Hip Region and Thigh

Question 1

In anatomy, what are the names given to the top and bottom of the leg?

Answer 1

Upper leg = THIGH

Lower leg (knee downwards) = LEG

Question 2

What does the superficial fascia of the thigh and leg contain?

Answer 2

Greater saphenous vein

Lesser saphenous vein

Cutaneous nerves

Question 3

Where does the greater saphenous vein start?

Answer 3

Dorsal-venous arch = where the dorsal veins of the 1st and 5th digit meet

Question 4

Does the greater saphenous vein run medial or lateral initially?

What structure does it encounter as it does this and where does it travel in relation to this structure?

Answer 4

Medially

It travels 1 finger breadth ANTERIOR to the MEDIAL MALLEOULUS

Question 5

Where does the grater saphenous vein travel after it has passed the medial malleolus?

Explain its route until just before it joins a larger vein.

Answer 5

It travels medially along the leg, posteriorly at the knee, back medially along the thigh then travels anteriorly to the front of the thigh

Question 6

What vein does the greater saphenous join?

What structures does it interact with in the process?

Answer 6

The greater saphenous punctures the fascia lata (deep fascia of the thigh) at the saphenous opening

Question 7

What is the name of the fascial layer that covers the thigh?

Answer 7

Fascia lata

Question 8

What is the name of the fascial layer that covers the back of the knee?

Answer 8

Popliteal fascia

Question 9

What is the name of the fascial layer that covers the leg?

Answer 9

Crural fascia

Question 10

What is the name of the fascial layer that covers the bottom of the foot?

Which bone does this attach to (heel bone)?

Answer 10

Plantar fascia

The calcaneous bone

Question 11

Which nerve follows the path of the greater saphenous vein?

What does this supply?

Which nerve is this a branch of and is this anterior or posterior?

Which structure does this nerve pass through as it travels downwards?

Answer 11

Saphenous nerve

It supplies medial leg and foot cutaneously

It is a posterior branch of the femoral nerve

It travels through the adductor canal and adductor hiatus

Question 12

How many compartments are there in the thigh?

Answer 12

3

Question 13

How many compartments are there in the leg?

Answer 13

3

Question 14

Where is the start of the lesser saphenous vein?

Answer 14

At the dorsal-venous arch, same as the greater saphenous vein

Question 15

Where does the lesser saphenous vein run after it has started?

Answer 15

Laterally

It runs inferior and posterior to the lateral malleolus

It then travels posteriorly up the leg

Question 16

What vein does the lesser saphenous join?

What structures does it interact with in the process?

Answer 16

It joins the popliteal nerve

It punctures the popliteal fascia to do this

Question 17

Which nerve follows the lesser saphenous nerve?

What nerve is this a branch of? (Be specific as to which branches form which nerves)

What does this nerve do?

Answer 17

Sural nerve

It is made from a combination of branches of the sciatic nerve branches:

• tibial nerve
• common fibular nerve

It supplies the lateral foot and leg cutaneously

Question 18

What function do the muscles of the anterior compartment of the thigh have?

Answer 18

1) extension of the knee

2) flexion of the hip

Question 19

What function do the muscles of the posterior compartment of the thigh have?

Answer 19

1) flexion of the knee

2) extension of the hip

Question 20

What function do the muscles of the medial compartment of the thigh have?

Answer 20

Hip ADDUCTION

Question 21

What function do the muscles of the anterior compartment of the leg have?

Answer 21

1) dorsiflexion of the foot

2) inversion of the foot

Question 22

What function do the muscles of the posterior compartment of the leg have?

Answer 22

1) plantar flexion of the foot

2) inversion of the foot

Question 23

What function do the muscles of the lateral compartment of the leg have?

Answer 23

1) eversion of the foot only

Question 24

Which two muscles cause foot inversion?

Which compartments are they in?

Answer 24

1) tibialis anterior = anterior compartment

2) tibialis posterior = posterior compartment

Question 25

Which nerve supplies the anterior compartment of the thigh? What are it’s roots?

