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106 Cards in this Set
- Front
- Back
Featured Bone in Thigh:
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Femur
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Main regions of Femur:
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-Proximal
-Shaft -Distal |
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Proximal Femur Features:
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-Head
-Neck -Greater/lesser trochs |
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Head of Femur articulates w/:
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Acetabulum
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Type of joint at hip:
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Ball/socket
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What muscle inserts at the intertrochanteric crest?
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Quadratus femoris
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What mucle inserts at the Greater trochanter?
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-piriformis
-obterator internus -gemelli -gluteus minimus/medius |
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Where do stress fractures most frequently occur in the femur?
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At the neck - if they occur - they don't often.
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What is the important feature of the shaft?
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Linea aspera - midline posterior ridge that is origin for thigh muscles
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What does linea aspera give rise to?
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Diverges to form medial/lateral
supracondylar ridges. |
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Which condyle at the distal femur is larger? Effect:
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Medial - to extend thigh/knee, foot externally rotates.
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What is between the medial / lateral condyles at posterior femur?
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Intercondylar notch
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Where do the MCL/LCL attach?
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At epicondyles
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What invests the muscles of the thigh?
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Fascia lata
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Attachments of Fascia lata:
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Superior: Inguinal ligament, iliac crest, sacrococcyx, sacrotuberous ligament, ischial tuberosity, pubis.
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What is the IT band?
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Extremely strong part of Fascia lata - from iliac crest to lateral condyle of tibia.
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Function of IT band:
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-insertion of many muscles
-posture -keeps thigh muscles aligned as Glut max flexes |
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What results from overuse of the IT Band? In who?
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IT Band Friction Syndrome - inflammation of tissue/bursa beneath IT Band - in runners.
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What/where is the Saphenous Opening?
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Opening in Fascia Lata - just beneath inguinal ligament (external inguinal canal)
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Why is the Saphenous opening important?
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It allows the Great Saphenous vein to go into the pelvis and join the femoral vein.
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What are the 3 intermuscular compartments in the thigh?
-Origin -Insertion |
Anterior, Posterior, Lateral
Origin: fascia lata Insert: linea aspera |
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3 Muscles in the Anterior Hip:
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-Ilipsoas
-Obturator externus -Tensor Fascia lata |
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What is the function of Ilipsoas?
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-Flexes thigh at the hip joint
-Flexes pelvis on the trunk |
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Origins of Iliacus + Psoas maj:
Common insertion of Iliopsoas: |
Psoas maj: T12-L5 vertebrae
Iliacus: Iliac fossa Common insertion: lesser trochanter |
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What innervaes
-Psoas major -Iliacus |
Psoas: ventral rami L1-L3
Iliacus: Femoral nerve |
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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 |
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Actions of Obturator Externus:
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-Deep, powerful external (lateral) rotation of thigh
-Weak adductor |
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Obturator externus
-origin -insertion -action |
Origin: obturator canal/ligament
Insert: trochanteric fossa Nerve: obturator nerve |
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Anterior Thigh Muscles
-Main function of all -Nerve to all |
Function: knee extension
Nerve: femoral nerve |
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Muscles of Anterior Thigh:
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-Sartorius
-Quadriceps femoris |
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Why is Sartorius called "tailor's muscle"?
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B/c tailors often cross their legs and develop prominent Sartorius muscles.
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Actions of Sartorius:
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-Flexes thigh when leg straight
-Abducts/lateral rotates thigh when crossed. |
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Pes anserinus:
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Common insertion of 3 muscles:
-Sartorius -Gracilis -Semitendinosis |
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4 Components of Quadriceps Femoris:
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-Rectus femoris
-Vastus lateralis -Vastus medialis -Vastus intermedius |
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Insertion of Quads:
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Common insertion at Tibial Tuberosity - contains Patella
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Patella - Type of bone
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Sesamoid, within the common insertion of quads.
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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 |
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Which muscle of quads is most superficial?
