In anatomy, the saphenous opening is an oval opening in the upper mid part of the fascia lata of the thigh. It lateral to the pubic tubercle and is about 3 cm long and 1.5 cm wide. Just inferolateral to the pubic tubercle the fascia extends downwards forming an arched margin of the lateral boundary of the opening, it is covered by a thin perforated part of the superficial fascia called the fascia cribrosa, pierced by the great saphenous vein, the 3 superficial branches of the femoral artery, lymphatics. It transmits the great saphenous vein and other smaller vessels including the superficial epigastric artery and superficial external pudendal artery, as well as the femoral branch of the genitofemoral nerve; the fascia cribrosa, pierced by the structures passing through the opening, closes the aperture and must be removed to expose it
In human anatomy, the sacral plexus is a nerve plexus which provides motor and sensory nerves for the posterior thigh, most of the lower leg and foot, part of the pelvis. It emerges from the lumbar vertebrae and sacral vertebrae. A sacral plexopathy is a disorder affecting the nerves of the sacral plexus caused by trauma, nerve compression, vascular disease, or infection. Symptoms may include pain, loss of motor control, sensory deficits; the sacral plexus is formed by: the lumbosacral trunk the anterior division of the first sacral nerve portions of the anterior divisions of the second and third sacral nervesThe nerves forming the sacral plexus converge toward the lower part of the greater sciatic foramen, unite to form a flattened band, from the anterior and posterior surfaces of which several branches arise. The band itself is continued as the sciatic nerve, which splits on the back of the thigh into the tibial nerve and common fibular nerve; the sacral plexus and the lumbar plexus are considered to be one large nerve plexus, the lumbosacral plexus.
The lumbosacral trunk connects the two plexuses. The sacral plexus lies on the back of the pelvis in front of the piriformis muscle and the pelvic fascia. In front of it are the internal iliac artery, internal iliac vein, the ureter, the sigmoid colon; the superior gluteal artery and vein run between the lumbosacral trunk and the first sacral nerve, the inferior gluteal artery and vein between the second and third sacral nerves. All the nerves entering the plexus, with the exception of the third sacral, split into ventral and dorsal divisions, the nerves arising from these are as follows of the table below: Cervical plexus Brachial plexus Lumbar plexus This article incorporates text in the public domain from page 957 of the 20th edition of Gray's Anatomy Thieme Atlas of Anatomy: General Anatomy and Musculoskeletal System. Thieme. 2006. ISBN 1-58890-419-9. Lumbosacral+Plexus at the US National Library of Medicine Medical Subject Headings Cross section image: pembody/body15a—Plastination Laboratory at the Medical University of Vienna MedicalMnemonics.com: 3544 2382 Illustration at backpain-guide.com
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
External obturator muscle
The external obturator muscle, obturator externus muscle is a flat, triangular muscle, which covers the outer surface of the anterior wall of the pelvis. It is sometimes considered part of the medial compartment of thigh, sometimes considered part of the gluteal region, it arises from the margin of bone around the medial side of the obturator membrane and surrounding bone, viz. from the inferior pubic ramus, the ramus of the ischium. The fibers springing from the pubic arch extend on to the inner surface of the bone, where they obtain a narrow origin between the margin of the foramen and the attachment of the obturator membrane; the fibers converge and pass posterolateral and upward, end in a tendon which runs across the back of the neck of the femur and lower part of the capsule of the hip joint and is inserted into the trochanteric fossa of the femur. The obturator vessels lie between the obturator membrane. In 33 % of people a supernumerary muscle is found between the adductor minimus. While this muscle, when present, is similar to its neighbouring adductors, it is formed by separation from the superficial layer of the external obturator, is thus not ontogenetically related to the adductor muscles of the hip.
This muscle originates from the upper part of the inferior pubic ramus from where it runs downwards and laterally. In half of cases, it inserts into the anterior surface of the insertion aponeurosis of the adductor minimus. In the remaining cases, it is either inserted into the upper part of the pectineal line or the posterior part of the lesser trochanter, it has been demonstrated by the course of the posterior branch of obturator nerve that the obturator externus is divided into a superior muscle fascicle and a main belly. The supernumerary muscle described above originates from the superior fascicle, while an anomalous fascicle — derived from the external obturator — originates from the main belly; the "original" external obturator, i.e. without these supernumerary muscular parts occurs in only 20% of cases, the external obturator undergoes ontogenetic variations. The external obturator muscle acts as the lateral rotator of the hip joint; as a short muscle around the hip joint, it stabilizes the hip joint as a postural muscle.
This article incorporates text in the public domain from page 477 of the 20th edition of Gray's Anatomy Cross section image: pelvis/pelvis-e12-15—Plastination Laboratory at the Medical University of Vienna lljoints at The Anatomy Lesson by Wesley Norman PTCentral
The obturator foramen is the large opening created by the ischium and pubis bones of the pelvis through which nerves and blood vessels pass. It is bounded by a thin, uneven margin, to which a strong membrane is attached, presents, superiorly, a deep groove, the obturator groove, which runs from the pelvis obliquely medialward and downward; this groove is converted into the obturator canal by a ligamentous band, a specialized part of the obturator membrane, attached to two tubercles: one, the posterior obturator tubercle, on the medial border of the ischium, just in front of the acetabular notch the other, the anterior obturator tubercle, on the obturator crest of the superior ramus of the pubis Reflecting the overall sex differences between male and female pelvises, the obturator foramina are oval in the male and wider and more triangular in the female. Additionally, unilateral pelvis hypoplasia can cause differences in size between the obturator foramina, there are rare reports of individual pelvises featuring a double obturator foramen in one of the hip bones.
