Posted by ESB on August 22, 2011 at 17:26:44:
In Reply to: Subinguinal Part III posted by isz on August 08, 2011 at 19:50:33:
: More Questions on Subinguinal Region:
: 2. Define the anterior cutaneous branches of the femoral nerve.
After the femoral nerve passes posterior to the inguinal ligament in the muscular lacuna it divides into anterior cutaneous branches that supply the anterior and medial cutaneous thigh. The intermediate (most lateral) branches pierce the fascia lata (and sometimes the sartorius depending on where they divide) on the the upper anterior aspect of the thigh, then run inferiorly anterior to the fascia lata, supplying the skin. The more medial branches descend on the superior and medial aspects of the sartorius and pierce the fascia lata in the lower part of the thigh, supplying cutaneous innervation to the skin on the middle and lower medial portions of the thigh and the skin superior and immediately anterior to the patella.
: 3. Define the lateral femoral cutaneous nerve.
The lateral femoral cutaneous nerve arises from L2-L3 and passes under the inguinal ligament in the iliacus muscle, then runs anterior to the sartorius and perforates the fascia lata to supply cutaneous innervation to the anterior lateral and posterior lateral aspects of the thigh.
: 4. Define the posterior femoral cutaneous nerve.
It arises from S1-S3 and travels through the greater sciatic foramen just medial to the sciatic nerve, also running deep to gluteus maximus along the course of the inferior gluteal artery. It runs superficial to the long head of biceps femoris but deep to the fascia lata, and its branches supply innervation to the cutaneous medial posterior thigh.
: 5. Discuss how these nerves go from a deep position in the body to a superficial one where they innervate areas of the skin. In other words,
what is the course of these nerves from deep to superficial.
(see above)
: 7. Discuss the origin and course of the medial femoral circumflex artery.
The medial circumflex artery usually branches off the deep femoral artery close to the branching of the deep femoral artery off the femoral artery. It runs medially, diving deep between the iliopsoas and pectineus muscles and then runs posteriorly around the femur while supplying adductor brevis and magnus. It plays a part in the cruciate anastamosis when it meets up with the lateral circumflex artery coming around the lateral neck of the femur.
: 8. Discuss the origin and course of the lateral femoral circumflex artery.
The lateral circumflex artery branches opposite the medial circumflex (see above) and runs laterally across the surface of rectus femoris deep to sartorius, then running laterally around the neck of the femur to meet up with the medial femoral circumflex artery at the cruciate anastamosis. It sends off a descending branch that becomes important in the genicular anastamosis.