Anatomy Tables - Anterior & Medial Thigh

Osteology
Bone Structure Description Notes
femur   the bone of the thigh the femur is the longest and strongest bone in the body (Latin, femur = thigh)
adductor tubercle a process that projects superior to the medial epicondyle of the femur it is the insertion site of the ischiocondylar part of the adductor magnus m.
lateral epicondyle the enlargement of bone on the lateral side of the femur just superior to the lateral condyle it is the attachment site of the fibular collateral ligament and the site of origin of the popliteus m. (Greek, kondylos = the knob formed by the knuckle of any joint)
lesser trochanter a large process that projects from the posteromedial surface of the femur just distal to neck it is the insertion site of the common tendon of the psoas major and iliacus mm. (iliopsoas m.) (Greek, trochanter = a runner or roller, from trochos, a wheel. Originally used for the head of the femur, which turns like a wheel in its socket. Eventually it came to mean the bony processes of the femur)
linea aspera a vertical ridge on posterior surface of the femur it is the insertion site of the medial (adductor) group of thigh muscles and the origin of the vastus intermedius m. and the short head of the biceps femoris m. (Latin, linea aspera = rough line, the linea aspera is a roughed longitudinal line on the posterior surface of the shaft of the femur which gives attachment to several muscles)
medial epicondyle the enlargement of bone on the medial side of the femur just superior to the medial condyle it is the attachment site of the tibial collateral ligament of the knee joint (Greek, kondylos = the knob formed by the knuckle of any joint)
pectineal line a prominent intermediate ridge extending from the central part of the linea aspera to the base of the lesser trochanter
ilium fan-shaped bone that forms the lateral prominence of the pelvis one of three bones that form the os coxae: ilium, ischium, pubis
arcuate line ridge running from anteroinferior to posterosuperior on the inner surface of the ilium inferior boundary of the iliac fossa; marks the plane of transition from abdominal cavity to pelvic cavity; part of the iliopectineal line (Latin, arcuate = bowed)
anterior inferior iliac spine inferior to anterior superior iliac spine attachment site of straight head of rectus femoris m.
anterior superior iliac spine spine at the anterior end of the iliac crest lateral attachment of the inguinal ligament
iliac crest arching superior margin of the ilium that forms the rim of the "fan" attachment for abdominal wall muscles
iliac tubercle roughened area along the outer edge of the iliac crest
posterior superior iliac spine spine at the posterior end of the iliac crest position marked by a dimpling of the skin
ischium   the "V"- shaped bone that forms the posteroinferior part of the pelvis one of the three bones that form the os coxae: ilium, ischium, pubis
  ischial ramus the limb of the ischium that passes anteriorly and superomedially toward the pubis it articulates with the inferior ramus of the pubis to form ischiopubic ramus (Greek, ischion = hip joint; Latin, ramus = a branch)
patella   the bone that forms the knee cap the patella is a sesamoid bone in the tendon of the quadriceps femoris muscle; it provides a protective function by withstanding the grinding forces of the quadriceps femoris tendon against the patellar surface of the femur, especially in full knee flexion (Latin, a kneecap)
pubis an angulated bone that forms the anterior part of the pelvis one of three bones that form the os coxae: ilium, ischium, pubis; its body forms 1/5 of the acetabulum; its symphyseal surface unites with the pubis of the opposite side to form the pubic symphysis; the superior and inferior pubic rami participate in the formation of the obturator foramen
body superolateral portion of the pubis the body of the pubis forms about 1/5 of the acetabulum
inferior ramus inferior "limb" that passes inferolaterally from the pubic symphysis articulates with the ischial ramus to form the ischiopubic ramus; attachment site for the root of the penis/clitoris (Latin, ramus = a branch)
pecten ridge on superior surface of the superior pubic ramus attachment point of the pectineal ligament
pubic crest ridge on the superior border of the superior ramus attachment of rectus abdominis & pyramidalis mm.
pubic tubercle process at the lateral end of pubic crest attachment point of the medial end of the inguinal ligament
tibia   the bone on the medial side of the leg the tibia is the weight-bearing bone of the leg (Latin, tibia = the large shin bone)
lateral condyle the heavy prominence on the lateral side of the proximal end of the tibia the lateral condyle articulates with the lateral condyle of the femur and with the head of the fibula (Greek, kondylos = the knob formed by the knuckle of any joint)
  medial condyle the heavy prominence on the medial side of the proximal end of the tibia the medial condyle articulates with the medial condyle of the femur; it is larger than the lateral condyle of the tibia (Greek, kondylos = the knob formed by the knuckle of any joint)
medial malleolus the large bony prominence on the medial side of the ankle the medial malleolus of the tibia forms the medial side of the ankle joint; it articulates with the medial surface of the talus (Latin, malleus = hammer)
tibial tuberosity the roughened protuberance on the anterior surface of the tibia located just distal to the condyles it is the attachment site of the patellar ligament, which represents the insertion of the quadriceps femoris tendon

