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    MSA - Lower Limb - Front and Medial Thigh

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    MSA - Lower Limb - Front and Medial Thigh

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    gataha
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    1 views94 pages

    MSA - Lower Limb - Front and Medial Thigh

    Uploaded by

    gataha

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 94

    Lower Limb Anatomy

    Dr. Gamal Taha Abdelhady


    Lecturer of Anatomy & Embryology

    Front and
    Medial
    Compartments
    of the Thigh
    Fascial Compartments of the
    Thigh
    ◼ Three fascial septa pass from the inner
    aspect of the deep fascial sheath of the
    thigh to the linea aspera of the femur.
    Making Anterior posterior & Medial
    compartments.

    ◼ Each compartment having its own


    distinctive muscles, nerves & arteries.
    Fascial Compartments of the
    Thigh
    A

    M L

    P
    Muscles of the Anterior
    Compartment of the Thigh

    1. Pectineus.
    2. Sartorius.
    3. Quadriceps
    Femoris.
    Pectineus muscle
    Origin: Pectineal line of the superior pubic
    ramus

    Insertion: Upper end of linea aspera of


    femur

    Action: Flexes and adducts the thigh at the


    hip joint

    Nerve supply: Femoral nerve, L3,4


    SARTORIUS

    Origin: anterior superior iliac


    spine

    Insertion: Upper part of the


    medial surface of the shaft of
    the tibia.
    SARTORIUS

    Action: Flexes, abducts,


    laterally rotates thigh at hip
    joint; and also a flexor at the
    knee joint

    Nerve supply: Branches of


    femoral nerve L2,3
    QUADRICEPS FEMORIS

    1. Rectus Femoris

    2. Vastus lateralis

    3. Vastus medialis

    4. Vastus intermedius
    Rectus Femoris

    Origin: Straight head:


    anterior inferior iliac spine
    (AIIS), Reflected head:
    ilium just above the
    acetabulum

    Insertion: Common
    quadriceps tendon then tibial
    tuberosity via patellar
    ligament
    Rectus Femoris

    Action: Extension of leg at


    knee joint and flexes thigh at
    hip joint

    Nerve supply: Branches of


    femoral nerve
    Insertion of Quadriceps Muscle
    Vastus lateralis

    Origin: 1. Upper part of


    inter-trochanteric line
    2. Root of greater
    trochanter
    3. Lateral lip of linea aspera
    Insertion: Common
    quadriceps tendon then
    tibial tuberosity via patellar
    ligament
    Vastus lateralis

    Action: Extension of leg at


    knee joint

    Nerve supply: branches of


    femoral nerve
    Vastus Medialis
    Origin:
    1. Lower part of
    intertrochanteric line of
    femur
    2. Spiral line
    3. Medial lip of linea aspera
    4. Upper part of the medial
    supracondylar line
    Insertion: Common
    quadriceps tendon then
    tibial tuberosity via patellar
    ligament
    Vastus Medialis

    Action: Extension of leg


    at knee joint;
    stabilizes patella

    Nerve supply:
    Branches of femoral
    nerve.
    Vastus Intermedius

    Origin: anterior and lateral


    surfaces of the femoral
    shaft

    Insertion: Common
    quadriceps tendon into
    patella and tibial
    tuberosity via patellar
    ligament
    Vastus Intermedius

    Action: Extension of
    leg at knee joint

    Nerve supply:
    Branches of femoral
    nerve
    Insertion of Quadriceps Muscle
    Femoral Triangle
    Femoral triangle

    A triangular depressed area situated


    in the upper part of the medial
    aspect of the thigh just below the
    inguinal ligament

    Contains Femoral Artery, Femoral Vein,


    Femoral Nerve, Femoral Canal
    Femoral triangle

    Boundaries

    Superiorly (base) : the inguinal ligament

    Laterally: medial border of sartorius

    Medially: medial border of adductor longus


    Femoral triangle

    Boundaries

    Apex: continuous with adductor canal

    Anterior wall: fascia lata

    Posterior wall: consists of iliopsoas,


    pectineus and adductor longus from lateral
    to medial side
    Femoral triangle

    Femoral sheath

    ◼ A funnel- shaped sheath

    ◼ Derived from transversalis fascia anteriorly


    and iliac fascia posteriorly
    Femoral Sheath
    ◼ It surrounds the femoral vessels and
    lymphatic about 2.5cm below the inguinal
    ligament.

    ◼ Its lower end disappears at the lower margin


    of the saphenous opening where the sheath
    fuses with the adventitia of the vessels.

