Thigh
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Transcript of Thigh
Dr. S. Nishan Silva(MBBS)
Frolich, Human Anatomy, Lower LImb
Surface Anatomy: Anterior Thigh + Leg
PalpatePatellaCondyles of femur
Femoral TriangleSartorius (lateral)Adductor longus
(medial)Inguinal ligament
(superior)Femoral a + v, lymph
nodespg 785
12-3
Surface Anatomy of the Lower Limb
Surface features of the Thigh Sartorius muscle Quadriceps femoris muscle Adductor longus muscle Hamstring muscles Femoral triange
Superficial structuresGreat saphenous vein Drains the medial end of dorsal venous
arch of footPasses upward directly in front of the
medial malleolus.Then ascends on medial side of the leg.Passes behind the knee and curves
forward around the medial side of the thigh.
Passes through the saphenous hiatus in the deep fascia and joins the femoral vein about 4 cm below and lateral to the pubic tubercle.
Superficial structuresTributaries:
Superficial lateral femoral v. Superficial medial femoral v. External pudendal v. Superficial epigastric v. Superficial iliac circumflex v.
Varicose veins
Superficial structures
Superficial fasciaSuperficial arteries:
superficial epigastric a. superficial iliac circumflex a. external pudendal a.
Cutaneous nerves: lateral femoral cutaneous n. anterior and medial cutaneous
branches of femoral n.cutaneous branches of obturator n.
lateral femoral cutaneous n.
anterior and medial cutaneous branches of femoral n.
Cutaneous branches of obturator n.
Superficial structures
Superficial inguinal lymph nodes
Superior group: Lies just distal to the inguinal ligament Receive lymph vessels from anterior
abdominal wall below umbilicus, gluteal region, perineal region, external genital organs
Inferior group: Lies vertical along the terminal great
saphenous v. Receives all superficial lymph vessels
of lower limb, except for those from the posterolateral part of calf
Efferent vessels drain into the deep inguinal ln. or external iliac ln.
Deep fascia of the thigh Fascia lata The deep fascia encloses the thigh like a
trouser leg.Saphenous hiatus
A gap in the deep fasica which lies about 4 cm below and lateral to the pubic tubercle. The falciform margin is the lower lateral border of the opening, which lies anterior to the femoral vessels.
Filled with loose connective tissue called the cribriform fascia
Deep fascia of the thigh Iliotibial tract
laterally the deep fascia forms a thick band, from the iliac tubercle to the lateral condyle of tibial.
The fascia lata sends intermuscular septa to the linea aspera of the femur. These separate the thigh into three compartments each of which contains a group of muscles, the vessels and the nerves.
Lacuna musculorum
Boundaries:Anteriorly: lateral portion
of inguinal ligamentPosterolaterally: ilium Medially: iliopectinal arch
Contents: Iliopsoas femoral n. lateral femoral cutaneous n.
Iliopectinal arch
Femoral n.
Iliopsoas
Lateral femoral cutaneous n.
Lacuna vasorum
Boundaries:Anteriorly: medial portion
of inguinal ligamentPosteriorly: fascia of
pecteineus and pectineal ligament
Medially: lacunar ligamentLaterally: iliopectinal arch
Contents: Femoral sheathFemoral a. and v.Genital branch of
genitofemoral n. Lymphatic vessels
Femoral a.
Femoral v.
Femoral ring
Frolich, Human Anatomy, Lower LImb
Anterior/Posterior compartments
ANTERIOR COMPARTMENT
POSTERIOR COMPARTMENT
MOVEMENT Extension Flexion
MUSCLES Quads
Shin
Hamstrings
Gastrocs
NERVES Femoral n.
(lumbar plexus)
Sciatic n.
(sacral plexus)
Frolich, Human Anatomy, Lower LImb
Frolich, Human Anatomy, Lower LImb
Anterior thigh (femoral n.)
Sartorius (Tailor’s muscle)
Quads (four)Rectus femoris
(crosses hip)3 vastus mm.
(vast--big)
Musculature
AnteriorRectus FemorisVastus LateralisVastus IntermediusVastus Medialis
Musculature
AnteriorPosterior
SemimembranosusSemitendinosusBiceps femorisPopliteus
Musculature
Lateral restrainers of kneeTensor Fascia LataIliotibial Band
Frolich, Human Anatomy, Lower LImb
Posterior Thigh
Gluts (gluteal nn.)Maximus—extensor of thighMedius--pelvic tilt
Lateral rotators (spinal nn.)Piriformis syndrome
Hamstrings (sciatic n.)Biceps femorisSemimembranousSemitendinous
Frolich, Human Anatomy, Lower LImb
Medial compartment (obturator n.)
