Lower Limb Flashcards
Ilioinguinal Nerve supply
Root of penis
Anterior 1/3rd of scrotum
Small area of thigh below medial end of inguinal lig
Ilioiguinal origin and course
L1, lies in NV plane b/w Int oblique + Transversus Abdominis m
Piereces IO and supplies lower fibres
Emerges on front of cord through superficial inguinal ring
Pierces external spermatic fascia
Femoral branch of genitofemoral nerve Origin & supply
L1 of L1,2
Supplies skin over femoral triangle
Medial femoral cutaneous nerve supply and origin
Off femoral N, supplies medial side of thigh to knee
Intermediate femoral cutaneous nerve origin and supply
Branch of femoral
Supplies front of thigh to knee
Lateral femoral cutaneous nerve origin and supply
Branch of lumbar plexus
Supplies anteriolateral surface of thigh
4 cutaneous branches of femoral artery (below inguinal lig)
Superficial circumflex
Superficial epigastric
Superficial external pudendal
Deep external pudendal
Great saphenous vein course
Continuation of medial marginal vein of foot
Passes in front of medial malleolus
Crosses medial surface of tibia
Lies hands breath behind medial border of patella
Spiral forward around thigh to pass through cribiform fascia covering sapheous opening
Superficial inguinal LN = lateral group receives
Lymph from buttock, flank and back below waist
Superficial inguinal LN = medial group receives
Lymph from umbilicus, anterior abdo wall, ext genitalia, lower anal canal, perineum, uterus around round lig
superficial inguinal LN = Distal group receives
Drainage from lower limb
TFL nerve supply
Superior gluteal nerve (L4,5,S1)
Action of TFL
Assist ITB, stabilise pelvis
Femoral triangle borders
Lateral - medial border of sartorius
Medial - medial border of add. Longus
Superior - inguinal lig
Roof - skin, fascia
Floor - iliacus, psoas, pectineus, adductor longus
Contents of femoral triangle
Lateral cutaneous nerve of the thigh
Femoral N and branches
Femoral sheath & contents
Femoral A and branches
Femoral Vein
Great saphenous V + tributaries
Sartorius origin and insertion
ASIS to medial part of tibia with gracilis & semitendinosus
Sartorius nerve supply
Ant div of femoral N L2-4
Iliacus origin and insert
Iliac fossa = lesser trochanter
Iliacus nerve supply
Femoral N L2,3
Psoas major origin & insertion
Lumbar spinal transverse processes => lesser trochanter
Psoas major nerve supply
First 3 lumbar nerves (mainly L2)
Pectineus origin and insertion
pectineal lines of pubis to vertical line below trochanter
Nerve supply of pectineus
Ant div of femoral N (L2,3)
Occasional twig from obturator N
Anterior relations to pectineus
Femoral V and canal
Posterior relations of pectineus
Add brevis
Anterior div of obturator N
Femoral sheath components
Femoral A, vein & canal
Fascia that make femoral sheath
Transversalis & iliopsoas fascia
Boundaries of femoral ring
Ant = inguinal lig
Posterior = pectineal lig
Medial = lacunar lig
Lateral = femoral V
Profunda femoris origin
Off femoral A as it emerges from femoral sheath
Branches of profunda femoris
4 perforating arteries
Lateral circumflex femoral A
MEdial circumflex femoral A
Perforating femoral A origin & what do they supply
Originate from profunda femoris
Supply adductor & hamstrings
Lateral circumflex A supply
Ascending, transverse, descending branch to vastas lateralis, intermedius, and anastomose with cruciates
Medial circumflex femoral A supply
Ascending branch - to trochanteric anastomosis
Horizontal branch - to cruciate anastomosis
Femoral V tributaries
Profunda femoris correspondence
Great saphenous V
Femoral N origin
Post div of anterior rami of L2-4
Femoral N supply
Supplies extensor compartment of thigh
iliacus
Pectineus
Sartorius
Rectus femoris
N to vastus medialis, lateralis
Saphenous nerve
Quadriceps femoris components & nerve
Rectus femoris
Vastus lateralis
Vastus intermedius
Vastus medialis
Femoral N
Rectus femoris origin
2 heads from ilium
- reflected head, groove above acetabulum
- straight head from AIIS
Insertion of quadriceps femoris
All form quad tendon => patella => patella tendon => tibial tuberosity
Origin vastus lateralis
Upper intertrochanteric line
GT
Lateral lip of linea aspera
Origin vastus intermedius
Anterior & lateral surfaces of upper 2/3rds of femoral shaft
Origin vastus medialis
Intertrochanteric line & medial lip of linea aspera
Adductor canal contents
Femoral A, V
Saphenous N
Nerve to vastus medialis
Adductor canal boundaries
Gutter shaped groove b/w vastus medialis & adductor muscles
Roof - sartorius
Floor - adductor longus & magnus
Where does the femoral A lie in the adductor canal
B/w femoral N and saphenous N
Muscles of medial compartment of thigh
Gracilis
Add. Brevis, longus, magnus
Obturator externus
Nerve of medial compartment of thigh
Obturator
Artery of medial compartment of thigh
Profunda femoris & obturator A
Gracilis origin & insertion
Inferior ramus of pubis
Medial surface of tibia behind sartorius
Gracilis nerve supply
Ant div of obturator
Adductor longus origin & insertion
Body of pubis -> middle 1/3rd of linea aspera
Nerve supply add. Longus
Ant div of obturator
Adductor brevis origin & insertion
Body and inf ramus of pubic bone (deep to pectineus & longus) ->
Upper part of linea aspera
Nerve of adductor brevis
Ant div of obturator N
Adductor magnus origin & insertion
Hamstring part - ischial tuberosity => adductor tubercle of femur
Adductor part - ischiopubic ramus => medial supracondylar line, linea aspera, gluteal tuberosity
Nerve supply to add magnus
Post div of obturator N
tibial part of sciatic N
Nerve supply obt. Externus
Post div of obturator N
Obturator externus origin & insert
Obturator membrane & anterior bony margin of obturator foramen => trochanteric fossa
Action of obturator externus
Stabilise hip, lower limb & lateral rotation of femur
Anterior div of obturator nerve supplies
Hip joint
Add longus, brevis
Gracilis
Subsartorial plexus
Posterior div of obturator externus
Supplies obturator externus
Add magnus
Gluteal muscles
Glut max, med, min
Piriformis
Sup + inf gemellus
Obturator internus
Quadratus femoris
What forms the greater sciatic foramen
Greater sciatic notch, sacrotuberous & sacrospinous lig
Gluteus maximus origin & insert
Gluteal surface of ilium, behind post gluteal line, lumbar fascia, lateral mass of sacrum & sacrotuberous lig
=> gluteal tuberosity & ITB
Nerve supply of glut max
Inferior gluteal nerve (ONLY muscle supplied by this nerve) L5,S1,S2
Function of glut max
Lateral rotator, hip extensor
Gluteus medius origin & insert
Arise from gluteal surface of ilium b/w mid & post gluteal lines
Insert into lateral surface of GT
Glut medius nerve supply
Sup gluteal N L4,5,S1
Function of gluteal medius
Abduct hip joint, anterior fibres medially rotate
Gluteus minimus origin and insert
Gluteal surface of ilium, b/w middle & inferior gluteal lines
Insert edge to edge with glut medius on lateral surface of GT