Anatomy Lecture 6: Anterior and Medial Compartments of the Thigh

Tensor Fasciae Latae Muscle origin

anterior superior iliac spine (ASIS)

Tensor Fasciae Latae Muscle insertion

iliotibial band

Tensor Fasciae Latae Muscle action

stabilizes IT band

hip/thigh abduction and flexion

Tensor Fasciae Latae Muscle nerve innervation

superior gluteal nerve

The anterior compartment of the thigh is generally innervated by what nerve?

femoral nerve

What muscles make up the anterior compartment of the thigh?

sartorius

quadriceps femoris muscles (4)

iliopsoas

What muscles are the quadriceps femoris?

rectus femoris

vastus lateralis

vastus intermedius

vastus medialis

Sartorius Muscle origin

anterior superior iliac spine (ASIS)

Sartorius Muscle insertion

medial side of proximal tibia

Sartorius Muscle action at the hip/thigh

thigh-

flexion

abduction

lateral rotation

Sartorius Muscle action at the knee/leg

flexion

The Sartorius crosses how many joints?

2 (knee and hip)

The Sartorius is also known as what?

"tailor's muscle"

What are the more superficial quadriceps femoris muscles?

vastus lateralis

rectus femoris

vastus medialis

What muscle is found deep to the rectus femoris?

vastus intermedius

Rectus Femoris muscle origin

anterior inferior iliac spine (AIIS)

Vastus muscles (lateralis, intermedius, medialis) origin

femur

All 4 quadriceps femoris muscles insertion

tibial tuberosity

The quadriceps femoris muscles insert onto the tibial tuberosity via what?

via the quadriceps tendon, patella and patellar ligament

All 4 quadriceps femoris muscles converge to form one tendon called:

quadriceps tendon

What is the continuation of the quadriceps tendon?

patellar ligament/tendon

Rectus Femoris muscle action

hip/thigh flexion

All 4 quadriceps femoris muscles action

knee/leg extension

spans from ASIS to pubic tubercle

Inguinal ligament

Psoas Major + Iliacus =

Iliopsoas

Iliopsoas Muscle origin

lumbar vertebrae

iliac fossa

Iliopsoas Muscle insertion

lesser trochanter

Iliopsoas Muscle action

hip/thigh flexion

The muscles of the medial compartment of the thigh are innervated by what nerve?

obturator nerve

What muscles make up the medial compartment of the thigh?

pectineus

adductor longus

adductor brevis

adductor magnus

gracilis

What are the superficial muscles of the medial compartment?

pectineus

adductor longus

What muscles are deep to the pectineus and adductor longus?

adductor brevis

adductor magnus

Pectineus and Adductor muscles origin

pubic bone

Pectineus and Adductor muscles insertion

medial femur

Pectineus and Adductor muscles action

hip/thigh adduction

The Adductor Hiatus is located where?

opening between the two parts of the adductor magnus

hamstring (Ischiocondylar) part of the adductor magnus

can be added to the hamstring but can only perform 1 of 2 hamstrings functions

Ischiocondylar insertion

adductor tubercle

Ischiocondylar action

hip/thigh extension

CANNOT flex the knee

Gracilis Muscle origin

pubic bone

Gracilis Muscle insertion

medial tibia

Gracilis Muscle action at hip/thigh

adduction

flexion

Gracilis Muscle action at knee/leg

flexion

What is the common insertion of the sartorius, gracilis and semitendinosus muscles into the anteromedial tibia?

