Lower limb 3 - anterior and medial compartments of the thigh

Question 1

What 3 articulations does the knee joint consist of between the distal end of the femur, tibia and patella?

Answer 1

1. medial femerotibial
2. lateral femerotibial
3. femeropatellar

Question 2

What bone does not take part in the knee joint?

Answer 2

fibula

Question 3

What is the patella?

Answer 3

• a triangular sesamoid bone that develops the tendon of the quadriceps muscle.

Question 4

What are the regions of the patella?

Answer 4

• base
• apex
• 2 surfaces - articular and anterior
• 2 facets

Question 5

How does the vastus medialis prevent the patella being pulled too laterally?

Answer 5

It pulls at a more oblique angle than the other 3 quadriceps

Question 6

What is the other mechanism that prevents the patella from being pulled too far laterally?

Answer 6

lateral femoral condyle - bony ridge

Question 7

What happens if the lateral femoral condyle is underdeveloped?

Answer 7

recurrent dislocations of the patella

Question 8

What happens to the patella if there is a direct blow to it and why is it not avulsed?

Answer 8

the patella may split or shatter

not avulsed - as quadricep expansion remains in tact

Question 9

What is avulsion?

Answer 9

full detachment

Question 10

Why is the knee joint dependent on the strength of surrounding muscles, ligaments and menisci for stability?

Answer 10

as the knee joint is incongruent

Question 11

What opening does the long (great) saphenous vein pass through the deep fascia?

Answer 11

saphenous hiatus or saphenous opening

Question 12

What superficial veins do you need to know?

Answer 12

1. femoral vein
2. saphenous ring
3. great saphenous vein
4. lateral side
5. dorsal venous arch
6. small saphenous vein
7. popliteal vein

Question 13

What provides a transient route through the thigh for the major vessels passing to and from the leg? (3)

Answer 13

1. femoral triangle
2. adductor canal
3. popliteal fossa

Question 14

Why is the anatomy of the femoral triangle important clinically? (4)

Answer 14

1. vascular access
2. femoral hernia
3. vascualr surgery
4. lymphatic spread of disease

Question 15

What are the borders of the femoral triangle?

Answer 15

Base - inguinal ligament

medial border - adductor longus

lateral border - sartonius muscle

floor - pectinous, adductor longs and iliopsoas

apex - fascia canal/ adductor canal

Question 16

What are the contents of the femoral triangle?

Answer 16

femoral nerve, vein and artery and lymphatics

NAVEL - order seen

Question 17

What muscles are supplied by the femoral nerve?

Answer 17

mainly anterior compartment of the thigh muscles

1. sartorius
2. pectineus
3. rectus femoris
4. vastus medialis
5. vastus lateralis
6. vastus intermedius

Question 18

What is the adductor canal?

Answer 18

carries femoral vessels

carries saphenous nerve

between femoral triangle and popliteal fossa

Question 19

What are the boundaries of the adductor canal?

Answer 19

anterior - sartorius

posteromedially - adductor longs and magnus

laterally - vastus medialis

Question 20

In which compartment are the quadricep muscles in?

Answer 20

anterior

Question 21

In which compartment are the pectinous and iliopsoas muscles?

Answer 21

anterior

Question 22

What muscles are involved in the medial compartment of the thigh and where do they all arise from?

Answer 22

arise - external surface of pubis and ischiopubic rams

1. adductor longus
2. adductor brevis
3. adductor magnus
4. gracilis
5. obturator externus

Question 23

Where is the adductor hiatus located?

Answer 23

between hamstring and adductor parts of adductor magnus