Answer 25

Femoral nerve Roots = L2-L4

Question 26

Which nerve supplies the medial compartment of the thigh? What are it’s roots?

Answer 26

Obturator never Roots = L2-L4

Question 27

Which nerve supplies the posterior compartment of the thigh? What are it’s roots?

Answer 27

Sciatic nerve Roots = L4-S3

Question 28

Which posterior thigh muscle section is innervated by the common fibular part of the sciatic nerve?

Answer 28

The short head of biceps femoris

Question 29

What are the muscles of the posterior compartment of the thigh? What are their innervations?

Answer 29

Biceps femoris (common fibular part of the sciatic nerve) Semitendinous (tibial part of the sciatic nerve) Semimembranous (tibial part of the sciatic nerve)

Question 30

What are the two divisions of the sciatic nerve? Which is anterior and which is posterior? Which compartment does each supply in the leg?

Answer 30

1) anterior division = tibial = supplies posterior compartment of leg 2) posterior division = common fibular = supplies anterior and lateral compartment of leg NB: division orientation = OPPOSITE to the compartment it supplies

Question 31

Which nerve supplies the sole of the foot?

Answer 31

Tibial nerve branch of the sciatic nerve which ends up forming the medial and lateral plantar nerves

Question 32

Which nerve supplies the dorsum of the foot?

Answer 32

Common fibular branch of the sciatic nerve

Question 33

What are the 2 divisions of the common fibular nerve and what does each innervate? What are the nerve roots for each?

Answer 33

1) superficial fibular nerve = lateral leg = roots L4-S1 | 2) deep fibular nerve = anterior leg = roots L4-S1

Question 34

What does the superior gluteal nerve innervate? What are it’s roots?

Answer 34

L4-S1 Gluteus minimus, medius and tensor fascia lata

Question 35

What does the inferior gluteal nerve innervate? What are it’s roots?

Answer 35

Gluteus maximus L5-S2

Question 36

What is the pathway of the common fibular nerve distal to the knee?

Answer 36

Around the neck of the fibula

Question 37

Which artery branches from the aorta to supply the lower leg? What artery does this eventually become and when?

Answer 37

External iliac Femoral artery after it bypasses under the inguinal ligament

Question 38

What is the largest branch of the femoral artery?

Answer 38

Profunda femoris

Question 39

What is another name for the common fibular nerve?

Answer 39

Common peroneal

Question 40

Which thigh compartments does the profunda femoris supply?

Answer 40

Medial and posterior thigh

Question 41

What are the boarders of the femoral triangle?

Answer 41

Superior boarder = inguinal ligament Lateral boarder = medial part of sartorius muscle Medial boarder = adductor longus Floor = adductor longus

Question 42

When does the femoral artery become the popliteal artery?

Answer 42

Once it penetrates Adductor Magnus through the adductor hiatus

Question 43

Where does the gluteal region blood supply arise from?

Answer 43

Branches of the INTERNAL iliac arteries

Question 44

Where dels the hip joint get its arterial supply from?

Answer 44

Branches of the profunda femoris

Question 45

Which artery supplies the anterior thigh compartment?

Answer 45

Femoral

Question 46

Explain the route the femoral artery takes to become the popliteal artery.

Answer 46

Travels in anterior compartment, anterior to posterior of femur bone, pierces adductor hiatus in the adductor Magnus muscle (found in the medial compartment)

Question 47

What does the popliteal artery branch into?

Answer 47

1) anterior tibial artery | 2) posterior tibial artery

Question 48

Explain the course of he anterior tibial artery.

Answer 48

Popliteal artery is posterior to knee Branches to form anterior tibial Anterior tibial travels posterior to anterior BETWEEN fibula and tibia Eventfully forms dorsalis pedis artery (pulse point)

Question 49

What does the posterior tibial artery further divide into?

Answer 49

1) peroneal artery | 2) plantar arteries

Question 50

Name 4 pulse points of the lower limbs.

Answer 50

1) femoral 2) popliteal 3) posterior tibial 4) dorsalis pedis

Question 51

What is the vein supply mirroring in the lower limb?

