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106 Cards in this Set

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Featured Bone in Thigh:
Femur
Main regions of Femur:
-Proximal
-Shaft
-Distal
Proximal Femur Features:
-Head
-Neck
-Greater/lesser trochs
Head of Femur articulates w/:
Acetabulum
Type of joint at hip:
Ball/socket
What muscle inserts at the intertrochanteric crest?
Quadratus femoris
What mucle inserts at the Greater trochanter?
-piriformis
-obterator internus
-gemelli
-gluteus minimus/medius
Where do stress fractures most frequently occur in the femur?
At the neck - if they occur - they don't often.
What is the important feature of the shaft?
Linea aspera - midline posterior ridge that is origin for thigh muscles
What does linea aspera give rise to?
Diverges to form medial/lateral
supracondylar ridges.
Which condyle at the distal femur is larger? Effect:
Medial - to extend thigh/knee, foot externally rotates.
What is between the medial / lateral condyles at posterior femur?
Intercondylar notch
Where do the MCL/LCL attach?
At epicondyles
What invests the muscles of the thigh?
Fascia lata
Attachments of Fascia lata:
Superior: Inguinal ligament, iliac crest, sacrococcyx, sacrotuberous ligament, ischial tuberosity, pubis.
What is the IT band?
Extremely strong part of Fascia lata - from iliac crest to lateral condyle of tibia.
Function of IT band:
-insertion of many muscles
-posture
-keeps thigh muscles aligned as Glut max flexes
What results from overuse of the IT Band? In who?
IT Band Friction Syndrome - inflammation of tissue/bursa beneath IT Band - in runners.
What/where is the Saphenous Opening?
Opening in Fascia Lata - just beneath inguinal ligament (external inguinal canal)
Why is the Saphenous opening important?
It allows the Great Saphenous vein to go into the pelvis and join the femoral vein.
What are the 3 intermuscular compartments in the thigh?
-Origin
-Insertion
Anterior, Posterior, Lateral
Origin: fascia lata
Insert: linea aspera
3 Muscles in the Anterior Hip:
-Ilipsoas
-Obturator externus
-Tensor Fascia lata
What is the function of Ilipsoas?
-Flexes thigh at the hip joint
-Flexes pelvis on the trunk
Origins of Iliacus + Psoas maj:
Common insertion of Iliopsoas:
Psoas maj: T12-L5 vertebrae
Iliacus: Iliac fossa
Common insertion: lesser trochanter
What innervaes
-Psoas major
-Iliacus
Psoas: ventral rami L1-L3

Iliacus: Femoral nerve
Tensor Fascia Lata:
-Function
-Nerve
Function: aids power of thigh muscles, keeps IT band tight as Glut max extends the knee.
Nerve: superior gluteal nerve
Actions of Obturator Externus:
-Deep, powerful external (lateral) rotation of thigh
-Weak adductor
Obturator externus
-origin
-insertion
-action
Origin: obturator canal/ligament
Insert: trochanteric fossa
Nerve: obturator nerve
Anterior Thigh Muscles
-Main function of all
-Nerve to all
Function: knee extension

