3 The femoral region (thigh)lies between the gluteal, abdominal, and perineal regions proximally and the knee region distally:anteriorly separated from the abdominal wallby the inguinal ligamentposteriorly separated from the gluteal regionby the gluteal fold superficiallyby the inferior margins of the gluteus maximus & quadratus femoris on deeper planes
4 Structures enter and leave the top of the thigh by 3 routes: Posteriorly continuous with the gluteal regionsciatic nerveAnteriorly abdominal cavity via aperture between inguinal ligament & pelvic boneMedially thigh & pelvic cavity communicates via obturator canalVessels and nerves passing between the thighand leg pass through the popliteal fossa posterior to the knee joint.
5 Superficial Fascia of the Thigh Deep Fascia of the Thigh (Fascia Lata) Attached to the deep fascia below the inguinal ligament.Deep Fascia of the Thigh (Fascia Lata)Encloses the thigh like a trouser leg.Saphenous openingA gap in the deep fascia in front of the thigh just below the inguinal ligament.Great saphenous vein via hiatus saphenus drains into femoral vein.Filled with loose connective tissue called the cribriform fascia.
6 Fascial Compartments of the Thigh 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 nervemuscles extend the leg at the knee joint.Medial compartment of thigh Obturator nervemuscles adduct the thigh at the hip joint.Posterior compartment of thigh Sciatic nervemuscles extend the thigh at the hip joint & flex the leg at the knee joint.
8 1. Which muscles are in the anterior part of the thigh? SartoriusOriginASIS & superior part of notch inferior to itfemoral nerveInsertionSuperior part of medial surface of tibia
9 1. Which muscles are in the anterior part of the thigh? Quadriceps femorisRectus femorisVastus lateralisVastus medialisVastus intermediusInsertionbase of patellaindirectly viapatellar ligamentto tibial tuberosityfemoral nerveOriginStraight headAnterior inferior iliac spineReflected headIlium just superior to the acetabulum
10 1. Which muscles are in the anterior part of the thigh? Quadriceps femorisRectus femorisVastus lateralisVastus medialisVastus intermediusInsertionbase of patellaindirectly viapatellar ligamentto tibial tuberosityfemoral nerveGreater trochanterLateral lip of linea asperaIntertrochanteric lineMedial lip of linea asperaAnterior and lateral surfaces of shaft of femur
11 1. Which muscles are in the anterior part of the thigh? Quadriceps femorisRectus femorisVastus lateralisVastus medialisVastus intermediusInsertionbase of patellaindirectly viapatellar ligamentto tibial tuberosityfemoral nerve
12 1. Which muscles are in the anterior part of the thigh? Quadriceps femorisRectus femorisVastus lateralisVastus medialisVastus intermediusInsertionbase of patellaindirectly viapatellar ligamentto tibial tuberosityfemoral nerve
13 functionally continuation of quadriceps femoris tendon Patellar ligamentfunctionally continuation of quadriceps femoris tendonattached above to apex and margins of patellabelow to the tibial tuberosity.Prepatellar bursasubcutaneousanterior to patella.Deep and subcutaneous infrapatellar bursaedeep and subcutaneous sides of the patellar ligament, respectively.Articularis genuspulls the synovial membrane superiorly during extension of the leg.prevents compression of the folds of the membrane between the femur and the patella
14 2…iliopsoas muscleIn 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 majorIlıopsoas
15 ILIOPSOAS 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.
16 Quadriceps femoris 3. Functions of the anterior thigh muscles Extends leg at knee joint.Rectus femoris also steadies hip joint &helps iliopsoas flex thigh.Flexion of thigh at hip jointRectus femorisSartorius
17 Sartorius 3. Functions of the anterior thigh muscles Flexes, abducts, and laterally rotates thighat hip joint.Flexes leg at knee joint (medially rotating leg when knee is flexed).Flexion of thigh at hip jointRectus femorisSartoriusAbduction of thigh at hip jointSartoriusLateral rotation of thigh at hip jointSartorius
18 1. Which muscles are in the medial part of the thigh? 1.Gracilis2. Pectineus3. Adductor longus4. Adductor brevis5. Adductor magnus 6.Obturator externus
19 Lateral rotation of thigh 2. Functions of the medial thigh musclesLateral rotation of thighAdduction of thighFlexion of thighExtension of thighAdductor longusAdductor brevisAdductor magnusAdductor brevisAdductor magnus“adductor part”Adductor magnus“hamstrings part”Obturator externusGracilisAdducts thigh; flexes leg; helps rotate leg mediallyPectineus
20 3. Adductor hiatusA 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.
21 1. Which muscles are in the posterior part of the thigh? Biceps femorisShort headBiceps femorisLong headSemitendinosusSemimembranosus
22 2. Features of hamstring muscles Proximal attachment to ischial tuberositydeep to the gluteus maximus.Distal attachment to the bones of the leg.Thus act on two joints, producinghip joint & knee joint.Innervation by tibial division of the sciatic nerve.
23 1. Which arteries enter the thigh? Femoral artery largest & main artery of lower limbObturator arteryInferior gluteal arteryInferior gluteal arteryObturator arteryFemoral artery
24 2. Femoral artery Distal continuation of external iliac artery. Passes under the inguinal ligament.Enters the femoral trianglemidpoint of the inguinal ligament(midway between ASIS & pubic tubercle).Continues down the thigh in the adductor canal.Becomes popliteal artery behind the knee.
