Organization of the ll, front and medial sides of thigh

ObjectivesObjectives

Organization of the lower limbOrganization of the lower limb

Bony featuresBony features

Front of the thighFront of the thigh

Dr. Dalia Saleh (Anatomy Dept)

Medial side of the thighMedial side of the thigh

Femoral triangleFemoral triangle

Adductor canal Adductor canal

OverviewOverview

It is connected to the axial skeleton It is connected to the axial skeleton

by a by a sacroiliac joint sacroiliac joint and its and its ligamentsligaments..

It is divided into:It is divided into:

The The glutealgluteal regionregion

Organization of the Lower LimbOrganization of the Lower Limb


The The glutealgluteal regionregion

The thighThe thigh

The legThe leg

The footThe foot

Organization of the Lower LimbOrganization of the Lower Limb Important landmarks in the lower limb:Important landmarks in the lower limb:

The femoral triangleThe femoral triangle

The The poplitealpopliteal fossafossa

The The posteromedialposteromedial aspect of the ankle aspect of the ankle


The The posteromedialposteromedial aspect of the ankle aspect of the ankle

jointjoint

Function Function Support body weight:Support body weight:

The center of gravity is:The center of gravity is:

Anterior to the edge of the SAnterior to the edge of the S2 2 vertebra in the pelvisvertebra in the pelvis

Slightly posterior to the hip jointsSlightly posterior to the hip joints


Slightly posterior to the hip jointsSlightly posterior to the hip joints

Anterior to the knee jointAnterior to the knee joint

Anterior to the ankle jointAnterior to the ankle joint

The ligaments are tight and joints The ligaments are tight and joints are well supportedare well supported

Function Function Locomotion:Locomotion:

Flexion and extension at hip jointFlexion and extension at hip joint

Abduction and adduction at hip jointAbduction and adduction at hip joint

Internal and external rotation of the hip jointInternal and external rotation of the hip joint

Flexion and extension at the knee jointFlexion and extension at the knee joint


Flexion and extension at the knee jointFlexion and extension at the knee joint

Plantar flexion and Plantar flexion and dorsiflexiondorsiflexion at the ankle at the ankle jointjoint

Inversion and Inversion and eversioneversion at the at the subtalarsubtalar jointjoint

ThighThigh

Compartments of the ThighCompartments of the Thigh FemurFemur Skin, superficial fascia and Skin, superficial fascia and

deep fasciadeep fascia Medial Medial intermuscularintermuscular septumseptum Lateral Lateral intermuscularintermuscular septumseptum


Posterior Posterior intermuscularintermuscularseptumseptum

Anterior compartmentAnterior compartment Medial compartmentMedial compartment Posterior compartmentPosterior compartment

Boney FeaturesBoney Features

Hip BoneHip Bone AcetabulumAcetabulum Anterior superior iliac spineAnterior superior iliac spine Anterior inferior iliac spineAnterior inferior iliac spine ObturatorObturator foramenforamen Body of pubic boneBody of pubic bone


Body of pubic boneBody of pubic bone Pubic crestPubic crest Pubic tuberclePubic tubercle Superior pubic Superior pubic ramusramus

((pectinealpectineal surface)surface) Inferior pubic Inferior pubic ramusramus

FemureFemure IntertrochantericIntertrochanteric lineline Anterior surface of body of Anterior surface of body of

femurefemure Greater Greater trochantertrochanter Lesser Lesser trochantertrochanter


Lesser Lesser trochantertrochanter IntertrochantericIntertrochanteric crestcrest PectinealPectineal lineline Linea Linea asperaaspera Medial Medial surachondylarsurachondylar lineline Adductor tubercleAdductor tubercle

TibiaTibia TibialTibial tuberositytuberosity Anterior border (shin of tibia)Anterior border (shin of tibia) Medial surface of tibiaMedial surface of tibia


Anterior CompartmentAnterior Compartment

Anterior Compartment Anterior Compartment Muscles:Muscles:

SartoriusSartorius IliopsoasIliopsoas PectineusPectineus Quadriceps Quadriceps

Region:Region:


Region:Region: Femoral triangleFemoral triangle

Contents:Contents: Femoral nerveFemoral nerve Femoral arteryFemoral artery Femoral veinFemoral vein Femoral LNFemoral LN

Sartorius Sartorius Strap like muscle.Strap like muscle. Divides front of thigh into upper Divides front of thigh into upper

medial and lower lateral partsmedial and lower lateral parts Origin: Origin:

ASIS.ASIS.


