Transcript Femoral triangle Occupy the upper third of the thigh. Bounderies

Cutaneous nerves of the thigh
• From the lumber plexus:
• 1- ilio-inguinal
nerve
(L1)
emerge
through
the
superficial inguinal ring distributed to the skin of the root
of the penis and adjacent part of the scrotum.
• 2- Femoral branch of the genitofemoral nerve (L1 L2)
enters the thigh behind the middle of the inguinal
ligament and on the anterior surface of the femoral
artery, it passes through the saphenous opening to
supply the skin over the femoral triangle.
• 3- Lateral cutaneous nerve of the thigh
(L2 L3) enters the thigh posterior to the
lateral part of the inguinal ligament divided
in to 2 branches anterior one supply the
anterolateral part of the thigh and posterior
one supply the posterolateral part of the
thigh.
From the femoral nerve
• Anterior cutaneous nerve of the thigh (L2 L3)
descend over the quadriceps muscle, they
divided into medial cutaneous nerves supply the
distal 2/3 of the anteromedial surface of the thigh
and upper part of the medial surface of the leg.
• Intermediate cutaneous nerves of the thigh
divided into 2 nerves supply the distal 3/4 of the
anterior aspect of the thigh and joins the patellar
plexus.
From the obturater nerve
•
Occasional branch to the medial side of
the thigh.
• Patellar plexus lies in the front of the
knee in the subcutaneous tissues over the
patella, it is formed from the terminal
branches of the lateral, intermediate and
medial cutaneous nerves of the thigh and
the infrapatellar branch of the saphenous
nerve.
Inguinal ligament
• It is the lower free border of the aponeurosis of
the external oblique muscle of the abdomen. It
extends from the pubic tubercle medially to the
anterior superior iliac spine laterally. Fascia lata
attached to the external surface of the ligament
making it convex inferiorly. Lateral to the pubic
tubercle the deep surface of the inguinal
ligament extends posteriorly to be attached to
the pectin pubis forming the lacunar ligament.
Inguinal ligament
Femoral triangle
• Occupy the upper third of the thigh.
Boundaries:
Superiorly(base): the inguinal ligament.
Medially: the medial border of the adductor
longus muscle.
Laterally: medial border of the sartorious
muscle.
Inferiorly (apex): continuous with the
adductor canal.
Boundaries of the femoral triangle
• The anterior wall of the triangle: composed of
the skin and the fascia. In the superficial fascia
there are the following structures:
• 1- The upper part of the great saphenous vein.
• 2- Superficial inguinal lymph nodes and vessels.
• 3- Femoral branch of the genitofemoral nerve.
• 4- Superficial branches of the femoral vessels.
• 5- Branches of the ilioinguinal nerve.
• The posterior wall (the floor): composed
of
muscles,
from
medial
to
lateral:
pectineus, adductor longus, psoas major
and iliacus muscles ( iliopsoas ).
Contents of the triangle
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Femoral vessels
Profunda femoris vessel.
Lateral and medial circumflex vessels.
Deep external pudendal artery
3-4 deep inguinal lymph nodes
Femoral branch of the genitofemoral nerve
Lateral cutaneous nerve of the thigh
Femoral nerve
Contents of the triangle
•
Femoral nerve (L2,3,4) arise from the lumber
plexus in the abdomen descend in groove
between psoas and iliacus muscles, and enter
the thigh posterior to the inguinal ligament and
lateral to the femoral sheath. 2cm below the
inguinal ligament it ends by dividing into anterior
and posterior branches.
• The anterior division gives:
• a- muscular branches to pectineus and
sartorious muscles.
• b- Cutaneous nerves includes the anterior
cutaneous nerve of the thigh.
• The posterior division gives:
• a- saphenous nerve runs downwards and
medially crosses the femoral artery from its
lateral to its medial side. It emerges on the
medial side of the knee between the tendons of
sartorius and gracilis muscles then run down the
medial side of the leg in accompany with the
great saphenous vein, it passes in front of the
medial border of the foot it terminates in the
region of the ball of the big toe.
• b- Muscular branches to the quadriceps
femoris muscle (rectus femoris, vastus
lateralis, medialis and intermedius(.
Femoral nerve
The adductor canal
• It is an intermuscular canal situated on the
medial aspect of the middle of the thigh beneath
the sartorius m. it conducts the femoral vessels
through the middle 1/3 of the thigh, it begins
about 15cm below the inguinal ligament at the
apex of the femoral triangle and ends at the
upper limit of the adductor hiatus.
Boundaries of the adductor canal
• Sartorius muscle anteromedially
• Vastus medialis muscle anterolaterally
• Adductor longus and magnus posteromedially
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The contents of the adductor canal are:
The femoral vessels.
Saphenous nerve.
Nerve to vastus medialis.
Contents of the adductor canal