Thigh Script

Question 1

There are two long bones in the leg: the __________and _________. Which is larger?

Answer 1

tibia; fibula

The tibia is the larger, weight-bearing long bone of the leg.

Question 2

What’s the name of the fascia of the thigh?

Answer 2

Fascia lata

Question 3

Three groups of thigh muscles

Answer 3

Posterior, Medial, and Anterior

*The fascia lata and its intermuscular septa divide the thigh muscles into these three groups

Question 4

The posterior thigh muscles are innervated by the __________ nerve. As a group, what is their action?

Answer 4

Sciatic

As a group, they act to extend the thigh at the hip and flex the leg at the knee.

Question 5

The medial thigh muscles (except for the hamstring part of adductor magnus) are innervated by the __________ nerve. As a group what is their action?

Answer 5

Obturator

As a group, they act to adduct the thigh.

Question 6

The anterior thigh muscles (except for psoas major) are innervated by the ________nerve. As a group, waht is their function?

Answer 6

femoral

As a group, they act to flex the thigh and extend the leg.

Question 7

What is the course of the sciatic nerve through the posterior compartment of the thigh?

Answer 7

The sciatic nerve enters the posterior thigh midway between the ischial tuberosity and the greater trochanter of the femur. It descends almost vertically through the posterior compartment of the thigh until it divides into its two terminal branches: the tibial and common fibular nerves.

Question 8

Three muscles form the posterior group of thigh muscles: ____________, ___________, and _____________.

Answer 8

semitendinosis, semimembranosus, and biceps femoris.

Question 9

Semimembranosus and semitendinosus are both innervated by the__________ portion of the sciatic nerve. What is their function?

Answer 9

tibial

Both muscles can extend the thigh and flex and internally rotate the leg.

Question 10

Whereas the long head of the biceps of the the femur is innervated by the ___________portion of the sciatic nerve, the short head is innervated by the __________ of the sciatic nerve. What are their functions?

Answer 10

tibial; common fibular portion

Both heads can flex and externally rotate the leg but only the long head can extend the thigh.

Question 11

The posterior thigh muscles that act across both the hip and knee joints (namely, semitendinosus, semimembranosus, and the long head of biceps femoris) are together called the ____________muscles.

Answer 11

hamstring

Question 12

Which muscle does the hamstrings assist in the walking gait?

Answer 12

Gluteus maximus

Question 13

Which spinal nerves provide all the nerve fibers that control flexion of the leg at the knee joint?

Answer 13

L5, S1, S2

Question 14

Which three nerve fibers contribute to the obturator nerve?

Answer 14

L2, L3, L4

Question 15

A fibrous membrane called the obturator membrane fills in all the space of the obturator foramen except for a very small passageway called the ______________.

Answer 15

obturator canal

*The obturator nerve approaches the obturator canal from the pelvic, or medial, side of the coxal bone and enters the medial muscle compartment of the thigh upon extending inferiorly through the obturator canal.

Question 16

What are the five medial muscles of the thigh?

Answer 16

Adductor magnus

Gracilis

Adductor brevis

Obturator externus

Adductor longus

Question 17

There is a gap in adductor magnus’ attachment to the femur; this gap is called the ____________.

Answer 17

hiatus of adductor magnus

Question 18

What are the two parts of the adductor magnus muscle? What is the function and innervation of those distinct parts?

Answer 18

• An adductor part that can adduct the thigh
  
  • ​Inserts onto the femur above the gap in its attachment to the femur
  • Innervated by the obturator nerve
• A hamstring part that can extend the thigh
  
  • ​Inserts onto the femur below the gap
  • Innervated by the tibial portion of the sciatic nerve

Question 19

Function and innervation of Gracilis muscle

Answer 19

Gracilis can adduct the thigh and flex (during the early part of the initial swing phase) and internally rotate the leg. It is innervated by the obturator nerve

Question 20

Adductor brevis can __________the thigh. It is innervated by the ___________ nerve.

Answer 20

adduct; obturator

Question 21

Obturator externus can ________ the thigh. It is innervated by the _________.

Answer 21

externally rotate; obturator nerve

Question 22

Adductor longus can _________ the thigh and is innervated by the ________ nerve.

Answer 22

adduct; obturator

Question 23

Aside from adducting the thigh, what other actions can the adductor longus execute?

Answer 23

When walking, adductor longus acts to flex the thigh during the terminal stance, pre swing, and initial swing phases.

Question 24

Which spinal nerve fibers make up the femoral nerve?

