Lecture 19 - Thigh Flashcards
2 fascial layers of the thigh
- superficial fatty layer
- deep membranous layer
The 2 fascial layer of the thigh are superficial to what?
fascia latae
deep fascia of the thigh
fascia latae
cutaneous nerves of the thigh
- ilioinguinal nerve
- genitofemoral nerve
- medial cutaneous nerve
- intermediate/anterior cutaneous nerve
- lateral femoral cutaneous nerve
- superficial/anterior branch of obturator nerve
- posterior cutaneous nerve
nerve from L1
ilioinguinal nerve
nerve from L1-2
genitofemoral nerve
nerve from L2-3
lateral femoral cutaneous nerve
cutaneous branches of femoral nerve
- genitofemoral nerve
- medial cutaneous nerve
- intermediate cutaneous nerve
ilioinguinal nerve
- L1
- supplies small area of skin below medial end of inguinal ligament
genitofemoral nerve
- L1-2
- lateral to femoral artery and pierces the sheath and fascia latae
- femoral branch enters femoral sheath
- supplies skin over femoral triangle
medial cutaneous nerve of thigh
- branch of femoral nerve
- supplies skin on medial side of thigh
intermediate cutaneous nerve of thigh
- also called anterior cutaneous nerve
- branch of femoral nerve
- supplies skin on front of thigh down to knee
lateral femoral cutaneous nerve of thigh
- L2-L3
- supplies anterolateral and posterolateral surfaces of thigh
superficial/anterior brach of obturator nerve
- supplies medial aspect of thigh
posterior cutaneous nerve of thigh
- branch of sacral plexus
- supplies posterior aspect of thigh
What represents an area of skin supplied by a specific spinal nerve, regardless of the cutaneous nerves distributed to the same area?
dermatome
Why are dermatomes important?
Can be tested for touch and temperature and are related to specific spinal cord levels
2 superficial veins of lower limb
- great saphenous vein
2. small/lesser saphenous vein
The ____ _______ vein drains the _____ venous arch, passes _____ to the medial _______, runs on the ______ side of the leg and then _______ to the medial _______ of the tibia and femur, ends on the _____ aspect of the thigh in the _______ vein after passing through the _______ _____ in the deep fascia.
The GREAT SAPHENOUS vein drains the DORSAL venous arch, passes ANTERIOR to the medial MALLEOLUS, runs on the MEDIAL side of the leg and then POSTERIOR to the medial CONDYLES of the tibia and femur, ends on the MEDIAL aspect of the thigh in the FEMORAL vein (after passing through the SAPHENOUS HIATUS in the deep fascia.
The _____ _______ vein begins ______ to the lateral malleolus (a continuation of the _____ _______ vein of the foot) and runs along the _____-_______ and reaches the _____ of the leg where it perforates the _____ fascia (at the _____ base) to drain into the ______ ______.
The SMALL/LESSER SAPHENOUS vein begins POSTERIOR to the lateral malleolus (a continuation of the LATERAL MARGINAL vein of the foot) and runs along the TENDO-CALCANEUS and reaches the MIDDLE of the leg where it perforates the DEEP fascia (at the POPLITEAL base) to drain into the POPLITEAL VEIN.
nodes located in upper part of femoral triangle
superficial inguinal nodes
nodes that lie on the medial side of the femoral vein
deep inguinal nodes
nodes that are located in popliteal fossa
popliteal nodes
largest node in the body that is the highest node in the deep inguinal nodes
Cloquet’s node
5 muscles of anterior compartment
- sartorius
- iliacus
- psoas major
- pectineus
- quadriceps femoris (4 heads)
5 muscles of medial compartment
- gracilis
- adductor longus
- adductor brevis
- adductor magnus (oblique fibers)
- obturator externus
4 muscles of posterior compartment
- biceps femoris
- semitendinosus
- semimembranosus
- adductor magnus (vertical/hamstring fibers)
What is the posterior compartment of the thigh is separated from the extensor compartment by?
lateral intermuscular septum
Is there a septum that separates the posterior compartment from the adductor compartment?
NO
The blood supply to the thigh is provided mostly by which artery?
femoral artery
What is the femoral artery an extension of?
- external iliac artery
The ____ _____ artery passes deep to the ______ _______ into the _____ triangle of the thigh, thus becoming the ______ artery and enclosed in the femoral ______. It then courses below the _______ muscle in the _____ ______. It then becomes the _____ artery by going through the _______ _______ in the adductor magnus.
The EXTERNAL ILIAC artery passes deep to the INGUINAL LIGAMENT into the FEMORAL triangle of the thigh, thus becoming the FEMORAL artery and enclosed in the femoral SHEATH. It then courses below the SARTORIUS muscle in the ADDUCTOR CANAL. It then becomes the POPLITEAL artery by going through the ADDUCTOR HIATUS in the adductor magnus.
branches of femoral artery
- superficial circumflex iliac artery
- superficial external pudendal artery
- deep external pudendal artery
- deep femoral/profunda femoral artery
- descending genicular artery
branches of deep femoral/profunda femoral artery
- lateral circumflex femoral artery
- medial circumflex femoral artery
- 3 perforating arteries
- muscular branches
branches of lateral circumflex femoral arteries
- ascending
- descending
- transverse
branches of medial circumflex femoral arteries
- transverse
- ascending
- acetabular
artery that ends at the 4th perforating artery and supplies muscles of the posterior compartment of the thigh
deep femoral artery
arteries that supply muscles of the medial compartment of the thigh
- branches of deep femoral artery
- obturator artery
The obturator artery is a branch of which artery?
internal iliac artery
this artery divides into a saphenous and articular branches; has anastomoses with other arteries around the knee
descending genicular artery
innervates pectineus (90% of time), quadriceps femoris, sartorius, iliacus
femoral nerve
innervates gracilis, adductor magnus (oblique fibers), adductor longus, adductor brevis, obturator externus
obturator nerve
innervates biceps femoris (long head), semimembranosus, semitendinosus
tibial portion of sciatic nerve
innervates biceps femoris (short head)
common peroneal portion of sciatic nerve
innervation supplied by ventral primary rami of L2-3
psoas major
The ______ nerve splits around the obturator _____ and _______ brevis into an anterior and ______ branch.
The OBTURATOR nerve splits around the obturator EXTERNUS and ADDUCTOR brevis into an anterior and POSTERIOR branch.
The _____ nerve continues into the _____ subcutaneous portion of the leg as the _______ nerve.
The FEMORAL nerve continues into the MEDIAL subcutaneous portion of the leg as the SAPHENOUS nerve.
nerve that runs with greater saphenous vein
saphenous nerve
supplies sensation to medial side of leg, ankle, and foot
saphenous nerve
femoral triangle boundaries
- superiorly - inguinal ligament
- medially - medial aspect of adductor longus
- laterally - medial margin of sartorius
floor of femoral triangle
lateral to medial:
- iliacus
- psoas major
- pectineus
- adductor longus
roof of femoral triangle
skin and fascia
contents of femoral triangle
- femoral nerve and branches (most lateral)
- femoral artery and vein (intermediate)-surrounded by femoral sheath
- deep inguinal lymph nodes (most medial)-surrounded by femoral sheath
- femoral canal with a superior portion called the femoral ring-formed by extraperitoneal tissue
triangular aponeurotic tunnel in the middle third of thigh
adductor/subsartorial canal
extends from apex of femoral triangle to opening of adductor magnus
adductor/subsartorial canal
adductor/subsartorial canal contents
- femoral artery and vein
- deep lymphatic vessels
- saphenous nerve
- nerve to vastus medialis (from femoral nerve)