The thigh region lies between the hip and knee joints. It contains a single bone, the femur. The thigh is divided into anterior, medial, and posterior compartments by intermuscular septa. The anterior compartment contains muscles that flex the hip and extend the knee, while the posterior compartment contains muscles that extend the hip and flex the knee. The femoral triangle located in the upper anterior thigh contains the femoral nerve, artery and vein. The adductor canal on the medial thigh contains the femoral vessels and continues below as they pass into the leg. Major muscles of the thigh include the quadriceps femoris, sartorius, gracilis, and adductors.

1. THIGH REGION
pg dept. Rachana sharir
DR. PRIYANKA
PG 2ND Yr.

2. INTRODUCTION
 Part of lower limb which
lies between the hip and
knee joints.
 Upper limit formed:
Inguinal Ligament.
 Lower: knee joint
 Single bone in thigh :
Femur

3. REGION OF THIGH
THIGH
LATERAL MEDIAL POSTERIOR
INTERMUSCULAR
SEPTA
Linea
aspera

4. INTERMUSCULAR SEPTUM
 Extension of deep fascial :
1) Medial Intermuscular Septum: passes from deep fascia to
medial lip of linea aspera.
It separates anterior & medial compartment.
2) Lateral intermuscular septum: passes deep fascia to
lateral lip of linea aspera.
It separates anterior & posterior compartment.
3) Posterior intermuscular septum: passes deep fascia to
medial lip to medial lip linea aspera.
It separates medial & posterior compartment.

6. Compartment of thigh
Femoral
nerve
Anterior
Flexion hip
Extension knee
Medial
Adductor of
hip
Posterior
Extension hip
Flexion knee
Obturator
nerve
Sciatic
nerve

7.  The anterior compartment of the thigh is
homologous to the posterior compartment of the
arm.
 The posterior compartment of the thigh is
homologous to the anterior compartment of the
arm.

8. Surface landmarks
 Iliac crest
 Anterior superior iliac
spine
 Tubercle of the iliac
crest
 Fold of groin
 Pubic tubercle
 Greater trochanter
 Mid inguinal point
 Patella
 Tibial tuberosity
 Ligamentum patellae
 Adductor tubercle

12. Dissectional Steps:
FRONT OF THIGH
1. Make curved incision from ASIS to pubic
tubercle.
2. Give a curve incision around scrotum
towards upper medial side of leg
3. Extend it vertically down below the
medial condyle of tibia till tibial
tuberosity.
4. Make a horizontal incision below the tibial
tuberosity till lateral side of leg.
 Reflect the skin laterally, exposing the
superficial fatty & deeper membranous
layers of superficial fascia.

13. Important structures in Front of thigh:
 Cutaneous nerves & superficial veins
 Inguinal ligament
 Spermatic cord
 Saphenous opening
 Cribiform fascia
 Superficial fascia
 Deep fascia/ Fascia lata
 Iliotibial tract
 Intermuscular septa
 Femoral triangle
 Adductor canal

14. Superficial fascia
 2 layers
 These layers are continuous with corresponding layer of anterior abdominal
wall
 These 2 layers are most distinct in uppermost part of thigh, near the groin
region , where the cutaneous nerves, vessels and lymphatic nodes lie
between two layers.
Superficial fatty layer
Deep membranous layer

15. Cutaneous nerves :
The skin of front of thigh is supplied by :
• Ilioinguinal nerve (L1)
• Femoral branch of genitofemoral nerve
(L1, L2)
• Lateral cutaneous nerve of thigh(L2,L3)
• Intermediate cutaneous nerve of thigh
(L2,L3)
• Medial cutaneous nerve of thigh (L2, L3)
• Saphenous nerve(L3,L4)

16. Great/Long Saphenous
Vein
 Largest & longest superficial vein
 Saphes means easily seen
 Begins:
Dorsum of foot from medial end of
dorsum venous arch,
Runs upward in front of medial
malleolus along medial side of leg,
behind knee.
In thigh, it inclines forward to reach
saphenous opening where it pierece
cribriform fascia & drains in femoral
vein.

