Anatomy of the Thigh: Fascia and Innervation

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Questions and Answers

What structures are contained within the femoral canal?

Only lymph vessels

Lymph vessels, nodes, loose connective tissue, and fat (correct)

Muscles and nerves

Blood vessels and organs

What is the primary function of the quadriceps femoris?

Medial rotation of the thigh

Extension of the leg at the knee joint (correct)

Flexion of the hip joint

Adduction of the thigh

How does the iliopsoas muscle contribute to thigh movement?

Abduction of the thigh

Flexion of the thigh (correct)

Extension of the thigh

Medial rotation of the thigh

Which muscle does NOT contribute to the adductor muscle group?

Rectus femoris Signup and view all the answers

Where does the adductor canal terminate?

At the adductor hiatus Signup and view all the answers

What is a consequence of a femoral hernia?

Protrusion of abdominal viscera through the femoral ring Signup and view all the answers

Which nerve is responsible for innervating the gracilis muscle?

Obturator nerve Signup and view all the answers

Which of the following is NOT a muscle that composes the quadriceps femoris?

Gracilis Signup and view all the answers

Which of the following arteries is NOT a branch of the femoral artery?

Anterior tibial artery Signup and view all the answers

The adductor muscle group primarily functions in which of the following movements?

Hip adduction Signup and view all the answers

Which structures are contained within the femoral canal?

Lymph vessels Signup and view all the answers

What is the primary function of the iliopsoas muscle?

Flexion of the hip Signup and view all the answers

Which nerve innervates the iliopsoas muscle?

Femoral nerve Signup and view all the answers

What is a potential risk associated with a femoral hernia?

Entrapment of femoral vessels Signup and view all the answers

Which statement correctly describes a femoral hernia?

It is characterized by protrusion through the femoral canal. Signup and view all the answers

The medial wall of the femoral sheath is primarily formed by which fascia?

Iliac fascia Signup and view all the answers

The tensor fascia lata is primarily attached to which structure?

Iliotibial tract Signup and view all the answers

Where can femoral pulsations be palpated?

2-3 cm inferior to the midpoint of the inguinal ligament Signup and view all the answers

What is the main function of the tensor fascia lata muscle?

Abducts and flexes the thigh Signup and view all the answers

Which nerve innervates the rectus femoris muscle?

Femoral nerve Signup and view all the answers

What is the primary origin of the iliopsoas muscle?

Transverse processes of T12-L5 vertebrae Signup and view all the answers

Which muscle is considered the longest and most superficial in the anterior thigh?

Sartorius Signup and view all the answers

What anatomical structure forms the lateral boundary of the femoral canal?

Femoral vein Signup and view all the answers

What branches from the deep femoral artery contribute to the arterial supply of the femur?

Medial and lateral circumflex femoral arteries. Signup and view all the answers

What is the origin of the gracilis muscle?

Body and inferior ramus of pubis Signup and view all the answers

What describes the pathway of the femoral nerve as it descends through the pelvis?

It descends posterolaterally to the midpoint of the inguinal ligament. Signup and view all the answers

What does the saphenous nerve do as it travels down the leg?

It pierces the deep fascia on the medial side of the knee. Signup and view all the answers

What is the primary function of the adductor magnus muscle?

Adducts and extends the thigh Signup and view all the answers

Which nerve innervates the pectineus muscle?

Femoral and obturator nerves Signup and view all the answers

Where does the great saphenous vein drain into the circulatory system?

Into the femoral vein at the saphenous opening. Signup and view all the answers

Which statement describes the adductor canal?

It is located deep to the sartorius muscle. Signup and view all the answers

What is the insertion point of the adductor longus muscle?

Middle third of the linea aspera of the femur Signup and view all the answers

What is the main role of the deep femoral artery in the thigh?

It is the chief artery of the femur. Signup and view all the answers

What is the primary role of the tensor fascia lata in relation to the iliotibial tract?

