Download NERVES AND VESSELS OF ANTERIOR COMPARTMENT OF

NERVES AND VESSELS OF ANTERIOR
COMPARTMENT OF THIGH
Learning Objectives
By end of this class students are able to:
Discuss the nerve supply of the anterior compartment of thigh.
Describe the blood supply and the venous drainage of anterior compartment of
thigh.
FEMORAL NERVE
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It is the main nerve of anterior or extensor compartment of the
thigh.
ROOT VALUE
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It is the largest branch of lumber plexus.
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Dorsal division of anterior primary rami of spinal nerves L2, L3 &
L4.
FEMORAL NERVE
COURSE
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It begins in abdomen within psoas major muscles
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Then enters the anterior compartment of thigh behind the inguinal ligament to enter
in femoral triangle.
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Runs downward in the groove between iliacus and psoas major muscles outside
the femoral sheath lateral to femoral artery.
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After a short course of about 2cm below the inguinal ligament it divides into
1.) Anterior division
2.) Posterior division
BRANCHES OF FEMORAL NERVES
Anterior divisions
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Two muscular branches
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Two cutaneous branches
Muscular braches are:
1.) Nerve to SARTORIUS
2.) Nerve to PECTINEUS
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CUTANEOUS BRANCHES
Intermediate cutaneous nerve of thigh
Medial cutaneous nerve of thigh
POSTERIOR DIVISION :
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FOUR MUSCULAR BRANCHES
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ONE CUTANEOUS BRANCH (Saphenous nerves)
Muscular branches to:
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Rectus femorus
Vastus medialis
Vastus latralis
Vastus intermidius
(articularis genu)
CUTANEOUS BRANCHES
Saphenous nerves
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This nerves cross the femoral vessels from to lateral to medial side and supply
a.) Branch to infra patellar plexus.
b.) Skin of the medial side of the
leg.
c.) Skin of the medial side of the
foot and ball of big toe.
ARTICULAR BRANCHES
1.) Hip joint is supply by nerve to rectus femoris.
2.) Knee joint is supply by nerve to three vasti.
Note: Nerve to vastus medialis contains numerous proprioceptive fibers from the knee joint.
FEMORAL ARTERY
It is a chief artery of anterior compartment of the thigh
COURSE
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Femoral Artery is a continuation of external iliac artery.
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It begins behind the inguinal ligament at the
midinguinal point.
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Then runs downward and medially first in femoral
triangle then in adductor canal
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Finally ends at the junction of middle and the lower
thirds of thigh by passing through the opening in
adductor Magnus muscles
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Then continues as popliteal artery in back of thigh
RELATION OF FEMORAL ARTERY IN FEMORAL TRIANGLE
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In femoral triangle, femoral artery lies with in the femoral
sheath lateral to femoral vein.
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Femoral nerve lies lateral to femoral artery outside the
femoral sheath
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At the apex of femoral triangle femoral artery lies on
femoral vein
RELATIONS OF
FEMORAL ARTERY
Anterior Relations:
Skin
- Superficial fascia
- Deep fascia
Anterior wall of femoral sheath
Posterior Relations:
- Psoas major, pectineus , adductor longus
- Posterior wall of femoral sheath
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RELATION OF FEMORAL ARTERY IN ADDUCTOR CANAL
Femoral artery enter the adductor canal at the apex of femoral triangle
Femoral vein lies posterior to the femoral artery at the apex and lateral to the artery
in the Lower part of the canal
Sephanous nerve cross the femoral artery from lateral to medial side
Nerve to vastus medialis lies lateral to femoral artery
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BRANCHES OF FEMORAL ARTERY
Three superficial branches
Three deep branches
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SUPERFICIAL BRANCHES
Superficial circumflex iliac artery
Superficial epigastric artery
Superficial external pudendal artery
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DEEP BRANCHES
Profunda femoris artery
Deep external pudendal artery
Muscular branches
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SUPERFICIAL CIRCUMFLEX ILIAC ARTERY
It pierce the deep fascia lateral to saphenous opening
Then runs upward below the inguinal ligament and reaches the anterior superior
iliac spine
There it anastomoses with deep circumflex iliac, superior gluteal artery and lateral
circumflex femoral artery.
SUPERFICIAL EPIGASTRIC ARTERY
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It pierces the cribriform fascia , runs towards the umbilicus
And then supplies lower part of anterior abdominal wall.
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SUPERFICIAL EXTERNAL PUDENDAL ARTERY
It pierces cribriform fascia, runs medially in front of spermatic cord
And supplies the external genitalia.
DEEP BRANCHES
Profunda Femoris Artery
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It is largest branch of femoral artery
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It is normally the vessel of supply for all thigh muscle
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Arises from the lateral side of the femoral artery about 3 to 4 cm below the
inguinal ligament
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Then spirals down deep to it passing between pectineus and adductor longus
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Continues down on adductor brevis and adductor magnus and ends as 4th
perforating artery.
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BRANCHES OF PROFUNDA FEMORIS ARTERY
4 perforating arteries.
Medial circumflex femoral artery.
Lateral circumflex femoral artery.
DEEP EXTERNAL PUDENDAL ARTERY
Pierces the fascia lata and passes behind the spermatic cord.
Supplies the skin of scrotum and (labium majus)
FEMORAL VEIN
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Continuation of popliteal vein
It begins at opening of adductor magnus muscle (hiatus magnus)
Runs upward in adductor canal and then femoral triangle
Ends by passing behind inguinal ligament as external iliac vein
It has 4 or 5 valves, the most constant ones being just above the junction with
great saphanous vein.
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TRIBUTARIES OF FEMORAL VEIN
Great saphenous vein,
Veins accompanying the 3 deep branches of femoral artery.
Lateral and medial circumflex femoral veins.
Descending genicular and muscular veins.
Clinical correlates
Femoral artery:
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Avascular Necrosis of the neck of the femur during
fracture is a result of disruption of the medial circumflex
femoral artery (a branch of the profunda femoral artery)
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Coronary angioplasty is often performed by entering the
femoral artery at the femoral triangle
Femoral vein:
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Occlusion of the femoral vein can be life-threatening.
The practice of delivering recreational drugs intravenously using the femoral vein is
relatively common amongst injecting drug users
Femoral veinepuncture is useful when there are no superficial veins that can be
aspirated in a patient, in the case of collapse
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