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CBS602 LL I: Hip, Thigh and Knee > Neurovasculature of the Hip, Thigh and Knee > Flashcards

Neurovasculature of the Hip, Thigh and Knee Flashcards

1
Q

What are the spinal levels that form the lumbar plexus?

A

The lumbar plexus is formed by the anterior rami of L1 to L4.

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2
Q

What nerve originates from the lumbar plexus and what is its spinal level?

A

Femoral Nerve: L2-L4
Obturator Nerve: L2-L4

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3
Q

What are the spinal levels that form the sacral plexus?

A

The sacral plexus is formed by the anterior rami of L4 to S3.

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4
Q

Which nerve originates from the sacral plexus and what are its spinal levels?

A

Sciatic Nerve: L4-S3

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5
Q

What is the origin of the common iliac artery?

A

The common iliac artery branches from the abdominal aorta at the level of L4.

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6
Q

What are the branches of the common iliac artery?

A

External Iliac Artery
Internal Iliac Artery

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7
Q

What are the branches of the lumbar plexus?

A

Obturator Nerve
Femoral Nerve
Superior Gluteal Nerve
Inferior Gluteal Nerve

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8
Q

What part of the body does the inguinal ligament associate with?

A

The inguinal ligament connects the anterior superior iliac spine to the pubic tubercle and forms the base of the inguinal canal.

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9
Q

What are the boundaries of the femoral triangle?

A

Lateral: Sartorius
Medial: Adductor longus
Superior: Inguinal ligament
Roof: Fascia lata
Floor: Iliopsoas & pectineus

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10
Q

What is the mnemonic for the boundaries of the femoral triangle?

A

SAIL: Sartorius, Adductor longus, Inguinal Ligament.

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11
Q

What structures are found inside the femoral triangle from lateral to medial?

A

NAVEL:

N: Femoral Nerve
A: Femoral Artery
V: Femoral Vein
E: Empty space
L: Deep inguinal lymph nodes

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12
Q

What are the clinical significances of the femoral triangle?

A

Important site for arterial blood sampling and procedures.
Common site for femoral hernias.

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13
Q

What forms the roof and floor of the femoral triangle?

A

Roof: Fascia lata
Floor: Iliopsoas and pectineus

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14
Q

Why is the femoral triangle a significant site for clinical procedures?

A

It allows easy access to the femoral artery for blood sampling, catheterization, and other procedures.

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15
Q

What condition is associated with the femoral triangle involving a protrusion near the femoral vein?

A

Femoral hernia

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16
Q

What is the function of the adductor canal?

A

It is a passageway for structures moving between the anterior thigh and posterior leg.

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17
Q

What is the pathway of the adductor canal?

A

It runs from the femoral triangle to the adductor hiatus.

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18
Q

What are the boundaries of the adductor canal?

A

Anteromedially: Sartorius
Laterally: Vastus medialis
Posteriorly: Adductor longus and magnus

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19
Q

What are the contents of the adductor canal?

A

Femoral artery
Femoral vein
Nerve to vastus medialis
Saphenous nerve

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20
Q

What is the clinical significance of the adductor canal?

A

It is a site for Adductor Canal Block, an anesthetic technique used in surgeries involving the knee.

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21
Q

Which nerve provides sensory innervation to the medial side of the leg and passes through the adductor canal?

A

The saphenous nerve.

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22
Q

What is the significance of the adductor hiatus in relation to the adductor canal?

A

It marks the end of the adductor canal and allows the femoral artery and vein to pass into the popliteal fossa as the popliteal artery and vein.

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23
Q

What is the lateral boundary of the adductor canal?

A

The vastus medialis muscle.

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24
Q

What areas does the profunda femoris artery supply?

A

It supplies the hip joint, as well as the anterior, posterior, and medial thigh.

25
Q

What are the main branches of the profunda femoris artery?

A

Lateral circumflex femoral artery
Medial circumflex femoral artery
Perforating arteries (3-4)

26
Q

What does the lateral circumflex femoral artery supply?

A

It supplies the muscles of the anterolateral thigh.

27
Q

What does the medial circumflex femoral artery supply?

A

It supplies the head and neck of the femur and muscles of the medial thigh.

28
Q

How does the medial circumflex femoral artery connect with other arteries?

A

It anastomoses with the lateral circumflex femoral artery.

