Fascial Compartments of the Thigh 1

Dr. Waleed Renno

Department of Anatomy
Faculty of Medicine
 2
Fascial Compartments of Thigh

Clemente, 416 and Moore , 5.29

 Anterior Compartment 3

Function
flex thigh at hip
extend leg at knee
5 muscles
sartorius
iliacus
psoas
pectineus
quadriceps femoris
Femoral nerve
Profunda femoral artery branches
Note the relative positions of the 5 muscles
Iliopsoas and pectineus form the floor of the
femoral triangle
Sartorius is superficial and forms the lateral
boundary of the triangle
Quadriceps femoris forms the bulk of the anterior
compartment
Clemente, 417 Vastus intermedius is deep to the rectus femoris
 Sartorius the 4
tailors muscle
Origin
anterior superior spine
Insertion
upper medial surface of
tibia
Action
crosses 2 joints
flexes and weakly
abducts and laterally
rotates the thigh
flexes the knee
sitting in the cross-legged
position
Moore, p533
 Iliacus and psoas
5

Origin
Iliacus: iliac fossa,
lumbar vertebrae
Psoas Maj.: T12 body
transverse process,
bodies and intervertebral
disks of lumbar vertebrae
Insertion
lesser trochanter

Action
crosses hip joint
flexes the thigh and
stabilizes the hip joint
Moore, p533
 6
Pectineus
Origin
superior ramus of
pubis

Insertion
below lesser
trochanter at the
linea aspera

Action
crosses hip joint
flexes and
Hollinshead, 17-37 adducts the thigh
 Quadriceps femoris 7
4 parts
Origin
Rectus femoris
straight head anterior
inferior spine
reflected head ilium
above acetabulum
Vastus lateralis
Base of greater
trochanter,
intertrochanteric line and
linea aspera
Vastus medialis
Intertrochanteric line and
linea aspera
Vastus intermedius
Anterior and lateral
Hollinshead, 17-35 surface of femur
 Quadriceps femoris 4 parts 8

Moore, Page 534

- Flexes hip at the thigh (rectus femoris)

- Extend leg at the knee by common insertion of quadriceps
tendon on the patella and via the patellar ligament to the tibial
tuberosity.
 Muscles of the Anterior Compartment of the Thigh 9
Nerve
Muscle Origin Insertion Action
Supply
Sartorius anterior superior iliac upper medial surface of flexes, abducts, laterally femoral nerve
spine tibial shaft rotates thigh;
flexes and medially
rotates leg at knee

Iliacus iliac fossa with psoas into lesser flexes thigh; if thigh is femoral nerve
trochanter fixed,
it flexes the trunk on the
thigh
as in sitting up

Psoas major 12th thoracic vertebral lesser trochanter same as iliacus segmental branches
body from lumbar plexus
transverse process,
bodies and intervertebral
disks of lumbar vertebrae

Pectineus superior ramus of pubis upper end shaft of femur flexes and adducts thigh femoral nerve

Rectus femoris straight head: anterior patella extension of leg femoral nerve
inferior iliac spine Flexes hip at the thigh
reflected head: ilium just
above the acetabulum

Vastus lateralis upper end shaft of femur quadriceps tendon into extension of leg femoral nerve
patella
Vastus medialis upper end shaft of femur quadriceps tendon to extension of leg femoral nerve
patella
Vastus shaft of femur quadriceps tendon to extension of leg femoral nerve
patella
intermedius
 10
Femoral nerve
Anterior Division
2 cutaneous
2 motor
- sartorius
- pectineus

Posterior Division
1 cutaneous
4 motor
- quadriceps

Grants Dissector, 5.9/Snell 2-36

 11
Femoral artery - branches
Profunda femoris
Medial femoral circumflex
(13)
Femoral artery
Lateral femoral circumflex
(3)
Deep femoral artery 4 perforating branches

Descending genicular (15)

Popliteal artery
Popliteal artery
5 genicular branches
Anterior and posterior tibial
arteries
Anterior and
posterior (Veins correspond to arterial
tibial arteries branches)
Rohen, 380
 12
Relationships
NAV (inguinal ligament)

Apex of femoral triangle

Subsartorial canal

Femoral nerve branches

Clemente, 421
 Function 13
Medial Compartment adduct and laterally
rotate the thigh at
the hip

5 muscles
gracilis
adductor longus*
adductor brevis
adductor magnus
obturator externus

Obturator nerve
except 1/2 muscle

Profunda femoris and

obturator arteries
Rohen, p 367 and Clemente, 418
 Adductor longus14
Origin
front of pubic bone
Insertion
Middle 1/3 of linea
aspera

