Cutaneous nerves of the thigh From the lumber plexus: 1- ilio-inguinal nerve (L1) emerge through the superficial inguinal ring distributed to the skin of the root of the penis and adjacent part of the scrotum. 2- Femoral branch of the genitofemoral nerve (L1 L2) enters the thigh behind the middle of the inguinal ligament and on the anterior surface of the femoral artery, it passes through the saphenous opening to supply the skin over the femoral triangle.

3- Lateral cutaneous nerve of the thigh (L2 L3) enters the thigh posterior to the lateral part of the inguinal ligament divided in to 2 branches anterior one supply the anterolateral part of the thigh and posterior one supply the posterolateral part of the thigh.

From the femoral nerve Anterior cutaneous nerve of the thigh (L2 L3) descend over the quadriceps muscle, they divided into medial cutaneous nerves supply the distal 2/3 of the anteromedial surface of the thigh and upper part of the medial surface of the leg. Intermediate cutaneous nerves of the thigh divided into 2 nerves supply the distal 3/4 of the anterior aspect of the thigh and joins the patellar plexus.

From the obturater nerve Occasional branch to the medial side of the thigh. Patellar plexus lies in the front of the knee in the subcutaneous tissues over the patella, it is formed from the terminal branches of the lateral, intermediate and medial cutaneous nerves of the thigh and the infrapatellar branch of the saphenous nerve.

Inguinal ligament It is the lower free border of the aponeurosis of the external oblique muscle of the abdomen. It extends from the pubic tubercle medially to the anterior superior iliac spine laterally. Fascia lata attached to the external surface of the ligament making it convex inferiorly. Lateral to the pubic tubercle the deep surface of the inguinal ligament extends posteriorly to be attached to the pectin pubis forming the lacunar ligament.

Inguinal ligament

Femoral triangle Occupy the upper third of the thigh. Boundaries: Superiorly(base): the inguinal ligament. Medially: the medial border of the adductor longus muscle. Laterally: medial border of the sartorious muscle. Inferiorly (apex): continuous with the adductor canal.

Boundaries of the femoral triangle

The anterior wall of the triangle: composed of the skin and the fascia The anterior wall of the triangle: composed of the skin and the fascia. In the superficial fascia there are the following structures: 1- The upper part of the great saphenous vein. 2- Superficial inguinal lymph nodes and vessels. 3- Femoral branch of the genitofemoral nerve. 4- Superficial branches of the femoral vessels. 5- Branches of the ilioinguinal nerve.

The posterior wall (the floor): composed of muscles, from medial to lateral: pectineus, adductor longus, psoas major and iliacus muscles ( iliopsoas ).

Contents of the triangle 1- Femoral vessels 2- Profunda femoris vessel. 3- Lateral and medial circumflex vessels. 4- Deep external pudendal artery 5- 3-4 deep inguinal lymph nodes 6- Femoral branch of the genitofemoral nerve 7- Lateral cutaneous nerve of the thigh 8- Femoral nerve

Contents of the triangle

Femoral nerve (L2,3,4) arise from the lumber plexus in the abdomen descend in groove between psoas and iliacus muscles, and enter the thigh posterior to the inguinal ligament and lateral to the femoral sheath. 2cm below the inguinal ligament it ends by dividing into anterior and posterior branches.

The anterior division gives: a- muscular branches to pectineus and sartorious muscles. b- Cutaneous nerves includes the anterior cutaneous nerve of the thigh.

The posterior division gives: a- saphenous nerve runs downwards and medially crosses the femoral artery from its lateral to its medial side. It emerges on the medial side of the knee between the tendons of sartorius and gracilis muscles then run down the medial side of the leg in accompany with the great saphenous vein, it passes in front of the medial border of the foot it terminates in the region of the ball of the big toe.

b- Muscular branches to the quadriceps femoris muscle (rectus femoris, vastus lateralis, medialis and intermedius(.

Femoral nerve

The adductor canal It is an intermuscular canal situated on the medial aspect of the middle of the thigh beneath the sartorius m. it conducts the femoral vessels through the middle 1/3 of the thigh, it begins about 15cm below the inguinal ligament at the apex of the femoral triangle and ends at the upper limit of the adductor hiatus.

Boundaries of the adductor canal Sartorius muscle anteromedially Vastus medialis muscle anterolaterally Adductor longus and magnus posteromedially

The contents of the adductor canal are: The femoral vessels. Saphenous nerve. Nerve to vastus medialis.

Contents of the adductor canal