Lower Limb 3: Anterior and Medial Compartments of the Thigh Flashcards
What does avulsed mean?
the action of pulling or tearing away
what 3 articulations make up the knee joint?
medial femerotibial
lateral femerotibial
femeropatellar
the fibula is not involved
What are the menisci?
2 c-shaped wedges of fibrocartilage
1 medial and 1 lateral
improve the congruency between tibial plateau and femoral condyles
how are the menisci associated with the knee joint?
medial: attached to joint capsule + tibial collateral ligament
Lateral: unattached to joint, connected to popliteus muscle
Describe the cruciate ligaments
anterior + posterior in the intercondylar region of knee and interconnect femur and tibia
criss-cross obliquely
describe the anterior cruciate ligament
extends from anterior intercondylar region of tibia and ascends supero-posteriorly to lateral condyle of femur
prevents anterior displacement of tibia and hyperextension
weaker
describe the posterior cruciate ligament
extends from posterior intercondylar region of tibia and ascends supero-anteriorly to medial condyle of femur
prevents posterior dislocation and hyperflexion
stronger
main stabiliser of the flexed knee when weight bearing (i.e. going down hill)
Why are the medial collateral ligament and the medial menisci often injured simultaneously?
they are attached to one another
what range of movements are possible at the knee joint?
Extension
Flexion
Medial rotation
Lateral rotation
through what does the long (great) saphenous vein pass
Saphenous hiatus/opening in the deep fascia
What are the borders of the femoral triangle?
Superiorly: Inguinal ligament Lateral: medial border of Sartorius Medial: medial border of adductor longus Roof: fascia lata Floor: Pectineus, iliopsoas and adductor longus
What are the contents of the femoral triangle?
From lateral to medial N-A-V-E-L Nerve(femoral) femoral artery femoral vein empty space to cope with fluctuating flow lymphatics
what does the femoral nerve innvervate?
anterior compartment of the thigh - pectineus, iliacus, Sartorius
+ knee extensors - quadriceps femoris muscles
provides sensory branches for the leg and foot
describe the arterial supply of the lower limb
3 arteries enter the thigh: femoral, obturator, inferior gluteal
anastamose around the hip
describe the course of the femoral artery
external iliac becomes femoral as it passes beneath inguinal ligament
passes down vertically through femoral triangle in adductor canal
leaves canal at adductor hiatus in adductor magnus muscle and becomes popliteal artery behind the knee
what is/the course of the largest branch of the femoral artery?
Profunda femoris artery
orginates from lateral side in femoral triangle
connects with popliteal at the knee
gives off the lateral and medial circumflex arteries, and 3 perforating branches
What are the boundaries of the adductor canal?
Anteriorly (roof): Sartorius
Posteromedially: adductor longus + adductor magnus
Laterally: Vastus medialis
What is the origin and insertion of Sartorius?
Origin: ASIS
Insertion: medial tibial shaft, near tibial tuberosity
What is the innervation and function of Sartorius?
Innervation: femoral nerve, L2, L3, L4
Function: flex thigh at hip and flex leg at knee. laterally rotate hip
How many muscles are there in the anterior compartment of the thigh?
8 Psoas major Iliacus Pectineus Sartorius the Quadriceps muscles: - rectus femoris - vastus lateralis - vastus medialis - vastus intermedialis
Which nerve innervates the muscles of the anterior compartment of the thigh?
Femoral nerve (L2, L3, L4)
What is the origin of rectus femoris?
Anterior Inferior Iliac Spine (AIIS)
What is the origin of vastus medialis?
Medial intertrochanteric line
What is the origin of vastus lateralis?
Lateral intertrochanteric line
What is the origin of vastus intermedialis?
Upper 2/3 of anterolateral femur
What is the common insertion of the quadriceps muscles?
Quadriceps femoris tendon (QFT)
+ medial and lateral border of patella for vastus’
What is the common function of the quadriceps muscles?
Extend leg at knee
+ rectus femoris flex thigh at hip
What are the muscles of the medial compartment of the leg?
Adductor Longus Adductor Brevis Adductor Magnus Gracilis Obturator externus
What is the principal function of the medial compartment of the thigh?
Adduct thigh at hip
What is the blood supply to the medial compartment?
Obturator artery
What is the common nerve supply of the medial compartment?
Obturator nerve
What is the origin and insertion of adductor longus?
Origin: body of pubis, lateral to pubic symphysis
Insertion: middle 1/3 linea aspera
What is the origin and insertion of adductor brevis?
Origin: body of pubis, inferior pubic ramus
Insertion: posterior pectineal line and upper 1/3 linea aspera
What is the origin and insertion of adductor magnus?
Adductor part:
Origin: ischiopubic ramus
Insertion: posterior medial lip of linea aspera
Hamstring part:
Origin: ischial tuberosity
Insertion: medial femoral condyle
What is the origin and insertion of gracilis?
Origin: inferior ischio-pubic ramus and pubic symphysis
Insertion: superior medial tibial shaft
What is the origin and insetion of obturator externus?
Origin: external obturator membrane and bone
Insertion: postero-medial trochanteric fossa
Where is the adductor hiatus located?
opening in distal tendon of adductor magnus
femoral artery and vein pass through this to enter popliteal fossa
Where is the femoral ring?
it is the entrance to the femoral triangle
How is the femoral ring associated with hernias?
some of the intestine can sometimes pass into the femoral canal, causing a femoral hernia
What are the borders of the femoral ring?
Anteriorly: inguinal ligament
Posteriorly: pectineal ligament
Medially: lacunar ligament
Laterally: femoral vein
