Lecture 4: Anterior And Medial Thigh + Femoral Triangle Flashcards by Sarah Gillen

Where does the great saphenous vein begin, travel, and end?

Begins at medial side of dorsal venous arches of the foot

Ascends medially and passes through saphenous opening in deep fascia

Terminates in femoral vein on anterior thigh

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The great saphenous vein corresponds to what 3 branches of femoral vein?

External pudendal v.

Superficial circumflex iliac v.

Superficial epigastric v.

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What branch of the femoral vein drains the penis and scrotum in males, the vulva and lower vagina in females, and the anal canal?

External pudendal v.

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What branch of the femoral vein drains the lateral thigh?

Superficial circumflex iliac v.

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What branch of the femoral vein drains the anterior abdominal wall?

Superficial epigastric v.

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The superficial inguinal lymph nodes are divided into what 2 groups?

Superior horizontal group

Inferior vertical group

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What division of superficial inguinal lymph nodes drains the external pudendal v., superficial circumflex iliac v., and superficial epigastric v.?

Superior horizontal group

[the inferior vertical group drains the remaining superficial tissues of the lower extremity]

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What are the 4 cutaneous nerves of the anterior and medial thigh?

Femoral cutaneous nerves (lateral, intermediate, medial)

Ilioinguinal n.

Genitofemoral n. (femoral branch)

Obturator n. (femoral branch)

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What stucture is responsible for dividing the thigh into compartments?

Fascia lata (thin, dense CT that also surrounds the thighs)

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What 2 muscles make up the anterior compartment of the thigh?

Quadriceps femoris m.

Sartorius m.

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What are the 4 muscles that make up the quadriceps femoris m.?

Rectus femoris
Vastus lateralis
Vastus intermedius
Vastus medialis

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3 out of the 4 muscles that make up the quadriceps femoris m. originate on the shaft of the femur, but which one originates on the anterior inferior iliac spine?

What is the significance of this?

Rectus femoris

Since it crosses both hip and knee joints, can perform leg extension AND thigh flexion

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What is the insertion for all 4 muscles that make up the quadriceps femoris m.?

Patella

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What is the innervation supplying all 4 muscles that make up the quadriceps femoris m.?

Femoral n.

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What is the general action of the quadriceps femoris m.?

Leg extension

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The quadriceps femoris m. extends the leg via the _________ tendon which inserts on the _______ ________

Patellar; tibial tuberosity

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Muscle origin, insertion, innervation, action:

Rectus femoris

Origin: anterior inferior iliac spine

Insertion: patella

Innervation: femoral n.

Action: leg extension and thigh flexion

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Muscle origin, insertion, innervation, action:

Vastus lateralis

Origin: shaft of femur

Insertion: patella

Innervation: femoral n.

Function: leg extension

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Muscle origin, insertion, innervation, action:

Vastus intermedius

Origin: shaft of femur

Insertion: patella

Innervation: femoral n.

Action: leg extension

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Muscle origin, insertion, innervation, action:

Vastus medialis

Origin: shaft of femur

Insertion: patella

Innervation: femoral n.

Action: leg extension

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Muscle origin, insertion, innervation, action:

Sartorius

Origin: anterior superior iliac spine

Insertion: medial surface of tibia inferior to tibial tuberosity

Innervation: femoral n.

Action: thigh and leg flexion (crosses hip and knee joints)

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How many muscles are in the medial compartment of the thigh?

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What are the 6 muscles in the medial compartment of the thigh?

Gracilis
Pectineus
Adductor longus
Adductor brevis
Adductor magnus
Obturator externus

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All 6 muscles of the medial compartment of the thigh originate from the ________ aspect of the ox coxae and ________ membrane

Anterior; obturator

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All 6 muscles of the medial compartment of the thigh insert on the ____ and _____

Femur; tibia

All 6 muscles of the medial compartment of the thigh are innervated by the obturator nerve except which one?

Pectineus m. (innervated by femoral n.) [also note that part of the adductor magnus is innervated by tibial n.]

Vascular supply to the 6 muscles of the medial compartment of the thigh come from what 2 arteries?

Obturator a. | Profunda femoris a.

Origin of gracilis

Body and inferior ramus of pubis

Insertion of gracilis

Medial surface of tibia inferior to tibial tuberosity (between insertions of sartorius and semitendinosus)

Only 1/6 muscles in the medial compartment of the thigh crosses two joints, meaning it is able to both ADDUCT the thigh and FLEX the leg. Which muscle does this?

Gracilis

Origin of pectineus

Pecten pubis and superior ramus of pubis

Insertion of pectineus

Pectineal line running from the lesser trochanter toward the linea aspera

Innervation of pectineus

Femoral n.

Innervation of gracilis

Obturator n.

Action of gracilis

Leg flexion | Thigh adduction

Action of pectineus

Medial rotation of hip

Origin of adductor longus

Body and inferior ramus of pubis (same as gracilis)

Insertion of adductor longus

Almost whole length of linea aspera (in line with pectineus)

Innervation of adductor longus

Obturator n.

Origin of adductor brevis

Body and inferior ramus of pubis (same as adductor longus and gracilis)

Insertion of adductor brevis

Inferior part of pectineal line and superior part of linea aspera

Origin of adductor magnus

Ischiopubic ramus and ischial tuberosity

Insertion of adductor magnus

Linea aspera and adductor tubercle

Innervation of adductor magnus

Obturator n. Tibial n. [since portion originating from ischial tuberosity has same embryonic tissue as hamstring muscle and this is also innervated by tibial n.]

