15- Anterior & Medial Thigh

head of femur

fovea of femur

neck of femur

greater trochanter of femur

lesser trochanter of femur

intertrochanteric line

intertrochanteric crest

quadrate tubercle of femur

linea aspera of femur

pectineal line of femur

medial lip of linea aspera

medial supracondylar line of femur

gluteal tuberosity of femur

lateral lip of linea aspera

lateral supracondylar line of femur

medial condyle of femur

medial epicondyle of femur

adductor tubercle of femur

tibial articular surface of femur

lateral condyle of femur

lateral epicondyle of femur

tibial articular surface

intercondylar fossa of femur

patellar articular surface of femur

superficial fascia of hip and thigh

-continuous with fascia from the inferior part of the anterolateral abdominal wall and buttocks

-loses its fat anteriorly and laterally and blends with the deep fascia

fascia lata

-limits outward extension of contracting muscles-->compresses veins to push blood towards the heart and make muscular contractions more efficient

anterior, medial, posterior

3 fascial compartments of the fascia lata

intermuscular septa

-attach to linea aspera on posterior femur

-lateral is strongest and continuous with fascia lata

saphenous opening

-gap in the fascia lata inferior to the medial part of the inguinal ligament

-great saphenous vein and lymphatic vessels pass through to enter femoral vein

great saphenous vein and lymphatic vessels

What is in the saphenous opening?

cribiform fascia

localized membrane layer of subcutaneous tissue that encloses the saphenous opening

crural fascia

-deep fascia

-continuous with fascia lata and attaches to anterior and medial borders of tibia and periosteum

-thick in proximal part of anterior aspect of leg--> forms part of proximal attachments of underlying muscle

extensor retinaculum

contains tendons as they descend along the anterior tibia into the ankle/foot

anterior and posterior intermuscular septa

-pass from deep surface of crural fascia

anterior, posterior, lateral

3 fascial compartments of the lower leg

transverse intermuscular septum

divides plantarflexor muscles in the posterior compartment into superficial and deep

great saphenous vein

-in subcutaneous tissue

-numerous valves

-formed by union of dorsal digital vein of the great toe and dorsal venous arch of the foot

-ascends anterior to medial malleolus

-passes posterior to medial femoral condyle

-traverses saphenous opening in fascia lata

-drains into femoral vein

union of dorsal digital vein of great toe and dorsal venous arch of the foot

What is the great saphenous vein formed by?

femoral vein

What does the great saphenous vein drain into?

small saphenous vein

-in subcutaneous tissue

-ascends posterior to lateral malleolus

-passes along lateral border of Achilles tendon

-Inclines to midline of fibula and penetrates deep fascia

-Ascends b/w Gastroc heads

arises on lateral side of foot from the union of dorsal digital vein of 5th digit with dorsal venous arch

What forms the small saphenous vein?

popliteal vein

What does the small saphenous vein drain into?

perforating veins

-pass between superficial and deep veins

-contain valves that allow blood to flow only from superficial and deep veins

-penetrate deep fascia at oblique angles

-prevents blood from flowing from deep to superficial veins

deep veins

-accompany major arteries and their branches

-contained within a vascular sheath with the artery whose pulsations help compress and move blood in the veins

popliteal vein

Where do deep veins from the leg drain?

joins terminal portion of femoral vein to become external iliac vein

What does the Profunda Femoris vein become?

external iliac vein

femoral artery

-main blood supply to the lower limb

-enters femoral triangle, continues through anterior compartment of thigh and passes through adductor hiatus to popliteal region

femoral artery

What does the external iliac artery become?

profunda femoris artery

supplies posterior and lateral thigh

adductor hiatus

When does the femoral artery become the popliteal artery?

anterior and posterior tibial arteries

What does the popliteal artery branch into?

posterior tibial artery

-courses through deep posterior compartment posterior to medial malleolus

medial and lateral plantar arteries

What are the branches of the posterior tibial artery?

dorsalis pedis artery

What does the anterior tibial artery branch into?

obturator artery

-supplies medial compartment of thigh

-arises from internal iliac artery

-passes through obturator foramen to medial compartment of thigh-->divides into anterior and posterior branches

-supplies obturator externus, pectineus, adductors, gracilis

-posterior branch gives off acetabular branch that supplies femoral head

medial circumflex femoral artery

-branch of the femoral artery

-passes between iliopsoas and pectineus to posterior femoral head and neck (anterior to quadratus femoris muscle)

lateral circumflex femoral artery

-branch of the femoral artery

-passes laterally across joint capsule to supply muscles on the lateral thigh

lateral cutaneous branch of subcostal nerve

-T12

-anterolateral hip

-#16

lateral femoral cutaneous nerve

-L2, L3

-anterolateral thigh

genitofemoral nerve

-L1, L2

-proximal anterior thigh inferior to inguinal ligament

cutaneous branch of obturator nerve

-L2, L3, L4

-proximal medial thigh

-L

anterior cutaneous branch of femoral nerve

-L2, L3, L4

-anterior thigh and distal medial thigh

-#1

ventral rami

-L1, L2, L3

-Psoas Major

-Motor

femoral nerve

-L2, L3, L4

-Iliacus, sartorius, rectus femoris, vastus lateralis, vastus medialis, pectineus (with obturator)

-motor

obturator nerve (motor)

-L2, L3, L4

-obturator externus, adductor longus, adductor brevis, gracilis, adductor magnus (with sciatic), pectineus (with femoral)

saphenous nerve

-Supplies impulses to the skin of the inner side of the leg and foot

-branch of the femoral nerve

psoas major

transverse processes L1-L5, vertebral bodies and intervertebral discs T12-L5

Origin of psoas major

lesser trochanter of femur

Insertion of psoas major

hip flexion, trunk flexion

Action of psoas major

anterior rami L1, L2, L3

Innervation of psoas major

psoas minor

assists with trunk flexion

Action of psoas minor

vertebral bodies and intervertebral discs T12-L1

Origin of psoas minor

iliopectineal eminence and pecten pubis

Insertion of psoas minor

anterior rami L1

Innervation of psoas minor

true

t/f psoas minor may be absent in some individuals

iliacus

hip flexion, trunk flexion

Action of iliacus

iliac crest, superior 2/3 of iliac fossa, ala of sacrum, anterior sacroiliac ligaments

Origin of iliacus

lesser trochanter of femur via tendon of psoas major

Insertion of iliacus

femoral nerve (L2, L3)

Innervation of iliacus

pectineus

bridges gap between anterior and medial compartments

hip adduction and flexion

Action of pectineus

superior pubic ramus

Origin of pectineus

pectineal line of femur

Insertion of pectineus

femoral nerve (L2, L3, L4); may also receive branches from obturator nerve

Innervation of pectineus

sartorius

longest muscle in the body

hip flexion, abduction, and external rotation; knee flexion and internal rotation

Action of sartorius

ASIS

Origin of sartorius

medial aspect of proximal tibia

Insertion of sartorius

femoral nerve (L2, L3)

Innervation of sartorius

rectus femoris, vastus lateralis, vastus medialis, vastus intermedius

What are the four quadriceps muscles?

rectus femoris

hip flexion, knee extension

Action of rectus femoris

ASIS and supra-acetabular groove of ilium

Origin of rectus femoris

tibial tuberosity via quadriceps tendon and patellar ligament

Insertion of rectus femoris

femoral nerve (L2, L3)

Innervation of rectus femoris

vastus lateralis