Thigh

Question 1

Describe Femur

Answer 1

• longest and heaviest bone (1/4 of a persons height)

Question 2

Define Angle of Inclination

Answer 2

• head of femur is connected to the shaft of the femur at 126 degree angle
• Angle WIDEST at birth (140 degrees) and diminishes with age (narrowest in old age, 110)
• Angle is less in females than males because females have wider hips

Question 3

Femoral branch of genitofemoral

Answer 3

L1, L2

- supply skin over FEMORAL TRIANGLE (proximal part of the anterior thigh)

Question 4

Medial cutaneous branch of femoral

Answer 4

• supply skin of MEDIAL THIGH

Question 5

Intermediate cutaneous branch of femoral

Answer 5

supply the skin of the DISTAL ANTERIOR THIGH

Question 6

Lateral femoral cutaneous nerve

Answer 6

L2, L3

• Enters the thigh medial to ASIS
• Supply LATERAL THIGH, lateral to the intermediate cutaneous branch of the femoral

Question 7

Posterior femoral cutaneous nerve

Answer 7

S1, S2, S3

• Supplies POSTERIOR THIGH and POPLITEAL region
• originate from sacral plexus
• Courses inferiorly into the thigh from the gluteal region

Question 8

Superficial epigrastric a

Answer 8

• branch of femoral a

- proceed superiorly to provide the skin over the LOWER ABDOMINAL WALL

Question 9

Superficial circumflex iliac artery

Answer 9

• Branch of femoral a
• Profeeds laterally inferior to the inguinal ligament
• parallels the course of the DEEP CIRCUMFLEX iliac a

Question 10

Great saphenous vein

Answer 10

• begins at foot and ascends to its termination Femoral vein
• located in superficial fascia
• has valves
• Enters thigh by passing posterior to medial condyl of femur
• receives numerous tributaries in the thigh and legs

Question 11

Fascia Lata

Answer 11

DEEP FASCIA

• prevents bulging of muscles
• dense layer of CT between muscles of thigh and superficial fascia
• Forms the ILIOTIBIAL TRACT (BAND) = lateral thickening of the fascia
• provides INTERMUSCULAR SEPTA to divide thigh into compartments
• All septa attached to LINEA ASPERA

Question 12

What are the attachments of Fascia lata

Answer 12

Superiorly attached:
- Inguinal ligament
- parts of hip bone
- sacrum and coccyx
- Scarpas fascia and sacrotruberous ligamen
Inferiorly continous with crural fascia (below knee)

Question 13

Contents of femoral triangle

Answer 13

• triangular space in proximal part of anterior compartment
• Femoral artery/vein/nerve + branches
• lymphatic vessels and nodes
• Femoral Sheath (femoral shaped fascial tube)
• Femoral hernias - usually originate at femoral ring

Question 14

boundaries of Adductors canal

Answer 14

• 15cm long canal that extends from apex of femoral triangle to the adductor hiatus in the adductor magnus muscle
• Anteromedial = SARTORIUS
• LATERAL = VASTUS MEDIALIS
• POSTERIOR = ADDUCTOR LONGUS and magnus

Question 15

What are the contents of ADDUCTORS CANAL

Answer 15

• femoral artery and vein
• Saphenous nerve
• nerve to vastus medialis

Question 16

FEMORAL NERVE

Answer 16

L2, L3. L4 - largest branch of lumbar plexus

• travels deep to inguinal ligament to enter femoral traingle
• NOT ENCLOSED by femoral sheath
• Lies lateral to femoral artery
• Breaks into sensory and motor branches while still in triangle

Question 17

Sensory branches of Femoral nerve

Answer 17

• Medial femoral cutaneous nerve
• Intermediate femoral cutaneous nerve
• saphenous nerve (travels through adductor canal and it leaves canal at its lower end to innervate skin of leg and foot)

Question 18

Motor branches of femoral nerve supply what muscles?

Answer 18

• Sartorius
• quadrecepts femoris
• articularis genu
• pectineus (also gets a branch from obturator nerve)

Question 19

Obturator nerve

Answer 19

Divides into anterior and posterior division in the obturator foramen

• ANTERIOR DIVISION = located between adductor longus and brevis
• -> supplies adductor longus, gravilis, adductor brevis and part of pectineus
• POSTERIOR DIVISION = located between adductor brevis and magnus
• -> supplies obturator externus, adductor brevis and adductor magnus

Question 20

Describe the cruciate anastomosis

Answer 20

• 1st perforating artery
• Medial, lateral femoral circumflex artery
• inferior gluteal arteries

Question 21

What does obturator artery branch off of?

Answer 21

Branch of internal iliac artery

Question 22

Popliteal fossa boundaries

Answer 22

Fat filled - diamond space at back of knee
BOUNDARIES:
- inferomedial and inferolateral = gastrocnemius muscle
- superolateral = bicep femoris
- superomedial = semimembranosus tendon
- floor = popliteal surface of femur and posterior knee ligament

Question 23

Contents of Popliteal fossa

Answer 23

• termination of small saphenous vein
• popliteal vessels + branches
• tibial and common peroneal nerves
• posterior cutaneous nerve of thigh
• popliteal lymph nodes and vessels

Question 24

Damage to superior gluteal nerve results in what?

Answer 24

Superior gluteal = L4-S1

- injury to supeior gluteal nerve would AFFECT GLUTEUS MEDIUS and MINIMUS and tensor fasciae latae muscles

Question 25

Damage to inferior gluteal nerve causes what?

Answer 25

Inferior gluteal = L5-S2 | - damage affects gluteus maximus muscle

Question 26

Damage to sciatic nerve?

Answer 26

``` Sciatic = L4-S3 Two branches: - Tibial = L4-S3 - Common peroneal = L4-S2 DAMAGE WILL NOT AFFECT GLUTEAL REGION ```

Question 27

Which nerves originate from posterior divison of L4-S4 roots?

Answer 27

- common peroneal - superior gluteal - inferior gluteal - posterior femoral cutaneous - nerve to piriformis

Question 28

Which nerves originate from anterior division of L4-S4 roots)

Answer 28

- tibial nerve - Nerves to obturator internus and quadratus femoris - pudendal nerve - nerve to levator ani