Quiz 5: Lecture 15-17 Flashcards
What are the 3 compartments of the thigh?
Anterior, Medial, Posterior
What do the muscles of the anterior compartment do?
Hip flexion, knee extension
What do the muscles of the medial compartment do?
Hip adduction
What do the muscles of the posterior compartment do?
Hip extension, knee flexion
What is the intermuscular septum?
The walls of fascia that divide the compartments of the thigh
Which nerve innervates the anterior compartment?
Femoral nerve (with the exception of psoas major which is innervated by L1,L2,L3)
Which artery supplies the anterior compartment?
Femoral artery (with the exception of iliopsoas which is supplied by the medial femoral circumflex artery and iliolumbar artery)
Where does the iliopsoas originate and insert? Action? Innervation? Blood Supply?
Origin: Iliac fossa and transverse processes of lumbar spine
Insertion: Lesser trochanter
Action: Hip flexion
Innervation: Femoral nerve (iliacus), Anterior rami L1-L3 (psoas)
Blood Supply: Medial femoral circumflex artery (iliacus), Iliolumbar artery (psoas)
Where does the sartorius originate and insert? Action? Innervation? Blood Supply?
Origin: ASIS
Insertion: Pes Anserinus
Action: Hip flexion, abduction, external rotation, knee flexion
Innervation: Femoral nerve
Blood Supply: Femoral artery
Where does the rectus femoris originate and insert? Action? Innervation? Blood Supply?
Origin: AIIS
Insertion: Tibial tuberosity
Action: Knee extension
Innervation: Femoral artery
Blood Supply: Femoral nerve
Where does the vastus lateralis originate and insert? Action? Innervation? Blood Supply?
Origin: Intertrochanteric line, lateral lip of linea aspera
Insertion: Tibial tuberosity
Action: Knee extension
Innervation: Femoral nerve
Blood Supply: Femoral artery
Where does the vastus medialis originate and insert? Action? Innervation? Blood Supply?
Origin: Intertrochanteric line, Medial lip of linea aspera
Insertion: Tibial tuberosity
Action: Knee extension
Innervation: Femoral nerve
Blood Supply: Femoral artery
Where does the vastus intermedius originate and insert? Action? Innervation? Blood Supply?
Origin: Anterior/lateral surface of the femur
Insertion: Tibial tuberosity
Action: Knee extension
Innervation: Femoral nerve
Blood Supply: Femoral artery
What is sometimes referred to as the “goose’s foot”?
Pes Anserinus (located on anterior/medial tibia)
Which muscles attach to the pes anserinus?
Gracilis, semitendinosus, sartorius
T or F? Most hip adductors can also do hip flexion
True
Where does the pectineus originate and insert? Action? Innervation? Blood supply?
Origin: Pectineal line of superior pubic ramus (superior to obturator foramen)
Insertion: Pectineal line of femur (inferior to lesser trochanter)
Action: Adduction and Flexion
Innervation: Femoral nerve
Blood Supply: Obturator artery
Where does the adductor longus originate and insert? Action? Innervation? Blood Supply?
Origin: Superior pubic ramus
Insertion: Inferior linea aspera of femur
Action: Adduction and flexion
Innervation: Obturator nerve
Blood supply: Deep femoral artery
Where does the adductor brevis originate and insert? Action? Innervation? Blood Supply?
Origin: Inferior pubic ramus
Insertion: Superior linea aspera of femur
Action: Adduction and flexion
Innervation: Obturator nerve
Blood supply: Deep femoral artery
Where does the gracilis originate and insert? Action? Innervation? Blood Supply?
Origin: Pubic symphysis
Insertion: Pes anserinus
Action: Hip adduction and knee flexion
Innervation: Obturator nerve
Blood Supply: Obturator artery
Where do the two parts of the adductor magnus originate and insert? Action? Innervation? Blood supply?
Origin:
- Inferior pubic ramus (adductor portion)
- Ischial tuberosity (hamstring portion)
Insertion:
- Linea aspera (adductor portion)
- Adductor tubercle (hamstring portion)
Action:
- Adduction and Flexion (adductor portion)
- Adduction and Extension (hamstring portion)
Innervation:
- Obturator nerve (adductor portion)
- Sciatic nerve (hamstring portion)
Blood Supply:
- Deep femoral artery (both adductor and hamstring)
Which structures create the boundaries of the femoral triangle?
Sartorius, adductor longus, inguinal ligament
From lateral to medial, the femoral triangle consists of…
Femoral nerve, femoral artery, femoral vein, lymph nodes
What is the adductor canal?
a canal located between the sartorius, vastus medialis, and adductor longus (runs from apex of femoral triangle to adductor hiatus carrying the femoral vein/artery, and saphenous nerve)
How many branches of the femoral nerve?
4
What is the largest branch of the femoral nerve?
saphenous nerve
Sensation of the anterior thigh is provided by the…
anterior femoral cutaneous nerve
The saphenous nerve provides sensory innervation to the…
medial knee, leg, and foot
What is the popliteal fossa?
The fat-filled space behind the knee
What is the nerve innervation of the posterior compartment?
Sciatic nerve (except for short head which is innervated by the common fibular nerve)
Which arteries supply the posterior compartment?
