05.46 Thigh II

Question 1

1. What is the role of the deep fascia?

Answer 1

Prevents bulging of muscles

Question 2

2. What is the deep fascia made of? And what is it between? Where is it strongerst?

Answer 2

Dense layer of connective tissue between the muscles of the thigh and the superficial fascia
Very strong on anterior and lateral thigh

Question 3

3. What is the iliotibial tract (band)?

Answer 3

A lateral thickening of the Deep Fascia

Question 4

4. What is the deep fascia/fascia lata attached to superiorly and inferiorly?

Answer 4

Inguinal Ligament
Parts of hip bone (Pubic bone, iliac crest, Ischial tuberosity)
Sacrum and coccyx
Scarpa’s fascia and the sacrotuberous ligament

Inferiorly at the knee joint is continuous with the crural fascia

Question 5

5. What are the fascia lata’s three septas/compartments?

Answer 5

Lateral intermuscular septa
Medial intermuscular septa
Posterior intermuscular septa

Question 6

6. What action does the anterior compartment perform? What is the nerve? What are the muscles in the anterior compartment?

Answer 6

Flex hip and extends knee

Femoral Nerve

Sartorius 
Rectus femoris
Vastus lateralis 
Vastus medialis 
Vastus intermedius 
Articularis genu 
Psoas major 
Iliacus 
Tensor fascia latae

Question 7

7. Give the attachment points of the Sartorius muscle

Answer 7

ASIS – superior medial surface of tibia

Question 8

8. Where does the rectus femoris attach?

Answer 8

AIIS – patella

Question 9

9. Where does the vastus lateralis attach?

Answer 9

Linea aspera – patella

Question 10

10. Where does the vastus medialis attach?

Answer 10

Linea aspera – patella

Question 11

11. Where does the vastus intermedius attach?

Answer 11

Femur body – patella

Question 12

12. Where does the articularis genu attach?

Answer 12

Anterior femur – synovial membrane of knee

Question 13

13. Where does the psoas major attach?

Answer 13

Lumbar vertebrae – lesser trochanter

Question 14

14. Where does the iliacus attach?

Answer 14

Iliac crest and fossa – lesser trochanter of femur

Question 15

15. Where does the tensor fascia latae attach?

Answer 15

ASIS - iliotibial tract

Question 16

16. What kind of action does the medial compartment of muscles perform? What is the nerve of this compartment? Give the muscles that make up the medial compartment.

Answer 16

Adductor group
Obturator nerve

1. Pectineus:
2. Adductor longus:
3. Adductor brevis
4. Adductor magnus:
5. Gracilis:
6. Obturator externus

Question 17

17. What does the pectineus attach to? Innervation?

Answer 17

Superior ramus of pubis – pectineal line of femur

Femoral and obturator nerves

Question 18

18. What does the adductor longus attach to?

Answer 18

Body of pubic bone – linea aspera

Question 19

19. Attachment for adductor brevis?

Answer 19

Inferior ramus of pubic bone – linea aspera

Question 20

20. Attachment for adductor longus?

Answer 20

Body of pubic bone – linea aspera

Question 21

21. What are the two parts of the adductor magnus? Give each’s attachment points and nerves

Answer 21

Adductor part: Ischiopubic ramus – linea aspera
Obturator nerve
Hamstring part: Ischial tuberosity – adductor tubercle of femus
Tibial nerve

Question 22

22. What is the attachment for the Gracilis muscle?

Answer 22

Inferior ramus of pubis – superior part of medial surface of tibia

Question 23

23. What are the attachments of the obturator externus?

Answer 23

Margins of obturator foramen/membrane – trochanteric fossa of femur

Question 24

24. What kinds of muscles does the posterior compartment have? What action? Nerve of compartment?

Answer 24

Hamstring muscles (except the short head of biceps femoris)
Act on two joints – extend hip and flex knee
Tibial nerve

Question 25

25. What are the attachments for the biceps femoris? Nerve?

Answer 25

Long head: Ischial tuberosity – Fibular head Innervated by tibial nerve Short head: Linea aspera – Fibular head Innervated by the common peroneal nerve

