Thigh Flashcards
Number of ossification sites on the femur
5
The primary ossification center of the femur is
Diaphysis (shaft)
Where are the 4 secondary ossification centers of the femur?
Head
Greater trochanter
Lesser trochanter
What is a slipped capitis femoris?
The slippage of the growth plate (epiphysis of the femoral head)
Physical exam of slipped capitis femoris will reveal
Positive trendelenburg sign because of unequal limb length
On passive extension of the hip. the thigh will abduct and externally rotate
What are the main superficial veins of the thigh and leg?
Great saphenous vein
Small saphenous vein
Great saphenous vein comes from
Femoral vein in inguinal region
Small saphenous vein comes from
Popliteal vein in popliteal fossa
Lymph in thigh drains into
Superficial inguinal lymph nodes (inferior or vertical group)
Superficial inguinal lymph nodes (superior or horizontal node)
Lymph in leg drains into
Popiteal lymph nodes
Retroinguinal space consists of
Lacuna musculorum
Lacuna vasorum
What is located in the lacuna musculorum?
Lateral femoral cutaneous nerve
Femoral nerve
Iliopsoas muscle
What is located in the lacuna vasorum?
Femoral branch of the genitofemoral nerve
Femoral sheath, which includes the femoral artery, femoral vein, and femoral canal lymphatics
Femoral triangle is bounded by
Inguinal ligament- superiorly
Sartorius- laterally
Adductor longus- medially
Medial branches of the external iliac/femoral arteries in the inguinal region
External pudendal arteries (superficial and deep)
Superior branches of the external iliac/femoral arteries in the inguinal region
Epigastric arteries (superficial and inferior)
Lateral branches of the external iliac/femoral arteries in the inguinal region
Circumflex iliac arteries (superficial and deep)
You can see variations in the branching pattern of which arteries?
Medial and lateral femoral circumflex arteries
Profunda femoris artery
The medial circumflex femoral artery typically passes between
Pectineus and iliopsoas muscles
What is avascular necrosis of the femoral head?
Damage to the retinacular arteries supplying the head of the femur
The trochanter anastomosis supplies
Neck and head of femur
Trochanter anastomosis is fored by
Superior and inferior gluteal arteries and medial and lateral femoral circumflex arteries
Retinacular vessels are located deep to
zona obicularis
Quads are usually innervated by
Femoral nerve
Adductors are usually innervated by
Obuturator nerve
What is innervated by the common fibular nerve and gluteal nerves
Gluteals
Short head of biceps femoris
What innervates the hamstrings and lateral rotators
Tibial nerve and nerves to lateral rotators
Psoas major and minor are innervated by (3)
Anterior rami of lumbar nerves (L1-L3)
Femoral nerve
Illiacus is innervated by
Femoral nerve (L2-L3)
Sartorius and quadriceps femoris is innervated by
Femoral nerve (L2-L4)
Pectineus is innervated by
Femoral nerve (L2-L3)
Obturator nerve (L2-L3)
Obturator externus is innervated by
Obturator nerve (L3-L4)
Gracilis is innervated by
Obturator nerve (L2-L3)
Adductor longus is innervated by
Obturator nerve (L2-L4)
Adductor brevis is innervated by
Obturator nerve (L2-L3)
Adductor magnus is innervated by
Adductor part innervated by obturator nerve (L2-L4)
Hamstring part by tibial part of sciatic nerve
Function of iliopectineal bursa
Reduces friction of iliacus and psoas muscles over hip joint
Branches of the femoral nerve
Anterior cutaneous branches
Muscular branches
Nerve to the vastus medialis
Femoral nerve continues as the
Saphenous nerve
Posterior branch of the obturator nerve- location
Descends behind adductor brevis, on the anterior surface of the adductor magnus
Posterior branch of the obturator nerve innervates
Adductor part of adductor magnus
Anterior branch of the obturator nerve- location
Descends behind pectineus and adductor longus, on the anterior surface of adductor brevis
Anterior branch of obturator nerve innervates
Gracilis
Adductor longus
Adductor brevis
Contributes to supply of pectineus
Cutaneous branch of obturator nerve is derived from
Anterior branch of obturator nerve
Cutaneous branch of obturator nerve innervates
Skin of medial thigh
Location of accessory obturator nerve
Exits pelvis through lacuna vasorum
3 terminal branches of accessory obturator nerve
Sensory branch to hip joint
Motor branch to pectineus