Pes Anserinus

The Pes Anserinus is made up of one muscle from each part of the thigh compartment. Name the muscles from each compartment.

anterior = sartorius

medial = gracilis

posterior = semitendinosus

What is the function of the Pes Anserinus?

reinforces the knee joint capsule medially

Femoral Triangle Contents

femoral nerve

femoral sheath

- femoral artery

- femoral vein

- lymphatics

Femoral Triangle Boundaries

inguinal ligament

sartorius muscle (medial border)

adductor longus (medial border)

What is the floor of the femoral triangle?

iliopsoas, pectineus, adductor longus

What covers the femoral nerve, femoral artery, and femoral vein?

skin

superficial fascia

fascia lata

The femoral nerve carries axons from

anterior rami of l2-l4 spinal nerves

Where does the femoral nerve pass?

under the inguinal ligament

Anterior lower limb dermatomes are supplied by what plexus?

lumbar levels

Posterior lower limb dermatomes are supplied by what plexus?

sacral levels

The patella is within what dermatome?

L4 dermatome

The patellar tendon reflex tests what level?

L4

the same nerve that supplies the joint, supply the muscles that act on the joint, and supply the skin superficial to the joint

Hilton's Law

The femoral nerve is in the femoral triangle but not what?

the femoral sheath

The external iliac artery and vein are renamed what as they pass deep to the inguinal ligament?

femoral artery and vein

space within the femoral sheath, medial to the Femoral Vein, normally filled with lymphatic nodes and ductules.

femoral canal

occurs at the femoral canal

an intestinal loop passes under the inguinal ligament and into the thigh

occurs most commonly in females

femoral herniation

Deep Femoral Artery is a branch of the

femoral artery

What are the circumflex femoral arteries?

lateral circumflex femoral artery

medial circumflex femoral artery

passes laterally between rectus femoris and vastus muscles

Lateral circumflex femoral artery

passes posteriorly between iliopsoas and pectineus muscles

Medial circumflex femoral artery

The circumflex arteries come off of what artery?

femoral or deep femoral artery

What does a hip fracture generally refer to?

a fracture of the femoral neck rather than the coxal bones

What arteries supply the femoral head and may be ruptured by a femoral neck fracture?

circumflex femoral arteries

Rupture of the circumflex femoral arteries can cause what?

necrosis (bone death) of the femoral head

Femoral pulse and pressure point

pulse of the femoral artery felt in the groin

Adductor canal is also called what

subsartorial canal

"Hunter's canal"

Where is the adductor canal located?

from the apex of the femoral triangle to the adductor hiatus

The adductor canal is found deep to

sartorius muscle

What descends within the adductor canal?

femoral nerve

femoral artery

femoral vein

What passes through the adductor hiatus?

femoral artery

femoral vein

What does NOT pass through the adductor hiatus?

femoral nerve

The femoral artery and vein exit the adductor canal via the adductor hiatus and enter what?

popliteal fossa

Upon entering the popliteal fossa, the femoral artery and vein are renamed

popliteal artery and vein

The muscles of the medial compartment of the thigh are innervated by the obturator nerve EXCEPT FOR

pectineus

The pectineus muscle is innervated by what nerve?

femoral

Where does the obturator nerve pass through?

obturator foramen

The anterior branch and the posterior branch of the obturator nerve descend where?

on either side of the adductor brevis muscle

The obturator nerve passes deep to the _________ where it splits into anterior and posterior branches

pectineus

The anterior branch of the obturator nerve pops out between these two muscles, separating them

pectineus

adductor brevis

The anterior branch of the obturator nerve separates what two muscles that overlay each other?

adductor longus

adductor brevis

The posterior branch of the obturator nerve runs deep to this muscle

adductor brevis

The posterior branch of the obturator nerve separates what two muscles?

adductor brevis

adductor magnus

longest vein in body;

drains blood from foot, leg, and thigh;

joins with femoral vein

Great saphenous vein

The great saphenous vein runs superficial to what?

fascia lata

What are the cutaneous nerves from the femoral nerve?

anterior and medial cutaneous nerve of the thigh

what nerve supplies the skin on the lateral side of thigh

lateral cutaneous nerve of the thigh

lateral cutanous nerve of the thigh contributes to what dermatomes

l2 and l3

entrapment of the lateral cutaneous nerve where it passes medial to ASIS and inferior to inguinal ligament

symptoms: pain, tingling, numbness on lateral thigh

Meralgia Paresthetica