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MSK > S4L1 - Anatomy of the knee, anterior and medial thigh and femoral triangle > Flashcards

S4L1 - Anatomy of the knee, anterior and medial thigh and femoral triangle Flashcards

1
Q

What form of joint is the knee joint?

A

Hinge-type synovial joint. Allows for flexion and extension with a small degree of medial and lateral rotation.

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2
Q

What 2 articulations form the knee joint

A
  1. Tibiofemoral - medial and lateral condyles of the femur articulate with the medial and lateral tibial condyles. The weight bearing joint of the knee.
  2. Patellofemoral - the patella articulates with the femur at the trochlear groove.

Both joint surfaces are lined with hyaline cartilage and enclosed within a single joint cavity.

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3
Q

How is the efficiency of the quadriceps femoris increased?

A

The patella allows the tendon of the quadriceps femoris to be inserted directly over the knee, increasing the efficiency of the muscle by using the patella as a fulcrum to increase the power of knee extension.

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4
Q

Describe the blood supply to the knee joint.

A

Blood supply is by the genicular branches of the femoral and popliteal arteries.

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5
Q

What is the clinical relevance of the popliteal and genicular arteries?

A

The popliteal artery is gradually occluded by atheroma, the genicular anastomoses can dilate to maintain the blood supply to the leg.

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6
Q

What nerves supply the knee joint?

A

Nerve supply is by the nerves that supply the muscles which cross the joint. These are femoral, tibial and common peroneal nerves.

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7
Q

How is the stability of the knee joint improved?

A
  1. The tibial Articular surface is deepened by the menisci

2. Joint is supported by the joint capsule, ligaments and surrounding musculature.

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8
Q

What are the menisci?

A

The medial and lateral menisci are fibrocartilaginous structures in the knee. The lateral meniscus is smaller than the medial meniscus. They are crescentric (c shaped), thicker peripherally than centrally and attach at both ends to the intercondylar area of the tibia.

Medial is attached to joint capsule, intercondylar area of tibia and medial collateral ligament so immobile.

Lateral meniscus in not attached to the lateral collateral ligament so is more mobile.

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9
Q

What is the function of the menisci?

A
  1. To deepen the articular surface of the tibia, increasing the stability of the joint.
  2. To act as shock absorbers by increasing surface area to further dissipate forces.
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10
Q

What is the medial menisci connected to?

A

It is connected to the intercondylar area of the tibia medially.
Peripherally to the medial tibial collateral ligament and joint capsule.

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11
Q

How are the two menisci connected?

A

By the transverse ligament of the knee

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12
Q

How is the posterior horn of the lateral meniscus stabilised?

A

The posterior meniscofemoral ligament helps stabilise the posterior horn of the lateral meniscus by attaching it to the medial femoral condyle.

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13
Q

How are the menisci stabilised?

A

They are loosely attached to the joint capsule and to the tibia by coronary ligaments.

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14
Q

Why does healing of the menisci impair with age?

A

As blood supply to the menisci is from the periphery, blood flow decreased with age, and the central meniscus is avascular by adulthood, leading to impaired healing after trauma.

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15
Q

What are the main intracapsular ligaments of the knee joint?

A

The cruciate ligaments which connect the femur and the tibia and cross each other. There are two cruciate ligaments; the anterior cruciate ligament and the posterior cruciate ligament.

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16
Q

Describe the location of the anterior cruciate ligament

A

Attaches proximally to the posterolateral aspect of the femoral intercondylar fossa (medial surface of the lateral condyle) and passes distally and anteromedially to attach to the anterior aspect of the intercondylar eminence of the tibia, where it is also adherent to the medial meniscus. It resists anterior translation and medial rotation of the tibia in relation to the femur.

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17
Q

Describe the location of the posterior cruciate ligament

A

Attaches proximally to the medial border and roof of the intercondylar fossa. It passes distally and posterolaterally to attach to the posterior intercondylararea of the tibia.

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18
Q

What is the purpose of the posterior cruciate ligament?

A

The posterior crucitate ligament is the main stabiliser of the weight-bearing flexed knee and prevents the femur from sliding off the anterior edge of the tibia. Also prevents posterior dislocation of the tibia on the femur.

