5/8/2015 "Gross Anatomy Ant/Medial Thigh and Knee Miriam L. Donohue"

Question 1

Define pes anserine and list its component muscles/tendons; indicate where they insert and their collective function.

Answer 1

Pes anserine = goosefoot, made of:
   Sartorius
   Semitendonous
   Gracilis
All insert on anteromedial portion of tibia
All FLEX the knee

Question 2

List the posterior thigh compartment muscles

Answer 2

Posterior thigh muscles = hamstring muscles:
Biceps femoris
Semitendinosus
Semimembranosus

Question 3

What is the innervation for the posterior thigh muscles?

Answer 3

Posterior thigh muscles = hamstring muscles:
   Biceps femoris
   Semitendinosus
   Semimembranosus
All innervated by sciatic nerve

Question 4

What are the origin and insertion points for the posterior thigh muscles?

Answer 4

Posterior thigh muscles = hamstring muscles:
   Biceps femoris
   Semitendinosus
   Semimembranosus
All originate on ischial tuberosity
All innervated by sciatic nerve
All insert on the tibia
Act on both hip and knee

Question 5

What is the function of the hamstring muscles?

Answer 5

Posterior thigh muscles = hamstring muscles:
   Biceps femoris
   Semitendinosus
   Semimembranosus
***Adductor magnus hamstring portion***
All originate on ischial tuberosity
All innervated by sciatic nerve
All insert on the tibia
Act on both hip and knee
Extend hip, flex knee

Question 6

Name 2 muscles in the anterior thigh compartment that act on more than one joint.

Answer 6

Sartorius:
   Flexes hip
   Flexes knee
Rectus femoris:
   Flexes hip
   Extends knee
*Rectus femoris is a quadricep muscle

Question 7

In what position is the knee most stable?

Answer 7

Extended position

Question 8

What ligaments stabilize the knee joint?

Answer 8

IT band - lateral stability
Pes anserine - medial stability
MCL - resists valgus forces
LCL - resists varus forces

Question 9

Injuries to what other structures often accompany traumatic damage to the MCL? What condition is this known as?

Answer 9

ACL and medial meniscus

“the unhappy triad”

Question 10

Which meniscus is more often injured and why?

Answer 10

Medial meniscus, because it’s attached to the MCL, and lateral forces damage the MCL (valgus forces)

MCL stronger than LCL bc of attachment to medial meniscus.

Question 11

What are the functions of the menisci?

Answer 11

Add depth and cushioning to the articular surfaces of the tibial plateau
Facilitate weight transfer and distribution from femur to tibia

Question 12

Which cruciate ligament is more often injured?

Answer 12

ACL because more common injury to have a forward movement stopped abruptly.

Question 13

Describe the function of the cruciate ligaments.

Answer 13

ACL resists ANTERIOR movement of the tibia on the femur

PCL resists POSTERIOR movement of the tibia on the femur

Question 14

How is locking of the knee joint accomplished?

Answer 14

As the knee comes into the extended position, the lateral femoral condyle comes into congruency with the lateral meniscus on the tibial plateau. The femur rotates medially on the tibia to allow the medial meniscus to meet the medial condyle. Then the knee is locked.
Locking of the knee permits long periods of standing with little exertion.

Question 15

What muscle unlocks the knee?

Answer 15

Popliteus muscle

Question 16

What are the muscles of the anterior thigh compartment?

Answer 16

Sartorius
Iliopsoas
Quadriceps femoris (rectus femoris, vastus lateralis, vastus medialis, vastus intermedius)
Pectineus

Question 17

What is the longest muscle in the body?

Answer 17

Sartorius

Question 18

What is the strongest ligament in the body?

Answer 18

Iliofemoral ligament

Question 19

What is the common insertion point for all the quadriceps femoris muscles?

Answer 19

Quadriceps tendon (over patella) 
Becomes patellar ligament

Question 20

What is the longest bone in the body?

Answer 20

Femur

Question 21

What separates the compartments of the thigh?

Answer 21

Deep fascia

Question 22

Where does obdurator nerve (L2-L4) provide cutaneous innervation?

Answer 22

Interior thigh

Question 23

Where does posterior femoral cutaneous nerve (S1-S3) provide cutaneous innervation?

Answer 23

Back of thigh

Question 24

What are the functions of the anterior compartment muscles?

Answer 24

Knee extensors
Hip flexors

Innervation by femoral nerve (L2-L4)

Question 25

What are the functions of the medial compartment muscles?

Answer 25

Hip Adductors

Question 26

What are the functions of the posterior compartment muscles?

Answer 26

Hip extensors | Knee flexors

Question 27

What special muscle is the initiator of hip flexion?

Answer 27

Pectineus (ATC) | Can get innervation from femoral AND obdurator bc it is a border muscle

Question 28

What thigh compartment is innervated by the femoral nerve (L2-L4)?

Answer 28

ATC

Question 29

What combined action would test the functions of the sartorius muscle?

Answer 29

Lifting up foot to see if you stepped on gum

Question 30

What part of the quadriceps muscle fails to keep the patella in place during aging?

Answer 30

Vastus medialis

Question 31

What is the only quadriceps muscle that acts on the hip joint, and is therefore the longest of the quadriceps muscles?

Answer 31

Rectus femoris

Question 32

What is the femoral triangle?

Answer 32

The femoral triangle is bounded: superiorly by the inguinal ligament. medially by the medial border of the adductor longus muscle. laterally by the medial border of the sartorius muscle. Its floor is formed by the pectineus and adductor longus muscles medially and iliopsoas muscle laterally. Its roof is formed by the fascia lata, except at the saphenous opening where it is formed by the cribriform fascia. Contents The femoral triangle is important as a number of vital structures pass through it, right under the skin. The following structures are contained within the femoral triangle (from lateral to medial): Femoral nerve and its (terminal) branches. Femoral sheath and its contents: Femoral artery and several of its branches. Femoral vein and its proximal tributaries (e.g., the great saphenous and deep femoral veins). Deep inguinal lymph nodes and associated lymphatic vessels. Clinical significance Since the femoral triangle provides easy access to a major artery, coronary angioplasty and peripheral angioplasty is often performed by entering the femoral artery at the femoral triangle.

Question 33

What are the muscles of the medial thigh compartment?

Answer 33

``` Pectineus (more MTC than ATC) Adductor brevis Gracilis Adductor Longus Adductor portion of Adductor Magnus (border of MTC and PTC) ``` Motor innervation from obdurator nerve

Question 34

What travels through the adductor hiatus?

Answer 34

Femoral artery --> popliteal artery

Question 35

Give the origin and insertion of gracilis muscle:

Answer 35

Pubis --> anteromedial tibia

Question 36

Give the origin and insertion of sartorius:

Answer 36

Anterior superior iliac spine --> anteromedial tibia

Question 37

Give the origin and insertion of Semitendinosus:

Answer 37

Ischial tuberosity --> anteromedial tibia

Question 38

What makes up the IT band?

Answer 38

Tensor fascia lata | Gluteus maximus

Question 39

The 6 P's describe what syndrome?

Answer 39

``` Compartment syndrome: Pain Paresthesias Pallor Paralysis Pulselessness Poikilothermia ```