The femoral region (thigh)lies between the gluteal, abdominal,
and perineal regions proximally and the knee region distally:
anteriorly separated from the abdominal wall by the inguinal
ligament posteriorly separated from the gluteal region by the
gluteal fold superficially by the inferior margins of the gluteus
maximus & quadratus femoris on deeper planes
Slide 4
Structures enter and leave the top of the thigh by 3 routes:
Posteriorly Posteriorly continuous with the gluteal region sciatic
nerve Anteriorly Anteriorly abdominal cavity via aperture between
inguinal ligament & pelvic bone Medially Medially thigh &
pelvic cavity communicates via obturator canal Vessels and nerves
passing between the thigh and leg pass through the popliteal fossa
posterior to the knee joint.
Slide 5
Superficial Fascia of the Thigh Attached to the deep fascia
below the inguinal ligament. Deep Fascia of the Thigh (Fascia Lata)
Encloses the thigh like a trouser leg. Saphenous opening A gap in
the deep fascia in front of the thigh just below the inguinal
ligament. Great saphenous vein femoral vein Great saphenous vein
via hiatus saphenus drains into femoral vein. cribriform fascia
Filled with loose connective tissue called the cribriform
fascia.
Slide 6
3 fascial septa pass from the inner aspect of the deep fascial
sheath of the thigh to the linea aspera of the femur. Anterior
compartment of thigh Femoral nerve muscles extend the leg at the
knee joint. Medial compartment of thigh Obturator nerve muscles
adduct the thigh at the hip joint. Posterior compartment of thigh
Sciatic nerve muscles extend the thigh at the hip joint & flex
the leg at the knee joint.
Slide 7
Slide 8
Sartorius Origin ASIS & superior part of notch inferior to
it ASIS & superior part of notch inferior to it Insertion
Superior part of medial surface of tibia Superior part of medial
surface of tibia femoral nerve
Slide 9
Quadriceps femoris Rectus femoris Vastus lateralis Vastus
medialis Vastus intermedius Insertion base of patella indirectly
via patellar ligament to tibial tuberosity femoral nerve Origin
Straight head Anterior inferior iliac spine Reflected head Ilium
just superior to the acetabulum
Slide 10
Quadriceps femoris Rectus femoris Vastus lateralis Vastus
medialis Vastus intermedius Insertion base of patella indirectly
via patellar ligament to tibial tuberosity femoral nerve 1.Greater
trochanter 2.Lateral lip of linea aspera 1.Intertrochanteric line
2.Medial lip of linea aspera Anterior and lateral surfaces of shaft
of femur
Slide 11
Quadriceps femoris Rectus femoris Vastus lateralis Vastus
medialis Vastus intermedius Insertion base of patella indirectly
via patellar ligament to tibial tuberosity femoral nerve
Slide 12
Quadriceps femoris Rectus femoris Vastus lateralis Vastus
medialis Vastus intermedius Insertion base of patella indirectly
via patellar ligament to tibial tuberosity femoral nerve
Slide 13
Patellar ligament functionally continuation of quadriceps
femoris tendon attached above to apex and margins of patella below
to the tibial tuberosity. Prepatellar bursa subcutaneous anterior
to patella. Deep and subcutaneous infrapatellar bursae deep and
subcutaneous sides of the patellar ligament, respectively.
Articularis genus pulls the synovial membrane superiorly during
extension of the leg. prevents compression of the folds of the
membrane between the femur and the patella
Slide 14
In addition, the terminal ends of the psoas major and iliacus
muscles pass into the upper part of the anterior compartment from
sites of origin on the posterior abdominal wall. Iliacus+psoas
major Ilopsoas
Slide 15
1.Chief flexor of the thigh 2. The most powerful of the hip
flexors with the longest range. 3. Can also contribute to lateral
rotation of the thigh. 4. Is also a postural muscle, active during
standing in maintaining normal lumbar lordosis and resisting
hyperextension of the hip joint.