Adductor musclesGracilisAdductor
Magnus Longus brevis
Femoral triangle A triangular depressed area situated in
the upper part of the medial aspect of the thigh just below the inguinal ligament
Boundaries Superiorly (base) : the inguinal ligament Laterally: medial border of sartorius Medially: medial border of adductor
longus Apex: continuous with adductor canalAnterior wall: fascia lataPosterior wall: consists of iliopsoas,
pectineus and adductor longus from lateral to medial side
Femoral triangle
Contents Femoral n.Femoral sheathFemoral a. and its branches Femoral vein and its tributaries.Femoral canalDeep inguinal lymph nodesFatty tissue
Femoral triangle
Femoral sheath A funnel- shaped sheath Derived from transversalis fascia
anteriorly and iliac fascia posteriorly
It surroumds the femoral vessels and lymphatic about 2.5cm belower the inguinal ligamemt.
Its lower end disappears at the lower margin of the saphenous opening where the sheath fuses with the adventitia of the vessels.
Femoral sheath
Femoral sheath Divided into three compartments by two fibrous
septa
Lateral compartment: femoral a. Middle compartment: femoral v.Medial compartment: femoral canal
The femoral canal About 1.3cm long , and its upper
opening is called the femoral ring Contains: a little loose fatty tissue,
a small lymph node, and some lymph vessels.
The boundaries of the femoral ring Anteriorly: the inguinal ligament Medially: the lacunar ligament Posteriorly: the pecten of pubis Laterally: the femoral vein Superior: covered by femoral
septum
Femoral hernia If a loop of intestine is forced
into the femoral ring, it expands to form a swelling in the upper part of the thigh. Such a condition is known as a femoral hernia .
A femoral hernia is more common in women than in men (possibly because their wider pelvis and femoral canal ).
Femoral artery
Femoral a. Continuation of the external iliac a. Begins midpoint of inguinal ligamentEnds at the adductor tendinous
opening by entering the popliteal fossa as the popliteal artery
Principal branch - deep femeral a. arises from the posterolateral surface of the
femoral artery about 5 cm below the inguinal ligament.
Medial femoral circumflex lateral femoral circumflex Four perforating arteries
Profunda femoris
Arises from the posterolateral surface of the femoral artery about 5 cm below the inguinal ligament.
Branches: Lateral circumflex artery. Medial circumflex artery.Perforating arteries
deep femeral a.
Lateral circumflex a. Medial circumflex a.
perforating arteries
Femoral vein Begins at the adductor tendinous
opening Continues as external iliac vein
deep to inguinal ligament Contains several valves
The deep inguinal lymph nodes
Lie medial to the femoral v.Receive deep lymphatics of
lower limb, perineal region, and efferent lymphatics from the superficial inguinal ln.
Drain into the external iliac ln.
Femoral nerve Arises from the lumbar plexus in
the abdomen, and enters the thigh posterior to the inguinal ligament and lateral to the femoral artery.
It ends by dividing into a number of branches 2 cm below the inguinal ligament.
Muscular branche to: pectineus, sartorius, quadriceps femoris
Femoral nerve
Cutaneous branches: Anterior cutaneous
nerves of the thigh Saphenous nerve is the
longest branch of the femoral nerve. It accompanies the femoral vessels in the adductor canal, then accompanies the great saphenous vein to the medial side of the leg and food.
Femoral n.
Femoral a.
Femoral v.
Saphenous nerve
Adductor canal An intermuscular cleft situated on the medial
aspect of the middle third of the thigh beneath the sartorius.
Extends from apex of femoral triangle to adductor tendinous opening
Boundies Anterior wall: adductor lamina and
sartorius Lateral wall : vastus medialis Posteomedial wall: adductors longus and
magmus Contents
Saphenous n. Femoral a. and femoral v. lymphatic vessels and loose connective
tissue
Blood vessels and nerve of medial side of thigh Obturator a.
Arises from internal iliac artery in the lesser pelvis
passes through the obturator canal where it divides into anterior and posterior branches.
Obturator n. Arises from the lumbar plexus in
the abdomen. Enters the thigh through the
obturator canal where it divides into anterior and posterior branches.
Supplies medial group of muscles of thigh, obturator externus, and skin of medial side of thigh
Obturator n.
Strains-hamstring
Strains- groin
AP LAT
FRACTURED LT. FEMUR