Lower Limb Anatomy: Front and Medial Thigh PDF

 Lower Limb The lower limb consists of six regions or parts: 1) Gluteal region (Buttock) 2) Femoral region (Thigh) 3) Knee joint 4) Leg region 5) Ankle joint 6) Foot  Thigh The thigh is divided into three c...

 Lower Limb The lower limb consists of six regions or parts: 1) Gluteal region (Buttock) 2) Femoral region (Thigh) 3) Knee joint 4) Leg region 5) Ankle joint 6) Foot  Thigh The thigh is divided into three compartments by intermuscular septa between the posterior aspect of the femur and the fascia lata: a) Anterior compartment (extensor) b) Posterior compartment (flexor) c) Medial compartment (adductor)  Anterior compartment of thigh Muscles: Hip flexors (Quadriceps femoris, Sartorius, Psoas major and Iliacus) Blood Vessels: Femoral vessels and Great saphenous vein Nerves: Femoral nerve Femoral Triangle Femoral Sheath Adductor Canal  Muscles Quadriceps femoris: a) Rectus femoris b) Vastus medialis c) Vastus intermedius d) Vastus lateralis Nerve supply: Femoral nerve Action: Knee extension and hip flexion (rectus femoris)  MUSCLES ORIGIN INSERTION ACTION Straight head: anterior inferior Flexes the Rectus iliac spine; reflected head: Quadriceps femoris hip joint and femoris ilium just superior to the tendon extends the acetabulum knee joint Femur-medial part of Vastus intertrochanteric line, Quadriceps femoris medialis pectineal line, medial lip of tendon and medial the linea aspera, medial border of patella supracondylar line Vastus Femur-upper two-thirds of Quadriceps femoris Extends tendon and lateral intermedius anterior and lateral surfaces margin of patella the knee joint Femur-lateral part of intertrochanteric line, margin Vastus Quadriceps femoris of greater trochanter, lateral lateralis tendon margin of gluteal tuberosity, lateral lip of the linea aspera  Muscles Sartorius oblique muscle Nerve supply: Femoral nerve Action: Knee flexion Hip flexion Thigh abduction and lateral rotation  Muscles Psoas major Nerve supply: L1-L3 nerves Action: Hip flexion Thigh lateral rotation Iliacus Nerve supply: Femoral nerve Action: Hip flexion Thigh lateral rotation  MUSCLES ORIGIN INSERTION NERVE SUPPLY ACTION Flexes, Anterior abduct and Anterior surface of laterally SARTORIU superior iliac tibia Femoral nerve rotate the S spine inferomedial [L2,L3] hip joint to tibial and flexes tuberosity the knee joint lumbar transverse Anterior rami PSOAS processes, I.V. L1,L2,L3 MAJOR discs, and Lesser adjacent bodies trochanter of Flexes the from T12 to L5 femur hip joint Femoral nerve [L2,L3] ILIACUS Iliac fossa  Anterior Femoral Triangle It is a triangular depressed area situated in the upper part of the medial aspect of the thigh just below the inguinal ligament. Boundaries: Superiorly: Inguinal ligament Laterally: Sartorius muscle Medially: Adductor longus muscle Floor: from lateral to medial (Iliopsoas, Pectineus, and Adductor longus) Roof: skin and fasciae of the thigh  Anterior Femoral Triangle Contents: from medial to lateral are: i. Femoral nerve and its (terminal) branches. ii. Femoral sheath and its contents:  Femoral artery and several of its branches.  Femoral vein and its proximal tributaries (e.g., the great saphenous and deep femoral veins).  Deep inguinal lymph nodes and associated lymphatic vessels.  Adductor (Subsartorial) Canal It is a long (approximately 15 cm), narrow passageway in the middle third of the thigh. It extends from the apex of the femoral triangle to the adductor hiatus in the tendon of the adductor magnus. Boundaries: Anteriorly and laterally: vastus medialis. Posteriorly: adductors longus and magnus. Medially: sartorius Contents: femoral artery and vein, the saphenous nerve, and the nerve to vastus medialis.  