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89 Cards in this Set

  • Front
  • Back
The femoral triangle is made up of:
-inguinal ligament
-sartorius
-Adductor longus
The apex of the femoral triangle is made up of:
-medial border of sartorius
-lateral border of adductor longus
What are the contents of the femoral triangle from lateral to medial:
-Femoral nerve
-Femoral artery
-Femoral vein
-Femoral canal (contains deep inguinal nodes and lymph vessels)
The ______ is a funnel shaped fascial tube found in the upper part of the femoral triangle
-femoral sheath
The three compartments of the femoral sheath contains:
-Lateral: femoral artery
-Intermediate: femoral vein
-Medial: femoral canal (contains connective tissue, fat, and lymphatic structure)

**femoral nerve is not in femoral sheath
The _____ bisects the femoral triangle
femoral artery
Pulse in the thigh can be felt in the:
-midpoint of the inguinal ligament (between ASIS and pubic tubercle)
The femoral artery exits the apex of the femoral triangle to enter ____
adductor hiatus
The first part of the femoral artery may be compressed against _____ to control bleeding
the superior pubic ramus
The femoral artery may be cannulated for _____ and _____
It can also be used for ____ especially in children
-angiography of heart and coronary vessels
-angioplasty

-blood gas exchange
The aberrant obturator artery arises from the _____ and supplies ____
-inferior epigastric artery
-area normally supplied by obturator artery
The femoral canal has a superior ____ that is the site of _____
-femoral ring
-femoral hernia
Femoral hernia is constricted medially by the _____. This puts the _____ in danger from hernia or during hernia therapy
-lacunar ligament
-aberrant or replaced obturator artery in danger
Most common type of hernia is _____
inguinal hernia
Femoral hernias are mostly found in _____
women
_____ hernias are inferolateral and _____ hernias are superomedial to the pubic tubercle
-femoral
-inguinal
The _____ extends from the femoral triangle to the adductor hiatus. The ______ makes up the roof of this structure
-adductor canal
-sartorius
The contents of the adductor canal:
This canal provides an intermuscular passageway of these vessels to the _____
-Femoral artery
-Femoral vein
-Saphenous nerve
-Nerve to the vastus medialis

-posterior aspect of knee (popliteal fossa)
The saphenous nerve is a _____ of the femoral nerve
It supplies the _____
It (does/does not) exit the adductor hiatus
-cutaneous branch (sensory)
-medal knee, leg and foot
-does NOT
_____ is irritation of the right iliopsoas by an inflammatory process in the right lower quadrant of the abdomen

How do you test for this?
-iliopsoas sign

-patient is asked to extend the right thigh against resistance with the knee flexed; the test is positive if the patient experiences pain as a result of stretching of the iliacus fascia
Tuberculous infection of the lumbar vertebrae or another retroperitoneal infection may track along the psoas ______ producing a bulge in the upper thigh and referred pain to the ______
-fascia deep to the inguinal ligament
-hip and/or knee joints
The iliopsoas is the chief ____
It is made up of _____
-flexor
-iliacus
-psoas major
-psoas minor
The action of the pectineus:
-flexes hip
-adducts hip
Sartorius is a _____ not a prime mover
Its actions are:
-synergist

-flexes hip
-extends knee
This iliacus of the iliopsoas my avulse:
lesser trochanter
Rectus femoris may avulse at ____
Its action is:
-AIIS (anterior inferior iliac spine)

-flex hip
-extend knee
*knee extension compromised during flexed hip
The quadriceps femoris is made up of:
All of their tendons unite distally to form:
The nerves that innervate them are:
-Vastus lateralis
-Vastus intermedius
-Vastus medialis
-Rectus femoris

-quadriceps tendon

-femoral nerve (L2-L4)
The petellar ligament is a direct continuation of _____ and inserts into the _____
-quadriceps tendon
-tibial tuberosity
The petellar reflex tests the integrity of _____
L3-L4
The petellar reflex is an example of a ____
-monosynaptic reflex arc (one sensory and one motor)
What are the three main adductors in the medial compartment of the leg?
-adductor longus
-adductor brevis
-adductor magnus
What is the action of the gracilis?
What can it be used for?
-flex knee
-weak adductor