It pulls on the iliotibial tract. Signup and view all the answers

Which of the following describes the saphenous opening?

It is a gap in the fascia lata inferior to the inguinal ligament. Signup and view all the answers

What structures can be found in the femoral triangle?

The femoral vessels, nerve, and inguinal lymph nodes. Signup and view all the answers

Which statement correctly describes the fascia lata?

It is a strong, dense layer that spans from the iliac crest to the tibia. Signup and view all the answers

The great saphenous vein pierces which part of the femoral sheath?

Medial wall. Signup and view all the answers

What is the function of the femoral sheath?

To provide a passage for the femoral vessels. Signup and view all the answers

Which muscle is NOT part of the floor of the femoral triangle?

Rectus femoris. Signup and view all the answers

Which of the following nerves is involved in the cutaneous innervation of the thigh?

Obturator nerve. Signup and view all the answers

Study Notes

Fascia of the Thigh

Superficial fascia contains a significant amount of fat and superficial vessels
Deep Fascia/Fascia lata is a tough, dense layer between the tubercle of the iliac crest and the tibia
The iliotibial tract is the strongest part of the fascia lata between the tubercle of the iliac crest and the tibia, where the tensor fascia lata and gluteus maximus attach to it
Tensor fascia lata pulls on the iliotibial tract
A gap in the fascia lata, just below the inguinal ligament, is the saphenous opening (fossa ovalis)
The sickle-shaped edge of the saphenous opening is called the "falciform margin"
The saphenous opening is covered by a sieve-like layer called the "cribriform fascia"

Cutaneous Innervation of the Thigh

Ilioinguinal nerve
Femoral branch of genitofemoral nerve
Subcostal nerve
Obturator nerve
Anterior cutaneous branch of femoral nerve and its medial branches
Lateral femoral cutaneous nerve

Femoral Triangle

Located in the superomedial part of the thigh
Contains the femoral vessels, femoral nerve, and inguinal lymph nodes
Boundaries:
- Superior: inguinal ligament
- Medial: medial border of the adductor longus muscle
- Lateral: medial border of the sartorius muscle
- Floor: medial part: adductor longus and pectineus muscles, lateral part: iliopsoas muscle.
- Roof: skin and fascia
The femoral pulsations can be easily felt 2-3 cm below the midpoint of the inguinal ligament
Contains:
- Femoral Vein
- Femoral Artery:
  - Superficial epigastric artery
  - Superficial iliac circumflex artery
  - Superficial and deep external pudendal arteries
  - Deep femoral artery
  - Medial circumflex femoral artery
  - Lateral circumflex femoral artery
- Femoral Nerve
- Saphenous Nerve
- Superficial and deep inguinal lymph nodes

Femoral Sheath

A funnel-shaped fascial tube (transversalis fascia anteriorly, iliac fascia posteriorly)
Covered by the fascia latae
Contains the femoral vessels - femoral canal
Ends 4 cm below the inguinal ligament
Medial wall of the femoral sheath is pierced by the great saphenous vein and lymphatic vessels
Divided into three compartments by two vertical septa:
- Lateral compartment: femoral artery
- Intermediate compartment: femoral vein
- Medial compartment: femoral canal

Femoral Canal

Short, conical canal
Contains a few lymph vessels, nodes, loose connective tissue and fat
Extends distally and ends about 4 cm below the the inguinal ligament
The small abdominal opening of the femoral canal is known as the Femoral Ring
- Boundaries:
  - Lateral: femoral vein
  - Posterior: pectineus muscle
  - Medial: lacunar ligament, conjoint tendon
  - Anterior: inguinal ligament and spermatic cord

Femoral Hernia

A protrusion of abdominal viscera through the femoral ring into the femoral canal

Anterior Thigh Muscles

Iliopsoas muscle: consists of the psoas major and iliacus muscles

Psoas Major Muscle

Origin: Transverse processes of vertebral bodies and intervertebral discs of T12-L5
Insertion: Lesser trochanter of femur via iliopsoas tendon
Nerve: Femoral nerve
Function: Acts together with the iliacus muscle to flex the thigh

