Movement Practical: Lower Limb 3 Flashcards
What type of bone is the patella and what does this mean?
Sesamoid
Bone is suspended completely within a tendon or muscle
Is the articular surface of the patella anterior or posterior?
Posterior
By what mechanism do the quadriceps muscles prevent lateral dislocation of the patella?
Vastus medialis pulls more obliquely than the other three muscles (which pull laterally)
What structure prevents avulsion of the patella due to trauma?
Patellar ligament
Is rotation at the knee always possible?
No, only when flexed
Where does the great saphenous vein penetrate the deep fascia?
Saphenous hiatus/opening
Which saphenous vein drains the lateral/posterior aspect of the leg?
Lesser saphenous vein
What do vessels pass through between the femoral triangle and popliteal fossa?
Adductor canal
Name three reasons for the clinical importance of the femoral triangle
Vascular access
Vascular surgery
Femoral hernia
Which boundary of the femoral triangle is formed by sartorius?
Lateral
Which muscle forms the medial boundary of the femoral triangle?
Adductor longus
What structure forms the base of the femoral triangle?
Inguinal ligament
Name three muscles that make up the floor of the femoral triangle
Adductor longus
Pectineus
Iliopsoas
Which blood vessels pass through the femoral triangle?
Femoral artery and vein
Perforating arteries
Does the femoral triangle have lymphatic contents?
Yes
What is the organisation of the femoral neurovascular bundle, from lateral to medial?
Femoral nerve
Femoral artery
Femoral vein
What drains into the femoral vein in the femoral triangle?
Greater saphenous vein
Which muscles does the femoral nerve supply in the anterior and medial compartments of the thigh and in the pelvis?
Anterior: every muscle
Medial: pectineus
Pelvis: iliacus
What is the only muscle with both functions of flexing the thigh at the hip joint AND flexing the knee joint?
Sartorius
What is the origin of sartorius?
Anterior superior iliac spine
Where does sartorius insert?
Medial surface of the proximal tibia
Which nerve roots from the femoral nerve innervate sartorius?
L2, L3
Does the adductor canal pass anterior or posterior to sartorius muscle?
Posterior
Does the adductor canal pass anterior or posterior to adductor longus and magnus?
Anterior
Which border of the adductor canal is formed by vastus medialis?
Lateral
What is the common insertion of the quadriceps femoris muscles?
Quadriceps femoris tendon onto patella (forms patellar ligament)
Which is the only quadriceps muscle that originates from the pelvis?
Rectus femoris
Has two tendons - one originates from the anterior inferior iliac spine, the other (“reflected head” from just superior to the acetabulum)
Origin of vastus medialis?
Medial intertrochanteric line
Pectineal line
Medial linea aspera
Origin of vastus lateralis?
Greater trochanter
Lateral intertrochanteric line
Lateral linea aspera
Where does vastus intermedius originate?
Wide origin acros the upper 2/3 of the anterolateral femur
What is the difference between the innervation of rectus femoris and the vastus muscles?
Rectus femoris: femoral nerve L2, L3
Vastus: femoral nerve L2, L3, L4
What is the common function of the quadriceps femoris muscles?
Extension of the leg at the knee joint
What additional function does rectus femoris have that the vastus muscles lack?
Flexion of the thigh at the hip joint
What are the muscles in the medial compartment of the thigh?
Adductor magnus Adductor longus Adductor brevis Gracilis Obturator externus
What is the common origin of the muscles in the medial compartment of the thigh?
External surface of the pubis
Ischiopubic ramus
What are the main functions of the medial compartment thigh muscles?
Adduction of the thigh at the hip
Rotation of the thigh - mostly medial
What is the medial compartment of the thigh innervated by, and what are its nerve roots?
Obturator nerve
L2, L3, L4
Where does adductor longus insert?
Middle 1/3 of linea aspera
Where does adductor brevis insert?
Upper 1/3 of linea aspera
What muscle does adductor brevis insert roughly posterior to?
Pectineus
Where does pectineus insert?
Pectineal line (from lesser trochanter to medial linea aspera)
Where does adductor magnus insert?
Linea aspera
Supracondylar line
Adductor tubercle on medial femur, just superior to medial epicondyle
Where does gracilis insert?
Proximal tibia (medial surface)
Where does obturator externus insert?
Tronchanteric fossa on proximal femur
Where is the adductor hiatus?
Distal adductor magnus (between adductor and hamstring parts)
What travels through the adductor hiatus?
Femoral vessels in the adductor canal
The distal tendons of which muscles join to form the pes anserinus, which inserts onto the medial tibia?
Gracilis
Semitendinosus
Sartorius