17. Deep Fascia/ Fascia Lata
 Tough fibrous sheath envelops the whole of the
thigh like a sleeve.
 Features:
 Lateral part: thick & form iliotibial tract
 Medial part: covers adductor magnus
 Around knee: thick & receives expansion from
laterally: biceps femoris
Medially: sartorius
Anteriorly: quadriceps femoris

19.  Attachments:
 Above:
Laterally: outer lip of iliac crest
Anterior: inguinal ligament, pubic tubercle, pubic crest,
pubic symphysis
Posterior: sacrotuberous ligament, coccyx, sacrum & pubic
arch.
 Below : All bony prominences around knee
 Condyles of femur & tibia.
 Head of fibula
 Margin of patella.
 Posteriorly : fascial roof of popliteal fossa
 Below the knee: deep fascia of leg.

20. SPECIALIZED COMPONENT OF DEEP FASCIA
 SAPHENOUS OPENING: oval gap in fascia
lata a little below & lateral to pubic
tubercle
 Cribriform fascia: thinner part below
pubic tubercle
 Iliotibial tract: thickened lateral part
 Intermuscular septa

21. Ilio tibial tract
 Condensed deep fascia of thigh or fascia lata on
lateral side forms a 5cm band.
 Attachments :
 Above: at the junction of upper 1/3rd &lower 2/3rd of
thigh, it splits into two layers
 Superficial layer attached to anterior 5cm of outer lip
of iliac crest.
 Deep layer blend with fibrous capsule of hip joint.
 Below: attached to oval facet on anterior surface of
lateral condyle of tibia.

23. IMPORTANCE
 2 muscle are inserted:
1) 3/4th part of Gluteus maximus
2) Tensor fascia latae
 Stabilizes the knee both in
extension & partial flexion
 It is used constantly during
walking & running
 Tract is main support of knee
against gravity.

24. FEMORAL TRIANGLE
 It is a triangular depression
on front of upper 1/3rd of
thigh immediately below
the inguinal ring.
 The apex of triangle is
directed downward formed
by point where medial &
lateral boundaries cross.
 The apex is continuous
below with adductor canal.

25. Femoral Triangle:
Borders:
 Superior: Inguinal
Ligament
 Medially: Adductor
Longus Muscle
 Laterally: Sartorius
Muscle

27.  Floor:
 Iliacus
 Psoas major
 Pectineus
muscle.
 Adductor
longus
muscle.
 Roof : Fascia
Lata

28. Contents(lateral to medial):
 Femoral Nerve
 Femoral Artery
 Femoral Vein
 Lymphatics

29. FEMORAL SHEATH
 Funnel shaped sleeve of fascia enclosing the
upper 3-4cm of femoral vessels.
 Sheath formed by
downward extension 2 layer of fascia of abdomen.
 Inferiorly sheath merges with connective tissue
around femoral vessels.
 Asymmetrical : lateral wall vertical
medial wall oblique
Anterior
(Fascia transversalis)
Posterior
(fascia iliaca)

30. Compartment of sheath
 Sheath divided into 3
compartments by
septa
 Lateral/arterial:
contains F.A &
femoral branch of
genitofemoral nerve
 Intermediate/ venous
 Medial/ lymphatics:
smallest of all &
known as femoral
canal.

31. FEMORAL CANAL
 Medial compartment of femoral sheath
 Conical in shape, being wide above or at base and
narrow below.
 1.5cm long, 1.5cm wide at base.
 Base or upper end is called femoral ring.
 Boundaries of femoral ring:
anterior: inguinal ligament
Posterior: pectineus & its covering fascia
Medially: lacunar ligament
Laterally: septum separating from femoral vein.
 Contains: lymph node Rosenmuller, lymphatics &
small amount areolar tissue.

32. Adductor canal
 also called the subsartorial canal or
Hunter’s canal.
 The adductor canal is an
intermuscular space situated on the
medial side of the middle one-third
of the thigh
 The canal extends from the apex of
the femoral triangle, above; to the
tendinous opening in the adductor
magnus, below
 The canal is triangular on cross-
section
 15cm in length.

33. Adductor Canal:
Borders:
 Lateral: Vastus medialis
muscle.
 Posterior: Adductor longus
and magnus.
 Anteromedial: Sartorius
muscle.

