The Knee + Anterior + Medial Thigh Flashcards
What are the muscles of the anterior thigh?
Rectus femoris
Vastus medalists
Vastus lateralis
Vastus intermedius
Pectineus
Sartorius
Iliopsoas - Iliacus + psoas major
Arterial supply of the anterior thigh
Branches of the femoral artery - LFCA + MFCA
- profunda femoris
Action of the quadriceps muscles
Extends knee
Innervation of the anterior thigh
Femoral nerve L2,3,4
Insertion of the quadriceps
Base of patella via quadriceps tendon
Function of Vastus medialis obliquus
Resists lateral displacement of patella
Order of the Pes anserinus superior to inferior
Say Grace before Tea
Sartorius
Gracilis
Semitendinosus
Name the muscle of the medial thigh from superior to inferior
Obturator externus
ADductor brevis
ADductor longus
ADductor Magnus
Gracillis medially
Innervation of the the medial thigh
Obturator nerve L2,3,4
Action of medial thigh
Hip ADductors
Arterial supply to medial thigh
Obturator artery
Borders of the femoral triangle
SAIL
Sartorius lateral
ADductor longus medial
Inguinal Ligament superior
Roof of the femoral triangle
Fascia lata
Base of the femoral triangle
Pectineus
Iliopsoas
Adductor longus
Contents of the femoral triangle
NAVEL
Lateral
femoral Nerve
femoral Artery
femoral Vein
Empty space
Lympathics
Medial
What structures are within the femoral sheath?
Femoral artery + vein
Lymphatics
What does the empty space in the femoral triangle allow?
Veins + lymph vessels to distend to cope with varying levels of flow
Contents of the femoral canal
Lymph nodes
Lymph vessels
Empty space
Loose connective tissue
Borders of the femoral canal
Medial - lacunar ligament
Lateral - femoral vein
Anterior - inguinal ligament
Posterior - pectineal ligament
- superior ramus of pubic bone
- Pectineus muscle
What is the femoral ring?
Opening at superior border of the femoral canal
What is the adductor canal?
Passageway for structures passing between anterior thigh + posterior leg
Contents of the adductor canal
Femoral artery + vein
Saphenous nerve
Nerve to Vastus medialis
Hypertrophy of borders of adductor canal can cause what?
ADducor canal compression syndrome
Borders of the adductor canal
Anterior - Sartorius
Lateral - Vastus medialis
Posterior - ADductor longus + Magnus
What type of joint is the knee joint?
Synovial hinge joint
Articulation of the knee joint
Distal femur
Proximal tibia
Patella
Joints of the knee
Tibiofemoral joint - weight bearing joint
Patellofemoral joint
Blood supply to the knee
Genicular anastomoses
What is the knee joint supported by?
Joint capsule
Ligaments
Menisci
Blood supply to the menisci of the knee + how it changes over time
From the periphery
Decreases with age»_space; central meniscus is a vascular in adulthood - impaired healing
Function of the posterior meniscofemoral ligament
Helps stabilise posterior horn of lateral meniscus by attaching it to the medial femoral condyle
What collateral ligament of the knee is more likely to tear and why?
Medial collateral ligament as it is attached to the medial meniscus
LCL isn’t attached to lateral meniscus
Function of meniscus
- Act as shock absorbers- increase surface area
- Deepens articular surface of tibia - increased stability
What is the inter nodular eminence an attachment site for?
ACL
Menisci
What is the unhappy triad?
Damage to the ACL, medial collateral ligament + medial meniscus
Function of the ACL
Prevents posterior movements of femur over tibia
Attachments of the ACL
Anterior medial tibia - intercondylar eminence
Lateral condyle of femur
Attachments of PCL
Posterior lateral tibia
Medial condyle of femur
Function of the PCL
Prevents femur from sliding anteriorly off tibia
Function of the medial collateral ligament
Resists valgus angulation }{
Attachments of medial collateral ligament
Medial epicondyle of femur
Medial condyle of tibia
Function of lateral collateral ligament
Resists varus angulation { }
Attachments of lateral collateral ligament
Lateral epicondyle of femur
Depression on lateral surface of fibular head
What are bursa?
Small sac lined by synovial membrane
Function of bursa
Reduce friction between bones and soft tissue
What are the 6 bursae of the knee
Suprapatellar bursa
Subcutaneous prepatellar bursa
Subcutaneous infrapatellar bursa
Deep infrapatellar bursa
Subsatorial bursa
Semimembranosus bursa
What muscles allow extension of knee?
Rectus femoris
Vastus medialis
Vastus intermedialis
Vastus lateralis
What muscles allow flexion of the knee?
Biceps femoris
Semimembranosus
Semitendinosus
What muscles allow lateral rotation of the knee?
Biceps femoris
What muscles allow for medial rotation of the knee?
Semimembranosus
Semitendinosus
Gracilis
Sartorius
Popliteus
What is the main artery that supplies the lower limbs?
Femoral artery
Where does the popliteal artery start and what from?
Femoral artery after leaving adductor canal
What does the femoral artery split into in the femoral triangle?
Profunda femoris artery which branches into:
- LFCA
MFCA
Perforating branches
What arteries supply the gluteal region?
Superior and inferior gluteal arteries
Where does the Obturator artery supply?
Medial thigh
Outline the deep veins of the lower limb
Popliteal vein > (adductor hiatus) > femoral vein > profunda femoris vein > (inguinal ligament) > external iliac vein
Superior + inferior gluteal veins > internal iliac vein
What are the main superficial veins of the lower limbs?
Where do they run?
Great saphenous vein - medially
Small saphenous vein - laterally
Where do the superficial medial lymph vessels drain into and what do they follow?
Inferior superficial inguinal lymph
Follows the great saphenous vein
Where do the superficial lateral lymph vessels drain into and what do they follow?
Deep inguinal nodes
Follows small saphenous vein
Where do the deep lymph vessels drain into?
Popliteal lymph nodes
Action of sartorius
- flexes, ABducts + laterally rotates thigh at hip joint
- flexes + medially rotates leg at knee joint
Action of pectineus
ADducts + flexes thigh at hip
Action of iliopsoas
Flexion at hip joint
Assists lateral rotation at hip
Action of obturator externus
Lateral rotation of thigh
Action of gracillis
ADducts thigh at hip
Flexes knee
What are the parts of adductor Magnus?
Adductor
Hamstring
Innervation of the parts of adductor magnus
- adductor compartment: obturator nerve S2-4
- hamstring compartment: sciatic nerve L4-S3
What separates the insertion of the parts of adductor magnus?
Adductor hiatus
What drains into the femoral vein in the femoral triangle?
Great saphenous vein