Communicating branch to anterior division of obturator nerve
Iliopsoas inserts on
Lesser trochanter and adjacent femoral shaft
Hip flexors of abdomen
Psoas minor
Psoas major
Iliacus
Iliopsoas
Quadriceps femoris- origin
Originate on ASIS and femoral shaft below intertrochanteric line
Quadriceps femoris- insertion
Quadriceps tendon and superior patella
Tibial tuberosity via patellar tendon
Quadriceps femoris is innervated by
Femoral nerve
Blood supply to quadriceps femoris
Lateral femoral artery, especially its descending branch
Sartorius- origin
ASIS
Sartorius- insertion
Proximal tibia as part of pes anserinus
Sartorius is innervated by
Femoral nerve
Function of sartorius
Flexus, abducts, and laterally rotates thigh
Flexes knee
Adductors of the thigh
Pectineus
Adductor longus
Adductor brevis
Adductor magnus
Gracilis
Most adductors originate around
Obturator foramen
Origin of pectineus
Pectineal line of pubis
Origin of adductor longus
Pubis, lateral to the symphysis
Adductor brevis- origin
Inferior pubic ramus
Adductor magnus- origin of adductor part
Ischiopubic ramus
Adductor magnus- origin of hamstring part
Ischial tuberosity
Gracilis- origin
Ischiopubic ramus
Insertion of pectineus
Line from lesser trochanter to linea aspera
Insertion of adductors
Linea aspera
Adductors originate on
Linea aspera
Hamstring part of adductor magnus inserts on
Adductor tubercle
Gracilis- insertion
Just distal to medial condyle of tibia
Where is the adductor hiatus located
Adductor magnus, between insertion site for hamstring and adductor part
Origin of obturator externus
External surface of obturator membrane
Insertion of obturator externus
Trochanteric fossa
What muscles laterally rotate the thigh?
Piriformis
Gemelli
Obturator internus
Quadratus femoris
Obturator externus is innervated by
Obturator nerve
Most lateral rotators of thigh are innervated by
Tibial nerve
Hamstrings muscles are
Semimembranosus
Semitendinosus
Biceps fermois, long head
Biceps femoris, short head
Which hamstrings attach on the ischial tuberosity
Semimembranosus
Semitendinosus
Biceps femoris, long head
Biceps femoris, short head originates on
Linea aspera
Semimembranosus- insertion
Medial tibial condyle
Semitendinosus- insertion
Pes anserinus
Biceps femoris- insertion
Head of fibula
Function of hamstrings
Hip extensors and knee flexors
Additional actions of semimembranosus and semitendenosus
Medially rotate thigh and leg
Additional action of biceps femoris
Laterally rotates thigh and leg
Innervation of hamstrings + exception
Tibial component of sciatic nerve
Exception: short head of biceps femoris which is innervated by common peroneal nerve
Blood supply to hamstrings- proximally
Inferior gluteal artery
Blood supply to hamstrings- middle
Perforating arteries from profunda femoris
Blood supply to hamstrings- distal
Popliteal artery
Which muscles insert on pes anserinus and what innervates each of these muscles
SGT FOT
Sartorius (femoral)
Gracilis (obturator)
Semitendinosus (Tibial division of sciatic nerve)
Which muscles originate on the adductor magnus and ischial tuberosity
Hamstrings
Adductor magnus
Insertions of powerful tendons are subject to ___ especially if the tendon inserts on an ___
Avulsion fractures
Especially if tendon inserts on epiphysis
Where does the femoral artery run? (over + under)
Behind sartorius and quads
Over adductors
Where does the profunda femoris run (over + under)
Behind adductor longus
Over adductor brevis and magnus
Perforating branches of femoral artery extend through
Adductor magnus
Adductor canal (location)
Starts at apex of femoral triangle
Runs behind sartorius and quads and in front of adductors
Ends at adductor hiatus
Arteries and veins in adductor canal emerge in
Popliteal fossa via adductor hiatus in adductor magnus
Which branch nerve passes through the adductor hiatus
Articular branch of obturator nerve to knee joint
What runs through the adductor canal? Which of these will pass through the adductor hiatus
Femoral artery and vein (emerge from canal to become popliteal artery and vein)
Saphenous nerve (does not go through hiatus)
Nerve to vastus medius (does not go through hiatus)
Femoral nerve branches (do not pass through hiatus)
Articular branch of obturator nerve to knee joint
What divides the thigh into compartments?
Intermuscular septa which are continuous with fasca lata