Download DEEP FASCIA OF THIGH ILIOTIBIALTRACT AND SAPHENOUS

DEEP FASCIA OF THIGH
ILIOTIBIALTRACT AND SAPHENOUS
OPENING
 LEARNING OBJECTIVES
 At the end of the lecture student should be able to:
 Know the arrangement of deep fascia in thigh and how the iliotibial
tract participates in walking and running
 Understand the location of saphenous opening and its relations
 Clinical application of the topic
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LECTURE OUTLINES
FASCIA OF THIGH
DEEP FASCIA OF THE THIGH (FASCIA LATA)
ILIOTIBIAL TRACT
FASCIAL COMPARTMENTS OF THE THIGH
ANTERIOR COMPARTMENT OF THIGH
MEDIAL COMPARTMENT OF THIGH
POSTERIOR COMPARTMENT OF THIGH
SUPERFICIAL VEINS
SAPHENOUS OPENING
APPLIED ASPECT
FASCIA OF THIGH
Subcutaneous tissue of hip & thigh is continuous with that of the
inferior abdominal wall and buttock.
 At the knee, subcutaneous tissue loses its fat and blends with deep
fascia
 Deep fascia: strong & inelastic; it limits outward expansion of the
contracting musculature, the increased pressure “pumps” the blood
proximally through the veins.
 Deep fascia of the thigh (fascia lata)
 Fascia lata attaches to and is continuous with:
 1.The inguinal ligament, pubic arch, body of the pubis and pubic
tubercle.
 2. Scarpa’s fascia of the inferior abdominal wall attaches to deep
fascia inferior to the inguinal ligament.
 3. Iliac crest (lateral & posterior).
 4. Sacrum, coccyx, sacrotuberous ligament, ischial tuberosity
postreiorly.
 5. Exposed parts of bones at the knee &
deep fascia of the leg.
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 DEEP FASCIA (FASCIA LATA)
 Encloses the thigh
 Upper end is attached to pelvis and its
ligaments
 Laterally thickened called ILIOTIBIAL
TRACT
o Above attached to iliac tubercle
o Below to lateral condyle of tibia
o Receives insertion of tensor fascia lata and gluteus Maximus
 Saphenous opening just below inguinal ligament.
 Filled with loose C.T. called cribriform fascia
 Transmits saphenous Vein
 ILIOTIBIAL TRACT
 Thickening of the fascia lata that
commences at the level of the greater
trochanter, where 3/4th of gluteus maximus
and tensor fascia lata are inserted into it
 Passes vertically downward along the
posterolateral aspect of thigh and is inserted into the lateral
condyle of tibia
 When knee is straight the tract maintains the knee in extended
position
 Particularly in action when slightly flexed knee is bearing the weight
of body.
 Thus in constant use during walking and running
 In rising from sitting position, gluteus maximus extends the hip and
then, as the knee is extended by quadriceps, the iliotibial tract
operates to assist quadriceps
 In leaning forward with the knee slightly flexed it provides the only
antigravity force supporting the knee joint.
 FASCIAL COMPARTMENTS OF THE
THIGH
 3 septa from deep fascia to linea
aspera
 So thigh is divided into 3
compartments
 Anterior
 Medial
 Posterior
 Each compartment has its own nerve
and blood supply.
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ANTERIOR COMPARTMENT OF THIGH
MUSCLES
Sartorius
Iliacus
Psoas
Pectineus
Quadriceps femoris
 ARETRY: Femoral Artery
 NERVE: Femoral Nerve
MEDIAL COMPARTMENT OF THIGH
 MUSCLES
 Gracilis
 Adductor longus
 Add. Brevis
 Add. Magnus
 Obturator externus
 ARTERY: Profunda A. +
Obturator A.
 NERVE: Obturator N.
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POSTERIOR COMPARTMENT OF THIGH
MUSCLES
Biceps femoris
Semitendinosus
Semimembranosus
Small part of Add. Magnus
 ARTERY: Profunda A.
 NERVE: Sciatic N.
 SUPERFICIAL VEINS
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 Great saphenous:
 Formed by the union of the dorsal
digital vein of the great toe and
the dorsal venous arch.
 Ascends anterior to the medial
malleolus, posterior to the
medial condyle of the femur. It freely communicates with the small
saphenous vein.
 Proximally it traverses the saphenous opening in the fascia to enter
the femoral vein.
 SAPHENOUS OPENING
 An oval 2 cm long gap in fascia lata infero-lateral to the inguinal
ligament,3 cm below and lateral to the pubic tubercle.
 Medial margin is smooth
 Lateral margin is sharp forming the falciform margin
 Cribiform fascia – a sieve like membrane covering the saphenous
opening which is perforated by great saphenous vein, two small
arteries and numerous lymphatic vessels
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APPLIED ASPECT
Femoral hernia
Compartment syndrome
Varicosities in superficial
veins of thigh
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