Deep Structures of the Anterior Leg

1. Deep Structures of theAnterior Leg Christine Grecco & Tobias Johnson

2. Deep Muscles • Muscles • Obturatorexternus • Adductor magnus • Adductor minimus • Gracilis • Adductor hiatus • Vastusmedialis

3. Deep muscles • Muscles • Vastusintermedius • Rectus femoris • Sartorius • Gracilis • Adductor magnus • Vastusmedialis

4. Tendons • Tendons • Pesanserinus • Sartorius • Semitendinosus • Adductor hiatus • Adductor magnus • Gracilis

5. Deep Muscles & Tendons • Muscles • Vastusmedialis • Tendons • Adductor Magnus tendon • Gastrocnemius tendon, medial & lateral head

6. Bursa • Suprapatellar bursa • Superficial prepatellar burse • Deep infrapatellar bursa • Superficial infrapatellar bursa • Pes anserine bursa • Subsartorial bursa • Iliopectineal bursa (not pictured)

7. Femoral vessels Tracing the supply of the lower extremeties • Common Femoral Artery (CFA) • Travels two-thirds of the thigh • Pierces the adductor magnus • Reaches the poplitealfossa behind the knee • Lies on the psoas major, pectineus • Branches to the deep (DFA) and superficial femoral artery CFA DFA

8. Femoral vessels Tracing the supply of the lower extremities • Deep Femoral Artery (DFA) • Also known as the profunda • Branches from the CFA posteriorly • Travels closer to the femur than the SFA • Between pectineus and adductor longus • Branches into perforating branches that perforate the adductor brevis and magnus adjacent to the femur. DFA

9. Femoral vessels Tracing the supply of the lower extremities • Superficial Femoral Artery (SFA) • Continues distally through the adductor canal • Can be found by cutting the sartorius near its middle and reflecting its two parts. • Leaves the thigh through the adductor hiatus to become the popliteal artery in the poplitealfossa SFA

10. Femoral nerve Innervating the muscles of locomotion • Femoral Nerve • Largest branch of the lumbar plexus • Emerges underneath the the inguinal ligament and branches into anterior and posterior • Lies lateral to the femoral artery in the femoral triangle

11. Femoral nerve Innervating the muscles of locomotion • Anterior Division • Include motor nerves to the pectineus and sartorius • Also more cutaneous branches • Nerve to the pectineus can be found by pushing the femoral vessels medially and probing behind them for a slender branch on the medial side of the nerve

12. Femoral nerve • Posterior Division • Include the saphenous nerve • Long sensory nerve to the medial knee • Also includes the four motor branches to the quadriceps femoris heads • Rectus femoris enters on the superior deep surface of the muscle • Vastuslateralis enters on the lower part of that muscle with the lateral circumflex femoral artery • Vastusmedialis branch travels with the saphenous nerve and enters the muscle at about its middle • The vastusintermedius branches enter the anterior surface of the muscle about the midpoint of the thigh Innervating the muscles of locomotion

13. The femur The bone that holds it all together • Anterior landmarks • Head • Neck • Greater trochanter • Lesser trochanter • Lateral condyle • Medial condyle • Intercondylarfossa • Medial epicondyle • Lateral epicondyle