Slide 16
Extends leg at knee joint. Rectus femoris also steadies hip
joint & helps iliopsoas flex thigh. Flexion of thigh at hip
joint Rectus femoris Sartorius Flexion of thigh at hip joint Rectus
femoris Sartorius
Slide 17
Flexes, abducts, and laterally rotates thigh at hip joint.
Flexes leg at knee joint (medially rotating leg when knee is
flexed). Flexion of thigh at hip joint Rectus femoris Sartorius
Flexion of thigh at hip joint Rectus femoris Sartorius Abduction of
thigh at hip jointSartorius Sartorius Lateral rotation of thigh at
hip jointSartorius Sartorius
Adductor longus Adductor brevis Adductor magnus Adductor brevis
Adductor magnus adductor part Adductor magnus hamstrings part
Obturator externus Adducts thigh; flexes leg; helps rotate leg
medially
Slide 20
distal attachment of the adductor part of the adductor magnus
tendinous distal attachment of the hamstring part A gap between the
aponeurotic distal attachment of the adductor part of the adductor
magnus & tendinous distal attachment of the hamstring part.
Transmits femoral artery & vein from the adductor canal in the
thigh to the popliteal fossa.
Slide 21
Biceps femoris Short head Biceps femoris Long head
SemitendinosusSemimembranosus
Slide 22
Proximal attachment to ischial tuberosity Proximal attachment
to ischial tuberosity deep to the gluteus maximus. Distal
attachment to the bones of the leg. Distal attachment to the bones
of the leg. Thus act on two joints, producing extension @ hip joint
& flexion @ knee joint. Innervation by tibial division of the
sciatic nerve. Innervation by tibial division of the sciatic
nerve.
Slide 23
Femoral artery largest & main artery of lower limb
Obturator artery Inferior gluteal artery Femoral artery Obturator
artery Inferior gluteal artery
Slide 24
external iliac artery Distal continuation of external iliac
artery. Passes under the inguinal ligament. Enters the femoral
triangle midpoint of the inguinal ligament (midway between ASIS
& pubic tubercle). Continues down the thigh in the adductor
canal. popliteal artery Becomes popliteal artery behind the
knee.
Slide 25
1. Superficial circumflex iliac artery 2. Superficial
epigastric artery 3. Superficial external pudendal artery 4. Deep
external pudendal artery 5. Profunda femoris artery Large and
important branch Arises from the lateral side of the femoral artery
below the inguinal ligament 6. Descending genicular artery
Slide 26
Great saphenous vein Largest superficial vein in the thigh
Originates from a venous arch on the dorsal aspect of the foot.
Ascends along the medial side of the lower limb. saphenous ring
Passes through the saphenous ring. femoral vein To connect with the
femoral vein in the femoral triangle. Superficial & deep
veins
Slide 27
Femoral vein Continuation of the popliteal vein proximal to the
adductor hiatus. Enters the femoral sheath Ends posterior to the
inguinal ligament, becomes external iliac vein Profunda Femoris
Vein drains into the femoral vein. Obturator Vein drains into the
internal iliac vein.
Slide 28
3 major nerves in the thigh, each associated with one of the 3
compartments: Femoral nerve anterior compartment of thigh Obturator
nerve medial compartment of thigh Sciatic nerve posterior
compartment of thigh
Slide 29
o Largest branch of the lumbar plexus. o Enters the thigh
lateral to the femoral artery and the femoral sheath, behind the
inguinal ligament. o In the femoral triangle lies on the lateral
side of the femoral artery
Slide 30
o Enters the medial compartment of thigh through the obturator
canal. o Supplies most of the adductor muscles and skin on the
medial aspect of the thigh.
Slide 31
o Descends in the midline of the thigh. o Ends by dividing into
the tibial and common peroneal nerves. o Innervates all muscles in
the posterior compartment of thigh and then its branches continue
into the leg and foot.