Insertion: Insertion: Upper part of medial surface of tibia.Upper part of medial surface of tibia.

Nerve supply: Nerve supply: Femoral nerve.Femoral nerve.

Action: Action: Flexes both hip and knee joints.Flexes both hip and knee joints.

IliopsoasIliopsoas Origin:Origin:

IliacusIliacus iiliac liac fossafossa of hip boneof hip bone PsoasPsoas majormajor Transverse processes, Transverse processes,

bodies, and bodies, and intervertebralintervertebral discs (Tdiscs (T12 12 ––LL55) )

Insertion:Insertion:


Insertion:Insertion: Into lesser Into lesser trochantertrochanter of femur. of femur.

Nerve supply:Nerve supply: Femoral nerve. Femoral nerve.

Action:Action: Flexes thigh on trunk.Flexes thigh on trunk. Flexes trunk on thigh (sitting, leaning). Flexes trunk on thigh (sitting, leaning).

PectineusPectineus Origin:Origin:

Superior Superior ramusramus of pubis of pubis

Insertion:Insertion: Upper end of Upper end of linealinea asperaaspera of shaft of of shaft of

femur femur

Nerve supply:Nerve supply:


Nerve supply:Nerve supply: Femoral nerve. Femoral nerve.

Action:Action: Flexes and adducts thigh at hip joint Flexes and adducts thigh at hip joint

Quadriceps – Rectus FemorisQuadriceps – Rectus Femoris Origin:Origin:

Straight head Straight head AIISAIIS Reflected head Reflected head iliumilium just superior to the just superior to the

acetabulumacetabulum

Insertion: Insertion: Quadriceps Quadriceps femorisfemoris tendon tendon patella patella


Quadriceps Quadriceps femorisfemoris tendon tendon patella patella ligamentumligamentum patellae patellae tibialtibial tuberositytuberosity

Nerve supply:Nerve supply: Femoral nerveFemoral nerve

Action:Action: Flexes the thigh at the hip joint Flexes the thigh at the hip joint Extends the leg at the knee jointExtends the leg at the knee joint

Quadriceps – VastiQuadriceps – Vasti Origin:Origin:

VastusVastus medialismedialis Upper end and shaft of femurUpper end and shaft of femur VastusVastus lateralislateralis Upper end and shaft of Upper end and shaft of

femurfemur VastusVastus intermediusintermedius anterior and lateral anterior and lateral

surfaces of femursurfaces of femurInsertion: Insertion:


Insertion: Insertion: Quadriceps Quadriceps femorisfemoris tendon tendon patella patella

ligamentumligamentum patellae patellae tibialtibial tuberositytuberosity Nerve Nerve supply:supply:

Femoral nerveFemoral nerve Action:Action:

Extends the leg at the knee jointExtends the leg at the knee joint

Medial CompartmentMedial Compartment

Medial Compartment Medial Compartment Muscles:Muscles:

PectineusPectineus Adductor Adductor longuslongus GracilisGracilis Adductor Adductor brevisbrevis Adductor Adductor magnusmagnus


Adductor Adductor magnusmagnus ObturatorObturator externusexternus

Region:Region: Adductor canal Adductor canal

Contents:Contents: Femoral artery and veinFemoral artery and vein SaphenousSaphenous nervenerve Nerve to Nerve to vastusvastus medialismedialis

GracilisGracilis Origin:Origin:

Inferior Inferior ramusramus of pubis, of pubis, ramusramus of of ischiumischium

Insertion: Insertion: Upper part of medial surface of shaft of tibiaUpper part of medial surface of shaft of tibia



ObturatorObturator nervenerve

Action:Action: Adducts thigh at hip jointAdducts thigh at hip joint Flexes leg at knee jointFlexes leg at knee joint

Adductor LongusAdductor Longus Origin:Origin:

Body of pubis, medial to pubic tubercleBody of pubis, medial to pubic tubercle

Insertion: Insertion: Posterior surface of shaft of femur Posterior surface of shaft of femur




