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Front of thigh.pptx
- 1. FRONT OF THIGH Dr. Anitha. B Assistant professor Department of Anatomy SLIMS 30.01.2023
- 2. OBJECTIVE • Introduction to lower limb • Compartments of thigh • Front of thigh • Superficial fascia and Deep fascia • Contents in front of thigh • Muscles • Vessels • Nerve • Femoral triangle • Femoral sheath • Adductor canal • Applied aspects
- 3. INTRODUCTION TO LOWERLIMB • Transmission of body weight • Locomotion
- 4. COMPARTMENTS OF THIGH • Anterior compartment (Front of thigh ) • Medial compartment • Posterior compartment ( back of thigh)
- 5. FRONT OF THIGH • Between hip joint and knee joint • Surface landmarks • Anterior superior iliac spine • Pubic tubercle • Midinguinal point • Midpoint of inguinal ligament • Greater trochanter • Medial and lateral condyles of femur and tibia • Adductor tubercle • Patella • Tibial tuberosity
- 6. SUPERFICIAL FASCIA • 2 layers • Superficial fatty layer • Campers fascia • Deep membranous layer • Scarpa’s fascia Contains cutaneous nerves, vessels ,superficial inguinal lymphnodes, great saphenous vein
- 8. DEEP FASCIA • Deep fascia - Fascia lata • Holdens line • Scarpa’s fascia attached to fascia lata in a horizontal line from pubic tubercle Fascia lata
- 9. MODIFICATION OF DEEP FASCIA • Saphenous opening • Oval opening in fascia lata • Lies 4cm below and 4 cm lateral to pubic tubercle
- 10. • Iliotibial tract • Thickening of fascia lata on the lateral aspect of thigh • Above - enclose gluteus maximus and tensor fascialata, gluteal aponeurosis • Below- attached to lateral condyle of tibia • Stabilizes the knee
- 12. CONTENTS • Muscles • Quadriceps femoris • Articularis genu • Sartorius • Tensor fascia lata • Vessels • Femoral artery , femoral vein • Nerve • Femoral nerve
- 14. MUSCLES • Quadriceps femoris • Rectus femoris • Vastus lateralis • Vastus intermedius • Vastus medialis • Supplied by femoral nerve
- 16. RECTUS FEMORIS • Origin - Ilium • Straight head -Anterior inferior iliac spine • Reflected head -Groove above acetabulum • Insertion • Base of patella • Nerve supply • Posterior division of femoral nerve • Action • Extends the knee, flexes the hip
- 17. VASTUS LATERALIS • Origin • Intertrochonteric line , greater trochanter, gluteal tuberosity, linea aspera • Insertion • Into the tendon of rectus femoris , lateral part of base of patella , lateral border of patella • Nerve supply • Posterior division of femoral nerve • Action • Extension of knee joint
- 19. VASTUS MEDIALIS • Origin • Intertrochanteric line , spiral line , medial lip of linea aspera, upper 2/3rd of medial supracondylar line, medial intermuscular septa • Insertion • Into the tendon of rectus femoris, medial part of base of patella, upper 2/3rd of medial border of patella • Nerve supply • Posterior division of femoral nerve • Action • Extension of knee joint
- 21. VASTUS INTERMEDIUS • Origin • Anterior and lateral aspect of upper 3/4th of femur • Insertion • Base of patella deep to rectus femoris • Nerve supply • Posterior division of femoral nerve • Action • Extension of knee joint
- 23. ARTICULARIS GENU • Detached part of vastus intermedius • Origin • Anterior surface of lower part of femur • Insertion • Upper part of synovial membrane of knee joint
- 24. Nerve supply Nerve to vastus intermedius Action Pulls up the synovial membrane during knee extension
- 25. SARTORIUS • Longest muscle of the body • Origin • Anterior superior iliac spine • Insertion • Upper part of medial surface of shaft of tibia Sartorius
- 26. • Nerve supply • Anterior division of femoral nerve • Action • flexion of hip and knee joint • Adducts and rotates the thigh laterally • Tailor’s muscle
- 27. TENSOR FASCIA LATA • Lies between gluteal region and upper part of front of thigh • Origin • Outer lip of iliac crest • From ASIS to iliac tubercle • Insertion • Iliotibial tract
