Describe the content of the subinguinal hiatus (space between the inguinal ligament and the pelvic rim)
- Psoas major, iliacus, pectineus muscles, femoral nerve, artery and vein, lymphatics, femoral branch of genitofemoral nerve, lateral cutaneous nerve of thigh
Describe the borders and content of the femoral triangle
- Base formed by inguinal ligament, medial border is medial margin of adductor longus, lateral margin formed by medial margin of the Sartorius
- (lateral to medial) femoral nerve, femoral artery, femoral vein, lymphatic vessels
Describe the walls and content of the adductor canal
- Fascial canal continuous with the apex of femoral triangle which descends medially down the thigh and posteriorly through an aperture in the lower end of the adductor magnus muscle to open into the popliteal fossa behind the knee
- Contains femoral artery and vein which become the popliteal vessels behind the knee
Describe the adductor hiatus
- A large circular gap situated inferiorly between the hamstring and adductor parts of the muscle that allows the femoral artery and associated veins to pass between the adductor canal on the anteromedial aspect of the thigh and the popliteal fossa of the knee
Describe the borders and contents of the popliteal fossa
- Semitendinosus, semimembranosus, biceps femoris, gastrocnemius, plantaris
- Contains the Popliteal artery, popliteal vein, and the tibial and common fibular nerves (posterior cutaneous nerve of thigh and small saphenous vein in roof of fossa)
Describe the pathogenesis of the Baker’s cyst and the prepatellar bursitis
- Baker’s cyst: (popliteal cyst) a synovial outpouching that arises from the posteromedial aspect of the knee joint (between the medial head of gastrocnemius and the semimembranosis tendon, lying medially within the popliteal fossa.
- Prepatellar bursitis: Prepatellar bursitis, also known as housemaid's knee, is a common cause of swelling and pain on top of the kneecap. The name "housemaid's knee" comes from the association of this condition with individuals whose work necessitates kneeling for extended periods of time. Prepatellar bursitis is common in professions such as carpet layers and gardeners.
Describe the pathogenesis of the foot drop
- Foot drop is a condition that describes the inability to lift the foot off the ground.
- Injuries of the peroneal nerve as well as stroke and spinal cord injuries can result in foot drop.
Describe the unhappy triad and the Pott fracture
- Unhappy Triad: injury of the medial collateral ligament, anterior cruciate ligament, and the medial meniscus.
- Pott Fracture: a fracture of the lower fibula and of the malleolus of the tibia, resulting in outward displacement of the foot.
Describe the cutaneous innervation of the lower limb
- Anterior: medial crural cutaneous nerves (branches of saphenous nerve), superficial fibular nerve, deep fibular nerve (web between toes 1 and 2)
- Posterior: sural nerve and its branches
Describe the borders of the femoral canal and the symptoms of the femoral hernia
-the most medial compartment of the femoral sheath, contains the lymphatics and is conical in shape
- femoral hernias involve an outpouching of abdominal contents into the femoral canal, intense pain
Describe the pes anserinus
- The tendinous expansions of the sartorius, gracilis, and semitendinous muscles at the medial border of the tuberosity of the tibia.
Describe the course of the saphenus nerve and the descending genicular artery
- Saphenous nerve runs deep to the Sartorius along the medial border of the lower thigh and proximal leg
- The descending genicular artery (highest genicular artery) arises from the femoral artery just before it passes through the opening in the tendon of the Adductor magnus
It immediately divides into: Saphenous branch of descending genicular artery Articular branches of descending genicular artery
Describe the venous circulation of the lower limb
- The great and small saphenous veins drain theblood of the lower limb into the femoral vein
Describe the anatomy of the lesser and greater sciatic foramina
-Lesser: An opening between the pelvis and the posterior thigh, the foramen is formed by the sacrotuberous ligament which runs between the sacrum and the ischial tuberosity and the sacrospinous ligament which runs between the sacrum and the ischial spine
-Greater: It is bounded as follows:
· anterolaterally by the greater sciatic notch of the illium
· posteromedially by the sacrotuberous ligament
· inferiorly by the sacrospinous ligament and the ischial spine
· superiorly by the anterior sacroilliac ligament
Describe the ligaments supporting the plantar arch
- plantar arch: long plantar ligament, short plantar ligament, plantar calcaneonavicular ligament, fibularis longus tendon
Describe the arterial supply of the femoral head and the possible fracture sites
- extracapsular arterial ring found around the base of the femoral neck made up of a large branch of the medial femoral circumflex artery and branches of the lateral femoral circumflex artery. It is enhanced by the superior and inferior gluteal arteries and obturator artery.
- Fracture sites: femoral neck (may necrose), intertrochanteric fracture (preserves the femoral neck blood supply, does not become ischemic), femoral shaft