Midterm I: Ventral Lower Limb Regions (Ben) Flashcards by Ben Dahlberg

What are the borders of the subinguinal region?

Superior: Inguinal (Poupart’s) Ligament

Inferior: Transverse line drawn on gluteal sulcus

Lateral: Vertical line thru ASIS

Medial: Medial edge of thigh

How well did you know this?

Not at all

Perfectly

What innervates the skin of the subinguinal region?

3 nerves

Anterior Femoral Cutaneous N. (<– femoral n.)
Lateral Femoral Cutaneous N. (<– lumbar plexus, skin under ASIS)
Femoral branch, Genitofemoral N.

ALF

How well did you know this?

Not at all

Perfectly

What are the 3 parts of the subinguinal hiatus and their contents?

Lacuna Musculonervosa
- Iliopsoas
- Femoral Nerve
- Lateral Femoral Cutaneous N.
Lacuna Vasorum
- Femoral Artery + Vein (in femoral sheath)
- Femoral Branch, Genitofemoral N.
Lacuna Lymphatica
- Lacunar Ligament
- Rosenmuller’s Lymph Node
- Femoral Ring (–> femoral canal)

How well did you know this?

Not at all

Perfectly

What separates the lacunae musculonervosa + vasorum from each other in the subinguinal hiatus?

Iliopectineal Arch

thickened band of iliac + psoas fascia from posterior inguinal ligament to iliopubic eminence of hip bone

How well did you know this?

Not at all

Perfectly

What is the CT structure surrounding the contents of the lacuna vasorum called?

What is it made up of?

Femoral Sheath

composed of psoas + transversalis fascia
blends with adventitia of vessels

How well did you know this?

Not at all

Perfectly

What important area in the medial subinguinal region is commonly a site of hernia?

What are its borders/walls?

Femoral Canal

the femoral ring (medial to femoral vein, lateral to lacunar ligament) leads into it

Walls:

Lateral: Femoral Vein
Medial/Posterior: Pectineus + Fascia
Anterior: Fascia Lata
Inlet/Outlet: Femoral Ring to Saphenous Hiatus

How well did you know this?

Not at all

Perfectly

What are the borders of the femoral triangle?

(What is the area formed by the “floor” of the triangle?)

Superior: Inguinal Ligament
Medial: Adductor Longus
Lateral: Sartorious
Floor: Iliopsoas (laterally) + Pectinus (medially)
the floor forms the iliopectineal fossa

How well did you know this?

Not at all

Perfectly

What are the contents of the femoral triangle/iliopectional fossa?

3 main things, from lateral to medial.

What notable nerve branches off a much larger nerve here?

Femoral N.
- gives the Saphenous N. (which enters adductor canal)
Femoral Artery
Femoral Vein
(some deep inguinal lymph nodes)

How well did you know this?

Not at all

Perfectly

What are the borders of the anterior femoral region?

Superior: Level of gluteal groove
Inferior: 3 fingers above patella
Medial/Lateral: Lines thru medial/lateral femoral condyles

How well did you know this?

Not at all

Perfectly

What CT covering of the anterior thigh is associated with a muscle on the lateral side of the leg?

(HINT: the muscle continues downward into a thickened CT structure that extends to the lateral knee)

What is the muscle + the structure it extends to?

Fascia Lata - encloses the thigh muscles + is associated with…

Tensor Fascia Latae which blends distally with the Iliotibial Tract

How well did you know this?

Not at all

Perfectly

What are the borders of the anterior genicular region?

Superior: 3 fingers above base of patella
Inferior: 3 fingers below apex of patella
Lateral: vertical line thru capitulum of fibula
Medial: vertical line thru medial epicondyle of femur

How well did you know this?

Not at all

Perfectly

What innervates the skin of the anterior genicular region?

4 nerves

Anterior Femoral Cutaneous Nerve
Lateral Femoral Cutaneous Nerve
Obturator Nerve
Saphenous Nerve

How well did you know this?

Not at all

Perfectly

What 3 muscles insert on the pes anserinus superficialis?

And on PA profundus?

Sartorius
Gracilis
Semitendinosus

semimembranosus on P.A.P.

How well did you know this?

Not at all

Perfectly

What are the 3 prepatellar bursae found in the anterior geniculate region?

And the other two bursae associated with the knee?

Subcutaneous - btwn skin + fascia
Subfascial - btwn fascia + quadriceps tendon
Subtendinous - btwn quad. tendon + patella

Suprapatellar + Infrapatellar Bursae

How well did you know this?

Not at all

Perfectly

Describe the arterial supply of the anterior genicular region based on numbers…

9, 11, 24, 27 + 28

…in this picture:

The anterior genicular region is supplied by the anastamosing of numerous vessels around the knee…

9/11: Sup/Inf Lateral Genicular Arteries
24: Descending Genicular Artery (from Femoral A., gives saphenous + articular branches)
27/28: Sup/Inf Medial Genicular Arteries

(both superiors = branches of popliteal a.)

How well did you know this?

Not at all

Perfectly

What are the borders of the anterior crural region?

