Upper Leg Anatomy Flashcards
State the location of the patella
Knee cap located anterior to the knee joint within the patellofemural groove of the femur
State the ligaments connected to patella
Quadriceps tendon attached superior and patellar ligament inferior to patella
What are the functions of patella
Leg extension - enhances the leverage the quadriceps tendon has on the femur
Protection - protects the anterior aspect of the knee joint from trauma
Describe the proximal end of the tibia
Medial and lateral epicondyle with intercondylar tubercules inbetween
Tibial tuberosity located on the anterior side
Describe the anatomy of the tibial shaft
Anterior side - tibial tuberosity
Posterior side - soleal line
Lateral side - interosseous membrane
Describe the anatomy of the distal end of the tibial shaft
Medial malleolus sticks out on medial side
Fibular notch on lateral side
Describe the anatomy of the fibula
There is a head, neck and facet for articulation with tibia on the proximal side
Lateral malleolus on distal side
State the components of the anterior thigh muscles
Iliopsoas, quadriceps femoris, sartorius, pectineus
What is the fascia lata
Deep fascia covering all the musculature of the thigh
Strong, extensible and elasticated stocking
What is the iliotibial tract and what are its functions
Longitudinal thickening of fascia lata and strengthened by gluteus maximus
Extensor, abductor and lateral rotator of the hip, with an additional role in providing lateral stabilisation to the knee joint
Iliopsoas - AFI
Consists of psoas major and iliacus
Attachments - psoas major originates from lumbar vertebrae
Iliacus originates from iliac fossa of pelvis
Both insert into lesser trochanter of femur
Actions - flexes lower limb at hip and assists in lateral rotation at hip
Innervation - psoas major innervated by anterior rami of L1 - L3
Iliacus innervated by femoral nerve
What does the quadriceps femoris contain
Vastus lateralis, vastus intermedius, vastus medialis, rectus femoris
Vastus lateralis - AFI
Attachments - originates from greater trochanter and inserts into patella through patellar tendon
Actions - extends the knee joint and stabilises the patella
Innervation - femoral nerve
Vastus intermedius - AFI
Attachments - originates from anterior and lateral surfaces of femoral shaft and insert into patella
Actions - extends the knee joint and stabilises the patella
Innervation - femoral nerve
Vastus medialis - AFI
Attachments - originates from intertrochanteric line and medial lip of linea aspera and inserts into patella
Actions - extends the knee joint and stabilises the patella (prevent lateral displacement)
Innervation - femoral nerve
Rectus femoris - AFI
Attachments - originates from ilium and attaches to patella by quadriceps femoris tendon
Actions - flexes leg at the hip joint and extends at the knee joint
Innervation - femoral nerve
Sartorius - AFI
Attachments - originates from anterior superior iliac spine and attaches to superior, medial surface of the tibia
Actions - flexor, abductor and lateral rotator at hip joint
Flexor at knee joint
Innervation - femoral nerve
Pectineus - AFI
Attachments - originates from pectineal line on the anterior surface of pelvis
Attaches to pectineal line on posterior side of femur
Actions - adduction and flexion at the hip joint
Innervation - femoral nerve and obturator nerve
State the medial thigh muscles of the leg
Adductor magnus, adductor longus, adductor brevis, obturator externus, gracilis
Adductor magnus - AFI
Divided into adductor and hamstring part
Attachments - adductor part originates from ischiopubic ramus and inserts to linea aspera of femur
Hamstring part originates form ischial tuberosity and attaches to adductor tubercle and medial supracondylar line of the femur
Actions - both adduct the thigh
Adductor component flexes the thigh, hamstring portion extends the thigh
Innervation - adductor part innervated by obturator nerve, hamstring part innervated by tibial nerve
Adductor longus - AFI
Attachments - originates from pubis, expands into fan shape and attaches to linea aspera of femur
Actions - adduction and medial rotation of thigh
Innervation - obturator nerve
Adductor brevis - AFI
Lies in-between anterior and posterior portions of obturator nerve
Attachments - originates from pubis and inferior pubic rami and attaches to linea aspera of femur
Actions - adduction of thigh
Innervation - obturator nerve
Obturator externus - AFI
Attachments - originates from membrane of obturator foramen, passes under neck of femur and attaches to posterior aspect of greater trochanter
Actions - laterally rotates the thigh
Innervation - obturator nerve
Gracilis - AFI
Attachments - originates from inferior rami of pubis and attaches to greater trochanter of tibia
Actions - adduction of thigh at hip and flexion of leg at knee
Innervation - obturator nerve
State the borders of the femoral triangle
- Lateral border - medial border of sartorius
- Medial border - medial border of adductor longus - thus also forms the floor
- Superior border - inguinal ligament
- Roof - fascia lata
- Floor - adductor longus, iliopsoas, pectineus
State the components of the femoral triangle
Femoral nerve - innervates anterior compartment of thigh and provides sensory branches for the leg and foot
Femoral artery - responsible for the majority of arterial supply to the lower limb
Femoral vein - great saphenous vein drains into the femoral vein within triangle
Femoral canal - contains deep lymph nodes and vessels
State the position of the components within the femoral triangle
NAVEL
From lateral to medial - femoral nerve, femoral artery, femoral vein, empty space, femoral canal
What is the significance of the empty space in the femoral canal
