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Questions and Answers
What structure is primarily affected by a femoral hernia?
What structure is primarily affected by a femoral hernia?
Which nerve is responsible for innervating the quadriceps muscle?
Which nerve is responsible for innervating the quadriceps muscle?
What anatomical landmark is found in the anterior and medial compartment of the thigh?
What anatomical landmark is found in the anterior and medial compartment of the thigh?
Which blood vessel primarily supplies the anterior thigh?
Which blood vessel primarily supplies the anterior thigh?
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What muscle group is primarily responsible for knee extension?
What muscle group is primarily responsible for knee extension?
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Which nerve primarily innervates the hip adductor muscles?
Which nerve primarily innervates the hip adductor muscles?
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What is the primary function of the quadriceps femoris muscle group?
What is the primary function of the quadriceps femoris muscle group?
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Which muscle serves as an attachment for the common tendinous insertion called the pes anserinus?
Which muscle serves as an attachment for the common tendinous insertion called the pes anserinus?
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What condition may lead to severe pain in the hip, thigh, or knee joint due to the accumulation of pus?
What condition may lead to severe pain in the hip, thigh, or knee joint due to the accumulation of pus?
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Which of the following statements about the adductor magnus is correct?
Which of the following statements about the adductor magnus is correct?
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What anatomical structure transmits the femoral artery and vein from the thigh to the popliteal fossa?
What anatomical structure transmits the femoral artery and vein from the thigh to the popliteal fossa?
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Which of the following muscles is NOT part of the posterior compartment of the thigh?
Which of the following muscles is NOT part of the posterior compartment of the thigh?
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What structure forms the medial boundary of the femoral triangle?
What structure forms the medial boundary of the femoral triangle?
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Which structure is contained within the femoral sheath?
Which structure is contained within the femoral sheath?
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Where does a femoral hernia typically protrude?
Where does a femoral hernia typically protrude?
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Which structure is considered the superior boundary of the femoral triangle?
Which structure is considered the superior boundary of the femoral triangle?
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Which artery is most likely to be closely related to a femoral hernia during surgical procedures?
Which artery is most likely to be closely related to a femoral hernia during surgical procedures?
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What is the primary function of the obturator artery?
What is the primary function of the obturator artery?
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What forms the lateral and anterior boundaries of the Adductor Canal?
What forms the lateral and anterior boundaries of the Adductor Canal?
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What term is used to refer to an obturator artery that arises from the external iliac artery?
What term is used to refer to an obturator artery that arises from the external iliac artery?
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Where does the obturator artery run to reach the obturator foramen?
Where does the obturator artery run to reach the obturator foramen?
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What anatomical structure is the obturator artery closely related to in some cases?
What anatomical structure is the obturator artery closely related to in some cases?
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What is the primary function of the femoral nerve?
What is the primary function of the femoral nerve?
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Which artery provides the most blood supply to the head and neck of the femur?
Which artery provides the most blood supply to the head and neck of the femur?
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Which nerve is responsible for the sensation in the anteromedial aspects of the knee, leg, and foot?
Which nerve is responsible for the sensation in the anteromedial aspects of the knee, leg, and foot?
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What occurs to the femoral artery after passing through the adductor hiatus?
What occurs to the femoral artery after passing through the adductor hiatus?
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What is the consequence of a femoral neck fracture regarding blood supply to the femoral head?
What is the consequence of a femoral neck fracture regarding blood supply to the femoral head?
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The obturator nerve divides into which two main branches?
The obturator nerve divides into which two main branches?
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Which artery is involved in the cruciate anastomosis posterior to the femur?
Which artery is involved in the cruciate anastomosis posterior to the femur?
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Which muscle is NOT innervated by the femoral nerve?
Which muscle is NOT innervated by the femoral nerve?
