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Objectives
   Organization of the lower limb
   Bony features
   Front of the thigh
   Medial side of the thigh
   Femoral triangle
   Adductor canal


                 Dr. Dalia Saleh (Anatomy Dept)
Overview
Organization of the Lower Limb
   It is connected to the axial skeleton
    by a sacroiliac joint and its ligaments.
                                  ligaments.

   It is divided into:

       The gluteal region

       The thigh

       The leg

       The foot



                          Dr. Dalia Saleh (Anatomy Dept)
Organization of the Lower Limb
   Important landmarks in the lower limb:

       The femoral triangle

       The popliteal fossa

       The posteromedial aspect of the ankle
        joint




                        Dr. Dalia Saleh (Anatomy Dept)
Function
   Support body weight:
       The center of gravity is:
           Anterior to the edge of the S2
                                        S2
            vertebra in the pelvis
           Slightly posterior to the hip joints
           Anterior to the knee joint
           Anterior to the ankle joint
           The ligaments are tight and joints
            are well supported

                          Dr. Dalia Saleh (Anatomy Dept)
Function
   Locomotion:
       Flexion and extension at hip joint
       Abduction and adduction at hip joint
       Internal and external rotation of the hip joint
       Flexion and extension at the knee joint
       Plantar flexion and dorsiflexion at the ankle joint
       Inversion and eversion at the subtalar joint




                            Dr. Dalia Saleh (Anatomy Dept)
Thigh
Compartments of the Thigh
    Femur
    Skin, superficial fascia and
     deep fascia
    Medial intermuscular septum
    Lateral intermuscular septum
    Posterior intermuscular
     septum
    Anterior compartment
    Medial compartment
    Posterior compartment


                        Dr. Dalia Saleh (Anatomy Dept)
Boney Features
Hip Bone
   Acetabulum
   Anterior superior iliac spine
   Anterior inferior iliac spine
   Obturator foramen
   Body of pubic bone
   Pubic crest
   Pubic tubercle
   Superior pubic ramus
    (pectineal surface)
   Inferior pubic ramus

                      Dr. Dalia Saleh (Anatomy Dept)
Femure
   Intertrochanteric line
   Anterior surface of body of
    femure
   Greater trochanter
   Lesser trochanter
   Intertrochanteric crest
   Pectineal line
   Linea aspera
   Medial surachondylar line
   Adductor tubercle

                     Dr. Dalia Saleh (Anatomy Dept)
Tibia
   Tibial tuberosity
   Anterior border (shin of tibia)
   Medial surface of tibia




                        Dr. Dalia Saleh (Anatomy Dept)
Anterior Compartment
Anterior Compartment
       Muscles:
         Sartorius
         Iliopsoas
         Pectineus
         Quadriceps
       Region:
         Femoral triangle
       Contents:
         Femoral nerve
         Femoral artery
         Femoral vein
         Femoral LN

                             Dr. Dalia Saleh (Anatomy Dept)
Sartorius
       Strap like muscle.
       Divides front of thigh into upper
        medial and lower lateral parts
       Origin:
         ASIS.
       Insertion:
         Upper part of medial surface of tibia.
       Nerve supply:
         Femoral nerve.
       Action:
         Flexes both hip and knee joints.

                            Dr. Dalia Saleh (Anatomy Dept)
Iliopsoas
       Origin:
         Iliacus  iliac fossa of hip bone
         Psoas major  Transverse processes,
          bodies, and intervertebral discs (T12 –
                                           (T12
          L5)
       Insertion:
         Into lesser trochanter of femur.
       Nerve supply:
         Femoral nerve.
       Action:
         Flexes thigh on trunk.
         Flexes trunk on thigh (sitting, leaning).