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19
Q

What does the mnemonic PAMs APpLes stand for?

A

Posterior passes Anterior inserts Medially

Anterior passes Posterior insert Laterally.

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20
Q

What is the suprapatellar bursa?

A

The suprepatellar bursa is located at the anterior of the knee joint where there is a deficiency in the knee capsule. Here the synovial membrane extends up beneath the patella.

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21
Q

What strengthens the joint capsule?

A

Laterally = inferior fibres of the vastus lateralis

Medially = inferior fibres of vastus medialis.

Posteriorly = oblique popliteal ligament

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22
Q

What are the medial and lateral collateral ligaments?

A

Strap like ligaments that act to stabilise the hinge motion of the knee, preventing excessive medial or lateral angulation of the tibia on the femur.

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23
Q

Describe the location of the medial tibial collateral ligament

A

A wide flat ligament found on the medial side of the joint. Proximally it attaches to the medial epicondyle of the femur, distally it attaches to the medial condyle of the tibia. It is also adherent to the medial meniscus.

The medial tibial collateral ligament resists valgus (lateral) angulation of the tibia on the femur.

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24
Q

What does valgus mean?

A

Knock knee. Lateral angulation on the tibia to the femur. The medial collateral ligament prevents this.
VaLgus = Lateral

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25
Q

Describe the structure and location of the lateral fibular collateral ligament

A

Thinner and rounder than the MCL.
It attaches proximally to the lateral epicondyle of the femur, distally it attaches to a depression on the lateral surface of the fibular head.
It is reinforced by the iliotibial tract.

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26
Q

What is the function of the lateral collateral ligament?

A

Resists Varus (medial) angulation of the tibia on the femur. Stops bow legs.

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27
Q

What does varus mean?

A

Bow legged - tibia is angled medially (inwards). Medial displacement of the leg .

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28
Q

What damage occurs from excessive lateral displacement of the tibia?

A

May cause the medial collateral ligament to tear, which in turn often results in tearing of the medial meniscus.

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29
Q

What is a bursa?

A

A small sac lined by synovial membrane containing a thin layer of synovial fluid. Found in association with most major joints of the body.

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30
Q

What is the function of a bursa?

A

Provides a cushion between the bones and tendons/muscles surrounding a joint, helps reduce friction between bones and soft tissues.

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31
Q

How many bursae are found in the knee joint?

What are they called?

A

Six
1. Suprapatellar bursa - extension of the synovial cavity of the knee, located between the quadriceps femoris muscle and the femur

  1. Prepatellar bursa - between the anterior surface of the patella and the skin
  2. Subcutaneous infrapatellar bursa - between the patellar ligament and the skin (beneath the prepatellar bursa)
  3. Deep infrapatellar bursa - between the tibia and the patellar ligament ( behind the subcutaneous infrapatellar bursa)
  4. Semimembranosus bursa - posterior to the knee joint, between the semimembranosus muscle and the medial head of the gastrocnemius
  5. Subsartorial (pes anserinus) bursa - between the common insertion of the pes anserinus tendons and the medial tibial condyle.
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32
Q

What are the 4 main movements of the knee joint?

A

Extension
Flexion
Lateral rotation (only possible in flexed knee)
Medial rotation ( only possible with a flexed knee)

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33
Q

What muscles are used in extension?

A

Quadriceps femoris (recurs femoris, vastus medialis, vastus intermedius and vastus lateralis) which inserts into the tibial tuberosity via the patellar ligament

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34
Q

What muscles are used in flexion of the knee?

A

Hamstrings ( biceps femoris, semimembranosus, semitendinosus) and assisted by other muscles (see textbook)

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35
Q

What muscles are involved in lateral rotation of the leg?

A

Biceps femoris

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36
Q

What muscles are involved in medial rotation of the leg?

A

Semimembranosus, semitendinosus, gracilia, sartorius and popliteus.

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37
Q

How does the knee lock when fully extended?

A

Slight medial rotation of the femoral condyles on the tibial plateau, cruciate ligaments tighten. Lower limb becomes a solid column adapted for weight bearing.

