SPR L6 Neurovascular Anatomy of the Lower Limb

Question 1

Learning Outcomes (for general perusal)

Answer 1

• Describe the superficial veins of the lower limb
• Identify the femoral, profunda femoris and popliteal arteries
• Describe the musculature of the anterior thigh
• Describe the boundaries and contents of the femoral triangle and sub-sartorial canal

Question 2

In the lower limb (thigh and leg), what types of muscles does the anterior compartment contain?

Answer 2

Extensor Muscles

Question 3

In the lower limb (thigh and leg), what types of muscles does the posterior compartment contain?

Answer 3

Flexor Muscles

Question 4

Venous Drainage - Lower Limb

Where does blood from the superficial structures of the lower limb drain into?​

Answer 4

Dorsal venous arch (located on the dorsum of the foot)

Short saphenous vein (located on the posterior aspect of the leg – see next slide)

Great saphenous vein (located on the medial aspect of the leg and medial thigh) - The great saphenous vein drains into the femoral vein within the femoral triangle.

Question 5

Venous Drainage - Lower Limb

Where are the following located?

1. Dorsal venous arch
2. Short saphenous vein
3. Great saphenous vein
   
   1. Where does this drain into?
   2. What is it useful for?

Answer 5

1. dorsum of the foot
2. located on the posterior aspect of the leg
3. the medial aspect of the leg and medial thigh
   
   1. the femoral vein within the femoral triangle.
   2. could harvest GSV for the operation. Very superficial vein. May also select the internal thoracic artery.

Question 6

Which vein is the arrow indicating?

Where does this vein drain into? (Where is this region?)

Answer 6

The Short Saphenous Vein

into the popilteal vein within the popliteal fossa (this region is located posterior to the knee joint)

Question 7

Arterial Supply - Lower Limb

1. What is the principal artery within the lower limb, and where does it originate from?
2. What important branch does the femoral artery give off? (What is it also known as?)
3. Where does the femoral artery enter?
   
   1. What does it become on passing this opening?

Answer 7

1. The Femoral Artery - a continuation of the External Iliac Artery (name change @ the inguinal ligament)
2. The Profunda Femoris Artery ( the deep artery of the thigh)
3. The Adductor Hiatus. (an opening in the lower part of the adductor magnus)
   
   1. The popliteal artery

Question 8

Movement of the Lower Limb

Movements at which joints need to be considered?

Answer 8

Hip Joint

Knee Joint

Ankle Joint

Subtalar Joints

Question 9

Hip and Knee Joint Movement

Outline the main movements of the

Hip Joint

Knee Joint

Ankle Joint

Subtalar Joints

Answer 9

• Lateral/External Rotation (L5, L1) 50 Degrees
• Medial/Internal Rotation (L1, L2, L3) 40 Degrees
• Abduction of the Hip (L1, L2, L3, L4)
• Adduction of the Hip (L5 S1)
• Extension (L4, L5)
• Flexion (L2, L3)
• Flexion (L5, S1)
• Extension (L3, L4)
• Dorsiflexion (L4, L5)
• Plantarflexion (S1, S2)
• Inversion (L4, L5)
• Eversion (L5, S1)
  
  • (These DO NOT take place at the ankle joints)

Question 10

Anterior Thigh

What is the Anterior Thigh musculature comprised of?

Answer 10

Quadriceps

• Rectus femoris m.
• Vastus medialis m.
• Vastus intermedius m.
• Vastus lateralis m.

and

Sartorius Muscle

Question 11

Which muscle is located deep to the rectus femoris muscle?

(in the picture)

Answer 11

Vastus Intermedius Muscle

Question 12

Quadriceps Group of Muscles

1. What is this powerful group of muscles collectively responsible for?
2. Which muscle crosses the knee joint?
   
   1. What is its action?

Answer 12

1. the extension of the lower limb at the knee joint
2. Rectus Femoris Muscle
   
   1. Flexion at the hip joint

Question 13

Femoral Triangle: Boundaries

1. What is the base formed by?
2. What is the medial border formed by?
3. What is the lateral border formed by?
4. Where is the apex?
5. What is the roof formed by?
6. What is the floor formed by?

Answer 13

1. The inguinal ligament
2. lateral border of the adductor longus m
3. medial border of the sartorius m
4. where the sartorius and adductor longus mm. overlap
5. Skin and Subcut tissue
6. Pectineus muscle, and iliopsoas muscle (ilacus m. located within the iliac fossa and iliopsoas muscle located on the posterior abdominal wall join together - powerful flexor of the lower limb at the hip joint)

Question 14

Femoral Triangle: Contents

List the contents

What is enclosed by the femoral sheath (a tube of fascia)?

Answer 14

Femoral Vein

Femoral Artery

Femoral Nerve

The Femoral Vein and Artery (NOT NERVE)

Question 15

Femoral Sheath

List the three compartments of the femoral sheath and what they contain

Answer 15

The femoral sheath is sub-divided into 3 compartments:

Lateral compartment: contains the femoral a.

Intermediate compartment: contains the femoral v.

Medial compartment: contains the femoral canal (usually find lymphatics here)

Question 16

Sub-sartorial Canal (Adductor Canal/ Hunter’s Canal)

Where is it located?

Answer 16

within the middle third of the thigh and runs from the apex of the femoral triangle to the adductor hiatus

Question 17

Sub-sartorial Canal: Boundaries

What are the following boundaries made up of?

1. Anteromedially
2. Anterolaterally
3. Posteriorly

Answer 17

1. sartorius m.
2. vastus medialis m.
3. adductor longus m. and adductor magnus m.

Question 18

Sub-sartorial Canal: Contents

List the contents

Answer 18

Femoral artery

Femoral vein

Saphenous nerve (a cutaneous branch of the femoral nerve)

Nerve to vastus medialis

Question 19

Summary of what was covered

Answer 19

Superficial venous drainage of the lower limb

The femoral, profunda femoris and popliteal arteries

Musculature of the anterior thigh

Femoral triangle

Sub-sartorial canal