Superior: 3 fingers below apex of patella
Inferior: Line between medial/lateral malleoli
Lateral: Line btwn lateral epicondyle + malleolus
Medial: Line btwn medial epicondyle + malleolus

What innervates the skin of the anterior crural region?

3 nerves

Lateral sural cutaneous nerve (from common peroneal n., innervates upper lateral part)
Medial crural cutaneous branches (from saphenous n., innervates medial + anterior parts)
Superficial Peroneal Nerve (lower lateral part)

What are the anterior muscles of the anterior crural region known as collectively?

What are they (3) ?

Extensors

Tibialis Anterior (most medial/anterior)
Extensor Digitorum Longus (more lateral)
Externos Hallucis Longus (deeper, emerges between other 2 in distal part of region)

What innervates the extensor muscles in the anterior crural region?

Deep Peroneal Nerve

What separates the extensor and peroneus compartments of the lower leg?

And extensor/flexor compartments?

From what CT structure are these separations derived?

Anterior Intermuscular Septum (btwn extensor/peroneus)

Posterior Intermuscular Septum (btwn extensor/flexor)

Both are continuations of the Crural Fascia that surrounds the lower leg.

Describe the course of the nerve innervating the peroneus muscles, including its terminal branches.

The superficial peroneal nerve branches off of the common peroneal nerve and then…

… travels between the peroneus longus + brevis, before…

…coursing anteriorly betwen peroneus brevis + extensor digitorum longus, and ending in…

Intermediate and Medial Dorsal Cutaneous Nerves of the foot.

What artery supplies the extensor muscles of the anterior crural region?

Anterior Tibial Artery

running with the deep peroneal nerve between extensor hallucis longus + tibialis anterior, in front of the interosseous membrane

What are the borders of the Dorsalis Pedis Region?

Superior: Line btwn malleoli
Inferior: Root of toes
Lateral: Line btwn lateral malleolus and root of 5th toe
Medial: Line btwn medial malleolus and root of 1st toe

What two CT structures stabilize the tendons of the extensor muscles in the anterior crural region and dorsum of the foot?

Superior and Inferior Extensor Retinacula

What nerves innervate the skin of the **dorsum of the foot** + toes? 4 nerves

1. **Superficial Peroneal N.** (most of dorsum) 2. **Deep Peroneal N.** (lateral half big toe, medial half 2nd toe) 3. **Lateral Dorsal Cutaneous N.** (from sural n., lateral edge) 4. **Medial Plantar N.** (tips of toes 1-3, half of toe 4)

Describe blood supply of the **dorsum of the foot** starting from the artery serving in the _anterior crural region_:

The **anterior tibial artery** continues to the dorsum of the foot as the **dorsalis pedis**, which gives: 1. **Lateral Tarsal Artery** (branching laterally across the tarsals, under the extensor digitorum longus tendons) 2. **Arcuate Artery** - arcs laterally across the metatarsals + gives: * **Dorsal Metatarsal Arteries** - each branching into two: * **Dorsal Digital Arteries**

What is the muscle indicated in red here? And the muscle just to the right of it in grey?

Red - **Extensor Hallucis Brevis** Grey - **Extensor Digitorum Brevis**

What innervates the skin of the **inguinal region**? 2 nervese

1. **Iliohypogastric N.** 2. **Ilioinguinal N.**

What are the borders of the inguinal canal?

* Superior/Roof: **Internal Oblique + Transverse Abdominal** * Anterior: **Ext. Oblique Aponeurosis** * Inferior/Floor: **Inguinal Ligament** * Posterior: **Transversalis Fascia + Transverse Abdominal**

What are the contents of the inguinal canal? 4 things (though only 3 per gender)

1. **Spermatic Cord** 2. **Round Ligament of Uterus** 3. **Genital Branch, Genitofemoral N.** 4. **Ilioinguinal N.**

What are the contents of the **spermatic cord**?

1. **Vas Deferens** 2. **Testicular Artery** 3. **Pampiniform Plexus** 4. **Genital Branch, Genitofemoral N.** 5. **Deferential A.** 6. **Cremaster Muscle** 7. **Testicular Plexus** (autonomic nerves) 8. Lymph Vessels (--\> lumbar + para-aortic nodes)

What are the 4 layers of the spermatic cord?

1. **Cremasteric Fascia** (\<--external oblique aponeurosis) 2. **Cremaster Muscle** (\<-- trans. abdominis + ext. oblique) 3. **Spermatic Fascia** (\<-- transversalis fascia) 4. **Tunica Vaginalis Testis** (\<-- peritoneum)

What are the 3 superficial branches of the femoral artery in the **subinguinal region**?

1. **Superficial Epigastric A.** 2. **Superficial Circumflex Ilial A.** 3. **External Pudendal A.** **ECIP**

What are the borders of the **adductor canal**? Entrance + exit?

* Lateral: **Vastus Medialis** * Medial: **Adductor Longus + Magnus** * Roof: **Vastoadductor Membrane** Entrance: **Femoral Triangle** Exit: **Adductor Hiatus** (btwn 2 attachment pts of add. magnus)