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Questions and Answers
Which muscle is primarily responsible for extending the knee joint?
What structure allows the femoral artery and vein to pass into the popliteal fossa?
What is the primary innervation for the majority of the medial thigh muscles?
Which of the following muscles assists in medial rotation of the thigh?
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How does the saphenous nerve continue its course after emerging at the medial knee?
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What is the primary function of the quadriceps muscle in the anterior compartment of the thigh?
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Which of the following landmarks is located superolateral on the femur?
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What angle of inclination is typical for a three-year-old child?
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What compartment of the thigh is primarily occupied by the hamstring muscles?
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Which structure provides continuity with the iliotibial band?
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What is the action of the pectineus muscle in the thigh?
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In which plane is the angle of torsion measured?
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Which muscle assists with medial rotation of the thigh?
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What is the insertion point for the iliacus muscle?
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Which nerve innervates the psoas major muscle?
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Which action is not performed by the sartorius muscle?
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What is the primary action of the rectus femoris muscle?
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Where does the vastus lateralis muscle originate?
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Which muscle is classified as a weak trunk flexor?
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What common insertion point is shared by the vasti muscles?
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Which muscle originates from the sides of T12-L5 vertebrae?
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Which of the following muscles primarily flexes the thigh at the hip joint?
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Study Notes
Bony Landmarks of the Femur
- The greater trochanter is a large bump located on the superolateral side of the femur.
- The lesser trochanter is smaller and located more medial and inferiorly on the femur.
- The gluteal tuberosity is a large ridge that extends down from the trochanters towards the linea aspera.
- The linea aspera is a rough line that runs down the posterior shaft of the femur.
- The intertrochanteric crest is a large ridge between the trochanters, located inferior and lateral to the neck of the femur.
- The intertrochanteric line is a less raised ridge on the anterior side of the femur.
- The supracondylar lines are located on the posterior side of the femur.
- The lateral supracondylar line is located laterally on the femur.
- The medial supracondylar line is located medially on the femur.
- The adductor tubercle is located on the medial epicondyle.
- The epicondyles are bumps that extend outwards from the femur.
- The medial epicondyle extends medially.
- The lateral epicondyle extends laterally.
- The medial condyle is the part of the femur that articulates with the medial side of the tibia.
- The lateral condyle is the part of the femur that articulates with the lateral side of the tibia.
- The popliteal surface of the femur is a posterior, triangular surface.
- The patellar surface of the femur is where the patella articulates with the femur.
Angle of Inclination and Angle of Torsion
- The angle of inclination is measured in the frontal plane.
- A 3-year-old child has an angle of inclination of 135 degrees.
- An adult has an angle of inclination of 126 degrees.
- An older adult has an angle of inclination of 120 degrees.
- The angle of torsion is measured in the transverse plane.
- The normal angle of torsion is 12-15 degrees off the frontal plane.
- Coxa vera is when the angle of torsion is smaller than normal.
- Coxa valga is when the angle of torsion is larger than normal.
Compartments of the Thigh
- The anterior compartment of the thigh is occupied by the quadriceps muscle.
- The medial compartment of the thigh is occupied by the adductor muscles.
- The posterior compartment of the thigh is occupied by the hamstrings.
Fascia of the Thigh
- The fascia lata originates from the gluteal muscles and extends down to wrap around all compartments of the thigh.
- The fascia lata connects to the crural fascia.
- The iliotibial band is a lateral thickening in the fascia lata.
Anterior Compartment Overview
- The anterior compartment of the thigh contains six key muscles.
- Some proximal muscles in the compartment cross the hip joint anteriorly and contribute to hip flexion.
- The remaining muscles in the compartment cross the knee joint and contribute to knee extension.
- All of these muscles are innervated by the femoral nerve.
- Blood supply to the compartment is from the femoral artery.
Pectineus
- The pectineus originates from the superior ramus of the pubis.
- The pectineus inserts on the pectineal line of the femur.
- The pectineus is innervated by the femoral nerve.
- The pectineus adducts and flexes the thigh and assists with medial rotation.
Iliacus
- The iliacus originates from the iliac crest, iliac fossa, ala of sacrum, and anterior sacroiliac ligaments.
- The iliacus inserts on the tendon of psoas major, lesser trochanter, and femur distal to it.
- The iliacus is innervated by the femoral nerve.
- The iliacus flexes the thigh at the hip and stabilizes the joint.
Psoas Major
- The psoas major originates from the sides of T12-L5 vertebrae and discs between them, and the transverse processes of all lumbar vertebrae.
- The psoas major inserts on the lesser trochanter of the femur.
- The psoas major is innervated by the anterior rami of lumbar nerves L1, L2, L3.
- The psoas major flexes the thigh at the hip and stabilizes the joint.
Psoas Minor
- The psoas minor originates from the sides of T12-L1 vertebrae and intervertebral discs.
- The psoas minor inserts on the pectineal line, iliopectineal eminence, and iliopectineal arch.
- The psoas minor is innervated by the anterior rami of lumbar nerves L1.
- The psoas minor acts on the lumbar spine and is a weak trunk flexor.
