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Lower Extremity Anatomy > Lumbar Plexus and Anterior Thigh Part 1 > Flashcards

Lumbar Plexus and Anterior Thigh Part 1 Flashcards

1
Q

Lumbar plexus

A
  • Ventral rami L1-4

- Ventral and dorsal divisions

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2
Q

Nerves of the lower extremity

A
  • Subcostal
  • Iliohypogastric
  • Ilioinguinal
  • Genitofemoral
  • Lateral femoral cutaneous
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3
Q

Subcostal nerve

A
  • Ventral rami T12

- Cutaneous supply to superior anterolateral thigh

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4
Q

Iliohypogastric nerve

A
  • Ventral division of L1)

- Gives off a cutaneous branch to posterolateral gluteal region

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5
Q

Ilioinguinal nerve

A
  • Ventral division of L1

- Gives off a cutaneous innervation of superomedial thigh

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6
Q

Genitofemoral nerve

A
  • Ventral divisions of L1,2
  • Femoral branch passes deep to inguinal ligament (vascular compartment)
  • Cutaneous supply over femoral triangle
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7
Q

Lateral femoral cutaneous nerve

A
  • Dorsal divisions of L2,3
  • Enters thigh deep to inguinal ligament near ASIS (can pass through it)
  • Cutaneous supply to anterolateral thigh
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8
Q

Nerves to psoas major muscle

A
  • Dorsal divisions of L2-4

- Branch directly off of ventral rami to innervate muscle

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9
Q

Nerve to iliacus muscle

A
  • Branch from femoral nerve
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10
Q

Femoral nerve

A
  • Dorsal divisions of L2-4
  • Travels between psoas major and iliacus muscles
  • Enters thigh deep to inguinal ligament, through muscular lacuna
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11
Q

Femoral nerve supplies branches to

A
  • Anterior thigh muscles (motor)
  • Hip and knee joints (sensory)
  • Cutaneous to anterior and inferomedial thigh and medial leg
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12
Q

Obturator nerve

A
  • Ventral divisions of L2-4

- Passes through lesser pelvis and through obturator canal to enter the thigh

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13
Q

Obturator nerve supplies branches to

A
  • Medial thigh muscles (motor)
  • Hip and knee joints (sensory)
  • Skin medial thigh
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14
Q

Accessory obturator nerve

A
  • Ventral divisions of L3,4
  • Not always present (10-30%)
  • If present passes over superior pubic ramus
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15
Q

Accessory obturator nerve supplies branches to

A
  • Pectineus muscle
  • Hip joint (sensory)
  • Skin of medial thigh
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16
Q

Lumbosacral trunk (L4,5)

A
  • Formed by a portion of L4 and all of L5
  • Passes over pelvic brim, anterior to SI joint
  • Joins sacral plexus
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17
Q

Psoas major origin

A
  • TP of lumbar vertebrae

- Vertebral bodies/discs T12-L5

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18
Q

Psoas major insertion

A
  • Lesser trochanter of femur
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19
Q

Psoas major pathway

A
  • Descends over pelvic brim, beneath inguinal ligament
  • Through muscular lacuna
  • Anterior to hip joint
  • Joins the tendon of iliacus
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20
Q

Psoas major innervation

A
  • Ventral rami L1-4

- Mostly from L2-4

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21
Q

Psoas major blood supply

A
  • Muscular branches of the iliac arteries

- Lumbar arteries

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22
Q

Psoas major function

A
  • Flex thigh
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23
Q

Iliacus origin

A
  • Upper 2/3 iliac fossa
  • Internal lip of iliac crest
  • Ala of sacrum
  • Anterior sacroiliac ligaments
  • Iliolumbar ligament
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24
Q

Iliacus insertion

A
  • Psoas major tendon/lesser trochanter of femur

- Similar path as the psoas major

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25
Q

Iliacus innervation

A
  • Femoral nerve (L2-4)
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26
Q

Iliacus blood supply

A
  • Muscular branches of the iliac arteries
  • Lumbar arteries
  • (same as psoas major)
27
Q

Iliacus function

A
  • Flex thigh

- (same as psoas major)

28
Q

Iliopsoas

A
  • Combination of iliacus and psoas major

- Advances the lower extremity during gait

29
Q

Fascia lata

A
  • Deep fascia of the thigh

- Surrounds thigh muscles

30
Q

Fascia lata attaches to

A
  • Inguinal ligament, pubic tubercle
  • Scarpa fascia
  • Iliac crest
  • Sacrum, coccyx, sacrotuberous ligament, ischial tuberosity
  • Iliotibial tract
31
Q

