THIGH
Dr Abayomi T.A
Department of Anatomy,
UNIOSUN
Introduction
• The thigh is the region of the lower limb that
lies between the hip and knee joints
• Anteriorly, it is separated from the abdominal
wall by the inguinal ligament;
• Posteriorly, it is separated from the gluteal
region by the gluteal fold superficially, and by
the inferior margins of the gluteus maximus
and quadratus femoris on deeper planes.
Structures that enter and leave the
upper thigh
• Posteriorly the sciatic nerve leaves the gluteal
region to enter the thigh
• Anteriorly, the iliopsoas and pectineus muscles,
the femoral nerve, artery and vein, and lymphatic
vessels; passes between the abdominal cavity
and the thigh through the aperture between the
inguinal ligament and the pelvic bone.
• Medially, structures (including the obturator
nerve and associated vessels) pass between the
thigh and pelvic cavity through the obturator
canal
Bones of the Thigh
• The skeletal framework of the thigh is formed
by the Femur which provides origin for the
gastrocnemius muscles.
N/B Refer to the lecture on Osteology of the
lower limbs for more details
3 Muscular Compartments of the thigh
• The thigh is divided into three compartments by
intermuscular septa between the posterior
aspect of the femur and the fascia lata
– The fascia lata is the thick layer of deep fascia that completely surrounds or
invests the thigh
• the anterior compartment of thigh extend the
leg at the knee joint;
• the posterior compartment of thigh extend the
thigh at the hip joint and flex the leg at the knee
joint;
• the medial compartment of thigh adduct the
thigh at the hip joint.
• The sciatic nerve innervates muscles in the
posterior compartment of thigh,
• the femoral nerve innervates muscles in the
anterior compartment of thigh,
• and the obturator nerve innervates most
muscles in the medial compartment of thigh.
Anterior compartment
• The muscles of the anterior compartment are;
• Iliopsoas
– Psoas major
– Ilacus
• Sartorius
• Quadricep femoris
– Rectus femoris
– Vastus medialis
– Vastus intermedius
– Vastus lateralis
Origin
Iliopsoas
• The psoas major: the lumbar
vertebrae, and the iliacus :the
iliac fossa of the pelvis.
Insertion
• They insert together as a
common tendon onto the lesser
trochanter of the femur.
Actions:
• The iliopsoas flexes the lower
limb at the hip joint and assists
in lateral rotation at the hip
joint.
Innervation:
• Psoas major: branches from the
anterior rami of L1 to L3
• Iliacus : branches from the
femoral nerve in the abdomen.
Sartorius
• Is the longest muscle in the
body. It is long and thin, runs
across the thigh in a
inferomedial direction.
• The sartorius is positioned
more superficially than the
other muscles in the leg.
• Origin: Anterior superior iliac
spine
• Insertion: Medial side of the
proximal shaft of the tibia
• Action: flex thigh at hip &
flex leg at knee
• Innervation: Femoral nerve
The quadriceps femoris
• The muscles that form quadriceps femoris
unite proximal to the knee, and distally attach
to the patella via the patella tendon. The
patella attaches to the tibia by the patella
ligament.
• The quadriceps femoris is the main extensor
of the knee.
Vastus Lateralis
• Origin: Greater
trochanter and the
lateral lip of linea aspera.
• Insertion: Tibial
tuberosity via patellar
ligament
• Actions: Extends the
knee joint and stabilises
the patella.
• Innervation: Femoral
nerve.
Vastus intermedius
• Origin: Anterior and
lateral surfaces of the
femoral shaft.
• Insertion: Tibial
tuberosity via patellar
ligament
• Actions: Extends the
knee joint and stabilises
the patella.
• Innervation: Femoral
nerve.
Vastus medialis
• Origin: The intertrochanteric
line and medial lip of the
linea aspera.
• Insertion: Tibial tuberosity
via patellar ligament
• Actions: Extends the knee
joint and stabilises the
patella, particularly due to
its horizontal fibres at the
distal end.
• Innervation: Femoral nerve.
Rectus Femoris
Unlike the vastus muscles, the rectus femoris muscle
crosses both the hip and the knee joints
• Origin: the anterior inferior iliac spine , and the ilium
just superior to the acetabulum.