Slide 32
Lateral cutaneous nerve of the thigh branch of the lumbar
plexus (L2& 3) Medial cutaneous nerve of the thigh branch of
the femoral nerve Intermediate cutaneous nerve of the thigh branch
of the femoral nerve Posterior cutaneous nerve of the thigh branch
of the sacral plexus
Slide 33
Superiorly inguinal ligament Medially lateral border of
adductor longus Laterally sartorius Contents; from lateral to
medial o Femoral nerve o Femoral sheath o Femoral artery o Femoral
vein o Deep inguinal lymph nodes
Slide 34
A funnel-shaped fascial tube Passes deep to the inguinal
ligament Encloses proximal parts of the femoral vessels and creates
the femoral canal medial to them. Formed by an inferior
prolongation of transversalis & iliopsoas fascia Subdivided
into three smaller compartments Lateral compartment for the femoral
artery. Intermediate compartment for the femoral vein. Medial
compartment constitutes the femoral canal
Slide 35
Smallest of the 3 compartments of the femoral sheath Lies
between the medial edge of the femoral sheath and the femoral
vein.
Slide 36
Boundaries Laterallyvertical septum between femoral canal &
femoral vein Laterally vertical septum between femoral canal &
femoral vein. Posteriorlysuperior ramus of the pubis covered by the
pectineus muscle and its fascia Posteriorly superior ramus of the
pubis covered by the pectineus muscle and its fascia. Medially
lacunar ligament Anteriorly medial part of the inguinal ligament
Medially lacunar ligament Anteriorly medial part of the inguinal
ligament. Upper opening of the femoral canal formed by the small
opening at its abdominal end.
Slide 37
Femoral sheath blends with the tunica adventitia of blood
vessels. a potentially weak area in the abdomen The part of the
femoral sheath that forms the medially located femoral canal is
not. femoral hernia A protrusion of peritoneum forced down the
femoral canal, pushing the femoral septum before it
Slide 38
Intermuscular cleft in the middle 1/3 of the thigh beneath the
sartorius muscle Extends from the apex of the femoral triangle to
the adductor hiatus
Slide 39
Contains o terminal part of the femoral artery o femoral vein
(lies behind the artery) o deep lymph vessels o saphenous nerve o
nerve to the vastus medialis o term o terminal part of the
obturator nerve Boundaries Anteriorly and laterally vastus medialis
Posteriorly adductors longus & magnus Medially sartorius, roof
of the canal
Slide 40
o An area of transition between the thigh and leg o Major route
by which structures pass from one region to the other. o Formed
between muscles in the posterior compartments of thigh and
leg.
Slide 41
Superolaterally Biceps femoris SuperomediallySemimembranosus
Inferolaterally and inferomedially Gastrocnemius Posteriorly Skin
& popliteal fascia (roof)
Slide 42
1)Termination of the small saphenous vein 2)Popliteal arteries
and veins and their branches and tributaries 3)Tibial and common
fibular nerves 4)Posterior cutaneous nerve of thigh 5)Popliteal
lymph nodes and lymphatic vessels
Slide 43
The sciatic nerve usually ends at the superior angle of the
popliteal fossa by dividing into tibial nerve & common fibular
nerve
Slide 44
tibial nerve descends vertically through the popliteal fossa
exits deep to plantaris muscle to enter posterior compartment of
leg. common fibular nerve exits by following the medial border of
the biceps femoris tendon over the lower lateral margin of the
popliteal fossa lateral compartment of leg continues to the lateral
side of the leg where it swings around the neck of the fibula and
enters lateral compartment of leg
Slide 45
Continuation of the femoral artery Begins as the femoral artery
passes through the adductor hiatus. Ends lateral to the midline of
the leg by dividing into anterior & posterior tibial arteries.
Popliteal vein is superficial to and travels with the popliteal
artery. (formation by ant. & post. tibial veins), becomes
femoral vein.