M: Anterior and medial compartments of the thigh Flashcards

1
Q

What type of bone is the patellar?

A

Triangular sesamoid bone

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2
Q

The patellar develops within what?

A

The quadriceps tendon

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3
Q

What are the 6 bony landmarks of the patellar?

A

1) Base (superiorly)
2) Apex
3) Articular surface
4) Anterior surface
5) Lateral facet
6) Medial facet
Both facets on the posterior surface

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4
Q

Which quadriceps muscle acts to prevent the patellar being pulled too laterally?

A

Vastus medialis - it pulls at a much more oblique angle than the other 3 quadriceps

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5
Q

Other than the pull of vastus medialis, what other mechanism exists to prevent the patellar being pulled too laterally?

A

A bony ridge can be found on the lateral femoral condyle - if this is underdeveloped it may lead to recurrent dislocations of the patellar

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6
Q

A blow patellar may split or shatter the patellar - why in this situation may the fragments not be avulsed?

A

Because the quadriceps expansion remains intact

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7
Q

What is meant by the term avulsed?

A

An injury in which a bony structure is forcibly detached from its normal position either by trauma or surgery

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8
Q

Why is the knee reliant on the strength or surrounding muscles, ligaments and menisci for stability?

A

Because the articular surfaces of the knee joint are incongruent

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9
Q

What are menisci and where are they situated?

A

2 c shaped wedges of fibrocartilage which are thicker at the external margins
They sit on the tibial plateau

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10
Q

What are the 4 intrinsic muscles of the knee?

A

1) Fibular collateral ligament
2) Tibial collateral ligament
3) Anterior cruciate
4) Posterior cruciate

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11
Q

What is the combined function of the fibular and tibial collateral ligament?

A

Stabilize the hinge like movement of the knee

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12
Q

What is the function of the posterior cruciate ligament? 3

A

Prevents posterior displacement of the tibia on the femur
Prevents hyperflexion
Main stabiliser of the flexed knee when weight bearing eg. walking down a hill

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13
Q

What is the function of the anterior cruciate ligament?

A

Prevents anterior displacement of the tibia on the femur

Prevents hyperextension

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14
Q

Why are the medial (tibial) collateral ligament and medial menisci commonly injured simultaneously?

A

Because they are firmly attached together

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15
Q

What movements are possible at the knee joint? 4

A

1) Extension
2) Flexion
3) Medial rotation of the leg when knee flexed at 90 degrees
4) Lateral rotation of the leg when knee flexed at 90 degrees

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16
Q

What opening in the deep fascia does the great saphenous vein pass through?

A

Saphenous hiatus/opening

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17
Q

What is the function of the femoral triangle?

A

Provides a transit route from the thigh for the major vessels passing to and from the leg

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18
Q

What are the borders of the femoral triangle?

A

Base - inguinal ligament
Medial border - medial margin of adductor longus in the medial compartment
Lateral border - medial margin of sartorius muscle in the anterior compartment of the thigh
Floor - formed medially by pectineus and adductor longus in the medial compartment of the thigh and formed laterally by iliopsoas muscle in the anterior compartment of the thigh

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19
Q

What are the 4 contents of the femoral triangle?

A

1) Femoral nerve
2) Femoral artery
3) Femoral vein
4) Lymphatics

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20
Q

What muscles are supplied by the femoral nerve?

A
Muscles of the anterior compartment of the thigh
4 quadriceps muscles
1) Rectus femoris
2) Vastus lateralis
3) Vastus medialis
4) Vastus intermedius
5) Sartorius muscle
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21
Q

What are the attachments of sartorius muscle?

A

Origin - ASIS

Insertion - Medial surface of tibia, inferomedial to tibial tuberosity

22
Q

What is the innervation of sartorius muscle?

A

Femoral nerve (L2, L3)

23
Q

What are the 2 actions of sartorius muscle?

