Thigh Flashcards
Which muscles attach to the lesser trochanter of the femur?
Psoas major
iliacus
Where does psoas major originate?
The deep part of psoas major originates from the transverse processes of L1-L4. The superficial part originates from the lateral surfaces of T12-L4 and the intervening vertebral discs
What is the action of psoas major?
Flexes and externally rotates the hip
Describe the blood supply to the head of the femur
Majority of blood supply is from the retinacular arteries, which arise as ascending cervical branches from the extracapsular arterial anastomosis. This is formed posteriorly by the medial femoral circumflex artery and anteriorly from branches of the lateral femoral circumflex artery with minor contributions from the superior and inferior gluteal arteries.
There is also supply from the artery of the ligamentum teres, also known as the artery of the round ligament of the femoral head (a branch of the obturator artery)
Where do the arteries supplying the femoral head originate?
The medial and lateral circumflex femoral arteries originate from the profunda femoris
The artery of the ligamentum teres originates from the obturator artery
Which muscle form the quadriceps?
Vastus lateralis
Vastus medialis
Vastus intermedius
rectus femoris
What are the origins, insertion, actions and innervation of vastus lateralis?
Origin - iliotibial line/greater trochanter/lateral linea aspera
Insertion - lateral patella
Innervation - femoral nerve
What are the origins, insertion, actions and innervation of vastus medialis?
Origin - iliotibial line/ medial linea aspera/ supracondylar line
insertion - medial patella
innervation - femoral
What are the origins, insertion, actions and innervation of vastus intermedius?
Origin - proximal anterior femoral shaft
Insertion - patella
Innervation - femoral
What are the origins, insertion, actions and innervation of rectus femoris?
Origin - straight head - Anterior inferior iliac spine
Reflected head - acetabular rim
Insertion - patella and tibial tubercle
Innervation - femoral
Which muscles make up the hamstrings?
Biceps femoris (long head)
Biceps femoris (short head)
Semitendinosus
Semimembranosis
What are the origins, insertion, actions and innervation of biceps femoris (long head)?
Origin - medial ischial tuberosity
Insertion - fibular head/ lateral tibia
Innervation - tibial
BWhat are the origins, insertion, actions and innervation of biceps (short head)
Origin - lateral linea aspera/ lateral intermuscular septum
Insertion - Lateral tibial crest
Innervation - peroneal
What are the origins, insertion, actions and innervation of semitendinosus?
Origin - distal medial ischial tuberosity
Insertion - anterior tibial crest
Innervation - tibial
What are the origins, insertion, actions and innervation of semimembranosus?
Origin - proximal lateral ischial tuberosity
Insertion - oblique popliteal ligament
posterior capsule, posterior/medial tibia, popliteus, medial meniscus
Innervation - tibial
What are the actions of the hamstring muscles?
All three muscles
- flexion of the leg at the knee joint
- extension of thigh at the hip
Biceps
- lateral rotation of the hip and knee
Semitendinosus and semimembranosus
- medially rotates the thigh at the hip joint and the leg at the knee joint
What are the boundaries of the popliteal fossa?
Laterally - biceps femoris above, lateral head of gastrocnemius and plantaris below
Medially - semimembranosus and semitendinosus above, medial head of gastrocnemius below
floor - popliteal surface of the femur, posterior ligament of the knee joint and popliteus msucle
roof - superficial and deep fascia
WHat structures are at risk in a supracondylar fracture of the femur?
popliteal artery - always check distal pulses and ABPI - consider CTA or arteriogram
What does the popliteal fossa contain?
Common peroneal nerve
tibial nerve
popliteal vein and artery
lymph nodes
small saphenous vein
posterior cutaneous nerve of the thigh
genicular branch of the obturator nerve
Describe the course of the tibial nerve in the popliteal fossa?
The tibial nerve lies superior to the vessels in the inferior aspect of the popliteal fossa. In the upper part of the fossa the tibial nerve lies lateral to the vessels, it then passes superficial to them to lie medially.
What is the deepest structure within the popliteal fossa?
Popliteal artery
What are the differentials for a patient with a lump in the popliteal fossa
Baker’s cyst
Popliteal artery aneurysm
Lipoma
Schwannoma
Popliteal vein varicosties
What are the boundaries of the femoral triangle?
Superior - inguinal ligament
Lateral - sartorisu
Medial - adductor longus
Floor - iliopsoas, pectineus and adductor longus
Roof - fascia lata and superficial fascia, superficial inguinal lymph nodes and long saphenous vein
What are the contents of the femoral triangle?
Medial to lateral Femoral vein
femoral artery (pulse at the mid-inguinal point)
femoral nerve
deep and superficial inguinal lymph nodes
lateral cutaneous nerve
great saphenous veing
femoral branch of the genitofemoral nerve
What are the boundaries of the adductor canal?
Lateral - vastus medialis
Posterior - adductor longus, adductor magnus
Roof - sartorius
What are the contents of adductor canal?
Saphenous nerve
Superfical femoral artery
superficial femoral vein (posterior to the artery in the upper part and then posterolateral)
nerve to vastus medialis
What are the surface markings of the adductor canal?
Adductor hiatus lies 2/3 long the line between ASIS and adductor tubercle of the femur
What are the surface markings of the femoral artery?
At the mid-inguinal point, lies halfway between the pubic symphysis and the ASIS
What is the vascular lacuna?
A compartment beneath the inguinal ligament which allows for passage of the femoral vessels, lymph vessels and lymph nodes
The muscular lacuna is the lateral compartment of the thigh inferior to the inguinal ligament, it is separated by the iliopectineal arch from the vascular lacuna
What are the contents of the lacuna vasorum?
Medial to lateral
- deep inguinal lymph nodes
- femoral vein
- femoral artery
- femoral branch of the genitofemoral nerve
What are the contents of the lacuna musculorum?
Femoral nerve
iliopsoas
Lateral femoral cutaneous nerve