Sartorius
- The sartorius originates from the ASIS and the superior part of the notch inferior to it.
- The sartorius inserts on the superior part of the medial surface of the tibia, sharing an insertion with the gracilis and semitendinosus muscles in the pes anserine.
- The sartorius is innervated by the femoral nerve.
- The sartorius flexes, abducts, and laterally rotates the thigh at the hip. It also flexes the leg at the knee joint.
Quadriceps Muscles
- The rectus femoris originates from the AIIS and the ilium superior to the acetabulum.
- The rectus femoris inserts on the base of the patella via a common tendon, and indirectly on the tibial tuberosity via the patellar ligament.
- The rectus femoris is innervated by the femoral nerve.
- The rectus femoris extends the leg at the knee joint, steadies the hip joint, and helps the iliopsoas flex the thigh.
- The vastus lateralis originates from the greater trochanter and the lateral lip of the linea aspera of the femur.
- The vastus lateralis inserts on the base of the patella via a common tendon and indirectly on the tibial tuberosity via the patellar ligament.
- The vastus lateralis is innervated by the femoral nerve.
- The vastus lateralis extends the leg at the knee joint.
- The vastus medialis originates from the intertrochanteric line and the medial lip of the linea aspera of the femur.
- The vastus medialis inserts on the base of the patella via a common tendon and indirectly on the tibial tuberosity via the patellar ligament.
- The vastus medialis is innervated by the femoral nerve.
- The vastus medialis extends the leg at the knee joint.
- The vastus intermedius originates from the anterior and lateral surfaces of the shaft of the femur.
- The vastus intermedius inserts on the base of the patella via a common tendon and indirectly on the tibial tuberosity via the patellar ligament.
- The vastus intermedius is innervated by the femoral nerve.
- The vastus intermedius extends the leg at the knee joint.
- The articularis genu has connections to the posterior aspect of the vastus intermedius and the distal femur.
- The articularis genu inserts into the synovium of the knee joint.
- The articularis genu pulls the joint capsule out of the way to prevent it from being pinched.
Anterior Compartment Neurovascular
- The femoral nerve innervates all muscles of the anterior compartment of the thigh.
- The femoral artery supplies the anterior compartment of the thigh.
- The femoral artery stems from the external iliac artery.
- The femoral artery runs under the inguinal ligament.
- The femoral artery becomes the femoral artery once it enters the femoral triangle.
Femoral Triangle
- The femoral triangle is located proximally in the anterior thigh.
- The superior boundary of the femoral triangle is the inguinal ligament.
- The lateral boundary of the femoral triangle is the sartorius muscle.
- The medial boundary of the femoral triangle is the adductor longus muscle.
- The floor of the femoral triangle is where the iliopsoas and pectineus cross.
- The femoral triangle is covered by the fascia lata.
- The femoral sheath bundles together the femoral nerve, artery, vein, and lymphatics.
Adductor Canal
- The adductor canal runs under the sartorius muscle and between the adductor longus and vastus medialis muscles.
- The femoral artery and vein run through the adductor canal.
- The nerve to the vastus medialis and the saphenous nerve pass through the adductor canal.
- The femoral artery and vein pass through an opening in the adductor magnus called the adductor hiatus.
- The popliteal artery continues to the posterior thigh into the popliteal fossa.
Medial Compartment of the thigh
- The muscles in the medial compartment run obliquely towards the femur.
- The medial compartment muscles contribute to adduction, which is the primary action of the compartment.
- The majority of the medial compartment muscles have attachments to the pubis.
- Most medial compartment muscles are innervated by the obturator nerve.
- Blood supply to the medial compartment is provided by the profunda or deep femoral artery.
Pectineus
- The pectineus originates from the superior ramus of the pubis.
- The pectineus inserts on the pectineal line of the femur.
- The pectineus is innervated by the femoral nerve.
- The pectineus adducts and flexes the thigh, and assists with medial rotation of the thigh.
Adductor Longus
- The adductor longus originates from the body of the pubis inferior to the pubic crest.
- The adductor longus inserts on the middle third of the linea aspera of the femur.
- The adductor longus is innervated by the obturator nerve.
- The adductor longus adducts the thigh.
Adductor Brevis
- The adductor brevis originates from the body and inferior ramus of the pubis.
- The adductor brevis inserts on the pectineal line and proximal part of the linea aspera of the femur.
- The adductor brevis is innervated by the obturator nerve.
- The adductor brevis adducts the thigh and flexes the thigh to a degree.
Adductor Magnus
- The adductor magnus originates from the inferior ramus of the pubis, the ramus of the ischium, and the ischial tuberosity.
- The part of the adductor magnus that originates from the inferior ramus of the pubis and ramus of the ischium inserts on the gluteal tuberosity, linea aspera, and medial supracondylar line of the femur.
- The part of the adductor magnus that originates from the ischial tuberosity inserts on the adductor tubercle of the femur.
- The adductor magnus is innervated by the obturator nerve and the tibial part of the sciatic nerve.
- The adductor magnus adducts the thigh and extends the thigh.
Gracilis
- The gracilis originates from the body and inferior ramus of the pubis.