34. CONTENTS:
From lateral to medial:
 Nerve to vastus medialis
 Saphenous nerve
 Femoral vein
 Femoral artery
 Posterior division of obturator nerve

35. Muscle of front of thigh
Anterior muscle Medial muscle
1. Iliacus
2. Psoas major
3. Tensor fascia lata
4. Sartorius
5. Quadriceps femoris
• Rectus femoris
• Vastus medialis
• Vastus intermedius
• Vastus lateralis
6. Articular genu
1. Gracilis
2. Pectineus
3. Adductor longus
4. Adductor brevis
5. Adductor part of Adductor
magnus

39. Iliacus
Origin:
 Iliac fossa
 Inner lip of iliac crest
 Iliolumbar ligament
 Lateral part of upper surface of
sacrum.
Insertion:
 Lesser trochanter of femur
Nerve supply: Femoral nerve
Action: flexion of thigh

40. Psoas major
Origin:
 Anterior surface of transverse process
lumbar vertebrae
 There are 5 slips:
highest b/w T12& L1;
Lowest b/w L4& L5
Insertion:
 Lesser trochanter of femur
Nerve : branches of ventral rami of spinal
nerves L1, L2& L3
Action:
 Flexion of thigh
 Flexion of lumbar part vertebral column

42. Tensor fasciae latae
Origin
 Anterior part of outer lip of iliac crest
 Outer aspect of anterior superior iliac
spine
Insertion:
 Upper end of Iliotibial tract
Nerve : superior gluteal nerve(L4,L5,S1)
Action:
 Helps in maintain erect posture by
stabilizing pelvis on head of femur, &
femur on tibia
 Extension of leg

43. Sartorius
Origin
 Anterior superior iliac spine
 Small area below spine
Insertion:
 Upper end of tibia on a vertical
line on upper part of medial
surface.
Nerve: Femoral nerve (L2,L3)
Action:
 Flexion of leg
 Flexion of thig
 Lateral rotation of thigh

44. Quadriceps femoris
1.Rectus femoris
2.Vastus medialis
3.Vastus laterialis
4.Vastus intermedius

45. Rectus femoris
Origin:
 Tendinous origin from hip bone
by 2 heads
 Straight head: from ant.inferior
iliac crest
 Reflected head: from ilium just
above acetabulum
Insertion: upper border of patella

46. Vastus medialis
Origin:
 Intertrochanteric line
 Spiral line
 Medial lip of linea
aspera
 Medial supracondylar
line
Insertion:
 Medial border of patella

47. Vastus intermedius
Origin:
 Shaft of femur from
anterior& lateral
surface.
Insertion:
 Deep to rectus femoris
i.e. upper boder of
patella

48. Vastus lateralis
Origin:
 Upper end of trochanteric line
 Anterior border of greater trochanter
 Lower boder of greater trochanter
 Lateral margin of gluteal tuberosity
 Lateral lip linea aspera
Insertion:
 Lateral border of patella

49. Insertion of quadriceps femoris:
 All 4 parts inserted into
patella
 Patella transmit pull
Ligamentum patellae
tibial tuberosity.

50. Nerve supply: Femoral nerve (L2,L3,L4)
Actions of quadriceps femoris:
 Muscle strengthens the lower extremity at
knee.
 Vastus medialis prevents lateral
displacement of patella.

51. Articular Genu
Origin:
 Anterior surface of lower part of
shaft of femur below origin of
vastus intermedius
Insertion:
 Synovial membrane of knee joint.
Action:
 Pull the synovial membrane of
knee joint during its extension.
Nerve: femoral nerve

52. FEMORAL ARTERY
3 superficial:
1. Sup. External pudenal
2. Sup. Epigastric
3. Sup. Circumflex iliac
3 deep branches:
1. Profunda femoris
2. Deep external
pudenal
3. Muscular branches

53. FEMORAL VEIN
 Begins as upward
continuation Popliteal vein
at lower end of adductor
canal & ends by becoming
continues with external iliac
behind inguinal ligament.
Tributaries it receives:
 Great saphenous vein
 Veins accompanying deep
branches of femoral artery
i.e. profunda, deep external
pudenal & muscular,