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38
Q

How does the knee unlock from full extension?

A

Popliteus contracts, rotating the femur laterally on the tibial plateau so that flexion of the knee can occur.

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39
Q

What are the inferior fibres of the vastus medialis?

A

Part of the quadriceps femoris, also known as the vastus medialis obliquus. These fibres contract to resist lateral displacement of the patella out of the trochlear groove.

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40
Q

What helps resist lateral displacement of the patella

A

The deep trochlear groove, which has a more prominent lateral femoral condyle anteriorly.

The fibres of the vastus medialis obliquus, contraction of these fibres resists lateral displacement of the patella.

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41
Q

Why does the femur have medial angulation?

A

To bring the knees closer to the bodies centre of gravity, increasing the stability of the body.

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42
Q

What landmarks are present on the posterior of the femur?

A

The linea aspera is a roughened ridge of bone running down the centre of the femur (origin of the short head of biceps femoris)
Proximally, the medial border of the linea aspera becomes the pectineal line. The lateral border becomes the gluteal tuberosity ( insertion of gluteus maximus).
Distally, the linea aspera widens to form the floor of the popliteal fossa and the medial and lateral borders form the medial and lateral supracondylar lines.

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43
Q

Why is the medial condyle larger than the lateral?

A

The medial condyle bears more weight than the lateral condyle because the bodies centre of gravity passes medial to the knee joint.

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44
Q

What is the trochlear groove?

A

Also known as the patellofemoral groove, the trochlear groove is on the anterior surface of the distal femur between the condyles. It articulates with the patella to form the patellofemoral joint.

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45
Q

Which condyle is more prominent anteriorly and why?

A

The lateral condyle is more prominent anteriorly to prevent lateral displacement of the patella during patellar tracking.

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46
Q

What are the medial and lateral epicondyles?

A

Bony elevations above the non-Articular areas of the condyles.

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47
Q

What is the intercondylar fossa?

A

A depression found on the Posterior surface of the distal femur, between the two condyles. It cruciate ligaments attaches to the intercondylar fossa.

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48
Q

What attaches to the patella?

A

The quadriceps tendon attaches to the superior aspect of the patella. The patellar ligament attaches to the inferior aspect of the patella.

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49
Q

What are the attachment points of the patellar ligament?

A

Attaches to the inferior aspect of the patella sesamoid bone. Connects the apex of the patella to the tibial tuberosity.

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50
Q

What markings are on the posterior of the patella bone?

A

Two facets.
The medial facet - articulates with the medial condyle of the femur
The lateral facet - articulates with the lateral condyle of the femur

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51
Q

What are the main functions of the patella?

A

Acts as a fulcrum to the quadriceps muscle, enhancing the leverage of the quadriceps tendon can exert on the femur, increasing the mechanical efficiency of the muscle.

Protection of the anterior aspect of the knee joint from physical trauma

Reduces the frictional forces between the quadriceps and the femoral condyles during extension of the leg.

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52
Q

Describe the structure of the proximal tibia?

A

Widened proximally by the medial and lateral condyles, aiding in weight bearing.
Condyles form a flat surface, known as the tibial plateau. This tibial plateau articulates with the femoral condyles to form the knee joint .
The head of the fibula articulates with the proximal tibia to form the proximal tibiofibular joint (not part of the knee joint)

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53
Q

What marks the posterior border of the tibia?

A

A ridge called the soleal line. This is the site of origin of the soleus muscle. The soleal line extends inferomedially to blend with the medial edge of the tibia.

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54
Q

What attaches to the later border of the tibia?

A

Also known as the interosseous border of the tibia, here the interosseous membrane attaches, binding the tibia and fibula together

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55
Q

Describe the distal structure of the tibia

A

The tibia widens at the distal end.
The medial malleolus is a bony projection continuing distally on the medial side of the tibia. It articulates with the tarsal bones.
Laterally there is the fibular notch, where the fibular in bound to the tibia to form the inferior tibiofibular joint.

56
Q

What is the main function of the fibula?

