Question

Case 2

Steve is a member of the West Coast Eagles football team. During practice, he suffered a high impact collided with a team-mate and injured the anterior compartment of his thigh. As a result of the collision, his quadriceps femoris muscle were compressed against the femur, resulting in quadriceps contusion or ‘cork thigh’.

1. Describe the gross anatomy of the [muscles, their attachments and actions and nerve supply] of the quadriceps [anterior] compartment of the thigh.

2. Explain what happens to the muscle compartment following such injuries. [3 marks]

3. Explain the signs and symptoms of such an injury.

4. If severe or left untreated left untreated, this type of injury can result in compartment syndrome. Explain what is meant by compartment syndrome and outline the consequences of this condition.

5. In severe injuries of this type, a condition known as myositis ossificans can occur. Explain the processes involved in the development of this condition, and the resulting consequences if left untreated.

6. using the APA 7 style of referencing. Start your list of end-text references on a new page. The list of references should be left aligned. Use a hanging indent for each reference and follow APA style format for all reference

Answer 1

GROSS ANATOMY OF THE ANTERIOR COMPARTMENT OF THE THIGH :-

• The musculature of the thigh can be split into three sections : anterior , medial and posterior.
• Each compartment has a distinct innervation and function.
• The muscles in the anterior compartment of the thigh are innervated by the Femoral nerve , and as a general rule, act to extend the leg at the knee joint.

There are three major muscles in the anterior thigh :  the pectineus, sartorius , quadriceps femoris

• in additon to these , the end of the iliopsoas muscle passes into the anterior compartment.

FIGURE : THE MUSCLE OF THE ANTERIOR THIGH

ILIOPSOAS :-

• The iliopsoas is actually two muscles , the psoas major and the iliacus . They originate in different areas , but come together to form a tendon , hence they are commonly reffered to as one muscle .

ATTACHMENTS : The psoas major originates from the lumbar vertebrae , and the iliacus originates from the iliac fossa of the pelvis . They insert together onto the lesser trochanter of the femur .

ACTION : Flexes the thigh at the hip joint .

INNERVATION : The psoas major is innervated by anterior rami of L1-3 , while the iliacus is innervated by the femoral nerve .

QUADRICEPS FEMORIS :

• The quadriceps femoris consists of individual muscles : vastus muscles and the rectus femoris .
• They form the main bulk of the thigh , and collectively are one of the most powerful muscles in the body .
• the muscles that form the quadriceps femoris unite proximal to the knee and attach to the patella via the quadriceps tendon .
• In turn , the patella is attached to the tibia by the patella ligament .
• The quadriceps femoris is the main extensor of the knee .

VASTUS LATERALIS :-

ATTACHMENT :  originates from the greater trochanter and the lateral lip of linea aspera.

ACTION : Extends the knee joint and stabilises the patella

INNERVATION : femoral nerve

VASTUS INTERMEDIUS : -

ATTACHMENT :  Anterior and lateral surfaces of the femoral shaft .

ACTION :  Extends the knee joint and stabilises the patella .

INNERVATION : Femoral nerve

VASTUS MEDIALIS :

ATTACHMENT : The intertrochanteric line and medial lip of the linea aspera

ACTION :  Extends the knee joint and stabilises the patella , particularly due to its horizontal fibres at the distal end .

INNERVATION :  femoral nerve

RECTUS FEMORIS :

ATTACHMENT :  Originates from the ilium , just superior to the acetabulum . It runs straight down the leg ( the latin word for straight is rectus ) and attaches to the patella by the quadriceps femoris tendon.

ACTION :  The only muscle of the quadriceps to cross both the hip and knee joints. It flexes the thigh at the hip joint , and extends at the knee joint .

INNERVATION : femoral nerve

SARTORIUS : -

• The sartorius is the longest mucle in the body . It is long and thin , running across the thigh in a inferomedial direction .The sartorius is positioned more superficially than the other muscles in the leg

ATTACHMENT :  Originates from the anterior superior iliac spine , and attaches to the superior , medial surface of the tibia.

ACTION : At the hip joint , it is a flexor , abductor and lateral rotator . At the knee joint , it is also a flexor .

INNERVATION :  Femoral nerve

PECTINEUS :-

ATTACHMENT :  It originates from the pectineal line on the anterior surface of the pelvis , and attaches to the pectineal line on the posterior side of the femur , just inferior to the lesser trochanter.

ACTION :  Adduction and flexion at the hip joint .

INNERVATION : Femoral nerve and also from obturator nerve.

WHAT IS MUSCLE COMPARTMENT SYNDROME ?

• compartment syndrome is painful condition that occurs when pressure within the muscles builds to dangerous levels. The pressure can decrease blood flow , which prevents nourishment and oxygen from reaching nerve and muscle cells . It can be either acute or chronic.

SYMPTOMS :

ACUTE COMPARTMENT SYNDROME :

• Pain , when muscle strectched
• tingling or burning sensation ( paresthesias ) in the skin
• numbness or paralysis

CHRONIC COMPARTMENT SYNDROME :

• NUMBNESS
• difficulty moving the foot
• visible mucle bulging