Joints and Ligaments
Joint Description Significance
inguinal ligament the ligament that connects the anterior superior iliac spine with the pubic tubercle the inguinal ligament is a specialization of the inferior border of the external abdominal oblique aponeurosis; it is the site of origin for a part of the internal abdominal oblique muscle and for a part of the transversus abdominis muscle; also known as: Poupart's ligament
pubic symphysis symphysis midline joint uniting the pubic bodies (Greek, symphysis = a growing together)
patellar ligament stretches from the apex of the patella distally to the tibial tuberosity continuation of quadriceps tendon
patellar retinacula aponeurotic insertions of the quadriceps muscle lateral and medial to the patellar ligament reinforces the knee joint capsule anteriorly

Muscles
Muscle Origin Insertion Action Innervation Notes
iliopsoas combination of iliacus (from iliac fossa) & psoas major (from lumbar vertebrae) lesser trochanter of femur flexes thigh; flexes & laterally bends lumbar spine ventral primary rami of L2-L4 and branches from femoral nerve none
sartorius anterior superior iliac spine medial surface of tibia (pes anserinus) flexes, abducts, and laterally rotates thigh; flexes leg femoral nerve (Latin, sartor = tailor, because its actions put the lower limb in the traditional cross-legged seated position of a tailor)
quadriceps femoris composed of 4 muscles: rectus femoris, vastus lateralis, vastus intermedius & vastus medialis tibial tuberosity via patellar ligament extends knee; rectus femorus flexes thigh femoral nerve none
rectus femoris straight head: anterior inferior iliac spine; reflected head: above superior rim of acetabulum patella and tibial tuberosity (via patellar ligament) extends leg, flexes thigh femoral nerve rectus femoris is part of the quadriceps femoris muscle
vastus lateralis lateral intermuscular septum, lateral lip of linea aspera and gluteal tuberosity patella and lateral patellar retinaculum extends leg femoral nerve vastus lateralis is part of the quadriceps femoris muscle (Latin, vastus = huge)
vastus medialis medial intermuscular septum, medial lip of linea aspera patella and medial patellar retinaculum extends leg femoral nerve vastus medialis is part of the quadriceps femoris muscle (Latin, vastus = huge)
vastus intermedius anterior and lateral surface of femur patella extends leg femoral nerve vastus intermedius is part of the quadriceps femoris muscle (Latin, vastus = huge)
pectineus pecten of pubis pectineal line of femur adducts, flexes, and medially rotates thigh femoral nerve and occasionally anterior division of obturator nerve none
gracilis pubic symphysis and inferior pubic ramus medial surface of tibia (via pes anserinus) adducts thigh, flexes leg, flexes and medially rotates thigh anterior division of obturator nerve pes anserinus is the common insertion of the gracilis, sartorius, and semitendinosus mm. (Latin, gracilis = slender)
adductor longus medial portion of superior pubic ramus linea aspera of femur adducts, flexes, and medially rotates femur anterior division of obturator nerve none
adductor brevis inferior pubic ramus pectineal line and linea aspera (deep to pectineus and adductor longus mm.) adducts, flexes, and medially rotates femur anterior division of obturator nerve anterior and posterior divisions of the obturator nerve lie on the anterior and posterior surfaces of adductor brevis
adductor magnus ischiopubic ramus and ischial tuberosity linea aspera of femur; ischiocondylar part inserts on adductor tubercle adducts, flexes, and medially rotates femur; extends femur (ischiocondylar part) posterior division of obturator nerve and tibial nerve (ischiocondylar part) the ischiocondylar part of adductor magnus is a hamstring muscle by embryonic origin and action, so it is innervated by the tibial nerve

Nerves
Nerve Source Branches Motor Sensory Notes
femoral lumbar plexus (ventral primary rami of L2-L4) anterior femoral cutaneous brs., nn. to: sartorius, rectus femoris, vastus lateralis, vastus intermedius, vastus medialis, pectineus sartorius, rectus femoris, vastus lateralis, vastus intermedius, vastus medialis, pectineus skin of anterior thigh passes under inguinal ligament lateral to femoral a.
femoral cutaneous, anterior femoral skin of anterior thigh (Latin, cutis = skin)
saphenous femoral infrapatellar br. skin of medial leg & foot travels with great saphenous v.; does not pass through the adductor hiatus at the knee; passes anterior to the medial malleolus at the ankle (Saphenous, arabic for "al safin" = hidden, for this vein does not show through the skin)
obturator lumbar plexus (ventral primary rami of L2-L4) anterior & posterior brs. adductors of thigh: longus, brevis & magnus; gracilis, obturator externus skin of lower medial thigh passes through obturator canal

