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Thigh Anatomy (1)
The anatomy of the Anterior and Medial thigh
Question | Answer |
---|---|
What are the arteries that run down the thing? | External iliac artery-->femoral artery-->popliteal artery-->anterior tibial artery (dorsalis pedis artery) and posterior tibial artery (medial and lateral plantar arteries, fibular artery) |
Where do the veins begin? | Begin as venous networks on the digits; superficial veins do not accompany any named arteries |
* *Where does the great saphenous vein run? | Passes ANTERIOR to MEDIAL malleolus-->up medial side of leg (receives branches of small saphenous vein)-->continues up medial side of thigh-->enters saphenous opening of fascia lata-->emites into femoral vein |
Describe the valves of the great saphenous vein and their relationship to varicose veins | One way valves maintain upward flow-->communicates by perforating veins with deep veins; incompentent valves cause VARICOSE VEINS |
Where is the small saphenous vein? What veins does it communicate with? | Ascends posterior to the lateral malleolus; winds up and posterior to the calf; drains into popliteal vein behind knee; communicates with deep veins via perforating veins |
Where are the superficial inguinal nodes? | ABOVE fascia lata in two groups: horizontal (below inguinal ligament) and vertical (follow upper end of great saphenous vein) |
* * Where do the superficial inguinal nodes receive lymph from? | anterior and posterior surfaces of the trunk below the umbilicus; perineum including half of the anal canal, vagina, all of the external genitlia (except testes); superifical lymph vessels of lower limb |
Where do the deep inguinal nodes lie? | On the medial side of the femoral vein DEEP TO THE FASCIA LATA |
What do the deep inguinal nodes drain? Where does the lymph of the deep inguinal nodes go? | Lymph from superficial nodes and from deep structures of the lower limb; efferent vessels fromt hese nodes ascend through FEMORAL CANAL and drain into EXTERNAL ILIAC NODES |
Where is the iliotibial tract? What is it? | Thickening of the fascia lata on the lateral aspect; runs from the iliac tubercle to the lateral condyle of the tibia |
What is the saphenous opening? What goes through it? | Gap in the deep fascia in the anterior thigh just below the inguinal ligament; transmits the great saphenous vein and lymph vessels |
What are the muscles of the anterior compartment of the thigh? | Sartorius, iliacus, psoas major, quadriceps femoris, pectineus |
What is the main nerve supply of the anterior compartment of the thigh? What is the main blood supply? | Femoral nerve and artery |
* * Nerve and action of the sartorius muscle | Femoral nerve; flexes and laterally rotates thigh, flexes and medially rotates leg; ACTS ACROSS TWO JOINTS (attached to anterior superior iliac spine) |
* * Nerve and action of the quadriceps femoris | EXTENSOR of the leg; femoral nerve; rectus femoris also flexes the hip joint; all of the quadriceps are important supports for the knee joint |
* * What are the four muscles of the quadriceps femoris? | rectus femoris, vastus medialis, vastus lateralis, vastus intermedius |
* * What is the patellar retinacula? | Expansions of the vastus medialis and the vastus lateralis portions of the quadriceps tendon; attach to the sides of the patella and patellar ligamen to the femoral and tibial condyles; strengthen capsule of knee joint |
* * What is the nerve and action of the iliopsoas? | Psoas: L2-L4, Iliacus: Femoral nerve; CHIEF FLEXOR OF THE HIP |
* * What is the nerve and action pectineus | Femoral nerve (sometimes help from obturator nerve); flexes and adducts the thigh |
* What are the contents of the medial compartment of the thigh? | Gracilus, adductor longus, adductor brevis, adductor magnus, and obturator externus |
What is the blood supply of the medial compartment of the thigh? | Profunda femoris artery, obturator artery; obturator nerve |
* * What is the nerve and action gracilus | Obturator; ADDUCTS the thigh at the hip joint, flexes the leg at the knee joint |
* * What is the nerve and action of the adductor longus | Obturator; adducts and flexes the thigh |
