Anterior compartment of the Thigh

  • Subcutaneous tissue
    • Cutaneous nerves
    • Lymphatic vessels & nodes
    • Termination & tributaries of great saphenous vein
    • Cutaneous branches of femoral artery
  • Borders:
    • Lateral intermuscular septum – posterior to vastus lateralis
    • Medial intermuscular septum – posterior to sartorius and vastus medialis
  • Function
    • Hip flexors
    • Knee extensors
  • Innervation
    • Femoral nerve

Arterial supply

Superficial Arteries

  • 4 cutaneous branches of femoral artery
    • Superficial circumflex iliac artery
      • Pierces fascia lata lateral to saphenous opening
      • Passes up below inguinal ligament
      • Anastomose at the ASIS
    • Superficial epigastric artery
      • Through saphenous opening
      • Crosses inguinal ligament
      • Runs towards umbilicus
    • Superficial external pudendal
      • Through saphenous opening
      • Passes medially, in front of spermatic cord (round ligament)
      • To penis & scrotum / labium majus
    • Deep external pudendal
      • Pierces fascia lata
      • Behind spermatic cord
      • Supplies
        • Skin of scrotum / labium majus

Deep arteries

  • Common femoral artery
  • Profunda femoris

Venous drainage

Superficial veins

  • Great saphenous vein
    • Longest vein in body
    • Path
      • Commences as medial marginal vein of foot
      • In front of medial malleolus
      • Hands breath behind medial border of patella
      • Through cribriform fascia of saphenous opening
        • 3cm below & lateral to pubic tubercle

Deep veins

  • Venae comitantes
    • Anastomosing set of veins running paired with the femoral artery

Nerve supply

Superficial nerves

  • Derived from L1-3
    • Ilioinguinal
    • Femoral branch of Genitofemoral
    • Medial, Intermediate & Lateral Femoral Cutaneous Nerves

Ilioinguinal L1

  • Collateral branch of iliohypogastric
  • Path
    • In anterior abdominal wall lies between internal oblique & transversus abdominis muscle
    • Pierces internal oblique
    • Deep to external oblique
    • Through superficial inguinal ring
  • Supplies
    • Lower fibres of internal oblique
    • Skin of
      • root of penis
      • anterior 1/3 scrotum
      • small area of thigh below medial end of inguinal ligament

Genitofemoral L1 2

  • only fibres of L1 pass into femoral branch which is given off as nerve lies on psoas major
  • Path
    • Runs down external iliac artery
    • Beneath inguinal ligament
    • Pierces fascia below the middle of inguinal ligament
    • Genital branch passes through deep ring
  • Supplies
    • Skin over femoral triangle

Medial femoral cutaneous nerve L2 3

  • Branch of femoral nerve
  • Path
    • Inclines medially over femoral vessels
    • Pierces fascia lata at mid thigh
  • Supplies
    • Medial side of thigh
    • Patellar plexus

Intermediate femoral cutaneous nerve L 2 3

  • Branch of femoral nerve
  • Path
    • Passes vertically downwards
    • Pierces sartorius
    • Pierces fascia lata at higher level than medial femoral cutaneous nerve
  • Supplies
    • Front of thigh down to knee
    • Patellar plexus

Lateral femoral cutaneous nerve L2 3

  • Path
    • Passes lateral border of psoas major
    • Lies behind fascia lata
    • At inguinal ligament it is incorporated with substance of iliac fascia
    • Passes behind or pierces fascia inguinal ligament 1 cm medial to ASIS
    • Divides into anterior & posterior branches which pierce fascia lata separately
  • Branches
    • Anterior
      • Supplies
        • Anterolateral surface of thigh
        • Patellar plexus
    • Posterior
      • Supplies
        • Posterolateral aspect from level of greater trochanter to mid thigh
  • Compression syndromes
    • Meralgia paraesthesia

Obturator nerve L 2 3 4

  • Sends twigs from anterior division into subsartorial plexus
  • Supplies
    • Skin over medial side of thigh

Patellar plexus

  • Formed by terminal branches of:
    • Medial & intermediate femoral cutaneous nerves
    • Anterior branch of lateral femoral cutaneous nerve
    • Infrapatellar branch of saphenous nerve

Muscles of anterior compartment

  • Quadriceps:
  • Rectus femoris
    • Two heads
    • Origins – superior acetabular ridge and AIIS
  • Vastus lateralis
    • Origin –
  • Vastus medialis
    • Origin – Anterior femoral shaft
  • Vastus intermedius
    • Origin –
  • Sartorius
  • Pectineus
  • Articularis genu
    • From distal anterior femur to capsule of knee joint
  • LYMPH NODES AND VESSELS
  • SUPERFICIAL FASCIA
  • FASCIA LATA
  • Tensor fascia latae
  • Iliotibial tract

References

Author Contributions

Sean Griffiths, Resident, Western Health 2020