femoral vein

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1
The femoral region (thigh)lies between the gluteal, abdominal, and
perineal regions proximally and the knee region distally:
anteriorly separated from the
abdominal wall
by the inguinal ligament
posteriorly separated from the
gluteal region
by the gluteal fold superficially
by the inferior margins of the
gluteus maximus & quadratus
femoris on deeper planes
Structures enter and leave the top of
the thigh by 3 routes:
Posteriorly continuous with the gluteal
region
sciatic nerve
Anteriorly abdominal cavity via aperture
between inguinal ligament & pelvic bone
Medially thigh & pelvic cavity communicates
via obturator canal
Vessels and nerves passing between the thigh
and leg pass through the popliteal fossa
posterior to the knee joint.
Superficial Fascia of the
Thigh
Attached to the deep fascia below
the inguinal ligament.
Deep Fascia of the Thigh
(Fascia Lata)
Encloses the thigh like a trouser leg.
Saphenous opening
A gap in the deep fascia in front of
the thigh just below the inguinal
ligament.
Great saphenous vein via hiatus
saphenus drains into femoral vein.
Filled with loose connective tissue
called the cribriform fascia.
3 fascial septa pass from the inner aspect of the deep fascial sheath of
the thigh to the linea aspera of the femur.
Anterior compartment of
thigh Femoral nerve
muscles extend the leg at the
knee joint.
Medial compartment of thigh
Obturator nerve
muscles adduct the thigh at the
hip joint.
Posterior compartment of
thigh Sciatic nerve
muscles extend the thigh at the
hip joint & flex the leg at the
knee joint.
Sartorius
Quadriceps femoris
Rectus femoris
Vastus lateralis
Vastus medialis
Vastus intermedius
Insertion
base of patella
indirectly via
patellar ligament
to tibial tuberosity
femoral nerve
Origin
Anterior inferior
Origin iliac
spine
superior
ASIS&&ilium
superior
part
acetabulum
ofto
notch
inferior to it
Insertion
Superior part of
medial surface of
tibia
In addition, the
terminal ends of the
psoas major and
iliacus muscles pass
into the upper part of
the anterior
compartment from
sites of origin on the
posterior abdominal
wall.
Iliacus+psoas major
Ilıopsoas
Extends leg at knee
joint.
Rectus femoris also
steadies hip joint &
helps iliopsoas flex
thigh.
Flexes, abducts, and
laterally rotates
thigh
at hip joint.
Flexes leg at knee
joint (medially
rotating leg when
knee is flexed).
Extension
of leg at
knee joint
Quadriceps
femoris
Flexion of
thigh at hip
joint
Rectus
femoris
Sartorius
Abduction of
thigh at hip
joint
Sartorius
Lateral
rotation of
thigh at hip
joint
Sartorius
1.Gracilis
2. Pectineus
3. Adductor longus
4. Adductor brevis
5. Adductor magnus
6.Obturator externus
Adductor longus
Adductor brevis
Adductor magnus
Adductor brevis
Adductor magnus
“adductor part”
Adductor magnus
“hamstrings part”
Obturator externus
Adducts thigh; flexes leg; helps rotate leg medially
A gap between the aponeurotic
distal attachment of the adductor part
of the adductor magnus & tendinous
distal attachment of the hamstring
part.
Transmits femoral artery & vein from
the adductor canal in the thigh to the
popliteal fossa.
Located lateral and superior to the
adductor tubercle of the femur.
Biceps femoris
Short head
Biceps femoris
Long head
Semitendinosus
Semimembranosus
Proximal attachment to ischial tuberosity
deep to the gluteus maximus.
Distal attachment to the bones of the leg.
Thus act on two joints, producing
extension @ hip joint & flexion @ knee joint.
Innervation by tibial division of the sciatic nerve.
Femoral artery largest & main artery of lower limb
Obturator artery
Inferior gluteal artery
Inferior gluteal
artery
Obturator
artery
Femoral artery
Distal continuation of external iliac
artery.
Passes under the inguinal ligament.
Enters the femoral triangle
midpoint of the inguinal ligament
(midway between ASIS & pubic tubercle).
Continues down the thigh in the
adductor canal.
Becomes popliteal artery behind the
knee.
1. Superficial circumflex iliac artery
2. Superficial epigastric artery
3. Superficial external pudendal artery
4. Deep external pudendal artery
5. Profunda femoris artery
Large and important branch
Arises from the lateral side of the
femoral artery below the inguinal
ligament
6. Descending genicular artery
Superficial & deep veins
Great saphenous vein
Largest superficial vein in the thigh
Originates from a venous arch on the
dorsal aspect of the foot.
Ascends along the medial side of the
lower limb.
Passes through the saphenous ring.
To connect with the femoral vein in
the femoral triangle.
Femoral vein
Continuation of the popliteal vein
proximal to the adductor hiatus.
