NERVES AND VESSELS OF ANTERIOR
COMPARTMENT OF THAIGH
Learning Objectives
By end of this class students are able:
a.) To understand nerve of supply of the anterior compartment of
thigh.
b.) To understand the blood supply and the venous drainage of anterior
compartment of thigh.
Lecture outline:
FEMORAL NERVE
It is the main nerve of anterior or extensor compartment of the thigh.
ROOT VALUE
It is the largest branch of lumber plexus.
Dorsal division of anterior primary rami of spinal nerves L2 L3 &L4
COURSE
It begins in abdomen with in psoas major muscles it enter the anterior
compartment of thigh behind the inguinal ligament to enter in femoral triangle.
It runs downward in the groove between iliacus and psoas major muscles
outside the femoral sheath lateral to femoral artery.
After a short course of about 2cm below the inguinal ligament it divides into
1.) Anterior division
2.) Posterior division
BRANCHES OF FEMORAL NERVES
Anterior divisions
It gives two muscular branches
And two cutaneous branches
Muscular braches to:
1.) SARTORIUS
2.) PECTINEUS
CUTANEOUS BRANCHES
1.) Intermediate cutaneous nerve of thigh
2.) Medial cutaneous nerve of thigh
POSTERIOR DIVISION IT GIVES FOUR MUSCULAR
BRANCHES AND ONE CUTANEOUS BRANCHES
Muscular branches to:
1.) Rectus femorus
2.) Vastus medialis
Quadriceps Femoris
3.) Vastus lateralis
4.) Vastus intermedius (articularis genu)
CUTANEOUS BRANCHES
1.) Saphenous nerves
This nerves cross the femoral vessels from to lateral to medial side and supply
a.) Branch to infra patellar plexus.
b.) Skin of the medial side of the leg.
c.) Skin of the medial side of the foot and ball of big toe.
ARTICULAR BRANCHES
1.) Hip joint is supply by nerve to rectus femoris.
2.) Knee joint is supply be nerve to three vasti.
NOTE
Nerve to vastus medialis contains numerous proprioceptive fibers form the knee
joint.
FEMORAL ARTERY
It is a chief artery of anterior compartment of the thigh
COURSE
It is a continuation of external iliac artery. It begins behind the inguinal ligament
at the midinguinal point. it runs downward and medially first in femoral triangle
then in adductor canal it ends at the junction of middle and the lower thirds of
thigh by passing through the opening in adductor Magnus muscles and continue
as popliteal artery in back of thigh
RELATION OF FEMORAL ARTERY IN FEMORAL
TRIANGLE
In femoral triangle femoral artery lies with in the femoral sheath lateral to femoral
vein and femoral nerve lies lateral to femoral artery outside the femoral sheath
At the apex femoral triangle femoral artery lies on femoral vein
ANTERIOR
- Skin
- Super facial fascia
- Deep fascia
- Anterior wall of femoral sheath
POSTERIOR
- Psoas major, pectinus.adductor longus
- Posterior wall of femoral sheath
RELATION OF FEMORAL ARTERY IN ADDUCTOR
CANAL
Femoral artery enter the adductor canal at the apex of femoral triangle
- Femoral vein lies posterior to the femoral at lateral to the artery in the
Lower part of the canal
- Sphenous nerve cross the femoral artery from lateral to medial side
- Nerve to vastus medialis lies lateral to femoral artery
BRANCHES OF FEMORAL ARTERY
-Three superficial branches
-Three deep branches
SUPERFACIAL BRACHES
- Superficial circumflex iliac artery
- Superficial epigastria artery
- Superficial external pudendal artery
DEEP BRANCHES ARE
- Profunda femoris artery
- Deep external pudendal artery
- Muscular branches
1.) SUPERFACIAL
CIRCUMFLEX ILIAC ARTERY
It pierce the deep facia lateral to saphenous opening and runs upward below the
inguinal ligament and reaches the anterior superior iliac spin and anastomos with deep
circumflex iliac, superior gluteal artery and lateral circumflex femoral artery.
2.) SUPERFICIAL EPIGASTRIC ARTERY
It pierces the cribriform fascia, and runs towards the umbilicus, and supplies
lower part of anterior abdominal wall.
3.) SUPERFICIAL
EXTERNAL PUDANDAL ARTERY
It pierces cribriform fascia runs medially, in front of spermatic cord, and
supplies the external genitalia.
DEEP BRANCHES
1.) Profunda Femoris Artery

It is largest branch of femoral artery

it is normally the vessel of supply for all thigh muscle it arise from the
lateral side of the femoral artery about 3 to 4 cm below the inguinal
ligament than spirals down deep to it passing between pectineus and
adductor longus then continue down on adductor brevis and adductor
magnus and end as 4th perforating artery.
BRANCHES OF PROFUNDA FEMORIS ARTERY
1.) 4 perforating arteries.
2.) Medial circumflex femoral artery.
3.) Lateral circumflex femoral artery.
2.) DEEP
EXTERNAL PUNDENDAL ARTERY
Pierces the fascia lata and passes behind the spermatic cord. To supply the
skin of scrotum and (labium majus)
FEMORAL VEIN
It is continuation of popliteal vein
It begins at opening of adductor magnus muscle(hiatus magnus)
It runs upward in adductor canal and then femoral triangle
It ends by passing behind inguinal ligament as external iliac vein,
It has 4 or 5 valves, the most constant ones being just above the junction with
great saphanous vein.
TRIBUTARIES OF FEMORAL VEIN
1.) great saphenous vein,
2.) veins accompanying the 3 deep branches of femoral artery.
3.) lateral and medial circumflex femoral veins.
4.) descending genicular and muscular veins.
CLINICAL CORRELATES
Femoral artery:
•
Avascular Necrosis of the neck of the femur during fracture is a result of
disruption of the medial circumflex femoral artery (a branch of the profunda
femoral artery)
•
Coronary angioplasty is often performed by entering the femoral artery at the
femoral triangle
Femoral vein:
•
Occlusion of the femoral vein can be life-threatening.
•
The practice of delivering recreational drugs intravenously using the femoral
vein is relatively common amongst injecting drug users
•
Femoral venopuncture is useful when there are no superficial veins that can be
aspirated in a patient, in the case of collapse
Femoral nerve:
•
It is also necessary to appreciate clinically that this is a case where the nerve
is more lateral than the vein. In most other cases the a nerve (relative to its
associated artery and vein) would be the deepest or more medial followed by
the artery and then the vein. But in this case it is the opposite. This must be
remembered when venous or arterial samples are required from the femoral
vessels.