Action
adducts and laterally
rotate thigh

Commonly ossified in
horseback riders, riders
Hollinshead, 17-37 strain
Hollinshead, 17-39
15
Adductor brevis
Origin
Inferior pubic ramus
Insertion
Upper part of linea
aspera above
insertion of adductor
longus
Action
adducts and assists
in lateral rotation of
thigh
Deep to adductor
longus
 16
Adductor magnus
Origin
Inferior ramus of pubis and
ischial ramus
Insertion
Adductor part, posterior
surface of shaft of femur,
linea aspera and medial
condyle
Hamstring part, by a
rounded tendon to
adductor tubercle
Action
Adducts, flexes and lateral
rotates thigh
and weakly extends thigh
Adductor hiatus
Hollinshead, 17-40 transmits femoral vessels
 17
Gracilis
Origin
Ischiopubic ramus
Insertion
upper part of medial
surface of tibia
Action
adducts thigh
flexes and medially
rotates the leg at
knee

A weak adductor, can be

used for transplant
Hollinshead, 17-40
 Origin
Outer surface of obturator membrane and ischiopubic rami 18
Insertion
Obturator
Passes below, then behind hip joint to medial surface of greater
trochanter
externus
Action
laterally rotates thigh

Hollinshead, 17-39
 Muscles of the Medial Compartment of the Thigh 19
Nerve
Muscle Origin Insertion Action
Supply
Gracilis inferior ramus of upper part of adducts thigh; obturator nerve
pubis; shaft of tibia flexes leg
ramus of on its medial
ischium surface
Adductor body of pubis posterior adducts thigh obturator nerve
longus surface of shaft and assists
of femur in lateral
rotation
Adductor inferior ramus of posterior adducts thigh obturator nerve
brevis pubis surface of shaft and assists in
of femur lateral rotation
Adductor inferior ramus of posterior Adducts, flexes obturator nerve
magnus pubis; ramus of surface of shaft and assists in and tibial part
ischium of femur; lateral rotation. of sciatic
ischial adductor Hamstring
tuberosity tubercle of part extends
femur thigh
 20
Obturator nerve
Nerve enters medial thigh via obturator
canal
Anterior division
Deep to pectineus, anterior to
adductor brevis
Supplies gracilis, adductor brevis
and longus,
skin to medial thigh

Posterior division
Between adductor brevis and
magnus
Supplies obturator externus,
adductor magnus (not hamstring)
and brevis,
Grants Dissector, 5.11 skin to medial knee
 21
Obturator nerve "Waddling gait"
Hip is in a marked
abducted position due
to paralysis of hip
adductor muscles

When walking, the foot

on the affected side, can
not be placed under
pelvis.
Patient has to "throw"
their weight laterally
when taking a step thus,
waddling to the affected
side.
 Blood Supply 22
Medial Compartment

Medial
circumflex
artery

Profunda
femoris artery

Obturator
artery

Clemente, 422 Hollinshead, 17-44 and 17-45

 Posterior compartment 23
Note common origin of muscles
under gluteus maximus
At the insertion the
semimembranosus muscle is deep
to the semitendinosus tendon

Function
hamstrings
extends thigh at hip
flexes and rotates leg at knee
3 muscles
biceps femoris
semitendinosus
semimembranosus
4 perforating branches of profunda
femoris
Sciatic nerve

Clemente, 427 Moore, p 563

 Biceps femoris 24

Origin
Long head, ischial
tuberosity
Short head, linea aspera
and lateral
supracondylar ridge
Insertion
Heads unite above knee
and common tendon
inserts into head of fibula
Action
extends thigh (long
head)
flexes and laterally
rotates the leg at knee
Moore, p 563
 Semitendinosus 25
Semimembranosus
Origin (both)
ischial tuberosity
Insertion
Semitendinosus, by long tendon to
upper medial shaft of tibia
Semimembranosus, posterior part of
medial condyle of tibia and a fibrous
expansion to lateral femoral condyle
Action
extends thigh
flexes and medially rotates the leg
at knee

Hamstring injuries
avulsion of ischium, Hurdlers injury
Muscle tears, hematoma
Moore, p 563
 Muscles of the Posterior Compartment of the Thigh26
Muscle Origin Insertion Action Nerve
Supply
Biceps femoris, ischial tuberosity head of fibula flexes and laterally tibial part of sciatic
long head rotates leg, nerve
extends thigh

Biceps femoris, shaft of femur head of fibula flexes and laterally common peroneal
short head rotates leg nerve

Semitendinosus ischial tuberosity upper part medial flexes and medially tibial part of sciatic
surface of tibia rotates leg;
extends thigh

Semimembranosus ischial tuberosity medial condyle of flexes and medially tibial part of sciatic
tibia; roates leg;
forms oblique extends thigh
popliteal ligament

Adductor magnus ischial tuberosity adductor tubercle extends thigh tibial part of sciatic
(hamstring part) of femur
 Sciatic Nerve 27

Long head of biceps reflected

Note origin of short head of
biceps and insertion of
adductor magnus
Sciatic nerve runs deep to long
head of biceps and on adductor
magnus divides
Adductor
magnus
Tibial nerve
Supplies semimembranosus,
semitendinosus, long head of
Short head of biceps
biceps, hamstring part of
adductor magnus
Common peroneal nerve
Supplies short head of biceps
Clemente, 428
 28
Blood Supply
posterior compartment

4 perforating arteries of
profunda femoris supply the
muscles

Pierce adductor magnus to

reach the compartment

Clemente, 428