Empty space needed to allow veins and lymph vessels to distend to cope with different levels of flow
What does the femoral sheath enclose
Femoral artery, femoral vein, femoral canal
Describe how you would palpate for the femoral artery and femoral vein
Palpate midway between the pubic symphysis and the anterior superior iliac spine = femoral artery
Femoral vein lies medial to femoral artery
Describe the lower limb arterial circulation
External iliac artery becomes femoral artery when it passes under inguinal ligament
Profunda femoris artery arises from femoral artery and gives off 3 major branches
Perforating branches - supply muscles on medial and posterior thigh
Lateral femoral circumflex artery - supply some muscles of the lateral thigh
Medial femoral circumflex artery - supply head and neck of femur
Describe the lower limb venous circulation
Great saphenous vein ascends up medial side of leg, passing anteriorly to medial malleolus at the ankle and passing posteriorly to medial condyle of knee
Great saphenous vein drains into femoral vein
State the superficial gluteal muscles
Gluteus maximus, gluteus medius, glutenis minimus, tensor fascia lata
Gluteus maximus - AFI
Attachments - originates from gluteal surface of ilium, sacrum and coccyx
Inserts into iliotibial tract and gluteal tuberosity of femur
Actions - main extensor of thigh and assists with lateral rotation
Only used when force is required - running, climbing
Innervation - inferior gluteal nerve
Gluteus medius - AFI
Attachments - originates from gluteal surface of ilium and inserts into lateral surface of greater trochanter
Actions - abducts and medially rotates lower limb
During movement, locks pelvis to prevent pelvis drop on opposite side
Innervation - superior gluteal nerve
Gluteus minimus - AFI
Attachments - originates from ilium and converges to form a tendon which inserts to anterior side of greater trochanter
Actions - abducts and medially rotates lower limb
Helps secure pelvic position
Innervation - superior gluteal nerve
Tensor fascia lata - AFI
Attachments - originates from anterior iliac crest and inserts into iliotibial tract which attaches to lateral condye of tibia
Actions - assists gluteus medius and minimus in abduction and medial rotation
Innervation - superior gluteal nerve
State the deep gluteal muscles
Piriformis, obturator internus, gemelli, quadratus femoris
Piriformis - AFI
Attachments - originates from anterior surface of sacrum and inserts into greater trochanter of femur
Actions - lateral rotation and abduction
Innervation - nerve to piriformis
Obturator internus - AFI
Attachments - originates from pubis and ischium at obturator foramen and inserts to greater trochanter of femur
Actions - lateral rotation and abduction
Innervation - nerve to obturator internus
Superior gemelli - AFI
Attachments - originates form ischial spine and attaches to greater trochanter of femur
Actions - lateral rotation and abducton
Innervation - nerve to obturator internus
Inferior gemelli - AFI
Attachments - originates from ischial tuberosity and attaches to greater trochanter of femur
Actions - lateral rotation and abducton
Innervation - nerve to quadratus femoris
Quadratus femoris - AFI
Attachments - originates from lateral side of ischial tuberosity and attaches to quadrate tuberosity on intertrochanteric crest
Actions - lateral rotation
Innervation - nerve to quadratus femoris
State the muscles of the posterior thigh (hamstrings)
Biceps femoris, semimembranosus, semitendinosus
Describe the vasculature of the gluteal region
Superior gluteal nerve and artery and inferior gluteal nerve and artery
Biceps fermoris - AFI
Attachments - long head originates from ischial tuberosity of pelvis
Short head originates from linea aspera on posterior surface of femur
Heads form a tendon which insert into head of fibula
Actions - flexion at knee and extends leg at hip
Laterally rotates at hip and knee
Innervation - long head innervated by tibial part of sciatic nerve
Short head innervated by common fibular part of sciatic nerve
Semitendinosus - AFI
Attachments - originates from ischial tuberosity and attaches to medial surface of tibia
Actions - flexion at leg and extension at hip
Medially rotates thigh and leg
Innervation - tibial part of sciatic nerve
Semimembranosus - AFI
Attachments - originates from ischial tuberosity and attaches to medial tibial condyle
Actions - flexion of leg and extension of thigh
Medially rotates thigh and leg
Innervation - tibial part of sciatic nerve
State the position of semimembranosus and semitendinosus relative to each other
Semimembranosus more medial
Semitendinosus more superior (top)
Which muscles are involved in flexion
Iliopsoas, rectus femoris, sartorius, pectineus (muscles at front)
Which muscles are involved in extension
Gluteus maximus, hamstrings - (semimembranosus, semitendinosus and biceps femoris)
Which muscles are involved in abduction
Gluteus medius, gluteus minimus, deep gluteals
Which muscles are involved in adduction
Adductor longus, brevis and magnus, pectineus and gracillis
Which muscles are involved in medial rotation
Gluteus medius and minimus, semitendinosus and semimembranosus
Which muscles are involved in lateral rotation
Biceps femoris, gluteus maximus, deep gluteals - piriformis, superior & inferior gemelli, obturator internus, quadratus femoris
Name the borders of the popliteal fossa
Superomedial border - semimembranosus
Superolateral border - biceps femoris
Inferomedial border - medial head of gastrocnemius
Inferolateral border - lateral head of gastrocnemius and plantaris
State the arrangement of the contents in the popliteal fossa
Medial to lateral - popliteal artery, popliteal vein, tibial nerve, common fibular nerve