Nerve: femoral nerve
Muscles of Anterior Thigh:
-Sartorius
-Quadriceps femoris
Why is Sartorius called "tailor's muscle"?
B/c tailors often cross their legs and develop prominent Sartorius muscles.
Actions of Sartorius:
-Flexes thigh when leg straight
-Abducts/lateral rotates thigh when crossed.
Pes anserinus:
Common insertion of 3 muscles:
-Sartorius
-Gracilis
-Semitendinosis
4 Components of Quadriceps Femoris:
-Rectus femoris
-Vastus lateralis
-Vastus medialis
-Vastus intermedius
Insertion of Quads:
Common insertion at Tibial Tuberosity - contains Patella
Patella - Type of bone
Sesamoid, within the common insertion of quads.
What are the distal divisions of the common Quad tendon?
-Superior to patella
-Med/Lat to patella
-Inferior to patella
Sup = quadriceps tendon
Med/lat = med/lat retinaculum
Inf = patellar ligament
Which muscle of quads is most superficial?
Rectus femoris
Functions of Rectus Femoris
CROSS BOTH HIP/KNEE JOINTS, so:
-Flex hip
-Extend knee
Vastus lateralis
-origin
-insertion
-Action
origin = greater troch
insert = lat patellar retinaculm
action: extends knee, controls mechanics of knee joint
Vastus medialis
-origin
-insertion
-action
origin = intertrochanteric line and linea aspera
insert = medial patellar retinaculum
action = extends knee and pulls patella medially
Vastus intermedius
-origin
-insertion
-action
Origin = lateral surfaces of femur
Insertion = vastus lateralis and medialis (fuses)
Actions = knee joint extension, stepping up
What athletes tend to get Patellar tendinitis?
Jumping - vball, bball
What is Patellar femoral pain syndrome (PFPS)?
Anterior knee pain seen in active or overweight patients
What causes PFPS?
Problems in Patellar tracking with the femur - VMO Vasus Medialis Obliquis
What is the result of VMO?
Vasus medialis obliquis = lateral retinaculum is tighter than medial, so kneecap is doslocated in a lateral dirctn.
What is the main action of all the muscles of the medial thigh?
Adduction
What innervates all the adductor muscles and what is the 1 exception?
Obturator nerve
-EXCEPT PECTINEUS
What is PECTINEUS innervated by?
Femoral nerve
What are the adductor muscles? (5)
1. Gracilus
2. Pectineus
3. Adductor longus
4. Adductor brevis
5. Adductor magnus
What is the weakest adductor?
Gracilus
Gracilus
-action
-nerve
Actions: adducts/flexes thigh + very weak internal rotator when knee is flexed
Nerve: obturator
What is the origin/insertion of gracilus?
Origin: pubic ramus/body
Insert: pes anserinus
Pectineus
-action
-nerve
Actions: adduct/flex thigh
Nerve: femoral
What is the origin/insertion of Pectineus?
Origin: pectineal line of pubis
Insert: pectineal line of femur
Adductor Longus
-action
-nerve
Action: Adducts/flexes thigh, rotates medially
nerve: obturator
A Pulled Adductor longus might be confused with:
inguinal hernia
Adductor brevis
-action
-nerve
Action = adduction
Nerve = obturator
Adductor Magnus - 2 parts:
-Adductor part
-Hamstring
Adductor Magnus - Adductor part:
-action
-nerve
Action: adducts/flexes thigh
Nerve: obturator
Adductor Magnus - Hamstrin part:
-action
-nerve
Action: EXTENSOR and medial rotator
Nerve: Tibial portion of Sciatic nerve
So the 2 exceptions to the innervation of medial thigh mm.:
1. Pectineus - femoral nerve
2. Hamstring/Adductor Magnus - tibial portion of sciatic nerve.
What is the adductor hiatus?
The junction of the Adductor canal and Popliteal fossa where the femoral vessels pass thru and become popliteal vessels.
What is the Adductor canal?
A canal underneath sartorius - the femoral vessels run w/in it.
Main difference between adductors and hamstrings:
Adductors - flex thigh

Hamstrings - extend thigh
What muscles are in the posterior compartment?
1. Biceps femoris
2. Semimembranosus (Medial)
3. Semitendinosus (beTween)
So what are the major actions of the hamstrings?
1. Extend thigh
2. Flex knee
What innervates the hamstrings?
Sciatic nerve
What is the common origin of the hamstrings / 1 exception?
Ischial tuberosity
EXCEPT shorthead biceps fem.
What does semitendinosis do in addition to thigh extension and knee flexion?
Medially rotates
What is the insertion point of Semitendinosis?
Pes anserinus with Gracilus and Sartorius - medial retinaculum.
Semimembranosus
-action
-insertion
-nerve
Action: same, plus medial rotation.
Insertion: posterior medial condyle of femur.
Nerve: tibial portion, sciatic
Biceps femoris insertion:
-Common for Long/Shortheads.
-Lateral collateral ligament - it splits the tendon insertion.
What results from the way the biceps femoris insertion is designed?
Most common site for tears.
Biceps femoris long head
-action
-nerve
Action: extend thigh, flex knee, AND LATERAL ROTATION
Nerve: tibial portion, sciatic
Main difference between Biceps femoris Longhead vs. Shorthead:
Long = 2-joint muscle; extends thigh, flexes knee.

