ANTERIOR AND MEDIAL

ASPECTS OF THE THIGH

AND THE HIP JOINT
And coping with rejection
Harshil Patel
1.The attachements,Modifiaction,Functions
and clinical relevance of facia lata

 Fascia is defined as a sheet or band of fibrous tissue lying deep to the skin
that lines, invests and separates structures within the body. There are three
general classifications of fascia:
 Superficial fascia: blends with the reticular layer beneath the dermis.
 Deep fascia: envelopes muscles, bones and neurovascular structures.
 Visceral fascia: provides membranous investments that suspend organs within
their cavities.
A.There are three modifications of the fascia
lata, which are known as the:

1.Iliotibial tract
2.Intermuscular septa
3.Saphenous opening
 1.Iliotibial tract

 On the lateral aspect of the thigh, the fascia

lata thickens to form the iliotibial tract.
Superiorly, the iliotibial tract splits into a
superficial and a deep layer.
 The superficial layer is attached to the iliac
crest and descends lateral to the tensor
fasciae latae muscle.
 The deep layer is medial to this muscle and
blends with the capsule of the hip joint.
Distally, the iliotibial tract blends with the
aponeurosis of the vastus lateralis
muscle before it attaches to Gerdy’s
tubercle, which is located on the
anterolateral surface of the lateral tibial
condyle.
 2.Intermuscular Septa

 There are two intermuscular septa formed

by the fascia lata and these septa form the
anterior, posterior and medial compartments
of the thigh. These septa are referred to
as the medial and lateral septum.
 The medial septum is thinner and weaker
than the lateral one. It lies between the
vastus medialis anteriorly and the adductor
and pectineus muscles posteriorly.
The lateral septum descends from
the gluteus maximus muscle to the lateral
condyle of the femur and lies between the
vastus lateralis and the short head of
the biceps femoris muscle. Both of these
septa are attached to the linea aspera of the
femur.
Saphenous Opening

 In the deep fascia, there is an opening 3 cm

lateral to the pubic tubercle, which allows
the passage of the long saphenous vein. This
aperture, referred to as the saphenous
opening, is covered by the superficial fascia
and is located inferomedial to the
superficial stratum of the fascia lata. It is
located lateral to the deep stratum and its
superior, inferior and lateral borders are
formed by the arched falciform margin.
B.Attachments
Onto the bony prominences and ligaments.
Proximal:
• Inguinal ligament
• Anterior superior iliac spine
• Sacrum
• Sacrotuberous ligament
• Body of pubis
• Pectineal line
• Ischial tuberosity
• Ischiopubic ramus

Distal:
• Tibial condyles
• Head of fibula
 C.Functions
1.Muscle attachements
2.Enclose and contain thigh muscles-Tensor fascia lata
-Gluteus maximus

3.Compartmentalize the thigh-

2. Identify the great saphenous vein and note its
tributaries.
 3.Define boundaries and content of the femoral triangle

Femoral Triangle
(contents) From lateral to medial:
1.Femoral nerve & its branches
2.Femora artery
3.Femoral vein
4.Lymphatic vessels and some deep inguinal lymph nodes.

The femoral artery, femoral vein and the lymph nodes

lies
within the fascial envelope, the Femoral sheath, occupying its lateral,
intermediate and medial compartments
respectively. The medial compartment is called the femoral canal.

ADDUCTOR CANAL (Subsartorial/Hunter’s canal)

#DEFINITION:
anaponeurotic tunnel for femoral artery & vein
#SITE:
In middle third of front of thigh deep to sartorius
#EXTENT:
From apex of femoral triangle
to adductor hiatus
#BOUNDARIES:
Roof (Anterior):
Sartorius (medially) and
vastusmedialis (laterally)
Floor (Posterior):
Adductor longus&magnus.
 433 Anatomy Team lecture 17:Thigh MS

SUMMARY
The thigh is divided into 3 compartments
1.MEDIAL 2.ANTERIOR 3.POSTERIOR
The anterior compartment is supplied Femoral
nerve.
The posterior compartment is supplied by
sciatic nerve.
The medial compartment is supplied by
Obturator nerve.
The Femoral Triangle is located in the upper third of
front of the thigh.
The Adductor canal is an aponeurotic tunnel for
femoral artery & vein.

