L17_The Anterior & Medial Thigh

Question 1

Tell me the names of the structures indicated by the numbers

Answer 1

1. head of the femur
2. Neck of the femur
3. lesser trochanter
4. greater trochanter
5. Linea aspera
6. Shaft
7. Supracondylar Ridge
8. Lateral epicondyle
9. Medial epicondyle
10. Lateral condyle
11. Medial condyle
12. Patellar surface

Question 2

Identify the structures indicated by the numbers

Answer 2

1. Medial tibial condyle
2. Lateral tibial condyle
3. Tibial tuberosity
4. Tibia
5. Fibula
6. Neck of the fibula
7. Head of the fibula
8. Intercondylar eminence

Question 3

Identify the structure indicated by the number

Answer 3

1. Tibial plateaus (lateral and medial)

Question 4

Identify the structures indicated by the numbers

Answer 4

1. Soleal line
2. Tibia
3. Fibula
4. Medial malleolus
5. Lateral malleolus

Question 5

The knee joint (classification, movements)

Answer 5

Classification: modified synovial hinge joint (modified because slightly more movement than just the typical flexion/extension)

Movements: Flexion/extension, slight medial and lateral rotation

Question 6

Anterior compartment of the thigh

Describe Iliopsoas muscle (origin, insertion, function, innervation)

Answer 6

Origin:

Iliacus-> iliac fossa

Psoas Major-> T12-L5 vertebrae

Insertion: Lesser trochanter of the femur

Function: Hip flexion and lateral rotation

Innervation: Branches from L2-L4

Iliacus and psoas major join together to insert onto lesser trochanter

Question 7

Anterior compartment of the thigh

Describe Sartorius muscle (origin, insertion, function, innervation)

Answer 7

Origin: ASIS

Insertion: Proximal anteromedial tibia via pes anserinus

Function: Hip flexion, abduction and lateral rotation Knee flexion

Innervation: Femoral Nerve (L2-L4)

One of the longest muscles of the body, because it travels obliquely all the way across the thigh from lateral to medial

Question 8

Anterior compartment of the thigh

Describe Quadriceps Femoris (RECTUS FEMORIS) muscle (origin, insertion, function, innervation)

Answer 8

Origin: AIIS

Insertion: Tibial tuberosity via quadriceps tendon and patellar ligament

Function: Hip flexion, Knee extension

Innervation: Femoral nerve (L2-L4)

Question 9

Anterior compartment of the thigh

Describe Quadriceps Femoris (VASTUS LATERALIS) muscle (origin, insertion, function, innervation)

Answer 9

Origin: Greater trochanter, intertrochanteric line, lateral linea aspera

Insertion: Tibial tuberosity via quadriceps tendon and patellar ligament

Function: Knee extension

Innervation: Femoral nerve (L2-L4)

Question 10

Anterior compartment of the thigh

Describe Quadriceps Femoris (VASTUS MEDIALIS) muscle (origin, insertion, function, innervation)

Answer 10

Origin: Intertrochanteric line and medial linea aspera

Insertion: Tibial tuberosity via quadriceps tendon and patellar ligament

Function: Knee extension

Innervation: Femoral nerve (L2-L4)

Question 11

Anterior compartment of the thigh

Describe Quadriceps Femoris (VASTUS INTERMEDIUS) muscle (origin, insertion, function, innervation)

Answer 11

Origin: Anterior and lateral shaft of femur

Insertion: Tibial tuberosity via quadriceps tendon and patellar ligament

Function: Knee extension

Innervation: Femoral nerve (L2-L4)

Question 12

Medial compartment of the thigh

Describe Pectineus muscle (origin, insertion, function, innervation)

Answer 12

Origin: Superior ramus of pubis

Insertion: Pectineal line of femur

Function: Hip flexion, adduction of the hip

Innervation: 80% of femoral nerve (L2-L4), 20% of Obturator nerve (L2-L4)

Question 13

Medial compartment of the thigh

Describe Adductor Longus muscle (origin, insertion, function, innervation)

Answer 13

Origin: Body of the pubis

Insertion: Linea aspera

Function: Hip adduction, flexion and medial rotation

Innervation: Obturator nerve (L2-L4)

