THIGH AND POPLITEAL FOSSA DR TAHIR HUSSAIN

OBJECTIVES Study the arrangement of the muscles of each compartment of the thigh and give their actions and nerve supply. Describe femoral triangle, adductor canal and popliteal fossa. Identify nerve supply, actions and fascia covering psoas major muscle. Define femoral sheath, femoral canal and femoral ring. List the contents of the femoral sheath and femoral canal. Explain the clinical importance of the femoral canal and femoral ring.

COMPARTMENT OF THE THIGH

MUSCLES OF ANTERIOR COMPARTMENT Tensor fascia lata Sartorius Quadriceps femoris –Rectus femoris –Vastus lateralis –Vastus medialis –Vastus intermedius Articularis genus

MUSCLES OF ANTERIOR COMPARTMENT NERVE SUPPLY Femoral nerve Except Tensor fascia lata which is supplied by the superior gluteal nerve

MUSCLES OF ANTERIOR COMPARTMENT ACTION MUSCLEACTION Tensor fascia lata Med. Rotation of thigh Abduction of thigh Sartorius Flexion & med. Rotation of leg Flexion & lat. Rotation of thigh Rectus femoris Extension of leg Flexion of thigh Vastus lateralis Extension of leg Vastus medialis Extension of leg Vastus intermedius Extension of leg Articularis genus Pulls up the synovial mem. Of knee joit

MUSCLES OF MEDIAL COMPARTMENT Pectineus Adductor longus Adductor brevis Adductor magnus Gracilis AM

MUSCLES OF MEDIAL COMPARTMENT NERVE SUPPLY Obturator nerve But Pectineus is also supplied by the femoral N & Hamstring part of adductor magnus is supplied by the tibial part of sciatic N

MUSCLES OF MEDIAL COMPARTMENT ACTION Adduction of thigh But Pectineus also causes flexion of thigh & Hamstring part of adductor magnus also causes extension of thigh & Gracilis also causes flexion and med. Rotation of leg

MUSCLES OF POSTERIOR COMPARTMENT Semimemranosus Semitendinosus Biceps femoris –Long head –Short head BF

MUSCLES OF POSTERIOR COMPARTMENT NERVE SUPPLY Sciatic N (Tibial part) Except short head of biceps femoris which is supplied by common peroneal part

MUSCLES OF POSTERIOR COMPARTMENT ACTION 1. Flexion of leg 2. Rotation of leg 1. 2 semi muscles: Medial rotation 2. Biceps femoris: Lateral rotation 3. Extension of thigh

MUSCLES OF ILIAC REGION ILACUS –N. supply: Femoral N –Action: Flexion of thigh PSOAS MAJOR –N. supply: from lumber plexus –Action: Flexion of thigh PM Iliacus

FEMORAL TRIANGLE LOCATION: Upper 1/3 rd of front of thigh SHAPE: Triangular BOUNDARIES –Lateral: Med. Border of sartorius –Medial: Med. Bor. of add. longus –Base: Inguinal ligament

FEMORAL TRIANGLE FLOOR From med. To lat. Side 1.Adductor longus 2.Pectineus 3.Psoas major 4.Iliacus

FEMORAL TRIANGLE CONTENTS Femoral sheath Femoral A & its branches Femoral V & its tributaries Femoral N & its branches Femoral br. Of genitofemoral N Deep inguinal lymph nodes

FEMORAL TRIANGLE CONTENTS

FEMORAL SHEATH LOCATION SHAPE FORMATION WALLS –Ant: Fascia trnsversalis –Post: Fascia iliaca

FEMORAL SHEATH COMPARTMENTS: 3 –Lateral –Intermediate –Medial CONTENTS –Lateral C: Femoral A & femoral br. Of genitofemoral N –Intermediate: Femoral V –Medial: is femoral canal

FEMORAL SHEATH CONTENTS

FEMORAL CANAL Medial compartment of femoral sheath 1.25 cm, wider in females Contents: L. node of Cloquet (Rossenmuller), drains from glans penis or from clitoris. Otherwise empty Purpose –Provides a dead space for the femoral V to dilate in times of increased blood flow –Provide a route for the efferent lymphatics from deep inguinal L.Ns to pass to abdomen

GLANS PENIS L. NODE OF CLOQUET

FEMORAL RING The upper opening (mouth) of the femoral canal SIZE: 1.25 cm RELATIONS –Ant. Inguinal lig. –Post. Pectineus –Lateral: Femoral V –Med. Lacunar lig. CLINICAL IMPORTANCE OF THE FEMORAL CANAL AND FEMORAL RING: Femoral hernia

FEMORAL CANAL RELATIONS

FEMPRAL HERNIA

ADDUCTOR CANAL OTHER NAMES –HUNTER’S CANAL –Subsartorius canal LOCATION –Middle 1/3 rd of med. Side of thigh EXTENT –From apex of femoral ∆ to opening in AM

ADDUCTOR CANAL BOUNDARIES –Anteriolateral: Vastus medialis –Posterior: Adductor longus & magnus –Roof: Fascial sheath under sartorius CONTENTS –Femoral A –Femoral V –Ant. & post. Divisions of obturator N –Saphenous N –N. to vastus medialis

POPLITEAL FOSSA LOCATION: Behind the knee J SHAPE: Diamond shaped BOUNDARIES: –Superiolateral: BF –Superiomedial:SM+ST –Inferiolateral: GN lat.head+Pl. –Inferiomedial: GN med.head

POPLITEAL FOSSA CONTENTS Popliteal A & its branches Popliteal V & its tributaries Tibial N & its branches Common peroneal N & its br. Popliteal lymph nodes

THE END ANY QUESTIONS THANKS