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Anatomy: Lower Limb > Part 1: Anterior Compartment of Thigh > Flashcards

Part 1: Anterior Compartment of Thigh Flashcards

1
Q

Where does ilioinguinal nerve originate and what does it supply?

A

Collateral branch of iliohypogastric (L1). Runs in NV plane (between transverse abdominis and internal oblique) in abdominal wall. Emerges in front of cord in superficial ring and supplies root of penis, anterior 1/3 scrotum and small area of thigh. Cutaneous only.

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2
Q

Where does femoral branch of genitofemoral nerve arise and where does it innervate?

A

1st and 2nd lumbar nerves. Femoral branch arises as nerve lies on psoas. Runs down external iliac a. and supplies most of skin over femoral triangle. Cutaneous branch.

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3
Q

Where does medial femoral cutaneous nerve arise and what does it innervate?

A

Branch of anterior divisions of femoral nerve (L2,L3). Supplies medial side of thigh with terminal twigs to patella plexus

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4
Q

Where does intermediate femoral cutaneous nerve arise and what does it innervate?

A

Common origin with medial femoral cut n (anterior division of femoral nerve, L2,L3). Passes vertically down beneath fascia lata to supply anterior thigh to knee

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5
Q

Where does the lateral femoral cutaneous nerve arise and what does it innervate?

A

Branch of lumbar plexus (L2,L3). Passes beneath then within iliac fascia then beneath inguinal ligament just medial to ASIS. Divides into:

  • anterior(L3) branch - supplies anterolateral surface of thigh
  • posterior(L2) branch - supplies posterolateral aspect of thigh
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6
Q

What are the 4 cutaneous branches of the femoral artery?

A

Superficial circumflex artery
Superficial epigastric artery
Superficial external pudendal artery
Deep external pudendal artery

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7
Q

Describe the course of the great saphenous vein

A

Arises as continuation of medial marginal vein of foot. Spirals backwards where it lies a handsbreadth behind the medial border of patella. Spirals forward again and pierces cribriform fascia to to join the femoral vein

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8
Q

What are the 3 main groups of lymph nodes in anterior thigh and where do they drain from?

A

Large lymphatic vessel accompanies great saph v. and joins with other vessels to form “T” pattern.
Vertical group: drain from lower limb
Lateral group: Receive from buttock, flank and back
Medial group: receive from below umbilicus and perineum and external genitalia (excludes testes)

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9
Q

Describe what happens to Scarpa’s fascia in the lower limb?

A

Extends below IL and fixes to fascia lata at flexure skin crease of hip where attachment of skin to fascia lata prevents further descent. The saphenous opening is below this line - hence femoral hernia cannot fill space beneath Scarpa’s fascia.

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10
Q

Fascia lata encloses thigh like a stocking. Describe the IT tract

A

Iliotibial tract is thickening of fascia lata - passes vertically down to be inserted in anterior surface of lateral condyle of tibia. Helps stabiles hyperextended knee. Also attached to lateral IM septum.

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11
Q

Describe tensor fascia lata and the role it plays

A

Arises from external lip of iliac crest and ASIS. Passes down and inserts into IT tract. Innervated by superior gluteal nerve, pulls up on IT tract and aids in knee extension and stabilisation - especially hyperextended knee.

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12
Q

What are the boundaries of the femoral triangle?

A

Lat: Medial border sartorius
Med: Medial border adductor longus
Sup: Inguinal ligament
Floor: iliacus, psoas, pectineus, glimpse of adductor brevis

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13
Q

What is the contents of femoral triangle?

A

Femoral nerve, artery and vein
(Femoral sheath)
Deep inguinal nodes

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14
Q

What is the origin, attachment, innervation and action of sartorius?

A

O: Immediately below ASIS
I: Upper med surface of shaft of tibia
A: Flexes, abducts and laterally rotates the thigh at hip. Weak mover.
N: Anterior division of femoral nerve

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15
Q

What is the origin, attachment, innervation and action of Iliacus?

A

O: Iliac fossa (in pelvis)
I: Lowermost surface of LT
A: Flexes hip
N: Femoral nerve in abdomen

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16
Q

What is the origin, attachment, innervation and action of Psoas Major?

A

O: Transverse process of L1-5 and bodies of T12-L5 and intervertebral discs below body of T12-L4.
I: Middle surface of LT
A: Flexes hip
N: First 3 lumbar nerves (mainly L2)

17
Q

What is the origin, attachment, innervation and action of Pectineus?

A

O: Pectineal line of pubis and narrow area of sup pubic ramus below it
I: Vertical line between spiral groove and gluteal crest below LT.
A: Flexes and adducts hip
N: Anterior division of femoral nerve (L2,3)

18
Q

What is the femoral sheath?

