TBL 15 Flashcards
the longest, heaviest, and strongest bone in the human skeleton
femur (thighbone)
supports the weight of the body and allows motion of the leg
femur
the femur is the ___ bone in the human skeleton that ___ and ___
longest, heaviest, and strongest;
supports the weight of the body;
allows motion of the leg
projects medially and upwards to articulate with the acetabulum of the pelvis forming the hip joint
femoral head
the femoral head projects ___ to articulate with the ___ forming the ___
medially and upwards;
acetabulum of the pelvis;
hip joint
blood supply of the femoral head includes:
medial circumflex femoral artery,
branches of the obturator artery
main blood supply to the femoral head in adults
medial circumflex femoral artery
main blood supply to the femoral head in children
branches of the obturator artery
receives blood from the medial circumflex femoral artery and branches of the obturator artery
femoral head
small, oval shaped depression on the femoral head
fovea capitis
the fovea capitis is a ___ on the ___ and the site of attachment for the ___
small, oval-shaped depression;
femoral head;
ligament of head of femur
site of attachment for the ligament of head of femur
fovea capitis
ligament of head of femur aka:
ligamentum capitis femoris,
ligamentum teres femoris
ligament of head of femur plays a role in
the stability of the hip joint
connects the head of the femur with the shaft
neck of femur
forms an angle of 125 degrees with the femoral shaft
femoral neck
common site for femoral fractures
femoral shaft
separated from the shaft in front by the intertrochanteric line
femoral neck
site of attachment for the iliofemoral ligament
intertrochanteric line of the femur
the intertrochanteric line of the femur is the site of attachment for the
iliofemoral ligament
the femoral necks connects the ___ with the ___ and forms an angle of ___ with the ___
femoral head; femoral shaft;
125 degrees; femoral shaft
the femoral shaft is the common site for
femoral fractures
narrower than the femoral head
femoral neck
the femoral neck is ___ than the femoral head to permit a ___ at the ___
narrower;
greater range of movement;
hip joint
projects from the junction of the femoral neck with the femoral shaft
greater trochanter of the femur
insertion site for the gluteus medius and minimus, piriformis, and obturator internus
greater trochanter of the femur
the greater trochanter of the femur projects from the ___ and is the insertion site for the ___
junction of the femoral neck with the femoral shaft;
gluteus medius and minimus, piriformis, and obturator internus
lies in the angle between the femoral neck and the femoral shaft
lesser trochanter of the femur
insertion site for the iliopsoas tendon
lesser trochanter of the femur
the lesser trochanter of the femur lies in the ___ and is the insertion site for the ___
angle between the femoral neck and the femoral shaft;
iliopsoas tendon
descends in a slightly medial direction to bring the knee closer to the body’s center of gravity to increase stability
femoral shaft
the femoral shaft descends in a ___ to bring the ___ to ___
slightly medial direction;
knee closer to the body’s center of gravity;
increase stability
key features of the femoral shaft include:
gluteal tuberosity, adductor tubercle, medial and lateral condyles, intercondylar notch (fossa), medial and lateral epicondyles
smooth prominence on a bone where it forms a joint with another bone
condyle
a condyle is a ___ on a ___ where it forms a ___
smooth prominence;
bone;
joint with another bone
insertion site for the gluteus maximus
gluteal tuberosity of the femoral shaft
insertion site for the adductor magnus muscle
adductor tubercle of the femoral shaft
articulate with the tibia and patella to form the knee joint
medial and lateral condyles of the femoral shaft
a depression in which key ligaments of the knee attach
intercondylar notch (fossa) of the femoral shaft
significantly strengthens the knee and protects it against torsional damage
intercondylar notch (fossa) of the femoral shaft
proximal to the condyles
medial and lateral epicondyles
site of attachment for key internal knee ligaments
medial and lateral epicondyles of the femoral shaft
the gluteal tuberosity of the femoral shaft is the insertion site for the
gluteus maximus
the adductor tubercle of the femoral shaft is the insertion site for the
