MSK 19 - Femoral Triangle And Anteromedial Thigh Flashcards
1
Q
where does the inguinal ligament extend from
A
ASIS to pubic tubercle
2
Q
at what vertebral level does the aorta divide
A
at L4 level
3
Q
what does the abdominal aorta divide into
A
into the right and left common iliac arteries
4
Q
what does the common iliac arteries divide into
A
internal and external iliac arteries
5
Q
at what level do the common iliac arteries divide
A
at the SIJ level
6
Q
what does the internal iliac artery supply
A
pelvic organs
7
Q
for the branches that come off the internal iliac artery what do they go on to supply and how
A
hip region via anastomotic vessels
8
Q
what demarcates the transition of the external iliac artery to the femoral artery
A
becomes the femoral artery once it passes under the inguinal ligament
9
Q
what happens to the path of the femoral artery as it goes down the femur
A
it starts off anterior but then becomes posterior as it approaches the knee
10
Q
what branch does the femoral artery give off and at what level does this happen
A
profundal femoris artery
at femoral neck level
11
Q
what are the 3 branches that come off the profunda femoris artery from proximal to distal
A
medial circumflex arteries
lateral circumflex arteries
perforating arteries
12
Q
what do the medial and lateral circumflex arteries supply
A
the hip joint
13
Q
what branch comes off the lateral circumflex femoral artery
A
descending branch of lateral circumflex femoral artery
14
Q
what does the descending branch of lateral circumflex femoral artery supply
A
the knee
15
Q
what do the perforating arteries of profunda femoris artery encircle
A
they go around the femur
16
Q
what is the femoral artery’s path down past the knee
A
it enters the popliteal fossa behind the knee
17
Q
what structure demarcates where the femoral artery transitions into the popliteal artery
A
after the femoral artery enters the popliteal fossa behind the knee
18
Q
after the popliteal artery exits the popliteal fossa inferiorly, what happens to it
A
it trifurcates into 3 arteries
19
Q
what three arteries branch off the popliteal artery
A
anterior tibial artery
posterior tibial artery
peroneal/fibular artery
20
Q
what does the anterior tibial artery become
A
dorsalis pedis artery
21
Q
most of the blood supply to the thigh and hip is via which artery
A
profundal femoris arteries
22
Q
what artery gives off the obturator artery
A
internal iliac artery
23
Q
some blood supply to adductor muscles is via what artery
A
via obturator artery from internal iliac artery
24
Q
what is fascia lata and what is it made out of
A
it is the deep fascia that envelops the entire lower limb
its made out of dense layer of connective tissue (collagen fibres)
25
where is the fascia lata found
on the muscle deep to subcutaneous fat
26
where is the deficiency in the fascia lata
deficiency is located anteriorly and inferior to the inguinal ligament
27
what is the name of the deficiency/hole in the fascia lata and how does this relate to its function
the saphenous opening
where the saphenous vein passes through to meet the femoral vein
28
where does the fascia lata attach to superiorly
to the pubic tubercle, pubis and inguinal ligament
29
where does the fascia lata attach to laterally
to the iliac crest
30
where does the fascia lata attach to posteriorly
sacrum, coccyx and ischial tuberosity
31
when the fascia lata extends down the leg it attaches where and becomes continuous with what structures
attaches around the knee
becomes continuous with the fascia in the leg
32
in the thigh how many compartments are formed by the fascia lata and intermusular septa
3
33
which intermuscular septa is the strongest
lateral
34
what are the 3 compartments of the thigh
anterior
medial
posterior
35
what is the significance of the thigh compartments in terms of nerve supply
the muscles grouped in the same compartments have mostly the same nerve supply
36
what does the fascia lata blend with laterally
blends with the tendon of tensor facia lata muscle
37
what forms the iliotibial band/tract
the fascia lata and tensor fascia lata blending together
38
what does the iliotibial band do
stabilizes the knee when standing straight
39
the fascia lata splits to envelop which 2 muscles
the tensor fascia lata and gluteus maximus
40
where does the iliotibial band attach to distally
on the lateral aspect of the tibia
41
what 2 muscles form the iliopsoas
iliacus and psoas
42
where is the origin and insertion of the psoas muscle
originates from L2-4 transverse process
inserts at the lesser trochanter
43
where does the psoas muscle pass relative to the inguinal ligament
passes under the inguinal ligament
44
what nerves innervates the psoas muscle
L2 & 3 spinal nerves
sometimes with L4 spinal nerve
45
what actions does the psoas muscle facilitate
flexes and externally rotates the thigh
46
where is the origin and insertion of the iliacus muscle
originates from the ilium
inserts onto the lesser trochanter
47
where does the iliacus muscle pass relative to the inguinal ligament
under the inguinal ligament
48
what nerve innervates the iliacus muscle
femoral nerve
49
what actions does the iliacus muscle facilitate
hip flexion and external rotation of the thigh
50
