Workbook - Anterior and medial compartments of the thigh Flashcards

1
Q

What bones are involved in the knee joint? (3)

A

Femur, tibia and patella.

-NOT fibula

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2
Q

What are the 3 articulations at the knee joint?

A
  • Medial femerotibial
  • Lateral femerotibial
  • Femeropatellar
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3
Q

What type of bone is the patella?

A

Triangular sesamoid bone.

-has a base(sup), an apex (inf) and 2 surfaces

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4
Q

What tendon does the patella develop in?

A

Quadriceps tendon.

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5
Q

What are the 2 surfaces of the patella?

A
  • Anterior

- Articular (post)

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6
Q

What are the 2 facets on the patella and where are they located?

A

Lateral and medial facets.

-on the articular surface

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7
Q

What articulates with the lateral facet of the patella?

A

Lateral condyle of the femur.

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8
Q

What articulates with the medial facet of the patella?

A

Medial condyle of the femur.

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9
Q

Which quadriceps muscle pulls at a more oblique angle than the others, and what effect does this have?

A

Vastus medialis.

-prevents patella from being pulled too laterally

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10
Q

What other structure prevents the patella from being pulled too laterally?

A

Bony ridge on the lateral femoral condyle.

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11
Q

Why are patella fragments not avulsed after a direct blow to the patella?

A

Quadriceps tendon remains intact and hold them together.

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12
Q

Are the bones of the knee joint a good fit?

A

No, they are quite incongruent.

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13
Q

What are the menisci and where are they located?

A

2 fibrocartliaginous c-shaped cartilages in the knee.

  • 1 lateral, 1 medial
  • improve congruency of the knee
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14
Q

What are the lateral and medial menisci interconnected by anteriorly?

A

Transverse ligament.

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15
Q

What is the medial menisci attached to?

A

Joint capsule and tibial collateral ligament.

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16
Q

What is the lateral menisci attached to?

A

Popliteal tendon.

-unattached to capsule&raquo_space; more mobile

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17
Q

Why are the medial menisci and tibial collateral ligament often injured simultaneously?

A

Medial menisci is firmly attached to the tibial collateral ligament.

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18
Q

What are the intrinsic ligaments of the knee?

A
Cruciate ligaments (ant & post).
-interconnect tibia and femur
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19
Q

What are the attachments of the anterior cruciate ligament?

A

-Ant intercondylar region of tibia
» sup/post
-Lat femoral condyle

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20
Q

What are the attachments of the posterior cruciate ligament?

A

-Post intercondylar region of tibia
» sup/ant
-Med femoral condyle

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21
Q

What is the function of the anterior cruciate ligament? (2)

A
  • Prevents hyperextension of the knee

- Prevents anterior displacement of the tibia on the femur

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22
Q

What is the function of the posterior cruciate ligament? (2)

A
  • Prevents hyperflexion of the knee

- Prevent posterior displacement of the tibia on the femur

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23
Q

Which ligament is the main stabiliser of the flexed knee when weight-bearing?

A

Posterior cruciate ligament.

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24
Q

What are the main extrinsic ligaments of the knee? (3)

A
  • Tibial collateral ligament
  • Fibular collateral ligament
  • Patellar ligament
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25
Q

What is the patellar ligament a continuation of?

A

Quadriceps femoris.

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26
Q

What are the attachments of the fibular collateral ligament?

A
  • Lateral femoral epicondyle

- Lateral fibular head

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27
Q

What is the function of the fibular collateral ligament?

A

Prevents adduction of the knee.

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28
Q

What are the attachments of the tibial collateral ligament?

A
  • Medial femoral epicondyle
  • Medial meniscus
  • Medial tibia
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29
Q

What is the function of the tibial collateral ligament?

A

Prevents abduction

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30
Q

What movements are possible at the knee joint? (2)

A
  • Flexion/extension

- Medial and lateral rotation

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31
Q

When can the knee be flexed more?

