Cross section of Anterior compartment of proximal thigh

Transcription

1 Cross sectional Anatomy of lower limb Thigh Anatomy Thigh is divided into three compartments by three septae which extend from inner aspect of deep fascial sheath to the linea aspera of femur. Anterior compartment Medial compartment Posterior compartment Each compartment having muscles, nerves and vessels. Anterior fascial compartment Anterior fascial compartment of thigh contains the knee extensors and hip flexors. Nerve supply: Femoral nerve Blood supply: Femoral artery Muscles Sartorius Illiopsoas Pectineus Quadriceps femoris Rectus femoris Vastus lateralis Vastus medialis Vastus intermedius Cross section of Anterior compartment of proximal thigh

2 Medial compartment of thigh Medial fascial compartment contains hip adductors. Muscles: Gracillus Adductors ( longus, brevis & magnus) Obturator externus Nerve supply Obturator nerve (L2-L4) Blood supply Profunda Femori Obturator Cross section proximal thigh: Medial compartment Posterior fascial compartment of thigh Posterior fascial compartment contains knee flexors and hip extensors. Muscles: (also called hamistring muscles except for short head of biceps femoris) Biceps femoris (short & long head) Semitendinosus Semimembranosus Nerve supply: Sciatic nerve specifically tibial nerve Short head of biceps femoris supplied by fibular nerve Blood supply: Profunda Femoris Branches Cross section proximal thigh: Posterior

3 compartment Cross section mid thigh: Anterior Compartment Cross section mid thigh: Middle compartment

4 Adductor canal (Subsartorial/ Hunter s canal) It is an apponeurotic tunnel in middle third of thigh, extending from apex of femoral triangle to the opening in adductor magnus. Boundaries: Anteriorly & laterally: Vastus medialis Posteriorly: Adductor longus & magnus Roof & medially: Sartorius Contents: Femoral artery, Femoral vein & Femoral nerve (specifically the vastus medialis), deep lymph vessels Adductor canal saphenous nerve & nerve to Cross section mid thigh: Posterior compartment

5 Cross section distal thigh: Anterior compartment Cross section distal thigh: Medial and Posterior compartment Nerve innervation of compartments of thigh

6 Knee joint Largest & most complicated joint in the body. It consist of two condylar joints between the medial and lateral condyles of femur and corresponding condyles of tibia and a gliding joint between patella and patellar surface of femur. Type of joint: Between tibia and femur: Synovial joint of hinge variety. Between patella & femur: Synovial joint of plain gliding variety Ligaments of Knee joint Ligaments are divided into two groups according to location Intracapsular ligaments: Cruciate ligaments: These are strong intracapsular ligaments that cross each other within joint cavity. They are named anterior and posterior according to their tibial attachment. 1. Anterior Cruciate ligament: It is attached to anterior antercondylar area of tibia, passes upward, backward & laterally to be attached to posterior part of lateral femoral condyle. 2. Posterior Cruciate ligament: It is attached to posterior antercondylar area of tibia, passes upward, farward & medially to be attached to anterior part of medial femoral condyle. Extracapsular ligaments: 1. Ligamentum patellae: Continuation of central portion of common tendon of quadriceps femoris. Attached to lower border of patella to tibial tuberosity. 2. Lateral collateral ligament: Cord like and attached to lateral condyle of femur to head of fibula. 3. Medial collateral ligament: Flat band, is attached to medial condyle of femur to medial surface of tibia. It is firmly attached to medial meniscus. 4. Oblique popliteal ligament: It is tendinous expansion of semimembranosus muscle Menisci of knee joint Menisci consist of C- shaped fibrocartillage.

7 Peripheral part is thick and attached to capsule and the inner border is thin, concave and forms free edge. Upper surface is in contact with femur and lower surface attached by anterior and posterior horns to tibia. Function: To deepen the articular surface of tibial condyle to receive convex femoral condyles. Serve as cushions between two bones. Leg anatomy Leg is divided into three compartments. Anterior Posterior ( superficial & deep ) Lateral Anterior compartment of Leg Muscles of ant: compartment dorsiflex the foot and toes. The tibialis anterior also assists turning the foot inward. Muscles: Tibialis anterior Extensor digitorum longus Peroneus tertius Extensor hellusus longus Nerve supply: Deep peroneal nerve Blood supply: Anterior tibial artery Lateral compartment of Leg Muscles of lateral compartment pull the foot outward. They also help with plantar flexion (pointing the foot). Muscles: Peroneus longus Peroneus brevis Blood supply: Branches from peroneal artery Nerve supply: Superficial peroneal nerve Cross section of mid leg: Anterior and lateral compartment

8 Posterior compartment of Leg Posterior compartment of leg contains plantar flexors. Nerve supply: Tibial nerve Divided into two groups: Superficial: Gastocnemius, Plantaris, Soleus. Deep: Poplitius, Flexor digitorum longus, Flexor hallucis longus, & Tibialis posterior Cross section of mid leg: Posterior compartment Ankle joint Ankle joint consists of deep socket formed by lower end of tibia and fibula into which body of talus articulates. Type: Synovial hinge variety Ligaments 1. Medial or Deltoid ligament 2. Lateral ligament 3. Anterior talofibular ligament 4. Calcaneofibular ligament 5. Posterior talofibular ligament

9 MRI of Ankle Thank you!