LECTURE 14 – ANTERIOR AND MEDIAL THIGH
SPECIAL FEATURES:
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great sapheonous vein: located in superficial fascia of medial leg and
thigh from. Begins at the dorsal venous arch of foot and empties into the
femoral vein via the saphenous opening in the fascia lata.
 clinical note: valves of the superficial veins become incompetent
this can result in varicose veins.
fascia lata: the deep fascia of the thigh is a dense layer of connective
tissue deep to the superficial fascia and overlying the muscles. Attaches to
and is continuous with inguinal ligament. Laterally thickens to for iliotibial
tract.
intermuscular septa: septa pass from the fascia lata to attach to the
femur to create anterior and posterior compartments of the thigh.
femoral triangle: located inferior to inguinal ligament bound by:
 Sartorius m.  laterally
 adductor longus m.  medially
 inguinal ligament m.  superiorly
 pectineus, iliopsoas and adductor longus mm.  floor
 fascia lata  roof
 contains from lateral to medial: femoral nerve, femoral artery,
femoral vein and deep inguinal lymphnodes (NAVL).
 femoral sheath: fascial tube containing the artery and vein (not the
nerve).
 femoral canal: medial space within femoral sheath that allows for
the femoral vein to expand; occupied by lnguinal lymph nodes; site
for femoral hernias.
 femoral ring: is the superior abdominal opening of femoral canal.
Outlines a weak spot in the anterior abdominal wall that is a
frequent site for femoral hernias. Hernias can protrude the
saphenous opening.
adductors canal: (aka Hunter’s or subsartorial canal) Fascial tunnel
covered by middle third of sartorius m. that conveys femoral vessels from
femoral triangle to adductor hiatus where they enter the popliteal fossa.
Contains to branches of femoral nerve:
1. nerve to vastus medialis
2. saphenous nerve
SKELETAL FEATURES:
1. os coxa:
 anterior superior iliac spine (ASIS): attachment for sartorius and
tensor fascia latae m. and superior end of inguinal ligament
 anterior inferior iliac spine (AIIS): attachment for rectus femoris
 pubic tubercle: inferior attachment for inguinal ligament; pubic crest is
medial to it
 pecten pubis: ridge on superior ramus of pubis, lateral to pubic
tubercle; attachment for pectineus m.
 obturator foramen: conveys obturator vessels and nerve from pelvis
 pubic arch: formed by two inferior ishiopubic rami; attachments for
adductors
 body of pubis: adjacent to the pubic symphysis
 Ischial tuberosity: attachment for hamstring mm.
2. Femur:
 lesser trochanter: attachment for iliopsoas m.
 linea aspera: vertical, roughened line on midposterior surface;
attachment for the following muscles from medial to lateral: vastus
medialis, pectineus & adductor longus, adductor brevis, adductor
magnus, gluteus max, biceps femoris (short head) and vastus
lateralis.
 adductor tubercle: superior aspect of medial epicondyle; attachment
for adductor magnus
3. Tibia: shaft is triangular in cross section with medial, lateral, and posterior
surface
 tibial tuberosity: attachment for patellar ligament
 Gerdy’s tubercle: located on lateral condyle, is the attachment of
tensor fascia lata
MUSCLES:
ANTERIOR THIGH COMPARTMENT:
1. Iliopsoas: (see posterior abdominal wall notes)
 attachments: superior part of iliac fossa (illiacus) and transverse
processes, bodies and intervertebral discs of T12 through L5 (psoas)
to lesser trochanter.
 innervation: femoral n (L2-L4, illiacus) and anterior primary rami L2-L4
(psoas)
 actions: flexion of thigh at hip
2. Sartorius:
 attachments: from ASIS to medial superior surface of tibia
 innervation: femoral n. - L2-4
 actions: flexion of leg at knee; flexion of thigh at hip
3. Tensor fasciae latae
 attachments: from ASIS and adjacednt iliac crest to iliotibial tract
(which attach to the lateral condyle of tibia
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innervation: superior gluteal n. L4-S1
actions: thigh abductor; stabilizes extended knee and trunk on hip
joint
Quadriceps femoris group:
 attach to tibial tuberocity via a common tendon (quadriceps tendon)
with sesamoid bone (patella); known beyond patella as patellar
ligament
 all innervated by femoral n. L2-4
 action of all is extension of leg at knee
4. Rectus femoris:
 attachment: AIIS to tibial tuberocity
 innervation: femoral n.
 action: extension of leg at knee AND flexion of femur at hip
5. Vastus lateralis:
 attachment: greater trochanter and lateral lip of linea aspera to tibial
tuberocity
 innervation: femoral n.
 action: extension of leg at knee
6. Vastus medialis:
 attachment: medial lip of linea aspera to tipial tuberocity
 innervation: femoral n.
 action: extension of leg at knee
7. Vastus intermedius:
 attachment: anterolateral femoral shaft to tibial tuberocity
 innervation: femoral n.
 action: extension of leg at knee
Clinical note: runner’s knee is a soreness due to hyperflexion of the knee or a
blow to the patella pulling the patella sideways
MEDIAL THIGH COMPARTMENT:
8. Pectineus:
 attachment: pecten pubis to pectineal line at top of linea aspera
 innervation: femoral n. (occasionally obturator) L2-4
 actions: flexion of femur at hip; adduction of thigh
9. Gracilis:
 attachments: body & inferior ramus of pubis to superior medial surface
of tibia, below Sartorius
 innervation: obturator n. L2-L4
 actions: adduction of thigh, flexion of leg at knee
10. Adductor longus:
 attachments: from body of pubis to middle third of linea aspera
 innervation: obturator n. L2-L4
 actions: adduction of thigh and flexion of thigh at hip
11. Adductor brevis:
 attachments: from body of pubis to superior third of linea aspera
 innervation: obturator n. L2-L4
 actions: adduction of thigh
12. Adductor magnus:
 attachments: inferior ramus of pubis, ramus and tuberosity of ischium
to linea aspera and adductor tubercle of femur
 innervation: obturator n. L2-L4
 actions: adduction of thigh, extension of thigh at hip
13. Obturator externus:
 attachments: from border of obturator foramen and obturator
membrane to intertrochanteric fossa of femur
 innervation: obturator n. L2-L4
 actions: lateral rotation of thigh; stabilizes hip joint
Clinical note: pulled groin is caused by strain or stretching of superior
attachments of medial thigh muscles
NERVES (from lumbar plexus)
1. femoral nerve: L2 - L4; supplies mm. noted above and cutaneous
branches (anterior and medial femoral cutaneous and saphenous n.)
2. obturator nerve: L2 - L4; supplies adductors and obturator externus and
small cutaneous field of medial thigh
3. lateral femoral cutaneous nerve: L2 - L3 ; supplies skin of lateral thigh
VESSELS:
1. femoral artery: from external iliac a.; changes to femoral a. after passing
deep to inguinal ligament, thru femoral triangle, deep to sartorius in
adductor canal, traverses adductor hiatus to become popliteal a.
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supplies anterior and medial thigh mm.
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main branch is the profunda femoris a. (deep femoral a.)
2. profunda femoris artery: supplies deep anterior & posterior thigh mm.
3. lateral and medial circumflex femoral arteries: which supply hip and
knee joints (medial passes between pectineus & iliopsoas mm.)
4. obturator artery: from internal iliac a. via obturator foramen to medial
thigh; supplies adductor mm. and obturator externus
5. great saphenous v.: see above
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RLF-LECTURE 14 ñ ANT#UNBR#