Week 11 pt4.pdf

Anterior and Medial Compartments of the Thigh Cutaneous Innervation of the Thigh  anterior surface of thigh, immediately below inguinal ligament (from lateral to medial):  lateral cutaneous branch of subcostal nerve  femoral branch of genitofemoral nerve...

Anterior and Medial Compartments of the Thigh Cutaneous Innervation of the Thigh  anterior surface of thigh, immediately below inguinal ligament (from lateral to medial):  lateral cutaneous branch of subcostal nerve  femoral branch of genitofemoral nerve  ilioinguinal nerve  remaining of anterior surface of thigh:  lateral cutaneous nerve of thigh (lateral femoral cutaneous nerve): supplies skin along lateral aspect of thigh  anterior cutaneous nerves of thigh (anterior femoral cutaneous nerves): branches of femoral nerve and supply skin of anterior and medial aspects of thigh  anterior branch of obturator nerve: supplies a small area of skin on medial aspect of thigh  posterior surface of thigh:  posterior cutaneous nerve of thigh (posterior femoral cutaneous nerve) Superficial Veins  located in superficial fascia  Great saphenous vein:  originates from medial end of dorsal venous arch of foot and ascends anterior to medial malleolus and along medial aspect of leg (with saphenous nerve) and passes posteromedial to knee joint (approximately a hand’s breath posterior to medial border of patella) and runs superiorly along medial aspect of thigh and in upper thigh passes through saphenous opening (opening in fascia lata) and drains into femoral vein  connected to deep veins via several perforating veins along its course and blood normally flows from superficial to deep veins through these perforating veins (valves prevent flow in opposite direction) and if valves become incompetent, perforating veins leak blood during muscular contraction and superficial veins become dilated and varicose  small saphenous vein:   originates from lateral end of dorsal venous arch of foot and passes inferior and then posterior to lateral malleolus and in lower ⅓ of leg, it lies just lateral to calcaneal (Achilles) tendon and as it ascends in leg, it inclines slightly medially to reach midline of calf and pierces crural fascia (dep fascia of leg) in middle or upper ⅓ of leg and drains into popliteal vein  along its course in foot and leg it is accompanied by sural nerve  connected to deep veins of leg via perforating veins and also communicates with great saphenous vein Inguinal Lymph Nodes  divided into superficial and deep groups  superficial inguinal lymph nodes:  lie in superficial fascia  horizontal group: lies just below and parallel to inguinal ligament and receives superficial lymph vessels from anterior abdominal wall (below umbilicus), perineum and gluteal region  vertical group: lies along terminal part of great saphenous vein and receives all superficial lymph vessels of lower limb (except those from lateral foot and lateral leg, which accompany small saphenous vein and drain into popliteal lymph nodes)  e erent vessels from superficial inguinal lymph nodes pass through saphenous opening and drain into deep inguinal lymph nodes Deep Fascia of the Thigh (Fascia Lata)  encloses thigh like a stocking  thickened along lateral aspect to form iliotibial tract (described in gluteal region with gluteus maximus muscle)  saphenous opening:  gap in fascia lata in superomedial part of anterior aspect of thigh  transmits great saphenous vein, small superficial branches of femoral vessels and e erent lymph vessels from superficial inguinal lymph nodes Spaces Under the Inguinal Ligament  inguinal ligament: lower free margin of aponeurosis of external oblique muscle and extends from ASIS to pubic tubercle  forms boundary between abdomen and thigh  space between inguinal ligament and hip bone is divided into muscular and vascular spaces (lacunae) by a thickening of iliac fascia (interlacunar ligament or iliopectineal ligament/arch)  muscular space (lacuna): located lateral to interlacunar ligament and contains psoas major and iliacus muscles, femoral nerve and lateral cutaneous nerve of thigh  vascular space (lacuna): located medial to interlacunar ligament and contains femoral artery and vein, lymphatics and femoral branch of genitofemoral nerve