Anterior Thigh Muscles 2024 PPT PDF

Lecture 3: The Anterior Thigh  Outline The bone(s) of the anterior thigh – Subdivisions, joints etc What’s in the anterior fascial compartment? – Muscles – Tendons – Nerves – Vascular structures The femoral triangle Summary  Aims To...

Lecture 3: The Anterior Thigh  Outline The bone(s) of the anterior thigh – Subdivisions, joints etc What’s in the anterior fascial compartment? – Muscles – Tendons – Nerves – Vascular structures The femoral triangle Summary  Aims To study – The femur, it’s landmarks, articulations and points of muscular origin and insertion. – The arrangement structure and function of the anterior femoral compartment muscles. – The nerves and vascular structures of the anterior thigh – The contents, borders and clinical significance of the femoral triangle.  Bone(s) The Femur – Longest, biggest, strongest bone. Articulates with – Patella – Tibia – ‘Pelvis’ Femur continued Femur continued Femur continued  Head of Femur Cortical bone – Strong, dense, rigid, provides structural integrity Cancellous bone – Less dense, spongier, more flexible, dissipates stress better  Ligaments of the hip Anterior view Posterior view Iliofemoral ligament  The anterior fascial compartment Whole thigh surrounded by supeficial f. Subdivided into anterior, medial and posterior compartments by deep f.  Iliotibial tract (band) Continous with the deep fascia of the thigh. Forms strong, thick band on anterolateral portion of thigh  Muscles of the anterior compartment (Psoas major) (Iliacus) Tensor fascia lata Sartorius Rectus femoris Vastus lateralis Vastus medialis Vastus intermedius Articularis genu  Tensor fascia lata Origin - Lateral iliac crest TFL Insertion - Lateral condyle of the tibia (via ITB) Action - Flexion and QuickTime™ and a medial rotation of thigh. TIFF (Uncompressed) decompressor are needed to see this picture. Stabilisation of knee & pelvis Antagonist - Lateral rotators Innervation - Superior gluteal (L4 & L5)  Sartorius Origin - ASIS Insertion - Proximal, medial tibia Action - Hip flexion, Sartorius abduction, lateral rotation, knee flexion and medial rotation Antagonists - Opposite of above Innervation - Femoral nerve (L2 - L4)  Quadriceps Rectus femoris Vastus Lateralis Vastus Medialis Vastus Intermedius – All work together as a functional group known as the quadriceps (quads).  Rectus femoris Origin - AIIS, groove above acetabulum Insertion - Tibial tuberosity, via patella and tendon Rectus femoris Action - Knee extension, hip flexion Antagonists - Hamstrings Innervation - Femoral nerve (L3 & 4)  Vastus lateralis Origin - Great trochanter, Lateral femur, linea aspera Insertion - Tibial Vastus lateralis tuberosity, via patella and tendon Action - Knee extension Antagonists - Hamstrings Innervation - Femoral nerve (L2 - L4)  Vastus medialis Origin - Intertrochanteric line, spiral line, linea aspera, m supracondylar line, A magnus. Insertion - Tibial tuberosity, via patella and tendon Action - Knee extension Vastus Medialis Antagonists - Hamstrings Innervation - Femoral nerve (L2 - L4)  Vastus Intermedius Origin - Anterior and lateral surfaces of femur Insertion - Tibial tuberosity, via patella and tendon Action - Knee Vastus intermedius extension Antagonists - Hamstrings Innervation - Femoral nerve (L2 -L4)  Articularis genu Origin - Anterior surface of femur, inferior and deep to vastus intermedius Insertion - Suprapatellar bursa Action - Retracts bursa during knee extension Antagonists - Innervation - Femoral nerve (L3 & L4)  Hip flexors Psoas major and iliacus work together as a functional group. Often referred to as iliopsoas  Psoas major Origin - 12th thoracic and lumbar vertebrae Insertion - Lesser Psoas major trochanter Action - Hip flexion Antagonists - Gluteus max, hamstrings Innervation - L1 - L3  Iliacus Origin - Upper 2/3rds of iliac fossa Insertion - Lesser trochanter Iliacus Action - Hip flexion Antagonists - Gluteus max, hamstrings Innervation - Femoral nerve L2 - L3  Practical surface anatomy Divide into groups of 4ish, indicate on a volunteer the following structures: – Vastus Medialis - ASIS – Vastus Lateralis - Iliac crest – Rectus Femoris - Great trochanter – Iliotibial band - Patella  Nerves All nerves of anterior thigh compartment arise from lumbar plexus May be described as: – Motor (muscular) or – Sensory (cutaneous)  Motor nerves Broadly motor nerves of hip flexors and knee extensors arise from L2, 3, 4 (femoral) L2, 3, 4 - kick the door! Exceptions are TFL and PM  Cutaneous nerves Most are branches of the femoral nerve – Medial femoral cutaneous – Intermediate cutaneous – Saphenous Lateral femoral cutaneous arises directly for the lumbar plexus Also: Obturator, ilioinguinal, genitofemoral Cutaneous nerves  Vascular structures Broadly – Arteries deliver blood from the heart to other structures – Veins return blood from other places to the heart – Veins are assisted by the lymphatic system  Arteries of the Ant. Thigh External iliac artery pierces inguinal ligament becomes femoral artery Splits into: – Profunda femoris (+perforating branches) – Medial & lateral (internal / external) femoral circumflex Becomes popliteal artery as it passes behind knee  Veins of the Ant. Thigh Femoral vein drains ‘spent’ blood from anterior thigh. The following supply the FV: – Popliteal vein – Great saphenous – Profunda femoris  Great saphenous vein Longest vein in the body Superficial Varicose veins Runs from foot to anterior thigh  Lymphatics Generally follow the course of the veins Drain into lymph nodes which act as filters Eventually all drains back into veinous system  The femoral triangle Contents – Femoral artery – Femoral vein – Inguinal lymph nodes Inguinal ligament Contained in femoral Sartorius sheath, funnel Iliopsoas shaped continuation of the deep fascia Pectineus (cribriform) – Femoral nerve Adductor longus Femoral sheath  Summary You should be able to, recognise and name: – Major landmarks of the femur. – The muscles of the anterior thigh and their relationship. – Major neural and vascular structures of the anterior compartment, where they go and what they do. – Contents of the femoral triangle and why it matters Any questions?  Look forward For next week: – Read around general issues raised today Specifically vascular tree and nerves Muscles – Names, where they go, what they do etc. Next week: Lecture a.m. the medial thigh.