• InsertionThe two heads of rectus femoris unite to
form an elongate muscle belly, which lies anterior to
the vastus intermedius muscle and between the
vastus lateralis and vastus medialis muscles, to which
it is attached on either side. At the distal end, the
rectus femoris muscle converges on the quadriceps
femoris tendon and inserts on the base of the patella.
• Actions: It flexes the leg at the hip joint, and extends
at the knee joint.
• Innervation: Femoral nerve.
Patellar ligament
• The patellar ligament
is functionally the
continuation of the
quadriceps femoris
tendon below the
patella
• It is attached above
to the apex and
margins of the
patella and below to
the tibial tuberosity
Posterior compartment
• There are three long muscles in the posterior
compartment of thigh:
– biceps femoris
– semitendinosus
– Semimembranosus
• Collectively known as the hamstrings
• All except the short head of biceps femoris cross both
the hip and knee joints.
• Flex the leg at the knee joint and extend the thigh at
the hip joint.
• They are also rotators at both joints
Biceps femoris muscle
• Two heads – a long head and a short head
• Most lateral muscle of the posterior
compartment
• The common tendon of the two heads can
be felt laterally at the posterior knee.
• Origin:
– The long head - the ischial tuberosity of the
pelvis.
– The short head –the linea aspera on posterior
surface of the femur
• Insertion:
– the heads form a tendon, which inserts into the
head of the fibula.
• Action: Main action is flexion at the knee.
The long head also extends and laterally
rotates the hip.
• Innervation:
– Long head is innervated by the tibial part of the
sciatic nerve
– short head is innervated by the common fibular
part of the sciatic nerve.
Semitendinosus
• Largely tendinous muscle.
• lies medially to the biceps femoris
• covers the majority of the
semimembranosus.
• Origin:
– the ischial tuberosity of the pelvis
along with the long head of the
biceps femoris muscle
• Insertion:
– attaches to the medial surface of
the tibia.
• Actions:
– Flexion of the leg at the knee joint.
Extension of thigh at the hip.
Medially rotates the thigh at the
hip joint and the leg at the knee
joint.
• Innervation:
– Tibial part of the sciatic nerve.
Semimembranosus
• Lies deep to the semitendinosus
muscle
• Origin:
– the ischial tuberosity, but does so
more superiorly than the
semitendinosus and biceps
femoris.
• Insertion:
– medial tibial condyle.
• Actions:
– Flexes the leg at the knee joint.
– Extends thigh at the hip.
– Medially rotates the thigh at the
hip joint and the leg at the knee
joint.
• Innervation:
– Tibial part of the sciatic nerve.
Medial compartment
• There are six muscles in the medial
compartment of the thigh:
– gracilis,
– pectineus,
– adductor longus,
– adductor brevis,
– adductor magnus, and
– obturator externus
Gracilis
• Most superficial of the muscles in the
medial compartment of thigh
• Descends almost vertically down the
medial side of the thigh
• Origin:
– outer surface of the ischiopubic ramus
of the pelvic bone
• Insertion:
– medial surface of the proximal shaft of
the tibia (sandwiched between the
tendon of sartorius in front and the
tendon of the semitendinosus behind).
• Action
– Adducts thigh at hip joint
– Flexes leg at knee joint
• Innervation
– Obturator nerve (L2, L3)
Pectineus
• is a flat quadrangular muscle
• Origin:
– pectineal line of the pelvic bone
and adjacent bone, and descends
laterally
• Insertion:
– oblique line extending from the
base of the lesser trochanter to the
linea aspera on the posterior
surface of the proximal femur.
• Action:
– Adducts and flexes thigh at hip joint
• innervation:
– Femoral nerve
Adductor longus
• Flat fan-shaped muscle that contributes to
the floor of the femoral triangle, and its
medial margin forms the medial border of the
femoral triangle.
• It also forms the proximal posterior wall of
the adductor canal.
• Origin:
– a small rough triangular area on the
external surface of the body of the pubis
just inferior to the pubic crest and lateral
to the pubic symphysis
• Insert:
– into the middle third of the linea aspera
via an aponeurosis
• Action:
– Adducts and medially rotates thigh at hip
joint
• Innervation:
– Obturator nerve (anterior division)
Adductor brevis
• Lies posterior to the pectineus
and adductor longus.