55. MUSCLE OF ADDUCTOR COMPARTMENT
 INTRINSIC:
1. Gracilis
2. Pectineus
3. Adductor longus
4. Adductor brevis
5. Adductor magnus
 EXTRINSIC:
1. Obturator externus

56. Dissection Steps
 Identify adductor longus which forma medial
boundary of femoral triangle.
 Cut this muscle 3cm below its origin &reflect
distal part laterally.
 Lateral to adductor longus is pectineus muscle.cut
to its origin & reflect laterally.
 Deeper to these, Adductor brevis & divide close to
its origin.
 Deepest muscle comprise the adductor magnus.
 Lyling vertically along medial side is Gracilis.

58. Gracilis
Origin
 Medial margin of lower half of body
of pubis
 Inf ramus pubis
 Adjoining part of ramus of ischium.
Insertion:
 Upper part medial surface of tibia
Nerve: obturator nerve(l2,l3)
Action
 Flexion of leg
 Medial rotation & adduction thigh.

59. PECTINEUS
Origin:
 Superior ramus pubis
Insertion:
 Posterior aspect on femur
on a line passing from
lesser trochanter to linea
aspera
Nerve:
 Femoral & obturator
Action:
 Adduction& flexion thigh

60. ADDUCTOR LONGUS
Origin:
 Front of body of pevis
Insertion:
 Posterior aspect of middle 1/3rd of
shaft of femur into linea aspera
b/w insertion of vastus medialis &
adductor brevis and magnus.
Nerve:
 Ant. Division of Obturator nerve.
Action:
 Adduction & flexion thigh.

61. ADDUCTOR BREVIS
Origin:
 Lower part of body of pubis
 Inferior ramus pubis.
Insertion:
 Line extending from lesser
trochanter to linea aspera
 Upper part linea aspera
Nerve: obturator nerve
Action: adduction & flexion
thigh.

62. Adductor magnus
Adductor part: Hamstring part:
Origin: ramus of ischium
Lower part inferior
ramus pubis
Origin: Inferior & lateral
part of ischial tuberosity
Insertion: medial margin
of gluteal tuberosity
• Linea aspera
• Medial condylar ridge
Insertion: adductor
tubercle on medial
condyle of femur
Nerve: obturator nerve Nerve: sciatic nerve

63. Dissectional images ant. thigh

67. Superficial
vessel on medial
side of thigh

74. Deep to
Rectus
femoris

75. Insertion of quadriceps tendon to patella

79. Femoral nerve branches

85. Medial compartment muscle
(superficial to deep)
Superficial layer
Lateral to medial
1.Pectineus
2.Adductor longus
3.Gracilis
Intermediate layer
• Adductor brevis
Deep layer
Adductor magnus

95. Back of thigh & popliteal fossa
 Region on post aspect of thigh
that extends from lower border
of gluteus maximum to upper
limit of popliteal fossa, vessels
& nerves of back of thigh
 Continues down from gluteal
region
 In lower 1/3rd thigh
Quadrilateral depression
Popliteal fossa

96. Content back of thigh
MUSCLES:
 HAMSTRING : Semitendinsous
semimembranosus
long head Biceps femoris
 Short head of Biceps femoris
 Hamstring part of Adductor Magnus
Nerves:
 Sciatic nerve
 Posterior cutaneous nerve of thigh
 The tibial nerve runs downwards
superficial to popliteal vein
Vessels
 Popliteal artery
 Popliteal vein

97. Dissection steps
 A transverse incision on
back of thigh at
junction of upper2/3rd
& lower1/3rd.
 A transverse incision on
back of leg at junction
of upper 1/4th & lower
3/4th
 A vertical incision
joining the mid points
of two transverse
incisions.

98. After incision
 Skin
 Fasciae
 Cutaneous innervations branches posterior cutaneous
nerve thigh
 Hamstring muscles
 Sciatic nerve
 Vessels

100. Muscles of back of thigh:
Upper part of thigh:
From medial to lateral(superficial)
 Semitendinosus
 Long head of biceps femoris
In deep layer
 Semimembranosus
 hamstring part of Adductor
magnus
Lower part of thigh
 Gastrocnemius: medial& lateral
 Plantaris (lateral side)

101. Common origin of hamstring muscle:
ischial tuberosity.
Insertion:
 Semitendinosus: upper part
medial surface tibia
 Semimembranosus: medial
condyl tibia
 Long head of biceps femoris:
both heads in common tendon
attached to head of fibula.

