The Thigh Flashcards
Lower limb is specialized for what
locomotion and weight bearing
4 parts of lower limb
Gluteal region
Thigh
Leg
Foot
Hip injuries make up what percent of lower limb injuries
3%
Femur
Directed inferomedially
Longest and heaviest bone
1/4 of a persons height
Proximal Epiphysis of femur
Head - projects superomedially and slightly anteriorly
Head of femur is connected to the shaft through…
the neck at about 126 degree angle = angle of inclination
Angle is widest when
at birth (140) and then diminishes with age and is narrowest at 110 degrees with old age
Angle male vs female
Less in females because females have wider hips
Superficial Fascia of thigh
lies deep to the skin
continuous with abdominal fascia
Has a lot of fat
Embedded in superficial fascia?
Lumbar plexus?
Cutaneous Nerves
- Genital Branches of Genitofemoral
- Femoral Branch of Genitofemoral
- Medial Cutaneous branch of femoral
- Intermediate cutaneous branch of femoral
- Lateral femoral cutaneous nerve
- Posterior femoral cutaneous nerve
Genital Branches of Genitofemoral
L1 L2
and Ilioinguinal (L1) nerves
Emerge from superficial ring to supply proximal medial thigh
Most branches go to genital region
Femoral Branch of Genitofemoral
L1 L2
Supplies skin over the femoral triangle (proximal part of anterior thigh)
Medial Cutaneous Branch of Femoral
Supplies skin of medial thigh
Intermediate Cutaneous Branch of Femoral
Supplies skin of distal anterior thigh
Lateral Femoral Cutaneous Nerve
L2, L3
Enters thigh medial to ASIS
Supplies lateral thigh, lateral to intermediate cutaneous branch of femoral nerve
Posterior Femoral Cutaneous Nerve
S1 S2 S3
Supplies the posterior thigh and popliteal region
Originates from sacral plexus
Courses inferiorly into the thigh from gluteal region
Superficial Vessels
Lite in the superficial fascia immediately below the skin
Superficial Arteries originate from
the proximal part of the femoral a
Branches from femoral in superficial fascia
Superficial epigastric
Superficial circumflex iliac
Superficial external pudendal
Superficial Epigastric Artery
Proceeds superiorly to provide the skin over the lower abdominal wall
Superficial Circumflex Iliac artery
Proceeds laterally inferior to the inguinal ligament
Parallels the course of the deep circumflex iliac
Veins in superficial thigh
Great saphenous vein
Great saphenous vein
Foot –> proximal part of thigh
Located in superficial fascia
Has valves
Path of Great Saphenous Vein
Enters the thigh by passing posterior to the medial condyle of the femur
Transverses the saphenous opening in the fascia lata to emtpy into femoral vein inferior to inguinal ligament
Deep Fascia of the thigh purpose
AKA Fascia Lata
Prevents bulging of the muscles
Define the deep fascia of the thigh
A dense layer of CT btw the muscles of the thigh and the superficial fascia
It is very strong along anterior and lateral parts of thigh
Iliotibial Tract
IT band
A lateral thickening of the deep fascia
Superiorly the fascia lata is attached to the
Inguinal ligament Part so the hip bone (Pubic, iliac crest, ischial tub) Sacrum Coccyx Scarpa's fascia Sacrotuberous ligament
Inferiorly at the knee joint, fascia lata
continuous with the crural fascia
Fascia Lata provides
Intermuscular septa that divide thigh into anterior, medial and posterior compartments
All septa attach at the
Linea Aspera
Lateral, Medial, Posterior Intermuscular Septa
Anterior Compartment
Action and Innvervation
Flexors of the hip and extensors of the knee
Nerve = Femoral
What is in the Anterior Compartment
- Sartorius
- Rectus Femoris
- Vastus Lateralis
- Vastus Medialis
- Vastus Intermedius
- Articularis Genu
- Psoas Major
- Iliacus
- Tensor Fascia Latae
Sartorius
ASIS to the superior medial surface of the tibia
Rectus Femoris
AIIS to patella
Vastus Lateralis
Linea Aspera to patella
Vastus Medialis
Lnea Aspera to patella
Vastus Intermedius
Body of femur to patella
Articularis Genu
Anterior part of femur - synovial membrane of knee
Psoas Major
Lumbar vertebrae to lesser trochanter of femur
Iliacus
Iliac crest and fossa to lesser trochanter of femur
Tensor Fascia Latae
ASIS to iliotibial tract
Medial Compartment Action and Innervation
Adductors
Obturator Nerve