                             Dr. Dalia Saleh (Anatomy Dept)
Pectineus
       Origin:
         Superior ramus of pubis
       Insertion:
         Upper end of linea aspera of shaft of
          femur
       Nerve supply:
         Femoral nerve.
       Action:
         Flexes and adducts thigh at hip joint




                            Dr. Dalia Saleh (Anatomy Dept)
Quadriceps – Rectus Femoris
       Origin:
         Straight head  AIIS
         Reflected head  ilium just superior to the
          acetabulum
       Insertion:
         Quadriceps femoris tendon  patella 
          ligamentum patellae  tibial tuberosity
       Nerve supply:
         Femoral nerve
       Action:
         Flexes the thigh at the hip joint
         Extends the leg at the knee joint

                            Dr. Dalia Saleh (Anatomy Dept)
Quadriceps – Vasti
       Origin:
         Vastus medialis Upper end and shaft of femur
                 medialis
         Vastus lateralis  Upper end and shaft of
          femur
         Vastus intermedius  anterior and lateral
          surfaces of femur
       Insertion:
         Quadriceps femoris tendon  patella 
          ligamentum patellae  tibial tuberosity
       Nerve supply:
         Femoral nerve
       Action:
         Extends the leg at the knee joint

                            Dr. Dalia Saleh (Anatomy Dept)
Medial Compartment
Medial Compartment
       Muscles:
         Pectineus
         Adductor longus
         Gracilis
         Adductor brevis
         Adductor magnus
         Obturator externus
       Region:
         Adductor canal
       Contents:
         Femoral artery and vein
         Saphenous nerve
         Nerve to vastus medialis

                            Dr. Dalia Saleh (Anatomy Dept)
Gracilis
       Origin:
         Inferior ramus of pubis, ramus of ischium
       Insertion:
         Upper part of medial surface of shaft of tibia
       Nerve supply:
         Obturator nerve
       Action:
         Adducts thigh at hip joint
         Flexes leg at knee joint




                            Dr. Dalia Saleh (Anatomy Dept)
Adductor Longus
       Origin:
         Body of pubis, medial to pubic tubercle
       Insertion:
         Posterior surface of shaft of femur
       Nerve supply:
         Obturator nerve
       Action:
         Adducts thigh at hip joint
         Lateral rotation of the thigh




                            Dr. Dalia Saleh (Anatomy Dept)
Adductor Brevis
       Origin:
         Inferior ramus of pubis
       Insertion:
         Posterior surface of shaft of femur
       Nerve supply:
         Obturator nerve
       Action:
         Adducts thigh at hip joint
         Lateral rotation of the thigh




                            Dr. Dalia Saleh (Anatomy Dept)
Adductor Magnus
       Origin:
         Inferior ramus of pubis, ramus of ischium, ischial
                                            ischium,
          tuberosity
       Insertion:
         Pubic part  Posterior surface of shaft of femur
         Ischial part  Adductor tubercle of the femur
       Nerve supply:
         Pubic part  Obturator nerve
         Ischial part  Sciatic nerve
       Action:
         Pubic part  Adducts and laterally rotate thigh
         Ischial part  Extends hip and flexes knee
                            Dr. Dalia Saleh (Anatomy Dept)
Obturator Externus
       Origin:
         Outer surface of obturator membrane
          and pubic and ischial rami
       Insertion:
         Medial surface of greater trochanter
       Nerve supply:
         Obturator nerve
       Action:
         Laterally rotates thigh




                            Dr. Dalia Saleh (Anatomy Dept)
Femoral Triangle
 Adductor Canal
Femoral Triangle
       Site:
         Triangular depressed area
         At the upper part of the medial
          aspect of the thigh
       Boundaries:
        Superiorly: The inguinal ligament
        Laterally: The sartorius muscle
        Medially: The adductor longus muscle
       Floor:
         Iliopsoas
         Pectineus
         Adductor longus

                            Dr. Dalia Saleh (Anatomy Dept)
Femoral Triangle
       Contents:
         Femoral nerve and its branches
         Femoral sheath containing:
            Femoral artery and its
             branches
            Femoral vein and its
             tributaries
            Femoral canal
            Femoral LN



                          Dr. Dalia Saleh (Anatomy Dept)
Adductor Canal
       Site:
        Lies on the medial aspect of the middle
         third of the thigh beneath the
         sartorius muscle
       Boundaries:
        Superiorly: the apex of the femoral
         triangle
        Inferiorly: the opening in the adductor
         magnus
        Posteriorly:
         Posteriorly: The adductor longus and
         adductor magnus
        Laterally: Vastus medialis
        Roof: Fascia and sartorius


                            Dr. Dalia Saleh (Anatomy Dept)
Adductor Canal
       Contents:
        The terminal part of the femoral artery