Iliacus Muscle

Origin: Iliac crest, iliac fossa, ala of sacrum
Insertion: Lesser trochanter
Function: Flexes the thigh, assisting the psoas major.
Nerve: Femoral nerve

Psoas Minor Muscle

Origin: T12-L1 intervertebral discs
Insertion: Pecten pubis, iliopubic eminence, and lateral side of iliac fascia
Function: Minimally flexes trunk
Nerve: L1

Tensor Fascia Lata Muscle

Origin: Anterior superior iliac spine
Insertion: Iliotibial tract
Function: Abducts and flexes thigh, helps to keep the knee extended in an upright position
Nerve: Superior gluteal nerve

Sartorius Muscle

The longest and most superficial thigh muscle
Covers the femoral artery
Origin: Anterior superior iliac spine
Insertion: Superior part of the medial surface of the tibia
Function: Flexes thigh and leg, abducts thigh and rotates it laterally
Nerve: Femoral nerve

Quadriceps Femoris Muscle

Consists of:
- Rectus Femoris
- Vastus Medialis
- Vastus Lateralis
- Vastus Intermedius
Origin: Rectus femoris: anterior inferior iliac spine and groove above the acetabulum; 3 vasti arise from the body of the femur
Insertion: Attach to the base of the patella and the tibial tuberosity, with a common tendon that continues inferiorly as the patellar ligament
Function: Extends leg at the knee joint
Nerve: Femoral nerve

Medial Thigh Muscles

Gracilis
Pectineus
Adductor Longus
Adductor Brevis
Adductor Magnus

Gracilis Muscle

Long strap-like muscle
The most superficial of the adductor group
Crosses the knee joint
Origin: Body and inferior ramus of pubis
Insertion: Superior part of the medial surface of the tibia
Function: Adducts thigh and flexes leg
Nerve: Obturator nerve

Pectineus Muscle

Small muscle on the floor of the femoral triangle
Origin: Pectineal line of pubis
Insertion: Pectineal line of femur
Function: Adducts and flexes thigh
Nerve: Femoral and obturator nerve

Adductor Longus Muscle

Anterior part of the adductor group muscles
Origin: Anterior surface of the body of pubis
Insertion: Middle third of the linea aspera of the femur
Function: Adducts and flexes the thigh
Nerve: Obturator nerve

Adductor Brevis Muscle

Origin: Body and inferior ramus of pubis
Insertion: Pectineal line and proximal part of the linea aspera of the femur
Function: Adducts thigh
Nerve: Obturator nerve

Adductor Magnus Muscle

Largest of the adductors
Origin: Inferior ramus of pubis, ramus of ischium, and ischial tuberosity
Insertion: Gluteal tuberosity, linea aspera, medial supracondylar line, and adductor tubercle of femur
Function: Adducts and extends thigh
Nerve: Anterior: Obturator nerve Posterior: Tibial nerve

Adductor Canal (Subsartorial Canal OR Hunter’s Canal)

A narrow fascial tunnel by an intermuscular cleft deep to the sartorius muscle
Middle third of the medial part of the thigh
Contains the femoral vessels as they pass to reach the popliteal fossa
Ends at the adductor hiatus; tendinous opening of the adductor magnus muscle
Contents:
- Femoral vessels: vein lies posterior to the artery

Fascia of the Thigh

Superficial fascia contains fat and superficial blood vessels
Deep fascia (fascia lata) is a strong, dense, broad layer connecting the iliac crest to the tibia
The iliotibial tract is the strongest part of the fascia lata, connecting the iliac crest to the tibia and providing attachment for the tensor fascia lata and gluteus maximus muscles

Saphenous Opening

A gap in the fascia lata, inferior to the inguinal ligament, known as the saphenous opening
The margin of this opening is called the "falciform margin"
The saphenous opening is covered by "cribriform fascia"

