This document describes the anatomy of the front of the thigh. It details the cutaneous nerves, muscles in the anterior compartment including the pectineus, sartorius and quadriceps femoris. It describes the femoral triangle containing the femoral vessels and nerve. The adductor canal containing the continuation of the femoral artery and vein is also summarized. Finally, the courses and branches of the femoral artery and vein are outlined.

1. ANATOMY OF THE FRONT OF THE
THIGH
Dr. Mohammed Mahmoud Mosaed

2. Cutaneous Nerves of the front of the thigh
The lateral cutaneous nerve of the
thigh, a branch of the lumbar plexus
(L2, 3), enters the thigh behind the
lateral end of the inguinal ligament.it
supplies the skin of the lateral aspect
of the thigh and knee.
The medial cutaneous nerve of the
thigh, a branch of the femoral nerve,
supplies the medial aspect of the
thigh and joins the patellar plexus.
The intermediate cutaneous nerve
of the thigh, a branch of the femoral
nerve. It supply the anterior aspect of
the thigh and joins the patellar
plexus.

3. The femoral branch of the
genitofemoral nerve, a branch of the
lumbar plexus (L1, 2), enters the thigh
behind the middle of the inguinal
ligament and supplies a small area of
skin.
The ilioinguinal nerve, a branch of
the lumbar plexus (L1), enters the
thigh through the superficial inguinal
ring. It supplies a small skin area
below the medial part of the inguinal
ligament
The patellar plexus lies in front of the
knee and is formed from the terminal
branches of the lateral, intermediate,
and medial cutaneous nerves of the
thigh and the infrapatellar branch of
the saphenous nerve

4. MUSCLES OF THE ANTERIOR
COMPARTMENT OF THE THIGH
1. Pectineus.
2. Sartorius.
3. Quadriceps Femoris.

5. Pectineus muscle
Origin:
Pectineal line of the
superior pubic ramus
Insertion: upper end
of linea aspera of
femur
Action: Flexes and
adducts the thigh at
the hip joint
Nerve supply:
femoral nerve (L3,4)

6. SARTORIUS
Origin: anterior superior iliac
spine
Insertion: Upper part of the
medial surface of the shaft of
the tibia.
Action: Flexes, abducts, laterally
rotates thigh at hip joint;
flexes and medially rotates leg
at knee joint
Nerve supply: branches of
femoral nerve L2,3

7. QUADRICEPS FEMORIS
1. Rectus Femoris
2. Vastus lateralis
3. Vastus medialis
4. Vastus intermedius

9. 1. Rectus Femoris
Origin:
1. Straight head: anterior
inferior iliac spine (AIIS)
2. Reflected head: ilium just
above the acetabulum
Insertion: Common quadriceps
tendon then tibial tuberosity
via patellar ligament
Action: Extension of leg at knee
joint and flexes thigh at hip
joint
Nerve supply: branches of
femoral nerve

10. 2. Vastus lateralis
Origin: 1. Upper part of
inter-trochanteric line
2. Root of greater
trochanter
3. Lateral lip of linea aspera
Insertion: Common
quadriceps tendon then
tibial tuberosity via
patellar ligament
Action: Extension of leg at
knee joint
Nerve supply: branches of
femoral nerve

11. 3. Vastus medialis
Origin:
1. Lower part of intertrochanteric
line of femur
2. Spiral line
3. Medial lip of linea aspera
4. Upper part of the medial
supracondylar line
Insertion: Common quadriceps
tendon then tibial tuberosity
via patellar ligament
Action: Extension of leg at knee
joint; stabilizes patella
Nerve supply: branches of
femoral nerve.

12. 4. Vastus intermedius
Origin: anterior and lateral surfaces
of the femoral shaft
Insertion: Common quadriceps
tendon into patella and tibial
tuberosity via patellar ligament
Action: Extension of leg at knee
joint
Nerve supply: Branches of femoral
nerve

13. Insertion of quadriceps muscle

14. Femoral triangle
The femoral triangle is
a triangular
depressed area
situated in the upper
part of the medial
aspect of the thigh
just below the
inguinal ligament

15. Boundaries of the femoral triangle
Lateral boundary is the medial margin of sartorius.
Medial boundary is the medial margin of adductor
longus.
The apex is where sartorius overlaps adductor longus.
Thebase is formed by the inguinal ligament.
The floor is gutter shaped and formed from lateral to
medial by:
the iliopsoas tendon which inserted into the lesser
trochanter of the femur, the pectineus, and the adductor
longus.
The roof is the overlying fascia lata.