- 28. • Nerve supply • Superior gluteal nerve • Action • Abducts hip joint • Maintain extended position of knee joint through iliotibial tract
- 29. FEMORAL TRIANGLE • Triangular depression in upper 1/3rd of front of thigh • Below inguinal ligament
- 30. BOUNDARIES • Lateral border • Medial border • Base • Apex • Roof • Floor
- 31. • Lateral • Sartorius • Medial • Adductor longus • Base • Inguinal ligament • Apex • Meeting point of sartorius and adductor longus
- 32. • Floor • Iliacus • Psoas major • Pectineus • Adductor longus
- 33. • Roof • Fascia lata with saphenous opening
- 34. • Roof • Superficial branches of femoral artery and accompanying veins • Great saphenous vein • Superficial inguinal lymphnodes • Femoral branch of genitofemoral nerve • Branches of ilioinguinal nerve
- 35. CONTENTS • Femoral artery and its branches • Femoral vein and its tributaries • Femoral nerve • Deep inguinal lymphnodes • Lateral cutaneous nerve of thigh
- 36. FEMORALARTERY • Continuation of external iliac artery Aorta Common iliac artery External iliac artery Internal iliac artery Femoral artery Midinguinal point
- 37. FEMORALARTERY Enters femoral triangle behind midinguinal point Runs downwards medially Lies lateral to femoral vein Leaves femoral triangle at apex Passing through adductor canal Midinguinal point Apex of femoral triangle
- 38. Femoral artery continues as popliteal artery
- 39. BRANCHES Branches in femoral triangle Branches in Adductor canal Superficial branches Deep branches • Superficial epigastric artery • Superficial circumflex iliac artery • Superficial external pudendal artery • Profunda femoris artery • Deep external pudendal artery • Muscular branches Muscular branches Descending genicular branches
- 40. BRANCHES
- 41. FEMORAL VEIN • Upward continuation of popliteal vein at adductor hiatus • Lies medial to femoral artery • Enters behind inguinal ligament • Continues as external iliac vein
- 42. FEMORAL SHEATH • Funnel shaped fascial sheath • Covers upper 3-4cm of femoral vessels Formed by fascia transversalis and fascia iliaca
- 43. Compartments Lateral intermediate Medial • Femoral artery • Femoral branch of genitofemoral nerve Femoral vein • Femoral canal • Lymphnode of cloquet
- 44. FEMORAL NERVE • Largest branch of lumbar plexus • Lies lateral to femoral artery • Formed by dorsal division of anterior rami of L2,L3,L4 Nerves
- 45. FEMORAL NERVE
- 46. Enters below inguinal ligament 2cm below inguinal ligament divides Femoral nerve Anterior division Posterior division Dorsal division anterior rami of L2,L3,L4 2 cutaneous branch 1 muscular branch • Medial cutaneous nerve of thigh • Intermediate cutaneous nerve of thigh Branch to sartorius 1 cutaneous branch 4 muscular branches Saphenous nerve Branch to rectus femoris, vastus lateralis, vastus intermedius, vastus medialis
- 47. ADDUCTOR CANAL • Subsartorial canal / hunter’s canal • Intermuscular tunnel • Medial side of middle 1/3rd of thigh
- 48. Extent From apex of femoral triangle to adductor hiatus
- 49. • Boundaries • Anterolateral • Vastus lateralis • Posterior • Adductor longus above , Adductor magnus below • Medial/roof • Fibrous membrane from anterolateral to posterior wall, Sartorius
- 50. CONTENTS • Femoral artery • Femoral vein • Saphenous nerve • Nerve to vastus medialis • Anterior and posterior division of obturator nerve • Descending genicular artery
- 51. ADDUCTOR CANAL
- 52. APPLIED ASPECTS • Ligation of femoral artery • Surgery for popliteal artery aneurysm artery ligated In adductor canal to control bleeding
- 53. • Compression , palpation , cannulation of femoral artery
- 54. • Femoral vein used for Intravenous cannulation, intravenous infusion
- 55. Femoral hernia • Protrusion of abdominal contents through femoral canal • Globular swelling in groin inferolateral to pubic tubercle below inguinal ligament
- 56. SUMMARY
- 57. Thank you