ANTERIOR & MEDIALCOMPARTMENTS

of theTHIGH

M1 - Anatomy

M1 Gross and Developmental Anatomy8:00 AM, October 28, 2008Dr. Milton M. Sholley

Professor of Anatomy and Neurobiology 2

Compartmentalization of the Thigh

Syllabus page 179

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PelvisFormed by two coxal (hip) bones and the sacrum

Hip bone Hip boneSacrum

Pubic symphysis

Sacroiliac jointSacroiliac joint

Adapted from:Grant’s Atlas, 12th ed.Fig. 4.22, p. 311

Sacral promontory

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Ilium

Ischium Pubis

Coxal (hip) boneA fusion of three bones in the adult

Adapted from:Grant’s Atlas, 12th ed.Fig. 5.31B, p. 397

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Coxal (hip) boneLateral view

Iliac crest

Anterior superioriliac spine

Anterior inferioriliac spine

Acetabulum(hip joint socket)

Pubic tubercle

Ischial tuberosity

Ischial spine

Lesser sciaticnotch

Greater sciaticnotch

Posterior superioriliac spine

Posterior inferioriliac spine

Obturator foramen

Adapted from:Grant’s Atlas, 12th ed.Fig. 5.31A, p. 397

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Coxal (hip) boneMedial view

Anterior superioriliac spine

Ischial spine

Symphysealsurface of pubis

Pectineal lineArcuate line

Adapted from:Grant’s Atlas, 12th ed.Fig. 4.23A, p. 312

7Grant’s Atlas, 12th ed.Fig. 4.24A, p. 313

Grant’s Atlas, 12th ed.Fig. 4.23C, p. 312

Sacrum and Coccyx

Anterior view Lateral view

8Grant’s Atlas, 12th ed.Fig. 4.23A, p. 312

Grant’s Atlas, 12th ed.Fig. 4.23C, p. 312

Grant’s Atlas, 12th ed.Fig. 4.26A, p. 316

Coxal boneMedial view

Sacrum (and coccyx)Lateral view

9Anterior view Posterior view

Grant’s Atlas, 12th ed.Fig. 5.22A, p. 380

Grant’s Atlas, 12th ed.Fig. 5.22C, p. 381

Anterior superioriliac spine

Greater trochanterGreater trochanter

Gluteal tuberosity

Ischial tuberosity

Lesser trochanter

Intertrochanteric crest

Intertrochanteric line

Linea asperaPectineal line

Patella

Tibial tuberosity

Pectineal line

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AP Radiograph of Pelvis

Adapted from:Grant’s Atlas, 12th ed.Fig. 4.22A&B, p. 311

11APPelvis(Hip)-21.jpg

Radiologic Anatomy

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Hip Joint Capsule(frontal section)

Fibrous capsule

Synovial capsule

Fibrous capsule

Synovial capsule

Grant’s Atlas, 12th ed.Fig. 5.32B, p. 398

Synovial cavity

Ligament of thehead of the femur

13Anterior view

Angle between neck and shaft of femur~126o = Normal angle in adult

Weight transfer across this angle produces greatstress in the neck of the femur. This stress isresisted by the natural support provided by theorientation of the bony trabeculae within thefemoral neck. Degeneration of bone in thesetrabeculae, as can occur from osteoporosis, maycause hip fracture due to failure of the femoral neckto support the body weight.

14Grant’s Atlas, 12th ed.Fig. 5.34 A, p. 400

Blood Supply to Neck and Head of Femur

1. Medial femoral circumflex artery2. Lateral femoral circumflex artery3. Artery of the ligament of the head

of the femur12

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Adapted from:Hollinshead’s Text, 5th ed.Fig.17-17, p. 328

Ascendingbranches

15Anterior view

Iliofemoral ligament(Y-ligament of Bigelow)

Tightens during hip extensionand thus limits hip extension

Adapted from:Grant’s Atlas, 12th ed.Fig. 5.29A, p. 394

16Posterior view

Ischiofemoral ligament

Adapted from:Grant’s Atlas, 12th ed.Fig. 5.29C, p. 395

Tightens during hip extensionand thus limits hip extension

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Compartmentalization of the Thigh

