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Anatomy - Lower limb > L15: Musculo-neuro-vascular systems of the anterior and posterior compartments of the thigh > Flashcards

L15: Musculo-neuro-vascular systems of the anterior and posterior compartments of the thigh Flashcards

1
Q

surface anatomy of the Anterior Thigh

A

ASIS: Anterior superior iliac spine
Tensor Fasciae Latae
Sartorius
Vastus Lateralis
Rectus Femoris
Vastus Medialis
Iliotibial Tract
Patella

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2
Q

surface anatomy of Lateral thigh

A

Gluteus maximus and tensor fasciae latae insert into iliotibial tract
At the knee, the iliotibial tract narrows as it approaches its insertion (lateral tibial condyle(Gerdy ’s tubercle) and is quite superficial (9)
Tendon of biceps fermoris is just posterior to this

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3
Q

surface anatomy of Posterior Thigh

A

Gluteal Fold
Iliotibial Tract
Tendons at the Knee:
*Semitendinosus (medially)
*Biceps Femoris Long Head (laterally)

Popliteal Fossa, you can take your pulse from here!

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4
Q

fascia of the thigh

A

*Fascia (connective tissue) divides the lower limb into compartments, just like it did with the upper limb.
*Superficial thigh is covered by fascia lata
*Fascia lata is thickened on the lateral thigh and is called the iliotibial tract or band. Tensor fascia latae is a muscle that tightens this band

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5
Q

Thigh compartments

A

Fascia lata and its septae divide the thigh into three compartments:
*Anterior compartment
*Posterior compartment
*Medial compartment

Each compartment has its own main innervation which supplies most of the muscles of that compartment

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6
Q

Muscles of thigh; Anterior Compartment (8)

A
  • pectineus
  • Iliopsoas
    • psoas major
    • iliacus
  • sartorius
  • quadriceps femoris
    • rectus femoris
    • vastus lateralis
    • vastus medialis
    • vastus intermedius
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7
Q

muscles of the thigh; Posterior compartment (3)

A
  • semitendinosus
  • semimembranosus
  • biceps femoris
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8
Q

pectineus, origin + insertion

A

origin: superior pubis ramus (pectineal line)

insertion: pectineal line of femur, inferior to lesser trochanter

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9
Q

Pectineus, Innervation + action

A

innervation: femoral nerve (L2,L3), sometimes branch from obturator nerve contributes too

actions: adducts hip, flexes hip, externally rotates hip

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10
Q

Iliopsoas, origin + insertion:

A

iliopsoas: Psoas major and iliacus

Origin:
- Psoas major: lateral part of T12-L5 vertebral bodies
- Iliacus: iliac fossa and crest, ala of sacrum, and sacro-iliac ligaments

insertion: Both muscles merge to insert into lesser trochanter of femur

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11
Q

Iliopsoas, innervation + actions

A

innervation:
- psoas major: direct branches from L1-3 anterior rami
- iliacus: femoral nerve (L2,L3)

Actions: flexes thigh at hip. most powerful hip flexor, lateral rotation at hip, stabilisation of leg when standing, maintenance of posture

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12
Q

Sartorius, origin + insertion

A

longest muscle in the body, crosses hip and knee joints

origin: ASIS- Anterior Superior Iliac Spine

Insertion: medial to tibial tuberosity

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13
Q

Sartorius, innervation + actions

A

innervation: femoral nerve

actions: flexes, abducts, externally rotates thigh at hip joint, flexes leg at knee joint

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14
Q

Rectus Femoris, origin + insertion

A

This muscle has 2 heads and sits superficial to vastus intermedius

origin:
- straight head: AIIS
- Reflected head: Ilium, superior to acetabulum

insertion: quadriceps tendon, and hence into tibial tuberosity via patellar ligament

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15
Q

Vastus Lateralis; origin + insertion

A

origin: greater trochanter and lateral lip of linea aspera of femur

insertion: quadriceps tendon, and hence into tibial tuberosity via patellar ligament

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16
Q

Vastus Lateralis; innervation + action

A

innervation: femoral nerve

action: extends leg at knee joint

17
Q

Vastus Medialis; origin + insertion

A

origin:
- intertrochanteric line of femur
- medial lip of linea aspera of femur

Insertion: quadriceps tendon, and hence into tibial tuberosity via patellar ligament

18
Q

Vastus Medialis; innervation + Action

A

innervation: femoral nerve

action: extends leg at knee joint

19
Q

Vastus Intermedius; origin + insertion

A

lies deep to rectus femoris. Only visible if rectus is resected.

origin: anterior and lateral shaft of femur

Insertion: quadriceps tendon, and hence into tibial tuberosity via patellar ligament

