Muscles, Neurovasculature of Anterior Compartment of Thigh, Femoral Triangle, Femoral Sheath & Adductor Canal

2. Anterior
Compartment of
Thigh
Dr. Atif Raza

3. Fascial
Compartments of the
Thigh
• Three fascial septa pass from the inner
aspect of the deep fascial sheath of the
thigh to the linea aspera of the femur.
• By this means, the thigh is divided into
three compartments, each having
muscles, nerves, and arteries.
• The compartments are
 Anterior Compartment (Femoral nerve)
 Medial Compartment (Obturator Nerve)
 Posterior Compartment (Sciatic Nerve)

4. ■ Muscles:
Sartorius, iliacus, psoas,
pectineus, and quadriceps
femoris
■ Blood supply:
Femoral artery
■ Nerve supply:
Femoral nerve
■ Action:
Flexion of Hip &
Extension of Knee
Anterior Fascial Compartment

5. Ilio-Psoas:
• Origin: Iliacus from Iliac Fossa
Psoas from T-12 & Lumbar Vertebrae
• Insertion: Lesser Trochanter of Femur
• Nerve Supply: Psoas Major by ant. Rami of L1 to L3 &
Iliacus by Femoral Nerve
• Action: Iliopsoas is a powerful flexor of the thigh at
the hip joint

6. Quadratus Femoris
• The large quadriceps femoris
muscle consists of:
• Three vastus muscles
 Vastus medialis,
 Vastus intermedius, and
 Vastus lateralis and
• Rectus femoris muscle

7. Quadratus Femoris
• Nerve Supply: Femoral Nerve (L2, L3, L4)
• Action: Extend leg at knee joint; rectus femoris also steadies hip joint and
helps iliopsoas

8. Sartorius:
• Origin: Anterior Superior Iliac Spine
• Insertion: Superior part of medial surface of tibia
• Nerve Supply: Femoral Nerve (L2-L3)
• Action: Flexes, abducts, and laterally rotates thigh at hip
joint; flexes leg at knee joint, medially rotating leg
when knee is flexed

9. Pectineus:
• Origin: Superior Ramus of Pubis
• Insertion: Pectineal Line of Femur
• Nerve Supply: Femoral Nerve & Obturator Nerve
• Actions: Adducts and Flexes Thigh

10. Flexors of Hip Joint:

11. Extensors of Knee Joint:

12. ORIGIN:
• The femoral artery enters the thigh from behind the
inguinal ligament, as a continuation of the external iliac
artery.
COURSE:
• It lies midway between the anterior superior iliac spine and
the symphysis pubis.
• It descends almost vertically toward the adductor tubercle of
the femur.
TERMINATION:
• Ends at the opening in the adductor magnus muscle by
entering the popliteal space as the popliteal artery.
Femoral Artery:

13. Branches:
• 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(Deep) artery is a large and important branch that
arises from the lateral side of the femoral artery below the inguinal
ligament. It passes medially behind the femoral vessels and enters the
medial fascial compartment of the thigh. It ends by becoming the fourth
perforating artery. At its origin, it gives off the medial and lateral femoral
circumflex arteries, and during its course it gives off three perforating
arteries.
• The descending genicular artery is a small branch that arises from the
femoral artery near its termination. It assists in supplying the knee joint.

14. Femoral Artery & Its Branches:

15. Femoral Vein:
• The femoral vein is a blood vessel that
accompanies the femoral artery in
the femoral sheath.
• It begins at the adductor canal (also
known as Hunter's canal) and is a
continuation of the popliteal vein.
• It ends at the inferior margin of the
inguinal ligament, where it becomes
the external iliac vein.
Drainage
Several large veins drain into the femoral vein:
• Popliteal vein
• Profunda femoris vein
• Great saphenous vein

16. Femoral Nerve:
• The femoral nerve originates from the lumbar plexus (spinal cord
segments L2-L4) on the posterior abdominal wall
• Enters the femoral triangle of the thigh by passing under the
inguinal ligament.
• In the femoral triangle the femoral nerve lies on the lateral side of
the femoral artery and is outside the femoral sheath, which
surrounds the vessels.
• Before entering the thigh, the femoral nerve supplies branches to the
iliacus and pectineus muscles.
• Immediately after passing under the inguinal ligament, the femoral
nerve divides into anterior and posterior branches.

17. Branches of the Femoral Nerve:
• Anterior cutaneous branches, which
penetrate deep fascia to supply skin on the
front of the thigh and knee;
• Numerous motor nerves, which supply the
quadriceps femoris muscles (rectus femoris,
vastus lateralis, vastus intermedius, and vastus
medialis muscles) and the sartorius muscle; and
• One long cutaneous nerve, the saphenous
nerve, which supplies skin as far distally as the
medial side of the foot.

18. Femoral Triangle:
• The femoral triangle is a wedge-shaped depression formed by
muscles in the upper thigh at the junction between the
anterior abdominal wall and the lower limb.
• Its apex is continuous with adductor canal.

19. Boundaries:
• Base: Inguinal ligament
• Medial border: Medial margin of the adductor longus muscle
• Lateral border: Medial margin of the sartorius muscle
• Floor: Medially by the pectineus and adductor longus muscles
and laterally by the iliopsoas muscle.
• Apex: Points inferiorly and is continuous with a fascial canal
(adductor canal).
• Roof : Fascia lata and cribriform fascia, subcutaneous tissue,
and skin

20. Content:
• Femoral nerve and its (terminal) branches.
• Femoral sheath and its contents:
 Femoral artery and several of its branches.
 Femoral vein and its proximal tributaries.
 Deep inguinal lymph nodes and associated
lymphatic vessels.
[Most Medial compartment of Femoral
Sheath (Femoral Canal) is the potential
space for Femoral Hernias.]

21. Adductor Canal:
• It is an intermuscular cleft situated on the medial aspect of the middle third of
the thigh beneath the sartorius muscle.
• It commences above at the apex of the femoral triangle and ends below at the
opening in the adductor magnus.
• In cross section, itis triangular, having an anteromedial wall, a posterior wall,
and a lateral wall.
■ 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:
• Terminal part of the femoral artery,
• Femoral vein,
• Deep lymph vessels,
• Saphenous nerve,
• Nerve to the vastus medialis, and
• Terminal part of the obturator nerve.