Anterior Compartment of the Thigh PDF

The thigh and femoral triangle INTRODUCTION  Compartment of the thigh Divided into three compartment (group of muscle): anterior, medial, and posterior The walls of these compartments are formed by the fascia lata and lateral intermuscular septum Generally, 1. the anterior...

The thigh and femoral triangle INTRODUCTION  Compartment of the thigh Divided into three compartment (group of muscle): anterior, medial, and posterior The walls of these compartments are formed by the fascia lata and lateral intermuscular septum Generally, 1. the anterior group is innervated by the femoral nerve, 2. the medial group by the obturator nerve, and 3. the posterior group by the tibial portion of the sciatic nerve. Compartment of the thigh  The Anterior compartment As a general rule, act to extend the leg at the knee joint and flex the femur at the hip. The anterior thigh muscles include the pectineus, iliopsoas, sartorius and quadriceps femoris group of muscles – Rectus femoris – Vastus lateralis – Vastus medialis – Vastus intermidus  MUSCLES OF ANTERIOR THIGH: FLEXORS OF HIP JOINT The Pectineus - flat quadrangular muscle located in the anterior part of the superomedial aspect of the thigh. It is composed of two layers, - superficial and deep, generally innervated by two different nerves. Proximal attachment – superior ramus of the pubis Distal attachment - Pectineal line of the femur, just inferior to the lesser trochanter Innervation - femoral nerve (L2, L3) Action – adduct and flex thigh. – Assist in medial rotation of the thigh The iliopsoas, the chief flexor of the thigh, is the most powerful of the hip flexors with the longest range Psoas Major, Psoas Minor and Iliacus Action PSOAS MAJOR Flex thigh at hip joint Proximal Distal attachment Innervation attachment Side of T12 – L5 lesser trochanter Anterior rami of lumber nerve (L1-3) PSOAS MINOR Proximal Distal attachment Innervation attachment Side of T12 – L1 Pectineal line and Anterior rami of iliopubic eminence lumber nerve (L1-2) ILIACUS Proximal Distal attachment Innervation attachment Iliac crest and iliac Tendon of psoas Femoral nerve (L2- fossa major and lesser L3) trochanter The sartorius - the longest muscle in the body. It is long and thin, running across the thigh in an inferomedial direction. The sartorius is positioned more superficially than the other muscles in the leg. Proximal attachment: The anterior superior iliac spine Distal attachment - the superior & medial surface of the tibia. Innervation: Femoral nerve (L2, L3) Actions: At the hip joint, - it is a flexor, abductor and lateral rotator of the thigh. At the knee joint, it is also a flexor.  MUSCLES OF ANTERIOR THIGH: EXTENSORS OF KNEE Quadriceps femoris - forms the main bulk of the anterior thigh muscles (4 muscles) and collectively constitutes the largest and one of the most powerful muscles in the body It covers almost all the anterior aspect and sides of the femur The quadriceps is the great extensor of the leg Rectus Femoris Proximal Attachments: Anterior inferior iliac spine and the area of the ilium immediately superior to the acetabulum. Distal Attachments: It runs straight down the leg and attaches to the patella via the quadriceps femoris tendon. Innervation: Femoral nerve (L2,L3,L4). Actions: It flexes the thigh at the hip joint, and extends the leg at the knee joint. Vastus Lateralis Proximal attachment: Originates from the greater trochanter and the lateral lip of linea aspera. Vastus Medialis Proximal attachment: The intertrochanteric line and medial lip of the linea aspera. Distal Attachments: It runs straight down the leg and attaches to the patella via the quadriceps femoris tendon. Actions: Extends the knee joint and stabilises the patella Innervation: Femoral nerve (L2,L3,L4). Vastus Intermedius Proximal attachment: Anterior and lateral surfaces of the femoral shaft. Distal Attachments: It runs straight down the leg and attaches to the patella via the quadriceps femoris tendon. Actions: Extends the knee joint and stabilises the patella Innervation: Femoral nerve (L2,L3,L4). Arteries of anterior thigh  VEINOUS DRAINAGE The femoral vein is the continuation of the popliteal vein. As it ascends through the adductor canal, the femoral vein lies posterolateral and then posterior to the femoral artery  FEMORAL TRIANGLE Is a triangular landmark useful in dissection and in understanding relationships in the region. Located at the superior medial 1/3 of the thigh. The femoral triangle is bounded: Superiorly- by the inguinal ligament Medially- by the lateral border of the adductor longus. Laterally- by the sartorius muscle Floor – Pectineus M.  Content of the FEMORAL TRIANGLE Femoral nerve and its (terminal) branches. Femoral sheath and its contents, Including: – Femoral artery and several of its branches. – Femoral vein and its proximal tributaries – Deep inguinal lymph nodes and associated lymphatic vessels.  FEMORAL HERNIA A femoral hernia occurs when tissue pushes through a weak spot in the muscle wall of the groin or inner thigh. – Symptoms can include a tender or painful lump, groin discomfort, abdominal pain. A femoral hernia can be examined by placing fingers over the femoral region and having the patient cough. – A bulge or impulse in this area may indicate a hernia. A strangulated hernia can cause nausea, vomiting, and severe abdominal pain. – If left untreated, the affected intestine can die and may need to be amputated.  Applied anatomy Femoral pulse Femoral venipuncture Heavy bleeding can be stopped by apply pressure to the point of femoral triangle