Best ppt for med students

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

7. Meralgia paresthetica

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

11. Extensor
Adductor
Flexor

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