Quiz 2- Lec 13-14 Flashcards
primary function of ANTERIOR DIVISION/PART of Femoral nerve?
primarily CUTANEOUS
primary function of POSTERIOR DIVISION/PART of Femoral nerve?
primarily muscular
branches of ANTERIOR division/part of Femoral nerve?
- intermediate femoral cutaneous = to skin of anterior thigh
- medial femoral cutaneous = to skin of anterior thigh
- muscular branch to Sartorious (often arises w/ internal femoral cutaneous nerve)
branches of POSTERIOR division/part of Femoral nerve?
incl. muscular branches to anterior thigh muscles:
- Rectus femoris
- vastus medialis
- vastus lateralis
- vastus intermedius & articularis genus
& cutaneous branches to leg/foot & infrapatellar branch (saphenous nerve)
articular branches to hip and knee joints (just below the patella)
cutaneous branches of FEMORAL NERVE and LATERAL CUTANEOUS nerve of thigh
- lateral cutaneous nerve of the thigh
- intermediate femoral cutaneous nerves
- medial femoral cutaneous nerves
- infrapatellar branch of saphenous nerve
- saphenous nerve
muscular branches of FEMORAL nerve
- articular branch to hip joint
- articular branches to the knee and hip joint arise from the branches to the quadriceps femoris group
obturator nerve is from
(ANTERIOR/POSTERIOR) division fibers
anterior/ventral division fibers
where does the OBTURATOR NERVE divide into the Anterior and Posterior parts?
w/in the obturator canal
name the components of the anterior division/part of OBTURATOR nerve:
- articular branch to hip joint
- cutaneous branch to skin on lower, medial side of thigh
- muscular branches to:
- adductor brevis (*usually)
- adductor longus
- gracillis
- pectinius (occasionally)
name the components of the posterior division/part of OBTURATOR nerve:
- articular branch to knee joint
- muscular branches to:
- adductor brevis (occasionally)
- adductor magnus
- obturator externus (or branch from obturator nerve trunk)
where is the obturator nerve found?
(compartment)
medial side/compartment
name the following structures (1-6)
- saphenous hiatus (opening)
- fasica lata
- lateral accessory saphenous vein
- femoral vein
- accessory saphenous vein
- great saphenous vein
name the following structures:
- PROXIMAL superficial inguinal nodes
- DISTAL superficial inguinal nodes
- saphenous hiatus
- great saphenous vein
mnemonic for contents of FEMORAL SHEATH
NAVEL
(femoral) Nerve, Artery, Vein, canal Empty space, Lacunar ligament
what are the 4 osteofascial compartments of the thigh?
- gluteal region
- anterior compartment
- medial compartment
- posterior compartment
what layers form the osteofascial compartments of the thigh?
- fasica lata
-
intermuscular septa
- lateral intermuscular septa
- medial intermuscular septa
- posterior intermuscular septa (disputed)
fascia lata: define
deep fascia of the thigh
intermuscular septa: define
sheets of connective tissue that extend from the femur to the fascia lata
what are the 3 septa of the thigh?
- medial intermuscular septum
- lateral intermuscular septum
- posterior intermuscular septum
medial intermuscular septum:
stretches from…
from: FASCIA LATA
to:
- spiral line
- medial lip of linea aspera
- medial supracondylar ridge
- adductor tubercle
lateral intermuscular septum:
stretches from…
- from: IT tract
- to:
- gluteal tuberosity
- lateral lip of linea aspera
- lateral supracondylar ridge
posterior intermuscular septum:
stretches from…
- from: probably epimysium (fibrous tissue surrounding a muscle) of adductor magnus separating it from hamstrings
- SEPARATES MEDIAL FROM LATERAL COMPARTMENT
in which comparment is the following found?
femoral nerve
anterior compartment
(dorsal division of ventral rami)
in which comparment is the following found?
obturator nerve
medial compartment
in which comparment is the following found?
tibial nerve
posterior compartment
anterior compartment: contents
- VL: vastus lateralis
- VI: vastus intermedius
- VM: vastus medialis
- RF: rectus femoris
- Femur
- Adductor canal
- saphenous nerve
- femoral artery
- femoral vein
- Sartorius
adductor canal: contents
- saphenous nerve
- femoral artery
- femoral vein
posterior compartment: contents
- BF: biceps femoris muscle (short head & long head)
- ST: semitendinous muscle
- SM: semimembranosus muscle
medial compartment: contents
- Longus (adductor)
- Gracilis
- Magnus (adductor)
- Obturator nerve
- Brevis (adductor)
lateral intermuscular septum: function
separates anterior from posterior
medial intermuscular septum: funciton
separates anterior from medial compartments
posterior intermuscular septum: function
separates posterior and medial compartments
anterior compartment: generalizations
- femoral nerve
- quads (knee extensors) and rectus femoris assists in hip flexion
- femoral and deep femoral arteries and veins
medial compartment: generalizations
- obturator nerve
- adductors which are adductors (flexors) of hip
- deep femoral & obturator arteries and nerves
posterior compartment: generalization
- tibial part of sciatic nerve
- hamstrings which are knee flexors (some hip extension)
- perforating branches of deep femoral artery and vein
overview: anterior compartment muscles (5)
- Vastus lateralis
- Vastus intermedius
- Vastus medialis
- Rectus femoris
- Sartorius
what various muscles make the “Quads”, or quadriceps femoris?