Arteries
Artery Source Branches Supply Notes
femoral external iliac superficial epigastric a., superficial circumflex iliac a., superficial & deep external pudendal aa., deep femoral, descending genicular, popliteal thigh, leg & foot the femoral a. is continuous with the popliteal a.; the name change occurs at the adductor hiatus
femoral, deep femoral medial & lateral circumflex femoral aa., perforating aa. (~3 or 4) hip joint, proximal thigh, posterior thigh the primary blood supply to muscles of the posterior compartment of the thigh
iliac, external common iliac inferior epigastric, deep circumflex iliac, femoral lower limb external iliac a. is continuous with the femoral a.; the name change occurs at the inguinal ligament; the common iliac artery bifurcates anterior to the sacroiliac articulation
obturator internal iliac, anterior division pubic br., acetabular br., anterior br., posterior br. medial thigh & hip anterior & posterior brs. pass on anterior and posterior sides of adductor brevis m.
circumflex femoral, medial deep femoral (or femoral) ascending & descending brs. medial thigh & hip (Latin, circum- = around + -felx = to bend)
circumflex femoral, lateral deep femoral (or femoral) ascending, transverse & descending brs. lateral thigh & hip (Latin, circum- = around + -felx = to bend)
popliteal femoral anterior & posterior tibial; 5 genicular brs. knee, leg & foot the popliteal a. is the continuation of the femoral a.; the name change occurs at the adductor hiatus (Latin, poples = the back of the knee)

Topographic Anatomy
Structure/Space Boundaries/Description Significance
adductor canal anterior - sartorius, lateral - vastus medialis, posterior - adductor longus & magnus; ends distally at adductor hiatus contains femoral a. & v., saphenous nerve & nerve to vastus medialis m.
adductor hiatus medial - tendon of adductor magnus to adductor tubercle, lateral - insertion of adductor magnus into linea aspera, inferior - femur femoral vessels pass through it to reach the posterior surface of the leg, becoming popliteal vessels (Latin, hiatus = to yawn)
anterior compartment (extensor), thigh located anterior to femur contains quadriceps femoris and sartorius mm.
pes anserinus adjacent insertions of sartorius, gracilis, and semitendinosus on proximal tibia medial to tibial tuberosity (Latin, pes = foot, anserinus = of the goose)
femoral canal location: medial compartment of the femoral sheath, deep to inguinal ligament; opens into the abdominal cavity superiorly at femoral ring may be the site of a femoral hernia; usually contains a deep inguinal lymph node (node of Cloquet)
femoral ring medial - lacunar ligament, lateral - fascia on femoral vein, anterior - inguinal ligament, posterior - iliopectineal fascia opening from abdominal cavity into the femoral canal
femoral sheath lateral compartment- for the femoral a. intermediate compartment- for the femoral v. medial compartment- the femoral canal does not enclose the femoral nerve
femoral triangle superior - inguinal ligament, lateral - sartorius, medial - medial edge of adductor longus m. contains femoral a., v. & femoral nerve branches; authors disagree on the medial boundary of this triangle
Hunter's canal see adductor canal
medial compartment (adductor), thigh located medial to femur contains: pectineus m., adductor longus, brevis & magnus mm.; gracilis m., obturator externus m.
saphenous hiatus opening in fascia lata located inferior to inguinal ligament, lateral to pubic tubercle site of passage of greater saphenous vein which joins the femoral vein; closed by cribriform fascia (Saphenous, arabic for "al safin" = hidden, for this vein does not show through the skin; Latin, hiatus = to yawn)
subsartorial canal see adductor canal

Lymphatics
Structure Location Afferents from Efferents to Regions drained Notes
deep inguinal nodes medial to femoral v. deep to fascia lata & inguinal ligament superficial inguinal & popliteal nodes external iliac nodes lower limb, external genitalia, lower anterior abdominal wall the deep inguinal node in femoral canal is called node (or gland) of Cloquet

Clinical Terms
Term Definition
femoral hernia a protrusion of abdominal viscera through the femoral ring into the femoral canal. A femoral hernia appears as a mass, often tender, in the femoral triangle, inferolateral to the pubic tubercle. The hernia is bounded by the femoral vein laterally and the lacunar ligament medially. Femoral hernias are more common in females, whereas inguinal hernias occur more commonly in males. Strangulation of the femoral hernia may occur particularly due to the lacunar ligament. This condition can be treated by excising the lacunar ligament. (Latin, hernia = to rupture)
obturator hernia protrusion of a loop of bowel through the obturator canal (Latin, hernia = to rupture)
knee jerk reflex (patellar tendon reflex) tapping the patellar ligament with a reflex hammer normally elicits the patellar reflex (knee jerk). This tests nerves L2-L4 and extension at the knee.


The material presented in these tables is contained in the book:
MedCharts Anatomy by Thomas R. Gest & Jaye Schlesinger
Published by ILOC, Inc., New York
Copyright © 1995, unauthorized use prohibited.
 The excellent editorial assistance of
Dr. Pat Tank, UAMS
is gratefully acknowledged.
Copyright© 2000 The University of Michigan. Unauthorized use prohibited.
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