- The gracilis inserts on the superior part of the medial surface of the tibia.
- The gracilis is innervated by the obturator nerve.
- The gracilis adducts the thigh, flexes the leg, and helps to medially rotate the leg.
Obturator Externus
- The obturator externus originates from the margins of the obturator foramen and obturator membrane.
- The obturator externus inserts on the trochanteric fossa of the femur.
- The obturator externus is innervated by the obturator nerve.
- The obturator externus laterally rotates the thigh and steadies the head of the femur in the acetabulum.
Neurovascular of Anterior and Medial Thigh
- The external iliac artery crosses under the inguinal ligament and becomes the femoral artery.
- The femoral artery gives off a deep branch called the profunda femoral artery.
- The profunda femoral artery runs toward the medial compartment of the thigh.
- The profunda femoral artery gives off branches called perforating arteries which supply the hamstrings.
- The lateral and medial circumflex femoral arteries help to provide blood supply to the hip joint.
- The femoral artery passes through the adductor hiatus and becomes the popliteal artery.
- The obturator artery branches off the internal iliac artery, runs in the pelvis, passes through the obturator foramen, and helps to supply blood to the medial compartment of the thigh.
- The femoral nerve has an anterior branch that provides sensation to the anterior thigh and skin.
- The saphenous nerve runs down the sub-sartorial canal and innervates the medial leg.
- The obturator nerve runs medial to the psoas muscle, dives into the pelvis, and passes through the obturator foramen into the medial thigh.
Cross Section of the Thigh
- The vastus medialis and vastus lateralis muscles wrap around the femur, with anterior, lateral, and posterior surfaces.
- The adductor magnus muscle takes up a large area in the cross section.
- The adductor canal is located directly deep to the sartorius muscle.
Pes Anserine
- The pes anserine is located proximally on the medial tibia.
- The sartorius muscle originates from the ASIS and is the most anterior attachment to the pes anserine.
- The gracilis muscle originates from the pubis and inserts posteriorly to the sartorius tendon.
- The semitendinosus muscle originates from the ischial tuberosity and has the most posterior tendon attachment to the pes anserine.
Posterior Thigh Overview
- The major muscles of the posterior thigh are the biceps femoris, semitendinosus, and semimembranosus.
- The posterior thigh is supplied by the perforating arteries.
- The posterior thigh is innervated by the tibial nerve.
Biceps Femoris
- The biceps femoris has a long and short head.
- The long head of the biceps femoris originates from the ischial tuberosity.
- The short head of the biceps femoris originates from the linea aspera and lateral supracondylar line of the femur.
- The biceps femoris inserts on the lateral side of the head of the fibula.
- The long head of the biceps femoris is innervated by the tibial division of the sciatic nerve.
- The short head of the biceps femoris is innervated by the common fibular division of the sciatic nerve.
- The biceps femoris flexes the leg and laterally rotates the leg when it is flexed. It also extends the thigh.
Semitendinosus
- The semitendinosus originates from the ischial tuberosity.
- The semitendinosus inserts on the medial surface of the superior part of the tibia.
- The semitendinosus is innervated by the tibial division of the sciatic nerve.
- The semitendinosus extends the thigh, flexes the leg, and medially rotates the leg when the knee is flexed. It can also extend the trunk when the thigh and leg are flexed.
Semimembranosus
- The semimembranosus originates from the ischial tuberosity.
- The semimembranosus inserts on the posterior part of the medial condyle of the tibia.
- The semimembranosus is innervated by the tibial division of the sciatic nerve.
- The semimembranosus extends the thigh, flexes the leg, and medially rotates the leg when the knee is flexed. It can also extend the trunk when the thigh and leg are flexed.
Blood Supply to Posterior Thigh
- The femoral artery travels through the adductor hiatus and becomes the popliteal artery.
- The popliteal artery continues inferiorly and splits into the posterior tibial artery and anterior tibial artery.
- The posterior tibial artery branches off into the fibular artery.
Sensory Innervation of the Thigh
- The lateral cutaneous nerve is only sensory and innervates the lateral thigh.
- The femoral nerve innervates all the muscles of the anterior compartment of the thigh and the corresponding skin superficially.
- The obturator nerve serves the medial compartment of the thigh and provides sensation to the medial thigh region.
- The posterior femoral cutaneous nerve is a cutaneous nerve coming off the sacral plexus that provides sensation to the posterior thigh.
Dermatomes
- The L1 dermatome covers the area of the inguinal ligament.
- The L2 dermatome covers the superior lateral thigh.
- The L3 dermatome covers the inferior, slightly medial thigh, and the area over the knee.
- The S2 dermatome covers the posterior thigh.
Superficial Veins
- The great saphenous vein runs medially.
- The small saphenous vein runs posteriorly and only goes up to the knee.
- Lymphatics follow the superficial veins.
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Description
Test your knowledge on the anatomy and functions of the thigh region. This quiz covers muscles, innervation, and various landmarks associated with the femur and thigh compartments. Whether you are a student or a professional in the medical field, this quiz will enhance your understanding of thigh anatomy.