Syllabus page 179 18

Compartmental Innervationsand

Actions of Contained Muscles

Syllabus page 184

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IV. Anterior compartment of the thigh(Contains muscles innervated bythe femoral nerve--see muscle charton syllabus page 189)

A. Iliopsoas muscle complex

B. Quadriceps femoris muscle

C. Sartorius muscle

D. Pectineus muscle

A

CD

B

B

B

(Syllabus location--page 184)

Adapted from:Grant’s Atlas, 12th ed.Fig. 5.20A, p. 375

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21 22

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From:Hollinshead’s Text, 5th ed.Fig.18-18 C&D, p. 364

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Borders of the Femoral Triangle

Inguinal ligament

Adductor longus m.

Sartorius m.

Syllabus page 185

25Grant’s Atlas, 12th ed.Fig. 5.17A, p. 372

Grant’s Atlas, 12th ed.Fig. 5.18C, p. 373

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LM

Adapted from:Grant’s Atlas, 10th ed.Fig. 5.12B, p. 314

Lateral Medial

Anterior

FemoralN A V EL

Head of femurSyllabus page 185

27Grant’s Atlas, 12th ed.Fig. 5.16A, p. 371

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Lateral Medial

Anterior

Head of femur

Femoral sheath encloses:1. Femoral artery2. Femoral vein3. Femoral canal

(i.e. empty spacewith lymphatics or EL)

Adapted from:Grant’s Atlas, 10th ed.Fig. 5.12B, p. 314

29Syllabus page 200 30Grant’s Atlas, 12th ed.Fig. 5.18C, p. 373

Grant’s Atlas, 12th ed.Fig. 5.18A, p. 373

31From:Hollinshead’s Text, 5th ed.Fig.18-18 E&F, p. 364

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Superficial veins and Superficial inguinal lymph nodesare located within the fat-containing superficial fascia, which lies

between the skin and the Fascia lata (deep fascia).

Grant’s Atlas, 12th ed.Fig. 5.15A, p. 370

Grant’s Atlas, 12th ed.Fig. 5.15C, p. 370

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Superficial Inguinal Lymph Nodes

Grant’s Atlas, 12th ed.Fig. 5.13A, p. 367

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Superficial Inguinal Lymph Nodes

Grant’s Atlas, 12th ed.Fig. 5.13A, p. 367

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Radiologic AnatomyPelvic Lymphangiogram

Pelvic Lymphangiogram-61l.jpg

SuperficialInguinalLymph Nodes

SuperficialInguinalLymph Nodes

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Greater Saphenous Vein

Medial malleolus

Lesser Saphenous Vein

Lateral malleolus

37Grant’s Atlas, 12th ed.p. 378

Medial Compartment Muscles(See muscle chart on syllabus

page 190 and Grant’s Atlas page 378 for labels.)

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Adductor hiatus - Anopening between the twoinsertions of the adductormagnus muscle that allowspassage of the femoral arteryand vein from the anteriorcompartment into the poplitealfossa.

Medial femoralcircumflex artery - Passesposteriorly in the fascialplane between the iliopsoasand pectineus muscles.

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Adapted from:Grant’s Atlas, 12th ed.Fig. 5.21A, p. 379

Pes anserinus

Combined tendons of:

Medial view

Sartorius

Gracilis

Semitendinosus

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Adapted from:Grant’s Atlas, 12th ed.Fig. 5.21B, p. 379

Muscular TripodOne muscle from eachcompartment provides supporton the medial side of the knee.The three combined tendonsof insertion form the pes anserinus.

Anterior view

S=SartoriusG=GracilisT=Semitendinosus

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Lumbar plexus in situ

Lateral femoralcutaneous nerve

Obturator nerve

Femoral nerve

Entrapment neuropathyhere causes

Meralgia parastetica

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Lumbar Plexus

Subcostal nerve

Lateral femoralcutaneous nerve (L2, 3)

Femoral nerve (L2-4)

Ventralrami

Iliohypogastric nerve (T12, L1)

Genitofemoral nerve (L1, 2)

T12

L1

L2

L3

L4

Ilioinguinal nerve (L1)

Obturator nerve (L2-4)Anterior divisionsPosterior divisions

Syllabus page 188