ANTERIOR & MEDIALCOMPARTMENTS
of theTHIGH
M1 - Anatomy
M1 Gross and Developmental Anatomy8:00 AM, October 28, 2008Dr. Milton M. Sholley
Professor of Anatomy and Neurobiology 2
Compartmentalization of the Thigh
Syllabus page 179
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PelvisFormed by two coxal (hip) bones and the sacrum
Hip bone Hip boneSacrum
Pubic symphysis
Sacroiliac jointSacroiliac joint
Adapted from:Grant’s Atlas, 12th ed.Fig. 4.22, p. 311
Sacral promontory
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Ilium
Ischium Pubis
Coxal (hip) boneA fusion of three bones in the adult
Adapted from:Grant’s Atlas, 12th ed.Fig. 5.31B, p. 397
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Coxal (hip) boneLateral view
Iliac crest
Anterior superioriliac spine
Anterior inferioriliac spine
Acetabulum(hip joint socket)
Pubic tubercle
Ischial tuberosity
Ischial spine
Lesser sciaticnotch
Greater sciaticnotch
Posterior superioriliac spine
Posterior inferioriliac spine
Obturator foramen
Adapted from:Grant’s Atlas, 12th ed.Fig. 5.31A, p. 397
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Coxal (hip) boneMedial view
Anterior superioriliac spine
Ischial spine
Symphysealsurface of pubis
Pectineal lineArcuate line
Adapted from:Grant’s Atlas, 12th ed.Fig. 4.23A, p. 312
7Grant’s Atlas, 12th ed.Fig. 4.24A, p. 313
Grant’s Atlas, 12th ed.Fig. 4.23C, p. 312
Sacrum and Coccyx
Anterior view Lateral view
8Grant’s Atlas, 12th ed.Fig. 4.23A, p. 312
Grant’s Atlas, 12th ed.Fig. 4.23C, p. 312
Grant’s Atlas, 12th ed.Fig. 4.26A, p. 316
Coxal boneMedial view
Sacrum (and coccyx)Lateral view
9Anterior view Posterior view
Grant’s Atlas, 12th ed.Fig. 5.22A, p. 380
Grant’s Atlas, 12th ed.Fig. 5.22C, p. 381
Anterior superioriliac spine
Greater trochanterGreater trochanter
Gluteal tuberosity
Ischial tuberosity
Lesser trochanter
Intertrochanteric crest
Intertrochanteric line
Linea asperaPectineal line
Patella
Tibial tuberosity
Pectineal line
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AP Radiograph of Pelvis
Adapted from:Grant’s Atlas, 12th ed.Fig. 4.22A&B, p. 311
11APPelvis(Hip)-21.jpg
Radiologic Anatomy
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Hip Joint Capsule(frontal section)
Fibrous capsule
Synovial capsule
Fibrous capsule
Synovial capsule
Grant’s Atlas, 12th ed.Fig. 5.32B, p. 398
Synovial cavity
Ligament of thehead of the femur
13Anterior view
Angle between neck and shaft of femur~126o = Normal angle in adult
Weight transfer across this angle produces greatstress in the neck of the femur. This stress isresisted by the natural support provided by theorientation of the bony trabeculae within thefemoral neck. Degeneration of bone in thesetrabeculae, as can occur from osteoporosis, maycause hip fracture due to failure of the femoral neckto support the body weight.
14Grant’s Atlas, 12th ed.Fig. 5.34 A, p. 400
Blood Supply to Neck and Head of Femur
1. Medial femoral circumflex artery2. Lateral femoral circumflex artery3. Artery of the ligament of the head
of the femur12
12
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Adapted from:Hollinshead’s Text, 5th ed.Fig.17-17, p. 328
Ascendingbranches
15Anterior view
Iliofemoral ligament(Y-ligament of Bigelow)
Tightens during hip extensionand thus limits hip extension
Adapted from:Grant’s Atlas, 12th ed.Fig. 5.29A, p. 394
16Posterior view
Ischiofemoral ligament
Adapted from:Grant’s Atlas, 12th ed.Fig. 5.29C, p. 395
Tightens during hip extensionand thus limits hip extension
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Compartmentalization of the Thigh
Syllabus page 179 18
Compartmental Innervationsand
Actions of Contained Muscles
Syllabus page 184
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IV. Anterior compartment of the thigh(Contains muscles innervated bythe femoral nerve--see muscle charton syllabus page 189)
A. Iliopsoas muscle complex
B. Quadriceps femoris muscle
C. Sartorius muscle
D. Pectineus muscle
A
CD
B
B
B
(Syllabus location--page 184)
Adapted from:Grant’s Atlas, 12th ed.Fig. 5.20A, p. 375
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21 22
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From:Hollinshead’s Text, 5th ed.Fig.18-18 C&D, p. 364
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Borders of the Femoral Triangle
Inguinal ligament
Adductor longus m.