Short = 1-joint; only flexes knee
Biceps femoris NERVES
-longhead
-shorthead
Longhead: tibial portion, sciatic nerve
Shorthead: fibular portion, sciatic nerve
Biceps femoris ORIGINS
-longhead
-shorthead
Long = ischial tuberosity
Short = linea aspera and supracondylar ridge
What is the Biceps Femoris longhead an important landmark for?
Sciatic nerve - runs btwn BF longhead and Adductor magnus (hamstring portion).
Popliteal Fossa Borders:
-Superolateral
-Superomedial
-Inferomedial
-Inferolateral
Superolat: Biceps femoris
Superomed: Semimemb/tendinosis
Inferomed: med head gastrocnem.
Inferolat: lat head gastrocnem.
Contents of the Popliteal fossa:
-Popliteal vein/artery
-Tibial/Common Femoral nerves (branches of sciatic nerve)
-Small saphenous vein
-Popliteal lymph nodes, fat, bursa sac
Which component of Popliteal fossa is subject to injury? Why?
Common peroneal nerve (fibular) - it runs very superficially.
Bakers cyst - what is it?
Ruptured popliteal bursa - causes swelling and inflammation behind the knee.
Where would trauma occur to injur the common peroneal nerve?
Medial aspect of knee
In general, what is the femoral triangle?
A depression inferior to the inguinal ligament when the hip is flexed - check femoral pulse
Boundaries of the Femoral Triangle:
-Sartorius
-Inguinal ligament
-Adductor longus
(floor = iliopsoas/pectineus)
What is the roof of the femoral triangle?
Fascia lata
Contents of the Femoral Triangle:
-Femoral nerve/artery/vein - in that order going lat->med
-Inguinal lymph nodes
-Femoral sheath
If inserting a venous line to the femoral vein, how would you find it?
Check for femoral pulse (artery) then move medially.
4 branches given off from Femoral artern in fem triangle:
1. Profunda femoris artery
2. Medial circumflex
3. Lateral circumflex
4. Continuation of femoral artery
What area is supplied by the Profunda femoris artery?
This is the "CHIEF ARTERY" of the thigh - supplies:
-Adductor magnus
-Hamstring muscles
What 2 vessels branch from Profunda femoris? What structures does each supply?
1. Medial circumflex -> head/neck of femur
2. Lateral circumflex -> lateral thigh muscles
Where does the Medial circumflex off Profunda femoris lie?
Between PECTINEUS muscle and ILIPSOAS
Where does the Lateral circumflex off Profunda fem lie?
Deep to SARTORIUS and RECTUS FEMORIS
What runs together to make the Femoral Vein?
-Profunda femoris vein
-Saphenous veins (great/small)
What does the Femoral Vein continue to become? Where?
After passing thru Femoral triangle & posterior to the Inguinal canal becomes External Iliac vein.
What lies within the Femoral Sheath?
Femoral VESSELS - not nerve.
What pierces the femoral sheath?
Great saphenous vein
What does the ADDUCTOR CANAL contain?
-Femoral artery/vein
-Saphenous nerve
What exits the adductor canal? Where does it go?
Femoral artery and vein - to the popliteal fossa
What does not exit the adductor canal? Where does it go?
Saphenous nerve - cutaneous branch of femoral nerve, runs between sartorius/gracilus mm.
-Supplies medial leg
What are the important veins in the thigh region?
1. Great saphenous
2. Small saphenous
Where does the Great saphenous vein travel?
-Dorsal venous arch of foot
-Up medial leg/thigh
-Thru saphenous opening - inguinal region
What happens to the Great saphenous vein at the thigh?
Joins with femoral in the inguinal fossa.
Why is the great saphenous vein clinically important?
Used in coronary bypass grafts.
Where does the Small saphenous vein run?
Posterior to LATERAL malleolus - up to popliteal fossa