Regions of Lower Limb
Compartments of Thigh
• Three Compartments
– Medial (adductor)
• Act mainly at the hip joint
– Anterior (extensor)
• Hip Flexors
• Knee Extensors
– Posterior (flexor)
• Hip Extension
• Knee Flexion
Femoral Triangle
• Boundaries
– Inguinal ligament
– Medial border of
sartorius muscle
– Lateral border of
adductor longus muscle
• Floor
– Iliopsoas
– pectineus
Femoral Triangle
• Contents
– Femoral Nerve
– Femoral Artery
– Femoral Vein
– Lymphatics
– NAVL
Femoral Triangle
• Femoral Artery Superficial
in Femoral Triangle
– Femoral pulse
– Femoral catheterization
– Coronary angiography
• Femoral Sheath
– Continuation of iliopsoas
fascia and transversalis
fascia
– Encloses proximal femoral
artery and vein
Femoral Hernia
• Femoral Ring
– Located at base of femoral
canal and is a weak area of
abdominal wall and site of
femoral hernia
– Hernia initially presents as
tender mass in femoral
triangle
– Can pass into subcutaneous
tissue via saphenous opening
– Strangulation and necrosis
can occur as a result of
compression against sharp,
medial edge of femoral ring
– Usually more rounded than
inguinal hernias
– More common in females
Muscles of Anterior Compartment
• Iliopsoas
– Proximal Attachment
• T12-L5 vertebrae and iliac
fossa
– Distal Attachment
• Lesser trochanter of femur
– Innervation
• Iliacus: Femoral nerve (L2, L3)
• Psoas Major: Anterior rami of
lumbar nerves (L1, L2, L3)
– Actions
• Flexes thigh at hip joint; if
thigh is fixed, flexes trunk on
the thigh
Muscles of Anterior Compartment
• Pectineus
– Proximal Attachment
• Superior ramus of pubis
– Distal Attachment
• Pectineal line of femur,
inferior to lesser trochanter
– Innervation
• Femoral Nerve (L2, L3),
may receive branch of
obturator nerve
– Actions
• Adducts and flexes thigh
and assists with medial
rotation of the thigh
Muscles of Anterior Compartment
• Sartorius
– Proximal Attachment
• Anterior superior iliac spine
– Distal Attachment
• Proximal part of medial
surface of tibia (pes
anserinus)
– Innervation
• Femoral Nerve (L2, L3)
– Actions
• Flexes, weakly abducts and
laterally rotates thigh at hip
joint; flexes leg at knee
joint (weaver’s muscle)
Muscles of Anterior Compartment
• Rectus Femoris
– Proximal Attachment
• Anterior inferior iliac spine and ilium superior
to acetabulum
– Distal Attachment
• Base of patella via common quadriceps tendon
and indirectly to tibial tuberosity to via patellar
ligament
– Innervation
• Femoral Nerve (L2, L3, L4)
– Actions
• Aids iliopsoas in thigh flexion and extends leg
at knee joint
• Most important muscle for knee extension,
especially when force required i.e. standing
from sitting or squatting, climbing stairs,
running jumping
• ~ 3 x’s stronger than hamstrings
• Also important in stabilizing knee joint
Muscles of Anterior Compartment
• Vastus Lateralis
– Proximal Attachment
• Greater trochanter and
lateral lip of linea aspera
– Distal Attachment
• Base of patella via common
quadriceps tendon and
indirectly to tibial
tuberosity to via patellar
ligament
– Innervation
• Femoral Nerve (L2, L3, L4)
– Actions
• extends leg at knee joint
Muscles of Anterior Compartment
• Vastus Medialis
– Proximal Attachment
• Intertrochanteric line and
medial lip of linea aspera
– Distal Attachment
• Base of patella via common
quadriceps tendon and
indirectly to tibial
tuberosity to via patellar
ligament
– Innervation
• Femoral Nerve (L2, L3, L4)
– Actions
• extends leg at knee joint
Muscles of Anterior Compartment
• Vastus Intermedius
– Proximal Attachment
• Anterior and lateral
surfaces of shaft of femur
– Distal Attachment
• Base of patella via common
quadriceps tendon and
indirectly to tibial
tuberosity to via patellar
ligament
– Innervation
• Femoral Nerve (L2, L3, L4)
– Actions
• extends leg at knee joint
Muscles of Medial Compartment
• Adductor Longus
– Proximal Attachment
• Body of pubis inferior to
pubic crest
– Distal Attachment
