Anteromedial Aspect of the Thigh | Gross HSB A Muscles of the anterior compartment

1st Year – 1st Semester – Midterm – 1st Week (Capulong, M.D.)

▪ Iliopsoas
Important muscles & structures (a checklist) o Psoas major
✓ Great saphenous vein ▪ Origin – sides of T12-L5 vertebrae & discs between them;
✓ Extensor (anterior) compartment muscles – iliopsoas, sartorius, quadriceps transverse processes of all lumbar vertebrae
femoris (rectus femoris, vastus lateralis, vastus medialis, & vastus ▪ Insertion – lesser trochanter of femur
intermedius) ▪ Nerve supply – anterior rami of lumbar nerve
✓ Adductor (medial) compartment muscles – gracilis, adductor longus, o Psoas minor
adductor magnus, adductor brevis, pectineus, & obturator externus ▪ Origin – sides of T12-L1 vertebrae and intervertebral discs
✓ Femoral triangle, femoral ring, and femoral sheath ▪ Insertion – pectineal line, iliopectineal eminence via iliopectineal arc
✓ Femoral nerve & saphenous nerve ▪ Nerve supply – anterior rami of lumbar nerve
✓ Obturator nerve o Iliacus
✓ Femoral artery & vein ▪ Origin – iliac crest, iliac fossa, ala of sacrum, and anterior sacroiliac
✓ Medial and lateral femoral circumflex artery & vein ligaments
✓ Medial, lateral, and posterior cutaneous nerve ▪ Insertion – tendon of psoas major, lesser trochanter, and femur
Surface anatomy of the thigh distal to it
▪ Surface features of the thigh ▪ Nerve supply – femoral nerve
o Sartorius muscle o Action – act conjointly in flexing & stabilizing the thigh at the hip joint
o Quadriceps muscle ▪ Sartorius
o Adductor longus muscle o Origin – anterior superior iliac spine & superior part of the notch inferior
o Femoral triangle to it
Anatomy of the thigh o Insertion – superior part of medial surface of tibia
▪ Divided compartments: o Nerve supply – femoral nerve
o Anterior compartment o Action – flexes, abducts, and laterally-rotates thigh at hip joint
o Medial compartment ▪ Also, flexes the leg at the knee joint
o Posterior compartment ▪ Also, medially-rotates the leg when knee is flexed
▪ Note: Separated by a fascia called ‘intermuscular septa’ ▪ Pectineus
▪ Facts about the thigh: o Origin – superior ramus of the pubis
o Anterior compartment muscles of the thigh o Insertion – pectineal line of femur, just inferior to lesser trochanter
▪ Flex – femur at hip o Nerve supply – femoral nerve, may receive branch from obturator nerve
▪ Extend – leg at knee o Action – adducts and flexes thigh
▪ Innervation – femoral nerve (L2, L3, L4) ▪ Also, assists with medial rotation of the thigh
▪ Note: Homologous to the posterior compartment of the arm ▪ Quadriceps femoris
o Posterior compartment muscle of the thigh
▪ Flex – leg at knee
▪ Extend – femur at hip
▪ Innervation – sciatic nerve (L2, L3, L4)
▪ Note: Homologous to the anterior compartment of the arm
o Medial compartment muscle of the thigh
▪ Innervation – obturator nerve (L4, L5, S1, S2, S3 from sacral
plexus)
▪ Adduct – thigh (all muscles)

