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ilium, pubis, ischium
Bones of the pelvis
Acetabulum
Where do the pelvic bones fuse?
Iliopsoas
What attaches to the lesser trochanter?
greater trochanter
What acts as the pulley for abducting the thigh?
labrum
Acts a suction cup, deepens the acetabulum to hold the head of the femur in place
transverse acetabular ligament
fills in the gap of labrum
iliofemoral (Y ligament)
Main anterior ligament of the hip, superior posterior ligment
pubofemoral
Tiny anterior ligament of the hip
ischiofemoral
Main ligament of the posterior hip
Hilton’s law
Nerve supply to the hip follows
medial and lateral circumflex, branches of obturator, gluteal arteries
Vascular supply to the hip
medial circumflex
What is the main artery for the joint of the hip?
deep femoral artery
The lateral and medial circumflex arteries are branches of the
ascending, transverse, descending
Branches of the lateral circumflex
lateral femoral cut. nerve
sensation to the anterior thigh, runs under the inguinal ligament
Meralgia paresthetica, lateral femoral cut. n.
A patient presents to the ER with numbness and tingling to the lateral portion of the thigh. While obtaining a history, you learn that the patient works in construction and wears a heavy tool belt daily. What could be going on with the patient and what nerve is affected?
Genitofemoral nerve
What does the sensory innervation of the upper femoral triangle, anterior scrotum/labia, and mons pubis?
cremaster muscle
The genitofemoral nerve supplies motor innervation to the ____________
inferior internal oblique, inferior transversus abdominis
What muscles does the ilioinguinal nerve supply?
inguinal canal
Where can you find the ilioinguinal nerve?
Obturator nerve
What nerve innervates the sensation of the lower inguinal region, anterior scrotum/labia, mons pubis, uppermost medial thigh?
L2-L4
The femoral and obturator originate from which spinal nerves?
Femoral
What nerve provides sensory innervation to the anterior thigh?
dermatomes
strips of skin innervated by a single spinal nerve
anterior/medial LL
What areas are supplied by lumbar spinal nerves?
genitals and posterior area
What areas are supplied by the sacral spinal nerves?
Great saphenous vein
Longest vein in the body, located medially and formed by the union of the dorsal vein of the great toe and dorsal venous arch of the foot
femoral vein
The great saphenous veins drains into the
readily accessible, long lengths between valves
A patient presents to the clinic for a coronary artery bypass, why is the great saphenous vein a good choice for reconstruction?
varicose veins, valve insufficiency
A patient presents to the clinic with dilated, tortuous veins. What are these called and what is the reason for their appearance?
extensor knee
Primary function of the anterior thigh
femoral nerve
The muscles of the anterior thigh are generally innervated by the
femoral or deep artery
The muscles of the anterior thigh are generally supplied by the
Rectus femoris, Vasta lateralis, Vasta intermedius, vastas medialis
Muscles of the Quadriceps Femoris
Rectus Femoris, it crosses 2 joints (hip and knee)
What is the weakest muscle of the quadriceps and why?
leg extension and hip flexion
Action of the Rectus femoris
leg extension
Function of the vasti muscles
quadricep tendon
All 4 quadricep muscles come together to form the
patellar ligament
After the quadricep tendon engulfs the patella, it becomes the
patella
Provides leverage for the quads, can withstand compression and friction during flexion/extension of the knee
articularis genu
Lifts the patella, extends the leg elevates upper portion synovial membrane
vastus intermedius
the articularis genu is deep to inferior part of
tibial tuberosity
The quadriceps attach distally at the
satorius
longest muscle in the body
flexes, abducts, and laterally rotates the hip, flexes knee
Action of the satorius (cross both the knee and hip)
primary flexor of thigh, flexion of the trunk
Actions of the iliopsoas
Femoral (flexion of hip) AND Obturator (adduction)
Innervation of the pectineus
spinal branches
The iliopsoas is innervated by
adduction, flexion, medial rotation of hip
Action of the pectineus muscle
½ pectineus, sartorius, quads, articularis genu
Muscles supplied by the femoral nerve
saphenous nerve
Terminal Branch of the femoral nerve that is sensory ONLY
patellar ligament (test femoral nerve)
If I wanted to test spinal cord segments L3-L4, what would I hit with a reflex hammer?
adduction, secondarily flex and or rotate the thigh
Function of the medial thigh
obturator nerve
Most of the medial thigh is innervated by the
obturator artery, deep femoral artery
Most of the medial thigh is supplied by the
hip adduction, pelvis, femur
Brevis, Longus, Magnus muscles AOIs
gracilis
Weakest and most medial adductor, crosses the hip and knee
sartorius (anterior), semitendinosus (posterior), gracilis (medial)
Pes anserinus is made up of tendons from
pes anserinus
What can you find on the MEDIAL side of the knee?
pectineus (1/2), longus, gracilis
Anterior division of the obturator nerve innervates the
brevis, magnus (1/2)
Posterior division of the obturator nerve innervates the
obturator and the sciatic (tibial)
The magnus is innervated by the
external iliac
The femoral artery comes from the
deep femoral
Largest branch of the femoral artery
adductor hiatus
Where does the femoral artery become the popliteal?
internal iliac
The obturator artery is a branch of the
obturator artery
Assists the deep artery with supply to the adductor groups and an acetabular branch to the head of the femur
inferior gluteal, medial circumflex, lateral circumflex, 1st perforating
Cruciate anastomosis is made up of the
inguinal ligament(superior), Longus (medial), Sartorius (lateral)
Walls of the femoral triangle
iliopsoas (lateral), pectineus (medial)
Floor of the femoral triangle
NAVL (femoral nerve, artery, vein, lymph nodes)
What can you find in the femoral triangle
femoral artery
Lateral compartment of the triangle contents
femoral vein
Intermediate compartment of the triangle contents
lymphatics, fat, maybe a deep inguinal node
Medial compartment of the triangle contents
Medial compartment of the femoral triangle
Femoral hernia occur where
femoral artery, femoral vein, saphenous nerve
Contents of the adductor canal
saphenous nerve
Which component of the adductor canal does NOT pas through the adductor hiatus?
females
Femoral hernias are more common in