20
Q

Vastus Intermedius; innervation + action

A

innervation: femoral nerve

action: extends leg at knee joint

21
Q

Patellar Disclocation

A

caused by a direct blow to patella or sudden twist of leg

patella slips from its normal position in the patellofemoral groove

usually slips laterally

22
Q

Patellar Fracture

A
  • usually caused by trauma directly to anterior knee or sudden contraction of quadriceps
  • if bony fragments become displaces, requires surgery to reapproximate the fragments
  • if bony fragments are nondisplaced, knee immobilised in cast for 6 weeks
23
Q

Semitendinosus; origin + insertion

A

in between semimembranosus and biceps femoris

origin: ischial tuberosity

insertion: medial to tibial tuberosity, part of pes anserinus

24
Q

Semitendinosus; innervation + actions

A

innervation: tibial division of sciatic nerve

actions: extends hip joint, flexes knee joint, medial rotation of leg at knee when knee is flexed, can extend trunk when rising from seated position

25
Q

Semimembranosus; origin + insertion

A

most medial of the three hamstrings

origin: ischial tuberosity

insertion:
-posterior part of medial tibial condyle
-oblique popliteal ligament

26
Q

Semimembranosus; innervation + action

A

innervation: sciatic nerve (tibial division)

actions: extends thigh at hip joint, flexes leg at knee joint, internal rotation of leg at knee when knee is flexed

27
Q

Biceps femoris; origin + insertion

A

most lateral of the 3. this muscle has 2 heads: long and short head

origin:
- long head: ischial tuberosity
- short head: lateral part of linea aspera in middle third of femur, lateral supracondylar line

insertion: lateral part of fibular head

28
Q

Biceps Femoris; innervation + actions

A

innervation:
-long head: sciatic nerve (tibial division)
-short head: sciatic nerve (fibular division)

actions: extends thigh at hip joint, flexes leg at knee joint, external rotation of leg at knee joint when knee is flexed

29
Q

Hamstring in situ
‘‘MTLS’’

A

Medial to lateral
- Membranosus
- Tendinosus
- Long head
- Short head

30
Q

Muscle injury grades: 1-3

A
  1. minor tear or overstretch of muscle fibres. Pain but function intact
  2. Partial tear across muscle. Pain and weakened function
  3. Complete tear across muscle. Pain and complete loss of function
31
Q

Thigh: cutaneous innervation

A

Cutaneous (sensory) innervation of the thigh is provided mostly by cutaneous branches of the femoral nerve
*Anterior and medial surface: anterior and medial cutaneous branches of the femoral nerve
*Posterior surface: posterior femoral cutaneous nerve
*Lateral surface: lateral femoral cutaneous nerve
Other contributions include:
*Genitofemoral nerve
*Cutaneous branch of obturator nerve

32
Q

arterial supply to lower limb

A

heart
|
Descending Aorta
|
Common iliac artery
| |
internal iliac artery external iliac artery
| |
supplies gluteal region goes on to become
& pelvic region femoral artery

33
Q

femoral artery
where does it come from?

A

*Inguinal Ligament is a complex ligament strung between ASIS and the pubic tubercle.
*As external iliac artery passes under the midpoint of inguinal ligament it changes name to femoral artery
*Femoral Artery supplies very little of thigh directly.
*It gives off a deep branch, profunda femoris, which supplies the thigh

34
Q

Profunda Femoris

A

*Arises from postero-lateral part of femoral artery in the femoral triangle (next lecture)
*Medial and lateral circumflex femoral branches supply proximal femur (neck + head)
*It runs deep in the thigh, alongside the femur supplying it and the deep muscles of the thigh
*Perforating branches: These wrap around the femur and supply all 3 thigh compartments. Usually there are 3-4 in total.
*Descending genicular branch: These supply the proximal knee

35
Q

Femoral Artery
where does it go ?

A

*Distally, it passes posterior to femur through a gap in the adductor magnus muscle called the adductor hiatus.
*It continues distally to enter the space at the back of the knee; the popliteal fossa.
*At this point the femoral artery becomes known as the popliteal artery.

36
Q

venous drainage of the lower limb

A

right atrium of heart
^
inferior vena cava
^
common iliac vein
^ ^
internal iliac vein external iliac vein
^ ^
superior and inferior common femoral
gluteal vein vein (main vein of
thigh)

37
Q

Venous drainage of thigh
superficial system

A

Superficial System
*The superficial regions of the thigh are drained by the Great Saphenous Vein
*Subsequently, the Great Saphenous Vein pierces through a gap in the fascia lata and drains directly into the Common Femoral Vei

38
Q

Venous Drainage of Thigh
Deep system

A

Deep System
*The deep regions of the thigh are drained by 3-4 deep perforating veins which subsequently drain into the profunda femoris vein
*The profunda femoris vein subsequently joins with the femoral vein to form the common femoral vein

Anatomy - Lower limb (6 decks)

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