A

When the hip is flexed.

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32
Q

What is the saphenous hiatus, and what structure passes through it?

A

An opening in deep fascia.

-great saphenous vein passes through

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33
Q

What does the great saphenous vein originate from?

A

Dorsal venous arch of foot and dorsal vein of great toe.

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34
Q

Where is the great saphenous vein located?

A

Travels up medial leg and thigh.

|&raquo_space; joins femoral vein in femoral triangle

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35
Q

Where is the femoral triangle located?

A

Upper thigh.

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36
Q

What is the superior border of the femoral triangle?

A

Inguinal ligament.

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37
Q

What is the medial border of the femoral triangle?

A

Medial margin of adductor longus.

38
Q

What is the lateral border of the femoral triangle?

A

Medial margin of sartorius.

39
Q

What is the floor of the femoral triangle?

A

Medially - pectineus & adductor longus

Laterally - iliopsoas

40
Q

What is the roof of the femoral triangle?

A

Fascia lata.

41
Q

What is the femoral canal continuous with inferiorly?

A

Adductor canal.

42
Q

Summarise the boundaries of the femoral triangle.

A
SUPERIOR - inguinal ligament
MEDIAL - adductor longus (med margin)
LATERAL - sartorius (med margin)
ROOF - fascia lata
FLOOR - lat = iliopsoas
  -med = pectineus & adductor longus
43
Q

What are the contents of the femoral triangle?

A

MEDIAL&raquo_space; LATERAL:

  • lymphatic vessels
  • femoral vein
  • femoral artery
  • femoral nerve

(lymph, V, A, N)

44
Q

Which component of the femoral triangle are the contents of the femoral sheath?

A
  • Lymphatic vessels
  • Femoral vein
  • Femoral artery
45
Q

What is the most medial part of the femoral sheath, and what does it contain?

A

Femoral canal.

-contains lymph vessels and deep lymph node

46
Q

What structures are supplied by the femoral nerve?

A

MOTOR

  • ant hip flexors (pectineus, iliacus, sartorius)
  • knee extensors (quadriceps femoris)

SENSORY

  • ant cutaneous branch&raquo_space; ant/med thigh
  • terminal cutaneous (saphenous) branch&raquo_space; med leg and foot
47
Q

What forms the roof of the adductor canal?

A

Sartorius muscle.

48
Q

What does the adductor contain and what is its path?

A

Femoral artery & vein, and saphenous nerve.

-between femoral triangle and popliteal fossa

49
Q

What are the boundaries of the adductor canal?

A

ANTERIOR - sartorius
LATERAL - vastus medialis
POSTERIOR - adductor longus & adductor magnus

50
Q

What nerve innervates the posterior compartment of the thigh?

A

Femoral nerve.

51
Q

What is the blood supply to the medial compartment of the thigh?

A

Obturator artery.

52
Q

What is the main function of the medial compartment of the thigh?

A

Adduct the thigh at the hip joint.

-except obturator externus (lat rotator)

53
Q

Where is the adductor hiatus located?

A

Between adductor magnus and the femur.

-opening in adductor magnus tendon

54
Q

What passes through the adductor hiatus?

A

Femoral vessels from anterior thigh to posterior thigh.

|&raquo_space; enter popliteal fossa to become popliteal vessels

55
Q

Which muscles are in the anterior compartment of the thigh? (4)

A

-Pectineus
-Sartorius
-Quadriceps femoris (x4)
(-End of iliopsoas)

56
Q

What muscles make up ilipsoas? (2)

A
  • Psoas major

- Iliacus

57
Q

What muscles make up quadriceps femoris? (4)

A
  • Rectus femoris
  • Vastus lateralis
  • Vastus medialis
  • Vastus intermedialis
58
Q

What nerve innervates the anterior compartment of the thigh?

A

Femoral nerve (L2-4).

59
Q

How can the quadriceps muscles be tested?

A

Patellar tap reflex.

