Thigh Flashcards
Femur surfaces
Anterior
Posteromedial
Posterolateral
Femur borders
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).
Lateral epicondyle
Upper facet - lateral head of gastrocnemius
Lower facet - popliteus muscle
ACL
medial side of lateral epicondyle
PCL
lateral side of medial epicondyle
Adductor tubercle
posterosuperior to medial epicondyle
Patella
Posterior surface of patella articulates with femur
Tibia intercondylar region (anterior)
3 facets
most anterior - anterior attachment of medial meniscus
2nd - attachment of ACL
3rd (lateral to ACL) - anterior attachment of lateral meniscus
TIbia intercondylar region (posterior)
3 facets
most anterior - posterior horn of lateral meniscus
Posteromedial to that is - posterior horn of medial meniscus
most posterior - attachment of PCL
Shaft of tibia
3 surfaces - lateral, medial and posterior
3 borders - anterior, interosseous and medial
Medial surface of tibia
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
Posterior surface of tibia
There is a roughened oblique line (soleal line)
Fibula borders and surfaces
3 borders - anterior, posterior and interosseous
3 surfaces - lateral, posterior and medial
Lateral surface of head of fibula
Attachment of biceps femoris
Anterior compartment of thigh
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)
Medial compartment of thigh
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
Posterior compartment of thigh
Biceps femoris Semitendinosus Semimembranosus All by sciatic nerve All crosses both hip and knee joint other than short head of biceps
Vastus medialis, lateralis and intermedius
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
Sartorius
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
Rectus femoris
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
Gracilis
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
Pectineus
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
Adductor longus
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
Adductor brevis
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
Adductor magnus
Distal posterior wall of adductor canal
Origin: pelvis
Insertion: Femur (adductor part) and adductor tubercle (hamstring part)
Adductor hiatus
Circular gap between adductor part and hamstring part of adductor magnus - allows femoral artery and veins to pass between adductor canal to popliteal fossa
Obturator externus
passes posterior to hip joint and neck of femur to insert on lateral wall of trochanteric fossa
Externally rotates the thigh
Biceps femoris
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
Semitendinosus
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
Semimembranosus
Lies deep to semitendinosus.
Origin: superolateral impression on ischial tuberosity
Insertion: medial tibial condyle
ARteries entering thigh
Femoral, obturator and inferior gluteal
Femoral artery route
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
4 cluster of small branches of femoral artery
Superficial epigastric
Superficial circumflex iliac artery
Superficial external pudendal
Deep external pudendal
Profunda femoris artery
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
Branches of profunda femoris
lateral and medial circumflex femoral branches
Lateral circumflex femoral artery
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
Medial circumflex femoral artery
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
Obturator artery
Anterior and posterior branch
Posterior branch contribute to supply to head of femur
Great saphenous vein
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
Femoral nerve branches
Anterior cutaneous nerve
Motor nerves to anterior compartment of thigh
Long cutaneous nerve - saphenous nerve
Saphenous nerve
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.
Obturator nerve
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
Sciatic nerve
Lies on adductor magnus, crossed by long head of biceps femoris
Proximal to knee divides into tibial nerve and common fibular nerve
Tibial nerve
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
Common peroneal nerve
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
Knee joint
Largest synovial joint in body
Knee menisci
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
Lateral collateral ligament
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
Medial collateral ligament
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
Vascular supply to knee
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
Borders of popliteal fossa
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
Floor of popliteal fossa
Capsule of knee joint, inferiorly popliteus muscle
Roof of popliteal fossa
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
Contents of popliteal fossa
Popliteal artery, popliteal vein and tibial and common peroneal nerves
Popliteal artery
appears under margin of semimembranosus muscle and descends obliquely through fossa and divides into anterior and posterior tibial arteries
Deepest structure in popliteal fossa
Popliteal vein
Superficial to and travels with popliteal artery.
Exits fossa superiorly to become femoral vein by pasing through adductor hiatus