adductor magnus muscle
the medial and lateral condyles of the femoral shaft articulate with the ___ to form the ___
tibia and patella;
knee joint
the intercondylar notch (fossa) of the femoral shaft is a ___ in which ___ attach and significantly ___ and ___
depression;
key ligaments of the knee;
strengthens the knee;
protects it against torsional damage
the medial and lateral epicondyles of the femoral shaft are the site of attachment for
key internal knee ligaments
a rough longitudinal line or ridge on the posterior aspect of the femur to which several muscles attach
linea aspera of the femur
a bony ridge on the shaft of the femur that extends downward from the lesser trochanter to the medial lip of the linea aspera
pectineal line of the femur
provides an insertion to the pectineus muscle
pectineal line of the femur
the linea aspera of the femur is a ___ on the ___ to which ___
rough longitudinal line / ridge;
posterior aspect of the femur;
several muscles attach
the pectineal line of the femur is a ___ on the __ that ___ and provides an insertion to the ___
bony ridge; shaft of the femur;
extends downward from the lesser trochanter to the medial lip of the linea aspera;
pectineus muscle
the femur is “bent” so that the
long axis of the head and neck lies at an angle (of inclination) to that of the shaft
the angle of inclination of the femur ___ with age, resulting in ___
decreases (becomes more acute);
greater stress at a time when bone mass is reduced
femoral neck fractures in people < 40yo usually result from
high-energy impacts (car accidents, skiing)
uncommon in most contact sports and usually result from high-energy impacts
femoral neck fractures in people < 40yo
femoral neck fractures are common in individuals > 60yo (esp women) because
femoral necks are weak and brittle due to hormonal changes leading to osteoporosis
loss of bony mass
osteoporosis
presents with groin pain, shortened and laterally (externally) rotated limb
femoral neck fracture
femoral neck fracture patients present with
groin pain, shortened and laterally (externally) rotated limb
femoral neck fracture patients are at high risk for ___ due to ___ mainly from ___
avascular necrosis of the femur head;
interruption of the blood supply to the femoral head;
the medial circumflex femoral artery
death of bone tissue
avascular necrosis
interruption of blood supply
ischemia
femoral head fractures are often associated with
posterior hip dislocation following a dashboard injury
often associated with a posterior hip dislocation following a dashboard injury
femoral head fracture
presents with groin pain and medial (lateral) rotation of the leg
femoral head fracture
femoral head fracture patients present with
groin pain and medial (lateral) rotation of the leg
femoral head fractures may ___ causing ___
compress the sciatic nerve;
foot drop
fracture that may compress the sciatic nerve and cause foot drop
femoral head
in a dashboard injury to the knee
the hip is positioned in flexion, adduction, and internal rotation
in a femoral head fracture, a common position of the ___ during ___ is related to the position during a ___
lower extremity;
hip dislocation;
dashboard injury to the knee
slide 17
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The musculature of the thigh can be split into
Three sections: anterior, medial, posterior
The muscles in the anterior compartment of the thigh are innervated by the… and act to…
Femoral nerve (L2 – L4); Extend the leg at the knee joint
Innervated by the femoral nerve and extend the leg at the knee joint
The muscles in the anterior compartment of the thigh
The principal blood supply of the muscles in the anterior compartment of the thigh
Femoral artery
The femoral artery is the principal blood supply to the
Muscles in the anterior compartment of the thigh
The three major muscles in the anterior thigh include:
Pectineus, Sartorius, quadriceps femoris
The end of the iliopsoas muscle passes into the
Anterior compartment of the thigh
The pectineus, Sartorius, quadriceps femoris, and the end of the iliopsoas muscle is included in the
Anterior compartment of the thigh
Thigh flexion only:
Iliopsoas and pectineus muscles
The iliopsoas muscle is the
Strongest flexor
Muscles that insert above the knee
pectineus and iliopsoas
Thigh flexion and thigh adduction
pectineus muscle