        The terminal part of the femoral vein

        The deep lymph vessels

        The saphenous nerve

        The nerve to the vastus medialis

        The terminal part of the obturator nerve




                            Dr. Dalia Saleh (Anatomy Dept)
For more details please go back to any text book




                Dr Dalia Saleh




                  Dr. Dalia Saleh (Anatomy Dept)

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Organization of the ll, front and medial sides of thigh

  • 1. Objectives  Organization of the lower limb  Bony features  Front of the thigh  Medial side of the thigh  Femoral triangle  Adductor canal Dr. Dalia Saleh (Anatomy Dept)
  • 3. Organization of the Lower Limb  It is connected to the axial skeleton by a sacroiliac joint and its ligaments. ligaments.  It is divided into:  The gluteal region  The thigh  The leg  The foot Dr. Dalia Saleh (Anatomy Dept)
  • 4. Organization of the Lower Limb  Important landmarks in the lower limb:  The femoral triangle  The popliteal fossa  The posteromedial aspect of the ankle joint Dr. Dalia Saleh (Anatomy Dept)
  • 5. Function  Support body weight:  The center of gravity is:  Anterior to the edge of the S2 S2 vertebra in the pelvis  Slightly posterior to the hip joints  Anterior to the knee joint  Anterior to the ankle joint  The ligaments are tight and joints are well supported Dr. Dalia Saleh (Anatomy Dept)
  • 6. Function  Locomotion:  Flexion and extension at hip joint  Abduction and adduction at hip joint  Internal and external rotation of the hip joint  Flexion and extension at the knee joint  Plantar flexion and dorsiflexion at the ankle joint  Inversion and eversion at the subtalar joint Dr. Dalia Saleh (Anatomy Dept)
  • 8. Compartments of the Thigh  Femur  Skin, superficial fascia and deep fascia  Medial intermuscular septum  Lateral intermuscular septum  Posterior intermuscular septum  Anterior compartment  Medial compartment  Posterior compartment Dr. Dalia Saleh (Anatomy Dept)
  • 10. Hip Bone  Acetabulum  Anterior superior iliac spine  Anterior inferior iliac spine  Obturator foramen  Body of pubic bone  Pubic crest  Pubic tubercle  Superior pubic ramus (pectineal surface)  Inferior pubic ramus Dr. Dalia Saleh (Anatomy Dept)
  • 11. Femure  Intertrochanteric line  Anterior surface of body of femure  Greater trochanter  Lesser trochanter  Intertrochanteric crest  Pectineal line  Linea aspera  Medial surachondylar line  Adductor tubercle Dr. Dalia Saleh (Anatomy Dept)
  • 12. Tibia  Tibial tuberosity  Anterior border (shin of tibia)  Medial surface of tibia Dr. Dalia Saleh (Anatomy Dept)
  • 14. Anterior Compartment  Muscles:  Sartorius  Iliopsoas  Pectineus  Quadriceps  Region:  Femoral triangle  Contents:  Femoral nerve  Femoral artery  Femoral vein  Femoral LN Dr. Dalia Saleh (Anatomy Dept)
  • 15. Sartorius  Strap like muscle.  Divides front of thigh into upper medial and lower lateral parts  Origin:  ASIS.  Insertion:  Upper part of medial surface of tibia.  Nerve supply:  Femoral nerve.  Action:  Flexes both hip and knee joints. Dr. Dalia Saleh (Anatomy Dept)
  • 16. Iliopsoas  Origin:  Iliacus  iliac fossa of hip bone  Psoas major  Transverse processes, bodies, and intervertebral discs (T12 – (T12 L5)  Insertion:  Into lesser trochanter of femur.  Nerve supply:  Femoral nerve.  Action:  Flexes thigh on trunk.  Flexes trunk on thigh (sitting, leaning). Dr. Dalia Saleh (Anatomy Dept)
  • 17. Pectineus  Origin:  Superior ramus of pubis  Insertion:  Upper end of linea aspera of shaft of femur  Nerve supply:  Femoral nerve.  Action:  Flexes and adducts thigh at hip joint Dr. Dalia Saleh (Anatomy Dept)