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Study Notes
Lower Limb Development
- Lower limbs develop similarly to upper limbs but undergo a 90-degree medial rotation, bringing the big toe to the medial side of the foot
- The thigh muscles are organized into three compartments: anterior, medial, and posterior
Anterior Thigh Muscles
- Sartorius – flexes, abducts, and laterally rotates thigh at hip joint, flexes leg at knee joint, proximal attachment on ASIS (Anterior Superior Iliac Spine)
- Quadriceps Femoris – main extensor of the leg, consists of rectus femoris, vastus lateralis, intermedius, and medialis muscles, tendons unite to form the quadriceps tendon that inserts onto the patella, Patellar ligament continues from the patella to the tibial tuberosity
- Pectineus – innervated by both femoral and obturator nerves
Psoas Major Muscle Abscess
- A retroperitoneal pus-forming infection in the abdomen or greater pelvis
- May result in the formation of a psoas abscess
- Severe pain may be referred to the hip, thigh, or knee joint
Medial Thigh Muscles
- Comprised of adductor longus, adductor brevis, adductor magnus, gracilis, and obturator externus
- Gracilis – inserts into the superior part of the medial surface of the tibia with the sartorius and semitendinosus, forming the pes anserinus (goose’s foot)
- Adductor Magnus – has an adductor part (innervated by obturator nerve) and a hamstring part (innervated by tibial nerve)
- Adductor Hiatus – gap between the adductor and hamstrings' attachments of the adductor magnus, transmits the femoral artery and vein from the adductor canal in the thigh to the popliteal fossa posterior to the knee
Femoral Triangle and Femoral Sheath
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Boundaries of the femoral triangle:
- Medial: Lateral border of the adductor longus muscle
- Lateral: Sartorius muscle
- Superior (Base): Inguinal ligament
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Contents of the femoral triangle, from lateral to medial:
- Femoral nerve and its terminal branches
- Femoral artery and vein
- Femoral canal (which contains deep inguinal lymph nodes)
- Femoral Sheath – a funnel-shaped fascial tube formed by an inferior prolongation of transversalis and iliopsoas fascia from the abdomen, surrounds proximal parts of the femoral artery, vein, and canal
Femoral Canal
- Medial compartment of the femoral sheath, contains lymph vessels and nodes
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Femoral Ring – upper end that opens into the abdomen
- Anterior: Inguinal ligament
- Posterior: Superior ramus of the pubis covered by the pectineal ligament
- Medial: Lacunar ligament
- Lateral: Femoral septum between the femoral canal and the femoral vein
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Femoral Hernia – protrusion of abdominal viscera through the femoral ring into the femoral canal, more common in females
- Emerges below and lateral to the pubic tubercle
- Passes posterior (deep) to the inguinal ligament
- May be closely related to the neck of a femoral hernia when the aberrant/accessory obturator artery is present, care must be taken during endoscopic repair of femoral hernias to protect this arterial variant
Adductor Canal
- Intermuscular passageway deep to the sartorius, traversed by the major neurovascular bundle of the thigh
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Boundaries:
- Laterally (and anteriorly) by the vastus medialis
- Posteriorly by the adductors longus and magnus
- Medially by the sartorius
- Contains the femoral artery, femoral vein, saphenous nerve, and nerve to vastus medialis
Nerves in the Anteromedial Thigh
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Femoral Nerve – posterior division of the ventral rami of L2-L4, innervates anterior thigh muscles (Sartorius, Pectineus, Quadriceps femoris, Iliacus)
- Saphenous Nerve – terminal branch of femoral nerve, innervates the skin on the anteromedial aspects of the knee, leg, and foot
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Obturator Nerve – anterior division of the ventral rami of L2-L4, passes through the obturator canal, divides into anterior and posterior branches
- Anterior Branch – passes anterior to adductor brevis, innervates adductor longus, adductor brevis, and gracilis muscles
- Posterior Branch – passes posterior to adductor brevis, supplies obturator externus and adductor magnus (adductor part)
Femoral Vessels
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Femoral Artery – continuation of the external iliac artery distal to the inguinal ligament, supplies most of the blood to the lower limb
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Deep Artery of the Thigh (Profunda femoris artery) – a branch of the femoral artery
- Branches include: medial and lateral circumflex femoral arteries, and four perforating arteries
- Becomes popliteal artery after passing through the adductor hiatus
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Deep Artery of the Thigh (Profunda femoris artery) – a branch of the femoral artery
- Femoral Vein – continuation of the popliteal vein proximal to the adductor hiatus
Cruciate Anastomosis
- Anastomosis posterior to the femur involving the medial and lateral circumflex femoral arteries, inferior gluteal artery, and the first perforating artery
- Provides the connection between the internal iliac and femoral arteries
- The medial circumflex femoral artery supplies most of the blood supply to the head and neck of the femur through its posterior retinacular arteries
Femoral Neck Fractures and Avascular Necrosis of the Head of the Femur
- Fractures of the femoral neck often disrupt the blood supply to the head of the femur
- The retinacular arteries are often torn when the femoral neck is fractured, leaving the artery to the ligament of the femoral head artery inadequate for maintaining the femoral head
- The femoral head may then undergo avascular necrosis
Obturator Artery
- Branch of the anterior division of the internal iliac artery
- Helps the profunda femoris artery supply the adductor muscles
- In ~20% of people, the obturator artery may arise from the external iliac artery (aberrant/accessory obturator artery)
- This artery runs close to or across the femoral ring to reach the obturator foramen
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Description
Test your knowledge on the development of the lower limbs, focusing on the anatomy and function of anterior thigh muscles. Explore conditions like the psoas major muscle abscess and its implications. This quiz will help reinforce your understanding of lower limb musculoskeletal anatomy.