A
  • act as an attachment site for muscles

- assist the tibia in weight bearing

57
Q

What three articulations does the fibula have?

A
  1. Proximal tibiofibular joint
  2. Distal tibiofibular joint
  3. Ankle joint
58
Q

What is vulnerable to damage in a proximal fibular fracture?

A

The common peroneal (common fibular) nerve. It winds around the posterior and lateral surface of the neck of the fibula.

59
Q

What are the surfaces of the fibular shaft?

A

3 surfaces: anterior, posterior and lateral.

Each fibular surface faces its respective compartment of the leg.

60
Q

What is the lateral malleolus?

A

A bony projection on the lateral distal surface of the fibula. It is more prominent than the medial malleolus of the tibia.

61
Q

What is the oblique popliteal ligament?

A

A ligament that strengthens the back of the knee joint. It is a continuation of tome of the fibres from the semimembranosus tendon in a superolateral direction from its insertion on the medial tibial condyle to the lateral femoral condyle.

62
Q

What are the 3 compartments of the thigh?

A

Anterior, posterior and medial

63
Q

What is the general nerve supply, functions and blood supply to muscles of the anterior thigh compartment?

A

Femoral nerve (L2-L4)
Extend leg
Branches of the femoral artery ( lateral and medial femoral circumflex arteries and the profunda femoris branch ).

64
Q

What are the four muscles in the anterior thigh?

A

Pectineus
Sartorius
Quadratus femoris (rectus femoris, vastus medialis, vastus intermedius, vastus lateralis)
Insertion of iliopsoas (iliacus and psoas major muscles)

65
Q

What 2 muscles form the iliopsoas?

A

Psoas major and iliacus.have a common function and insertion

66
Q

What is the origin and insertion of psoas major muscle?

A

Origin : transverse process of the T12 -> L5 vertebrae and the lateral margins of the intervertebral discs between them.

Insertion: lesser trochanter of the femur.

67
Q

What is the origin and insertion of the iliacus muscle?

A

Origin: Iliac fossa of the pelvis

Insertion: Lesser trochanter of the femur

68
Q

What is the innervation of iliopsoas?

A

2 separate innervations.
Psoas major = anterior rami of L1-L3
Iliacus = femoral nerve

69
Q

What is the origin, insertion, action and innervation of vastus lateralis?

A

Origin: Greater trochanter, lateral lip of the linea aspera
Insertion: quadriceps tendon to the base of the patella
Action: extends knee joint, stabilises the patella
Innervation:femoral nerve

70
Q

What is the origin, insertion, action and innervation of vastus intermedius?

A

Origin: Anterior and lateral surface of the femoral shaft
Insertion: base of patella via quadriceps tendon
Action: extends knee joint, stabilises patella
Innervation: femoral nerve

71
Q

What is the origin, insertion, action and innervation of vastus medialis?

A

Origin: inter trochanter is line of the femur (on anterior proximal femur) and medial lip of the linea aspera
Insertion: base and medial aspect of the patella via the quadriceps tendon
Action: Vastus medialis extends the knee joint and stabilises the knee joint and the patella. Horizontal fibres of vastus medialis obliquus resists lateral displacement of the patella
Innervation: Femoral nerve
Innervation:

72
Q

What is the origin, insertion, action and innervation of rectus femoris?

A

Origin: 2 origins from 2 different tendons which unite. Anterior tendon inserts onto the the anterior inferior iliac spine, the posterior tendon attaches to a groove above the rim of the acetabulum.
Insertion: base of the patella via the quadriceps femoris tendon.
Action: Flexes at the hip, extend the leg at the knee joint
Innervation: Femoral nerve

73
Q

What is the origin, insertion, action and innervation of Sartorius?

A

Origin: anterior superior iliac spine
Insertion: medial aspect of the proximal tibia as part of the pes anserinus.
Actions: Flexes the knee, abducts and externally (laterally) rotates the thigh at the hip joint. Medially rotates the tibia at the knee joint.
Innervation : femoral nerve

74
Q

What is the origin, insertion, action and innervation of pectineus?

