which gluteal muscles air above the hip joint and can therefor abduct the hip?

A

Minimus and medius

76
Q

What are the 3 main foramen in the pelvic region?

A

Greater sciatic foramen

Lesser sciatic foramen

Obturator foramen

77
Q

What separated greater from lesser sciatic foramen?

Why is it called this?

A

Sacrospinous ligament

It attaches to sacrum and ischial spine