Anterior and Medial Thigh

Question 1

What are the two thigh fascia layers?

Answer 1

Superficial and Deep

Question 2

What is in the superficial thigh fascia?

Answer 2

It’s deep to the dermis and contains fat, cutaneous nerves and veins

Question 3

What is in the deep thigh fascia?

Answer 3

It’s called Fascia Lata, is dense connective tissue and located between the superficial fascia and thigh muscles

Question 4

Where does the Greater Saphenous Vein start?

Answer 4

It’s found in the superficial fascia and begins at the medial end of the dorsal venous arch.

• anterior to the medial malleolus
• posterior to the medial femoral condyle

Question 5

What is the longest vein in the body?

Answer 5

The Greater Saphenous Vein

Question 6

Where does the Greater Saphenous Vein run?

Answer 6

Superolaterally to the Saphenous opening

• frequently communicates with the accessory Saphenous vein
• terminates into the Femoral vein

Question 7

How many valves are in the Greater Saphenous Vein?

Answer 7

10-12 flaps of endothelium
More in the leg than thigh
Located inferiorly to perforating veins

Question 8

What are the three main Venous Tributaries near the termination of the Greater Saphenous Vein?

Answer 8

Superficial Circumflex Iliac
Superficial Epigastric
External Pudendal

Question 9

What can the Greater Saphenous Vein be used for?

Answer 9

To administer blood, electrolytes, drugs and for coronary bypass surgery

Question 10

What is a Saphenous cutdown and what can it result in?

Answer 10

It’s an incision made anterior to medial malleolus to harvest part of the vein. It can result in pain along the medial border of the foot from the Saphenous nerve.

Question 11

Where do most cutaneous thigh nerves derive from?

Answer 11

Lumbar and Sacral Plexuses

Question 12

What is the Lumbar Plexus formed from?

Answer 12

L1-L4 Ventral Rami within Psoas major

Question 13

What are the two largest and most important branches of the Lumbar Plexus?

Answer 13

Obturator nerve L2-L4, medial thigh

Femoral nerve L2-L4, front of leg

Question 14

Spinal Roots of Obturator nerve?

Answer 14

L2-L4

Question 15

Spinal Roots of Femoral Nerve?

Answer 15

L2-L4

Question 16

What does the Sacral Plexus consist of?

Answer 16

It consists of the lumbosacral trunk, descending part of L4/L5 and S1-S4 ventral rami

Question 17

What are the two main nerves of the Sacral Plexus?

Answer 17

Sciatic nerve and Pudendal nerve

Question 18

Name the 6 anterior cutaneous nerves of the thigh

Answer 18

Lateral cutaneous branch of the sub costal nerve- T12
Femoral branches of the genitofemoral nerve-L1 and L2
Ilioinguinal nerve-L1
Lateral Femoral cutaneous nerve- L2/L3
Anterior(intermediate and medial) cutaneous branches of the femoral nerve- L2-L4
Cutaneous branch of the obturator nerve- L2

Question 19

What is the greater Saphenous also called (heart as well)

Answer 19

Fossa Ovalis

Question 20

What is the Falciform Margin?

Answer 20

backwards “C”. Sharply curved free margin of the Saphenous opening in the Fascia Lata. It forms the superior, inferior, and lateral boundaries of the Saphenous opening.
Also called Margo falciformis

Question 21

Where is the Saphenous opening?

Answer 21

Just inferior to the inguinal ligament, where the greater Saphenous vein reaches the Femoral Vein

Question 22

What is the Cribriform Fascia?

Answer 22

Medial margin of Saphenous Opening, its a thin sieve-like layer of connective tissue

Question 23

What is a Distinct Feature of the Fascia Lata?

Answer 23

It thickens laterally and is called iliotibial tract

Question 24

Where is the Iliotibial Tract found?

Answer 24

Goes from Iliac Tubercle to “Gerdy’s tubercle” on the lateral tibial condyle

Question 25

What is the Fascia Lata made up of?

Answer 25

Reinforced by tendinous fibers from TFL and G Max

Question 26

What does Fascia Lata do?

Answer 26

Acts to stabilize the hip and knee

Question 27

What do the Medial thigh muscles do?

Answer 27

ADDuction | Innervated by Obturator nerve

Question 28

What do the Anterior thigh muscles do?

Answer 28

Extension | Innervated by the Femoral nerve

Question 29

What are the three sections of thigh muscles?

Answer 29

Anterior, Medial and Posterior

Question 30

What are the Anterior Thigh Muscles? Hip Flexors and Knee Extensors

Answer 30

Pectineus Sartorius Iliopsoas- P. Major, P. Minor and Iliacus Quadriceps Femoris- Rectus Femoris, Vastus Lateralus, V. Medialis, V. Intermedius Tensor Fascia Latae

Question 31

Attachments for Pectineus?

Answer 31

P: Superior Ramus of Pubis | D. Pectineal line of Femur, just below the lesser trochanter

Question 32

Innervation for Pectineus?

