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MRCS > Thigh > Flashcards

Thigh Flashcards

1
Q

Femur surfaces

A

Anterior
Posteromedial
Posterolateral

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2
Q

Femur borders

A

Medial
Lateral
Posterior - form linea aspera (roughened crest) which widens to form a posterior surface at the distal end (Which forms floor of popliteal fossa).

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3
Q

Lateral epicondyle

A

Upper facet - lateral head of gastrocnemius

Lower facet - popliteus muscle

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4
Q

ACL

A

medial side of lateral epicondyle

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5
Q

PCL

A

lateral side of medial epicondyle

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6
Q

Adductor tubercle

A

posterosuperior to medial epicondyle

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7
Q

Patella

A

Posterior surface of patella articulates with femur

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8
Q

Tibia intercondylar region (anterior)

A

3 facets
most anterior - anterior attachment of medial meniscus
2nd - attachment of ACL
3rd (lateral to ACL) - anterior attachment of lateral meniscus

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9
Q

TIbia intercondylar region (posterior)

A

3 facets
most anterior - posterior horn of lateral meniscus
Posteromedial to that is - posterior horn of medial meniscus
most posterior - attachment of PCL

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10
Q

Shaft of tibia

A

3 surfaces - lateral, medial and posterior

3 borders - anterior, interosseous and medial

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11
Q

Medial surface of tibia

A

there is an area of slightly roughened, elongate elevation somewhat inferior to tibial tuberosity. Site of attachment for sartorius, gracilis and semitendinosus which descend from the thigh

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12
Q

Posterior surface of tibia

A

There is a roughened oblique line (soleal line)

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13
Q

Fibula borders and surfaces

A

3 borders - anterior, posterior and interosseous

3 surfaces - lateral, posterior and medial

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14
Q

Lateral surface of head of fibula

A

Attachment of biceps femoris

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15
Q

Anterior compartment of thigh

A

quadriceps femoris (rectus femoris, vastus lateralis, vastus medialis and vastus intermedius)
sartorius
All innervated by femoral nerve
Terminal ends of psoas major (anterior rami L1 to L3) and iliacus (femoral nerve)

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16
Q

Medial compartment of thigh

A

gracilus, pectineus, adductor longus, adductor magnus, adductor brevis and obturator externus
All by obturator nerve except
pectineus - femoral nerve
part of adductor magnus - sciatic nerve

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17
Q

Posterior compartment of thigh

A 
Biceps femoris
Semitendinosus
Semimembranosus 
All by sciatic nerve
All crosses both hip and knee joint other than short head of biceps
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18
Q

Vastus medialis, lateralis and intermedius

A

Femoral nerve
Extends leg at knee joint
Originate from femur
All insert into quadriceps femoris tendon and margins of patella - hence also helps stabilise patella during knee joint movement

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19
Q

Sartorius

A

ASIS to medial surface of tibia just inferomedial to tibial tuberosity. Most superficial in thigh
Femoral nerve
Upper 1/3 of thigh - forms lateral border of femoral triangle
Middle 1/3 - anterior wall of adductor canal

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20
Q

Rectus femoris

A

Femoral nerve
Extends leg at knee and helps flex hip
Originate from pelvic bone (crosses both knee and hip joint). Two heads of origin - from AIIS (Straight head) and another from roughened area of ilium immediately superior to acetabulum (reflected head)
Muscle belly lies anterior to vastus intermedius, between vastus medialis and lateralis

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21
Q

Gracilis

A

Most superficial muscle in medial.
Origin: ischium
Insertion: medial surface of proximal surface of tibia (between sartorius anteriorly and semitendinosus posteriorly)
Adducts thigh and flexes leg at knee joint

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22
Q

Pectineus

A

Origin: pectineal line of pelvic bone
Insertion: oblique line from lesser trochanter to linea aspera on posterior surface of femur
Forms part of the floor of medial half of femoral triangle

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23
Q

Adductor longus

A

Origin: external surface of body of pubis just inferior to pubic crest and lateral to pubic symphysis.
Insertion: descends posterolaterally to middle third of linea aspera
Floor of femoral triangle, proximal posterior wall of adductor canal

24
Q

Adductor brevis

A

Lies posterior to pectineus and adductor longus.
Origin: body of pubis and inferior pubic ramus just superior to origin of gracilis.
Insertion: upper aspect of linea aspera lateral to adductor longus

25
Q

Adductor magnus

A

Distal posterior wall of adductor canal
Origin: pelvis
Insertion: Femur (adductor part) and adductor tubercle (hamstring part)

26
Q

Adductor hiatus

A

Circular gap between adductor part and hamstring part of adductor magnus - allows femoral artery and veins to pass between adductor canal to popliteal fossa

27
Q

Obturator externus

A

passes posterior to hip joint and neck of femur to insert on lateral wall of trochanteric fossa
Externally rotates the thigh

28
Q

Biceps femoris

A

Lateral in posterior compartment, has two heads
Long head origin: upper area of ischial tuberosity
Short head origin: lateral lip of line aspera on femur shaft
Insertion: lateral surface of head of fibula

29
Q

Semitendinosus

A

Medial to biceps femoris
Originates with long head of biceps femoris from upper area of ischial tuberosity
Attaches onto medial surface of tibia just posterior to sartorius and gracilis

30
Q

Semimembranosus

A

Lies deep to semitendinosus.
Origin: superolateral impression on ischial tuberosity
Insertion: medial tibial condyle

