LOWER LIMB' TOPOGRAPHIC REGIONS

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LOWER LIMB. TOPOGRAPHIC REGIONS
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Regions under the inguinal ligament. Lacuna
musculorum

• Boundaries
• os ilium - popsteriorly
• lig. inguinale - anteriorly
• arcus iliopectineus - medially
• Content
• m. Iliopsoas
• n. femoralis
• Communications
• greater pelvis
• spinal column lumber region

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Lacuna vasorum
Boundaries arcus iliopectineus - laterally lig.
lacunare - medially lig. inguinale
- anteriorly pecten ossis pubis -
posteriorly Content a. ? v. femoralis n.
genitofemoralis (r. femoralis) anulus femoralis
medial to v. femoralis Communications
subperitoneal region of pelvis
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Upper thigh

• Canalis femoralis
• Boundaries
• From anulus femoralis to hiatus saphenus (1-2
  ?m)
• triangular section
• Content
• loose connective tissue
• lymph nodes
• Communications
• lower thigh and pelvis

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Canalis obturatorius

• Boundaries
• sulcus obturatorius superiorly
• membrana ? mm. obturatorii inferiorly
• oblique course - 2 ?m length
• Content
• a. et v. obturatoria
• n. obturatorius
• Communications
• Lesser pelvis and
• medial compartment of upper thigh.

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Thigh
Boundaries Above - lig. Inguinale ? sulcus
gluteus Below 2 finger breath above the
patella. Two vertical lines from the femur
epicondyles to spina iliaca anterior superior and
symphisis pubica divide the thigh into two
regions regio femoris anterior regio femoris
posterior
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Fascia lata
Ensheaths entirely the thigh muscles. Proximally
attached to lig. Inguinale, crista iliaca,
symphisis, ischial bone. Posteriorly fuses with
gluteal fascia.
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Fascia lata

• Structures
• Ligamentum inguinale
• In trigonum femorale
• - superficial layer
• - deep layer (fascia iliopectinea).
• Hiatus saphenus

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Fascia lata

• Tractus iliotibialis
• - lateral on the thigh
• Septa intermuscularia
• - septum intermusculare laterale
• - septum intermusculare mediale
• septum intermusculare posterius
• Fascial beds for
• m. sartorius,
• m. tensor fasciae latae,
• m. gracilis.

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Femoral triangle
Upper third of the thigh (L10
?m). Boundaries - base - lig. Inguinale - apex
crossing of m. sartorius and m. adductor longus -
bottom - m. iliopsoas and m. pectineus (fossa
iliopectinea).
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Femoral triangle

• Content
• - a. femoralis
• superficial branches
• - epigastrica superficialis
• - circumflexa ilium superficialis
• - pudendae externae
• deep branches
• - a profunda femoris
• - a. circumflexa femoris medialis et lateralis
• - v. femoralis
• - v. saphena magna
• - vv. circumflexae femoris
• - v. profunda femoris
• - n. femoralis
• - Motor and sensory for anterior thigh region
• - for m. pectineus
• - n. saphenus

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• A. femoralis
• A. profunda femoris
• A. circumflexa femoris lateralis
• A. circumflexa femoris medialis
• Main vessel for the head and neck of the femur.
• Anastomosis cruciata
• a. glutea inferior (a. iliaca interna)
• ?a. circumflexa? femoris medialis et lateralis
  --gt collateral route for lower limb

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Canalis adductorius

• Location- from apex of trigonum femorale to
  hiatus tendineus, opening into fossa poplitea.
• Parts
• Upper subsartorial, 3 walls
• - lateral - m. vastus medialis
• - medial - m. adductor longus
• - anterior - m. sartorius
• Content
• - a. femoralis - anteriorly
• - v. femoralis posteriorly and laterally
• - n. saphenus - laterally

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Canalis adductorius

• Lower subaponeurotic part
• Boundaries
• - Lateral wall - m. adductor magnus
• - Medial wall - lamina vastoadductoria
• - Anterior wall - m. vastus medialis
• Content
• - a. femoralis - anteriorly
• - v. femoralis posteriorly and laterally
• - n. saphenus anteriorly and medially. Exits in
  the middle through opening in lamina
  vastoadductoria.
• Hiatus tendineus exit of the canal. Between the
  tendon of m. adductor magnus and m. vastus
  medialis.

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Regio glutea
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Cutaneous nerves

• Nn. clunii superiores (L1-L3)
• Nn. clunii medii (S1-S3)
• Nn. clunii inferiores
• N. cutaneus femoris posterior

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Muscles

• Extensors, abductors and lateral rotators in hip
  loint.

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Muscles

• gluteus maximus
• gluteus medius
• gluteus minimus
• piriformis
• gemellus superior
• obturatorius internus
• gemellus inferior
• obturatorius externus
• quadratus femoris

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Arteries

• Branches of a. iliaca interna.
• Exit through
• for. ischiadicum major
• A. glutea superior
• A. glutea inferior
• A. pudenda interna

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Nerves

• From plexus lumbosacralis
• N. gluteus superior (thru for. suprapiriformis).
  For m. tensor fasciae latae.
• N. gluteus inferior
• N. ischiadicus
• N. cutaneus femoris posterior
• N. pudendus
• N. to m. quadratus femoris and m. gemellus
  inferior
• N. to m. obturatorius internus and m. gemellus
  superior

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Fossa poplitea
Behind - the distal femur - knee joint and -
proximal tibia. Apparent in flexion.
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Fossa poplitea

• Covered by skin and fasciae.
• Fascia poplitea superficialis fat tissue, v.
  saphena parva, n. saphenus, n. cutaneus surae
  medialis.
• V. saphena parva pierces fascia poplitea profunda
  and enters v. poplitea.
• Fascia poplitea profunda covers nerve-vascular
  bundle ????????????? ????.

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Fossa poplitea

• Bony base
• Femur
• condylus medialis
• condylus lateralis
• Tibia
• condylus medialis
• condylus lateralis
• Boundaries
• Upper medial - semitendinosus (ST)
• Lower medial gastrocnemius caput mediale (MG)
• Upper medial - biceps femoris (B)
• Lower medial - gastrocnemius caput laterale (LG)

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Fossa poplitea - content

• Arteries
• A. poplitea continuation of a. femoralis
• A. superior medialis genus
• A. superior lateralis genus
• A. inferior medialis genus
• A. inferior lateralis genus
• A. media genus
• Nerves
• N. tibialis
• N. peroneus communis

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• Fossa poplitea - bottom
• fossa poplitea femoris
• tibia
• lig. popliteum obliquum
• m. popliteus

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