A

1) Flexes thigh at hip joint

2) Flexes leg at knee joint

24
Q

What forms the roof of the adductor canal?

A

Sartorius muscle

25
What is the function of the adductor canal?
Carries the femoral vessels and saphenous nerve between the femoral triangle and popliteal fossa
26
What are the boundaries of the adductor canal?
``` Anterior/roof = sartorius muscle Lateral = vastus medialis Posterior = adductor longus and adductor magnus ```
27
What marks the apex of the adductor canal?
Apex of the adductor canal is marked by the adductor hiatus
28
What is the adductor hiatus?
A gap between the adductor and hamstring attachments of adductor magnus
29
What are the orgins and insertions of rectus femoris?
Origin - straight head = AIIS, reflected head = Ilium superior to acetabulum Insertion = Quadriceps femoris tendon
30
What is the innervation and 2 saction of rectus femoris?
``` Innervation = femoral nerve (L2-L4) Actions = flexes thigh at hip joint, extends leg at knee joint ```
31
What is the origin and insertion of vastus lateralis?
Origin - femur (lateral intertrochanteric line, margin of greater trochanter, gluteal tuberosity and lateral lip of linea aspera Insertion - quadriceps femoris tendon
32
What is the origin and insertion of vastus medialis?
Origin - femur (medial intertrochanteric line, pectineal line, medial lip of linea aspera, medial supracondylar line) Insertion - quadriceps femoris tendon and medial border of patellar
33
What is the innervation and 1 action of vastus lateralis?
Femoral nerve L2-L4 | Extends the leg at the knee joint
34
What is the innervation and 1 action of vastus medialis?
Femoral nerve L2-L4 | Extends the leg at the knee joint
35
What is the origin and insertion of vastus intermedius?
Origin - femur (upper 2/3 of anterior and lateral surfaces) | Insertion - quadriceps femoris tendon and laterla margin of patellar
36
What is the innervation and 1 action of vastus intermedius?
Femoral nerve L2-4 | Extends leg at knee joint
37
In addition to the 4 quadriceps and sartorius whar 2 other muscles does the anterior compartment contain?
1) Iliopsoas muscles | 2) Pectineus
38
The medial compartment contains muscles which arise from where?
The external surface of the pubis and the ischiopubic ramus
39
What 5 muscles can be found in the medial compartment of the thigh?
1) Adductor longus 2) Adductor brevis 3) Adductor magnus 4) Gracilis 5) Obturator externus
40
What is the chief function of the muscles of the medial compartment of the thigh?
Adduct the thigh at the hip joint
41
What is the origin and insertion of adductor longus?
Origin - Body of pubis | Insertion - linea aspera on medial 1/3 of shaft of femur
42
What is the innervation of adductor longus?
Anterior division of obturator nerve L2-4
43
What is the origin and insertion of adductor brevis?
Origin - body of pubis and inferior pubic ramus | Insertion - post proximal femur and upper 1/3 of linea aspera
44
What is the innervation of adductor brevis?
Obturator nerve L2-3
45
What is the origin of the adductor part of adductor magnus?
Origin - ischiopubic ramus | Insertion - Posterior proximal femur, linea aspera and medial supracondylar line
46
What is the origin and insertion of the hamstring part of adductor magnus?
Origin - ischial tuberosity | Insertion - Adductor tubercle and supracondylar line
47
What are the 2 different innervations of the adductor part and hamstring part of adductor magnus?
Adductor part = obturator nerve L2-4 | Hamstring part = tibial division of sciatic nerve L2-4
48
What is the origin and insertion of gracilis?
Origin - body of pubis, inferior pubic ramus and ramus of the ischium Insertion - medial proximal tibia
49
What is the innervation of gracilis?
Obturator nerve L2-4
50
What is the origin and insertion of obturator externus?
Origin - external surface of obturator membrane and adjacent bone Insertion - trochanteric fossa
51
What is the innervation of obturator externus?
Obturator nerve L3,L4