Inguinal ligament
The inguinal ligament is a band running from the pubic tubercle to the anterior superior iliac spine. It forms the base of the inguinal canal; the inguinal ligament runs from the anterior superior iliac crest of the ilium to the pubic tubercle of the pubic bone. It is formed by the external abdominal oblique aponeurosis and is continuous with the fascia lata of the thigh. There is some dispute over the attachments. Structures that pass deep to the inguinal ligament include: Psoas major, pectineus Femoral nerve and vein Lateral cutaneous nerve of thigh Lymphatics The ligament serves to contain soft tissues as they course anteriorly from the trunk to the lower extremity; this structure demarcates the superior border of the femoral triangle. It demarcates the inferior border of the inguinal triangle; the midpoint of the inguinal ligament, halfway between the anterior superior iliac spine and pubic tubercle, is the landmark for the femoral nerve. The mid-inguinal point, halfway between the anterior superior iliac spine and the pubic symphysis, is the landmark for the femoral artery.
It is referred to as Poupart's ligament, because François Poupart gave it relevance in relation to hernial repair, calling it "the suspender of the abdomen". It is sometimes termed the Fallopian ligament. Colles' ligament is reflex ligament not inguinal ligament. Pelvis Anatomy figure: 12:03-02 at Human Anatomy Online, SUNY Downstate Medical Center - "Deep muscles of the anterior thigh." Anatomy photo:35:os-0107 at the SUNY Downstate Medical Center - "Anterior Abdominal Wall: Osteology and Surface Anatomy " Anatomy photo:35:08-0100 at the SUNY Downstate Medical Center - "Anterior Abdominal Wall: The Inguinal Ligament" Anatomy image:7179 at the SUNY Downstate Medical Center Anatomy image:7431 at the SUNY Downstate Medical Center Diagram at gensurg.co.uk
Pectineus muscle
The pectineus muscle is a flat, quadrangular muscle, situated at the anterior part of the upper and medial aspect of the thigh. The pectineus muscle is the most anterior adductor of the hip; the muscle does adduct and medially rotate the thigh but its primary function is hip flexion. It can be classified in the anterior compartment of thigh; the pectineus muscle arises from the pectineal line of the pubis and to a slight extent from the surface of bone in front of it, between the iliopectineal eminence and pubic tubercle, from the fascia covering the anterior surface of the muscle. The pectineus is in relation by its anterior surface with the pubic portion of the fascia lata, which separates it from the femoral artery and vein and internal saphenous vein, lower down with the profunda artery. By its posterior surface with the capsule of the hip joint, with the obturator externus and adductor brevis, the obturator artery and vein being interposed. By its external border with the psoas major, the femoral artery resting upon the line of interval.
By its internal border with the outer edge of the adductor longus. Obturator foramen is situated directly behind this muscle, it forms part of the floor of the femoral triangle. The lumbar plexus is formed from the anterior rami of nerves L1 to L4 and some fibers from T12. With only five roots and two divisions, it is less complex than the brachial plexus and gives rise to a number of nerves including the femoral nerve and accessory obturator nerve; the pectineus muscle is considered a composite muscle as the innervation is by the femoral nerve and a branch of the obturator nerve called the accessory obturator nerve. When it is present, the accessory obturator nerve innervates a portion of the pectineus muscle, entering the muscle on its dorsomedial aspect; the greater nerve to the muscle is the femoral nerve. Unlike the obturator accessory nerve, the femoral nerve is always present and provides the sole innervation for the pectineus muscle in over 90% of cases; the muscle is innervated by the accessory obturator nerve in the 8.7% of cases in which the nerve occurs.
It is one of the muscles responsible for hip flexion. It adducts the thigh. Thigh This article incorporates text in the public domain from page 472 of the 20th edition of Gray's Anatomy Woodburne, Russell. "The Accessory Obturator Nerve and the Innervation of the Pectineus Muscle". Michigan Library Med School: 367–369. Retrieved 2 December 2015. Saladin, Kenneth S. Anatomy & Physiology: The Unity of Form and Function. New York, NY: McGraw-Hill, 2007. Pg.493. Print. Anatomy figure: 12:02-05 at Human Anatomy Online, SUNY Downstate Medical Center - "Muscles of the anterior compartment of the thigh." Anatomy figure: 12:03-04 at Human Anatomy Online, SUNY Downstate Medical Center - "Deep muscles of the anterior thigh." Cross section image: pelvis/pelvis-e12-15—Plastination Laboratory at the Medical University of Vienna
Thigh
In human anatomy, the thigh is the area between the hip and the knee. Anatomically, it is part of the lower limb; the single bone in the thigh is called the femur. This bone is thick and strong, forms a ball and socket joint at the hip, a modified hinge joint at the knee; the femur is the only bone in the thigh and serves for an attachment site for all muscles in the thigh. The head of the femur articulates with the acetabulum in the pelvic bone forming the hip joint, while the distal part of the femur articulates with the tibia and kneecap forming the knee. By most measures the femur is the strongest bone in the body; the femur is the longest bone in the body. The femur is categorised as a long bone and comprises a diaphysis, the shaft and two epiphysis or extremities that articulate with adjacent bones in the hip and knee. In cross-section, the thigh is divided up into three separate compartments, divided by fascia, each containing muscles; these compartments use the femur as an axis, are separated by tough connective tissue membranes.
