Important Landmarks and Neurovasculature of the Thigh (Nursing)

by Darren Salmi, MD, MS

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    00:02 One anatomic landmark that we're going to point out here, going back to the anterior surface is something called the femoral triangle, though.

    00:10 So what we have here is one other muscle that we didn't really talk about it's kind of funky, but it's kind of cool, sartorius.

    00:19 Sartorius has a long serpiginous course.

    00:23 And it actually refers to the word meant for being a tailor, which is not very intuitive why that might be.

    00:31 That's because it does a complicated combination of movements that I'll just summarize as basically the hacky sack movement.

    00:40 Its external rotation, and it's hip flexion, kind of all at the same time.

    00:47 And it's thought of as the sartorius, because that's where people would have to sit when they were getting their pants tailored, very not intuitive name, but kind of a neat story.

    00:58 But that's going to be part of the border of our femoral triangle.

    01:02 We're also going to have the adductor longus.

    01:06 And then we're going to have something called the inguinal ligament up on our pelvic bones.

    01:11 And so these three things is going to form a triangle called the femoral triangle where some important femoral structures are going to go through.

    01:19 Importantly, the femoral nerve, femoral artery and femoral vein.

    01:27 And there's a little interesting quirk here that there's almost sort of an empty spot.

    01:32 It's not really empty, but it's a spot where you could potentially have structures pass through that shouldn't.

    01:39 And when something passes through an opening it shouldn't we call that a hernia.

    01:44 So this is where you can have a femoral hernia at this medial portion of the femoral triangle.

    01:53 So another anatomic landmark that we alluded to but didn't really say why it was there yet.

    02:00 Was that opening that we saw when we're talking about the medial compartments? That brings us to the adductor canal.

    02:07 So if we look at the femoral triangle superiorly, and we go down to that little opening or hiatus, we see that we have the pathways for the femoral artery and vein.

    02:18 Now as the femoral artery and vein are coming down as certain point, they're going to have to cross the knee.

    02:24 And if you think about an artery carrying blood fluid, essentially, if it were to pass anteriorly on the knee, every time you bent your knee, you would compress it so much, the blood couldn't move past it.

    02:37 So instead, the femoral artery and vein pass posteriorly through this opening this adductor hiatus, so that it can go behind the knee.

    02:47 And at that point, it changes name to become the popliteal vessels, because we generally refer to the back of the knee as the popliteal space.

    03:00 Another thing going on here is that nerve that we mentioned the obturator nerve.

    03:05 Obturator kind of refers to this general medial compartment area, because we also said there was an obturator foramen and sort of the medial part of the bony pelvis.

    03:17 In terms of the posterior thigh, we alluded to that really large sciatic nerve, but the sciatic nerve story won't be over with just in the posterior thigh, it's going to branch and provide a lot of important innervation when we learn about the leg.

    03:32 We also see that there are a bunch of perforating arteries supplying the thigh in this area.

    03:39 And then eventually, we see from the posterior point of view, that femoral artery passing through to move posteriorly as the popliteal artery behind the knee.

    03:53 So we have the femoral artery as really the main entry point into the lower limb.

    03:58 And then some branches like the deep femoral artery.

    04:02 We have the medial femoral circumflex artery.

    04:06 We also have the lateral femoral circumflex artery, which again, fairly analogous to the ones we saw up in the humerus.

    04:14 And then if we zoom in, in that general area of the knee, we see the femoral artery again going through the adductor hiatus to turn into the popliteal.

    04:25 The nerves going down into the lower limb are coming from this roughly brachial plexus equivalent, though not quite as complicated, called the lumbosacral plexus.

    04:38 And for orientation sake, here we have the 12th rib, and this square muscle called the quadratus lumborum, along which some of these lumbo sacral nerves are going to pass around, such as the iliohypogastric.

    04:53 Ilio, again, referring to that iliac type area, hypogastric meaning sort of below the stomach.

    05:00 Ilioinguinal same idea for ilio but inguinal means basically growing.

    05:06 Then we have lateral femoral cutaneous that's getting a little more clear because lateral femoral, we know what those words meaning cutaneous refers to skin.

    05:16 We have genital femoral nerve, which will have a genital branch and a femoral branch.

    05:21 And then this large one is the femoral nerve.

    05:25 Posteriorly a little harder to see is going to be the sciatic nerve going through those external rotators.

    05:33 And so again, we had the superior gluteal nerve, and the inferior gluteal nerve, taking care of our various gluteal muscles.

    05:41 We have the posterior cutaneous nerve, the thigh for cutaneous sensation in this area.

    05:46 And that large sciatic nerve going all the way down towards the knee where it's eventually going to branch into a tibial nerve and a common perineal or fibular nerve.

    About the Lecture

    The lecture Important Landmarks and Neurovasculature of the Thigh (Nursing) by Darren Salmi, MD, MS is from the course Anatomy of the Musculoskeletal System (Nursing).

    Included Quiz Questions

    1. Sartorius
    2. Adductor longus
    3. Rectus femoris
    4. Vastus lateralis
    5. Vastus medialis
    1. Femoral nerve
    2. Sural nerve
    3. Tibial nerve
    4. Genitofemoral nerve
    5. Sciatic nerve
    1. Adductor canal
    2. Lumbosacral plexus
    3. Femoral triangle
    4. Iliotibial tract

    Author of lecture Important Landmarks and Neurovasculature of the Thigh (Nursing)

     Darren Salmi, MD, MS

    Darren Salmi, MD, MS

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