A

Origin: pectineal line on the anterior surface of the superior pubic ramus.
Insertion: pectineal line on the posterior of the proximal femur, just inferior to the lesser trochanter
Actions: adduction, flexion of the thigh at the hip joint.
Innervation: femoral nerve, may also receive a branch from the obturator nerve

75
Q

Why is pectineus considered a transitional muscle?

A

Sometimes has dual innervation (femoral and obturator nerve) and can be considered a transitional muscle between the anterior thigh and the medial thigh compartments.

76
Q

What muscles are in the medial compartment of the thigh?

A

Gracilis, obturator externus, adductor brevis, adductor longus and adductor Magnus.

77
Q

What is the action, innervation and blood supply of muscles of the medial compartment of the thigh

A

Action: hip adductors
Innervation: obturator nerve (lumbar plexus, anterior divisions of L2,L3,L4)
Blood supply: obturator artery

78
Q

What is the origin, insertion, action and innervation of adductor magnus?

A

Origin: 2 parts(hamstring and adductor component). Adductor component orginates at the inferior ramus of the pubis and ischium. Hamstring component originates at the ischial tuberosity.

Insertion: Adductor component inserts onto the idea aspera of the femur. Hamstring component inserts onto the adductor tubercle and medial supercondylar line.

Action: both adduct the thigh. Adductor component flexes thigh, hamstring component extends the thigh.

Innervation: adductor component= obturator nerve (L2-L4), hamspring component = tibial component of the sciatic nerve ( L4-S3)

79
Q

What is the origin, insertion, action and innervation of adductor longus?

A

Origin: body of the pubis
Insertion: middle third of the linea aspera.
Action: adductor longus
Innervation: obturator nerve (L2-L4)

80
Q

What is the origin, insertion, action and innervation of adductor brevis?

A

Origin: body of the pubis and the inferior pubic ramus
Insertion: linea aspera, proximal to the adductor longus
Action: adduction of the thigh
Innervation: obturator nerve (L2-L4)

81
Q

How is adductor brevis used as an anatomical landmark?

A

Used to identify anterior and posterior divisions of the obturator nerve. Situated between the two divisions.

82
Q

What is the origin, insertion, action and innervation of Gracilis?

A

Origin: inferior pubic ramus and body of the pubis
Insertion: medial surface of the proximal tibia, between the tendons of sartorius (anteriorly) and semitendonosus (posteriorly)
Action: adducts the thigh, flexes the leg at the knee
Innervation:Obturator nerve (L2-L4)

83
Q

The tendons of which muscles form the per anserinus?

A

From anterior to posterior: sartorius, gracilis, semitendinosis

84
Q

What is the origin, insertion, action and innervation of Obturator externus?

A

Origin: external surface of the obturator membrane
Insertion: posterior aspect of the greater trochanter.
Action: adduction and lateral rotation of the thigh
Innervation: obturator nerve (L2-L4)

85
Q

What compartment is obturator externus classified into?

A

Sometimes classed as a member of the deep muscles of the gluteal region and sometimes classed as part of the medial compartment of the thigh.

86
Q

What is the femoral triangle?

A

Anatomical region of the proximal anterior thigh

87
Q

What are the 3 borders of the femoral triangle?

A

Superior border - Inguinal ligament

Lateral border - medial border of the sartorius muscle

Medial border - medial border of the adductor longus muscle

88
Q

What is the inguinal ligament?

A

A ligament that runs from the ASIS to the pubic tubercle. Acts as a flexor retinaculum, supports content of the femoral triangle during flexion at the hip. Forms the superior border of the femoral triangle

89
Q

What structures form the roof and base of the femoral triangle?

A

Roof - fascia lata

Floor - pectineus, iliopsoas, adductor longus

90
Q

What are the structures of the femoral triangle?

A 
From lateral to medial:
N - Femoral nerve
A - Femoral artery
V - Femoral vein
E - empty space 
L - Lymphatics (within the femoral canal)
91
Q

What is the femoral sheath?

A

A fasciae compartment the contains the femoral artery, vein and canal. Does not contain the femoral nerve.

92
Q

Where is the femoral artery located in the femoral triangle?

A

At the mid-inguinal point. Midway between the ASIS and the symphysis pubis.

