M: Anterior and medial compartments of the thigh Flashcards

1
Q

What type of bone is the patellar?

A

Triangular sesamoid bone

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2
Q

The patellar develops within what?

A

The quadriceps tendon

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3
Q

What are the 6 bony landmarks of the patellar?

A

1) Base (superiorly)
2) Apex
3) Articular surface
4) Anterior surface
5) Lateral facet
6) Medial facet
Both facets on the posterior surface

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4
Q

Which quadriceps muscle acts to prevent the patellar being pulled too laterally?

A

Vastus medialis - it pulls at a much more oblique angle than the other 3 quadriceps

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5
Q

Other than the pull of vastus medialis, what other mechanism exists to prevent the patellar being pulled too laterally?

A

A bony ridge can be found on the lateral femoral condyle - if this is underdeveloped it may lead to recurrent dislocations of the patellar

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6
Q

A blow patellar may split or shatter the patellar - why in this situation may the fragments not be avulsed?

A

Because the quadriceps expansion remains intact

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7
Q

What is meant by the term avulsed?

A

An injury in which a bony structure is forcibly detached from its normal position either by trauma or surgery

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8
Q

Why is the knee reliant on the strength or surrounding muscles, ligaments and menisci for stability?

A

Because the articular surfaces of the knee joint are incongruent

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9
Q

What are menisci and where are they situated?

A

2 c shaped wedges of fibrocartilage which are thicker at the external margins
They sit on the tibial plateau

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10
Q

What are the 4 intrinsic muscles of the knee?

A

1) Fibular collateral ligament
2) Tibial collateral ligament
3) Anterior cruciate
4) Posterior cruciate

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11
Q

What is the combined function of the fibular and tibial collateral ligament?

A

Stabilize the hinge like movement of the knee

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12
Q

What is the function of the posterior cruciate ligament? 3

A

Prevents posterior displacement of the tibia on the femur
Prevents hyperflexion
Main stabiliser of the flexed knee when weight bearing eg. walking down a hill

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13
Q

What is the function of the anterior cruciate ligament?

A

Prevents anterior displacement of the tibia on the femur

Prevents hyperextension

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14
Q

Why are the medial (tibial) collateral ligament and medial menisci commonly injured simultaneously?

A

Because they are firmly attached together

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15
Q

What movements are possible at the knee joint? 4

A

1) Extension
2) Flexion
3) Medial rotation of the leg when knee flexed at 90 degrees
4) Lateral rotation of the leg when knee flexed at 90 degrees

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16
Q

What opening in the deep fascia does the great saphenous vein pass through?

A

Saphenous hiatus/opening

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17
Q

What is the function of the femoral triangle?

A

Provides a transit route from the thigh for the major vessels passing to and from the leg

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18
Q

What are the borders of the femoral triangle?

A

Base - inguinal ligament
Medial border - medial margin of adductor longus in the medial compartment
Lateral border - medial margin of sartorius muscle in the anterior compartment of the thigh
Floor - formed medially by pectineus and adductor longus in the medial compartment of the thigh and formed laterally by iliopsoas muscle in the anterior compartment of the thigh

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19
Q

What are the 4 contents of the femoral triangle?

A

1) Femoral nerve
2) Femoral artery
3) Femoral vein
4) Lymphatics

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20
Q

What muscles are supplied by the femoral nerve?

A
Muscles of the anterior compartment of the thigh
4 quadriceps muscles
1) Rectus femoris
2) Vastus lateralis
3) Vastus medialis
4) Vastus intermedius
5) Sartorius muscle
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21
Q

What are the attachments of sartorius muscle?

A

Origin - ASIS

Insertion - Medial surface of tibia, inferomedial to tibial tuberosity

22
Q

What is the innervation of sartorius muscle?

A

Femoral nerve (L2, L3)

23
Q

What are the 2 actions of sartorius muscle?

A

1) Flexes thigh at hip joint

2) Flexes leg at knee joint

24
Q

What forms the roof of the adductor canal?

A

Sartorius muscle

25
Q

What is the function of the adductor canal?