25 3. .. branches of the femoral artery 1. Superficial circumflex iliac artery2. Superficial epigastric artery3. Superficial external pudendal artery4. Deep external pudendal artery5. Profunda femoris arteryLarge and important branchArises from the lateral side of the femoral artery below the inguinal ligament6. Descending genicular artery
26 1 . Which veins are seen in the thigh? Superficial & deep veinsGreat saphenous veinLargest superficial vein in the thighOriginates from a venous arch on the dorsal aspect of the foot.Ascends along the medial side of the lower limb.Passes through the saphenous ring.To connect with the femoral vein in the femoral triangle.
27 2. Other veins in the thigh Femoral veinContinuation of the popliteal vein proximal to the adductor hiatus.Enters the femoral sheathEnds posterior to the inguinal ligament, becomes external iliac veinProfunda Femoris Veindrains into the femoral vein.Obturator Veindrains into the internal iliac vein.
28 1. Major nerves of the thigh 3 major nerves in the thigh, each associated with one of the 3 compartments:Femoral nerveanterior compartment of thighObturator nervemedial compartment of thighSciatic nerveposterior compartment of thigh
29 2. ..femoral nerve (L2-L4) Largest branch of the lumbar plexus. Enters the thigh lateral to the femoral artery and the femoral sheath, behind the inguinal ligament.In the femoral triangle lies on the lateral side of the femoral artery
30 3… obturator nerveEnters the medial compartment of thigh through the obturator canal.Supplies most of the adductor muscles and skin on the medial aspect of the thigh.
31 4… sciatic nerve Descends in the midline of the thigh. Ends by dividing into the tibial and common peroneal nerves.Innervates all muscles in the posterior compartment of thigh and then its branches continue into the leg and foot.
32 5… cutaneous nerves of the thigh Lateral cutaneous nerve of the thighbranch of the lumbar plexus (L2& 3)Medial cutaneous nerve of the thighbranch of the femoral nerveIntermediate cutaneous nerve of the thighPosterior cutaneous nerve of the thighbranch of the sacral plexus
33 1. Femoral triangle Superiorly inguinal ligament Medially lateral border of adductor longusLaterally sartoriusContents; from lateral to medialFemoral nerveFemoral sheathFemoral arteryFemoral veinDeep inguinal lymph nodes
34 2. Femoral sheath A funnel-shaped fascial tube Passes deep to the inguinal ligamentEncloses proximal parts of the femoral vessels and creates the femoral canal medial to them.Formed by an inferior prolongation of transversalis & iliopsoas fasciaSubdivided into three smaller compartmentsLateral compartmentfor the femoral artery.Intermediate compartmentfor the femoral vein.Medial compartmentconstitutes the femoral canal
35 3. femoral canal Smallest of the 3 compartments of the femoral sheath Lies between the medial edge of the femoral sheath and the femoral vein.
36 4. femoral ringUpper opening of the femoral canal formed by the small opening at its abdominal end.BoundariesLaterally vertical septum between femoral canal & femoral vein.Posteriorly superior ramus of the pubis covered by the pectineus muscle and its fascia.Medially lacunar ligament Anteriorly medial part of the inguinal ligament.
37 5. femoral herniaFemoral sheath blends with the tunica adventitia of blood vessels.a potentially weak area in the abdomenThe part of the femoral sheath that forms the medially located femoral canal is not.femoral herniaA protrusion of peritoneum forced down the femoral canal, pushing the femoral septum before it
38 6. ..adductor canalIntermuscular cleft in the middle 1/3 of the thigh beneath the sartorius muscleExtends from the apex of the femoral triangle to the adductor hiatus
39 6. ..adductor canal Contains terminal part of the femoral artery femoral vein (lies behind the artery)deep lymph vesselssaphenous nervenerve to the vastus medialisterminal part of the obturator nerveBoundariesAnteriorly and laterally vastus medialisPosteriorly adductors longus & magnusMedially sartorius, roof of the canal
40 1. Where is popliteal fossa located? An area of transition between the thigh and legMajor route by which structures pass from one region to the other.Formed between muscles in the posterior compartments of thigh and leg.
41 2. What are the boundaries of the popliteal fossa? SuperolaterallyBiceps femorisSuperomediallySemimembranosusInferolaterally and inferomediallyGastrocnemiusPosteriorlySkin & popliteal fascia (roof)
42 3. What are the contents of the popliteal fossa? Termination of the small saphenous veinPopliteal arteries and veins and their branches and tributariesTibial and common fibular nervesPosterior cutaneous nerve of thighPopliteal lymph nodes and lymphatic vessels
43 4. Nerves in the popliteal fossa The sciatic nerve usually ends at the superior angle of the popliteal fossa by dividing intotibial nerve&common fibular nerve
44 4. Nerves in the popliteal fossa tibial nervedescends vertically through the popliteal fossaexits deep to plantaris muscle to enter posterior compartment of leg.common fibular nerveexits by following the medial border of the biceps femoris tendon over the lower lateral margin of the popliteal fossacontinues to the lateral side of the leg where it swings around the neck of the fibula and enters lateral compartment of leg
45 5. Popliteal artery/vein Continuation of the femoral arteryBegins 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.