Each of these compartments has its own blood and nerve supply, contains a different group of muscles. Medial fascial compartment of thigh, adductor Posterior fascial compartment of thigh, hamstring Anterior fascial compartment of thigh, extensionAnterior compartment muscles of the thigh include sartorius, the four muscles that comprise the quadriceps muscles- rectus femoris, vastus medialis, vastus intermedius and vastus lateralis. Posterior compartment muscles of the thigh are the hamstring muscles, which include semimembranosus and biceps femoris. Medial compartment muscles are pectineus, adductor magnus, adductor longus and adductor brevis, gracilis; because the major muscles of the thigh are the largest muscles of the body, resistance exercises of them stimulate blood flow more than any other localized activity. The arterial supply is by the obturator artery; the lymphatic drainage follows the arterial supply and drains to the lumbar lymphatic trunks on the corresponding side, which in turn drains to the cisterna chyli.
The deep venous system of the thigh consists of the femoral vein, the proximal part of the popliteal vein, various smaller vessels. The venae perfortantes connect the deep and the superficial system, which consists of the saphenous veins. Thigh weakness can result in a positive Gowers' sign on physical examination; the thigh meat of some animals such as chicken and cow is consumed as a food in many parts of the world
Femoral sheath
The femoral sheath is formed by a prolongation downward, behind the inguinal ligament, of the abdominal fascia, the transverse fascia being continued down in front of the femoral vessels and the iliac fascia behind them. The femoral sheath is contained within the femoral triangle; the sheath assumes the form of a short funnel, the wide end of, directed upward, while the lower, narrow end fuses with the fascial investment of the vessels, about 4 cm. below the inguinal ligament. It is strengthened in front by a band termed the iliopubic tract; the lateral wall of the sheath is perforated by the lumboinguinal nerve. The sheath is divided by two vertical partitions which stretch between its anterior and posterior walls; the lateral compartment contains the femoral artery and femoral branch of genitofemoral nerve, the intermediate the femoral vein, while the medial and smallest compartment is named the femoral canal, contains some lymphatic vessels and a lymph gland embedded in a small amount of areolar tissue.
The femoral canal is conical and measures about 1.25 cm. in length. Its base, directed upward and named the femoral ring, is oval in form, its long diameter being directed transversely and measuring about 1.25 cm. The spermatic cord in the male and the round ligament of the uterus in the female lie above the anterior margin of the ring, while the inferior epigastric vessels are close to its upper and lateral angle; the femoral ring is closed by a somewhat condensed portion of the extraperitoneal fatty tissue, named the septum femorale, the abdominal surface of which supports a small lymph gland and is covered by the parietal peritoneum. The septum femorale is pierced by numerous lymphatic vessels passing from the deep inguinal to the external iliac lymph glands, the parietal peritoneum above it presents a slight depression named the femoral fossa; this article incorporates text in the public domain from page 625 of the 20th edition of Gray's Anatomy Photo and overview at gla.ac.uk antthigh at The Anatomy Lesson by Wesley Norman Diagram at washington.edu
Anterior superior iliac spine
The anterior superior iliac spine is a bony projection of the iliac bone and an important landmark of surface anatomy. It refers to the anterior extremity of the iliac crest of the pelvis, which provides attachment for the inguinal ligament, the sartorius muscle; the tensor fasciae latae muscle attaches about 5 cm away at the iliac tubercle. The anterior superior iliac spine provides a clue in identifying some other clinical landmarks, including: McBurney's point Roser-Nélaton line True leg length A – Anterior S – Superior I – Iliac S – Spine Bone terminology Anatomical terms of location Ilium Human anatomical terms Anatomy photo:17:os-0105 at the SUNY Downstate Medical Center – "Major Joints of the Lower Extremity: Hip bone" Anatomy photo:35:os-0103 at the SUNY Downstate Medical Center – "Anterior Abdominal Wall: Osteology and Surface Anatomy" "Anatomy diagram: 03281.000-3". Roche Lexicon - illustrated navigator. Elsevier. Archived from the original on 2012-07-22. Diagram at Wayne State
Gluteal sulcus
The gluteal sulcus is an area of the body of humans and great apes, described by a horizontal crease formed by the inferior aspect of the buttocks and the posterior upper thigh. The gluteal sulcus is formed by the posterior horizontal skin crease of the hip joint and overlying fat, is not formed by the lower border of the gluteus maximus muscle, which crosses the fold obliquely, it is one of the major defining features of the buttocks. Children with developmental dysplasia of the hips are born with uneven gluteal folds and can be diagnosed with physical examination and sonogram
