Dissection 1

Question 1

what is the femoral sheath?

Answer 1

short tube of transversalis and iliopsoas fascia from the abdominal wall which surrounds the most proximal parts of the femoral artery and vein

Question 2

describe the course of the femoral nerve

Answer 2

formed in lumbar plexus (L2, L3, L4)
Saphenous nerve branches off around the adductor canal by passing between sartorius and gracilis in the medial compartment
This then goes on to supply the fascia and skin of the anteromedial knee and leg and medial foot where it joins with the great saphenous vein

Question 3

how does a femoral hernia occur?

Answer 3

increased abdominal pressure results in peritoneum herniating into the femoral canal (can be with or without abdominal contents)
painful lump in the groin below the inguinal ligament

Question 4

what is contained within the femoral canal and where is it found?

Answer 4

deep inguinal lymph nodes and adipose tissue

forms the most medial part of the femoral sheath

Question 5

describe the course and function of the medial and circumflex arteries

Answer 5

emerge from the profundal femoris artery and wrap around the head of the femur and anastamose behind it
they supply the head of the femur, largely through retinacular branches

Question 6

why is the femoral pulse useful?

Answer 6

used to locate femoral vein and nerve

can be used for cannulation and nerve block procedures etc

Question 7

what is the inguinal ligament and where is it found?

Answer 7

inferior border of external oblique aponeurosis

runs between the ASIS and pubic tubercle

Question 8

what is found at the inguinal canal?

Answer 8

medial half contains inguinal canal which houses spermatic cord / round ligament
femoral vessels, nerve and iliopsoas muscle enter/leave lower limb via retroinguinal space which sits deep to inguinal ligament

Question 9

where can the inguinal ligament be palpated?

Answer 9

at the junction between the external oblique aponeurosis and deep fascia of the thigh (fascia lata)

Question 10

what are the muscles of the anterior thigh?

Answer 10

iliopsoas
sartorius
quadriceps
- rectus femoris
- vastus lateralis
- vastus intermedius
- vastus medius

Question 11

which muscles in the anterior thigh extend the leg?

Answer 11

quadriceps

• rectus femoris
• vastus lateralis
• vastus intermedius
• vastus medialis

Question 12

which muscles in the anterior thigh flex the thigh?

Answer 12

iliopsoas
rectus femoris
sartorius

Question 13

where does the iliopsoas attach and insert?

Answer 13

iliac fossa and lumbar transverse process

inserts at lesser trochanter of femur

Question 14

where does the sartorius attach and insert?

Answer 14

attaches at ASIS

inserts at medial tibia

Question 15

where does the rectus femoris attach and insert?

Answer 15

attaches at ASIS

inserts at the patella

Question 16

where do the vastus muscles attach and insert?

Answer 16

attach at the shaft of the femur

insert at the patella

Question 17

what nerves supply the anterior thigh muscles?

Answer 17

femoral nerve supplies everything apart from iliopsoas

iliopsoas = anterior rami of lumbar spinal nerves

Question 18

what does the knee jerk response test?

Answer 18

action of the quadriceps muscles and femoral nerve (L2-L4)

Question 19

what are the muscles of the medial thigh?

Answer 19

adductor longus
adductor brevis
adductor magnus
gracilis
obturator

Question 20

which medial thigh muscle has 2 actions?

Answer 20

adductor magnus

- has a hamstring function as well as adductor function

Question 21

describe the gracilis muscle

Answer 21

most medial
thin strap descending down medial thigh
acts as a hamstring

Question 22

describe the positioning of the adductor muscles

Answer 22

adductor brevis and longus are anterior to magnus

brevis is superior to longus

Question 23

where do the medial thigh muscles attach and insert?

Answer 23

attach at pubis, ischiopubic ramus or ischial tuberosity

insert at posterior surface of femur shaft or adductor tubercle of tibia

Question 24

what nerves innervate the medial thigh muscles?

Answer 24

obturator nerve (L2-L4) supplies all except hamstring part of adductor magnus which is supplied by tibial nerve

Question 25

how do the obturator nerve, artery and vein enter the medial compartment of the thigh?

Answer 25

via the obturator foramen of the hip bone

Question 26

describe the course of the obturator nerve?

Answer 26

originated L2-L4
passes into medial thigh via obturator foramen
then divides into anterior and posterior branches at upper border of adductor brevis

Question 27

name 3 nerves which provide sensory innervation to the thigh

Answer 27

anterior cutaneous nerve of the thigh (branch of femoral)
lateral cutaneous nerve of the thigh (branch of lumbosacral plexus)
cutaneous branch of obturator nerve

Question 28

what does lymphatic drainage follow in the lower limb?

Answer 28

follows venous drainage

i.e - lymph from superficial structures follows saphenous veins

Question 29

where does lymph following the great saphenous go?

Answer 29

drains into superficial inguinal nodes (in fascia around vein) > external iliac nodes and some into deep inguinal

Question 30

where does lymph following small saphenous vein go?

Answer 30

popliteal lymph nodes > deep inguinal nodes

Question 31

where are the deep inguinal nodes found?

Answer 31

deep to deep fascia of the thigh (fascia lata) medial to the femoral vein

Question 32

where do deep inguinal nodes drain?

Answer 32

external iliac nodes

therefore all lymph from lower limb ultimately ends up in external iliac nodes