Answer 24

L2-L4

Question 25

The ___________ligament is the structure that serves as the boundary between the abdomen and thigh in the front of the body.

Answer 25

inguinal

Question 26

What are the 8 muscles that make up the anterior muscles of the thigh?

Answer 26

Pectineus

Psoas major

Iliacus

Vastus medialis

Vastus intermedius

Vastus lateralis

Rectus femoris

Sartorius

Question 27

Function and innervation the pectineus muscle

Answer 27

Pectineus can both flex and adduct the thigh and is innervated by both the femoral and obturator nerves.

Question 28

Because iliacus and psoas major share a common tendon of insertion and usually act together, they are frequently referred to as a single muscular entity called ______________.

Answer 28

iliopsoas

Question 29

Which muscle or muscle group is the most powerful flexor of the thigh?

Answer 29

Iliopsoas

Question 30

Iliacus is innervated by the ___________, and psoas major is innervated by_____________.

Answer 30

femoral nerve; branches of the anterior rami of L1, L2, and L3

Question 31

_______ and ________ are the spinal nerves which provide most of the nerve fibers that control flexion of the thigh at the hip joint.

Answer 31

L1 and L2

Question 32

____________ is named for being the thigh muscle that begins as four separate muscles: vastus medialis, vastus intermedius, vastus lateralis, and rectus femoris.

Answer 32

Quadriceps femoris

Question 33

All four muscles of quadriceps femoris are innervated by the ____________nerve.

Answer 33

femoral

Question 34

The knee jerk test

Answer 34

• Tap the quadriceps femoris tendon of insertion to try to elicit a reflexive contraction of the quadriceps femoris muscle
• is conducted as the patient sits on an examination table with the legs dangling over the edge.
• The examiner first rests the palm of one of his/her hands on the anterior surface of the patient’s thigh immediately above the knee, and then, using a reflex hammer held in the other hand, imparts a gentle but firm and quick tap on the patellar ligament.

Question 35

. It is important to recognize that the quadriceps femoris tendon reflex test assesses spinal cord reflex activity in the __________,________, and _________ spinal cord segment levels

Answer 35

L2, L3, and L4

Question 36

______ and _______ are the spinal nerves which provide most of the nerve fibers that control extension of the leg at the knee joint.

Answer 36

L3 and L4

Question 37

Actions and Innervation of Sartorius muscle

Answer 37

Action: flexion, abduction, and external rotation of the thigh at the hip, and flexion and internal rotation of the leg at the knee.

Innervation: Femoral nerve

Question 38

Largest artery of the thigh

Answer 38

Femoral artery

Question 39

What is the course of the femoral artery as it deviates from the common iliac artery?

Answer 39

• The left and right common iliac arteries arise in front of the left side of the body of the 4th lumbar vertebra as the paired terminal branches of the abdominal aorta.
• The arteries diverge as they extend inferolaterally to opposite sides of the posterior abdominal wall.
• As each common iliac artery passes in front of the sacroiliac joint, it divides into two terminal branches, the internal and external iliac arteries.
• The external iliac artery follows a course alongside psoas major which leads the artery to pass deep to the inguinal ligament.
• Upon passing deep to the inguinal ligament, the artery enters the thigh, and its name changes to the femoral artery.

Question 40

As the femoral artery passes through the hiatus of adductor magnus, it’s name changes to what?

Answer 40

At the distal end of the adductor canal, the femoral artery extends through the hiatus of adductor magnus to enter the popliteal fossa (which is the region behind the knee joint) and its name changes to the popliteal artery.

Question 41

What is the largest branch of the femoral artery?

Answer 41

The deep artery of the thigh

Question 42

The deep artery of the thigh arises where?

Answer 42

The deep artery of the thigh arises in the femoral triangle from the posterior aspect of the femoral artery.

Question 43

The deep artery of the thigh gives rise to…

Answer 43

the medial and lateral circumflex femoral arteries and the 1st, 2nd, 3rd, and 4th perforating arteries.

Question 44

Chief blood supply of the hamstrings

Answer 44

The four perforating arteries are the chief source of blood supply to the hamstrings.

Question 45

The extracapsular vascular ring around the base of the neck of the femur gives rise to branches called ___________ arteries.

Answer 45

retinacular

Question 46

Femoral neck fractures in the distal half of the neck of the femur are ___________fractures.

Answer 46

extracapsular

*Extracapsular femoral neck fractures generally do not disrupt femoral head blood supply, and thus are associated with a lower incidence of avascular necrosis of the femoral head.

Question 47

Largest vein of the thigh

Answer 47

Femoral vein