Anterior and Medial Thigh

ilium, pubis, ischium

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