where is the origin and insertion of the pectineus muscle
originates from superior pubic ramus
inserts slightly posterior and inferior to the lesser trochanter
51
relative to the compartments of the thigh where does the pectineus muscle lie
between the anterior and medial compartments of the thigh
52
what nerve innervates the pectineus muscle
femoral nerve
sometimes with obturator nerve as well
53
what actions does the pectineus muscle facilitate
mainly thigh adduction
also some hip flexion
54
where is the origin and insertion of the tensor fascia lata muscle
originates from ASIS
inserts to the iliotibial band/lateral aspect of the proximal tibia
55
what nerve innervates the tensor fascia lata muscle
superior gluteal nerve
56
what actions does the tensor fascia lata muscle facilitate
thigh abduction with some flexion
stabilizes knee joint when walking
57
what is the origin and insertion of the sartorius muscle
originates from the ASIS
inserts onto the medial aspect of the proximal tibia at the pes ansernius
58
what is the innervation of the sartorius muscle
femoral nerve
59
what is the function of the sartorius muscle
pulls leg into sitting position when sitting cross legged
flexes knee and externally rotates the thigh
60
what is the longest muscle in the body
sartorius
61
what is the pes ansernius
3 tendons that attach to the medial aspect of the proximal tibia
62
what is the origin and insertion of the rectus femoris
origins from the anterior inferior iliac spine and superior acetabular rim
inserts onto the superior pole of the patella
63
what innervates the rectus femoris muscle
femoral nerve
64
what is the function of the rectus femoris muscle
thigh flexion
knee extension/straightens knee
65
what is the origin and insertion of the vasti muscles
originates from the proximal femur - upper 1/3 of femur
inserts onto the superior pole of the patella
66
the vasti muscles share a common tendon with which muscle
rectus femoris
67
what innervates the vasti muscle
femoral nerve
68
what is the function of the vasti muscles
knee extension
69
vastus lateralis attaches where relative to the linea aspera
posteriorly to the linea aspera
70
what are the 3 vasti muscles from lateral to medial
vastus lateralis
vastus intermedius
vastus medialis
71
what are the 11 muscles of the thighs anterior compartment
pectineus
iliopsoas (psoas major and iliacus)
tensor fascia lata
sartorius
rectus femoris
quadriceps femoris
vastus lateralis/intermedius/medialis
72
what are the 5 muscles of the thigh's medial compartment
adductor longus
adductor brevis
adductor magnus
gracilis
obturator externus
73
what is the function of all the muscles in the thigh's medial compartment
adduct the thigh
74
what is the innervation of all but one of the muscles within the medial compartment of the thigh
what is the one muscle that is not innervated by this nerve
obturator nerve
adductor magnus - only part of it is innervated by obturator nerve
75
what is the origin and insertion of adductor longus
originates from the body of the pubis and inserts onto the linea aspera posteriorly
76
what is the innervation of the adductor longus
obturator nerve
77
what is the function of the adductor longus
adducts the thigh
and also flexes thigh
78
what is the origin and insertion of adductor brevis
originates from the inferior pubic rami
inserts onto the linea aspera behind adductor longus
79
what innervates adductor brevis
obturator nerve
80
what does the obturator nerve sit on
sits on adductor brevis
81
what is the function of adductor brevis
adducts the thigh
also flexes the thigh
82
what is the origin and insertion of adductor magnus
the adductor part originates from the inferior pubic ramus
the hamstring part originates from the ischial tuberosity
both insert onto the linea aspera. adductor tubercle and supracondylar ridge
83
what are the two parts of the adductor magnus at its origin
one is the adductor part
one is the hamstring part
84
what innervates the adductor part of the adductor magnus
obturator nerve
85
what innervates the hamstring part of the adductor magnus
sciatic (tibial nerve)
86
what is the function of adductor magnus
adducts the thigh
also flexes and extends the thigh
87
what is the origin and insertion of gracialis
originates from the body of the pubis
inserts to the superior part of the medial tibia - pes ansernius
88
what is the innervation of gracialis
obturator nerve
89
what is the function of gracialis
adducts
and internally rotates the leg
90
the gracialis muscle goes down what aspect of the thigh
medial side of the thigh
91
what 3 tendons form the ansernius
sartorius
gracilis
semitendinosus
92
what is pes ansernius clinically important
tendons can be used for repair of anterior cruciate ligament tears in the knee
93
what are the 3 nerves to know
femoral
sciatic
obturator
94
the femoral nerve and obturator nerve originate from where
from the lumbar plexus
L2-L4 spinal nerve roots
95
what is the path of the femoral nerve through the abdomen and pelvis to the thigh
passes along the posterior abdominal wall and through the pelvis
enter the thigh under the inguinal ligament
96
what branch of the femoral nerve innervates the skin on the anterior aspect of the thigh
anterior cutaneous nerve of the thigh
97