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Rectus femoris
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Functions of Rectus Femoris
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CROSS BOTH HIP/KNEE JOINTS, so:
-Flex hip -Extend knee |
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Vastus lateralis
-origin -insertion -Action |
origin = greater troch
insert = lat patellar retinaculm action: extends knee, controls mechanics of knee joint |
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Vastus medialis
-origin -insertion -action |
origin = intertrochanteric line and linea aspera
insert = medial patellar retinaculum action = extends knee and pulls patella medially |
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Vastus intermedius
-origin -insertion -action |
Origin = lateral surfaces of femur
Insertion = vastus lateralis and medialis (fuses) Actions = knee joint extension, stepping up |
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What athletes tend to get Patellar tendinitis?
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Jumping - vball, bball
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What is Patellar femoral pain syndrome (PFPS)?
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Anterior knee pain seen in active or overweight patients
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What causes PFPS?
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Problems in Patellar tracking with the femur - VMO Vasus Medialis Obliquis
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What is the result of VMO?
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Vasus medialis obliquis = lateral retinaculum is tighter than medial, so kneecap is doslocated in a lateral dirctn.
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What is the main action of all the muscles of the medial thigh?
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Adduction
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What innervates all the adductor muscles and what is the 1 exception?
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Obturator nerve
-EXCEPT PECTINEUS |
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What is PECTINEUS innervated by?
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Femoral nerve
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What are the adductor muscles? (5)
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1. Gracilus
2. Pectineus 3. Adductor longus 4. Adductor brevis 5. Adductor magnus |
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What is the weakest adductor?
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Gracilus
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Gracilus
-action -nerve |
Actions: adducts/flexes thigh + very weak internal rotator when knee is flexed
Nerve: obturator |
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What is the origin/insertion of gracilus?
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Origin: pubic ramus/body
Insert: pes anserinus |
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Pectineus
-action -nerve |
Actions: adduct/flex thigh
Nerve: femoral |
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What is the origin/insertion of Pectineus?
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Origin: pectineal line of pubis
Insert: pectineal line of femur |
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Adductor Longus
-action -nerve |
Action: Adducts/flexes thigh, rotates medially
nerve: obturator |
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A Pulled Adductor longus might be confused with:
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inguinal hernia
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Adductor brevis
-action -nerve |
Action = adduction
Nerve = obturator |
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Adductor Magnus - 2 parts:
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-Adductor part
-Hamstring |
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Adductor Magnus - Adductor part:
-action -nerve |
Action: adducts/flexes thigh
Nerve: obturator |
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Adductor Magnus - Hamstrin part:
-action -nerve |
Action: EXTENSOR and medial rotator
Nerve: Tibial portion of Sciatic nerve |
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So the 2 exceptions to the innervation of medial thigh mm.:
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1. Pectineus - femoral nerve
2. Hamstring/Adductor Magnus - tibial portion of sciatic nerve. |
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What is the adductor hiatus?
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The junction of the Adductor canal and Popliteal fossa where the femoral vessels pass thru and become popliteal vessels.
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What is the Adductor canal?
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A canal underneath sartorius - the femoral vessels run w/in it.
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Main difference between adductors and hamstrings:
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Adductors - flex thigh
Hamstrings - extend thigh |
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What muscles are in the posterior compartment?
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1. Biceps femoris
2. Semimembranosus (Medial) 3. Semitendinosus (beTween) |
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So what are the major actions of the hamstrings?
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1. Extend thigh
2. Flex knee |
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What innervates the hamstrings?
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Sciatic nerve
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What is the common origin of the hamstrings / 1 exception?
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Ischial tuberosity
EXCEPT shorthead biceps fem. |
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What does semitendinosis do in addition to thigh extension and knee flexion?
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Medially rotates
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What is the insertion point of Semitendinosis?
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Pes anserinus with Gracilus and Sartorius - medial retinaculum.
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Semimembranosus
-action -insertion -nerve |
Action: same, plus medial rotation.
Insertion: posterior medial condyle of femur. Nerve: tibial portion, sciatic |
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Biceps femoris insertion:
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-Common for Long/Shortheads.
-Lateral collateral ligament - it splits the tendon insertion. |
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What results from the way the biceps femoris insertion is designed?
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Most common site for tears.