A

Funnel shaped prolongation of the extra-peritoneal fascia derived from transversalis fascia in front and psoas fascia behind. This prolongation of fascia fuses with vessels adventita about 2.5cm below inguinal ligament. Contains artery and vein, femoral nerve is not part of sheath as it arises behind abdomen thus does not need to pierce fascia.

19
Q

What is the purpose of the femoral sheath?

A

Gives freedom for femoral vessels to glide in and out beneath IL during movement of hip

20
Q

What is the femoral space/canal?

A

Medial side of femoral vein within femoral sheath

  • this space allows for dilation of vein
  • holds lymph vessels
21
Q

What are the boundaries of the femoral ring?

A

Anterior: medial part of IL
Medial: Crescentic edge of lacunar ligament
Posterior: Pectineal ligament
Lateral: Femoral vein

22
Q

Where does the femoral artery enter the anterior thigh?

A

Midway between ASIS and pubic symphysis, just medial to deep inguinal ring

23
Q

Describe the course of the femoral artery

A

Enters under IL. Emerges from femoral sheath, enters adductor canal. Has 4 small branches below IL and just after termination of sheath gives off profunda femoris.

24
Q

What are the branches of profunda femoris?

A

Lateral circumflex femoral artery: different card
Medial circumflex artery: different card
Perforating arteries: pass backwards and upwards to supply adductors and hamstrings

25
Q

Describe course of lateral circumflex femoral artery and branches

A

Arises from PFA. Passes laterally between branches of femoral nerve.
Ascending branch - runs up vastus lateralis to ASIS
Transverse branch - across VL to form cruciate anastomosis
Descending branch - slopes steadily down supply lower end of femur

26
Q

Describe course of medial circumflex femoral artery

A

Medial side of PFA. Passes backwards. Divides on quadratus femoris
Ascending branch: to trochanteric anastomosis
Horizontal branch: to cruciate anastomosis

27
Q

Describe the femoral nerve

A

Formed from posterior divisions of anterior rami L2,3,4.

Divides shortly after entering thigh under IL into superficial and deep group. Supplies extensor compartment of thigh.

28
Q

What are the superficial divisions of the femoral nerve?

A

Cutaneous:
- intermediate cutaneous and medial femoral cutaneous
Muscular:
Sartorius and pectineus

29
Q

What are the deep divisions of the femoral nerve?

A 
Cutaneous:
Saphenous
Muscular:
Nerve to recuts femoris
Nerve to VM (largest branch with most proprioceptive fibres to knee joint)
Others to VL and VI
30
Q

What is the origin, attachment, innervation and action of Rectus Femoris?

A 
O: Straight head - ASIS
Reflected head - ilium above acetabulum
I: Quadriceps tendon
N: Deep branch femoral nerve
A: Extends leg at knee and flexes hip
31
Q

What is the origin, attachment, innervation and action of Vastus Lateralis

A

O: Upper interchanteric line, base of trochanter, lateral linea aspera and upper supracondylar line of femur.
I: Lat quadriceps tendon
N: Deep branch of femoral nerve
A: Extends knee

32
Q

What is the origin, attachment, innervation and action of Vastus intermedius?

A

O: GT and anterolateral surface of upper 2/3 femur
I: Quadriceps tendon
N: Deep branch of femoral nerve
A: Extends knee

33
Q

What is the origin, attachment, innervation and action of Vastus Medialis?

A

O: Spiral line and medial lip of linea aspera
I: Quadriceps tendon, and lowest fibres directly into medial border of patella tendon
N: Deep branch of femoral nerve
A: Extends knee, low fibres attach to medial patella help provide stability and prevent lateral dislocation

34
Q

What provides patella stability?

A

Bone: Forward prominence of lateral condyle
Ligaments: Medial patella retinaculum (connect sides patella to lower margins of condyles of tibia)
Muscle - Insertion of VM to medial border

35
Q

Quadriceps tendon is trilaminar. What is the order of layers?

A

Rectus femoris - superficial
Vastus lateralis next
Vastus intermedius deep.
VM inserts into the VI and most distal RF before inserted into medial patella

36
Q

What is the adductor canal?

A

Gutter shaped groove between vastus medialis and the front of adductor muscles roofed by fascia

37
Q

What lies in adductor canal?

A

Femoral artery, femoral vein and saphenous nerve

38
Q

How do the vessels leave the adductor canal?

A

Femoral vessels leave the adductor canal by passing into the popliteal fossa

Anatomy: Lower Limb (14 decks)

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