Through the canal the obturator artery, obturator vein and obturator nerve pass out of the pelvis. Obturator internus muscle Obturator externus muscle This article incorporates text in the public domain from page 237 of the 20th edition of Gray's Anatomy Anatomy photo:17:st-0205 at the SUNY Downstate Medical Center - "Major Joints of the Lower Extremity: hip and sacrum" Atlas image: male_urethrogram at the University of Michigan Health System - "Pelvis & Perineum: Male Urethrogram" Photo at vc.cc.tx.us
The genitofemoral nerve refers to a human nerve, found in the abdomen. Its branches, the genital branch and femoral branch supply sensation to the upper anterior thigh, as well as the skin of the anterior scrotum in males and mons pubis in females; the femoral branch is different from the femoral nerve, which arises from the lumbar plexus. The genitofemoral nerve originates from the upper L1-2 segments of the lumbar plexus, it emerges from its anterior surface. The nerve divides into two branches, the genital branch and the lumboinguinal nerve known as the femoral branch, both of which continue downwards and medially to the inguinal and femoral canal respectively; the genital branch enters the inguinal canal. In men, the genital branch supplies the scrotal skin. In women, the genital branch accompanies the round ligament of uterus, terminating in and innervating the skin of the mons pubis and labia majora; the femoral branch passes underneath the inguinal ligament, travelling through the lateral muscular compartment of the femoral canal where it innervates skin of the upper leg.
Passing through the cribriform fascia of the saphenous opening of the fascia lata of the thigh, it supplies the skin of the upper and medial side of thigh. The genitofemoral nerve pierces and passes through the psoas major muscle before bifurcating into a genital branch and a femoral branch midway along its anterior surface. In 25% of cases, the genitofemoral nerve splits into these branches before it enters the psoas major or within the muscle belly of psoas major; this variation causes the split to be occur earlier in the genitofemoral nerve, at the upper rather than mid-portion of the anterior surface of the psoas major. The genitofemoral nerve is responsible for both the sensory and motor portions of the cremasteric reflex, which describes contraction of the cremasteric muscle when the skin of the superior medial part of the thigh is touched. Anatomy photo:36:07-0305 at the SUNY Downstate Medical Center - "Inguinal Region and Testes: Layers of the spermatic cord" Anatomy figure: 40:07-13 at Human Anatomy Online, SUNY Downstate Medical Center - "Muscles and nerves of the posterior abdominal wall."
Posteriorabdomen at The Anatomy Lesson by Wesley Norman
The labia majora are two prominent longitudinal cutaneous folds that extend downward and backward from the mons pubis to the perineum. Together with the labia minora they form the labia of the vulva; the labia majora are homologous to the male scrotum. Labia majora is the Latin plural for big lips; the Latin term labium/labia is used in anatomy for a number of paired parallel structures, but in English it is applied to two pairs of parts of female external genitals —labia majora and labia minora. Labia majora are known as the outer lips, while labia minora, which run alongside between them, are referred to as the inner lips. Traditionally, to avoid confusion with other lip-like structures of the body, the labia of female genitals were termed by anatomists in Latin as labia majora pudendi. Embryologically, they develop from labioscrotal folds, it means that they develop in the female foetus from the same sexually undifferentiated anatomical structure as the scrotum, the sac of skin below the penis in males.
The same process of sex differentiation concerns other male and female reproductive organs, with some organs of both sexes developing similar, yet not identical and functions. But other male and female sex organs become different and unique, like the internal female genitalia; the scrotum and labia majora develop to have crucial differences. Like the scrotum, labia majora after puberty may become of a darker color than the skin outside them, also grow pubic hair on their external surface. But, during sexual differentiation of the foetus, labioscrotal folds in the males fuse longitudinally in the middle, forming a sack for male gonads to descend into it from the pelvis, while in the females these folds do not fuse, forming the two labia majora and the pudendal cleft between them. Female gonads do not descend from the pelvis, thus the structure of labia majora may seem simpler and of lesser significance for functioning of the female body as a whole than the scrotum with testicles for males; the ridge or groove remaining of the fusion can be traced on the scrotum.
In some cases of intersex with disorders of sex development male/female genitalia may look ambiguous for either gender with phallus too small for a typical penis yet too big for a clitoris, with external urethral opening in an atypical location, with labia/scrotum or fused but without descended gonads in them. Undescended testicles, may occur in otherwise healthy male infants; the labia majora constitute the lateral boundaries of the pudendal cleft, which contains the labia minora, interlabial sulci, clitoral hood, clitoral glans, frenulum clitoridis, the Hart's Line, the vulval vestibule, which contains the external openings of the urethra and the vagina. Each labium majus has two surfaces, an outer and covered with strong, pubic hair; the labia majora are covered with squamous epithelium. Between the two there is a considerable quantity of areolar tissue, a tissue resembling the dartos tunic of the scrotum, besides vessels and glands; the labia majora are thicker in front, form the anterior labial commissure where they meet below the mons pubis.
Posteriorly, they are not joined, but appear to become lost in the neighboring integument, ending close to, nearly parallel to, each other. Together with the connecting skin between them, they form another commissure the posterior labial commissure, the posterior boundary of the pudendum; the interval between the posterior commissure and the anus, from 2.5 to 3 cm in length, constitutes the perineum. The anterior region of the perineum is known as the urogenital triangle which separates it from the anal region. Between the labia majora and the inner thighs are the labiocrural folds. Between the labia majora and labia minora are the interlabial sulci. Labia majora atrophy after menopause; the fat pad of the labia majora can be used as a graft as a so-called "Martius labial fat pad graft", can be used, for example, in urethrolysis. Femalia Labia Labia minora Labia pride Labia Majora Medical Definition