Sartorius m.
Syllabus page 185
25Grant’s Atlas, 12th ed.Fig. 5.17A, p. 372
Grant’s Atlas, 12th ed.Fig. 5.18C, p. 373
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LM
Adapted from:Grant’s Atlas, 10th ed.Fig. 5.12B, p. 314
Lateral Medial
Anterior
FemoralN A V EL
Head of femurSyllabus page 185
27Grant’s Atlas, 12th ed.Fig. 5.16A, p. 371
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Lateral Medial
Anterior
Head of femur
Femoral sheath encloses:1. Femoral artery2. Femoral vein3. Femoral canal
(i.e. empty spacewith lymphatics or EL)
Adapted from:Grant’s Atlas, 10th ed.Fig. 5.12B, p. 314
29Syllabus page 200 30Grant’s Atlas, 12th ed.Fig. 5.18C, p. 373
Grant’s Atlas, 12th ed.Fig. 5.18A, p. 373
31From:Hollinshead’s Text, 5th ed.Fig.18-18 E&F, p. 364
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Superficial veins and Superficial inguinal lymph nodesare located within the fat-containing superficial fascia, which lies
between the skin and the Fascia lata (deep fascia).
Grant’s Atlas, 12th ed.Fig. 5.15A, p. 370
Grant’s Atlas, 12th ed.Fig. 5.15C, p. 370
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Superficial Inguinal Lymph Nodes
Grant’s Atlas, 12th ed.Fig. 5.13A, p. 367
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Superficial Inguinal Lymph Nodes
Grant’s Atlas, 12th ed.Fig. 5.13A, p. 367
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Radiologic AnatomyPelvic Lymphangiogram
Pelvic Lymphangiogram-61l.jpg
SuperficialInguinalLymph Nodes
SuperficialInguinalLymph Nodes
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Greater Saphenous Vein
Medial malleolus
Lesser Saphenous Vein
Lateral malleolus
37Grant’s Atlas, 12th ed.p. 378
Medial Compartment Muscles(See muscle chart on syllabus
page 190 and Grant’s Atlas page 378 for labels.)
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Adductor hiatus - Anopening between the twoinsertions of the adductormagnus muscle that allowspassage of the femoral arteryand vein from the anteriorcompartment into the poplitealfossa.
Medial femoralcircumflex artery - Passesposteriorly in the fascialplane between the iliopsoasand pectineus muscles.
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Adapted from:Grant’s Atlas, 12th ed.Fig. 5.21A, p. 379
Pes anserinus
Combined tendons of:
Medial view
Sartorius
Gracilis
Semitendinosus
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Adapted from:Grant’s Atlas, 12th ed.Fig. 5.21B, p. 379
Muscular TripodOne muscle from eachcompartment provides supporton the medial side of the knee.The three combined tendonsof insertion form the pes anserinus.
Anterior view
S=SartoriusG=GracilisT=Semitendinosus
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Lumbar plexus in situ
Lateral femoralcutaneous nerve
Obturator nerve
Femoral nerve
Entrapment neuropathyhere causes
Meralgia parastetica
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Lumbar Plexus
Subcostal nerve
Lateral femoralcutaneous nerve (L2, 3)
Femoral nerve (L2-4)
Ventralrami
Iliohypogastric nerve (T12, L1)
Genitofemoral nerve (L1, 2)
T12
L1
L2
L3
L4
Ilioinguinal nerve (L1)
Obturator nerve (L2-4)Anterior divisionsPosterior divisions
Syllabus page 188