* * What is the nerve and action of the adductor longus? | Adductor portion: obturator nerve; adducts and flexes the thigh. Hamstring portion: Tibial divison of the sciatic nerve; extends the thigh |
* * What is the action of the obturator externus? | Obturator nerve; laterally rotates the thigh |
* * What are the superior, lateral, and medial borders of the femoral triangle? Floor? | Superior: inguinal ligament; Medial: adductor longus; Lateral: sartorius; Floor: illiopsoas (lateral) and pectineus, adductor longus (medial) |
* * What are the contents of the femoral canal (LATERAL TO MEDIAL)? | Femoral nerve (not in sheath!), femoral sheath (artery, vein), deep inguinal nodes |
* * What is the femoral sheath? | Downward potrusion of the extraperitoneal fascia enveloping the iliac vessels in the abdomen |
* * What are the contents of the femoral sheath (lateral to medial)? | Divided into three compartments by septa: femoral artery, femoral vein, femoral canal (NOTE THAT THE FEMORAL NERVE IS NOT INSIDE) |
* * * Where is the femoral canal? | Small medial compartment in the femoral sheath; Borders: anterior--inguinal ligament, posterior--pectineus muscle and fascia, superior ramus of pubis, medial--lacunar ligament, lateral--femoral vein |
* * Where is the femoral ring? | Upper opening of the canal into the abdomen; closed by extraperitoneal connective tissue |
* * What are the contents of the canal? | Fat, all efferent vessels from deep inguinal nodes, one deep inguinal lymph node |
* * What is a femoral hernia? | Potrusion of abdominal contents through femoral canal; more common in females (wider canal structure) |
* * * Where is a femoral hernia found relative to the pubic tubercle? Direct inguinal hernia? | BELOW AND LATERAL to pubic tubercle; ABOVE and MEDIAL. Femoral hernia pass out femoral canal below the inguinal ligament onto the thigh |
What is a strangulated hernia? | Compression of the blood supply of the viscus |
* * Where is the adductor canal? | narrow fascial tunnel approximately 15 cm long, DEEP to sartorius muscle; begins at apex of the femoral triangle and ends at the adductor hiatus |
* * What are the borders of the adductor canal? Lateral, postermedial, anterior | Lateral: vastus medialis, Posteromedial: adductor longus and magnus; Anterior: sartorius |
The adductor canal at the adductor hiatus (gap in the adductor magnus tendon for passage of the femoral vessels into the ____ ___ behind the knee. | Popliteal fossa |
Where do the femoral vessels change name to the popliteal vessels? | They change name as they pass through the adductor hiatus |
* * What spinal nerves supply the femoral nerve? where does it enter thigh? What does it break up into + where? | Nerves L2-L4; enters deep to the inguinal ligament and lateral to the femoral sheath; numerous muscular and cutaneous branches within femoral triangle |
* What is the terminal branch of the femoral nerve? | The saphenous nerve |
* What spinal nerves supply the obturator nerve? What are its branches? What muscles do they pass through? | L2, L3, L4; branches into anterior and posterior in obturator canal; both branches emerge into thigh behind the pectineus muscle in front of OR through obturator externus |
* Where is the femoral artery(how does it enter)? | Enters the thigh by passing behind inguinal ligament as direct continuation of the external iliac artery; lies midway between anterior superior iliac spine and the symphisis pubis |
* Where is the profunda femoris? | From the LATERAL SIDE of the FEMORAL ARTERY within the FEMORAL TRIANGLE; passes behind femoral vessels and enters medial compartment of thigh behind adductor longus and on surface of adductor magnus |
* What are the branches of the profunda femoris? | Lateral circumflex femoral artery, medial circumflex femoral artery, four perforating arteries; pierce tendons of the adductor muscles to enter posterior compartment of thigh |
* * What is the chief blood supply of the posterior compartment of the thigh? | Fourth perforating artery of the profunda femoris; it is a direct continuation of the profunda femoris |
The ____ artery plays a relatively minor role in the blood supply of the thigh | Obturator |