Fascia lata is continuous with

A
  • Deep fascia of leg

- Attaches to tibia inferiorly

32
Q

Iliotibial tract

A
  • Lateral thickening of fascia lata

- Attaches to iliac tubercle and Gerdy’s tubercle (tibia)

33
Q

3 intermuscular septa divide thigh into 3 compartments

A
  • Posterior
  • Lateral
  • Medial
  • Lateral extends from iliotibial trace, very strong
34
Q

Anterior thigh compartment content

A
  • Muscles are primarily leg (knee extensors)
  • Some hip flexors and rotators
  • Femoral nerve
35
Q

Medial thigh compartment content

A
  • Muscles are primarily adductors of thigh (hip)
  • (There are others)
  • Obturator nerve
36
Q

Posterior thigh compartment content

A
  • Muscles are primarily hip extensors and knee flexors

- Sciatic nerve

37
Q

Aorta bifurcates into

A
  • Common iliac arteries

- L4

38
Q

Common iliacs arteries divide

A
  • L5/S1
  • Internal iliac
  • External iliac
39
Q

Internal iliac artery

A
  • Travels into pelvis
40
Q

External iliac artery

A
  • Travels toward anterior thigh

- Becomes femoral artery as it passes inguinal ligament

41
Q

External iliac artery branches

A
  • Deep circumflex iliac artery

- Inferior epigastric

42
Q

Deep circumflex iliac artery

A
  • Branches just proximal to inguinal ligament

- Travels toward ASIS where it anastomoses with other vessels

43
Q

Retro-inguinal space (sub-inguinal space)

A
  • Deep to inguinal ligament

- Passageway between abdominal cavity and lower limb

44
Q

Retro-inguinal space (sub-inguinal space) is divided into 2 compartments by

A
  • The iliopectineal arch (interlacunar ligament)
45
Q

Interlacunar ligament

A
  • Thickening iliacus/psoas fascia

- Attaches to inguinal ligament

46
Q

2 compartments of retro-inguinal space

A
  • Muscular compartment (lacuna)

- Vascular compartment (lacuna)

47
Q

Muscular compartment (lacuna) contents

A
  • Iliacus muscle (lateral)
  • Psoas major muscle (medial)
  • Femoral nerve: between iliacus and psoas major muscles
  • Lateral femoral cutaneous nerve (sometimes)
48
Q

Vascular compartment (lacuna) contents are surrounded by

A
  • Femoral sheath
49
Q

Vascular compartment (lacuna) contents

A
  • Femoral artery
  • Femoral vein
  • Femoral canal (empty space and lymphatics)
  • Femoral branch of genitofemoral nerve
50
Q

Lateral to medial arrangement of structures passing under ligament

A
  • Nerve
  • Artery
  • Vein
  • Empty space (femoral canal)
  • Lymphatics
  • (NAVEL)
51
Q

Great saphenous vein arises from

A
  • Dorsal venous arch (medial marginal vein)

- Dorsal vein of 1st digit

52
Q

Great saphenous vein pathway

A
  • Ascends medially
  • Anterior to medial malleolus
  • Posterior to medial femur condyle
  • Passes through saphenous opening (fossa ovalis)
53
Q

Great saphenous vein drains into

A
  • Femoral vein
54
Q

Tributaries of great saphenous vein

A
  • Anterior and posterior accessory saphenous veins
  • Superficial epigastric
  • Superficial circumflex iliac
  • External pudendal veins
  • Small saphenous can also drain into the GSV
55
Q

Inguinal lymph nodes

A
  • Superficial inguinal
  • Horizontal group
  • Vertical group
  • Deep inguinal
56
Q

Superficial inguinal lymph nodes (in superficial fascia) drain into

A
  • Deep inguinal nodes

- External iliac nodes

57
Q

Horizontal group

A
  • 5-6 nodes

- Located right below inguinal ligament

58
Q

Horizontal group receives lymph from

A
  • Superficial gluteal region and proximal thigh
  • Trunk below the umbilicus
  • Perineum
59
Q

Vertical group

A
  • 4-5 nodes

- Located along terminal end of saphenous vein

60
Q

Vertical group drains

A
  • Most regions superficial to deep fascia (except posterior/lateral leg and foot)
61
Q

Deep inguinal lymph nodes

A
  • 1-3 nodes
  • Located deep to fascia lata
  • Within the femoral triangle
  • Medial to femoral vein
62
Q

Cloquets node

A
  • Most cephalad node

- Llocated at femoral ring

63
Q

Cloquets node drains

A
  • Deep tissue/structures of thigh
64
Q

Cloquets node receives lymph from

A
  • Popliteal nodes (tissues deep to deep fascia)

- Superficial inguinal nodes

Lower Extremity Anatomy (35 decks)

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