Femoral Region

Question 1

What are the boundaries of the femoral triangle?

Answer 1

• superior – inguinal ligament
• medially – adductor longus
• laterally –sartorius
• floor – iliopsoas and pectineus
• roof – deep fascia (fascia lata)

Question 2

What are the contents of the femoral triangle?

Answer 2

Femoral Nerve
Femoral Artery
Femoral Vein
Lymphatics

Question 3

The femoral _____1_____ are enveloped by the femoral sheath. The sheath does not envelop the ____2____, which lies outside and lateral to the sheath.

Answer 3

1) artery and vein

2) femoral nerve

Question 4

What roots is the femoral nerve from? Where is it formed

Answer 4

Spinal roots- L2,3 and 4 formed in the lumbar plexus.

Question 5

Where does the saphenous nerve branch from? Where does it go? What does it supply?

Answer 5

The femoral nerve
leaves adductor canal distally by passing between sartorius and gracilis (from the medial compartment)
supplies the fascia and skin of the anteromedial aspects of the knee and leg and the medial aspect of the foot where it accompanies the great saphenous vein.

Question 6

What is the femoral canal?

Answer 6

passageway by which femoral structures exit from the abdomen into the upper thigh

Question 7

What does the femoral canal contain?

Answer 7

only contains the deep inguinal lymph nodes and adipose tissue, and forms the most medial part of the femoral sheath.
The deep inguinal lymph nodes run in a chain in the femoral canal medial to the femoral vein.

Question 8

What arteries supply the majority of blood to the head of the femur?

Answer 8

The medial and lateral circumflex femoral arteries supply the majority of blood to the head of the femur through their retinacular branches

Question 9

Name four muscle groups of the anterior compartment of the thigh?

Answer 9

pectineus, iliopsoas (joined muscle of psoas and iliacus), sartorius and quadriceps femurus (four muscles)

Question 10

What are the muscles of anterior compartment of the thigh supplied by?

Answer 10

Femoral nerve (L2, 3 and 4)
Except psoas major (L1,2 and 3)

Question 11

Proximal and distal attachments of ilipsoas muscle? Action?

Answer 11

Proximal: iliac fossa (iliacus) and lumbar transverse processes/IV discs (psoas major)
Distal: lesser trochanter of the femur
Flexion at the hip

Question 12

Proximal and distal attachments of sartorius muscle? Action?

Answer 12

Proximal: ASIS
Distal: Medial surface of proximal tibia (via pes anserinus)
Flexion at the hip and knee

Question 13

Four muscles of the quadriceps femoris group?

Answer 13

Rectus femoris
Vastus Lateralis
Vastus Intermedius
Vastus medius

Question 14

Proximal and distal attachments of all the quadriceps? Action?

Answer 14

Proximal: Rectus femoris is from ASIS , the other three from the shaft of the femur.
Distal: All Patella (via quadriceps tendon) then tibial tuberosity (via patellar tendon/ligament)

Extension of the knee (and weak flexion of the hip for rectus femoris)

Question 15

Main actions of the anterior compartment of the thigh?

Answer 15

Flexors of the thigh and leg extensors

Question 16

Main function of the medial compartment of the thigh?

Answer 16

Adductors of the thigh

Question 17

What are the muscles of the medial compartment of the thigh?

Answer 17

gracilis and adductors brevis, longus & magnus, and obturator externus

Question 18

Proximal and distal attachments of gracilis? Action?

Answer 18

Proximal: inferior pubic ramus
Distal: Superiomedial aspect of the tibia
Adduction of the thigh

Question 19

Proximal and distal attachments of the adductor muscles? Action?

Answer 19

• Proximal attachments: Pubis, ischiopubic ramus or the ischial tuberosity (“hamstring” part of adductor magnus)
• Distal attachments: Posterior surface of the shaft of the femur along the linea aspera, or the adductor tubercle of the femur (“hamstring” part of adductor magnus)
  Adduction of the thigh

Question 20

Origin and insertion of obturator externus? Action

Answer 20

Insertion‎: ‎trochanteric fossa of ‎femur Actions‎: ‎adduct thigh, Laterally rotates thigh
Origin‎: ‎obturator foramen‎
Adduction of the thigh

Question 21

The muscles of the medial compartment of the thigh are all innervated by the ______1_______ except for the _____2________ which is supplied by the ____3_____

Answer 21

1) obturator nerve (L2-4)
2) “hamstring part” of adductor magnus,
3) tibial nerve

Question 22

The obturator nerve, artery and vein enter the medial compartment of thigh via the ______1_________. The nerve then divides into anterior and posterior branches at the upper border of ____2_____. The anterior branch can be located between ______3______in the superior part of the medial compartment.

Answer 22

1) obturator foramen of the hip bone
2) adductor brevis
3) adductors longus (anteriorly) and brevis (posteriorly)

Question 23

Describe sensory innervation of the thigh

Answer 23

The anterior cutaneous nerve of the thigh, which is a branch of the femoral nerve (L2-L4) The lateral cutaneous nerve of the thigh, which is a branch of the lumbosacral plexus (L2-3) The cutaneous branch of the obturator nerve (L2-4).

Question 24

What does all lymph from the lower limb ultimately drain into?

Answer 24

external iliac nodes

Question 25

The posterior compartment of the thigh is made up of what group of muscles?

Answer 25

The hamstrings

Question 26

What three muscles make up the hamstring group?

Answer 26

Semitendinosus, semimembranosus and bicep femoris (this has a short head and a long head)

Question 27

What three features do all hamstring muscles share?

Answer 27

- Proximal attachment to the ischial tuberosity deep to gluteus maximus - Distal attachment to the bones of the leg (thus they span and act on two joints, producing extension at the hip joint and flexion at the knee joint) - Innervation by the tibial division of the sciatic nerve

Question 28

Action of the hamstrings?

Answer 28

extensors of thigh & flexors of leg

Question 29

What hamstring is not a true hamstring? Why?

Answer 29

short head of bicep femoris as it does not come from the ischial tuberosity and does not cross the hip joint and supplied by common fibular branch not tibia

Question 30

Semitendinous (long tendon) proximal and distal attachments?

Answer 30

Proximal: ischial tuberosity Distal: Medial surface of superior part of tibia

Question 31

Semimembranous (shiny membrane) proximal and distal attachments?

Answer 31

Proximal: Ischial tuberosity Distal: Posterior part of medial condyle of tibia.

Question 32

Biceps femoris proximal and distal attachments?

Answer 32

Proximal: long head attaches to ischial tuberosity but short head attaches to the line aspera and lateral supracondylar line of femur Distal: Lateral side of head of fibula. Tendon is split at this site by fibular collateral ligament of the knee.

Question 33

What is the acetabular labrum? What does it do?

Answer 33

ring of cartilage that surrounds the acetabulum of the hip, increases the depth of the acetabulum

Question 34

The hip joint has three ligaments which spiral from the pelvis to the head of the femur, what are they?

Answer 34

iliofemoral pubofemoral ischiofemoral

Question 35

Moving anterior to posterior give order of adducts muscles?

Answer 35

Adductor longus, adductor brevis, adductor magnus

Question 36

How to tell semimebranosus from semitendonosus?

Answer 36

Semimebranosus is wider flatter and deeper, the semitendonosus is on top and lies over middle. They both curve round to attach to medial part of leg.