93
Q

What is the femoral canal?

A

Anatomical compartment within the femoral triangle. Small and most medial. It contains lymphatic vessels, deep lymph node (lacunar node), empty space, loose connective tissue.

94
Q

What structures form the 4 borders of the femoral canal?

A

Medial border - lacunar ligament
Lateral border - femoral vein
Anterior border - inguinal ligament
Posterior border - pectineal ligament ( extension of the lacunar ligament), superior ramus of the pubic bone, pectineus muscle.

95
Q

What is the femoral ring?

A

Located at the top of the femoral canal, it is the opening of the femoral canal. It is close by a connective tissue layer known as the femoral septum. Femoral septum is pierced by lymphatic vessels exiting the femoral canal.

96
Q

Why is empty space in the femoral canal necessary?

A

To allow room for distension of the femoral vein when there is increased venous return.

97
Q

What is the adductor canal?

A

Narrow conical tunnel located in the thigh. Extends from the apex of the femoral canal to the adductor hiatus.

98
Q

What structures pass through the adductor canal?

A

Structures that pass between the anterior thigh and posterior leg.

  • superficial femoral artery
  • femoral vein
  • nerve to the vastus medialis
  • saphenous nerve
99
Q

What muscular structures border the adductor canal?

A

Anterior: sartorius
Lateral: vastus medialis
Posterior: adductor longus and adductor magnus

100
Q

What marks the apex of the adductor canal?

A

The adductor hiatus

101
Q

How is the femoral nerve formed?

A

Formed in the lumbar plexus, from the posterior divisions of the L2, L3 and L4 roots.

102
Q

Describe the path of the femoral nerve from the lumbar plexus to the femoral triangle

A

Originates in the lumbar plexus in the abdomen. Descends by passing through the fibres of the psoas major muscle. Exits psoas major at the inferior part of its lateral border. Passes behind the fascia overlying the iliacus muscle to the mid point of the inguinal ligament (half way between the ASIS and the pubic tubercle). Passes behind the inguinal ligament. After 4cm it splits into the he anterior and posterior divisions. Is not enclosed in the femoral sheath within the femoral triangle.

103
Q

What are the divisions of the femoral nerve?

A

Initially splits to form the posterior and anterior divisions of the femoral nerve. After passing through the femoral triangle, it gives off Articular branches to the hip and knee joints. The terminal branch of the femoral nerve is the saphenous nerve.

104
Q

What does the femoral nerve innervate

A

The anterior thigh muscles that flex the hip joint and extend the knee.

105
Q

What cutaneous branches does the femoral nerve supply?

A
  1. Anterior cutaneous branch to the anteromedial thigh.

2. Saphenous nerve - skin on medial side of the leg and foot.

106
Q

How is the obturator nerve formed?

A

Formed in the lumbar plexus from anterior divisions of L2,L3 and L4 nerves.

107
Q

Describe the path of the obturator nerve to the thigh

A

Descend through the fibres of the psoas major muscle. Runs laterally along the pelvic wall to the obturator foramen. Enters thigh through the obturator canal and then splits into the anterior and posterior divisions.

108
Q

What does the anterior branch of the obturator nerve supply?

A

Descends between adductor longus/pectineus and the adductor brevis. Gives off branches to the adductor long, adductor brevis and gracilis, and occasionally gives off a branch to the pectineus. The anterior branch of the obturator nerve then pierces the fascia lata to supply the skin over the middle part of the medial thigh.

109
Q

What does the posterior branch of the obturator nerve supply?

A

Supplies the obturator externus, the adductor brevis and the adductor component of adductor magnus.

110
Q

What forms the femoral artery?

A

The femoral artery is a continuation of the external iliac artery, which itself is a termination of the common iliac artery. The external iliac artery is known as the femoral artery once it has passed under the inguinal ligament to enter the femoral triangle

111
Q

What major branch is given from the femoral artery within the femoral triangle?

A

The profunda femoris (deep femoral) artery branches from the posterolateral aspect of the common femoral artery.

112
Q

What 3 branches does the profunda femoris (deep femoral) artery give off?

