Lower Limb Anatomy: Hip, Pelvis, and Thigh

What is the Os Coxa?

Ilium, Ischium, and Pubis

What is the largest sesamoid?

The Patella

What separates the lower limb into superiorly + inferiorly

The Linea aspera

How many compartments are in the lower limb

3- Anterior, Medial, and Posterior

Anterior compartment contains:

Vastus lateralis, vastus medialis, vastus intermedius, rectus femoris, femoral artery + vein, nerve to vastus medialis, Saphenous nerve, and Sartorius

Medial compartment contains:

Deep femoral artery + vein, Adductor longus, Adductor brevis, Adductor magnus, and Gracilis

Posterior compartment contains:

Biceps femoris short + long head, Sciatic nerve, Semitendinosus, Semimembranosus

Varicose Veins

Can form anywhere theres a back up in blood but most common in the legs

Venous Stasis and Ulceration

Bulging veins, leg begins to swell, skin and texture changes, venous ulcers. Tissue breakdown due to abnormal blood flow, tissues cant fight infection, tissue then dies

Deep Vein Thrombosis and Pulmonary Embolism

There is a blood clot in the vein (femoral) and that blood clot can travel up towards the lungs and cause pulmonary embolism

Lymphatic Drainage in pelvis

Follow the veins and enters the lumbar lymphatic trunk, enters chyle cistern, thoracic duct and left venous angle

Lower limb lymphedema

Lymph nodes or vessels are not working to drain excess fluids

Dermatome L1

Inguinal region

Dermatome L2

Medial thigh

Dermatome L3

Medial knee

Dermatome L4

Medial malleolus

Dermatome L5

Lateral leg

Dermatome S1

Lateral foot

Dermatome S2

Medial Heel

Dermatome S3-S5

Saddle Sensation

Boundaries of femoral triangle

Inguinal ligament, adductor longus, and sartorius

Upper border of femoral triangle

Inguinal ligament

Lateral border of femoral triangle

Sartorius

Medial border of femoral triangle

Adductor longus

Importance of femoral triangle

NAVEL, can find pulse here

NAVEL

Femoral nerve, artery, vein, empty space, and lymph nodes

Pectineus

Innervated by femoral nerve, does adduct/flex hip and internal rotation of hip

Iliopsoas

Chief hip flexor

Sartorius

Tailor sitting muscle, “FAbER” (Flexor, Abduction, External rotation

Rectus femoris

Crosses hip joint and does not originate on femur and flexes the hip (only one)

Innervates Adductor longus + brevis

Obturator nerve (L3)

Adductor magnus

Anterior head (obturator nerve L3) and Posterior head (tibial part of sciatic nerve L3 L4)

Gracilis

Adduct hip and internal rotate and knee flex

Pes Anserine insertion

Sartorius, Gracilis and Semitendinosus tendon

Obturator externus

Laterally rotate hip

Femoral Nerve (L2, L3, L4)

Largest branch of the lumbar plexus

Saphenous nerve

Branch of femoral nerve, temporarily goes behind the knee then innervates medial lower leg

Femoral artery

After the external iliac artery passes the inguinal ligament

Profunda femoris

Deep artery of the thigh

Adductor Canal

Connects femoral triangle and popliteal fossa

Adductor Canal Border- Anteriorly + Laterally

The Vastus Medialis

Adductor Canal Border- Posteriorly

The Adductors Longus + Magnus

Adductor Canal Border- Medially

The Sartorius

Adductor Hiatus

Allows a window for the Saphenous Nerve + Femoral A+V to go behind the knee into popliteal fossa