o Rectus femoris
▪ Origin – anterior inferior iliac spine & ilium superior to acetabulum
o Vastus lateralis
▪ Origin – greater trochanter & lateral lip of linea aspera of femur
o Vastus medialis
▪ Origin – intertrochanteric line & medial lip of linea aspera of femur
o Vastus intermedius
▪ Origin – anterior & lateral surfaces of shaft of femur
o Insertion – base of the patella & its ligament to the tibial tuberosity via a
common quadriceps tendon
o Nerve supply – femoral nerve
o Action – extend leg at knee joint
▪ Also, rectus femoris steadies hip joint and helps iliopsoas flex thigh
 Note: Adduction – common action of medial compartment muscles
▪ Tensor fascia lata Blood supply of the medial compartment
o Origin – iliac crest close to anterior iliac spine ▪ Obturator artery
o Insertion – iliotibial tract ▪ Branch of the internal iliac artery
o Nerve supply – superior gluteal nerve Adductor hiatus
o Action – flexes & medially-rotates hip ▪ Description – an opening in the distal attachment of the adductor magnus
Note: Primarily a flexor of the thigh since it ▪ Function – transmits the femoral artery & vein from the adductor canal in the
has no direct connection with the leg thigh to the popliteal fossa posterior to the knee
▪ Note: Femoral nerve – common innervation of Femoral triangle
anterior compartment muscles ▪ Borders of the femoral triangle:
▪ Note: Hip flexion & knee extension – common o Lateral – medial border of the sartorius muscle
action of anterior compartment muscles o Medial – lateral border of the adductor longus
Blood supply of the anterior compartment o Superior – inguinal ligament from anterior
▪ Branches of the femoral artery: superior iliac spine to pubic tubercle
o Superficial circumflex iliac artery o Floor – ilipsoas, pectineus, and adductor longus
o Superficial epigastric artery ▪ Contents of the femoral triangle: (lateral-to-medial)
o Superficial & deep external pudendal artery o Femoral nerve – not in femoral sheath
o Descending genicular artery o Femoral artery
o Deep femoral artery (profunda femoris) o Femoral vein
o Lateral & medial femoral circumflex artery o Lymphatics
Clinical correlation Femoral sheath
▪ Genu varum (bowleg) ▪ Description – layer formed by an inferior prolongation of transversalis &
o Description – medial angulation of the leg in relation to the thigh iliopsoas fascia from the abdomen
o Incidence – frequently 1-to-2 years after starting to walk ▪ Components of the femoral sheath:
▪ Genu valgum (knock-knee) o Lateral compartment
o Description – lateral angulation of the leg in relation to the thigh o Intermediate compartment
o Incidence – frequently 2-to-4 years of age o Medial compartment (femoral canal)
▪ Quadriceps femoris paralysis ▪ Contents of the femoral sheath:
o Description – inability to extend the leg against resistance o Femoral artery & its several branches
o Result – can lead to abnormal patellar movement & loss of joint stability o Femoral vein (great saphenous & deep femoral)
▪ Patellar dislocation o Lymphatics
o Description – occurs more often in women Femoral canal
▪ Psoas abscess ▪ Description – smallest of the three femoral sheath compartments
o Description – caused by pyogenic infections of the abdominal cavity or ▪ Path – extends distally to the level of the proximal edge of the saphenous
gastrointestinal tuberculosis opening
Muscles of the medial compartment ▪ Function – allows the femoral vein to expand when venous return from the
▪ Gracilis lower limb is increased
o Origin – body & inferior ramus of the pubis Femoral ring
o Insertion – superior part of the medial surface of tibia ▪ Description – small proximal opening of the femoral canal
o Action – adducts thigh, flexes the leg, and helps rotates leg medially ▪ Boundaries of the femoral ring:
▪ Adductor longus o Lateral – partition between the femoral canal & femoral vein
o Origin – body of pubis inferior to pubic crest o Posterior – superior ramus of the pubis
o Insertion – middle third of linea aspera of femur o Medial – lacunar ligament
o Action – adducts thigh o Anterior – medial part of the inguinal ligament
▪ Adductor brevis
o Origin – body & inferior ramus of pubis
o Insertion – pectineal line & proximal part of linea aspera of femur
o Action – adducts thigh & to some extent, flexes it
▪ Adductor magnus
o Origins
▪ Adductor part – inferior ramus of pubis & ramus of ischium
▪ Hamstrings part – ischial tuberosity
o Insertions
▪ Adductor part – gluteal tuberosity, linea aspera, and medial
supracondylar line
▪ Hamstrings part – adductor tubercle of femur
o Nerve supply
▪ Adductor part – obturator nerve
▪ Hamstrings part – tibial part of the sciatic nerve
o Action – mainly adducts thigh
▪ Adductor part – also, flexes the thigh
▪ Hamstrings part – also, extends the thigh
▪ Obturator externus
o Origin – margins of obturator foramen & its membrane
o Insertion – trochanteric fossa of femur
o Nerve supply – obturator nerve
o Action – laterally-rotates thigh & steady the head of femur in acetabulum

Note: Obturator nerve – common innervation of medial compartment muscles

 Ad astra per aspera.
RICO2018 – FEU-NRMF SMT

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