Anterior Thigh

iliotibial tract

A special thickened region of the fascia lata on the lateral side of the thigh

b. Runs from iliac tubercle to anterolateral tibial tubercle

c. Aponeurosis of the tensor fasciae latae and gluteus maximus muscles

Femoral triangle and adductor canal

Inverted triangle in proximal region of anterior thigh

Borders of Femoral Triangle

Superior border - inguinal ligament

Medial border - adductor longus muscle

Lateral border - sartorius

Floor

a. Lateral portion - iliopsoas

b. Medial portion - pectineus

 Roof - fascia lata

Contents of Femoral Triangle

Femoral Nerve

Femoral Artery

Femoral Vein

Adductor Canal

Runs from the apex of the femoral triangle to the adductor hiatus

Deep to the sartorius muscle

Anterior Thigh Compartment Muscles

1. Pectineus

2. Sartorius

3. iliopsoas

4. Quadriceps Femoris

Pectineus

O- Superior ramus of pubis

Ins- pectineal line of femur, just inferior to lesser trochanter

Inn- Femoral Nerve

A- Hip ADduction

Hip flexion

Medial Rotation

Sartorius

Most superficial muscle in compartment

O- anterior superior iliac spine and superior part of notch inferior to it

Ins- superior part of medial surface of tibia

Inn- femoral nerve

A- Hip ADduction

Hip Flexion

Laterally rotates hip

Knee Flexion

Iliopsoas

Psoas major

iliacus

Psoas Major

O-sides of T12–L5 vertebrae and discs between them; transverse processes of all lumbar vertebrae

Ins- lesser trochanter of femur

Inn- anterior rami of lumbar nerves

A- Acting with iliacus flexes hip joint

Iliacus

O- Iliac crest, iliac fossa, ala of sacrum, and anterior sacroiliac ligaments

Ins- tendon of psoas major, lesser trochanter, and femur distal to it

Inn- Femoral nerve

A- Acting with psoas major flexes hip joint

Quadriceps Femoris

1. Rectus Femoris

2. Vastus Lateralis

3. Vastus Medialis

4. Vastus Intermedius

Rectus Femoris

O- anterior inferior iliac spine and reflected head is on the ilium superior to acetabulum

Ins- - quadriceps tendon, patella, patellar tendon to the tibial tuberosity

Inn- Femoral Nerve

A- Hip Flexion, Knee extension

Vastus Lateralis

Largest of the Vasti Group

O- greater trochanter and lateral lip of linea aspera

Ins- quadriceps tendon, patella, patellar tendon to the tibial tuberosity. Also attach to tibia and patella via aponeuroses

Inn- Femoral Nerve

A- Knee extension

Vastus Medialis

O- intertrochanteric line and medial lip of linea aspera

Ins- quadriceps tendon, patella, patellar tendon to the tibial tuberosity. Also

attaches to tibia and patella via aponeuroses

Inn-  Femoral Nerve

A- Vastus medialis longus - extends the knee

   Vastus medialis obliquus - dynamic medial stabilizer of the patella

Vastus Intermedius

O- anterior and lateral surfaces of shaft of femur

Ins- - quadriceps tendon, patella, patellar tendon to the tibial tuberosity

Inn- Femoral Nerve

A- Knee extension

Greater saphenous vein

Superficial vein draining the medial side of the lower extremity

2. Drains into the femoral vein reaching it through the saphenous opening in the

fascia lata

3. Saphenous opening is found inferior to the inguinal ligament

4. Following the saphenous vein into the saphenous opening will take you to the

femoral triangle region - contains the femoral nerve, artery, and vein

Lesser saphenous vein

Superficial vein draining the lateral side of the leg

Drains into the popliteal vein

Femoral artery

Primary blood supply for the lower extremity

2. It is a continuation of the external iliac artery. Called the femoral artery once

reaches inferior border of inguinal ligament

3. Runs through the thigh, between the anterior and medial compartments in the

adductor canal deep to the sartorius muscle. It enters the adductor hiatus in the

distal medial thigh to become the popliteal artery

4. Branches of interest to us are the profunda femoral artery

and the medial and lateral femoral circumflex arteries which usually arise from

the profunda femoral artery

Profunda femoral artery

Major branch from femoral artery

2. Typically arising in the distal femoral triangle region

3. Provides blood supply to the posterior, lateral, and medial aspects of the thigh

Lateral femoral circumflex artery

Branches of the profunda femoral artery shortly after the profunda femoral

artery branches off the femoral artery

2. Gives rise to 3 branches

a. Ascending branch - passes deep to the tensor fasciae latae muscle to

anastomose with the superior gluteal artery

b. Transverse branch - will wrap posteriorly to anastomose with the

medial femoral circumflex artery

c. Descending branch - key branch supplying the lateral portion of the

anterior compartment

Medial femoral circumflex artery

Branches of the profunda femoral artery shortly after the profunda femoral

artery branches off the femoral artery

2. Will wrap around and anastomose with the transverse branch of the lateral

femoral artery - these form the important collateral circulation around the hip

joint

Dermatomes

Dermatomes are the location of sensory distribution based on spinal nerves

2. Like upper extremity, the lower extremity has dermatomes as well. Also like the upper extremity, you can expect variability in the different dermatomes “maps” that you will find in published materials.

Peripheral sensory nerves

Femoral nerve - anteromedial thigh

2. Sural nerve - proximal 2/3s lateral leg

3. Saphenous nerve

a. Sensory branch of femoral nerve

b. Medial leg

c. Inferior patellar region - often numb after surgeries involving the

patellar tendon

4. Superficial fibular nerve - distal lateral 3rd of leg and dorsum of foot

5. Deep fibular nerve - web space between 1st and 2nd toe

6. Medial plantar nerve - medial plantar surface of foot

7. Lateral plantar never - lateral plantar surface of foot

Nerves in the anterior thigh

Femoral nerve