Thigh, Knee and Leg

Thigh

Front of the right upper thigh (female)

Part of the fascia lata (deep fascia of the thigh, 14) has been removed to display the femoral vessels and nerve and the adjacent muscles. The femoral nerve (21), artery (20), vein (18) and canal (17) lie in that order from lateral to medial beneath the inguinal ligament (19). The great saphenous vein (12) passes through the saphenous opening (16) in the fascia lata to enter the femoral vein (18); a number of smaller veins enter the great saphenous just before it joins the femoral.

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Various superficial veins ( 5, 13, 15, 25 ) run into the great saphenous vein ( 12 ); this helps to distinguish the great saphenous from the femoral vein ( 18 ), which superficially at this level receives only the great saphenous itself. See p. 70 for further details of the great saphenous vein.
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Although arising at the front of the thigh, the profunda femoris artery is the main supply to muscles on the back of the thigh as well as those on the front.
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The adductor canal, which is triangular in cross section, is bounded in front by sartorius, laterally by vastus medialis, and behind by adductor longus (above) and adductor magnus (below). The contents of the adductor canal are the femoral artery and vein, the saphenous nerve and the nerve to vastus medialis.
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The femoral pulse can be felt midway between the anterior superior iliac spine and the midline pubic symphysis (the midinguinal point or femoral point).

1

Anterior superior iliac spine
2

External oblique aponeurosis
3

Cut edge of rectus sheath
4

Rectus abdominis
5

Superficial epigastric vein
6

Superficial inguinal ring
7

Round ligament of uterus
8

Mons pubis
9

Gracilis
10

Adductor longus
11

Pectineus
12

Great saphenous vein
13

Superficial external pudendal vessels
14

Fascia lata
15

Accessory saphenous vein
16

Lower edge of saphenous opening
17

Position of femoral canal
18

Femoral vein
19

Inguinal ligament
20

Femoral artery
21

Femoral nerve
24

Sartorius
25

Superficial circumflex iliac vessels
26

Fascia lata overlying tensor fasciae latae

Front of the right upper thigh (male)

In this deeper dissection the removal of part of sartorius (3) displays the profunda femoris artery (24). The femoral artery (9) passes in front of adductor longus (18); the profunda (24) passes behind it. Separation of the adjacent borders of pectineus (13) and adductor longus (18) allows the anterior division of the obturator nerve (15) to be seen in front of adductor brevis (17). The medial circumflex femoral artery (12) disappears backward between pectineus (13) and the tendon of psoas (hidden behind the uppermost part of the femoral artery (upper 9). The lateral circumflex femoral artery (11, which often arises directly from the femoral artery, as here, and not from the profunda) courses laterally and supplies adjacent muscles. Branches of the femoral nerve (8) include the saphenous nerve (25), which will run as far as the medial side of the foot.

1

Tensor fasciae latae
2

Lateral femoral cutaneous nerve
3

Sartorius
4

Iliacus
5

Superficial circumflex iliac artery (double)
6

Inguinal ligament
7

Superficial epigastric artery
8

Femoral nerve
9

Femoral artery
10

Femoral vein
11

Lateral circumflex femoral artery
12

Medial circumflex femoral artery
13

Pectineus
14

Superficial external pudendal artery
15

Anterior branch of obturator nerve
16

Spermatic cord
17

Adductor brevis
18

Adductor longus
19

Gracilis
20

Vastus medialis
21

Vastus intermedius
22

Rectus femoris
23

Nerve to vastus medialis
24

Profunda femoris artery
25

Saphenous nerve
26

Nerve to rectus femoris

Lower right thigh, medial side

The lower part of sartorius (3) has been displaced medially to open up the lower part of the adductor canal and expose the femoral artery (4) passing through the opening in adductor magnus (6) to enter the popliteal fossa behind the knee and become the popliteal artery.

1

Gracilis
2

Adductor magnus
3

Sartorius
4

Femoral artery
5

Saphenous nerve
6

Opening in adductor magnus
7

Vastus medialis and nerve
8

Rectus femoris
9

Iliotibial tract
10

Quadriceps tendon
11

Patella
12

Medial patellar retinaculum
13

Lowest (horizontal) fibres of vastus medialis
14

Saphenous branch of descending genicular artery

Axial section through lower right thigh

The section is viewed as when looking upward from knee to hip. The three vastus muscles (1, 3, 5) envelop the femur (2) at the front and sides, and rectus femoris (4) at this level is narrow and is becoming tendinous. The femoral vessels (20) are between vastus medialis (1) and adductor magnus (12), approaching the adductor magnus opening (13), and the profunda femoris vessels (11) lie close to the back of the femur (2). The sciatic nerve (10) is deeply placed between biceps (8, 9) laterally and semimembranosus (14) and semitendinosus (15) medially.

1

Vastus medialis
2

Femur
3

Vastus intermedius
4

Rectus femoris
5

Vastus lateralis
6

Iliotibial tract
7

Lateral intermuscular septum
8

Short head of biceps
9

Long head of biceps
10

Sciatic nerve
11

Profunda femoris vessels
12

Adductor magnus
13

Opening in adductor magnus
14

Semimembranosus
15

Semitendinosus
16

Gracilis
17

Sartorius
18

Great saphenous vein
19

Saphenous nerve
20

Femoral vessels

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The muscles commonly called the hamstrings span both the hip and knee joints: they arise from the ischial tuberosity and run to the upper end of the tibia and fibula, and consist of semitendinosus, semimembranosus, and the long head of biceps. The short head of biceps is not a hamstring, since although it joins the long head it arises from the back of the femur and hence does not span the hip joint. Semitendinosus is named from the long tendon at its lower end. Semimembranosus is named from the broad tendinous origin at its upper end.

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