Cutaneous Innervation

The thigh is innervated by the ilioinguinal nerve, femoral branch of the genitofemoral nerve, subcostal nerve, obturator nerve, anterior cutaneous branch of the femoral nerve, and lateral femoral cutaneous nerve

Femoral Triangle

Located in the superomedial part of the thigh and contains the femoral vessels, femoral nerve, and inguinal lymph nodes
The boundaries are:
- Superior: Inguinal ligament
- Medial: Medial border of the adductor longus muscle
- Lateral: Medial border of the sartorius muscle
The floor is formed by the adductor longus and pectineus muscles (medial) and the iliopsoas muscle (lateral)
The roof is made up of skin and fascia
The femoral pulsations can be palpated 2-3 cm below the midpoint of the inguinal ligament

Femoral Triangle Contents

Femoral vein
Femoral artery, which has several branches:
- Superficial epigastric artery
- Superficial iliac circumflex artery
- Superficial and deep external pudendal arteries
- Deep femoral artery
- Medial circumflex femoral artery
- Lateral circumflex femoral artery
Femoral nerve
Saphenous nerve
Superficial and deep inguinal lymph nodes

Femoral Sheath

A funnel-shaped fascial tube made of transversalis fascia (anteriorly) and iliac fascia (posteriorly)
Covered by the fascia lata and contains the femoral vessels and femoral canal
Extends 4 cm inferior to the inguinal ligament
The medial wall of the femoral sheath is pierced by the great saphenous vein and lymph vessels
Subdivided by two vertical septa:
- Lateral compartment: For the femoral artery
- Intermediate compartment: For the femoral vein
- Medial compartment: Called the femoral canal

Femoral Canal

A short, conical canal that contains lymph vessels, nodes, connective tissue, and fat
Extends distally and ends about 4 cm inferior to the inguinal ligament
The small abdominal opening of the femoral canal is called the femoral ring

Femoral Ring Boundaries

Lateral: Femoral vein
Posterior: Pectineus muscle
Medial: Lacunar ligament, conjoint tendon
Anterior: Inguinal ligament and spermatic cord

Femoral Hernia

A protrusion of abdominal viscera through the femoral ring into the femoral canal

Anterior Thigh Muscles

Iliopsoas muscle, consisting of the psoas major and iliacus muscles
Tensor fascia lata muscle
Sartorius muscle
Quadriceps femoris muscle, composed of:
- Rectus femoris
- Vastus medialis
- Vastus lateralis
- Vastus intermedius

Iliopsoas Muscle

Psoas major muscle origin: Transverse processes of vertebral bodies and intervertebral discs of T12-L5
Psoas major muscle insertion: Lesser trochanter of the femur
Psoas major muscle action: Flexes the thigh
Psoas major muscle innervation: Femoral nerve
Iliacus muscle origin: Iliac crest, iliac fossa, ala of sacrum
Iliacus muscle insertion: Lesser trochanter
Iliacus muscle action: Flexes the thigh
Iliacus muscle innervation: Femoral nerve

Psoas Minor Muscle

Origin: T12-L1 intervertebral discs
Insertion: Pecten pubis, iliopubic eminence, and lateral side of the iliac fascia
Action: Minimally flexes the trunk
Innervation: L1 nerve

Tensor Fascia Lata Muscle

Origin: Anterior superior iliac spine
Insertion: Iliotibial tract
Action: Abducts and flexes the thigh, helps to keep the knee extended in upright posture
Innervation: Superior gluteal nerve

Sartorius Muscle

Longest and most superficial muscle in the thigh
Origin: Anterior superior iliac spine
Insertion: Superior part of the medial surface of the tibia
Action: Flexes the thigh and leg, abducts the thigh and rotates laterally
Innervation: Femoral nerve