- rectus femoris
- vastus lateralis
- v. intermedius
- v. medialis
is Sartorius considered a quadricep muscle?
no. It crosses obliquely across the anterior compartment of the thigh
sartorius: origin and insertion
crosses hip and knee; sartor = “tailor”
- o: ASIS & from interspinous fossa
- i: pes anserinus (“goose’s foot - anterior to gracilis and semitendinosus)
sartorius: action
- hip flexion
- lateral rotation
- ABduction
- knee flexion
- medial rotation of leg w/ knee flexed
sartorius: innervation
femoral nerve (anterior division)
rectus femoris: origin and insertion
rectus = “straight”; crosses at hip and knee
- o: straight head from AIIS (anterior inferior iliac spine)
- reflected head from supra-acetabular sulcus
- i: aponeurotic insertion into base of patella (flat tendon)
rectus femoris: action
knee extension & hip flexion (can do simultaneously)
quadriceps femoris muslces: innervation
all quadriceps femoris muslces are innervated by FEMORAL NERVE (posterior division)
quadriceps femoris versus sartorious innervation
quadriceps femoris: femoral nerve (posterior division/part)
sartorius: femoral nerve (anterior divison/part)
vastus lateralis: origin and insertion
vastus = huge; crosses knee
- o: upper part of trochanteric line; anterior/inferior borders of greater trochanter; lateral edge of gluteal tuberosity; proximal part of lateral lip of linea aspera
- i: base & lateral border of patella; patellar ligament and lateral patellar retinaculum
vastus lateralis: action
knee extension
vastus medialis: origin and insertion
crosses knee
- o: lower part of intertrochanteric line, spiral line, upper part of medial supracondylar ridge, medial lip of linea aspera (medial intermuscular septum & from tendons of adductor longus and magnuns)
- ins: medial border of patella (& base; patellar ligament & medial patellar retinaculum)
vastus medialis: action
knee extension & resists/prevents lateral patellar tracking (VMO)
vastus intermedius: origin and insertion
crosses knee
- o: proximal 2/3 of anterior and lateral surfaces of femur; distal 1/2 of lateral lip of linea aspera; distal 1/2 of lateral intermuscular septum
- ins: base of patella via aponeurosis (joins VM and VL)
vastus intermedius: action
knee extension
patellar ligament (ligamentum patellae):
formation & location
- formed by tendons of quadricept femoris muscle group
- extends from patella to the distal 1/2 of tibial tuberosity
articularis genu: origin and insertion
- o: femur (distal anterior surface)
- ins: suprapatellar bursa (upper part)
articularis genu: action
stabilizes bursa
articularis genu: innervation
twig from femoral nerve branch to vastus intermedius
Review muscle origins and insertions
- sartorius
- rectus femoris
- v. lateralis
- v. intermedius
- articularis genu
- v. medialis
- v lateralis
- v intermedius
femoral triangle: boundaries
- base: inguinal ligament
- floor: pectineus & iliopsoas muscles
- lateral border: sartorius
- medial border: adductor longus
- roof: fascial lata, subcutaneous tissue, and skin
femoral triangle: contents
Fem NAV, contained in femoral sheath
- femoral Nerve
- femoral Artery
- femoral Vein
- great saphenous vein –> drains into femoral vein
femoral triangle: clinical relevance
- femoral artery pulse (palpate ASIS and pubic tuberle; femoral triangle is between there)
- IV line
- catheterization
- femoral hernias
remember: NAVEL mnemonic?
what is it, and where is it?
contents of femoral sheath!
- femoral Nerve
- femoral Artery
- femoral Vein
- Empty space
- Lacunar ligament
adductor canal: other names?
Hunter’s canal
Subsartorial canal
adductor canal: borders
- roof - sartorius
- anterolateral - vastus medialis
- posterior - adductor longus, and adductor magnus
adductor canal: contents
- femoral artery & vein
- saphenous nerve
- nerve to vastus medial
CC: trauma to adductor canal
could damage 2 major structures!
(femoral artery/vein and saphenous nerve)
where is femoral artery located w/in adductor canal?
located anterior to vein at proximal end of adductor canal
where does adductor canal end inferiorly?
inferiorly at the adductor hiatus
what does the femoral artery/vein become named after it passes through the adductor hiatus?
popliteal vessels
(artery and vein)
iliotibial tract (band): what is it? where located?
Thickening of the fascia lata along the lateral side of the thigh
iliotibial tract (band): attachments
- proximal: iliac crest
- distal: lateral tibial condyle, femur, head of fibula & the aponeurosis of vastus lateralis
- lateral: along much of length, attached to lateral intermuscular septum
which muscles insert into the iliotibial tract (band)?
- gluteus maximus
- tensor fasciae latae, and it’s superficial fibers act as aponeurosis (long flat tendons of insertion)
iliotibial tract (band): action
contributes to stability of both hip and knee (thru deep fibers)
where does the fasciate lata become thicker?
around the ILIOTIBIAL TRACT is where the fascia lata thickens
Gerdy’s tubercle:
other name, clinical significance
- eponymous name for the lateral condyle of the proximal tibia (where it is located anterolaterally)
- site of insertion for: iliotibial band and anterior tibialis muscle
oblique line of the tibia
aka “soleal line”
prominent ridge on posterior upper surface of tibia; extends obliquely downward from back part of the articular facet for the fibula to the medial border, at junction of it’s upper and middle 1/3s
- *lower limit of insertion of popliteus muscle, &
- site of origin for soleus, flexor digitorum longus, & tibialis posterior muscles
CC: iliotibial band syndrome (ITBS)
- one of the leading causes of lateral knee pain in runners
- inflammation of IT band as it crosses the lateral femoral epicondyle
- caused by repetitve flexion/extension of knee
- *more common in females than males
- common in runners/cyclists
in what position is the IT band posterior to femoral condyle?
at 30º of flexion