Action:Action: Adducts thigh at hip jointAdducts thigh at hip joint Lateral rotation of the thigh Lateral rotation of the thigh

Adductor BrevisAdductor Brevis Origin:Origin:

Inferior Inferior ramusramus of pubisof pubis

Insertion: Insertion: Posterior surface of shaft of femur Posterior surface of shaft of femur




Action:Action: Adducts thigh at hip jointAdducts thigh at hip joint Lateral rotation of the thigh Lateral rotation of the thigh

Adductor MagnusAdductor Magnus Origin:Origin:

Inferior Inferior ramusramus of pubis, of pubis, ramusramus of of ischiumischium, , ischialischialtuberositytuberosity

Insertion: Insertion: Pubic part Pubic part Posterior surface of shaft of femur Posterior surface of shaft of femur

IschialIschial part part Adductor tubercle of the femurAdductor tubercle of the femur


IschialIschial part part Adductor tubercle of the femurAdductor tubercle of the femur

Nerve supply:Nerve supply: Pubic part Pubic part ObturatorObturator nervenerve IschialIschial part part Sciatic nerveSciatic nerve

Action:Action: Pubic part Pubic part Adducts and laterally rotate thighAdducts and laterally rotate thigh IschialIschial part part Extends hip and flexes kneeExtends hip and flexes knee

Obturator ExternusObturator Externus Origin:Origin:

Outer surface of Outer surface of obturatorobturator membrane membrane and pubic and and pubic and ischialischial ramirami

Insertion: Insertion: Medial surface of greater Medial surface of greater trochantertrochanter



Nerve supply:Nerve supply: ObturatorObturator nervenerve

Action:Action: Laterally rotates thighLaterally rotates thigh

Femoral TriangleAdductor CanalFemoral TriangleAdductor CanalAdductor CanalAdductor Canal

Femoral TriangleFemoral Triangle Site:Site:

Triangular depressed areaTriangular depressed area At the upper part of the medial At the upper part of the medial

aspect of the thighaspect of the thigh

Boundaries: Boundaries: Superiorly:Superiorly: The inguinal ligamentThe inguinal ligament


Superiorly:Superiorly: The inguinal ligamentThe inguinal ligament Laterally:Laterally: The The sartoriussartorius musclemuscle Medially:Medially: The adductor The adductor longuslongus musclemuscle

Floor:Floor: IliopsoasIliopsoas PectineusPectineus Adductor Adductor longuslongus

Femoral TriangleFemoral Triangle Contents:Contents:

Femoral nerve and its branchesFemoral nerve and its branches Femoral sheath containing:Femoral sheath containing:

Femoral artery and its Femoral artery and its branchesbranches


branchesbranches Femoral vein and its Femoral vein and its

tributariestributaries Femoral canal Femoral canal Femoral LNFemoral LN

Adductor CanalAdductor Canal Site:Site:

Lies on the medial aspect of the middle Lies on the medial aspect of the middle third of the thigh beneath the third of the thigh beneath the sartoriussartorius musclemuscle

Boundaries: Boundaries: Superiorly:Superiorly: the apex of the femoral the apex of the femoral


Superiorly:Superiorly: the apex of the femoral the apex of the femoral triangle triangle

Inferiorly:Inferiorly: the opening in the adductor the opening in the adductor magnusmagnus

PosteriorlyPosteriorly:: The adductor The adductor longuslongus and and adductor adductor magnusmagnus

Laterally: Laterally: VastusVastus medialismedialis Roof: Roof: Fascia and Fascia and sartoriussartorius

Adductor CanalAdductor Canal Contents:Contents:

The terminal part of the femoral arteryThe terminal part of the femoral artery

The terminal part of the femoral veinThe terminal part of the femoral vein

The deep lymph vesselsThe deep lymph vessels


The The saphenoussaphenous nervenerve

The nerve to the The nerve to the vastusvastus medialismedialis

The terminal part of the The terminal part of the obturatorobturator nervenerve

For more details please go back to any text bookFor more details please go back to any text book

Dr Dalia Dr Dalia SalehSaleh


Dr Dalia Dr Dalia SalehSaleh

Health & Medicine

Organization of the ll, front and medial sides of thigh