The iliopsoas and pectineus muscles
Flex the thigh
Lower leg extension only:
Four quadriceps femoris muscles
The four quadriceps femoris muscles include… and perform…
Vastus intermedius, medialis, lateralis, rectus femoris;
Lower leg extension
Muscle attached to the hip that helps extend or raise the knee and flexes the thigh
Rectus femoris
The only quadriceps muscle that can flex the hip
Rectus femoris
The rectus femoris is the only quadriceps muscle that can
Flex the hip
Lower leg and thigh flexion
Sartorius muscle
Muscle originated in the pelvis and inserted below the knee
Sartorius muscle
Muscle that aids in thigh abduction and external rotation
Sartorius muscle
The sartorius muscle performs:
Lower leg and thigh flexion;
Thigh abduction and external rotation
The sartorius muscle originates in the… and inserts…
Pelvis;
below the knee
The rectus femoris muscle is attached to the… and helps to…
Hip;
extend or raise the knee; flex the thigh
Proximally attached to the iliacus from the internal aspect of the ileum and the psoas major from the lumbar vertebra
iliopsoas
Distally attached to the lesser trochanter of the femur
Iliopsoas
The lumbar nerve plexus is formed within
Iliopsoas
The iliopsoas muscle is proximally attached to the… And distally attached to the… And acts as a… And forms the…
Iliacus from the internal aspect of the ileum and the psoas major from the lumbar vertebra;
lesser trochanter of the femur;
chief thigh flexor;
lumbar nerve plexus within it
Proximally attached to the superior pubic ramus
Pectineus
Distally attached to the pectineal line of the femur
Pectineus
The floor of the femoral triangle
Pectineus
The pectineus muscle is proximally attached to the… And Distally attached to the… Performing… And is the…
Superior pubic ramus;
Pectineal line of the femur;
Thigh flexion and abduction;
floor of the femoral triangle
Proximally attached to the anterior superior iliac spine
Sartorius
Distally attached to the proximal medial tibia at the pes anserinus
Sartorius
Crosses obliquely from lateral to medial as it descends
Sartorius
The sartorius muscle is proximally attached to the… And distally attached to the… And performs… And crosses…
ASIS;
proximal medial tibia at the pes anserinus;
hip flexion, thigh and knee abduction and lateral rotation, leg flexion;
obliquely from lateral to medial as it descends
Proximally attached to the anterior inferior iliac spine
Rectus femoris
Proximally attached to various parts of the femur
Vastis intermedius, medialis, lateralis
Distally attached to the common Tendon to the Tibial tuberosity
The quadriceps femoris muscles
The rectus femoris is proximally attached to the… And distally attached to the… And performs…
Anterior inferior iliac spine;
common tendon to the tibial tuberosity;
knee extension and hip flexion
The vastus intermedius, medialis, and lateralis, or proximally attached to the… And distally attached to the… And perform…
Various parts of the femur;
common tendon to the tibial tuberosity;
knee extension
The hip adductors
The muscles of the medial thigh compartment
Muscles of the medial compartment of the thigh include:
Gracilis, obturator externus, adductor brevis, adductor longus, adductor Magnus
Crosses both hip and knee joints
Gracilis muscle
Thigh adductor and lower leg flexor, also contributes to thigh rotation
Gracilis muscle
The gracilis muscle crosses… And acts as a… And contributes to…
Both hip and knee joints;
Thigh adductor and lower leg flexor;
Thigh rotation
Often used as a transplant To replace a damaged muscle in the hand or face
Gracilis muscle
The gracilis muscle with its nerves and blood vessels are often used as a transplant to replace a damaged muscle in the…
Hand or face
Can be relocated and repositioned to create a replacement for a non-functional external anal sphincter
Gracilis muscle
The gracilis muscle can be relocated and repositioned to create…
A replacement for a non-functional external anal sphincter
The adductor muscles are innervated by the
obturator nerve (L2 - L4)
The “hamstring part” of the adductor Magnus is innervated by the
tibial nerve
The obturator nerve innervates
The adductor muscles of the medial compartment of the thigh
The principal blood supply to the medial compartment of the thigh
Obturator artery
The obturator artery is the principal blood supply of the
Medial compartment of the thigh