17. Contents of femoral triangle
The femoral sheath
contains the femoral
vessels.
The femoral nerve
which lies lateral to
the artery and
outside the femoral
sheath
The triangle also
contains fat and
lymph nodes

19. Adductor (subsartorial) Canal
• The adductor canal is an intermuscular cleft situated on the medial
aspect of the middle third of the thigh.
• It begins at the apex of the femoral triangle and ends below at the
opening in the adductor magnus.
• Boundaries
• The anteromedial wall is formed by the sartorius muscle and
fascia.
• The posterior wall is formed by the adductor longus and
magnus.
• The lateral wall is formed by the vastus medialis.
• Contents
• the terminal part of the femoral artery, the femoral vein,
the deep lymph vessels, the saphenous nerve, the nerve
to the vastus medialis, and the terminal part of the
obturator nerve.

22. Femoral Nerve
• The femoral nerve is the largest branch of the lumbar
plexus (L2, 3, and 4).
• It emerges from the lateral border of the psoas muscle
within the abdomen and passes downward in the interval
between the psoas and iliacus.
• It lies behind the fascia iliaca and enters the thigh lateral
to the femoral sheath, behind the inguinal ligament.
• About 1.5 in. (4 cm) below the inguinal ligament, it
terminates by dividing into anterior and posterior
divisions. The femoral nerve supplies all the muscles of
the anterior compartment of the thigh .
• Note that the femoral nerve does not enter the thigh
within the femoral sheath.

23. Branches
• Anterior Division gives off .
• The cutaneous branches are: the medial cutaneous nerve
of the thigh and the intermediate cutaneous nerves that
supply the skin of the medial and anterior surfaces of the
thigh
• The muscular branches supply the sartorius and the
pectineus.
• Posterior Division gives off:
• Muscular branches to the quadriceps muscle. The
muscular branch of the rectus femoris also supplies the hip
joint; the branches to the three vasti muscles also supply
the knee joint.
• Cutaneous branch: The saphenous nerve

24. The saphenous nerve
• The saphenous nerve runs
downward and medially and crosses
the femoral artery from its lateral to
its medial side . It emerges on the
medial side of the knee between the
tendons of sartorius and gracilis. It
then runs down the medial side of
the leg in company with the great
saphenous vein. It passes in front of
the medial malleolus and along the
medial border of the foot, where it
terminates in the region of the ball
of the big toe.

26. Femoral artery
Origin: The femoral artery is a
continuation of the external iliac
artery
It begins behind the inguinal ligament,
midway between the anterior
superior iliac spine and the pubic
symphysis (midinguinal point(
It descends almost vertically toward the
adductor tubercle
The femoral artery is the main arterial
supply to the lower limb
Termination: it ends at the opening in
the adductor magnus muscle by
entering the popliteal space as the
popliteal artery

27. Branches of the femoral artery
• The superficial circumflex iliac artery is a small branch that runs
up to the region of the anterior superior iliac spine .
• The superficial epigastric artery is a small branch that crosses the
inguinal ligament and runs to the region of the umbilicus.
• The superficial external pudendal artery is a small branch that
runs medially to supply the skin of the scrotum (or labium majus).
• The deep external pudendal artery runs medially and supplies
the skin of the scrotum (or labium majus).
• The profunda femoris artery (deep femoral artery)
• Branches of profunda femoris artery:
• Medial circumflex femoral artery
• Lateral circumflex femoral artery
• 4 perforating arteries

30. Femoral vein
Beginning: at the adductor opening as the continuation of the popliteal
vein.
Termination: posterior to the inguinal ligament as the external iliac vein.
Course: The vein is posterolateral to the femoral artery in the distal
adductor canal. At the apex of the femoral triangle, the vein lies
posterior to the artery. At the base of the triangle the vein lies medial to
the artery.
The vein occupies the middle compartment of the femoral sheath,
between the femoral artery and femoral canal; fat in the canal permits
expansion of the vein. There are usually four or five valves in the femoral
vein
Tributaries:
1. The muscular tributaries.
2. The profunda femoris vein
3. The great saphenous vein which enters the vein anteriorly.
4. Lateral and medial circumflex femoral veins are usually tributaries of the
femoral vein.