Question 26

26. What are the attachment points of the semitendinosus?

Answer 26

Ischial tuberosity – medial surface of upper tibia

Question 27

27. What are the attachments points of the semimembranosus?

Answer 27

Ischial tuberosity – medial tibial condyle

Question 28

``` 28. Give the following boundaries of the femoral triangle Superior Medial Lateral Base Apex Roof Floor ```

Answer 28

Superior - inguinal ligament Medial - medial border of adductor longus Lateral - medial border of Sartorius Base – inguinal ligament Apex - where the sartorius crosses the adductor longus Roof - fascia lata Floor - iliopsoas and pectineus muscles

Question 29

29. Give the contents of the femoral triangle

Answer 29

``` femoral artery and branches femoral vein and branches femoral nerve and branches lymphatic vessels and nodes Femoral sheath ```

Question 30

30. What is the femoral sheath and what compartment does it contain?

Answer 30

It is a funnel-shaped fascial tube Lateral Intermediate Medial – femoral canal

Question 31

31. Femoral hernias usually start where?

Answer 31

Femoral ring

Question 32

32. Where does the adductor canal extend to? (aka subsartorial/Hunter’s canal)

Answer 32

Extend from the apex of the femoral triangle to the adductor hiatus in the adductor

Question 33

33. What are the boundaries of the adductor canal?

Answer 33

Anteromedial – Sartorius Lateral - vastus medialis Posterior - adductor longus and magnus

Question 34

34. What are the contents of the adductor canal?

Answer 34

Femoral artery and vein Saphenous nerve Nerve to vastus medialis

Question 35

35. What lumbar levels is the femoral nerve and how does it size compare to other branches of the lumbar plexus? What does it travel under to enter? How is it unlike the femoral artery and vein? Position to femoral artery?

Answer 35

Femoral nerve (L2,L3,L4) Is the largest branch of lumbar plexus Travels under the inguinal ligament to enter the femoral triangle Unlike femoral artery/vein, is not enclosed by the femoral sheath Lies lateral to the femoral artery

Question 36

36. What are the sensory branches of the femoral nerve?

Answer 36

Medial femoral cutaneous nerve Intermediate femoral cutaneous nerve Saphenous nerve

Question 37

37. What does the saphenous nerve travel through and what does it innervate?

Answer 37

Adductor canal | Innervate skin of leg and foot

Question 38

38. What muscles does the femoral nerve provide motor branches to? What is the exceptional muscle that receives nerves from both femoral and another nerve? Name it and the other nerve

Answer 38

Sartorius Quadriceps femoris Articularis genu Pectineus Pectineus –also innervated by branch of obturator nerve

Question 39

39. The obturator nerve divides into what divisions in the obturator foramen? Where are these divisions located between?

Answer 39

Anterior division Located between adductor longus and brevis Posterior division Located between adductor brevis and magnus

Question 40

40. What do the two divisions of the obturator nerve innervate?

Answer 40

``` Anterior Adductor longus Gracilis Adductor brevis Pectineus (partly) Posterior Obturator externus adductor brevis adductor magnus ```

Question 41

41. The femoral artery is a continuation of? How does it enter the thigh and what is its position in relation to the femoral vein?

Answer 41

Continuation of external iliac artery | Enter thigh by passing below the inguinal ligament, lateral to the femoral vein

Question 42

42. What are the branches of the femoral artery in the thigh?

Answer 42

``` Superficial circumflex iliac Superficial epigastric Superficial and deep external pudendal Lateral femoral circumflex Medial femoral circumflex Profunda femoris ```

Question 43

43. What arteries compose the cruciate anastomosis?

Answer 43

1st perforating a Medial femoral circumflex a Lateral femoral circumflex a Inferior gluteal a

Question 44

44. What is the obturator artery a branch of?

Answer 44

Internal iliac a

Question 45

45. What does the popliteal fossa contain and where is it?

Answer 45

Fat filled | Diamond space at the back of the knee

Question 46

46. What are boundaries of the popliteal fossa?

Answer 46

Inferomedial and inferolateral –gastrocnemius muscle Superolateral –biceps femoris Superomedial –semimembranosus tendon Floor –popliteal surface of femur and posterior knee ligaments

Question 47

47. What are the contents of the popliteal fossa?

Answer 47

``` End of small saphenous vein Popliteal vessels and branches Tibial and common peroneal nerves Posterior cutaneous nerve of thigh Popliteal lymph nodes and vessels ```