Proximally attached to the body of the pubis
Adductor longus
Distally attached to the middle third linea aspera
Adductor longus
The most anterior medial compartment of the thigh
Adductor longus
The adductor longus muscle is proximally attached to the… And distally attached to the… Performing… And is the…
Body of the pubis;
middle third of the linea aspera;
Thigh adduction;
most anterior
Proximally attached to the body and inferior ramus of the pubis
Adductor brevis,
Gracilis
Distally attached to the proximal linea aspera
Adductor brevis
Deep to the adductor longus
Adductor brevis
The adductor Brevis is proximally attached to the… And distally attached to the… Performing… And is…
Body and inferior ramus of the pubis;
proximal linea aspera;
Thigh adduction and some flexion;
deep to the Adductor longus
Proximally attached to the ischiopubic ramus
Adductor portion of the adductor magnus
Distally attached to the linea aspera
Adductor portion of the adductor magnus
Proximally attached to the ischial tuberosity
Hamstring portion of the adductor magnus
The adductor portion of the adductor Magnus is Proximally attached to the… And distally attached to the… Performing…
ischiopubic ramus;
Linea Aspera;
Thigh adduction and flexion
The hamstring portion of the adductor magnus is proximally attached to the… and distally attached to the… Performing…
Ischial tuberosity;
adductor tubercle;
Thigh extension
Distally attached to the proximal medial tibia at the pes anserinus
Gracilis
The most superficial medial compartment of the thigh
Gracilis
The Muscle of the medial compartment of the thigh that crosses two joints
Gracilis
The Gracilis muscle proximally attaches to the… And distally attaches to the… Performing… And is the… That crosses…
body and inferior pubic ramus;
proximal medial tibia at the pes anserinus;
Thigh adduction, leg flexion and medial rotation;
most superficial;
two joints
Proximally attaches to the margins of the obturator foreman
obturator Externus
Distally attaches to the trochanteric fossa of the femur
obturator Externus
The lateral rotator of the medial compartment of the thigh
obturator externus
The obturator externus proximally attaches to the… And distally attaches to the… Performing…
Margins of the obturator foreman;
trochanteric Fossa of the femur;
lateral rotation of the thigh
adductor longus muscle strains often occur in
sports that require fast acceleration, deceleration, and changes in direction (ice hockey, cricket, breaststroke swimming, football, rugby) or in horseback riders
often occur from sports that require fast acceleration, deceleration, and changes in direction
muscle strains of the adductor longus
often occur in ice hockey, cricket, breaststroke swimming, football, rugby
muscle strains of the adductor longus
rider’s strain
muscle strains of the adductor longus
may occur in horseback riders and produce pain
muscle strains of the adductor longus (rider’s strain)
ossification sometimes occurs in the tendons of the adductor longus because
horseback riders actively adduct their thighs to keep from falling off
___ sometimes occurs in the ___ because horseback riders ____ to keep from falling off
ossification;
tendons of the adductor longus;
actively adduct their thighs
the muscles in the posterior compartment of the thigh are called ___ and consist of ___
the hamstrings;
biceps femoris, semitendinosus, semimembranosus
the posterior compartment muscles of the thigh act to
extend at the hip and flex at the knee
the principal blood supply for the muscles of the posterior compartment of the thigh include:
the inferior gluteal and profunda femoris arteries
the biceps femoris, semitendinosus, and semimembranosus are the muscles of the ___
posterior compartment of the thigh, aka hamstrings;
muscles innervated by the inferior gluteal and profunda femoris arteries
muscles of the posterior compartment of the thigh (hamstrings)
muscles that extend at the hip and flex at the knee
muscles of the posterior compartment of the thigh (hamstrings)
proximally attached to the ischial tuberosity deep to the gluteus maximus
semitendinosus, semimembranosus, long head of the biceps femoris
the hamstrings are distally attached to the ___ and act on ___ producing ___
bones of the leg;
two joints;
extension at the hip joint and flexion at the knee joint
how do you test the hamstrings