Question 14

Medial compartment of the thigh

Describe Adductor brevis muscle (origin, insertion, function, innervation)

Answer 14

Origin: Body of the pubis and inferior pubic ramus

Insertion: Proximal linea aspera

Function: Hip adduction, flexion and medial rotation

Innervation: Obturator nerve (L2-L4)

Question 15

Medial compartment of the thigh

Describe Gracilis muscle (origin, insertion, function, innervation)

Answer 15

Origin: Body and inferior pubic ramus

Insertion: Proximal anteromedial tibia via pes anserinus

Function: hip adduction, knee flexion, medial rotation of the leg when sitting

Innervation: Obturator nerve (L2-L4)

Question 16

Medial compartment of the thigh

Describe Adductor magnus (ADDUCTOR PART) muscle (origin, insertion, function, innervation)

Answer 16

Origin: Inferior pubic ramus, ischial ramus

Insertion: Medial lip of linea aspera

Function: Hip adduction, flexion and medial rotation

Innervation: Obturator nerve (L2-L4)

Question 17

Medial compartment of the thigh

Describe Adductor magnus (HAMSTRING PART) muscle (origin, insertion, function, innervation)

Answer 17

Origin: Ischial tuberosity

Insertion: Adductor tubercle of the femur

Function: Extends the thigh

Innervation: Tibial part of sciatic nerve (L4)

Question 18

Describe the pes anserinus insertion

Answer 18

Common insertion located on proximal anteromedial tibia

Say: Sartorius

Grace: Gracilis

before

Tea: SemiTendinosus

Question 19

The obturator nerve (location, motor innervation)

Answer 19

Location: Travels through the false pelvis into the true pelvis and exits through the obturator foramen (Travels through the obturator canal) in the medial compartment of the thigh

L2-L4

Motor innervation to: Obturator externus, Adductor longus + Brevis, Pectineus (20%), Adductor Magnus (adductor part), Gacilis

Question 20

The Femoral nerve (location, motor innervation, sensory innervation)

Answer 20

Location: Travels through the false pelvis underneath the inguinal ligament in the anterior compartment of the thigh

L2-L4

Motor innervation to: Sartorius, Quadriceps Femoris, Pectineus (80%)

Sensory innervation: Terminal branch of the femoral nerve -> saphenous nerve (Cutaneous innervation to medial leg and foot)

-> anterior femoral cutaneous nerve (cutaneous innervation to the anterior thigh)

Question 21

The Saphenous nerve (location, sensory innervation)

Answer 21

splits from the femoral nerve and travels down to the medial side of the leg

Sensory innervation: medial leg + medial foot

Question 22

What are the borders and the contents of the femoral triangle?

Answer 22

Borders:

Lateral - Sartorius (medial border)

Medial - Adductor Longus (lateral border)

Superior - Inguinal Ligament

Floor - Pectineus and Iliopsoas

Contents:

Femoral nerve

Femoral artery and vein

Inguinal lymph

Those structures are in the femoral sheath (funnel-shaped elongation on transversalis fascia from abdomen that’s holding all of the structures together.

The contents are separated in different compartments

• Lateral: femoral artery
• Intermediate: femoral vein
• Medial: inguinal lymph

the femoral nerve is not located in the femoral sheath

N: Femoral nerve

A: Femoral artery

V: Femoral vein

IL: Inguinal Lymph

Question 23

Explain the femoral hernia (How, Location)

Answer 23

How: when the intestine of a patient can try to work their way outside the abdomen and the false pelvis and end up in the anteromedial thigh.

Location: It passes in the femoral canal in the femoral triangle (femoral sheath)

Question 24

Describe the course of the femoral artery and vein as it transitions into the popliteal artery and vein

Answer 24

• > External iliac a.v.
• > Femoral a.v. when it passes the inguinal ligament

Passes through the Adductor Canal -> then through the Adductor Hiatus

-> Popliteal a.v. when it travels behind the knee

The saphenous nerve and the femoral a.v. travel together

The saphenous nerve pierces through the adductor canal and then goes to the skin of the medial thigh