Answer 51

The arterial supply

Question 52

Where are the only lymphatic nodes in the lower limb?

Answer 52

Deep nodes in the popliteal fascia

Question 53

Which nodes in the thigh region does the whole lower limb drain to? What else drains here?

Answer 53

Superficial inguinal nodes Anterior abdomen Genitals Lower back Gluteal region

Question 54

What are the 2 types of lymphatic drainage vessels? What structures does each follow?

Answer 54

1) deep lymphatic drainage (follows arteries) | 2) superficial lymphatic drainage (follows great saphenous vein)

Question 55

How common are anterior and posterior hip dislocations?

Answer 55

Posterior = 9/10 Anterior = 1/10

Question 56

What position would the lower limb be in for each type of hip dislocation?

Answer 56

Posterior dislocation = hip flexion = adduction = internal rotation Anterior dislocation = mild hip flexion = abduction = external rotation

Question 57

What is a normal hip join flexion range? What limits this?

Answer 57

Unlimited, limited only but soft tissues

Question 58

What is a normal hip join extension range? What limits this?

Answer 58

20 degrees limited by ligaments

Question 59

What is a normal hip joint abduction range?

Answer 59

60 degrees

Question 60

What is a normal hip joint adduction range?

Answer 60

30 degrees

Question 61

What is the main arterial supply to the inside of the capsule of the hip joint? What may damage to this this cause? (And therefore require thinking about during hip fractures)

Answer 61

Medial femoral circumflex artery (a profunda femoris branch) Avascular necrosis of the femoral head/neck

Question 62

What are the trochanters of the femur used for?

Answer 62

Muscle attachment

Question 63

Which muscle inserts to the lesser trochanter?

Answer 63

Iliopsoas

Question 64

Which muscle inserts to the quadratic tubercle?

Answer 64

Quadratus femoris

Question 65

What is the normal angle of the axis of the femur between the neck and shaft? What is this angle called?

Answer 65

125 degrees Angle of inclination

Question 66

What is an abnormally low angle of inclination called? Who may you see this in?

Answer 66

Coxa vara Elderly

Question 67

What is an abnormally high angle of inclination called? Who may you see this in?

Answer 67

Coxa vaga Children

Question 68

What is the angle of anteversion/declination/torsion? What is a normal angle?

Answer 68

The angle the neck is at compared to the centre of the femur It is usually 15 degrees forwards

Question 69

What is the femoral shaft angle/an atomic axis of the femur? Why is this needed?

Answer 69

The angle between the distal and proximal ends of the femur caused by the neck pushing the femur away from the hip, usually about 6 degrees, to keep the weight of the body held by the distal femur

Question 70

Which ligament fills the gap of the inferior part of the acetabulum?

Answer 70

Transverse acetabular ligament

Question 71

Which ligament attaches the acetabulum to the femoral head? What is the name of the notch in the femoral head to which this ligament attaches? Which artery travels with this and what is it a branch of?

Answer 71

Ligament of the head of the femur Fovea The acetabular branch of the obturator artery (with the obturator being a branch of the internal iliac artery)

Question 72

What 3 ligaments strengthen the hip joint capsule? Which is the strongest?

Answer 72

1) pubofemoral 2) iliofemoral (strongest = biggest bone) - Y shape 3) ishiofemoral

Question 73

Which line can you look at on an X-ray to see if a dislocation or displaces fracture may be present?

Answer 73

Shenton’s line

Question 74

Where is worst for femoral fractures for poor salvageability of the head of the femur?

Answer 74

In the capsule = vessels will not survive = avascular necrosis

Question 75

Which gluteal muscles air above the hip joint and can therefor abduct the hip?

Answer 75

Minimus and medius

Question 76

What are the 3 main foramen in the pelvic region?

Answer 76

Greater sciatic foramen Lesser sciatic foramen Obturator foramen

Question 77

What separated greater from lesser sciatic foramen? Why is it called this?

Answer 77

Sacrospinous ligament It attaches to sacrum and ischial spine