31
Q

ARteries entering thigh

A

Femoral, obturator and inferior gluteal

32
Q

Femoral artery route

A

Vertically through femoral triangle and continues down in adductor canal behind vastus medialis. Leaves by passing through addutor hiatus of adductor magnus and becomes popliteal behind the knee

33
Q

4 cluster of small branches of femoral artery

A

Superficial epigastric
Superficial circumflex iliac artery
Superficial external pudendal
Deep external pudendal

34
Q

Profunda femoris artery

A

Largest branch of femoral artery (lateral side of artery).
Passes posteriorly between pectineus and adductor longus, and then between adductor longus and adductor brevis.
Then inferiorly between adductor longus and adductor magnus, and eventually penetrating through adductor magnus to join popliteal artery

35
Q

Branches of profunda femoris

A

lateral and medial circumflex femoral branches

36
Q

Lateral circumflex femoral artery

A

passes deep to sartorius and rectus femoris before dividing into 3 terminal branches
ascending - neck of femur
descending - connects with popliteal artery
transverse - cruciate anastomosis

37
Q

Medial circumflex femoral artery

A

Passes medially around shaft of femur, first between pectineus and iliopsoas and then between obturator externus and adductor brevis.
Divides into 2 major branches deep to quadratus femoris

38
Q

Obturator artery

A

Anterior and posterior branch

Posterior branch contribute to supply to head of femur

39
Q

Great saphenous vein

A

arises from venous arch on dorsal aspect of foot and ascends along medial side of lower limb to proximal thigh. Passes through saphenous ring in deep fascia to connect with femoral vein in femoral triangle

40
Q

Femoral nerve branches

A

Anterior cutaneous nerve
Motor nerves to anterior compartment of thigh
Long cutaneous nerve - saphenous nerve

41
Q

Saphenous nerve

A

accompanies femoral artery through adductor canal but does not pass through adductor hiatus with femoral artery.
Pierces through tissues at the end of canal to appear between sartorius and gracilis and continues down medial side of leg to the foot.

42
Q

Obturator nerve

A

Divids into anterior and posterior branch which are separated by adductor brevis
Posterior - behind adductor brevis and anterior to magnus, supplies obturator externus and adductor brevis + part of adductor magnus
Anterior - anterior to adductor brevis, behind pectineus and adductor longus. supplies to adductor longus, gracilis and adductor brevis and cutaneous branch to medial thigh

43
Q

Sciatic nerve

A

Lies on adductor magnus, crossed by long head of biceps femoris
Proximal to knee divides into tibial nerve and common fibular nerve

44
Q

Tibial nerve

A

Descends through popliteal fossa with popliteal artery and vein. Tibial nerve most superficial, then vein and artery deepest.
Innervates:
Posterior compartment of leg
All intrinsic muscles of foot (including first 2 dorsal interossei which may also receive nerves from deep peroneal)
Skin on posterolateral side of lower half of leg and lateral side of foot, and skin on sole of foot and toes

45
Q

Common peroneal nerve

A

Short head of biceps.
All muscles in anterior and lateral compartment of leg
One muscle (EDB) on dorsal aspect of foot
First 2 dorsal interossei
Skin over lateral aspect of leg and ankle, dorsal aspect of foot and toes

46
Q

Knee joint

A

Largest synovial joint in body

47
Q

Knee menisci

A

Medial meniscus attached to capsule of joint and tibial collateral ligament, whereas lateral meniscus unattached to capsule hence is more mobile
Menisci connected anteriorly by transverse ligament of knee.
Lateral meniscus connected to tendon of popliteus

48
Q

Lateral collateral ligament

A

Attached superiorly to lateral femoral epicondyle just above groove for popliteus tendon (superficial to popliteus). Inferiorly attached to depression on lateral surface of fibular head

49
Q

Medial collateral ligament

A

Anchored superiorly to medial femoral epicondyle inferior to adductor tubercle and descends anteriorly to attach to medial surface of tibia above and behind attachment of sartorius, gracilis and semitendinosus

50
Q

Vascular supply to knee

A

Descending and genicular branches from femoral, popliteal and lateral circumflex femoral arteries in thigh
Circumflex fibular artery and recurrent branches from anterior tibial artery in leg

51
Q

Borders of popliteal fossa

A

Margins of upper part of diamond
Medially by distal ends of semitendinosus and semimembranosus
Laterally by biceps femoris
Margins of lower part
Medially - medial head of gastroc
Laterally - plantaris and lateral head of gastroc

52
Q

Floor of popliteal fossa

A

Capsule of knee joint, inferiorly popliteus muscle

53
Q

Roof of popliteal fossa

A

superficial fascia
Most important structure here is small saphenous vein
Another structure is posterior cutaneous nerve of thigh, which descends through thigh superficial to hamstrings and continues inferiorly with small saphenous vein

54
Q

Contents of popliteal fossa

A

Popliteal artery, popliteal vein and tibial and common peroneal nerves

55
Q

Popliteal artery

A

appears under margin of semimembranosus muscle and descends obliquely through fossa and divides into anterior and posterior tibial arteries
Deepest structure in popliteal fossa

56
Q

Popliteal vein

A

Superficial to and travels with popliteal artery.

Exits fossa superiorly to become femoral vein by pasing through adductor hiatus

MRCS (28 decks)

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