  • 18. Quadriceps – Rectus Femoris  Origin:  Straight head  AIIS  Reflected head  ilium just superior to the acetabulum  Insertion:  Quadriceps femoris tendon  patella  ligamentum patellae  tibial tuberosity  Nerve supply:  Femoral nerve  Action:  Flexes the thigh at the hip joint  Extends the leg at the knee joint Dr. Dalia Saleh (Anatomy Dept)
  • 19. Quadriceps – Vasti  Origin:  Vastus medialis Upper end and shaft of femur medialis  Vastus lateralis  Upper end and shaft of femur  Vastus intermedius  anterior and lateral surfaces of femur  Insertion:  Quadriceps femoris tendon  patella  ligamentum patellae  tibial tuberosity  Nerve supply:  Femoral nerve  Action:  Extends the leg at the knee joint Dr. Dalia Saleh (Anatomy Dept)
  • 21. Medial Compartment  Muscles:  Pectineus  Adductor longus  Gracilis  Adductor brevis  Adductor magnus  Obturator externus  Region:  Adductor canal  Contents:  Femoral artery and vein  Saphenous nerve  Nerve to vastus medialis Dr. Dalia Saleh (Anatomy Dept)
  • 22. Gracilis  Origin:  Inferior ramus of pubis, ramus of ischium  Insertion:  Upper part of medial surface of shaft of tibia  Nerve supply:  Obturator nerve  Action:  Adducts thigh at hip joint  Flexes leg at knee joint Dr. Dalia Saleh (Anatomy Dept)
  • 23. Adductor Longus  Origin:  Body of pubis, medial to pubic tubercle  Insertion:  Posterior surface of shaft of femur  Nerve supply:  Obturator nerve  Action:  Adducts thigh at hip joint  Lateral rotation of the thigh Dr. Dalia Saleh (Anatomy Dept)
  • 24. Adductor Brevis  Origin:  Inferior ramus of pubis  Insertion:  Posterior surface of shaft of femur  Nerve supply:  Obturator nerve  Action:  Adducts thigh at hip joint  Lateral rotation of the thigh Dr. Dalia Saleh (Anatomy Dept)
  • 25. Adductor Magnus  Origin:  Inferior ramus of pubis, ramus of ischium, ischial ischium, tuberosity  Insertion:  Pubic part  Posterior surface of shaft of femur  Ischial part  Adductor tubercle of the femur  Nerve supply:  Pubic part  Obturator nerve  Ischial part  Sciatic nerve  Action:  Pubic part  Adducts and laterally rotate thigh  Ischial part  Extends hip and flexes knee Dr. Dalia Saleh (Anatomy Dept)
  • 26. Obturator Externus  Origin:  Outer surface of obturator membrane and pubic and ischial rami  Insertion:  Medial surface of greater trochanter  Nerve supply:  Obturator nerve  Action:  Laterally rotates thigh Dr. Dalia Saleh (Anatomy Dept)
  • 28. Femoral Triangle  Site:  Triangular depressed area  At the upper part of the medial aspect of the thigh  Boundaries:  Superiorly: The inguinal ligament  Laterally: The sartorius muscle  Medially: The adductor longus muscle  Floor:  Iliopsoas  Pectineus  Adductor longus Dr. Dalia Saleh (Anatomy Dept)
  • 29. Femoral Triangle  Contents:  Femoral nerve and its branches  Femoral sheath containing:  Femoral artery and its branches  Femoral vein and its tributaries  Femoral canal  Femoral LN Dr. Dalia Saleh (Anatomy Dept)
  • 30. Adductor Canal  Site:  Lies on the medial aspect of the middle third of the thigh beneath the sartorius muscle  Boundaries:  Superiorly: the apex of the femoral triangle  Inferiorly: the opening in the adductor magnus  Posteriorly: Posteriorly: The adductor longus and adductor magnus  Laterally: Vastus medialis  Roof: Fascia and sartorius Dr. Dalia Saleh (Anatomy Dept)
  • 31. Adductor Canal  Contents:  The terminal part of the femoral artery  The terminal part of the femoral vein  The deep lymph vessels  The saphenous nerve  The nerve to the vastus medialis  The terminal part of the obturator nerve Dr. Dalia Saleh (Anatomy Dept)
  • 32. For more details please go back to any text book Dr Dalia Saleh Dr. Dalia Saleh (Anatomy Dept)