Overview of LE and Compartments of Thigh

In standing position, you only really need ___ muscles to maintain balance

Plantarflexor

Male vs Female Pelvis

Male: Taller, lesser subpubic angle, smaller inlet/outlet

Female: Shorter, greater subpubic angle, larger inlet/outlet

The _____ surface of the acetabulum is the only part with articular cartilage

lunate

The head of the femur is covered by cartilage except for the _____ region, where the ligamentum _____ enters the head along with a branch from the _____ artery

fovea capitis; teres; obturator

Angle of inclination for a normal hip joint, coxa vara, and coxa valgus

Normal: ~126 degrees

Coxa Vara: <115 degrees

Coxa Valgus: >140 degrees

The (lateral/medial) side of the patellar sulcus on the femur is taller than the (lateral/medial) side

lateral; medial

True/False: The Fibula assists the tibia in weight bearing

False

Function of the fibula

Stabilizes the mortise of the talocrural joint and is a site for muscle attachment

Mortise

The distal tibia and fibula

The ___ MT is much thicker and shorter than the others

1st

Superior and inferior borders of gluteal region

Superior: Iliac crest

Inferior: Gluteal fold

Greater sciatic foramen borders (4)

Superior: Anterior sacroiliac ligament

Posteromedial: Sacrotuberous ligament

Anterolateral: Greater sciatic notch of ilium

Inferior: Sacrospinous ligament

Contents of the greater sciatic foramen

Superior to piriformis: Superior gluteal artery/vein/nerve

Inferior to piriformis: Inferior gluteal artery/nerve, pudendal nerve, sciatic nerve, nerve to obturator internus and quadratus femoris

Lesser sciatic foramen borders (3)

Superior: Sacrospinous ligament

Anterior: Ischial spine, lesser sciatic notch

Posterior: Sacrotuberous ligament

Contents of the lesser sciatic foramen

Pudendal nerve, obturator internus tendon and nerve

The Posterior Sacroiliac ligament provides strong ___ stability

SIJ

Sacrotuberous ligament

Runs from the ischial tuberosity to the sacrum, coccyx and sacroiliac ligament

Forms posterior borders of both the lesser and greater sciatic foramen

Sacrospinous ligament

Runs from the ischial spine to sacrum, coccyx

Splits the greater and lesser sciatic foramen

Superficial Gluteal Muscles (4)

1. Gluteus Maximus

2. Gluteus Medius

3. Gluteus Minimus

4. TFL

Deep Gluteal Muscles (5)

1. Piriformis

2. Obturator Internus

3. Gemellus Superior

4. Gemellus Inferior

5. Quadratus Femoris

The superior gluteal artery enters _____ the piriformis

above

The inferior gluteal artery enters _____ the piriformis

below

Course of the internal pudendal artery

Through the greater sciatic foramen (below piriformis) then the lesser sciatic foramen

The sciatic nerve is a combination of these 2 major lower extremity nerves

Tibial nerve and common fibular nerve

The major superficial vein draining the medial LE

Greater saphenous vein

IT Band Course

Iliac tubercle → Gerdy’s tubercle

Innervation of anterior compartment thigh muscles

Femoral n.

Innervation of posterior compartment thigh muscles

Tibial n. (except for short head of biceps femoris: common fibular n.)

Innervation of medial compartment thigh muscles

Obturator n. (except HS portion of adductor magnus: tibial n.)

Borders and Floor of Femoral Triangle

Superior: Inguinal ligament

Medial: Adductor longus

Lateral: Sartorius

Floor: Iliopsoas and Pectineus

Contents of Femoral Triangle

Femoral Nerve, Artery, and Vein

Course of Adductor canal

Runs from the apex of femoral triangle to the adductor hiatus under the sartorius muscle

Contents of adductor canal

Femoral artery and vein, saphenous nerve (sensory)

Anterior Thigh Muscles (8)

1. Pectineus

2. Sartorius

3. Psoas Major

4. Iliacus

5. Rectus Femoris

6. Vastus Lateralis

7. Vastus Medialis

8. Vastus Intermedius

Tailor’s muscle

Sartorius

The iliopsoas muscles enter the thigh _____ to the inguinal ligament

deep

Largest vasti group muscle

Vastus Lateralis

2 Heads of the Vastus Medialis

Vastus Medialis longus and Vastus Medialis obliquus (stabilizer)

The greater saphenous vein drains into the _____ vein through the _____

femoral; saphenous opening

The lesser/small saphenous vein drains into the _____ vein

Popliteal

The femoral artery is a continuation of the _____ artery

external iliac

Superior border of femoral artery

Inferior border of inguinal ligament

Course of femoral artery

Runs through the thigh in the femoral triangle and adductor canal, enters the adductor hiatus to become the popliteal artery

Primary blood supply for LE

Femoral artery

The profunda femoral artery provides blood supply to the _____,_____, and _____ aspects of the thigh

Posterior; lateral; medial

The lateral circumflex femoral artery (descending branch) supplies the _____ side

lateral anterior

Medial thigh compartment muscles (5)

1. Gracilis

2. Adductor Longus

3. Adductor Brevis

4. Adductor Magnus

5. Obturator Externus

The _____ artery supplies all medial compartment thigh muscles

Obturator

The obturator artery arises from the _____ artery and passes through the _____

internal iliac; obturator foramen

The obturator nerve passes through the _____, and splits into an anterior and posterior branch around the _____

obturator foramen; adductor brevis

Primary blood supply of posterior thigh

Deep femoral artery; some assistance from inferior gluteal artery

Divisions of the Sciatic nerve, and their innervations in the posterior thigh

Tibial nerve - Everything except short head biceps femoris

Common fibular nerve - short head biceps femoris

Area of division of the sciatic nerve

Popliteal fossa

Course of Tibial nerve after splitting from sciatic

Continues through the middle of the popliteal fossa into the posterior leg

Course of common fibular nerve after splitting from sciatic

Wraps around the neck of the fibula, splitting into superficial fibular and deep fibular nerves.

The superficial fibular nerve enters the lateral leg.

The deep fibular nerve enters the anterior leg.

Borders, Floor, and Rood of the Popliteal Fossa

Superior Borders: Semimembranosus and Biceps Femoris

Inferior Borders: Gastrocnemius heads

Floor: Popliteal surface of femur

Roof: Tough popliteal fascia

Divisions of the popliteal artery and their location

The popliteal artery divides into the anterior tibial and posterior tibial arteries at the end of the popliteal fossa.

Components of the Knee Anastomosis

• Superior lateral genicular artery

• Superior medial genicular artery

• Middle genicular artery

• Inferior lateral genicular artery

• Inferior medial genicular artery