Lumbar Plexus and Anterior Thigh Part 1 Flashcards
(64 cards)
1
Q
Lumbar plexus
A
- Ventral rami L1-4
- Ventral and dorsal divisions
2
Q
Nerves of the lower extremity
A
- Subcostal
- Iliohypogastric
- Ilioinguinal
- Genitofemoral
- Lateral femoral cutaneous
3
Q
Subcostal nerve
A
- Ventral rami T12
- Cutaneous supply to superior anterolateral thigh
4
Q
Iliohypogastric nerve
A
- Ventral division of L1)
- Gives off a cutaneous branch to posterolateral gluteal region
5
Q
Ilioinguinal nerve
A
- Ventral division of L1
- Gives off a cutaneous innervation of superomedial thigh
6
Q
Genitofemoral nerve
A
- Ventral divisions of L1,2
- Femoral branch passes deep to inguinal ligament (vascular compartment)
- Cutaneous supply over femoral triangle
7
Q
Lateral femoral cutaneous nerve
A
- Dorsal divisions of L2,3
- Enters thigh deep to inguinal ligament near ASIS (can pass through it)
- Cutaneous supply to anterolateral thigh
8
Q
Nerves to psoas major muscle
A
- Dorsal divisions of L2-4
- Branch directly off of ventral rami to innervate muscle
9
Q
Nerve to iliacus muscle
A
- Branch from femoral nerve
10
Q
Femoral nerve
A
- Dorsal divisions of L2-4
- Travels between psoas major and iliacus muscles
- Enters thigh deep to inguinal ligament, through muscular lacuna
11
Q
Femoral nerve supplies branches to
A
- Anterior thigh muscles (motor)
- Hip and knee joints (sensory)
- Cutaneous to anterior and inferomedial thigh and medial leg
12
Q
Obturator nerve
A
- Ventral divisions of L2-4
- Passes through lesser pelvis and through obturator canal to enter the thigh
13
Q
Obturator nerve supplies branches to
A
- Medial thigh muscles (motor)
- Hip and knee joints (sensory)
- Skin medial thigh
14
Q
Accessory obturator nerve
A
- Ventral divisions of L3,4
- Not always present (10-30%)
- If present passes over superior pubic ramus
15
Q
Accessory obturator nerve supplies branches to
A
- Pectineus muscle
- Hip joint (sensory)
- Skin of medial thigh
16
Q
Lumbosacral trunk (L4,5)
A
- Formed by a portion of L4 and all of L5
- Passes over pelvic brim, anterior to SI joint
- Joins sacral plexus
17
Q
Psoas major origin
A
- TP of lumbar vertebrae
- Vertebral bodies/discs T12-L5
18
Q
Psoas major insertion
A
- Lesser trochanter of femur
19
Q
Psoas major pathway
A
- Descends over pelvic brim, beneath inguinal ligament
- Through muscular lacuna
- Anterior to hip joint
- Joins the tendon of iliacus
20
Q
Psoas major innervation
A
- Ventral rami L1-4
- Mostly from L2-4
21
Q
Psoas major blood supply
A
- Muscular branches of the iliac arteries
- Lumbar arteries
22
Q
Psoas major function
A
- Flex thigh
23
Q
Iliacus origin
A
- Upper 2/3 iliac fossa
- Internal lip of iliac crest
- Ala of sacrum
- Anterior sacroiliac ligaments
- Iliolumbar ligament
24
Q
Iliacus insertion
A
- Psoas major tendon/lesser trochanter of femur
- Similar path as the psoas major
25
Iliacus innervation
- Femoral nerve (L2-4)
26
Iliacus blood supply
- Muscular branches of the iliac arteries
- Lumbar arteries
- (same as psoas major)
27
Iliacus function
- Flex thigh
| - (same as psoas major)
28
Iliopsoas
- Combination of iliacus and psoas major
| - Advances the lower extremity during gait
29
Fascia lata
- Deep fascia of the thigh
| - Surrounds thigh muscles
30
Fascia lata attaches to
- Inguinal ligament, pubic tubercle
- Scarpa fascia
- Iliac crest
- Sacrum, coccyx, sacrotuberous ligament, ischial tuberosity
- Iliotibial tract
31
Fascia lata is continuous with
- Deep fascia of leg
| - Attaches to tibia inferiorly
32
Iliotibial tract
- Lateral thickening of fascia lata
| - Attaches to iliac tubercle and Gerdy’s tubercle (tibia)