Hip bone
The hip bone is a large irregular bone, constricted in the center and expanded above and below. In some vertebrates it is composed of three parts: the ilium and the pubis; the two hip bones join at the pubic symphysis and together with the sacrum and coccyx comprise the skeletal component of the pelvis – the pelvic girdle which surrounds the pelvic cavity. They are connected to the sacrum, part of the axial skeleton, at the sacroiliac joint; each hip bone is connected to the corresponding femur through the large ball and socket joint of the hip. The hip bone is formed by three parts: ilium and pubis. At birth, these three components are separated by hyaline cartilage, they join each other in a Y-shaped portion of cartilage in the acetabulum. By the end of puberty the three regions will have fused together, by the age 25 they will have ossified; the two hip bones join each other at the pubic symphysis. Together with the sacrum and coccyx, the hip bones form the pelvis. Ilium is the largest region.
It makes up two fifths of the acetabulum. It is divisible into the ala or wing of ilium; the body of ilium forms the sacroiliac joint with the sacrum. The edge of the wing of ilium forms the S-shaped iliac crest, located through the skin; the iliac crest shows clear marks of the attachment of the three abdominal wall muscles. The ischium forms the lower and back part of the hip bone and is located below the ilium and behind the pubis; the ischium is the strongest of the three regions. It is divisible into three portions: the body, the superior ramus, the inferior ramus; the body forms one-third of the acetabulum. The ischium forms a large swelling, the tuberosity of the ischium referred to colloquially as the "sit bone"; when sitting, the weight is placed upon the ischial tuberosity. The gluteus maximus leaves it free in the seated position; the pubic region or pubis is the anterior of the three parts forming the hip bone. It is divisible into a body, a superior ramus, an inferior ramus; the body forms one-fifth of the acetabulum.
The body forms the wide, strong and flat portion of the pubic bone which unites with the other pubic bone in the pubic symphysis. The fibrocartilaginous pad which lies between the symphysial surfaces of the coxal bones, that secures the pubic symphysis, is called the interpubic disc; the pelvic brim is a continuous oval ridge of bone that runs along the pubic symphysis, pubic crests, arcuate lines, sacral alae, sacral promontory. The false pelvis is that portion superior to the pelvic brim; the true pelvis is the region inferior to the pelvic brim, entirely surrounded by bone. The pelvic inlet is the opening delineated by the pelvic brim; the widest dimension of the pelvic inlet is from left to right, that is, along the frontal plane. The pelvic outlet is the margin of the true pelvis, it is bounded anteriorly by the pubic arch, laterally by the ischia, posteriorly by the sacrum and coccyx. The superior pubic ramus is a part of the pubic bone, it extends from the body to the median plane where it articulates with its fellow of the opposite side.
It is conveniently described in two portions: a medial flattened part and a narrow lateral prismoid portion. The inferior pubic ramus is flat, it passes downward from the medial end of the superior ramus. It becomes narrower as it descends and joins with the inferior ramus of the ischium below the obturator foramen; the hip bone is ossified from eight centers: three primary, one each for the ilium and pubis, five secondary, one each for the iliac crest, the anterior inferior spine, the tuberosity of the ischium, the pubic symphysis, one or more for the Y-shaped piece at the bottom of the acetabulum. The centers appear in the following order: in the lower part of the ilium above the greater sciatic notch, about the eighth or ninth week of fetal life. At birth, the three primary centers are quite separate, the crest, the bottom of the acetabulum, the ischial tuberosity, the inferior rami of the ischium and pubis being still cartilaginous. By the seventh or eighth year, the inferior rami of the pubis and ischium are completely united by bone.
About the thirteenth or fourteenth year, the three primary centers have extended their growth into the bottom of the acetabulum, are there separated from each other by a Y-shaped portion of cartilage, which now presents traces of ossification by two or more centers. One of these, the os acetabuli, appears about the age of twelve, between the ilium and pubis, fuses with them about the age of eighteen; the ilium and ischium become joined, lastly the pubis and ischium, through the intervention of this Y-shaped portion. At about the age of puberty, ossification takes place in each of the remaining portions, they join with the rest of the bone between the twentieth and twenty-f