-replace external anal sphincter
What is the action of the obturator externus?
-lateral rotator
Groin pull is a strain, stretch, or tearing of what portion of the thigh muscles?
-proximal attachments of the anteromedial thigh muscles
The adductor longus, brevis, longus, pectineus, and obturator externus are all innervated by what nerve?
-obturator nerve (L2, 3, 4)
Pes Anserinus, also known as ____, is the insertion of conjoined tendon of 3 muscles to the _____
These three muscles are (from anterior to posterior):
-goose foot
-Medial aspect of tibia

-Sartorius (Ant.)
-Gracilis (Medial)
-Semitendinosus (Post.)
*all knee flexors
If a patient complains of medial-sided knee pain, this could be:
pes anserinus bursitis
Give the path of the common iliac artery
-common iliac --> external/internal

-external iliac artery --> femoral artery (at inguinal ligament)

-internal iliac artery --> superior and inferior gluteal arteries and obturator artery
What artery supplies the reproductive organs and the lower limbs?
-internal iliac artery
What are the 5 branches of the femoral artery?
-profunda femoris (deep femoral) artery
-lateral femoral circumflex artery
-medial femoral circumflex artery
-perforating branches
-descending genicular artery
What artery is the main blood supply to the head of the femur?
medial femoral circumflex
What artery supplies the posterior thigh compartment?
perforating branches of the femoral artery
After exiting the adductor canal, the femoral artery changes its name to:
-popliteal artery
The obturator artery is the _____ branch of the internal iliac artery, and enters the ____ compartment of the leg by exiting through the ______
-anterior
-adductor compartment
-obturator foramen
The obturator artery divides into the anterior and posterior branches, which is separated by the ____
-adductor brevis
20% of the time, the obturator artery may be replaced by ____ or joined by _____, both of which are usually branches of _____
-aberrant or replaced obturator artery
-accessory obturator artery
-inferior epigastric artery
The lumbar plexus is formed by ____ within the _____
-anterior rami of spinal nerves L1-4 (upper half of 4)

-psoas major
The lower half of the anterior rami of L4 and L5 join together to form _____
-lumbosacral trunk near ala of sacrum
Give the 6 branches of the lumbar plexus and what nerves make them up
1. Iliohypogastric n.- L1
2. Ilioinguinal n.- L1
3. Genitofemoral n.- L1, L2
4. Lat. femoral cut. n.- L2, L3
5. Femoral n.- L2, L3, L4
6. Obturator n.- L2, L3, L4
The motor branches of the femoral nerve are:
-quadriceps femoris
-sartorius
-pectineus
-iliacus
The anterior cutaneous branch that supplies the anterior thigh is a branch of ____
-femoral nerve
The saphenous nerve is a (motor/sensory) nerve and it supplies:
-sensory
-medial knee, leg, foot
Femoral injury in the abdomen can cause paralysis to: (muscles/actions)
-iliopsoas - weakness of flexing thigh
-quadriceps femoris - knee extension/knee jerk reflex
Stab wound in the upper thigh, in the femoral triangle, will cause a loss of: (muscle/action)
This will also cause loss of sensation on what part of the leg?
-quadriceps femoris - knee extension/knee jerk reflex
**Will affect iliopsoas**
-anterior thigh (femoral nerve) and medial leg, ankle, foot (saphenous nerve)
The posterior branch of the obturator nerve supplies:
-obturator externus
-adductor brevis
-adductor magnus
The anterior branch of the obturator nerve supplies:
-adductor longus
-gracilis
-adductor brevis
-pectines (sometimes)
The obturator nerve also carries sensory information from the:
-medial thigh
The obturator nerve arises from the anterior divisions of what spinal nerves?
-L2, 3, 4
What may cause a paresis (weakness) or paralysis of the adductor muscles of the thigh? Ex. Soccer kicks or crossing leg becomes difficult.
-pelvic tumor or pregnant uterus affecting the obturator nerve
Meralgia paresthetica may be caused by entrapment of:
lateral femoral cutaneous nerve
What structures pass through the obturator canal?
-obturator nerve
-obturator vessels
What structures pass between the inguinal ligament and the pelvic bone?
Muscles:
-psoas major
-iliacus
-pectinius

Vessels:
-femoral artery
-femoral vein
-lymphatics

Nerves:
-femoral branch of genitofemoral nerve
-lateral cutaneous nerve of thigh
What are the boarders of the popliteal fossa?
-Biceps femoris
-Semimembranosus
-Semitendinosus
-Lateral/medial heads of gastrocnemius
Name the main structures that can be found in the popliteal fossa:
-poplitleal artery
-poplitleal vein
-tibial and common fibular branch of the sciatic nerve
The popliteal artery is a continuation of the _____ and divides into:
-femoral artery (at adductor hiatus)
-anterior and posterior tibial arteries
The superior part of the popliteal artery lies against _____ which can cause vascular complications if fractured.
posterior surface of femur
The ____ gives of 5 genicular (knee) branches that help provide collateral circulation around the joint (genicular anastomoses)