What muscles are in the medial compartment
- Pectineus
- Adductor Longus
- Adductor Brevis
- Adductor Magnus
- Gracilis
- Obturator Externus
Pectineus
Superior ramus of pubis - pectineal line of femur
Innervated by femoral and obturator
Adductor Longus
Body of pubic bone - linea aspera
Adductor Brevis
Inferior ramus of pubic bone - linea aspera
Adductor part of Adductor Magnus
Ischiopubic ramus - linea aspera
Supplied by obturator
Hamstring part of Adductor Magnus
Ischial tuberosity - adductor tubercle of femur
Supplied by tibial nerve
Gracilis
Inferior ramus of pubis - superior part of medial surface of tibia
Obturator Externus
Margins of obturator foramen and obturator membrane - trochanteric fossa of femur
Posterior Compartment
Action and innervation
Hamstring muscles (except short head of biceps femoris) Act on two joints - extends hip and flexes knee Tibial Nerve innervation
What muscles are in the posterior compartment
Biceps Femoris
Semitendinosus
Semimembranosus
Biceps Femoris Long Head
Ischial tuberosity - fibular head
Tibial Nerve
Biceps Femoris Short Head
Linea Aspera - fibular head
Common Peroneal Nerve
Semitendinosus
Ischial tuberosity - medial surface of upper tibia
Semimembranosus
Ischial tuberosity - medial tibial condyle
Where is the femoral triangle
proximal part of anterior compartment
Boundaries of femoral tri Superior Medial Lateral Base Apex Roof Floor
Sup = inguinal ligament Med = med border of add longus Lat = med border of sartorius Base = inguinal ligament Apex = where sart crosses longu Roof = fascia lata Floor = iliopsoas and pectineus
Contents in femoral triangle
Femoral artery and branches Femoral vein and branches Femoral nerve and branches Lymphatic vessels and nodes Femoral Sheath
Femoral Sheath
Funnel shaped fascial tube with 3 compartments
Lateral, Intermediate, Medial (femoral canal)
Femoral Hernias
Usually originate from femoral ring
Adductor Canal
About 15 cm long
Extends from apex of femoral triangle to adductor hiatus in adductor magnus muscle
Boundaries of adductor canal
Anteromedial
Lateral
Posterior
Antero = sartorius Lateral = vastus medialis Post = adductor longus and magnus
Contents in the Adductor Canal
Femoral artery and vein
Saphenous nerve
Nerve to vastus medialis
Femoral Nerve
L2-L4 Largest branch of lumbar plexus Deep to inguinal ligament NOT in sheath Lies lateral to femoral artery Breaks up into sensory and motor branches while in triangle
Sensory Branches from femoral nerve
- Medial femoral cutaneous
- Intermediate femoral cutaneous
- Saphenous
Saphenous nerve
Travels through adductor canal and leaves canal at its lower end to innervate the skin of leg and foot
Motor branches of femoral go to which muscles
Sartorius
Quadriceps Femoris
Articularis Genu
Pectineus (also gets obturator branch)
Obturator Nerve
Divides into anterior and posterior divisions in obturator foramen
Anterior Division of Obturator Nerve
Location and muscles it innervates
Located btw adductor longus and brevis
Supplies adductor longus, gracilis, adductor brevis and part of pectineus
Posterior Division of Obturator Nerve
Location and muscles it innervates
Located btw adductor brevis and magnus
Supplies obturator externus, adductor brevis, and adductor magnus
Femoral Artery
Continuation of external iliac artery
Enters thigh by passing below inguinal ligament, lateral to femoral vein
Branches in thigh
Superficial circumflex iliac Superficial epigastric Superficial and deep external pudendal Lateral femoral circumflex Medial femoral circumflex Profunda femoris
Cruciate Anastomosis
1st perforating a
Medial femoral circumflex a
Lateral femoral circumflex a
Inferior gluteal a
Obturator Artery
Branch of the internal iliac artery
Popliteal Fossa
Fat filled - diamond space at back of the knee
Boundaries of popliteal fossa Interomedial and inferolateral Superolateral Superomedial Floor
Intero - Gastrocnemius
Superolat - Biceps femoris
Superomed - Semimembranosus tendon
Floor - Popliteal surface of femur and posterior knee ligaments
Contents in the popliteal fossa
Temination of small saphenous vein Popliteal vessels and branches Tibial and common peroneal nerves Post cutaneous nerve of thigh Popliteal lymph nodes and vessels