patient flexes the leg against resistance; these muscles should be prominent as the knee bends
common in individuals who run and/or kick hard
hamstring strains
often occur in running, jumping, and quick-start sports (baseball, basketball, football, soccer)
hamstring strains
hamstring strains often occur in individuals who
run and/or kick hard
the violent muscular exertion of the hamstrings can lead to
a partial tear of the proximal tendinous attachments of the hamstrings to the ischial tuberosity
covers the muscles of the thigh
membranous, deep fascia (fascia lata)
the fascia lata allows the ___ to ___, making their ___ more efficient in ___ and reduces the ___
muscles; bind tightly together; contraction; compressing deep veins; overall force required for movement at the hip joint
ensures adequate venous return to the heart from the lower limbs
more efficient muscle contraction in compressing deep veins
the fascia lata is superiorly attached to the
pubic symphysis, pubic crest, pubic rami, ischial tuberosity, inguinal and sacro tuberous ligaments, and the sacrum and coccyx
the fascia lata is inferiorly attached to the
bones of knee
the fascia lata is inferiorly continuous with the
deep fascia of the leg (crural fascia)
allows the thigh muscles to bind tightly together
fascia lata (deep fascia of the thigh)
makes thigh contraction more efficient
tightly bound thigh muscles
the thickened lateral portion of the fascia lata
iliotibial tract (IT band)
extends from the iliac crest to the lateral tibial condyle
iliotibial tract (IT band)
the iliotibial tract (IT band) is the ___ portion of the ___ that extends from the ___ to the ___ and functions to ___ both in ___ and ___, so it’s constantly used when ___
thickened lateral; fascia lata; iliac crest; lateral tibial condyle; stabilizes the knee; extension; partial flexion
when a person is leaning forwards with a slightly ___, the ___ is it’s main support against gravity
flexed knee;
iliotibial tract
an oval gap in the fascia lata below the inguinal ligament that is covered by the cribriform fascia
saphenous opening (saphenous hiatus)
part of the superficial fascia of the thigh
cribriform fascia
Provides a pathway for the greater saphenous vein
saphenous opening / hiatus
the saphenous opening / hiatus is a(n) ___ in the ___ below the ___ covered by the ___ and provides a ___
oval gap; fascia lata; inguinal ligament; cribriform fascia; pathway for the greater saphenous vein
the fascial compartments of the lower limbs are generally
closed spaces
trauma to the muscles and/or vessels in the thigh compartments from ___ may produce ___
burns, sustained intense use of muscles, or blunt trauma;
hemorrhage, edema, inflammation of the muscles
the ___ forming the boundaries of the leg compartments are strong, so increased volume from trauma ___
septa and deep fascia of the leg;
increases pressure in the compartments of the thigh (Thigh compartment syndrome)
common signs and symptoms associated with thigh compartment syndrome include:
“The 5 P’s”:
pain pallor (pale skin) paresthesia (numbness) pulselessness (faint pulse) paralysis (weakness in movements)
the pressure in thigh compartment syndrome may reach levels high enough to ___ in the compartment
compress structures
particularly vulnerable to compression in the thigh
small vessels of muscles and nerves (vasa nervorum)
structures ___ to the compressed area may become ___ and ___
distal;
ischemic; permanently injured
increased pressure in a confined anatomical space adversely affects the ___ and threatens the ___
circulation; function and viability of tissue within or distally
the deep fascia overlying the anterior compartment of the thigh is ___ providing ___
superiorly dense;
part of the proximal attachment of the muscle immediately deep to it
more susceptible to compartment syndromes
anterior compartment of the thigh because is confined on three sides by 2 bones, interosseous membrane, and dense fascia
obvious sign of arterial compression
loss of distal leg pulses and decreased temperature of tissues distal to the compression
loss of distal leg pulses and decreased temperature of distal tissues is an obvious sign of
arterial compression
incision of overlying fascia or a septum to relieve pressure
fasciotomy
boundaries of the femoral triangle include:
superior: inguinal ligament;
medial: lateral border of adductor longus;
lateral: sartorius