RememberThat:
Remember that the three Adductors ( longus, brevis, magnus ) have
the same insertion area ( the posterior border of the femur *Linea
Aspera*).
 7.Their attachment, and
aspects of the medial
and anterior aspects of
the thigh.
Anterior Extensors of
Flexors of hip
Nerve supply:
Compartment knee Femoral nerve

Nerve supply:
Medial
I liked this so I
Adductors of
hip Obturator
Compartment nerve

put it
Posterior Flexors of extensors of Nerve supply:
Compartment knee hip Sciatic nerve

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 433 Anatomy Team lecture 17:Thigh MS

Muscles and their

actions(Anterior)
Anterior Compartment of Thigh

Extensors of
Flexor of knee (Quadriceps
the hip femoris)

Vastus intermedius
Iliacus (deep to rectus femoris)

psoas major Vastus medialis

Pectineus Vastus lateralis

Sartorius Rectus femoris

They act on the hip

joint as felxors as
 Nerve Supply: Femoral Nerve
well
433 Anatomy Team lecture 17:Thigh MS

Sartorius

ORIGIN

Anterior superior iliac spine

INSERTION

Upper part of medial surface

of tibia

ACTION;TAILOR’S POSITIONͿ
hip joint Flexion, abduction & lateral rotation
 On Knee Joint Flexion
433 Anatomy Team lecture 17:Thigh MS

Pectineus

ORIGIN

Superior pubic ramus

INSERTION

Back of femur (below lesser

trochanter)

ACTION:
 Flexion & adduction of the hip joint

(It only acts on the hip join)

433 Anatomy Team lecture 17:Thigh MS

Iliacus& Psoas major (Iliopsoas)

ORIGIN

Psoas major: T12 & lumbar

vertebrae

Iliacus: Iliac fossa

INSERTION

Lesser trochanter of femur

ACTION:
 Flexion of the hip joint

(It only acts on the hip join)

In less than 50 percent of humans the psoas major is accompanied by
the psoas minor. It is located in front of the psoas major muscle.
 433 Anatomy Team lecture 17:Thigh MS

Quadriceps Femoris
INSERTION(ALL FOUR):
ORIGIN:

Rectus femoris: Anterior inferior iliac spine  Into PATELLA (Patella

Vastusintermedius:Front of shaft of femur is a sesamoid bone)

 From patella into TUBEROSITY
Vastusmedialis:Posterior border of femur
OF TIBIA through Ligamentum
Vastuslateralis:Posterior border of femur Patellae (Patellar Ligament)

ACTION:
 On Knee Joint
Extension

 Sesamoid bone is a bone

embedded/developed within a
tendon
 433 Anatomy Team lecture 17:Thigh MS

Medial Compartment of Thigh

ACTION
• Adductor longus
• Adductor brevis • ADDUCTION OF • OBTURATOR
• Adductor magnus HIP JOINT NERVE
• Gracilis • N.B.: Gracilis also
flexes knee joint
NERVE
MUSCLE SUPPLY
 433 Anatomy Team lecture 17:Thigh MS

Medial Compartment of Thigh

#Origin &Insertion :

Origin Bod -Body of pubis -Inferior pubic ramus

y of -Ischial ramus.
-Inferior
pub
pubic
is
ramus.
Insertion Posterior border of femur (Linea Aspera) Upper part
of medial
surface of tibia
(behindsartorius
)
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433 Anatomy Team lecture 17:Thigh MS

Femoral Triangle
• It is a deep hollow in theUpper third of front of
thighinferior to the inguinal ligament.
Note: the inguinal region is the
junction between the lower limbs
and abdomen.

#Boundaries :
Left inguinal region
*Base:
Inguinal ligament

*Medial:
Medial border of the adductor
longus muscle

*Lateral:
Medial border of the sartorius muscle

*Roof:
Skin, superficial &deep fascia.

*floor:(from media to lateral)

( adductorlongus, Pectineus, Psoas major, Iliacus )
 433 Anatomy Team lecture 17:Thigh MS

These youtube videos can help :

Muscles of the Thigh Part 1 - Anterior Compartment - Anatomy Tutorial

https://www.youtube.com/watch?v=8trLEtQYDGw

Muscles of the Thigh Part 2 - Medial Compartment - Anatomy Tutorial

https://www.youtube.com/watch?v=MjPAPTJdxa8

Multiple Choice Questions

1.The nerve supply of the medial compartment is : A.Sciatic

nerve. B.Obturator nerve C.Median nerve.

2.The action of Iliacus& Psoas major (Iliopsoas)is :

A.flexion of the hip joint.B.Adduction of the hip joint.C.Extention of the knee joint.

3.The insertion of the Quadriceps Femorisis :

A.Lesser trochanter of femur B.medial surface of tibia C.Patella

4. One of the Gracilisactions :

A.flexion of the knee joint.B.Extention of the.C.Rotation

Answers

1. B 2.A 3.C 4.A

 433 Anatomy Team lecture 17:Thigh MS

Muscle
Name
Sartorius Pectineus Iliacus& Psoas
major (Iliopsoas)
Psoas major: T12 & lumbar
Body of pubis - Superior pubic vertebrae
Origin
ramus
Iliacus: Iliac fossa

Insertion Upper part of medial Back of femur Lesser trochanter of femur

surface of tibia (below lesser
trochanter)

Action TAILOR’S POSITION Flexion & Flexion of the hip joint

(‫ة عيب ر‬ adduction of the
‫ ت)ال‬On hip hip joint
joint:Flexion,
abduction & lateral
rotation
On Knee Joint:
Flexion

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Good Luck