These branches are:
-popliteal artery

-Lateral superior genicular a.
-Superior medial genicular a.
-Lateral inferior genicular a.
-Inferior medial genicular a.
-Middle genicular a.
What are the superior anastomoses of the femoral/popliteal artery?
What are the inferior?
-Descending branch of lateral femoral circumflex artery
-Descending genicular artery from femoral artery
Two articulations of the knee joint are between:
-patella and femur
-femur and tibia

**fibula does not participate
The superior portion of the tibia, where the femur articulates is called the:
tibial plateau
The synovial cavity is partly subdivided into superior and inferior compartments by:
-medial and lateral menisci
What structures stabilize the knee joint in the:
anterior:
lateral:
medial:
posterior:
Anterior:
-quadriceps femoris tendon
-patella ligament

Lateral:
-lateral patellar retinacula
-fibular collateral ligament

Medial:
-medial patellar retinacula
-tibial collateral ligament

Posterior:
-oblique popliteal ligament
-arcuate popliteal ligament
What structure, that extends from the medial epicondyle of the femur to the medial condyle of the tibia, is often torn with the medial meniscus?
Tibial (medial) collateral ligament (MCL)
What separates the fibular (lateral) collateral ligament from the lateral meniscus?
popliteal tendon
What structure passes from the lateral epicondyle of the femur to the head of the fibula?
What splits around this ligament?
-fibular (lateral) collateral ligament

-tendon of biceps femoris
What are the two intracapsular ligaments of the knee joint?
Where do these attach?
-Anterior cruciate ligament (ACL) - anterior intercondylar area of tibia to lateral femoral condyle

-Posterior cruciate ligament (PCL) - posterior intercondylar area of tibia to medial femoral condyle
Rupture of the ACL (3rd degree sprain) shows what sign?
-anterior drawer sign - tibia can be pulled anteriorly on a fixed femur

*ACL prevent posterior displacement of femur and hyperextension of knee
Rupture of the PCL (3rd degree sparin) shows what sign?
-posterior drawer sign - tibia can be pushed posteriorly on a fixed femur

*PCL prevents anterior displacement of femur on tibia
The (anterior drawer test/Lachman test) is more sensitive for ACL damage
Lachman
Describe how to do anterior drawer test
Posterior drawer test?
Hip flexed 45 degree
Knee flexed 90 degrees
Both hand behind knee
Sitting on dorsum of foot
Both hands grasp proximal tibia and slide it forward

Posterior is the same, except tibia is directed posteriorly

**hamstring can cause false negative for test - wait for it to relax**
Describe how to do the Lachman test
-patient supine and hip flexed 20-30 degrees
-on hand just above patella
-other hand tries to dislodge the patella forward
A blown knee may damage what 3 parts of the knee as an "unhappy triad"
-tibial (medial) collateral ligament (MCL)
-medial meniscus
-anterior cruciate ligament (ACL)
An anterior dislocation will rupture what structures?
-both cruciate ligaments (ACL/PCL)
A complete dislocation will rupture what structures?
-medial collateral ligament
-medial meniscus
-both cruciate ligaments (ACL/PCL)
-posterior capsule
Name the four bursae associated with the quadriceps femoris tendon
-suprapatellar bursa - may mask joint effusion (water in knee) or spread infection of knee

-prepatellar bursa, superficial and deep infrapatellar bursae - all may be irritated by friction
Housemaids knee is also called:
prepatellar bursitis
If a posterior bursae that communicates with the knee swells with joint effusion, it may form ______, which can interfere with joint movement. If the cyst ruptures, acute pain and swelling may resemble _____
-Baker's (popliteal) cyst
-deep vein thrombosis
If the medial tibiofemoral angle is too large, it is called:
If medial tibiofemoral angle is too small, it is called:
-genu valgum - "knock knees" (lateral compression)
-genu varum - "bow legs" (medial compression)
What are some predisposing factors that increase the chance of patellar dislocations?
-shallow patellar groove
-abnormal patella
-laterally displaced quadriceps femoris insertion