apex: where the medial sartorius crosses the lateral adductor longus
contents of the femoral triangle (lateral to medial) include:
NAVEL:
Femoral Nerve; Femoral Artery; Femoral Vein; Empty space (femoral canal); Lymphatics
formed by an inferior prolongation of transversalis and iliopsoas fascia from the abdomen, below the inguinal ligament
femoral sheath
the femoral sheath is formed by ___ from the ___ and is located ___
an inferior prolongation of transversalis and iliopsoas fascia;
abdomen;
below the inguinal ligament
contents of the femoral sheath include:
femoral artery and vein;
femoral branch of genitofemoral nerve;
femoral canal;
deep inguinal lymph nodes
the femoral nerve ___ the femoral sheath, ___ to the ___
lies outside;
lateral; femoral artery
the distal end of the femoral sheath reaches the
level of the proximal end of the saphenous opening
the femoral sheath is internally subdivided into:
lateral compartment for the femoral artery;
intermediate compartment for the femoral vein;
medial compartment (femoral canal)
the femoral sheath allows the femoral artery and vein to ___ during ___
glide deep to the inguinal ligament;
movements of the hip joint
the smallest and most medial part of the femoral sheath
femoral canal
boundaries of the femoral canal include:
medial: lacunar ligament;
lateral: femoral vein;
anterior: inguinal ligament;
posterior: pectineal ligament, superior ramus of the pubic bone, and pectineus muscle
opening to the femoral canal
femoral ring
the femoral ring is located at the ___ of the ___
superior border;
femoral canal
part of the intestine can sometimes pass through the ___ into the ___ causing a ___
femoral ring;
femoral canal;
femoral hernia
a femoral hernia can be caused if ___ passes through the ___ into the ___
part of the intestine;
femoral ring;
femoral canal
contents of the femoral canal include:
lymphatic vessels;
deep lymph node (lacunar node);
empty space;
loose connective tissue
the lymphatic vessels of the femoral canal drain the
deep inguinal lymph nodes
deep lymph node
lacunar node
allows distension of the adjacent femoral vein
empty space of the femoral canal
the empty space of the femoral canal allows
distension of the adjacent femoral vein
allows the femoral vein to cope with increased venous return or increased intra-abdominal pressure
distension of the adjacent femoral vein
distension of the adjacent femoral vein allows
the femoral vein to cope with increased venous return or increased intra-abdominal pressure
weak area in the anterior abdominal wall that normally is of a size sufficient to admit the tip of the little finger
femoral ring
the femoral ring is a ___ in the ___ that’s normally the size sufficient to ___
weak area;
anterior abdominal wall;
admit the tip of the little finger
usual originating site of a femoral hernia
femoral ring
protrusion of abdominal viscera
femoral hernia
loop of small intestine
abdominal viscera
a femoral hernia appears as a ___ in the ___, ___ and ___
tender mass;
femoral triangle;
below the inguinal ligament;
lateral to the pubic tubercle
the femoral hernia is bounded by the
femoral vein (laterally) and the lacunar ligament (medially)
compresses the contents of the femoral canal
hernial sac
females have a
wider pelvis and smaller inguinal canals and rings
the rigid boundaries of the femoral ring may cause ___ which interferes with the ___ to the ___ and may result in ___ which can be ___
strangulation of a femoral hernia;
blood supply; herniated intestine;
necrosis (death) of tissue;
fatal
Begins at the apex of the femoral triangle and ends at the adductor hiatus (hiatus tendineus)
adductor canal
Lies between the adductor magnus and longus muscles and the vastus medialis muscle, and is covered by the sartorius muscle and fascia
adductor canal
the adductor canal begins at the ___ and ends at the ___ and lies between the ___ and is covered by the ___ and contains the ___
apex of the femoral triangle; adductor hiatus (hiatus tendineus);
adductor magnus and longus muscles and the vastus medialis muscle;
sartorius muscle and fascia;
femoral artery and vein, the saphenous nerve, and the nerve to the vastus medialis
formed by the thickened inferior edge of the aponeurosis of the external oblique muscle as this attaches to the bones of the pelvis
inguinal ligament
Anchors the aponeurosis of the external oblique muscle to the pelvis.
