Antat Anterior & Medial Thigh (1 cont.)

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  1. Femoral Canal
    • the medial & smallest compartment of the femoral sheath; contains efferent lymphatic vessels & a lymph node
    • is a potential route for abdominal contents (eg. intestines) in the case of hernia
  2. Femoral Artery
    • continuation of the external iliac artery which comes from the common iliac artery which is one of the branches of the aorta
    • when the external iliac artery passes UNDER the inguinal ligament it becomes the femoral artery (which then goes on to branch into the superficial & deep femoral arteries)
    • Image Upload 1
  3. Superficial Femoral Artery
    travels down the back of the thigh → passes through the popliteal fossa in the back of the knee → provides blood to the knee joint → goes on to the leg & foot
  4. Deep Femoral Artery
    • runs more laterally & branches into Circumflex femoral arteries, which supply blood to the HIP joint, particularly the neck & head of the femur*
    • circumflex means to go around/surround something (& potentially connect up) to provide collateral circulation around a particular area
  5. The circumflex arteries produce an __________ between the medial femoral circumflex (which goes posteriorly around the head & neck of the femur) & the lateral femoral circumflex (which goes around anteriorly around the top of the femur)
    • anastomosis
    • medial femoral circumflex: provides arteries to the HEAD of the femur
    • lateral femoral circumflex: provides arteries to the neck & greater trochanter of the femur (?)
    • Image Upload 2
  6. A fracture of the neck of the femur may rupture which arteries?
    • the medial femoral circumflex arteries
    • this will deprive the head of the femur of its blood supply → avascular necrosis (death of the bone)
    • Image Upload 3
    • left arrow: lateral circumflex
    • right arrow: medial circumflex
  7. How do the superficial femoral artery & vein travel in relation to each other?
    • they travel together down the adductor canal (ALONG WITH the saphenous nerve)
    • the artery starts lateral to the vein but then twists around so the artery becomes anterior to the vein
    • will travel through an opening in the adductor magnus muscle to travel behind the knee where they turn into the popliteal vessels
    • Image Upload 4
  8. Arteriogram
    using dye can visualize arteries & tell if there's an occlusion anywhere
  9. Femoral Nerve
    provides motor branches to the quadriceps muscle(s) & to the sartorius
  10. Saphenous Nerve
    • branches from the femoral nerve & runs down the adductor canal between the vastus medialis & the adductor muscles in the medial part of the thigh all the way down to the medial part of the ankle
    • a sensory nerve only (contains no motor branches) - will provide sensation down its path
  11. Medial Compartment
    • contains the adductor muscles - bring the thigh closer to the midline
    • supplied by the obturator nerve
    • originate on the pubis, superior ramus, the body, & the inferior ramus → run laterally → insert on the linea aspera (back of the femur)
    • arranged in 2 planes: an anterior more superficial one & a deeper plane
    • Image Upload 5
  12. Gracilis ("Graceful")
    crosses the knee joint from the medial side & inserts near where the sartorius inserts on the upper, medial, anterior part of the tibia
  13. Adductor Brevis
    lies posterior to the superficial adductor muscles
  14. Adductor Magnus
    • lies posterior to the superficial adductor muscles
    • have both horizontally & vertically oriented muscle fibers
    • also has perforations close to its attachments on the linea aspera for branches of the deep femoral artery to perforate the posterior muscles of the thigh
    • Image Upload 6
  15. What is the one part of the adductor muscle is not supplied by the obturator nerve? What nerve is it innervated by?
    the hamstring part of the adductor magnus is supplied by the tibial division of the sciatic nerve (instead of the obturator nerve)
  16. Adductor Hiatus ("Opening")
    • an opening where the hamstring part of the adductor magnus becomes a tendon
    • the superficial femoral artery & femoral vein will travel down the lower part of the thigh & pass through this opening, allowing them to go from the medial compartment of the thigh → the posterior compartment of the knee
    • *this is where the femoral artery & vein become the popliteal artery & vein
    • Image Upload 7
  17. Lumbar Plexus of Nerves
    give rise to the femoral & obturator nerves
  18. Spinal Nerves
    • there are 31 pairs of spinal nerves
    • 8 in the cervical region, 12 in the thoracic region, & 5 in both the lumbar & sacral region
    • grey matter contains the cell bodies of neurons; white matter contains the neuron axons
    • Image Upload 8
  19. Dorsal v. Ventral Roots
    • ventral roots contain motor nerves that stimulate the contraction of muscle (effect nerve fibers CNS → periphery)
    • dorsal roots contain sensory neurons (afferent nerve fibers → periphery)
    • come together to form the typical spinal nerve which then goes on to divide into the typical ventral & dorsal primary ramus
  20. Ventral Primary Rami
    • cover more of the body than the dorsal primary rami in terms of sensation & motor innervation
    • mixed ventral primary rami are what form plexuses, connections between multiple spinal chord levels
    • (Dorsal primary rami only innervate muscles in the back)
  21. Plexus
    • orderly intermingling of the ventral primary rami of spinal nerves
    • eg. the femoral nerve has contributions from L2, L3, & L4
    • the obturator nerve also originates from the 2nd, 3rd, & 4th lumbar part of the spinal chord (from those ventral primary rami)
  22. Femoral Nerve Area of Sensation (blue)
    • Image Upload 9thigh: anterior cutaneous branches of the femoral nerve
    • medial side of leg/ankle: provided by saphenous nerve (branch of the femoral nerve)
    • femoral nerve also supplies motor innervation to the quadriceps muscle
  23. Patellar Tendon (Quadriceps) Reflex
    • stimulating sensory fibers carried by the saphenous branch of the femoral nerve back toward the CNS
    • sets up a reflex arc
  24. Obturator Nerve Area of Sensation (blue)
    • mostly innervates the adductor muscles but has an area of sensation on the upper medial part of the thigh
    • Image Upload 10
  25. Dermatomes ("slice of skin")
    • an area of skin that is mainly supplied by a single spinal nerve
    • can divide body into 'slices' such that sensation within dermatones will go back to a particular spinal chord level
    • different from sensation provided by peripheral nerve
    • eg. if you damage the ventral primary ramus of L3, might lose sensation along the L3 dermatomes (wouldn't lose it entirely b/c there's some dermatome overlap)
    • eg. if you cut the femoral nerve itself, you would lose sensation in a wider part of the skin (all areas where L2, L3, L4 innervate/are)
    • Image Upload 11
Card Set
Antat Anterior & Medial Thigh (1 cont.)
Exam 1 - Part 2
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