Femoral Nerve Largest branch of lumbar plexus (L2,3,4). Formed inside psoas muscle, enter thigh deep to inguinal lig. lateral to femoral sheath then immediately divided into terminal branches. Branches: 1. Anterior cutaneous branches 2. Motor branches 3. one long cutaneous nerve, the Saphenous nerve, which supplies skin as far distally as the medial side of the foot.  Femoral Artery Continuation of external iliac A. after passing deep to inguinal lig. It descends vertically in femoral triangle until leaving it through adductor canal and exit through adductor hiatus as popliteal A. Branches: 1) Superficial epigastric artery 2) Superficial circumflex iliac artery 3) Superficial external pudendal A. 4) Deep external pudendal artery 5) Profunda femoris artery  Deep Artery of Thigh (Profunda femoris artery) Largest branch of femoral A. that provide the main blood supply of thigh. It passes between the pectineus and adductor longus muscles and then between the adductor longus and adductor brevis muscles eventually penetrating through the adductor magnus to connect with branches of the popliteal artery behind the knee.  Deep Artery of Thigh (Profunda femoris artery) Branches: 1) Lateral circumflex femoral A. (ascending, transverse, descending) 2) Medial circumflex femoral A. 3) Four Perforating arteries: penetrating adductor magnus to supply the post. compartment  Femoral Vein The major deep vein draining the limb. It becomes the external iliac vein when it passes under the inguinal ligament to enter the abdomen. Tributaries of the femoral vein follow the branches of femoral artery (vena comittantes)  Great Saphenous Vein It originates from the medial side of the dorsal venous arch on the dorsal aspect of the foot, and then ascends up the medial side of the leg, knee, and thigh to connect with the femoral vein through the saphenous ring in deep fascia just inferior to the inguinal ligament.  Medial Compartment of Thigh Muscles: Three adductors (Adductor longus, brevis and Magnus), Gracilis, Pectineus and Obturator externus. Blood Supply: Deep artery of thigh and Obturator Artery Nerve Supply: Obturator nerve MUSCLES ORIGIN INSERTION NERVE SUPPLY ACTION Obturator Adducts and Linea aspera on Adductor External surface nerve medially middle one-third Longus of body of pubis of shaft of femur [L2,L3,L4] rotates thigh at hip joint Posterior surface External surface of proximal Obturator Adductor of body of pubis femur and upper nerve Adducts thigh Brevis and inferior one-third of [L2,L3] at hip joint pubic ramus linea aspera Posterior surface Obturator Adductor part- of proximal Adducts and ischiopubic nerve Adductor femur, linea [L2,L3,L4], medially ramus Magnus aspera, medial rotates thigh at Hamstring part- Sciatic supracondylar hip joint ischial tuberosity Nerve line  MUSCLES ORIGIN INSERTION NERVE SUPPLY ACTION A line on the external surfaces of the body of the Medial surface of Obturator Adducts thigh at hip joint and Gracilis pubis, the inferior proximal shaft of nerve flexes leg at pubic ramus, and the tibia [L2,L3] knee joint the ramus of the ischium Oblique line Pectineal line and extending from Obturator Adducts and Pectineus adjacent bone of base of lesser nerve flexes thigh at pelvis trochanter to [L2,L3] hip joint linea aspera External surface Obturator Lateral rotation Obturator of obturator Trochanteric nerve of thigh at hip externus membrane and fossa [L3,L4] joint adjacent bone  Obturator Artery It is a branch of the internal iliac artery in the pelvic cavity and enters the medial compartment of thigh through the obturator canal. it bifurcates into an anterior branch and a posterior branch, which together form a channel that circles the margin of the obturator membrane and lies within the attachment of the obturator externus muscle.  Obturator Nerve It arises from the lumbar plexus (L2, 3, and 4) and emerges on the medial border of the psoas muscle within the abdomen. It reaches the obturator foramen and divided into anterior and posterior divisions.  THANK YOU FOR LISTENIN G