A

Lateral femoral circumflex artery
Medial femoral circumflex artery
Perforating branches

113
Q

What does the lateral circumflex artery supply?

A

Wraps around the anterolateral aspect of the proximal femur
Contributes to the extracapsular arterial ring supplying th femoral neck and head.
A descending branch supplies some muscles of the lateral thigh

114
Q

What does the medial circumflex artery supply?

A

Major contribution to the extracapsular arterial ring that supplies the neck and head of the femur

115
Q

What does the perforating branches from the profunda femoris supply?

A

Perforate the adductor magnus muscle and contribute to the blood supply of the muscles of the medial and posterior thigh.

116
Q

How is the superficial femoral artery formed?

A

The superficial femoral artery is a continuation of the femoral artery after the profunda femoris has been given off.

117
Q

Describe the path of the superficial femoral artery?

A

Exits the apex of the femoral triangle. Enters the adductor canal. Passes through the adductor hiatus at the end of the adductor canal. Enters the posterior compartment of the thigh, proximal to the knee joint.

118
Q

What does the superficial femoral artery supply?

A

Anterior thigh muscles.

119
Q

How is the popliteal artery formed?

A

Formed when the superficial femoral artery passes into the posterior compartment of the thigh through the adductor hiatus, just above the popliteal fossa.

120
Q

How is the obturator artery formed?

A

Arises from the internal iliac artery in the pelvis region.

121
Q

What does the obturator artery supply?

A

Supplies the medial aspect of the thigh. Enters via the obturator canal.

122
Q

What arteries supply the gluteal region?

A

The superior and inferior gluteal arteries. These arise from the internal iliac artery and enter the gluteal region via the great sciatic foramen.

123
Q

How is the piriformis an important anatomical landmark of arteries?

A

Both the inferior and superior gluteal arteries exit the greater sciatic notch from behind the piriformis muscle. The superior gluteal muscle leaves above the piriformis, whilst the inferior gluteal muscle leaves below the piriformis.

124
Q

How is the femoral vein formed?

A

The femoral vein is a continuation of the popliteal vein after it enters the thigh via the adductor hiatus.

125
Q

What is the external iliac vein?

A

A continuation of the common femoral vein (that has already received contributions from the profunda femoris vein) after it has passed deep to the inguinal ligament.

126
Q

What are the two main superficial veins?

A

The great saphenous vein

The small saphenous vein

127
Q

How is the great saphenous vein formed?

A

By the dorsal venous arch of the foot and the dorsal vein of the big toe. Passes anteriorly to the medial malleolus.

128
Q

Where does the great saphenous vein travel anteriorly?

A

Travels medial to and then posterior to the tibia. Passes a hands breadth posterior to the medial border of the patella. Ascends the medial aspect of the thigh to pierce the saphenous opening of the fascia lata.

129
Q

What does the great saphenous vein drain into?

A

Drains into the femoral vein at the saphenofemoral junction in the femoral triangle.

130
Q

How is the small saphenous vein formed?

A

Formed by the dorsal venous arch of the foot and the dorsal vein of the little toe. Passes posterior to the lateral malleolus.

131
Q

Describe the path of the small saphenous vein?

A

Passes posterior to the lateral malleous, ascends along the lateral border of the Achilles’ tendon. Passes between the two head of gastrocneumius.

132
Q

What does the small saphenous vein drain into?

A

Drains into the popliteal vein at the saphenopopliteal junction in the popliteal fossa.

133
Q

What drains into the the lymphatic system?

A

Drains tissue fluid, plasma proteins, and other cellular debris.

134
Q

What are the 2 classifications of superficial lymphatic vessels?

A
  1. Medial vessels - closely follow the course of the great saphenous vein. Drain into the inferior group of superficial inguinal lymph nodes in the femoral triangle.
  2. Lateral vessels - follow the course of the small saphenous vein. Drain into the popliteal lymph nodes or drain into the superficial inguinal lymph nodes.
135
Q

What are the 3 main groups of deep lymphatic vessels in the leg?

A

Anterior tibial, posterior tibial and peroneal, following their corresponding artery.

MSK (17 decks)

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