60
Q

What is the main function of the anterior compartment of the thigh?

A

Extend the leg at the knee.

61
Q

What muscles are in the medial (adductor) compartment of the thigh? (5)

A
  • Adductor longus
  • Adductor brevis
  • Adductor magnus
  • Gracilis
  • Obturator externus
62
Q

What is the main function of the medial compartment of the thigh?

A

Adduct thigh at hip.

63
Q

What is the nerve supply to the medial compartment of the thigh?

A

Obturator nerve.

64
Q

What is the blood supply to the medial compartment of the thigh?

A

Obturator artery.

65
Q

What muscles are in the posterior compartment of the thigh? (3)

A
  • Biceps femoris
  • Semimembranosus
  • Semitendinosus
66
Q

What are the muscles in the posterior compartment of the thigh collectively known as?

A

The hamstrings.

67
Q

What is the collective function of the posterior compartment of the thigh?

A

Extension at the hip and flexion at the knee.

68
Q

What is the nerve supply to the posterior compartment of the thigh?

A

Sciatic nerve (L4-S3).

69
Q

Why might the great saphenous vein be removed during surgery?

A

Can be used to replace occluded vessels in coronary artery bypasses.

70
Q

Which 3 arteries are the main blood supply to the lower limb?

A
  • Femoral artery
  • Obturator artery
  • Inferior gluteal artery
71
Q

What is the femoral artery a continuation of, and where does this transition occur?

A

Continuation of external iliac artery.

-under inguinal ligament

72
Q

What is the course of the femoral artery?

A

External iliac becomes femoral artery under inguinal ligament
» passes through femoral triangle
» descends down med thigh in adductor canal
» leaves canal at adductor hiatus
» becomes popliteal artery behind the knee

73
Q

What are the main branch of the femoral artery?

A

Profunda femoris artery

74
Q

Where does the profunda femoris artery originate?

A

In the femoral triangle.

75
Q

What branches does the profunda femoris artery give off?

A
  • Lateral circumflex femoral artery
  • Medial circumflex femoral artery
  • 3 Perforating branches
76
Q

What artery does the profunda femoris artery join with?

A

Popliteal artery at the knee.

77
Q

Where do the circumflex femoral arteries originate?

A

From lat/med profunda femoris artery.

78
Q

Where does the lateral circumflex femoral artery pass?

A

Deep to sartorius and rectus femoris.

79
Q

What are the main branches of the lateral circumflex femoral artery? (3)

A
  • Ascending branch (» neck of femur)
  • Descending branch (» connects with popliteal branch)
  • Transverse branch (» cruciate anastomosis)
80
Q

Where does the medial circumflex femoral artery pass?

A

Passes around the medial shaft of femur, and over superior margin of adductor magnus, then divides deep to quadratus femoris.

81
Q

What do the 2 branches of the medial circumflex femoral artery supply?

A
  • Trochanteric fossa

- Hip anastomoses

82
Q

What is the obturator artery a branch of?

A

Internal iliac artery in pelvic cavity.

83
Q

How does the obturator artery enter the thigh?

A

Enters medial thigh in the obturator canal.

84
Q

What does the obturator artery divide into?

A

Anterior and posterior branches near obturator externus attachment.

85
Q

What does the obturator artery supply?

A

Head of femur in anastomoses.

86
Q

What does the inferior gluteal artery arise from?

A

Internal iliac artery.

87
Q

Where does the inferior gluteal artery pass?

A

Through the greater sciatic foramen inferior to piriformis.

88
Q

What does the inferior gluteal artery supply?

A

Gluteal region, and contributes to posterior thigh.

89
Q

Which arteries form the cruciate anastomosis? (4)

A
  • 1st perforating branch of the profunda femoris artery
  • inferior gluteal artery
  • lateral and medial femoral circumflex arteries.
90
Q

Where is the cruciate anastomosis?

A

Posterior to the proximal femur, in the upper thigh.