inguinal ligament
Protects a number of important structures as they pass from the pelvic cavity into the thigh and inguinal canal
inguinal ligament
forms the base of the femoral triangle and the floor of the inguinal canal
inguinal ligament
the inguinal ligament is formed by the ___ that attaches to the ___, is superiorly attached to the ___, and inserts onto the ___
thickened inferior edge of the aponeurosis of the external oblique muscle;
bones of the pelvis;
ASIS of the ilium;
pubic tubercle of the pubic bone
the functions of the inguinal ligament include:
anchors aponeurosis of external oblique to the pelvis;
protects important structures as they pass from the pelvic cavity into the thigh and inguinal canal;
forms the base of the femoral triangle and the floor of the inguinal canal
___ of the inguinal ligament pass ___ to attach to the___, forming the ___
deeper fibers;
posteriorly;
superior pubic ramus;
lacunar ligament (ligament of Gimbernat)
ligament of Gimbernat
lacunar ligament
the most ___ of the deeper fibers of the inguinal ligament continue to run along the ___ as the ___
lateral;
pecten pubis;
pectineal ligament (ligament of Cooper)
ligament of Cooper
pectineal ligament
the inguinal ligament crosses anterior to the
iliopsoas and pectineus muscles, the femoral nerve, the lateral cutaneous nerve of the thigh and inguinal lymph nodes
the point where the external iliac artery becomes the femoral artery and the femoral vein becomes the external iliac vein
inguinal ligament
the inguinal ligament is the point where the ___ becomes the ___, and the ___ becomes the ___
external iliac artery;
femoral artery;
femoral vein;
external iliac vein
landmark for the femoral nerve
midpoint of the inguinal ligament
the midpoint of the inguinal ligament is located
halfway between the ASIS and pubic tubercle
the mid-inguinal point is located
halfway between the pubic symphysis and ASIS
can palpate the femoral arterial pulse here
mid-inguinal point
halfway between the pubic symphysis and ASIS
mid-inguinal point
main arterial supply to the lower limb
femoral artery
the femoral artery begins at the level of ___ as continuation of the ___ and ends at the ___, then enters the ___ and becomes the ___
the inguinal ligament; external iliac artery; adductor hiatus; popliteal fossa; popliteal artery
the femoral artery descends through the ___ and lies ___ in the femoral triangle
femoral triangle;
medial to the femoral nerve and lateral to the femoral vein
the femoral artery and its branches supplies
most of the thigh and the entirety of the leg and foot
femoral artery branch that supplies the inferior part of the anterior abdominal wall
superficial circumflex iliac artery and superficial epigastric artery
the superficial circumflex iliac artery and superficial epigastric artery supplies the
inferior part of the anterior abdominal wall
femoral artery branch that supplies the external genitalia
superficial and deep external pudendal arteries
the superficial and deep external pudendal arteries supply the
external genitalia
largest and most important branch of the femoral artery
profunda femoris artery
the profunda femoris artery is the chief source of blood supply for the ___, originates from the ___ in the ___, passes ___ to the ___ and ___ to the ___, and terminates as the ___, piercing the ___
thigh musculature;
femoral artery; femoral triangle;
posterior; adductor longus;
anterior; adductor brevis and magnus;
4th perforating artery;
adductor magnus
passes posteriorly between the iliopsoas and pectineus muscles, supplying the muscles of the medial compartment, femur, and hip joint
medial circumflex femoral artery
runs laterally anterior to the iliopsoas between branches of the femoral nerve, passes posterior to the sartorius and rectus femoris, and supplies muscles of the anterior compartment, femur, and the joints of the hip and knee
lateral circumflex femoral artery
usually 4 that pierce the adductor magnus and supply to the posterior compartment muscles
perforating arteries
terminal branch of the profunda femoris artery
4th perforating artery
the medial circumflex femoral artery passes ___ and supplies the ___
posteriorly between the iliopsoas and pectineus muscles;
muscles of the medial compartment, femur, and hip joint
the lateral circumflex femoral artery runs ___, passes ___, and supplies the ___
laterally anterior to the iliopsoas between branches of the femoral nerve;
posterior to the sartorius and rectus femoris;
muscles of the anterior compartment, femur, and the joints of the hip and knee