Enters the femoral sheath
Ends posterior to the inguinal
ligament, becomes external iliac vein
Profunda Femoris Vein
drains into the femoral vein.
Obturator Vein
drains into the internal iliac vein.
3 major nerves in the thigh, each associated with one of the 3
compartments:
Femoral nerve
anterior compartment of thigh
Obturator nerve
medial compartment of thigh
Sciatic nerve
posterior compartment of thigh
o Largest branch of the lumbar
plexus.
o Enters the thigh lateral to the
femoral artery and the femoral
sheath, behind the inguinal
ligament.
o In the femoral triangle lies on the
lateral side of the femoral artery
o Enters the medial
compartment of thigh
through the obturator canal.
o Supplies most of the
adductor muscles and skin
on the medial aspect of the
thigh.
o Descends in the midline of the
thigh.
o Ends by dividing into the tibial
and common peroneal nerves.
o Innervates all muscles in the
posterior compartment of thigh
and then its branches continue
into the leg and foot.
Lateral cutaneous nerve of the
thigh
branch of the lumbar plexus (L2& 3)
Medial cutaneous nerve of the
thigh
branch of the femoral nerve
Intermediate cutaneous nerve of
the thigh
branch of the femoral nerve
Posterior cutaneous nerve of the
thigh
branch of the sacral plexus
Superiorly inguinal ligament
Medially lateral border of adductor
longus
Laterally sartorius
Contents; from lateral to medial
o
o
o
o
o
Femoral nerve
Femoral sheath
Femoral artery
Femoral vein
Deep inguinal lymph nodes
A funnel-shaped fascial tube
Passes deep to the inguinal ligament
Encloses proximal parts of the femoral vessels
and creates the femoral canal medial to them.
Formed by an inferior prolongation of
transversalis & iliopsoas fascia
Subdivided into three smaller compartments
Lateral compartment
for the femoral artery.
Intermediate compartment
for the femoral vein.
Medial compartment
constitutes the femoral canal
 Smallest of the 3
compartments of the
femoral sheath
 Lies between the
medial edge of the
femoral sheath and the
femoral vein.
Upper opening of the femoral
canal formed by the small
opening at its abdominal end.
Boundaries
Laterally vertical septum
between femoral canal &
femoral vein.
Posteriorly superior ramus of
the pubis covered by the
pectineus muscle and its
fascia.
Medially lacunar ligament
Anteriorly medial part of the
inguinal ligament.
Femoral sheath blends with the
tunica adventitia of blood vessels.
a potentially weak area in the
abdomen
The part of the femoral sheath that
forms the medially located femoral
canal is not.
femoral hernia
A protrusion of peritoneum forced
down the femoral canal, pushing
the femoral septum before it
 Intermuscular
cleft in the middle
1/3 of the thigh
beneath the
sartorius muscle
 Extends from the
apex of the femoral
triangle to the
adductor hiatus
Contains
o terminal part of the femoral
artery
o femoral vein (lies behind the
artery)
o deep lymph vessels
o saphenous nerve
o nerve to the vastus medialis
o terminal part of the obturator
nerve
Boundaries
Anteriorly and laterally vastus
medialis
Posteriorly adductors longus &
magnus
Medially sartorius, roof of the canal
o An area of transition
between the thigh and leg
o Major route by which
structures pass from one
region to the other.
o Formed between muscles
in the posterior
compartments of thigh and
leg.
Superolaterally
Biceps femoris
Superomedially
Semimembranosus
Inferolaterally and
inferomedially
Gastrocnemius
Posteriorly
Skin & popliteal fascia (roof)
1) Termination of the
small saphenous vein
2) Popliteal arteries and
veins and their
branches and
tributaries
3) Tibial and common
fibular nerves
4) Posterior cutaneous
nerve of thigh
5) Popliteal lymph nodes
and lymphatic vessels
The sciatic nerve usually
ends at the superior angle of
the popliteal fossa by
dividing into
tibial nerve
&
common fibular nerve
tibial nerve ,medial and larger terminal
branch of the sciatic nerve, descends
vertically through the popliteal fossa
and exits deep to the margin of
plantaris muscle to enter the posterior
compartment of leg.
common fibular nerve , lateral, smaller
terminal branch of the sciatic nerve,
exits by following the medial border of
the biceps femoris tendon over the
lower lateral margin of the popliteal
fossa, and continues to the lateral side
of the leg where it swings around the
neck of the fibula and enters the
lateral compartment of leg
Continuation of the femoral
artery
Begins as the femoral artery
passes through the adductor
hiatus.
Ends lateral to the midline of
the leg by dividing into anterior
& posterior tibial arteries.
 Popliteal vein is superficial to
and travels with the popliteal
artery. (formation by ant. & post.
tibial veins), becomes femoral
vein.
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