Origin of obturator externus

External surface of obturator membrane and surrounding margins of pubis and ischium

Insertion of obturator externus

Trochanteric fossa (passes posterior to neck of femur)

Action of obturator externus

Lateral rotation of the thigh Holds head of femur in acetabulum

Muscle origin, insertion, action, and innervation: Gracilis

Origin: body and inferior ramus of pubis Insertion: medial surface of tibia inferior to tibial tuberosity (between insertions of sartorius and semitendinosus) Action: flexion of leg and adduction of thigh Innervation: obturator n.

Muscle origin, insertion, and innervation: Pectineus

Origin: pecten pubis and superior ramus of pubis Insertion: pectineal line running from the lesser trochanter toward the linea aspera Innervation: femoral n.

Muscle origin, insertion, and innervation: Adductor longus

Origin: body and inferior ramus of pubis Insertion: almost whole length of linea aspera (in line with pectineus) Innervation: obturator n.

Muscle origin, insertion, and innervation: Adductor brevis

Origin: body and inferior ramus of pubis Insertion: inferior part of pectineal line and superior part of linea aspera Innervation: obturator n.

Muscle origin, insertion, and innervation: Adductor magnus

Origin: ischiopubic ramus and ischial tuberosity Insertion: linea aspera and adductor tubercle Innervation: obturator n. and tibial n.

Muscle origin, insertion, and innervation: Obturator externus

Origin: external surface of obturator membrane and surrounding margins of pubis and ischium Insertion: trochanteric fossa (passes posterior to neck of femur) Actions: lateral rotation of thigh, holds head of femur in acetabulum

Most fibers of the fascia lata are oriented horizontally, but which part has vertically oriented fibers?

Iliotibial tract (IT band)

The IT tract/band begins as an _________ of gluteus maximus and tensor fascia lata

Aponeurosis

There are 1-3 lymph nodes located medial to the femoral vein (either within the femoral canal or just inferior to it); what do these drain?

Drain lymph FROM deep structures of lower extremities, penile urethra, glans penis, and glans clitoris INTO external iliac nodes (adjacent to external iliac artery)

What makes up the boundaries of the femoral triangle?

Inguinal ligament Medial border of sartorius Lateral border of adductor longus

What 2 muscles make up the "floor" of the femoral triangle?

Pectineus m. | Iliopsoas m.

What two muscles come together to form the iliopsoas m.?

Iliacus | Psoas major

Other than the structures that make up the boundaries of the femoral triangle, what are its contents?

``` Femoral a. and all of its branches Femoral v. and all of its tributaries Femoral n. Lymphatics Femoral sheath ```

What is the femoral sheath?

Extraperitoneal areolar tissue that surrounds external iliac vessels in abdomen and extends into the anterior thigh, where it surrounds femoral vessels and some lymphatic vessels deep to the fascia lata

What are the 3 compartments of the femoral sheath and what do they contain?

Lateral - contains femoral a. Middle - contains femoral v. Medial (aka femoral canal) - contains some LNs and lymph vessels

Which compartment of the femoral sheath is continuous with the abdominal cavity via the femoral ring?

Medial compartment aka femoral canal

What is a potential pathology associated with the femoral canal?

Femoral hernia = abdominal viscera like small intestine protrudes through the femoral ring (superior opening of femoral canal) 3x more common in females due to differences in osteology of os coxae

The apex of the femoral triangle leads to a narrow, triangular-shaped intermuscular tunnel roughly 6 inches long. What are the 4 muscles that make up the 3 "walls" of this tunnel?

``` Vastus medialis (lateral wall) Adductor longus and adductor magnus (medial wall) Sartorius (roof) ```

Other than the walls that make up the apex of the femoral triangle, what are the contents of the intermuscular tunnel?

Femoral a. and veins Saphenous a. Saphenous n. Nerve to vastus medialis

The femoral artery is continuous with what other artery after passing through the adductor hiatus at the inferior limit of the adductor canal?

Popliteal artery

The saphenous artery and nerve become cutaneous as they pass between which 2 muscles to the medial side of the knee?

Gracilis | Sartorius

The femoral a. is a continuation of what artery?

External iliac a.

The femoral artery enters the thigh beneath the ________ ligament, midway between the _______ ______ _____ and ______ _____

Inguinal Anterior superior iliac spine Pubic tubercle

What are the 4 named branches of the femoral artery?

External pudendal a. Superficial circumflex iliac a. Superficial epigastric a. Profunda femoris a.

Which branch of the femoral artery supplies the lateral thigh?

Superior circumflex iliac a.

Which branch of the femoral a. supplies the anterior abdominal wall inferior to the umbilicus?

Superficial epigastric a.

Which branch of the femoral a. supplies the penis and scrotum in males, the vulva and lower vagina in females, and the lower half of the anal canal?

External pudendal a.

What are the branches of the profunda femoris (which is itself a branch of the femoral a.)?

2 circumflex branches (lateral and medial) 4 perforating arteries

The profunda femoris a., a branch of the femoral a., has 2 circumflex branches (lateral and medial), and 4 perforating arteries. What do the 2 circumflex branches supply?

Hip joint and gluteal region

The profunda femoris a., a branch of the femoral a., has 2 circumflex branches (lateral and medial), and 4 perforating arteries. What do the 4 perforating arteries supply?

Posterior and medial compartments of the thigh