what does the anterior cutaneous nerve of the thigh innervate
the skin on the anterior aspect of the thigh
98
what branch of the femoral nerve innervates the skin on the medial leg and medial foot
saphenous nerve
99
what does the saphenous nerve innervate
the skin on the medial leg and medial foot
100
what vessel does the saphenous nerve run with
the saphenous vein
101
what does the femoral nerve supply
the hip joint in part
102
where does the femoral nerve originate from
L2 L3 and L4 spinal nerves
103
where does the obturator nerve originate from
L2 L3 and L4 spinal nerves
104
what is the path of the obturator nerve through the abdomen and pelvis to the thigh
passes along posterior abdominal wall and around pelvis
enters thigh under through obturator foramen
105
the muscular branches of the obturator nerve are supplied to what compartment and muscle group
to the medial compartment thigh muscles
106
what branch of the obturator nerve innervates the small area of skin on the anterior thigh
cutaneous branch of obturator nerve
107
what does the cutaneous branch of obturator nerve innervate
the small area of skin on the anterior thigh
108
what muscle does the obturator nerve sit on
on the adductor brevis
109
where is the small saphenous vein
on the posterior leg
110
where is the great saphenous vein
runs medially up the leg
111
where does the great saphenous vein join the femoral vein
via defect in the fascia lata in femoral triangle
112
what passes through the defect in the fascia lata
great saphenous vein
113
where is the femoral triangle on the thigh
a fascial space on the superior aspect of the thigh
114
what are the superior, lateral and medial borders of the femoral triangle
superior = inguinal ligament
lateral = sartorius
medial = adductor longus
115
what makes up the floor and roof of the femoral triangle
floor = iliopsoas and pectineus
roof = fascia lata, subcutaneous tissue and skin
116
what are the contents of the femoral triangle from lateral to medial
femoral nerve
femoral sheath
femoral artery
femoral vein
lymphatic vessels
117
what structures in the femoral triangle are within the sheath
why is this
all except for femoral nerve
the femoral nerve emerges posteriorly from spinal nerve and comes down back of the pelvis on psoas muscle whereas artery and vein emerges outpouching of peritoneum
118
the femoral nerve is formed within which muscle
psoas major
119
the femoral nerve passes under which point of the inguinal ligament and places where medially-laterally in the femoral triangle
passes under the midpoint of the inguinal triangle
femoral nerve is most lateral structure in the femoral triangle
120
the terminal branch of the femoral nerve is what nerve
saphenous nerve
121
the saphenous nerve is what kind of nerve and where does it run
cutaneous nerve
descends medially
122
where does the femoral sheath start and in what direction does it extend
at the inguinal ligament and extends inferiorly
123
what does the femoral sheath contain
contains the femoral artery, vein and lymphatics
124
the medial part of the femoral sheath contains what structure
the femoral canal
125
the proximal end of the femoral sheath is called what
the femoral ring
126
where the adductor canal relative to muscles
occurs deep to the middle third of sartorius
127
the adductor canal provides passage for what structures and where do these structures travel to
passage for femoral artery, nerve and vein
allows these structures to pass through the thigh to reach the popliteal fossa and become the popliteal vessels
128
the adductor canal is bordered by what structures medially, posteriorly and laterally
medially = sartorius
posteriorly = adductor longus
laterally = vastus medialis
129
the inlet and outlet to the adductor canal is what structure
inlet = apex of femoral triangle
outlet = adductor hiatus in the adductor magnus muscle
130
what are the 4 contents of the adductor canal
femoral artery, vein and nerve to vastus medialis and saphenous nerve (cutaneous branch of femoral nerve)
131
what is the adductor canal block and what does it achieve - which nerves does it affect
interfascial plane block performed in the thigh
anesthetizes multiple distal branches of the femoral nerve including saphenous nerve and branches of he mixed sensory and motor nerves to the quadricep (vastus medialis) and branches of the obturator nerve
132
when is adductor canal block used
for anasthesia for surgery of knee, medial lower leg and ankle
133
what is the clinical application of the femoral artery
the femoral artery is often used for arterial samples when unable to collect peripheral samples
also used for cardiac and angiography procedures
134
what is the clinical application of the femoral vein
central access as its easy to find and access
catheter inserted into vein to take blood samples or pressure measurements from the right side of the heart
135
what is the clinical application of the femoral nerve block
place nerve block around the femoral nerve
feel for femoral artery and 1-2 finger widths lateral to that to get to the nervw
136
what is a femoral hernia
femoral ring is weak area and is a site for hernia
hernia can be at risk of strangulation if it extends beyond the femoral canal through the saphenous opening into the thigh
