Sadek PhD MD MRCPCH Assistant Professor of anatomy and embryology Fascia of the Thigh A Superficial Fascia Superficial fatty layer Deep membranous Both layers ID: 1047744
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1. Front of thighDr Ashraf Sadek PhD, MD, MRCPCH.Assistant Professor of anatomy and embryology.
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6. Fascia of the ThighA) Superficial Fascia:Superficial fatty layerDeep membranousBoth layers are continuous with corresponding layers in anterior abdominal wall
7. Contents of superficial fascia of thighCutaneous nervesCutaneous vesselsUpper part of greatsaphenous veinSuperficial inguinal LN
8. Great (Long) Saphenous VeinLongest vein in the bodyBegins on dorsum of foot from medial end of dorsal venous archAscends infront of medial malleolusIn the thigh it ascends upwards to reach the saphenous opening, where it receives the 3 superficial inguinal veins thenpierces the cribriform fascia to end in the femoral vein.
9. Applied AnatomyGreat saphenous vein (GSV) contains many valves along its course WHY ....?Perforating veins connect the great saphenous vein with deep veins in the leg.Perforating veins contain valves which allow passage of blood from GSV to deep veins of leg & not in the opposite direction.
10. Dr Azza KamalGreat saphenous veinPerforating veinsDeep veinsof legBlood passes from GSVthrough perforating veins todeep veins of the leg
11. Failure of these valves as in regurgitation of venous blood from deep veins to the GSV which becomes dilated, tortuous & engorged with bloodVaricose Veins
12. Clinical note:The great saphenous vein can be used for blood or fluid transfusion and alsoin coronary by-pass surgery.
13. Superficial inguinal lymph nodes:These nodes lie in the superficial fascia below the inguinal ligament.They are arranged into 2 groups forming the shape of letter T:Upper horizontal group:are arranged below andparallel to the inguinal ligamentLower vertical group:are arranged along the upperpart of the great saphenous vein.
14. B) Deep Fascia of Thigh ( Fascia lata)Fibrous tough and strong sheath surrounds completely the whole thigh like a stocking except the saphenous opening.the deep layer of the superficial fascia of the abdominal wall (Scarpa’s fascia) blends with the fascia lata just below the inguinal ligament.Thinned out medially to form thecribriform fascia.while thickened laterally to form theiliotibial tract.
15. Groin hematoma Extend to the line of fusion between the fascia lata and the deep layer of the superficial fascia
16. Iliotibial tractAttachment:Above to tubercle of iliac crest Below front of lateral condyle of tibiaIts upper part splits to receive the insertion of 2 muscles :Tensor fascia lataGluteus maximusFunction:It maintains the erect posture by steadying the pelvis on the head of femur & the femoral condyles on the tibiaThis maintains extension of kneejoint during standing.
17. Compartments of the thigh :(Extensor)(Flexor)(Adductor)knee (supplied byfemoral n)Med. Comp. adductors of hip (supplied by obturator n)Post. Comp. Flexors of knee (supplied by sciatic n)They divide the thigh into 3 compartments:1) Ant. Comp. extensors of
18. 2Muscles of front of thigh
19. 4ANTERIOR COMPARTMENT
20. 5Quadriceps FemorisRectus FemorisVastus LateralisVastus MedialisVastus IntermediusSartoriusPsoas major & iliacusTensor fascia latadescribed in gluteal regionANTERIOR COMPARTMENT
21. SartoriusIliopsoasQuadriceps femoris :Rectus femorisVastus lateralisVastus medialisVastus intermediusVastus medialisANTERIOR COMPARTMENT Iliopsoas
22. 7SartoriusIliacusPsoas Major123ANTERIOR COMPARTMENT
23. Insertion: upper part ofmedial surface of tibiaOrigin : ASISstrap-like muscle with parallel fibers representing the longest muscle in the body.Action:cross leg postion. the tailor position.1-Flexion, abduction & lateral rotation of the thigh 2-Flexionof the knee joint.Sartorius
24. PSOAS MAJOR:ILIACUS:- common tendon inserted into the lesser trochanter.- Nerve supply:Psoas Major from the lumbar plexusIliacus from femoral nerveActions of both:If acting from aboveflex the thigh on the trunk.If acting from belowflex the trunk on the thigh.
25. Psoas AbscessCollection of purulent fluid in the iliopsoas compartment The iliopsoas compartment is a retroperitoneal anatomical space composed of the psoas major, psoas minor, and iliacus muscles.The muscle group originates from the lateral borders of the 12th thoracic to 5th lumbar vertebraepasses posterior to the inguinal ligament and anterior to the hip joint, inserting on the lesser trochanter.
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27. Quadriceps FemorisRectus FemorisVastus MedialisVastus LateralisVastus Intermedius1 musclewith 4 heads1 1 43 2 3 2= Quadriceps femoris
28. Straight head AIISReflected head groove above acetabulumRectus femorisQuadriceps femoris
29. Quadriceps femorisVastusLateralisVastusmedialisVastusintermediusVastus lateralis:lateral margin of gluteal tuberosity and upper half of lateral lip of the linea aspera.
30. Quadriceps femorisVastusLateralisVastusmedialisVastusintermediusVastus medialis: spiral line, medial lip of linea aspera and upper part of medial supracondylar line.
31. Quadriceps femorisVastusLateralisVastusmedialisVastusintermediusVastus intermedius:arises from the upper 2/3 of the anterolateral surface of the shaft of the femur.
32. 15Insertion of quadricepsBy a common quadriceps tendon intobase of patellathen through ligamentum patellaeintotibial tuberosityQuadriceps femoris
33. Insertion of quadricepsVastus lateralis gives a tendinous expansion on the lateral side of the patella which descends to the lateral tibial condyle lateral patellar retinaculum.Vastus medialis gives a tendinous expansion on the medial side of the patella which is attached to the medial tibial condylemedial patellar retinaculum.medial & lateral patellar retinacula stabilize the knee joint
34. Articularis genus :is a small muscle blends with the lower deep fibers of the vastus intermedius, arises from the anterior surface of the lower part of the shaft of femur and attaches into the upper part of the synovial membrane of the knee joint
35. Function:The main function of quadriceps isextend the leg at the knee joint.Rectus femoris help in hip flexion.Articularis genus muscle pulls the synovial membrane upwards during extension of the knee preventing it from being crushed between the patella and the femur.Quadriceps femoris
36. Quadriceps femorisFunction:.Both medial & lateral patellar retinacula stabilize the knee joint.
37. Definition:A depressed triangular area that occupiesthe front of upper 1/3 of the thigh just below the inguinal ligament.
38. Boundaries:Triangular in shape, having a 1- base superiorly,Inguinal ligament (from ASIS to pubic tubercle).2- medial borders:Medial border of adductor longus 3- lateral borders:Medial border of sartorius ms 4- an apex inferiorly
39. Apex :meeting of medial & lateral borders (overlap The Sartorius over the adductor longus)↓is continuous below withadductor canal
40. SkinSuperficial fasciaSuperficial inguinal LNsUpper part of GSVCutaneous nervesSuperficial brs of femoral a3- Deep fasciaSaphenous openingRoof of Femoral Triangle
41. Floor of Femoral TriangleIliopsoas muscle. Pectineus muscle. Adductor longus m.
42. Contents of Femoral Triangle1-Femoral artery. 2-Femoral vein.3-Femoral sheath. 4-Femoral nerve.Femoral branch of the genitofemoral nerveLateral cutaneous nerve of thethighDeep inguinal lymph nodes.
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