29
Q

What do the perforating arteries of the profunda femoris artery supply?

A

They supply the muscles of the posterior thigh.

30
Q

What is the function of the cruciate anastomosis?

A

It provides an alternative route for blood flow when the femoral artery is blocked.

31
Q

Which branch of the profunda femoris artery contributes to the cruciate anastomosis?

A

The lateral circumflex femoral artery contributes to the cruciate anastomosis.

32
Q

What is the mortality rate for neck of femur (NOF) fractures after one year?

A

The mortality rate is approximately 30% at one year.

33
Q

What type of blood supply does the neck of femur receive?

A

The neck of the femur receives a retrograde arterial supply via the retinacular arteries.

34
Q

How much blood supply does the artery to the head of the femur provide in adults?

A

In adults, the artery to the head of the femur provides negligible blood supply.

35
Q

How does an intracapsular NOF fracture affect blood supply?

A

An intracapsular NOF fracture can disrupt the blood supply, often leading to avascular necrosis of the femoral head.

36
Q

Why does an intracapsular NOF fracture often require a joint replacement?

A

Because it disrupts the blood supply, causing avascular necrosis, which necessitates joint replacement rather than fixation.

37
Q

How do intertrochanteric fractures differ from NOF fractures in terms of blood supply?

A

Intertrochanteric fractures generally preserve the blood supply to the femoral head.

38
Q

What is the origin of the obturator nerve?

A

The obturator nerve originates from the lumbar plexus, specifically from L2-L4.

39
Q

Describe the course of the obturator nerve.

A

The obturator nerve passes through the psoas major muscle, then travels through the obturator canal.

40
Q

Into which divisions does the obturator nerve branch?

A

The obturator nerve divides into the anterior and posterior divisions, which surround the adductor brevis muscle.

41
Q

Which muscles are innervated by the obturator nerve?

A

The obturator nerve innervates the muscles of the medial compartment of the thigh, except for the hamstring part of adductor magnus (which is innervated by the tibial part of the sciatic nerve).

42
Q

Which structures enter the gluteal region through the greater sciatic foramen?

A

All major structures of the gluteal region, including the superior gluteal vessels and nerves, inferior gluteal vessels and nerves, sciatic nerve, posterior femoral cutaneous nerve, nerve to quadratus femoris, and nerve to obturator internus.

43
Q

What structures are located superior to the piriformis muscle in the gluteal region?

A

The superior gluteal vessels and nerve.

44
Q

What muscles are innervated by the superior gluteal nerve?

A

The gluteus medius, gluteus minimus, and tensor fascia lata (TFL).

45
Q

What structures are located inferior to the piriformis muscle in the gluteal region?

A

The inferior gluteal vessels and nerve, sciatic nerve, posterior femoral cutaneous nerve, nerve to quadratus femoris, and nerve to obturator internus.

46
Q

Which nerve innervates the gluteus maximus muscle?

A

The inferior gluteal nerve.

47
Q

What is the function of the posterior femoral cutaneous nerve?

A

It provides sensory innervation to the skin of the posterior thigh, knee, and proximal leg.

48
Q

Which muscles are innervated by the nerve to quadratus femoris?

A

The quadratus femoris and gemellus inferior.

49
Q

Which muscles are innervated by the nerve to obturator internus?

A

The obturator internus and gemellus superior.

50
Q

Where does the sciatic nerve originate from?

A

The lumbosacral plexus (L4-S3).

51
Q

What are the two main components of the sciatic nerve?

A

The tibial component and the common fibular component, encased in a fibrous sheath.

52
Q

Which muscles are supplied by the tibial component of the sciatic nerve?

A

The hamstrings and the hamstring part of the adductor magnus.

53
Q

Which muscle is supplied by the common fibular component of the sciatic nerve?

A

The short head of the biceps femoris.

54
Q

Where does the sciatic nerve divide, and what does it divide into?

A

It divides at the popliteal fossa into the tibial nerve and the common fibular nerve.

55
Q

Where does the common fibular nerve travel after division?

A

It travels laterally towards the neck of the fibula.

56
Q

What percentage of people have the sciatic nerve passing below the piriformis muscle?

A

87%.

57
Q

In what percentage of people does the sciatic nerve pass through the piriformis muscle?

A

12.5%

58
Q
A

CBS602 LL I: Hip, Thigh and Knee (3 decks)

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