Anterior thigh Flashcards
Fascia lata
The fascia lata is the thick layer of deep fascia that encloses the thigh and sends septa to divide the muscles into groups.
Proximally: iliac crest and the inguinal ligament.
- Approximately 3cm below and lateral to the pubic tubercle is the saphenous opening, which is covered by cribriform fascia.
Distally: inferior margins of the tibial condyles, the head of the fibula and the patella, blending with the patellar retinacula.
Laterally it forms the iliotibial tract which receives the insertions of tensor fasciae latae and gluteus maximus. This passes vertically down the posterolateral aspect of the thigh to insert onto the anterior aspect of the lateral tibial condyle.
Quadratus femoris
Three muscles arising from the femur and one from the hip bone. Their common tendon converges via the patella and the ligamentum patellae onto the tibial tuberosity.
They extend the knee, with the rectus femoris being also a hip flexor. They are supplied by branches of the femoral nerve
Rectus femoris
Originates from the anterior inferior iliac spine, with a reflected head arising from the upper acetabular margin and hip joint capsule.
It attaches to the patella superiorly
Vastus medialis
Arises from the medial lip of the linea aspera, an area inferior to the lesser trochanter, and the intertrochanteric line.
Its lowest fibres are inserted into the medial border of the patella and are important in maintaining patellar stability
Vastus lateralis
Arises from the lateral lip of the linea aspera, extending up to the base of the greater trochanter.
It attaches to the lateral aspect of the patella
Vastus intermedius
Lies deepest, and originates from the upper two-thirds of the shaft of the femur.
It is attached to the deep surface of the extensor quadriceps mechanism
Patellofemoral joint
The patellofemoral joint slides superiorly when the knee extends and inferiorly when the knee flexes. A slight amount of medial and lateral deviation, as well as tilting, takes place during normal movement.
The lateral and upwards pull of the rectus femoris and vastus lateralis muscles on the patella is counteracted by the lowest fibres of vastus medialis and the prominent lateral femoral condyle
Sartorius
Sartorius arises from the anterior superior iliac spine and inserts into the upper part of the medial surface of the tibia
It is supplied by the femoral nerve.
Its action is a combination of flexion and lateral rotation of the hip, knee flexion, and medial rotation of the flexed knee, i.e. sitting cross-legged.
It is also the longest muscle in the body
Femoral triangle
The femoral triangle is a triangular space bounded superiorly by the inguinal ligament, laterally by the medial border of sartorius, and medially by the medial border of adductor longus. The floor is formed by iliacus, psoas major, and pectineus.
The contents are the femoral vessels surrounded by the femoral sheath, with the femoral nerve lateral to the sheath and outside it. The femoral canal lies medial to the vein within the femoral sheath, and transmits all the lymphatics from the lower limb. It provides space into which the femoral vein can expand and is the site of a femoral hernia.
Medial compartment of the thigh
This compartment comprises six muscles: obturator externus, pectineus, adductors longus, brevis and magnus, and gracilis.
They adduct the thigh, except obturator externus, which is a lateral rotator of the hip.
They are supplied by branches of the obturator nerve, except pectineus which is mainly supplied by the femoral nerve, and the ischial head (‘hamstring’ part) of adductor magnus which is supplied by the tibial branch of the sciatic nerve
Common attachments of the 3 adductors of the thigh
Arise from the pubic bone and ischiopubic ramus to descend to the linea aspera of the femur.
Adductor magnus
Arise from the pubic bone and ischiopubic ramus to descend to the linea aspera of the femur.
Additional origin from the ischial tuberosity. Distally, it also sends a tendon to the adductor tubercle on the medial femoral condyle. The femoral artery passes lateral to the tendon to run from the anteromedial thigh to the popliteal fossa, where it is situated deeply, next to the bone
Adductor brevis
Arises from the pubic bone and ischiopubic ramus to descend to the linea aspera of the femur.
Lies anterior to adductor magnus, and separates the two divisions of the obturator nerve.
Adductor longus
Arises from the pubic bone and ischiopubic ramus to descend to the linea aspera of the femur.
longer and thinner than brevis. It lies more anteriorly and obliquely, and its medial border forms the medial boundary of the femoral triangle
Gracilis
Ribbon-like muscle running down the medial thigh to insert into the upper part of the tibial shaft, posterior to sartorius and also flexes the knee