    ◼ Contains 3 compartments, for the artery,


    vein and femoral canal
    The Femoral Canal

    ◼ About 1.3cm long , medial compartment


    of the femoral sheath, and its upper
    opening is called the femoral ring

    ◼ Contains: a little loose fatty tissue, a small


    lymph node, and some lymph vessels.
    Femoral Hernia
    ◼ If a loop of intestine is forced
    into the femoral ring, it
    expands to form a swelling in
    the upper part of the thigh.

    ◼ A femoral hernia is more


    common in women than in
    men (possibly because their
    wider pelvis and femoral
    canal ). Presents as a
    swelling inferolateral to the
    pubic tubercle
    Femoral Nerve
    ◼ Femoral nerve (L2,3,4) arise from the
    lumber plexus in the abdomen descend in
    groove between psoas and iliacus muscle

    ◼ 2 cm below the inguinal ligament it ends by


    dividing into anterior and posterior
    branches.
    Femoral Nerve
    ◼ The anterior division gives:

    A. Muscular branches to pectineus and


    Sartorius muscles.

    B. Cutaneous nerves includes the anterior


    cutaneous nerve of the thigh.
    Femoral Nerve
    ◼ The posterior division gives:

    A. Saphenous nerve runs downwards and medially to the


    medial side of the knee and medial side of the leg to
    terminates in the region of the ball of the big toe.

    B. Muscular branches to the quadriceps femoris muscle (rectus


    femoris, vastus lateralis, medialis and intermedius).
    Adductor
    Compartment
    Adductor Compartment

    ◼ Adductor muscles
    ◼ Gracilis

    ◼ Pectineus

    (Mentioned earlier)
    ◼ Adductor

    ◼ Longus
    ◼ Magnus
    ◼ brevis
    Obturator Externus

    Origin: External surface of obturator


    membrane and adjacent bone

    Insertion: Trochanteric fossa

    Action: Lateral rotator of the thigh

    Nerve Supply: Obturator nerve


    Gracilis Muscle

    Origin: Inferior pubic ramus

    Insertion: Medial surface of proximal shaft


    of the tibia

    Action: Adducts thigh, flexes leg at knee,


    rotates leg medially

    Nerve Supply: Obturator nerve


    Adductor Longus

    Origin: Outer surface of body of pubis

    Insertion: Linea aspera on middle one-third


    of shaft of femur

    Action: Adducts and medially rotates thigh


    at hip joint

    Nerve Supply: Obturator nerve


    Adductor Brevis

    Origin: External surface of body of pubis


    and inferior pubic ramus

    Insertion: Posterior surface of proximal


    femur and upper one-third of linea aspera

    Action: Adducts thigh at hip joint

    Nerve Supply: Obturator nerve


    Adductor Magnus

    Origin: Pubic part, adductor part-


    ischiopubic ramus
    Ischial part, ischial tuberosity

    Insertion: Pubic part, Posterior surface of


    proximal femur, linea aspera, medial
    supracondylar line
    Ischial part, Adductor tubercle and
    supracondylar line
    Adductor Tubercle
    Adductor Magnus

    Action: Adducts and medially rotates thigh


    at hip joint

    Nerve Supply: Pubic part, Obturator


    nerve
    Ischial part, Sciatic nerve
    Adductor Compartment
    Nerve Supply
    ALL ADDUCTORS ARE SUPPLIED BY
    Anterior division of the obturator nerve

    EXCEPT

    Pubic part of ADDUCTOR MAGNUS By the


    posterior division of the obturator nerve.

    Pectineus muscle is enervated by the femoral


    nerve
    Adductor Compartment -
    Action
    ◼ All the muscles of this group adduct the thigh.

    ◼ Pectineus helps in hip flexion.

    ◼ Gracilis helps in flexion of the knee and rotates the semi-flexed


    knee medially.

    ◼ Ischial part of adductor magnus extends the hip joint.

    ◼ Adductor longus, adductor brevis and pubic part of adductor


    magnus, medially rotate the thigh at the hip joint.

    ◼ Gracilis with the sartorius and semitendinosus act as a


    muscular triad to stabilize the pelvis on tibia (Guy ropes).
    Obturator Nerve
    Origin:
    Branch of lumbar plexus,

    From anterior division of ventral rami of L2,3,4

    Course & relations:

    1. It passes medial to psoas major

    2. It passes through obturator canal, above obturator vessels, to reach the


    thigh

    3. In the thigh, it divides into anterior (between adductor longus & brevis)
    and posterior (between adductor brevis & magnus) divisions.
    Obturator Nerve
    Branches:

    From anterior division:


    Muscular to:
    1. adductor longus,
    2. adductor brevis &
    3. gracilis
    Articular to: hip joint
    Cutaneous to: middle part of thigh

    From posterior division:


    Muscular to:
    1. adductor portion of adductor magnus,
    2. obturator externus
    Articular to: knee joint
    ◼ For further inquiries
    PLZ feel free to
    contact at any time
    through email

    [email protected]

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