Answer 32

Femoral Nerve ( sometimes also Obturator)

Question 33

Functions of Pectineus?

Answer 33

Adduct and flex hip joint, assist with medial rotation

Question 34

Blood supply for Pectineus?

Answer 34

Medial Femoral Circumflex Artery

Question 35

Attachments for Sartorius?

Answer 35

P: ASIS, Superior part of notch inferior to it D: Superior part of medial surface of tibia

Question 36

Innervation of Sartorius?

Answer 36

Femoral Nerve | L2 and L3

Question 37

Functions of Sartorius?

Answer 37

Flex, ABduct, lateral hip rotation, flex knee

Question 38

Blood supply of Sartorius?

Answer 38

Lateral Femoral Circumflex Artery

Question 39

What are the muscles of Iliopsoas?

Answer 39

Psoas Major, Iliacus, and Psoas Minor

Question 40

Attachments for Psoas Major?

Answer 40

P: sides of T12-L5 vertebrae and the discs between them Transverse processes of all lumbar vertebrae D: Lesser Trochanter of the Femur

Question 41

Innervation of Psoas Major?

Answer 41

Anterior Rami of Lumbar nerves L1-L3

Question 42

Functions of Psoas Major?

Answer 42

Flex hip, and controls deviation of trunk during standing

Question 43

Blood supply of Psoas Major?

Answer 43

Subcostal artery, Lumbar aa

Question 44

Iliacus attachments?

Answer 44

P: Iliac fossa and Iliac crest, ala of sacrum D: Lesser trochanter of femur

Question 45

Innervation of Iliacus?

Answer 45

Femoral Nerve

Question 46

Functions of Iliacus?

Answer 46

Flex hip, and controls deviation of trunk during standing

Question 47

Blood supply of Iliacus?

Answer 47

Subcostal artery and Lumbar aa

Question 48

Why is Psoas Minor weird?

Answer 48

Only 50-60% of people have it, and its usually only present on one side

Question 49

What are the muscles of Quadriceps Femoris?

Answer 49

Vastus Lateralis, Vastus Intermedius, Rectus Femoris, Vastus Medialis

Question 50

What is the innervation of Quadriceps Femoris?

Answer 50

Femoral Nerve

Question 51

What are the functions of Quadriceps Femoris?

Answer 51

Extend the knee joint

Question 52

What is the Blood supply of Quadriceps Femoris?

Answer 52

Lateral femoral circumflex artery

Question 53

Attachments for Vastus Lateralis?

Answer 53

Greater trochanter and lateral lip of the lines aspera Wide aponeurosis at the distal femur and attaches to the base of the patella via the common quadriceps tendon

Question 54

Attachment for Vastus Intermedius?

Answer 54

Anterior and lateral surfaces of shaft of femur Common quadriceps tendon at the base of patella

Question 55

Attachment for Rectus Femoris?

Answer 55

ASIS and ilium superior to acetabulum Common quadriceps tendon at the base of patella Extend knee joint, stabilize hip joint, and help iliopsoas flex hip

Question 56

Attachment for Vastus Medialis?

Answer 56

Intertrochanteric line and medial lip of Linda aspera Common quadriceps tendon at the base of patella

Question 57

What us the innervation of Tensor Fasciae Latae?

Answer 57

Superior gluteal nerve, L4, L5, S1

Question 58

What are the Attachments of Tensor Fasciae Latae?

Answer 58

ASIS and anterior external Iliac crest Lateral tibial condyle via iliotibial tract- Gerdy’s tubercle

Question 59

What does the Patellar Tendon Reflex test?

Answer 59

Test the integrity of femoral nerve, L2-L4

Question 60

What is the mechanism of the Patellar Tendon Reflex test?

Answer 60

AFFÉRENT fibers of muscle spindles in the quadriceps sends impulses to the spinal cord EFFERENT impulses are transmitted back to the the quadriceps, resulting in a jerk-like extension of the leg

Question 61

What are the medial thigh muscles?

Answer 61

``` Adductor Longus, Adductor Brevis Pectineus Gracilis Adductor Magnus Obturator externus ```

Question 62

What is the Femoral Triangle?

Answer 62

Subfacial space-triangular depression along the superomedial 1/3 thigh

Question 63

What are the Boundaries of the Femoral Triangle?

Answer 63

Floor- Pectineus and Iliopsoas | Roof- fascia lata

Question 64

What’s in the Femoral Triangle?

Answer 64

Femoral Nerve, branches Femoral Artery, branches Femoral Vein, tributaries Inguinal Lymph Nodes

Question 65

What is the Femoral Nerve?

Answer 65

Largest branch of the Lumbar Plexus, supplies most anterior thigh muscles, knee and hip joint

Question 66

Where does the Femoral Nerve go?

Answer 66

Enters thigh just lateral to midpoint of inguinal ligament-lateral to femoral arteries Terminal branch of Femoral Nerve is the Saphenous Nerve

Question 67

What is the chief arterial supply to the lower limb?

Answer 67

Femoral Artery