102. Long head
Biceps femoris
Semimembranosus semitendinosus

103. Nerve supply of hamstring:
Tibial part of sciatic
nerve(L4,5,S1,2,3)
ACTION
FLEXION OF LEG AT KNEE JOINT
Medial rotator of legin semiflxed knee.

104. Biceps femoris
Origin:
 Short head: linea aspera of
femur
 Long head: ischial tuberosity
Insertion:
 Head of fibula
Nerve innervation:
 Long head: tibial part of sciatic
nerve
 Short head: peroneal part of
sciatic nerve

105. Adductor magnus
 Hybrid muscle bcz double nerve
supply.
Origin:
 Hamstring part: ischial tuberosity
larteral part
 Adductor part : ramus of ischium
& inf. Ramus pubis.
Insertion:
 Adductor part: gluteal tuberosity&
linea aspera
 Hamstring part: adductor tubercle
of femur

107. Sciatic nerve relation
 In gluteal region : enters through greater sciatic
foramen below piriformis.
 In thigh: enters in back of thigh at lower border of
gluteus maximus.
 It runs vertically downwards till popliteal fossa at
junction of upper 2/3rd & lower1/3rd of thigh
where it terminates into tibial & common
perinoeal
Relations:
 Superficial: cross by long head biceps femoris
 Deep: adductor magnus
 Medial semimembranosus & semitendinosus.
 Lateral: biceps femoris

109. Arteries of back
 Terminal branches
 profunda femoris
 Deep branch
femoral artery

110. Anastomoses on back of thigh

111. Popliteal fossa
 Popliteal in latin Hamstring
of knee.
 Shallow diamond shaped
depression felt best at back
of knee joint, when knee is
semi flexed.
 Correspond to cubital fossa
of fore arm.

112.  Shape: diamond / rhomboid shape
 Importance:
 Provides passage for main vessels & nerves
from thigh to leg.
 Boundaries:
Above:
medial: semitendinosus & semimembranosus
lateral: biceps femoris
Below:
medial: medial head gastrocnemius
lateral: lateral head of gastrocnemius &
plantaris

113. Roof:
 skin & subcutaneous tissue
 superficial fascia: contains
1. short saphenous vein
2. three cutaneous nerve:
post cut. Nerve thigh
post. Division of medial cut. Nerve thigh
sural communicating branches
 Deep fascia or popliteal fascia.
 Floor:
1. Popliteal surface of femur
2. Capsule of knee joint
3. Strong popliteal fascia.

114. CONTENTS
1. The popliteal artery and its branches
2. The popliteal vein and its tributaries
3. The tibial nerve and its branches
4. The common peroneal nerve and its
branches
5. The posterior cutaneous nerve of the
thigh
6. The genicular branch of the obturator
nerve
7. The popliteal lymph nodes
8. Fat: Surrounds and supports all the
above structures

116. Vessels arrangement at diff level

118. Popliteal artery
 Continuation femoral artery
 Begins at opening of adductor
magnus
 Branches:
 Several muscular branches
 Cutaneous branches
 5 genicular branches
 Medial & lateral sup. Genicular
 Medial & lateral inf genicular
 Middle genicular

119. Popliteal vein
 Begins at lower border of
popliteus
 Union of Ant. &Post. Tibial
vein
 It receives:
 Small saphenous vein
 Corresponding to popliteal
artery

120. Tibial Nerve branches
 3 genicular branches
 Superior medial
genicular
 Middle genicular
 Inferior medial
genicular
 Cutaneous nerve i.e.
sural
 Muscular branches

121. Common peroneal nerve
 Cutaneous branches :
Lateral cut. Nerve
Sural communicating
 Articular branches:
i. Superior lateral genicular
ii. Inferior lateral genicular
iii. Recurrent genicular
 Muscular branches

130. Str. Passing roof popliteal fossa