Lower Limb

Question 1

What are the structures of the lesser sciatic foramen

Answer 1

i.Inferior Gluteal Artery and Nerve(L5,S1,S2)
ii. Internal Pudendal artery and nerve(S2,S3,S4)
iii.Nerve to obturator internus(L5,S1,S2)
iv. Sciatic nerve(L4,L5,S1,S2,S3)
v.Posterior femoral cutaneous nerve

Question 2

what vessels form the trochanteric anatamosis

Answer 2

i.descending branch of the superior gluteal artery.
ii. lateral circumflex femoral artery
iii.medial circumflex femoral artery
iv. Obturator artery
v. inferior gluteal artery

Question 3

In the hip joint what is the main artery supplying this

Answer 3

medial circumflex femoral artery

Question 4

Write short notes on the anatomy of the femur

Answer 4

The femur is a long bone which consists of a head, neck, shaft and expended lower head. On standing in lies inferomedially.

head:
is shaped as half a sphere with a pit present for insertion of the ligamentum teres. It is inserted into the acetabulum further deepened by a fibrocartilage (the labrum).
To increase stability there are 3 main ligaments associated with the head of the femur
i.Ileofemoral- prevents extension and is attached from ASIS to intratrochanteric line
ii.Pubofemoral- superior ramus of the obturator crest and blends into the capsule
iii.ischiofemoral- inferior margin of the acetabulum and spirals upwards into the capsule

blood supply:
i.Trochanteric anastamoses(superior gluteal artery, medial and lateral circumflex arter)
ii.medullary
iii.Artery of ligamentum teres- from obtuarator
nervous supply:
i.Nerve to femoris- femoral branch
ii.anterior obturator nerve
iii.twigs from sciatic nerve

Relations:
Anteriorly: Separated by femoral artery by the psoas muscle,
Medially: Separated from femoral vein by pectineus
Inferiorly:obturator externus lies below
posteriorly: piriformis, and obturator internus and gemelli separate the capsule from the sciatic nerve
Laterally: Capsule binds the ITB

Neck:
Lies superomedially,
There is presence of a lower and greater trochanter in the junction between the shaft and the neck and in between them lies the intratrochnateric line.
Capsule lies up to the neck of the intratrochenteric line. In between greater and lesser trochanter and wraps posteriorly in the intertrochanteric fossa

Greater trochanter: attachment
i.Piriformis
ii.Obturator internus and gemelli
iii.Obturator externus on the intertrochanteric fossa
iv. Gluteus minimus
v. Gluteus Medius

Lesser trochanter:
i. Iliopsoas

Shaft:
has a posterior linea aspira
medial part of the crest becomes the medial supracondylar surface and laterally the supracondylar surface
below the greater trochanter lies the gluteal tuberosity
Origins:
i.intertrochanteric line becomes the spiral line : origin of vastus medialis. above, vastus lateralis also lies from this .
ii.vastus intermedius origin is on the anterolateral 2/3 of the shaft
iii.Biceps femoris

Insertions:
i.Pectinues
ii.Adductor brevis
iii.Adductor Magnus at gluteal tuberosity
iv. Ans ansirus
Ends with two condyles with the intercondylar fossa between them an trochlea surface with the patella.
ACL: far back on the lateral epicondyle
PCL: forwards to the medial epicondyle
Above the medial epicondyle is the adductor tubercle
behind the medial epicondyle is the origin of gastrocnemius.
lateral epicondyle lies the origin of the
i.gastrocnemius
ii.Lateral epicondyle where the lateral collateral ligament lie
iii.poplitues tendon