• Origin:
– the body of the pubis and
inferior pubic ramus just
superior to the origin of the
gracilis muscle
• Insertion
– upper aspect of linea aspera of
femur
• Action:
– adducts the thigh at the hip joint
• Innervation:
– obturator nerve
Adductor magnus
• is the largest and deepest of the muscles in
the medial compartment of thigh
• is a triangular or fan-shaped muscle
• It forms the distal posterior wall of the
adductor canal
• Origin
– Adductor part – ischiopubic ramus
– Hamstring part – ischial tuberosity
• Insertion
– Adductor part – Posterior surface of
proximal femur, linea aspera, medial
supracondylar line
– Hamstring part – Adductor tubercle and
supracondylar line
• Action:
– The adductor magnus adducts and
medially rotates the thigh at the hip joint.
• Innervation:
– The adductor part - obturator nerve
– hamstring part - tibial division of the
sciatic nerve.
Obturator externus
• Flat fan-shaped muscle.
• Origin:
– external aspect of the obturator
membrane and adjacent bone
• Insertion:
– lateral wall of Trochanteric fossa
• Action:
– rotates the thigh at the hip joint
• Innervation:
– posterior branch of the obturator
nerve
Arteries of the thigh
• Three arteries enter the thigh:
– femoral artery,
– obturator artery
– inferior gluteal artery which also contributes
towards the vasculature of the posterior thigh.
• The femoral artery is the largest and supplies
most of the lower limb.
Femoral artery
• The femoral artery is the continuation of the external
iliac artery
• The external iliac becomes the femoral artery when it
crosses under the inguinal ligament and enters the
femoral triangle.
• It passes vertically through the femoral triangle and
then continues down the thigh in the adductor canal.
• It leaves the canal by passing through the adductor
hiatus in the adductor magnus muscle and becomes
the popliteal artery behind the knee.
Branches of femoral artery
Small branches
• They arise from the anterior aspect of the
proximal part and include:
– Superficial epigastric artery
– superficial circumflex iliac artery
– superficial external pudendal artery
– deep external pudendal artery.
• These arteries supply cutaneous regions of the
upper thigh, lower abdomen, and perineum
Deep artery of thigh (Profundus Femoris artery)
• Is the largest branch of the femoral artery in the
femoral triangle and is the major source of blood
supply to the thigh.
• It arises from the posterolateral aspect of the femoral
artery.
• It travels posteriorly and distally, giving off three main
branches:
– lateral circumflex femoral branches
– Medial circumflex femoral branches
– Perforating branches.
• Perforating branches – Consists of three or four arteries
that perforate the adductor magnus, contributing to the
supply of the muscles in the medial and posterior thigh.
• Lateral femoral circumflex artery – Wraps round the
anterior, lateral side of the femur, supplying some of the
muscles in the lateral side of the thigh.
• Medial femoral circumflex artery – Wraps round the
posterior side of the femur, supplying the neck and head of
the femur. In a fracture of the femoral neck, this artery can
easily be damaged, and avascular necrosis of the femur
head can occur.
Obturator artery
• Arises from internal iliac artery in the pelvic
region.
• It descends via the obturator canal to enter the
medial thigh, bifurcating into two branches:
• Anterior branch – This supplies the pectineus,
obturator externus, adductor muscles and
gracilis.
• Posterior branch – This supplies some of the
deep gluteal muscles.
Veins in the thigh
• Consist of superficial and deep veins.
• Deep veins generally follow the arteries and have
similar names.
• Superficial veins are in the superficial fascia,
interconnect with deep veins, and do not
generally accompany arteries.
• The largest of the superficial veins in the thigh is
the great saphenous vein.
• The great saphenous vein originates from a
venous arch on the dorsal aspect of the foot and
ascends along the medial side of the lower limb
to the proximal thigh
• In the thigh the great
saphenous vein passes
through the saphenous
ring in deep fascia covering
the anterior thigh to
connect with the femoral
vein in the femoral triangle
• As the popliteal vein enters
the thigh, it becomes
the femoral vein
• The femoral vein leaves
the thigh by running
underneath the inguinal
ligament, at which point it
is known as the external
iliac vein.
Nerves
• There are 3 major nerves
in the thigh, each
associated one of the
three compartments.
• Femoral nerve- anterior
compartment
• Obturator nerve- medial
compartment
• Sciatic nerve- posterior
compartment
Assignment
• Discuss the clinical correlates associated with
the thigh