Deep femoral artery, inferior gluteal artery
What are the 3 joints of the knee?
- 2 tibiofemoral joints
- 1 patellofemoral
What is a trochlea?
Pulley
What is the tibial plateau?
The view looking down on the tibia
In regards to the articular cartilage of the distal femur, which side is more likely to experience a chondral lesion? Medial or Lateral
Medial
Which facet of the femur is larger and steeper? Lateral or medial
Lateral
What type of bone is the patella?
Sesamoid
What are the facet joints of the patella from lateral to medial?
Lateral, medial, odd (Only comes into contact with femur during full flexion)
T or F? The lateral facet is bigger than the medial facet
True
During knee flexion, the patella slides which way?
Downwards on the femur
During knee extension, the patella slides which way?
Upwards on the femur
Where do the cruciate ligaments attach?
Intercondylar fossa
T or F? The cruciate ligaments sit within a capsule
True
T or F? The cruciate ligaments sit in synovial fluid in the capsule
False, although the cruciate ligaments sit within the capsule, they sit outside the synovial fluid
What is the purpose of the cruciate ligaments?
They resist extreme movement
Where does the Anterior Cruciate Ligament (ACL) attach?
Proximal: Posterior inner surface of the lateral femoral condyle
Distal: Anterior medial intercondylar area of the tibia
What is the function of the ACL when weight bearing?
Prevents posterior movement of femur on tibia
What is the function of the ACL when non-weight bearing?
Prevents anterior movement of tibia on femur
T or F? ACL ruptures are 5x more common than PCL ruptures
False, ACL ruptures are 10x more common than PCL ruptures
Where does the Posterior Cruciate Ligament attach to
Proximal: Anterior inner surface of the medial femoral condyle
Distal: Posterior lateral intercondylar area of the tibia
What is the function of the PCL?
Prevents anterior displacement of the femur on the tibia and posterior displacement of the tibia on the femur
also prevents knee hyperflexion
Where does the Medial Collateral Ligament (MCL) attach? What does it do?
Proximal: Medial epicondyle of the femur
Distal: Superior medial tibia (on shaft, not condyle)
- Deep fibers attach to meniscus
- Tight in extension
- Resists valgus
- Extra-capsular (outside of capsule)
Where does the Lateral Collateral Ligament (LCL) attach? What does it do?
Proximal: Lateral epicondyle of femur
Distal: Head of fibula
- Tight in extension
- Resists varus
- Extra-capsular (outside of capsule)
Which collateral ligament is thicker and stronger? MCL or LCL?
MCL
What are menisci (pleural for meniscus)? Function?
Fibrocartilage discs on the tibial plateau (1 medial, 1 lateral)
Thicker on outer portion where it attaches to the capsule
Function: Cushions and improves joint congruency
What are some characteristics of the lateral meniscus?
- Smaller
- Almost a complete circle
- NOT attached to LCL
What are some characteristics of the medial meniscus?
- Larger
- Elongated C-shape
- Attached to MCL
- Minimal motion (immobile)
What is a bursa?
A sac of synovial fluid that lies between bony and soft tissue to reduce friction and irritation
T or F? The are 12 bursa associated with the knee
False, there are 20+
What are the contents of the popliteal fossa?
- Popliteal artery and vein
- Tibial and Fibular (peroneal) nerve
- popliteal lymph nodes
What are the four most important bursa of the knee?
- Pre-patellar
- Infrapatellar
- Suprapatellar
- Pes anserine
What are the boundaries of the popliteal fossa?
Semimembranosus, biceps femoris, medial/lateral heads of gastrocnemius
What is chondromalacia?
Runner’s knee
(Softening and swelling of the articular cartilage)
Direction of patellar tracking is dictated by what?
Line 1: center of patella to ASIS
Line 2: center of patella to tibial tuberosity
This ultimately results in the patella going superior lateral when it tracks
What is excessive genu valgum (knock knee)?
When the knee is at an angle of less than or equal to 165 degrees (measured from lateral side)
What is genu varum (bow-leg)?
When the knee is at an angle of greater than 180 degrees (measured from lateral side)
What is patella alta?
When the patella rides too high (causes a loose patella tendon, tight quadriceps)
What is patella baja
When the patella rides too low (causes weak quadriceps)
What is the strongest quad muscle?
Vastus lateralis
Where do the semimembranosus, semitendinosus, and biceps femoris long head and short head originate and insert?
Semimembranosus
- Origin: Ischial tuberosity
- Insertion: Posterior medial tibial condyle
Semitendinosus
- Origin: Ischial tuberosity
- Insertion: Pes anserinus
Biceps femoris long head:
- Origin: Ischial tuberosity
- Insertion: Fibular head
Biceps femoris short head
- Origin: Linea aspera
- Insertion: Fibular head
Which nerve innervates the hamstrings?
Tibial portion (L5-S2) of sciatic nerve
(except biceps femoris short head… innervated by common peroneal nerve)
Which artery supplies the hamstrings?
Inferior gluteal artery
What is the groove between the femoral condyles called?
trochlea or intercondylar groove
What is a normal angle of knee valgus?
15 degrees
What is an anatomical risk for potential ACL injury?
Narrow intercondylar fossa
