Thigh Flashcards
What is the deep fascia of the thigh?
Fascia lata
What is the deep fascia of the leg?
Crural fascia
What vein runs on the posterior side?
Small saphenous vein
What is the course of the great saphenous vein?
Exits saphenous opening in proximal thigh, courses posteriorly and then back anteriorly at knee where it stays medially
What is the major nerve of the posterior leg?
Sural nerve
What veins “fail first” in causing vericose veins?
Perforating veins
What is the IT band?
A thickening of the fascia lata
What is the ridge of the posterior femur called?
Linea aspera
What are the compartments of the thigh?
Anterior (largest)
Medial
Posterior
What is compartment syndrome?
Build up of fluid/pressure in one of the compartments of the leg because fascia separates each compartment.
What are the muscles of the anterior thigh?
Psoas major
Iliacus (^ together iliopsoas)
Quadriceps femoris: Rectus femoris Vastus medialis Vastus lateralis Vastus intermedius
What is the main nerve of the anterior thigh?
Femoral nerve (except the psoas major)
What are the attachments of psoas major?
T12 - L5
to lesser trochanter with iliacus
What are the attachments
Inside of pelvis (iliacus fossa) to lesser trochanter w/ psoas major
What does the iliopsoas do?
Flexes the hip! Directly anterior to hip and thus are the strongest flexors
What is the innervation of the psoas major?
??
What 3 muscles do NOT cross the hip joint?
Vastus lateralis
Vastus medius
Vastus intermedius
What is the only muscle that acts on/crosses the hip joint of the quadriceps femoris?
Rectus femoris
What are the connections of the patellar tendon/ligament?
Patella to tibial tuberosity
Ligaments attach ____ to ____.
bone to bone
What major muscle attaches to the top of the patella?
Rectus femoris
What is the long ribbon-like muscle that crosses the anterior thigh to attach posteriorly to the tibia (“pes anserinus”)?
Sartorius
What does the sartorius do?
Knee flexion
External hip rotation
Hip abduction
What muscles form the pes anserinus? Where does it attach?
Medial aspect of the tibia
Gracilis (medial c.)
Semitendinosus (posterior c.)
Sartorius (anterior c.)
What is the cutaneous innervation of the medial leg and foot?
Saphenous nerve
What cutaneous innervation does the femoral nerve supply?
Anterior and Medial thigh
The femoral nerve travels ____ to the inguinal ligament.
Deep
What are the spinal cord segments of the femoral nerve?
L2-L4
What spinal cord levels does the patella tendon reflex test?
L3, L4
What spinal cord levels involve hip flexion?
L2, L3
What spinal cord levels involve knee extension?
L3, L4
What are the medial compartment muscles of the thigh?
Pectineus
Adductor longus
Adductor brevis (deep)
Gracilis
Adductor magnus (adductor and hamstring portions) Obturator externus
Where do the muscles of medial thigh compartment originate?
Pubic bone (except…)
What do the medial compartment muscles do?
Adduct the hip
pectineus and adductor longus, and adductor brevis also have minor flexion
What is the only medial thigh compartment muscle to NOT attach to the femur?
Gracilis! It’s part of the pes anserinus
What is the space of the addcutor magnus between the vertical fibers of hamstring portion and oblique adductor fibers?
Adductor hiatus
What does the hamstring portion of the adductor magnus do in addition to adduction?
Hip extension
What is the innervation of the innervation of the adductor magnus?
Adductor portion: obturator nerve
Hamstring portion: tibial nerve
What is the innervation of the pectineus muscle?
Femoral nerve AND
Obturator nerve
What are attachments of the obturator externus?
Obturator foramen
Greater trochanter
What is the action of the obturator externus?
External rotation
What is the course of the obturator nerve?
Enters LE by passing through obturator canal
Descends on either side of the adductor brevis (i.e. pretty deep)
What is the cutaneous innervation of the obturator nerve?
Medial aspect of thigh
What are the muscles of the posterior thigh compartment?
Semimembranosus
Semitendinosus
Biceps femoris long head
Biceps femoris short head
What are the attachemnts of the hamstring muscles?
Ischial tuberosity
to tibia
What nerves does the sciatic nerve branch into at the knee?
Tibial and common fibular (peroneal) nerve
What are the spinal cord origins of the sciatic nerve?
L4-S3
What muscles does the tibial division of the sciatic nerve innervate?
Semimembranosus
Semitendinosus
Biceps femoris long head
What muscles does the common fibular (peroneal) nerve innervate?
Biceps femoris short head
What provides cutaneous sensation to the posterior nerve?
Posterior cutaneous nerve of the thigh
The sciatic nerve goes _____ to the long head of the biceps femoris. ______ to the long head is the ________ nerve.
Deep
Superficial
Posterior cutaneous nerve
What forms the femoral triangle?
Inguinal ligament Medial: adductor longus Lateral: sartorius Floor: iliopsoas and pectineus Roof: fascia/skin
What are the contents of the femoral triangle?
NAVEL (lateral to medial)
Nerve Artery Vein Empty space Lymphatics
What is the only thing NOT in the femoral sheath as it passes through the femoral triangle?
The nerve
What is the femoral ring?
Proximal potential opening to the femoral canal if the femoral septum is no longer closed.
What is the clinical correlation of the femoral ring?
A femoral hernia can form (i.e. intestine pouches out the thigh). More common in women due to their wider pelvis.
What are the branches of the deep femoral artery?
Lateral circumflex femoral a.
Medial circumflex femoral a.
Perforating arteries (4)
What is the “superficial femoral artery”?
Continuation of the femoral artery after it gives off the deep branch.
What are the branches of the lateral circumflex femoral artery?
Ascending -> retinacular branches that feed the head of the femur
Transverse (cruciate anastomosis)
Descending (genicular anastomosis)
Where does the medial circumflex femoral artery travel?
Between the iliopsoas and the pectineus
Winds around posteriorly
What are the branches of medial circumflex femoral artery?
Ascending branch -> retinacular branch major bloody supply to the femoral head
Transverse branch (cruciate anastomosis)
What provides the major blood supply to the femur head?
Ascending branch of the medial circumflex femoral artery
What do the perforating
Provides blood to all compartments of thigh, esp posterior
The ____ perforating artery contributes to the cruciate anastomosis and the ____ perforating artery forms an anastomosis with the popliteal artery.
1st, 4th
What forms the cruciate anastomosis?
Inferior gluteal artery (i)
Medial circumflex fem a. (e)
Lateral circumflex fem a. (e)
First perforating artery (e)
Provides communication between internal and external iliac arteries
What is the adductor canal?
Space from the apex of the femoral triangle to adductor hiatus.
What travels through the adductor canal?
Femoral artery and vein
Saphenous nerve
Nerve to the vastus medialis
What passes through the adductor magnus (adductor hiatus opening) to reach the popliteal fossa?
Femoral artery and vein
What makes a direct anterior approach to the hip unique?
Between an intermuscular plane and internervous plane
Scalpel goes between sartorius and TFL
What nerves/vessels are at risk in a THA?
Lateral cutaneous nerve
Ascending branch of lateral circumflex femoral artery
What does the obturator artery do/supply?
Branches into anterior and posterior branch (-> acetabular artery to artery of the head of femur).