A

Carries the femoral vessels and saphenous nerve between the femoral triangle and popliteal fossa

26
Q

What are the boundaries of the adductor canal?

A
Anterior/roof = sartorius muscle
Lateral = vastus medialis
Posterior = adductor longus and adductor magnus
27
Q

What marks the apex of the adductor canal?

A

Apex of the adductor canal is marked by the adductor hiatus

28
Q

What is the adductor hiatus?

A

A gap between the adductor and hamstring attachments of adductor magnus

29
Q

What are the orgins and insertions of rectus femoris?

A

Origin - straight head = AIIS, reflected head = Ilium superior to acetabulum
Insertion = Quadriceps femoris tendon

30
Q

What is the innervation and 2 saction of rectus femoris?

A
Innervation = femoral nerve (L2-L4)
Actions = flexes thigh at hip joint, extends leg at knee joint
31
Q

What is the origin and insertion of vastus lateralis?

A

Origin - femur (lateral intertrochanteric line, margin of greater trochanter, gluteal tuberosity and lateral lip of linea aspera
Insertion - quadriceps femoris tendon

32
Q

What is the origin and insertion of vastus medialis?

A

Origin - femur (medial intertrochanteric line, pectineal line, medial lip of linea aspera, medial supracondylar line)
Insertion - quadriceps femoris tendon and medial border of patellar

33
Q

What is the innervation and 1 action of vastus lateralis?

A

Femoral nerve L2-L4

Extends the leg at the knee joint

34
Q

What is the innervation and 1 action of vastus medialis?

A

Femoral nerve L2-L4

Extends the leg at the knee joint

35
Q

What is the origin and insertion of vastus intermedius?

A

Origin - femur (upper 2/3 of anterior and lateral surfaces)

Insertion - quadriceps femoris tendon and laterla margin of patellar

36
Q

What is the innervation and 1 action of vastus intermedius?

A

Femoral nerve L2-4

Extends leg at knee joint

37
Q

In addition to the 4 quadriceps and sartorius whar 2 other muscles does the anterior compartment contain?

A

1) Iliopsoas muscles

2) Pectineus

38
Q

The medial compartment contains muscles which arise from where?

A

The external surface of the pubis and the ischiopubic ramus

39
Q

What 5 muscles can be found in the medial compartment of the thigh?

A

1) Adductor longus
2) Adductor brevis
3) Adductor magnus
4) Gracilis
5) Obturator externus

40
Q

What is the chief function of the muscles of the medial compartment of the thigh?

A

Adduct the thigh at the hip joint

41
Q

What is the origin and insertion of adductor longus?

A

Origin - Body of pubis

Insertion - linea aspera on medial 1/3 of shaft of femur

42
Q

What is the innervation of adductor longus?

A

Anterior division of obturator nerve L2-4

43
Q

What is the origin and insertion of adductor brevis?

A

Origin - body of pubis and inferior pubic ramus

Insertion - post proximal femur and upper 1/3 of linea aspera

44
Q

What is the innervation of adductor brevis?

A

Obturator nerve L2-3

45
Q

What is the origin of the adductor part of adductor magnus?

A

Origin - ischiopubic ramus

Insertion - Posterior proximal femur, linea aspera and medial supracondylar line

46
Q

What is the origin and insertion of the hamstring part of adductor magnus?

A

Origin - ischial tuberosity

Insertion - Adductor tubercle and supracondylar line

47
Q

What are the 2 different innervations of the adductor part and hamstring part of adductor magnus?

A

Adductor part = obturator nerve L2-4

Hamstring part = tibial division of sciatic nerve L2-4

48
Q

What is the origin and insertion of gracilis?

A

Origin - body of pubis, inferior pubic ramus and ramus of the ischium
Insertion - medial proximal tibia

49
Q

What is the innervation of gracilis?

A

Obturator nerve L2-4

50
Q

What is the origin and insertion of obturator externus?

A

Origin - external surface of obturator membrane and adjacent bone
Insertion - trochanteric fossa

51
Q

What is the innervation of obturator externus?

A

Obturator nerve L3,L4