• Middle 1/3 of linea
aspera
– Innervation
• Anterior division of
obturator nerve (L2, L3,
L4)
– Actions
• Adducts thigh
Muscles of Medial Compartment
• Adductor Brevis
– Proximal Attachment
• Body and inferior ramus of
pubis
– Distal Attachment
• Pectineal line and proximal
linea aspera
– Innervation
• Anterior division of
obturator nerve (L2, L3, L4)
– Actions
• Adducts thigh and to some
extent flexes it
Muscles of Medial Compartment
• Adductor Magnus
– Proximal Attachment
• Adductor Part: inferior ischiopubic
ramus
• Hamstring Part: ischial Tuberosity
– Distal Attachment
• Adductor Part: Gluteal tuberosity,
linea aspera and medial
supracondylar line
• Hamstring Part: adductor tubercle
– Innervation
• Adductor Part: posterior division of
obturator nerve (L2, L3, L4)
• Hamstring Part: tibial part of sciatic
nerve (L4)
– Actions
• Adducts Thigh
• Flexes Thigh (adductor portion)
• Extends Thigh (Hamstring portion)
Muscles of Medial Compartment
• Gracilis
– Proximal Attachment
• Body and inferior ramus of
pubis
– Distal Attachment
• Proximal part of medial
surface of tibia (pes
anserinus)
– Innervation
• Obturator nerve (L2, L3)
– Actions
• Adducts Thigh, flexes leg,
helps stabilize knee and
acts as synergist with other
adductors
• Gracilis Transplants
Muscles of Medial Compartment
• Obturator Externus
– Proximal Attachment
• External surface of
obturator membrane and
surrounding bone
– Distal Attachment
• Trochanteric fossa of
femur
– Innervation
• Obturator nerve (L3, L4)
– Actions
• Laterally rotates thigh;
steadies head of femur in
acetabulum
Muscles of Anterior and Medial
Compartment
Muscles of Anterior and Medial
Compartment
Muscles of Posterior Compartment
• Semitendinosus
– Proximal Attachment
• Ischial tuberosity
– Distal Attachment
• Proximal part of medial
surface of tibia (pes anserinus)
– Innervation
• Tibial division of sciatic nerve
(L5, S1, S2)
– Actions
• Extends thigh, flexes leg and
rotates it medially when leg is
flexed
• When thigh and leg are fixed,
these muscles can extend
trunk
Muscles of Posterior Compartment
• Semimembranosus
– Proximal Attachment
• Ischial tuberosity
– Distal Attachment
• posterior part of medial
condyle of tibia
– Innervation
• Tibial division of sciatic
nerve (L5, S1, S2)
– Actions
• Extends thigh, flexes leg
and rotates it medially
when leg is flexed
• When thigh and leg are
fixed, these muscles can
extend trunk
Muscles of Posterior Compartment
• Biceps Femoris
– Proximal Attachment
• Long Head: ischial tuberosity
• Short Head: linea aspera and
lateral supracondylar ridge of
femur
– Distal Attachment
• Lateral side of head of fibula
– Innervation
• Long Head: Tibial division of
sciatic nerve (L5, S1, S2)
• Short Head: Common Fibular
division of sciatic nerve (L5, S1,
S2)
– Actions
• Extends thigh, flexes leg and
rotates it laterally when leg is
flexed
• When thigh and leg are fixed,
long head can extend trunk
Arteries of Thigh
• Femoral
– Deep Artery of Thigh
(Profunda femoris)
• Lateral Circumflex (ascending,
transverse and descending)
• Medial Circumflex
• Perforating Arteries
Arteries of Thigh
• Obturator
– Anterior Branch
– Posterior Branch
Nerves of Thigh
• Femoral (L2-L4)
– Anterior cutaneous
nerve branches
– Motor nerves to muscles
of anterior compartment
– Saphenous nerve
Gray’s Anatomy for Students, 2 nd Edition, Drake, Vogl and Mitchell
Nerves of Thigh
• Obturator (L2-L4)
– Posterior Branch
• Obturator externus
• Adductor brevis
• Adductor portion of
adductor magnus
– Anterior Branch
• Adductor longus
• Gracilus
• Adductor brevis
• Cutaneous branches to
skin on medial thigh
Gray’s Anatomy for Students, 2nd Edition, Drake, Vogl and Mitchell
Nerves of Thigh
• Sciatic (L4-S3)
– Tibial Nerve
• Biceps femoris (long
head)
• Semitendinosus
• Semimembranosus
– Common Fibular Nerve
• Biceps femoris (short
head)
Gray’s Anatomy for Students, 2 nd Edition, Drake, Vogl and Mitchell
Cross Section of Thigh