Quadriceps Femoris Muscle

Origin: Rectus femoris: Anterior inferior iliac spine and groove superior to acetabulum. Three vasti muscles originate from the body of the femur.
Insertion: Base of the patella and the tibial tuberosity through a common tendon that continues inferiorly as the patellar ligament
Action: Extends the leg at the knee joint
Innervation: Femoral nerve

Medial Thigh Muscles

Gracilis
Pectineus
Adductor longus
Adductor brevis
Adductor magnus

Gracilis Muscle

Long, strap-like muscle
Most superficial of the adductor group
Crosses the knee joint
Origin: Body and inferior ramus of the pubis
Insertion: Superior part of the medial surface of the tibia
Action: Adducts the thigh and flexes the leg
Innervation: Obturator nerve

Pectineus Muscle

Small muscle on the floor of the femoral triangle
Origin: Pectineal line of the pubis
Insertion: Pectineal line of the femur
Action: Adducts and flexes the thigh
Innervation: Femoral and obturator nerves

Adductor Longus Muscle

Anterior part of the adductor group of muscles
Origin: Anterior surface of the body of the pubis
Insertion: Middle third of the linea aspera of the femur
Action: Adducts and flexes the thigh
Innervation: Obturator nerve

Adductor Brevis Muscle

Origin: Body and inferior ramus of the pubis
Insertion: Pectineal line and proximal part of the linea aspera of the femur
Action: Adducts the thigh
Innervation: Obturator nerve

Adductor Magnus Muscle

Largest of the adductors
Origin: Inferior ramus of the pubis, ramus of the ischium, and ischial tuberosity
Insertion: Gluteal tuberosity, linea aspera, medial supracondylar line, and adductor tubercle of the femur
Action: Adducts and extends the thigh
Innervation: Anterior part: Obturator nerve, posterior part: Tibial nerve

Adductor Canal (Subsartorial Canal or Hunter's Canal)

A narrow fascial tunnel deep to the sartorius muscle in the middle third of the medial part of the thigh
Contains the femoral vessels as they pass to the popliteal fossa
Ends at the adductor hiatus, the tendinous opening of the adductor magnus muscle
Contents:
- Femoral vessels (vein located posterior to the artery)
- Saphenous nerve does not cross the adductor canal; it pierces the deep fascia (vasto-adductor intermuscular membrane) on the medial side of the knee and passes down with the saphenous vein

Arteries of the Thigh

Femoral artery has several branches:
- Superficial epigastric artery
- Superficial circumflex iliac artery
- External pudendal arteries (superficial and deep)
- Deep femoral artery (largest branch, chief artery of the femur)
- Descending genicular artery

Deep Femoral Artery

Arises from the lateral side of the femoral artery within the femoral triangle, about 4 cm inferior to the inguinal ligament
Branches:
- Medial circumflex femoral artery
- Lateral circumflex femoral artery
- Perforating arteries
- Nutrient arteries for the femur

Medial Circumflex Femoral Artery

Important for arterial supply to the head and neck of the femur

Veins of the Thigh

Superficial veins:
- Great saphenous vein: Begins at the medial end of the dorsal venous arch of the foot, passes anterior to the medial malleolus, obliquely crosses the tibia to the medial aspect of the knee, runs superolaterally to the anterior midline of the thigh, and drains into the femoral vein at the saphenous opening.
Deep veins:
- Femoral vein

Femoral Nerve (L2, L3, L4)

Descends posterolaterally through the pelvis to the midpoint of the inguinal ligament
Passes lateral to the femoral vessels, outside the femoral sheath
Cutaneous branches:
- Lateral femoral cutaneous nerve
- Anterior cutaneous branches of the femoral nerve
- Saphenous nerve

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Description

Explore the key components of the thigh's fascia and its intricate cutaneous innervation. This quiz covers significant features such as the superficial and deep fascia, the iliotibial tract, and the nerves responsible for sensation in the thigh region. Test your understanding of these essential anatomical concepts.