the perforating arteries pierce the ___ and supply the ___
adductor magnus;
muscles of the posterior compartment
((check muscular branches in the video))
dont forget
emerges into the upper thigh from beneath the inguinal ligament one third of the distance from the symphysis pubis to the ASIS
common femoral artery
optimal site for palpation of the femoral pulse (site of auscultation)
in the inner thigh, at the mid-inguinal point, halfway between the pubic symphysis and ASIS
the common femoral artery emerges into the ___ from ___
upper thigh;
beneath the inguinal ligament 1/3 distance from the symphysis pubis to the ASIS
largest branch of the lumbar plexus
femoral nerve
the femoral nerve originates from the ___ of the vertebral column
posterior divisions of ventral rami L2-L4
the femoral nerve emerges from the ___, descends in the ___, enters the ___ by passing ___, and terminates by ___
lateral border of the psoas major muscle within the abdomen;
interval between the psoas major and iliacus;
thigh; posterior to the inguinal ligament;
dividing into branches about 4cm inferior to the inguinal ligament
the femoral nerve is located ___ in the femoral triangle
lateral to the femoral artery and outside the femoral sheath
the muscular branches of the femoral nerve innervate:
iliacus,
sartorius,
pectineus,
and 4 heads of the quadriceps femoris
the anterior cutaneous branches of the femoral nerve innervate the
skin of the anterior surface and part of the medial surface of the thigh
the articular branches of the femoral artery innervate the
hip and knee joints
the terminal cutaneous branch of the femoral nerve is the ___ that passes ___ in the ___ and crosses the ___ to supply the ___
saphenous nerve; inferiorly and medially; femoral triangle and adductor canal; femoral artery anteriorly; skin of the medial aspect of the leg and along the medial border of the foot to the ball of the big toe
indications of a femoral nerve block
femur, patella, quadriceps tendon, and knee surgery;
analgesia for hip fracture
ultrasound of a femoral nerve block may
reduce the risk of a femoral artery puncture
the femoral nerve is ___ to the vessel and covered by the ___
lateral femoral artery;
fascia iliac
the obturator artery originates in the ___ from the ___, runs ___ with the ___, leaves the ___ and enters the ___ via the ___, and passes ___
pelvis; internal iliac artery;
anteriorly on the lateral pelvic wall; obturator nerve and vein;
pelvis; medial compartment of the thigh; obturator canal;
around the margins of the obturator foramen
upper part of the obturator foramen
obturator canal
the obturator artery helps the ___ supply the ___ via ___, which anastomose
profunda femoris artery;
adductor muscles;
anterior and posterior branches
the ___ of the obturator artery gives off ___ branch that supplies the ___
posterior branch;
acetabular;
head of the femur
receives tributaries that correspond to branches of the obturator artery and drains into internal iliac vein
obturator vein
the obturator vein drains into the
internal iliac vein
the posterior femoral cutaneous nerve arises from the ___, passes through the ___, runs ___, and emerges from the ___, descends in the ___ and pierces the ___, to innervate the ___
sacral plexus (S1-S3);
greater sciatic foramen below the piriformis muscle;
deep to the gluteus maximus muscle;
inferior border of the gluteus maximus muscle;
posterior midline of the thigh deep to the fascia lata;
fascia lata near the popliteal fossa;
skin of the buttock, posterior thigh, and calf
the obturator nerve supplies the
skin on the medial aspect of the thigh
the superficial inguinal group of lymph nodes is located ___, receives lymph from the ___, and drains into the ___
subcutaneously near the saphenofemoral junction and drains the superficial thigh region;
anterolateral abdominal wall below the umbilicus, gluteal region, lower parts of the vagina and anus, and external genitalia except the glands;
external iliac nodes
the deep inguinal group of lymph nodes is located ___, receives lymph from the ___, and drains into the ___
deep to the fascia lata on the medial side of the femoral vein;
deep lymph vessels (efferents of the popliteal nodes) that accompany the femoral vessels and from the glans penis / clitoris;
external iliac nodes
Small branch that originates from femoral artery before it pierces the adductor magnus
descending genicular artery
the descending genicular artery contributes to
arterial anastomosis around knee joint