33
3 intermuscular septa divide thigh into 3 compartments
- Posterior
- Lateral
- Medial
- Lateral extends from iliotibial trace, very strong
34
Anterior thigh compartment content
- Muscles are primarily leg (knee extensors)
- Some hip flexors and rotators
- Femoral nerve
35
Medial thigh compartment content
- Muscles are primarily adductors of thigh (hip)
- (There are others)
- Obturator nerve
36
Posterior thigh compartment content
- Muscles are primarily hip extensors and knee flexors
| - Sciatic nerve
37
Aorta bifurcates into
- Common iliac arteries
| - L4
38
Common iliacs arteries divide
- L5/S1
- Internal iliac
- External iliac
39
Internal iliac artery
- Travels into pelvis
40
External iliac artery
- Travels toward anterior thigh
| - Becomes femoral artery as it passes inguinal ligament
41
External iliac artery branches
- Deep circumflex iliac artery
| - Inferior epigastric
42
Deep circumflex iliac artery
- Branches just proximal to inguinal ligament
| - Travels toward ASIS where it anastomoses with other vessels
43
Retro-inguinal space (sub-inguinal space)
- Deep to inguinal ligament
| - Passageway between abdominal cavity and lower limb
44
Retro-inguinal space (sub-inguinal space) is divided into 2 compartments by
- The iliopectineal arch (interlacunar ligament)
45
Interlacunar ligament
- Thickening iliacus/psoas fascia
| - Attaches to inguinal ligament
46
2 compartments of retro-inguinal space
- Muscular compartment (lacuna)
| - Vascular compartment (lacuna)
47
Muscular compartment (lacuna) contents
- Iliacus muscle (lateral)
- Psoas major muscle (medial)
- Femoral nerve: between iliacus and psoas major muscles
- Lateral femoral cutaneous nerve (sometimes)
48
Vascular compartment (lacuna) contents are surrounded by
- Femoral sheath
49
Vascular compartment (lacuna) contents
- Femoral artery
- Femoral vein
- Femoral canal (empty space and lymphatics)
- Femoral branch of genitofemoral nerve
50
Lateral to medial arrangement of structures passing under ligament
- Nerve
- Artery
- Vein
- Empty space (femoral canal)
- Lymphatics
- (NAVEL)
51
Great saphenous vein arises from
- Dorsal venous arch (medial marginal vein)
| - Dorsal vein of 1st digit
52
Great saphenous vein pathway
- Ascends medially
- Anterior to medial malleolus
- Posterior to medial femur condyle
- Passes through saphenous opening (fossa ovalis)
53
Great saphenous vein drains into
- Femoral vein
54
Tributaries of great saphenous vein
- Anterior and posterior accessory saphenous veins
- Superficial epigastric
- Superficial circumflex iliac
- External pudendal veins
- Small saphenous can also drain into the GSV
55
Inguinal lymph nodes
- Superficial inguinal
- Horizontal group
- Vertical group
- Deep inguinal
56
Superficial inguinal lymph nodes (in superficial fascia) drain into
- Deep inguinal nodes
| - External iliac nodes
57
Horizontal group
- 5-6 nodes
| - Located right below inguinal ligament
58
Horizontal group receives lymph from
- Superficial gluteal region and proximal thigh
- Trunk below the umbilicus
- Perineum
59
Vertical group
- 4-5 nodes
| - Located along terminal end of saphenous vein
60
Vertical group drains
- Most regions superficial to deep fascia (except posterior/lateral leg and foot)
61
Deep inguinal lymph nodes
- 1-3 nodes
- Located deep to fascia lata
- Within the femoral triangle
- Medial to femoral vein
62
Cloquets node
- Most cephalad node
| - Llocated at femoral ring
63
Cloquets node drains
- Deep tissue/structures of thigh
64
Cloquets node receives lymph from
- Popliteal nodes (tissues deep to deep fascia)
| - Superficial inguinal nodes