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Biceps femoris long head
-action -nerve |
Action: extend thigh, flex knee, AND LATERAL ROTATION
Nerve: tibial portion, sciatic |
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Main difference between Biceps femoris Longhead vs. Shorthead:
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Long = 2-joint muscle; extends thigh, flexes knee.
Short = 1-joint; only flexes knee |
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Biceps femoris NERVES
-longhead -shorthead |
Longhead: tibial portion, sciatic nerve
Shorthead: fibular portion, sciatic nerve |
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Biceps femoris ORIGINS
-longhead -shorthead |
Long = ischial tuberosity
Short = linea aspera and supracondylar ridge |
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What is the Biceps Femoris longhead an important landmark for?
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Sciatic nerve - runs btwn BF longhead and Adductor magnus (hamstring portion).
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Popliteal Fossa Borders:
-Superolateral -Superomedial -Inferomedial -Inferolateral |
Superolat: Biceps femoris
Superomed: Semimemb/tendinosis Inferomed: med head gastrocnem. Inferolat: lat head gastrocnem. |
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Contents of the Popliteal fossa:
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-Popliteal vein/artery
-Tibial/Common Femoral nerves (branches of sciatic nerve) -Small saphenous vein -Popliteal lymph nodes, fat, bursa sac |
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Which component of Popliteal fossa is subject to injury? Why?
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Common peroneal nerve (fibular) - it runs very superficially.
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Bakers cyst - what is it?
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Ruptured popliteal bursa - causes swelling and inflammation behind the knee.
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Where would trauma occur to injur the common peroneal nerve?
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Medial aspect of knee
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In general, what is the femoral triangle?
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A depression inferior to the inguinal ligament when the hip is flexed - check femoral pulse
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Boundaries of the Femoral Triangle:
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-Sartorius
-Inguinal ligament -Adductor longus (floor = iliopsoas/pectineus) |
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What is the roof of the femoral triangle?
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Fascia lata
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Contents of the Femoral Triangle:
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-Femoral nerve/artery/vein - in that order going lat->med
-Inguinal lymph nodes -Femoral sheath |
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If inserting a venous line to the femoral vein, how would you find it?
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Check for femoral pulse (artery) then move medially.
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4 branches given off from Femoral artern in fem triangle:
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1. Profunda femoris artery
2. Medial circumflex 3. Lateral circumflex 4. Continuation of femoral artery |
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What area is supplied by the Profunda femoris artery?
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This is the "CHIEF ARTERY" of the thigh - supplies:
-Adductor magnus -Hamstring muscles |
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What 2 vessels branch from Profunda femoris? What structures does each supply?
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1. Medial circumflex -> head/neck of femur
2. Lateral circumflex -> lateral thigh muscles |
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Where does the Medial circumflex off Profunda femoris lie?
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Between PECTINEUS muscle and ILIPSOAS
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Where does the Lateral circumflex off Profunda fem lie?
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Deep to SARTORIUS and RECTUS FEMORIS
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What runs together to make the Femoral Vein?
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-Profunda femoris vein
-Saphenous veins (great/small) |
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What does the Femoral Vein continue to become? Where?
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After passing thru Femoral triangle & posterior to the Inguinal canal becomes External Iliac vein.
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What lies within the Femoral Sheath?
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Femoral VESSELS - not nerve.
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What pierces the femoral sheath?
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Great saphenous vein
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What does the ADDUCTOR CANAL contain?
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-Femoral artery/vein
-Saphenous nerve |
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What exits the adductor canal? Where does it go?
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Femoral artery and vein - to the popliteal fossa
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What does not exit the adductor canal? Where does it go?
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Saphenous nerve - cutaneous branch of femoral nerve, runs between sartorius/gracilus mm.
-Supplies medial leg |
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What are the important veins in the thigh region?
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1. Great saphenous
2. Small saphenous |
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Where does the Great saphenous vein travel?
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-Dorsal venous arch of foot
-Up medial leg/thigh -Thru saphenous opening - inguinal region |
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What happens to the Great saphenous vein at the thigh?
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Joins with femoral in the inguinal fossa.
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Why is the great saphenous vein clinically important?
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Used in coronary bypass grafts.
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Where does the Small saphenous vein run?
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Posterior to LATERAL malleolus - up to popliteal fossa
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