Anterior and Medial Thigh

Question 1

Tissue Layers of Thigh

Answer 1

1. Superficial Fascia
2. Deep fascia
3. Intermuscular Septum

Question 2

Deep Fascia of Lower Limb

Answer 2

• fascia lata
• Iliotibial tract or iliotibial band

Question 3

Anterior Compartment of the Thigh

Answer 3

• Leg extensors/ Thigh flexors
• Femoral nerve
• Muscles: Sartorius, iliopsoas, pectineus, vastus lateralis, rectus femoris, vastus intermedius, vastus medialis
• Action: extension of leg at knee, flexion of thigh
• Nerve supply: femoral nerve (L2, L3, L4)
• Blood supply: Femoral artery/vein

Question 4

Medial Compartment

Answer 4

• Thigh adductors
• Obturator nerve
• Muscles:
  
  • adductor longus
  • adductor brevis
  • adductor magnus
  • gracilis
  • obturator externus
• Action: adduction of thigh at hip joint
• Nerve: obturator nerve
• Blood: obturator artery and obturator vein

Question 5

Posterior Compartment

Answer 5

• Leg flexors/ Thigh extensors
• Sciatic nerve

Question 6

Compartment Syndrome of Thigh

Answer 6

• Increased pressure in fascial compartment that restricts blood flow and compresses nerves
  
  • caused by fracture, contusion/compression to thigh compartment
• Deep fascia covering compartment unable to expand as pressure builds
• Treated with fasciotomy

Question 7

Iliopsoas

Answer 7

• Distal attachment: lesser trochanter of femur
• Innervation: femoral nerve
• Action: main flexor of thigh at hip joint

Question 8

Sartorius

Answer 8

• Origin: Anterior superior iliac spine
• Innervation: femoral nerve
• Action:
  
  • flex abduct and laterally rotate thigh at hip joint
  • flex leg at knee joint

Question 9

Pectineus

Answer 9

• Innervation: Femoral nerve and obturator nerve
• Action: Flex and adduct thigh at hip joint

Question 10

Quadriceps Femoris Muscle

Answer 10

• Group of 4 muscles:
  
  • Rectus Femoris
  • Vastus Medialis
  • Vastus Intermedius
  • Vastus Lateralis
• Innervated by femoral nerve (L2-L4 nerve roots)
• Muscle action:
  
  • extension of leg at knee joint
    
    • rectus femoris does flexion of thigh

Question 11

Rectus femoris

Answer 11

• Origin: anterior inferior iliac spine
• Insertion: patella via quadriceps femoris tendon; and then tibial tuberosity via patellar ligament
• Innervation: femoral nerve
• Action:
  
  • Extend leg at knee joint
  • Flex thigh at hip joint

Question 12

Vastus Medialis

Answer 12

• Distal Attachment: patella via quadriceps femoris tendon: and then to tibial tuberosity via patellar ligament
• Innervation: Femoral nerve
• Action: extend leg at knee joint

Question 13

Vastus Intermedius

Answer 13

• Distal attachment: patella via quadriceps femoris tendon; and then tibial tuberosity via patellar ligament
• Innervation: femoral nerve
• Action: extend leg at knee joint

Question 14

Quadriceps Femoris Tendon

Answer 14

• The tendon is a combination of 4 muscle tendons of quadriceps femoris
• attaches from muscle to patella
• strong tendon

Question 15

Patellar Ligament

Answer 15

• Continuation of distal part of quadriceps tendon
• Attaches from patella to tibial tuberosity
• strong ligament

Question 16

Patellar Reflex

Answer 16

• Test the integrity of femoral nerve (L2-L4 spinal cord segments)
• Procedure: have patient sit with legs dangling. Give firm tap on petellar ligament with reflex hammer
• Normal response: quadriceps femoris muscle contracts as a reflex response to the tap –> Leg extends at knee joint

Question 18

Adductor Longus

Answer 18

• innervation: obturator nerve
• Action: adducts thigh at hip joint

Question 19

Adductor Brevis

Answer 19

• Innervation: obturator nerve
• Action: adducts thigh at hip joint

Question 20

Adductor Brevis

Answer 20

• Innervation: obturator nerve
• Action: adducts thigh at hip joint

Question 21

Adductor Magnus

Answer 21

• has dual innervation
  
  • obturator
  • tibial division of sciatic
• Opening in tendon called adductor hiatus
  
  • For passage of blood vessels to posterior aspect of lower limb
• Origin: ishcial tuberosity
• Insertion: adductor tubercle
• Action: adducts thigh at hip joint

Question 22

Gracilis

Answer 22

• innervation: obturator nerve
• Action: adducts thigh at hip joint, flexes leg at knee joint

Question 23

Obturator Externus

Answer 23

• Innervation: obturator nerve
• Action: laterally rotates thigh

Question 24

Femoral Nerve

Answer 24

• L2, L3, L4
• Motor function: muscle strength and function of anterior thigh compartment muscles (sartorius, pectineus, quadriceps femoris, iliopsoas)
  
  • injury: weakness or inability to extend knee, flex thigh
• Sensory function: normal skin sensation along anterior thigh, anterior-medial leg, medial side of foot
  
  • injury: decrease or loss of skin sensation along pathway

Question 25

Obturator nerve

Answer 25

* L2, L3, L4 * Motor: muscle strength and function of medial thigh muscles (adductor group, gracilis, obturator externus) * Injury: weakness or inability to adduct thigh * Sensory: cutaneous sensation on medial aspect of thigh * diminished sensation on medial aspect of thigh

Question 26

Cutaneous Nerve

Answer 26

one or more spinal nerves combine to form a specific named nerve that transmits sensory information from an area skin

Question 27

Dermatome

Answer 27

a single spinal nerve sending sensory information from an area of skin

Question 28

Arterial Supply to Anterior and Medial Thigh

Answer 28

*