Anatomy - Thigh
What sides are each of the major groups of muscles on?
Adductor muscles medial. Rectus femoris medial anterior. Vastuses lateral anterior. Hamstrings (Semis+Biceps femoris) posterior medial. Sartorius going medial. Gracilis medial. Pes Anserinus medial.
Where do all the adductors insert to?
Along the medial border of the femur (linea aspera). Developmentally, distal part of adductor magnus turns into the medial collateral ligament.
3 Exceptions of innervations in thigh
Anterior is all Femoral n. except Pectineus m. (femoral n. + obturator n.) Adductors are all Obturator n. except for the hamstring part of Adductor magnus m. (Tibial n.) Posterior is all Tibial n. except for short head of Biceps femoris m. (Common Fibular n.) + Nerve to vastus medialis
What is interesting about obturator externus m.?
By innervation (obturator n.) it is an adductor, but functionally, it is a lateral rotator (part of the glutes) Other lateral rotators: Piriformis, Obturator internus, Gemellus superior, Gemellus inferior
What is the order of the retroinguinal neurovascular structures?
NAVL from Lateral to Media Nerves, Artery, Vein, Lymph nodes
Where does the sciatic nerve run?
Posterior to thigh in between adductor muscles and hamstrings
Pes-anserinus - SGT FOT
Semimembranus - Femoral n. Gracilis - Obturator n. semiTendinous - Tibial component of sciatic n.
What parts of the hamstrings medially rotate the thigh, what parts laterally? What nerve innervates them?
Semitendinosus and Semimembranosus mm. medially rotate the thigh. Biceps femoris (Which is attached to the fibular) laterally rotates the thigh. Tibial nerve innervates them except for the short head of the biceps femoris (which is innervated by Common Fibular)
What are the main lymph nodes of the lower limb?
Superficial inguinal lymph nodes and Deep inguinal lymph nodes (the deep ones are near the femoral artery and vein)
What are the arteries of the trochanteric anastomosis supplied by?
Superior and Inferior Gluteal AA. and the Medial and Lateral Femoral Circumflex AA.
Where are the femoral a., profunda femoris a., and perforating branches of the profunda femoris in related to the muscles?
The Femoral A. is just behind the sartorius/quads. The profunda femoris is sandwiched by adductor longus and brevis/magnus and the perforating branches go to the adductor magnus.
What nerve comes up below the piriformis?
The gigantic sciatic nerve
What are the 2 main superficial veins of the leg?
The great and small saphenous veins. The Great Saphenous V. is anterior and joins the femoral vein up in the inguinal region. The Small Saphenous V. is anterior and joins the Popliteal V. (which is also an extension of the femoral vein)
What are the borders and contents of the retro-inguinal space?
The retro-inguinal space is formed right below the inguinal ligament and separated into two spaces (lacunar musculorum and vasorum) via the iliopectineal arch. The lateral musculorum contains the Lateral Femoral Cut N., Femoral nerve as well as the Iliacus & Psoas major muscles. The medial vasorum contains the Femoral branch of the Genitofemoral N., Femoral Artery, Femoral Vein, and lymph node
What are the roles of the hamstrings and where to they originate from?
They are knee flexors and hip extensors. Ischium except for the short head of biceps femoris from femur.
What are the arterial branches of the external iliac and femoral arteries in the inguinal region?
2 superior - Superficial and Inferior Epigastric AA. 2 medial - Superficial and Deep External Pudendal AA. 2 lateral - Superficial and Deep Circumflex Iliac AA. *Anything superficial or inferior will usually branch from below inguinal ligament
What does the Sartorius m. do?
Laterally rotate thigh, flex, abduct.
What side of the body is pes anserinus?
Medial...inserts on tibia
Avascular necrosis of femoral head (Clinical)
Damage to the retinacular arteries forming the trochanteric anastamoses (Neck of femur)
What vessels do you find just underneath the sartorius muscle?
Femoral artery and vein
What neurovascular structures go through the adductor canal?
Femoral nerve branches, arteries, and veins Femoral nerve branches, nerve to vastus medialis, and saphenous n. don't go through the adductor hiatus
What are the powerful hip flexors in the body?
Iliacus m., Psoas major & Psoas minor m.
Distribution of obturator n. and an important landmark
Important landmark for distinguishing branches of the obturator n. is Adductor brevis m. Anterior branch of obturator n. and a. is above adductor brevis. Posterior branch under adductor brevis m.
What are the boundaries of the femoral triangle?
Inguinal ligament, Sartorius M., and Adductor Longus M.
What are some sites on the pelvis at risk for avulsion fractures?
Ischial tuberosity, AIIS
What is the purpose of the patella?
It allows for a smooth extension when quadriceps tendons fire on the tibia. (Rectus femoris originates from ASIS while the vastuses originate on femoral shaft)
