Prelab Images - Anterior & Medial Thigh

Prelab Images - Anterior & Medial Thigh

Prelab should consist of reading the lab manual and dissector answers and viewing the dissection video. To begin your study, you may find it useful to look over the Netter's Atlas images listed below.
Step 1. Review the bony landmarks. (Play movie)
Pubic symphysis is in plate 248. The pubic tubercle and pubic pectin is labeled in plate 486 and the pubic crest is in the small area between the two although it is unlabeled. The anterior superior iliac spine, iliac crest, tubercle (tuberculum) of ilium, and posterior superior iliac spine are all in plate 486. The ischiopubic ramus is labeled in plates 359 and 383 and is basically the ramus of the ischium plus the inferior pubic ramus (plate 486). The lesser trochanter, pectineal line, linea aspera, medial epicondyle, lateral epicondyle, and adductor tubercle of the femur are all labeled in plate 489. The patella is seen in plates 507 and 511. The tibia, fibula, tibial condyles, tuberosity of the tibia, medial malleolus, and lateral malleolus are all labeled in plate 513.
Step 2. Dissect the femoral triangle, noting its boundaries and contents. (Play movie)
Plates 262 and 500 show the femoral triangle. The sartorius muscle and pes anserinus are labeled in plate 492. Adductor longus, pectineus, and iliopsoas muscles are labeled in plates 492 and 500. For a view of the full iliopsoas muscle (iliacus plus psoas major) see plate 496. The femoral nerve, artery, and vein are shown in plates 500 and 262. The termination of the greater saphenous vein into the femoral vein is seen in plates 500 and 544. The femoral sheath (surrounds artery and vein) and the femoral canal are labeled in plate 262. The femoral canal has deep inguinal lymph nodes within it (plate 546). Plate 500 shows the fascia lata being removed and plate 505 will help you find the intermuscular septum.
Step 3. Define the adductor canal, open it and identify its contents. (Play movie)
Plate 500 (right picture) shows the adductor canal with the femoral nerve, artery, and vein passing through it (the vastoadductor membrane which is labeled the anteromedial intermuscular septum in plate 500 and the reflected sartorius muscle would form the roof of the canal). Plate 493 shows the femoral artery and vein passing through the adductor hiatus and plate 502 shows the artery and vein emerging in the popliteal fossa. Plate 512 also allows you to trace the femoral artery. Plates 500 and 538 label the nerve to vastus medialis.
Step 4. Clean and identify the blood vessels of the anterior and medial thigh. (Play movie)
Plates 500 and 512 identify the femoral, superficial epigastric, superficial external pudendal, and superficial circumflex iliac arteries. The deep femoral artery and descending genicular arteries are shown in plates 501 and 512. Plate 544 shows the saphenous vein joining the deep femoral vein and plates 500, 501, and 502 show the relationship of the femoral artery and vein as they travel down the thigh and in the popliteal fossa. Plates 501, 504, and 512 show the medial and lateral femoral circumflex arteries branching from the deep femoral artery. Plates 501 and 512 show the perforating branches of the deep femoral artery.
Step 5. Clean and identify the components of the quadriceps femoris muscle. (Play movie)
Plates 500 and 501 identify the quadriceps muscles that need to be cleaned and identified (rectus femoris, vastus lateralis, vastus medialis, and underneath rectus femoris is vastus intermedialis). To see the reflected head of rectus femoris you will need to retract tensor fasciae latae, gluteus medius, and gluteus minimus similar to how the hook is retracting tensor fasciae latae in the right picture in plate 500. The patellar ligament and patellar retinacula are labeled in plates 501 and 507 (top picture). Plate 501 shows the femoral nerve branching to sartorius and the quadriceps muscles.
Step 6. Clean and identify the muscles and nerves of the medial femoral compartment. (Play movie)
The obturator nerve can be seen in plates 497 and 498 coming from the lumbar plexus and going through the obturator foramen to enter the medial thigh. Plate 501 follows its course in the medial thigh and shows its anterior and posterior branches. Plate 539 shows its muscular and cutaneous distribution. Plates 492 and 501 label the gracilis muscle and plate 493 labels the pes anserinus. Looking at plate 500, you can see the terminal branches of the obturator nerve going to gracilis. Clean adductor longus and pectineus and reflect them using the anterior branch of the obturator nerve to separate them from adductor brevis as seen in plate 501. Now find the posterior branch of the obturator nerve laying on adductor magnus and use it to separate adductor brevis and magnus when you reflect adductor brevis. You should now have a view like plate 493, except the posterior branch of the obturator nerve will be fully exposed and lying on adductor magnus. Plate 493 also shows the adductor tendon and adductor hiatus. Plate 539 reviews the motor and cutaneous distribution of the obturator nerve. Plates 490 and 491 review the origin and insertion of all the muscles covered in this lab.